Elizabeth Dinces

Behavioral and electrophysiological measures of auditory change detection in children following late cochlear implantation: A preliminary study

OBJECTIVE The purpose of the current study was to longitudinally assess the development of automatic sound feature discrimination and compare it to behavioral discrimination in late-implanted cochlear implant users. METHODS Scalp-recorded auditory evoked potentials (AEPs) and behavioral discrimination of frequency, duration and intensity differences within an oddball paradigm using complex stimuli were recorded in three late-implanted cochlear implant subjects beginning on turn-on day. RESULTS Variable results were obtained in behavioral and AEPs that were consistent with the amount of pre-implant auditory experience each subject had. The best user showed rapid development of neurophysiologic indices of change detection along with improvement in behavioral and real-world auditory skills. In contrast, there were no recordable AEPs in the poorer CI user and there was little change in behavioral outcomes. CONCLUSION There is evidence of utilization of usual auditory processing pathways in the AEPs of some children who receive cochlear implants late in their childhood. Some plasticity in the auditory cortical pathways may be present despite prolonged auditory deprivation in school-aged children who are late-implanted cochlear implant recipients.

Hearing Impairment Prevalence and Associated Risk Factors in the Hispanic Community Health Study/Study of Latinos

IMPORTANCE Hearing impairment is common in adults, but few studies have addressed it in the US Hispanic/Latino population. OBJECTIVE To determine the prevalence of hearing impairment among US Hispanic/Latino adults of diverse backgrounds and determine associations with potential risk factors. DESIGN, SETTING, AND PARTICIPANTS The Hispanic Community Health Study/Study of Latinos (HCHS/SOL) is a population-based sample of Hispanics/Latinos in four US communities (Bronx, New York; Chicago, Illinois; Miami, Florida; and San Diego, California). Examinations were conducted from 2008 through 2011. The HCHS/SOL examined 16,415 self-identified Hispanic/Latino persons aged 18 to 74 years recruited from randomly selected households using a stratified 2-stage area probability sample design based on census block groups and households within block groups. MAIN OUTCOMES AND MEASURES Hearing thresholds were measured by pure-tone audiometry. Hearing impairment was defined as a pure-tone average (PTA) of thresholds at 0.5, 1, 2, and 4 kHz greater than 25 dB hearing level. Bilateral hearing impairment required a PTA greater than 25 dB hearing level in both ears. Multivariable analyses included adjustments for sociodemographic and lifestyle variables, body mass index, and medical conditions. RESULTS The prevalence of hearing impairment was 15.06% (SE, 0.44%) overall, and 8.24% (SE, 0.33%) had bilateral hearing impairment. The prevalence of hearing impairment was higher among people 45 years and older, ranging by Hispanic/Latino background from 29.35% to 41.20% among men and 17.89% to 32.11% among women. The multivariable-adjusted odds of hearing impairment was greater for participants of Puerto Rican background compared with Mexican background (odds ratio [OR], 1.57 [95% CI, 1.10-2.25]). The odds of hearing impairment were lower with more education (OR, 0.71 [95% CI, 0.59-0.86] for at least high school) and higher income (OR, 0.58 [95% CI, 0.36-0.92] for >

Processing intensity at rapid rates: Evidence from auditory evoked potentials in 9—11-year-old children

75,000 vs ≤

Pediatric fluctuating sensorineural hearing loss: problems in medical management.

10,000). Noise exposure (OR, 1.35 [95% CI, 1.07-1.70]), diabetes (OR, 1.57 [95% CI, 1.27-1.94]), and prediabetes (OR, 1.37 [95% CI, 1.12-1.67]) were associated with hearing impairment. CONCLUSIONS AND RELEVANCE Hearing impairment is a common problem for older Hispanics/Latinos in these communities and is associated with socioeconomic factors, noise exposure, and abnormal glucose metabolism. Longitudinal studies are needed to determine whether these factors are involved in the etiology of hearing impairment and to identify ways to prevent or delay age-related changes in hearing.

