This is an open access article under the terms of the Creative Commons Attribution License, which... more This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Since simplified methods have been generated to measure psychoacoustic tuning curves (PTC), they ... more Since simplified methods have been generated to measure psychoacoustic tuning curves (PTC), they have proved to be useful in clinical workup. Nevertheless, further research is necessary for high level tuning. In the present study PTCs have been generated utilizing a discrete simultaneous masking tone-on-tone paradigm. Thresholds were determined using an adaptive up-down transformed procedure, thus obtaining normative data. The experimental groups allowed frequency-independent, mild to moderate hearing loss, in order to minimize such variable. Results indicate that PTCs were normal in 8 subjects suffering from conductive hearing loss and abnormal in 8 subjects with cochlear loss. Normative high level data and a new quantifying index confirms these results.
Although still widely implanted, Pulsar Med-El is rarely considered for small incision approach. ... more Although still widely implanted, Pulsar Med-El is rarely considered for small incision approach. Overall, 30 teen-age and adult patients were operated upon with a novel small incision (4-5 cm). Full insertion of the electrode array was achieved in all cases. No major intra-operative complications occurred. At follow-up, no flap-related complications and no migration of the receiver-stimulator were observed in the "device suture" (14 patients) or "no device suture" groups (16 patients). All patients are full-time users of the device. In conclusion, a small incision for the Pulsar Med-El cochlear implant is feasible, safe and reproducible. Ligature fixation of the device is not critical with this operation. Also with this device, in adult and teen-age patients, it is, therefore, possible to retain several typical advantages of small incision approaches.
Functional gain (FG) and insertion gain (IG) are currently used as real ear gain measurement of h... more Functional gain (FG) and insertion gain (IG) are currently used as real ear gain measurement of hearing aids. The gain differences observed with hearing aid modifications made in order to achieve the desired prescriptive target must be greater than the variability associated with repetition of measurement in order to be really useful. Limited research is available on FG and IG intratester variability. In order to evaluate single variability factors, some studies use experimental designs not common in clinical work-up while others use equipment mot available commercially. The present study evaluates intratester variability of FG and IG (Madsen IGO 1500 equipment) in a typical clinical configuration in 42 users of behind-ear hearing aids. Mean standard deviation of FG test-retest differences was 5.19 dB. Range of variability was expressed in term of centiles. 5-- and 95-- centiles were -9.8 and 8.7 dB respectively. Mean s.d. of IG test-retest differences was 3.18 dB; 5-- and 95-- centiles were -5.2 and 6.05 dB respectively. Major variability was found at higher frequencies. High variability at lower frequencies was also found probably due to sealing problems of ear molds in the ear canal. Accord between FG and IG was also examined. A good mean correspondence in mid frequency range was found (FG-IG mean difference less than 5 dB) with large inter-subject differences between the two measurements (s.d. 11 dB).
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Systematic use of preoperative antibiotic prophylaxis (PAP) and nasal packing (NP) in septoplasty... more Systematic use of preoperative antibiotic prophylaxis (PAP) and nasal packing (NP) in septoplasty-both directly and indirectly affecting the cost of surgery (length of hospitalization)-appear based on controversial scientific data and, at times, even on unjustified clinical "habits". A controlled study was thus performed on 100 adults undergoing exclusive nasal septoplasty to determine whether these techniques are actually useful. The subjects were randomly divided into four groups: TN-PAP-(29 subjects), TN-PAP+ (25 subjects), TN+ PAP- (21 subjects) and TN+ PAP+ (25 subjects). Surgery was always performed by the same surgeon and was concluded with continuous suture of the mucoperichondrial layers. Only one patient (TN-PAP-) presented complications of infection (vestibulitis). Three patients in the TN- group required nasal packing a few hours after surgery because of moderate bleeding. As of three months after surgery no other complications had arisen. Postoperative pain, evaluated on an analogicalvisual scale, was higher during the 12 hours after surgery. Analysis of variance showed that the only pain-related factor was nasal packing while PAP and the interaction between TN and PAP did not prove significant. The above results suggest that PAP and TN should not be systematically used, thus reducing the hospitalization period for septoplasty to the day of surgery (Day surgery).
