Saman Kiumehr

The prevalence and characteristics of tinnitus in the youth population of the United States

To evaluate the prevalence, characteristics, and associated risk factors of tinnitus in U.S. adolescents.

Transcanal approach for implantation of a cochlear nerve electrode array

To evaluate a transcanal approach for placement of a stimulating electrode array in the cochlear nerve.

Customized Versus Noncustomized Sound Therapy for Treatment of Tinnitus: A Randomized Crossover Clinical Trial

Objectives: To determine the effectiveness of a customized sound therapy and compare its effectiveness to that of masking with broadband noise. Methods: Subjects were randomized to receive either customized sound therapy or broadband noise for 2 hours per day for 3 months and then switched to the other treatment after a washout period. The outcome variables were tinnitus loudness (scored 0-10), Tinnitus Handicap Inventory (THI), Beck Anxiety Inventory (BAI), minimum masking levels (MML), and residual inhibition (RI). Results: Eighteen subjects completed the study. Mean age was 53 ± 11 years, and mean tinnitus duration was 118 ± 99 months. With customized sound therapy, mean loudness decreased from 6.4 ± 2.0 to 4.9 ± 1.9 (P = .001), mean THI decreased from 42.8 ± 21.6 to 31.5 ± 20.3 (P < .001), mean BAI decreased from 10.6 ± 10.9 to 8.3 ± 9.9 (P = .01), and MML decreased from 22.3 ± 11.6 dB SL to 17.2 ± 10.6 dB SL (P = .005). After 3 months of broadband noise therapy, only BAI and, to a lesser degree, MML decreased (P = .003 and .04, respectively). Conclusions: Customized sound therapy can decrease the loudness and THI scores of tinnitus patients, and the results may be superior to broadband noise.

Posterior Semicircular Canal Dehiscence Following Endolymphatic Sac Surgery

Posterior semicircular canal dehiscence is a rare otologic entity that presents with third window signs and symptoms. Petrous apex cholesteatoma, fibrous dysplasia, high riding jugular bulb, and eosinophilic granuloma have been reported to be associated with posterior semicircular canal dehiscence. Here we report a case of development of posterior semicircular canal dehiscence following an endolymphatic sac surgery for the first time. Laryngoscope, 2012

Investigation of a novel completely-in-the-canal direct-drive hearing device: a temporal bone study.

Hypothesis Whether a prototype direct-drive hearing device (DHD) is effective in driving the tympanic membrane (TM) in a temporal bone specimen to enable it to potentially treat moderate-to-severe hearing loss. Background Patient satisfaction with air conduction hearing aids has been low because of sound distortion, occlusion effect, and feedback issues. Implantable hearing aids provide a higher quality sound but require surgery for placement. The DHD was designed to combine the ability of driving the ossicular chain with placement in the external auditory canal. Methods DHD is a 3.5-mm wide device that could fit entirely into the bony ear canal and directly drive the TM rather than use a speaker. A cadaveric temporal bone was prepared. The device developed in our laboratory was coupled to the external surface of the TM and against the malleus. Frequency sweeps between 300 Hz to 12 kHz were performed in 2 different coupling methods at 104 and 120 dB, and the DHD was driven with various levels of current. Displacements of the posterior crus of the stapes were measured using a laser Doppler vibrometer. Results The DHD showed a linear frequency response from 300 Hz to 12 kHz. Placement against the malleus showed higher amplitudes and lower power requirements than when the device was placed on the TM. Conclusion DHD is a small completely-in-the-canal device that mechanically drives the TM. This novel device has a frequency output wider than most air conduction devices. Findings of the current study demonstrated that the DHD had the potential of being incorporated into a hearing aid in the future.