Implantable hearing aids for moderate-to-severe hearing loss

OBJECTIVE The ability to understand speech requires processing of rapidly changing acoustic information. Much more is known about processing the rapid spectro-temporal properties of speech than is known about processing of intensity, even though intensity is a fundamental cue for accurate speech perception. The purpose for the current study was to characterize, in 9-11-year-old typically language-developing children, the auditory event-related brain potentials elicited by different tone intensities when presented in complex environments (i.e., varying in frequency and intensity) at rapid rates. METHODS Pure tones of four different intensity levels (66, 74, 78, and 86dB SPL) and five different stimulus frequencies were presented at a stimulus rate of 10Hz. The latency and amplitude of the auditory event-related brain potentials were measured. RESULTS At this fast rate, a positive (P1) followed by a negative component was elicited. The lowest intensity sound elicited the lowest P1 amplitude and the highest intensity sound elicited the highest P1 amplitude. The P1 elicited by the two middle tone intensities had amplitudes that fell between the lowest and highest amplitudes but they were not significantly different from each other. The negative component following the P1 was unaffected by intensity variation. CONCLUSIONS Intensity variation of sounds presented in a complex environment at a rapid rate modulated only the amplitude of the earliest obligatory auditory component (P1), consistent with our previous studies in which only the P1 could follow the rapid stimulation rate. P1 amplitude changes reflected the relative differences among the sounds, not the absolute differences in loudness among the sounds presented together in the sequence. The results suggest that the environment, or context, within which rapid sounds occur, influences the relative amplitude of the P1 in children.

Sleep Apnea Is Associated with Hearing Impairment: The Hispanic Community Health Study/Study of Latinos.

Objectives To discuss the diagnosis and management of children with fluctuating sensorineural hearing loss, especially focusing on those problems dealing with autoimmune inner ear disease.

Risk factors for hearing impairment among adults with diabetes: The Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

Abstract Common modalities of aural rehabilitation include external hearing aids, cochlear implantation, and bone anchored hearing aids. In recent years, there has been research, development, and application of implantable and semi-implantable hearing aids. These devices act by vibration of the ossicular chain by piezoelectric or electromagnetic energy. Although only recently approved by the U.S. Food and Drug Administration, implantable hearing aids are evolving as a plausable option for patients with sensorineural or conductive hearing loss. Here, we review all current devices and surgical techniques for implantation.

Attentional resources are needed for auditory stream segregation in aging

STUDY OBJECTIVE Sleep apnea (SA) may promote hearing impairment (HI) through ischemia and inflammation of the cochlea. Our objective was to assess an independent association between SA and HI in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) participants. METHODS We used data from the HCHS/SOL, a multicenter population-based study of self- identifying Hispanic/Latinos 18- to 74-y-old adults from four US urban communities. We performed home SA testing and in-clinic audiometry testing in all participants. SA was defined as an apnea-hypopnea index (AHI) ≥ 15 events/h. HI was defined as a mean hearing threshold > 25 dB hearing level in either ear at the frequencies: 3,000 to 8,000 Hz for high-frequency HI (HF-HI) and 500 to 2,000 Hz for low-frequency HI (LF-HI). Combined-frequency HI (CF-HI) was defined as both conditions present, and Any-HI was considered as HI in either low or high frequencies. RESULTS Of 13,967 participants, 9.9% had SA and 32.3% had Any-HI. Adjusted for risk factors for HI, those with SA had a 30% higher odds of Any-HI (95% confidence interval [CI] = 8% to 57%), 26% higher odds of HF-HI (CI = 3% to 55%), 127% higher odds of LF-HI (CI = 21% to 326%), and 29% higher odds of CF-HI (CI = 0% to 65%). A dose-response association was observed between AHI severity and Any-HI (versus no SA, OR for AHI ≥ 15 and < 30 = 1.22, CI = 0.96 to 1.54, and OR for AHI ≥ 30 = 1.46, CI = 1.11 to 1.91, p = 0.002). CONCLUSION SA is associated with HF-HI and LF-HI, independent of snoring and other confounders. COMMENTARY A commentary on this article appears in this issue on page 641.

Building a Multidisciplinary Cochlear Implant Team

Highlights • Hearing impairment was experienced by 59% of adults with diabetes.• Modifiable risk factors were smoking, high alcohol use and high triglycerides.• Lesser education and lower income were associated with hearing impairment.• Suboptimal glycemic control was not associated with hearing impairment.

Evaluation of Esterified Hyaluronic Acid as Middle Ear-Packing Material

The ability to select sound streams from background noise becomes challenging with age, even with normal peripheral auditory functioning. Reduced stream segregation ability has been reported in older compared to younger adults. However, the reason why there is a difference is still unknown. The current study investigated the hypothesis that automatic sound processing is impaired with aging, which then contributes to difficulty actively selecting subsets of sounds in noisy environments. We presented a simple intensity oddball sequence in various conditions with irrelevant background sounds while recording EEG. The ability to detect the oddball tones was dependent on the ability to automatically or actively segregate the sounds to frequency streams. Listeners were able to actively segregate sounds to perform the loudness detection task, but there was no indication of automatic segregation of background sounds while watching a movie. Thus, our results indicate impaired automatic processes in aging that may explain more effortful listening, and that tax attentional systems when selecting sound streams in noisy environments.