Background: Given an increase in the aging population and its impact on healthcare systems, polic... more Background: Given an increase in the aging population and its impact on healthcare systems, policy makers for provision of health and social services are aiming to keep older adults in good health for longer, in other words towards 'healthy aging'. Our study objective is to show that rehabilitation with cochlear implant treatment in the elderly with hearing impairment improves the overall health-related quality of life and general well-being that translate into healthy aging. Methods: The multicentre, prospective, repeated measures, single-subject, clinical observational study will accrue 100 elderly, first-time, unilateral CI recipients (≥ 60 years) and analyze changes on specific measurement tools over ca. 20 months from preimplant to postimplant. Evaluations will consist of details collected through case history and interview questionnaires by clinicians, data logging, self-report questionnaires completed by the recipients and a series of commonly used audiometric measures and geriatric assessment tools. The primary indicator of changes in overall quality of life will be the HUI-3. Discussion: The protocol is designed to make use of measurement tools that have already been applied to the hearing-impaired population in order to compare effects of CI rehabilitation in adults immediately before their implantation, (pre-implant) and after gaining 1-1.5 years of experience (post-implant). The broad approach will lead to a greater understanding of how useful hearing impacts the quality of life in elderly individuals, and thus improves potentials for healthy aging. Outcomes will be described and analyzed in detail. Trial registration: This research has been registered in ClinicalTrials.gov (http://www.clinicaltrials.gov/), 7 March 2017 under the n°NCT03072862.
With the improved life expectation of patients with beta-thalassemia-major (BTM) or Cooley's Dise... more With the improved life expectation of patients with beta-thalassemia-major (BTM) or Cooley's Disease, new clinical problems, such as hearing damage, have emerged. The authors describe audiometric data of 50 patients with BTM. High-frequency thresholds were higher in BTM than those of a control group. Prevalence of hearing loss in BTM was 14-26%, depending on the frequency range considered, while in the control group it was between 4.3-19.1%. The prevalence of hearing loss in BTM with respect to that of the general population was 7-10% higher. Hearing loss ranged from mild to moderate. A good correlation was found between hearing loss and the cumulative dose of desferoxamine administered. These data were indicative of an ototoxic effect of this drug. Many patients (28.6%) showed significant hearing threshold deterioration after 3 years. On the light of these results, the authors suggest regular audiologic follow-up of patients with BTM.
A brief questionnaire concerning auditory disability in every day listening was developed. The ai... more A brief questionnaire concerning auditory disability in every day listening was developed. The aim was to generate a simple, practical test for rehabilitational purposes. The questionnaire was administered to 255 hearing-impaired subjects coming under observation consecutively. The only requirement for participation was an expression of communicational difficulties due to adult onset of hearing loss. Some items were not applicable for all subjects. The higher scores were observed for hearing problems related to speech-in-noise. Good linear correlations were found between better-ear auditory and questionnaire score-based indexes in the 'family' and 'social' sections.
their influence on outcomes was performed. Independently reported preferred methods for microphon... more their influence on outcomes was performed. Independently reported preferred methods for microphone placement are collectively summarised. Results: The average implant experience was 3.5 years. Satisfaction increased significantly over time (p < 0.05). No correlation with covariates examined was observed. Feedback significantly decreased over time, showing a significant correlation with microphone location, primary motivation, gender, age at implantation, and contralateral hearing aid use (p < 0.05). Patient satisfaction was inversely correlated with reports of system feedback (p < 0.05). The implantable microphone was most commonly on the posterior inferior mastoid line, in 42/66 (65%) cases, correlating with less likelihood for feedback and consistent with author surgical preference. Conclusion: Carina recipients in this study present as satisfied consistent daily users with very few reports of persistent feedback. As microphone location is an influencing factor, a careful surgical consideration of microphone placement is required. The authors prefer a posterior inferior mastoid line position whenever possible.