Efficacy of Commercial Earplugs in Preventing Water Intrusion during Swimming

Objective To evaluate and compare the efficacy of commercially available earplugs in preventing water intrusion in healthy individuals. Study Design Experimental study. Setting Tertiary care medical center. Subjects and Methods Ten subjects (20 ears) were assessed. After insertion of the earplugs, subjects underwent 3 standardized head-wetting protocols, including (1) surface swimming for 10 minutes, which entailed no head submersion and moderate splashing; (2) head submersion at a 90-cm depth for 20 seconds with their head upright; and (3) head submersion at a 90-cm depth with head tilted 90 degrees left and then tilted 90 degrees right for 10 seconds on each side to apply vertical pressure. Color change of a wetness indicator was used to determine water intrusion after each protocol. The same protocol was repeated for all 9 earplugs. Results Water intrusion was observed in 44%, 67%, and 88% of ears after surface swimming, horizontal submersion, and vertical submersion, respectively. The results revealed a significant difference in the waterproofing qualities of the various types of earplugs. The soft silicone type (Pillow Soft) earplug had the lowest rate of water penetration during all 3 protocols (P < .001). The difference between the most effective earplugs, Pillow Soft and Aquaseal, were only significant during the horizontal submersion protocol (P = .008). Conclusion Water intrusion occurred even with the use of earplugs. The intrusion was more significant with horizontal or vertical head submersion. The soft silicone Pillow Soft earplug was the most effective earplug for preventing water intrusion in surface swimming.

Novel Completely-in-the-Canal Magnet-Drive Micro Hearing Aid

Objective: To describe a novel magnet-drive micro hearing aid (MMHA), a 3.5-mm wide device, that fits entirely into the bony canal and drives the tympanic membrane (TM) using a magnet in a noncontact fashion. To test the effectiveness and optimal positioning of the magnet on the TM. Method: Cadaveric temporal bones were prepared for laser Doppler vibrometry (LDV) of the stapes. MMHA was placed at 1 and 2 mm away from the TM, and the magnets were glued to umbo and lateral process of the malleus. Frequency sweeps between 300 Hz to 12 kHz were performed. Results: The MMHA showed frequency response from 300 Hz to 12 kHz at loudness levels from 60 to 120 dBA at 10 dBA steps. Placement of magnet on the umbo resulted in higher amplitudes and lower power requirements than placement on the lateral process. The same results were observed when the device was placed at 1-mm distance from the TM. Conclusion: MMHA is a small completely-in-the-canal hearing aid that drives the TM in a noncontact fashion through a magnet. This novel device has a frequency output wider than air conduction devices. The device’s ability to directly drive the TM enables it to potentially sound more naturally and similar to implantable devices.

Epidemiology and Complications of Acoustic Neuroma Excision

Objective: 1) To examine surgical outcomes, charges, and demographics information for patients who have undergone an acoustic neuroma excision. 2) To determine if outcome measures and charges are significantly different between high-volume and low-volume centers. Method: Case data for acoustic neuroma excisions performed in California from 2008 to 2010 were examined using California Hospital Discharge Data (CHDD). Cases were identified if they contained the principal procedure ICD-9-CM code 04.01. Postoperative complications were identified if cases contained ICD-9-CM codes for specific diagnoses and procedures (ie, meningitis, ventriculostomy, etc). Results: There were 1158 cases. Most patients were between the ages of 35 and 64 years (72.8%), women (54%), and white (76.0%). The median total charge was

Efficacy of Commercial Earplugs in Preventing Water Intrusion during

103,485, the average hospital stay was 5.1 days, 90.3% of patients were discharged routinely (ie, home), and 7.3% of patients endured postoperative complications. High-volume centers (10 ≤ surgeries per year average) had less complications (5.7% of patients had complication(s) vs 13%; P < .001), shorter hospital stays (4.7 days vs 6.6 days; P < .001), higher rates of routine discharges (94.8% vs 73.6%; P < .001), and lower average charges per day and total charges (P < .001). Conclusion: Compared with lower volume centers, high-volume centers had fewer complications, shorter hospital stays, higher rates of routine discharges, and lower total charges for all services rendered and average charges per day. Interestingly, CHDD demonstrates that median total charges have risen dramatically from data reported in 1996 to 1998 (

Efficacy of Commercial Earplugs in Preventing Water Exposure

103,485 vs