Tinnitus is a widespread symptom that is chronically experienced by approximately 10% of the adul... more Tinnitus is a widespread symptom that is chronically experienced by approximately 10% of the adult population. While the vast majority of individuals do not feel impaired by their ear noise, about 0.5-3% of the adult population develops severe distress and feels impaired in everyday life. The severity of the distress experienced can only partially be explained by the characteristics of the ear noise itself (e.g. objective tinnitus loudness or duration). Psychological variables such as tinnitus acceptance are being increasingly investigated by tinnitus research. The aim of this study was to analyse the psychometric quality of the Italian version of the "Chronic Tinnitus Acceptance Questionnaire" (CTAQ-I). The CTAQ-I is an adaption of the Italian "Chronic Pain Acceptance Questionnaire (CPAQ)" and altered for the study of tinnitus acceptance. This cross-sectional multicentre questionnaire study included 141 outpatients with chronic tinnitus. Sociodemographic and clinical data were assessed with the Tinnitus Sample Case History (TSCH), tinnitus acceptance with the Italian "Chronic Tinnitus Acceptance Questionnaire" (CTAQ-I), tinnitus distress with the Tinnitus Handicap Inventory (THI) and the Tinnitus Questionnaire Short Form (TQ 12-I). Furthermore, we assessed the patient's general psychological distress (Brief Symptom Inventory-BSI) and Health Related Quality of Life (SF-36). Psychometric and factorial evaluation of the CTAQ-I were carried out. To investigate the influence of sociodemographic and numerous clinical variables on tinnitus acceptance we calculated correlation coefficients, analysis of variance and independent sample-t-tests. The factor analysis revealed a two-factor solution ("activity engagement" and "tinnitus willingness"), accounting for 41.1% of the variance. Good internal consistency for the total score (α = 0.84) and both factors (α = 0.80-0.88) was found. Moderate negative correlations with tinnitus distress indicated good validity. Tinnitus acceptance was further correlated with lower psychological distress and subjective tinnitus loudness, as well as increased emotional well-being. Tinnitus acceptance is considered to be an important source of therapeutic change in behavioural-based treatments as well as in professional counselling for tinnitus. Our study shows that the CTAQ-I is a reliable and valid instrument to measure the acceptance of patients suffering from chronic tinnitus.
An epidemiological survey of the prevalence of snoring was performed on 1146 adults consecutively... more An epidemiological survey of the prevalence of snoring was performed on 1146 adults consecutively observed in the offices of several practitioners. A reliable, previously assessed snoring questionnaire was given to all patients. Snoring was found as a common sign as 31% of the subjects referred to this symptom. However, the prevalence of every-night snoring was 13.5-17.7%. Snoring was an age-related phenomena: its prevalence raised with age. Males more frequently proved to be heavy snorers although no great difference was found between sexes in the later decades of life.
This is a case of successful cochlear implantation in a 50-year-old man who experienced sudden he... more This is a case of successful cochlear implantation in a 50-year-old man who experienced sudden hearing loss and developed ipsilateral severe tinnitus at three years following conservative stage 1 vestibular schwannoma retrosigmoid surgery. After cochlear implantation, tinnitus improved from THI grade 4 to 2. Localisation skills improved. Hearing in noise (S/N + 7 dB) with target signal from the operated side improved from 38 to 100% of correct answers. A significant improvement of spatial and speech items of the "speech, spatial and qualities of sounds" questionnaire was also measured. In conclusion, cochlear implantation is a feasible and effective solution after conservative vestibular schwannoma surgery should delayed hearing loss occur.
A questionnaire concerning problems inherent to ronchopathy was evaluated in order to assess its ... more A questionnaire concerning problems inherent to ronchopathy was evaluated in order to assess its test-retest reliability and the interobserver variability of the items. The results indicate the existence of three orders of variables. The first (class A) was characterized by good intra- and inter- observer reliability. It included all interval variables (i.e. weight, height, arterial pressure) and most ordinal variables (i.e. grading of snoring, excessive daytime somnolence, morning headache, smoking, etc.). The second (class B) was characterized by good intra-observer and poor inter-observer reliability. It included snoring onset time and morning somnolence. The third class (class C) was characterized by both poor intra- and inter-observer reliability. It included sleep apnea. For large epidemiological survey purposes the authors suggest that only class A variables be used.
Excessive daytime somnolence (EDS) is highly correlated to the presence of obstructive sleep apne... more Excessive daytime somnolence (EDS) is highly correlated to the presence of obstructive sleep apnea syndrome (OSAS). It appears that interest in such disorders may also be extended to extraneurological fields. The Authors report the results of a study on EDS in 1,146 adult subjects seen consecutively by different physicians. Excessive Somnolence during normal activity was reported in 4.5% of the subjects studied. In a subgroup of habitual snorers, EDS was observed in 8.3% of the subjects and in 2.0% in a group of non-snorers. The subjects with EDS has a mean age and body mass index (BMI) greater than those of the control group and a higher frequency of certain performance disturbances. No sex differences were found. EDS and habitual snoring had a similar age-related trend.
On the basis of a previous pilot study a multiple-choice questionnaire about hearing disabilities... more On the basis of a previous pilot study a multiple-choice questionnaire about hearing disabilities was developed. The questionnaire (SDU) allowed 20 items. The answers were tailored to the single question and scaled in increasingly order of disability (form A) or in random order (form B). Modalities of administration (self-report or interview) and form (A or B) were randomized in a group of 123 adult subjects with different degree of hearing impairment. Only one factor, attributable to hearing disability, was extracted by a factor analysis. This factor explains a major variance ratio of items related to speech perception in difficult listening context. A good correlation (r = .74) was found between SDU total score and hearing threshold in the better ear. No difference in mean score, variance and time of reduction of the SDU was found between form A and B. The Authors so propose the use of form A because of a more easy compute of the total score. Self-report was more time-consuming respect to interview (11.7' vs. 8.4'). Furthermore, self-report was non possible in 13.8% of subjects for severe virus impairment and illiteracy and in 6.1% some form of support was necessary. No difference of mean score and variance between self-report and interview was found. SDU represents a tool for hearing disability evaluation useful in aural rehabilitation protocols. The principal advantage is high applicability thanks to short time required, simplicity of task and flexibility in the modality of administration.
This is an open access article under the terms of the Creative Commons Attribution License, which... more This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Since simplified methods have been generated to measure psychoacoustic tuning curves (PTC), they ... more Since simplified methods have been generated to measure psychoacoustic tuning curves (PTC), they have proved to be useful in clinical workup. Nevertheless, further research is necessary for high level tuning. In the present study PTCs have been generated utilizing a discrete simultaneous masking tone-on-tone paradigm. Thresholds were determined using an adaptive up-down transformed procedure, thus obtaining normative data. The experimental groups allowed frequency-independent, mild to moderate hearing loss, in order to minimize such variable. Results indicate that PTCs were normal in 8 subjects suffering from conductive hearing loss and abnormal in 8 subjects with cochlear loss. Normative high level data and a new quantifying index confirms these results.
Although still widely implanted, Pulsar Med-El is rarely considered for small incision approach. ... more Although still widely implanted, Pulsar Med-El is rarely considered for small incision approach. Overall, 30 teen-age and adult patients were operated upon with a novel small incision (4-5 cm). Full insertion of the electrode array was achieved in all cases. No major intra-operative complications occurred. At follow-up, no flap-related complications and no migration of the receiver-stimulator were observed in the "device suture" (14 patients) or "no device suture" groups (16 patients). All patients are full-time users of the device. In conclusion, a small incision for the Pulsar Med-El cochlear implant is feasible, safe and reproducible. Ligature fixation of the device is not critical with this operation. Also with this device, in adult and teen-age patients, it is, therefore, possible to retain several typical advantages of small incision approaches.
Functional gain (FG) and insertion gain (IG) are currently used as real ear gain measurement of h... more Functional gain (FG) and insertion gain (IG) are currently used as real ear gain measurement of hearing aids. The gain differences observed with hearing aid modifications made in order to achieve the desired prescriptive target must be greater than the variability associated with repetition of measurement in order to be really useful. Limited research is available on FG and IG intratester variability. In order to evaluate single variability factors, some studies use experimental designs not common in clinical work-up while others use equipment mot available commercially. The present study evaluates intratester variability of FG and IG (Madsen IGO 1500 equipment) in a typical clinical configuration in 42 users of behind-ear hearing aids. Mean standard deviation of FG test-retest differences was 5.19 dB. Range of variability was expressed in term of centiles. 5-- and 95-- centiles were -9.8 and 8.7 dB respectively. Mean s.d. of IG test-retest differences was 3.18 dB; 5-- and 95-- centiles were -5.2 and 6.05 dB respectively. Major variability was found at higher frequencies. High variability at lower frequencies was also found probably due to sealing problems of ear molds in the ear canal. Accord between FG and IG was also examined. A good mean correspondence in mid frequency range was found (FG-IG mean difference less than 5 dB) with large inter-subject differences between the two measurements (s.d. 11 dB).
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Systematic use of preoperative antibiotic prophylaxis (PAP) and nasal packing (NP) in septoplasty... more Systematic use of preoperative antibiotic prophylaxis (PAP) and nasal packing (NP) in septoplasty-both directly and indirectly affecting the cost of surgery (length of hospitalization)-appear based on controversial scientific data and, at times, even on unjustified clinical "habits". A controlled study was thus performed on 100 adults undergoing exclusive nasal septoplasty to determine whether these techniques are actually useful. The subjects were randomly divided into four groups: TN-PAP-(29 subjects), TN-PAP+ (25 subjects), TN+ PAP- (21 subjects) and TN+ PAP+ (25 subjects). Surgery was always performed by the same surgeon and was concluded with continuous suture of the mucoperichondrial layers. Only one patient (TN-PAP-) presented complications of infection (vestibulitis). Three patients in the TN- group required nasal packing a few hours after surgery because of moderate bleeding. As of three months after surgery no other complications had arisen. Postoperative pain, evaluated on an analogicalvisual scale, was higher during the 12 hours after surgery. Analysis of variance showed that the only pain-related factor was nasal packing while PAP and the interaction between TN and PAP did not prove significant. The above results suggest that PAP and TN should not be systematically used, thus reducing the hospitalization period for septoplasty to the day of surgery (Day surgery).
Background: Given an increase in the aging population and its impact on healthcare systems, polic... more Background: Given an increase in the aging population and its impact on healthcare systems, policy makers for provision of health and social services are aiming to keep older adults in good health for longer, in other words towards 'healthy aging'. Our study objective is to show that rehabilitation with cochlear implant treatment in the elderly with hearing impairment improves the overall health-related quality of life and general well-being that translate into healthy aging. Methods: The multicentre, prospective, repeated measures, single-subject, clinical observational study will accrue 100 elderly, first-time, unilateral CI recipients (≥ 60 years) and analyze changes on specific measurement tools over ca. 20 months from preimplant to postimplant. Evaluations will consist of details collected through case history and interview questionnaires by clinicians, data logging, self-report questionnaires completed by the recipients and a series of commonly used audiometric measures and geriatric assessment tools. The primary indicator of changes in overall quality of life will be the HUI-3. Discussion: The protocol is designed to make use of measurement tools that have already been applied to the hearing-impaired population in order to compare effects of CI rehabilitation in adults immediately before their implantation, (pre-implant) and after gaining 1-1.5 years of experience (post-implant). The broad approach will lead to a greater understanding of how useful hearing impacts the quality of life in elderly individuals, and thus improves potentials for healthy aging. Outcomes will be described and analyzed in detail. Trial registration: This research has been registered in ClinicalTrials.gov (http://www.clinicaltrials.gov/), 7 March 2017 under the n°NCT03072862.
With the improved life expectation of patients with beta-thalassemia-major (BTM) or Cooley's Dise... more With the improved life expectation of patients with beta-thalassemia-major (BTM) or Cooley's Disease, new clinical problems, such as hearing damage, have emerged. The authors describe audiometric data of 50 patients with BTM. High-frequency thresholds were higher in BTM than those of a control group. Prevalence of hearing loss in BTM was 14-26%, depending on the frequency range considered, while in the control group it was between 4.3-19.1%. The prevalence of hearing loss in BTM with respect to that of the general population was 7-10% higher. Hearing loss ranged from mild to moderate. A good correlation was found between hearing loss and the cumulative dose of desferoxamine administered. These data were indicative of an ototoxic effect of this drug. Many patients (28.6%) showed significant hearing threshold deterioration after 3 years. On the light of these results, the authors suggest regular audiologic follow-up of patients with BTM.
A brief questionnaire concerning auditory disability in every day listening was developed. The ai... more A brief questionnaire concerning auditory disability in every day listening was developed. The aim was to generate a simple, practical test for rehabilitational purposes. The questionnaire was administered to 255 hearing-impaired subjects coming under observation consecutively. The only requirement for participation was an expression of communicational difficulties due to adult onset of hearing loss. Some items were not applicable for all subjects. The higher scores were observed for hearing problems related to speech-in-noise. Good linear correlations were found between better-ear auditory and questionnaire score-based indexes in the 'family' and 'social' sections.
their influence on outcomes was performed. Independently reported preferred methods for microphon... more their influence on outcomes was performed. Independently reported preferred methods for microphone placement are collectively summarised. Results: The average implant experience was 3.5 years. Satisfaction increased significantly over time (p < 0.05). No correlation with covariates examined was observed. Feedback significantly decreased over time, showing a significant correlation with microphone location, primary motivation, gender, age at implantation, and contralateral hearing aid use (p < 0.05). Patient satisfaction was inversely correlated with reports of system feedback (p < 0.05). The implantable microphone was most commonly on the posterior inferior mastoid line, in 42/66 (65%) cases, correlating with less likelihood for feedback and consistent with author surgical preference. Conclusion: Carina recipients in this study present as satisfied consistent daily users with very few reports of persistent feedback. As microphone location is an influencing factor, a careful surgical consideration of microphone placement is required. The authors prefer a posterior inferior mastoid line position whenever possible.
Tinnitus is a widespread symptom that is chronically experienced by approximately 10% of the adul... more Tinnitus is a widespread symptom that is chronically experienced by approximately 10% of the adult population. While the vast majority of individuals do not feel impaired by their ear noise, about 0.5-3% of the adult population develops severe distress and feels impaired in everyday life. The severity of the distress experienced can only partially be explained by the characteristics of the ear noise itself (e.g. objective tinnitus loudness or duration). Psychological variables such as tinnitus acceptance are being increasingly investigated by tinnitus research. The aim of this study was to analyse the psychometric quality of the Italian version of the "Chronic Tinnitus Acceptance Questionnaire" (CTAQ-I). The CTAQ-I is an adaption of the Italian "Chronic Pain Acceptance Questionnaire (CPAQ)" and altered for the study of tinnitus acceptance. This cross-sectional multicentre questionnaire study included 141 outpatients with chronic tinnitus. Sociodemographic and clinical data were assessed with the Tinnitus Sample Case History (TSCH), tinnitus acceptance with the Italian "Chronic Tinnitus Acceptance Questionnaire" (CTAQ-I), tinnitus distress with the Tinnitus Handicap Inventory (THI) and the Tinnitus Questionnaire Short Form (TQ 12-I). Furthermore, we assessed the patient's general psychological distress (Brief Symptom Inventory-BSI) and Health Related Quality of Life (SF-36). Psychometric and factorial evaluation of the CTAQ-I were carried out. To investigate the influence of sociodemographic and numerous clinical variables on tinnitus acceptance we calculated correlation coefficients, analysis of variance and independent sample-t-tests. The factor analysis revealed a two-factor solution ("activity engagement" and "tinnitus willingness"), accounting for 41.1% of the variance. Good internal consistency for the total score (α = 0.84) and both factors (α = 0.80-0.88) was found. Moderate negative correlations with tinnitus distress indicated good validity. Tinnitus acceptance was further correlated with lower psychological distress and subjective tinnitus loudness, as well as increased emotional well-being. Tinnitus acceptance is considered to be an important source of therapeutic change in behavioural-based treatments as well as in professional counselling for tinnitus. Our study shows that the CTAQ-I is a reliable and valid instrument to measure the acceptance of patients suffering from chronic tinnitus.
An epidemiological survey of the prevalence of snoring was performed on 1146 adults consecutively... more An epidemiological survey of the prevalence of snoring was performed on 1146 adults consecutively observed in the offices of several practitioners. A reliable, previously assessed snoring questionnaire was given to all patients. Snoring was found as a common sign as 31% of the subjects referred to this symptom. However, the prevalence of every-night snoring was 13.5-17.7%. Snoring was an age-related phenomena: its prevalence raised with age. Males more frequently proved to be heavy snorers although no great difference was found between sexes in the later decades of life.
This is a case of successful cochlear implantation in a 50-year-old man who experienced sudden he... more This is a case of successful cochlear implantation in a 50-year-old man who experienced sudden hearing loss and developed ipsilateral severe tinnitus at three years following conservative stage 1 vestibular schwannoma retrosigmoid surgery. After cochlear implantation, tinnitus improved from THI grade 4 to 2. Localisation skills improved. Hearing in noise (S/N + 7 dB) with target signal from the operated side improved from 38 to 100% of correct answers. A significant improvement of spatial and speech items of the "speech, spatial and qualities of sounds" questionnaire was also measured. In conclusion, cochlear implantation is a feasible and effective solution after conservative vestibular schwannoma surgery should delayed hearing loss occur.
A questionnaire concerning problems inherent to ronchopathy was evaluated in order to assess its ... more A questionnaire concerning problems inherent to ronchopathy was evaluated in order to assess its test-retest reliability and the interobserver variability of the items. The results indicate the existence of three orders of variables. The first (class A) was characterized by good intra- and inter- observer reliability. It included all interval variables (i.e. weight, height, arterial pressure) and most ordinal variables (i.e. grading of snoring, excessive daytime somnolence, morning headache, smoking, etc.). The second (class B) was characterized by good intra-observer and poor inter-observer reliability. It included snoring onset time and morning somnolence. The third class (class C) was characterized by both poor intra- and inter-observer reliability. It included sleep apnea. For large epidemiological survey purposes the authors suggest that only class A variables be used.
Excessive daytime somnolence (EDS) is highly correlated to the presence of obstructive sleep apne... more Excessive daytime somnolence (EDS) is highly correlated to the presence of obstructive sleep apnea syndrome (OSAS). It appears that interest in such disorders may also be extended to extraneurological fields. The Authors report the results of a study on EDS in 1,146 adult subjects seen consecutively by different physicians. Excessive Somnolence during normal activity was reported in 4.5% of the subjects studied. In a subgroup of habitual snorers, EDS was observed in 8.3% of the subjects and in 2.0% in a group of non-snorers. The subjects with EDS has a mean age and body mass index (BMI) greater than those of the control group and a higher frequency of certain performance disturbances. No sex differences were found. EDS and habitual snoring had a similar age-related trend.
On the basis of a previous pilot study a multiple-choice questionnaire about hearing disabilities... more On the basis of a previous pilot study a multiple-choice questionnaire about hearing disabilities was developed. The questionnaire (SDU) allowed 20 items. The answers were tailored to the single question and scaled in increasingly order of disability (form A) or in random order (form B). Modalities of administration (self-report or interview) and form (A or B) were randomized in a group of 123 adult subjects with different degree of hearing impairment. Only one factor, attributable to hearing disability, was extracted by a factor analysis. This factor explains a major variance ratio of items related to speech perception in difficult listening context. A good correlation (r = .74) was found between SDU total score and hearing threshold in the better ear. No difference in mean score, variance and time of reduction of the SDU was found between form A and B. The Authors so propose the use of form A because of a more easy compute of the total score. Self-report was more time-consuming respect to interview (11.7' vs. 8.4'). Furthermore, self-report was non possible in 13.8% of subjects for severe virus impairment and illiteracy and in 6.1% some form of support was necessary. No difference of mean score and variance between self-report and interview was found. SDU represents a tool for hearing disability evaluation useful in aural rehabilitation protocols. The principal advantage is high applicability thanks to short time required, simplicity of task and flexibility in the modality of administration.
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