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Hearing Loss in Patients with Extracranial Complications of Chronic Otitis Media
ORIGINAL ARTICLE Hearing loss in patients with extracranial complications of chronic otitis media Authors’ Contribution: BCDE AF A – Study Design Tomasz Przewoźny , Jerzy Kuczkowski B – Data Collection C – Statistical Analysis D – Data Interpretation Department of Otolaryngology, Medical University of Gdańsk, Gdańsk, Poland E – Manuscript Preparation F – Literature Search G – Funds Collection Article history: Received: 13.04.2017 Accepted: 10.04.2017 Published: 15.06.2017 ABSTRACT: Objective: A pure tone audiomety analysis of patients with extracranial complications of chronic suppurative otitis media (ECCSOM). Material and methods: We retrospectively analyzed audiometric data performed before treatment from 63 pa- tients with ECCSOM (56 single, 7 multiple complications) including groups of frequencies. Results: The greatest levels of hearing loss were noted for 6 and 8 kHz (79.0 and 75.7 dBHL) and for the frequency groups high tone average (76.1 dBHL). As regards the severity of hearing impairment in pure tone average the prev- alence of complications was as follows: labyrinthitis (77.8±33.6 dBHL), facial palsy (57.1±14.3 dBHL), perilymphatic fistula (53.9±19.9 dBHL) and mastoiditis (42.2±9.5 dBHL) (p=0.023). Conclusions: Hearing loss in ECCSOM is dominated by mixed, high-tone, moderate type of hearing loss, most pro- found in labyrinthitis. In 11% of patients the complication causes total deafness. KEYWORDS: chronic suppurative otitis media, complications extracranial, hearing loss INTRODUCTION ing discharge from the ear and mixed or conductive hearing loss can be observed [4-5]. Labyrinthitis is associated with Chronic suppurative otitis media (CSOM) is a destructive slowly progressive high-frequency sensorineural hearing loss disease of the ear. -
Hearing Screening Training Manual REVISED 12/2018
Hearing Screening Training Manual REVISED 12/2018 Minnesota Department of Health (MDH) Community and Family Health Division Maternal and Child Health Section 1 2 For more information, contact Minnesota Department of Health Maternal Child Health Section 85 E 7th Place St. Paul, MN 55164-0882 651-201-3760 [email protected] www.health.state.mn.us Upon request, this material will be made available in an alternative format such as large print, Braille or audio recording. 3 Revisions made to this manual are based on: Guidelines for Hearing Screening After the Newborn Period to Kindergarten Age http://www.improveehdi.org/mn/library/files/afternewbornperiodguidelines.pdf American Academy of Audiology, Childhood Screening Guidelines http://www.cdc.gov/ncbddd/hearingloss/documents/AAA_Childhood%20Hearing%2 0Guidelines_2011.pdf American Academy of Pediatrics (AAP), Hearing Assessment in Children: Recommendations Beyond Neonatal Screening http://pediatrics.aappublications.org/content/124/4/1252 4 Contents Introduction .................................................................................................................... 7 Audience ..................................................................................................................... 7 Purpose ....................................................................................................................... 7 Overview of hearing and hearing loss ............................................................................ 9 Sound, hearing, and hearing -
Consultation Diagnoses and Procedures Billed Among Recent Graduates Practicing General Otolaryngology – Head & Neck Surger
Eskander et al. Journal of Otolaryngology - Head and Neck Surgery (2018) 47:47 https://doi.org/10.1186/s40463-018-0293-8 ORIGINALRESEARCHARTICLE Open Access Consultation diagnoses and procedures billed among recent graduates practicing general otolaryngology – head & neck surgery in Ontario, Canada Antoine Eskander1,2,3* , Paolo Campisi4, Ian J. Witterick5 and David D. Pothier6 Abstract Background: An analysis of the scope of practice of recent Otolaryngology – Head and Neck Surgery (OHNS) graduates working as general otolaryngologists has not been previously performed. As Canadian OHNS residency programs implement competency-based training strategies, this data may be used to align residency curricula with the clinical and surgical practice of recent graduates. Methods: Ontario billing data were used to identify the most common diagnostic and procedure codes used by general otolaryngologists issued a billing number between 2006 and 2012. The codes were categorized by OHNS subspecialty. Practitioners with a narrow range of procedure codes or a high rate of complex procedure codes, were deemed subspecialists and therefore excluded. Results: There were 108 recent graduates in a general practice identified. The most common diagnostic codes assigned to consultation billings were categorized as ‘otology’ (42%), ‘general otolaryngology’ (35%), ‘rhinology’ (17%) and ‘head and neck’ (4%). The most common procedure codes were categorized as ‘general otolaryngology’ (45%), ‘otology’ (23%), ‘head and neck’ (13%) and ‘rhinology’ (9%). The top 5 procedures were nasolaryngoscopy, ear microdebridement, myringotomy with insertion of ventilation tube, tonsillectomy, and turbinate reduction. Although otology encompassed a large proportion of procedures billed, tympanoplasty and mastoidectomy were surprisingly uncommon. Conclusion: This is the first study to analyze the nature of the clinical and surgical cases managed by recent OHNS graduates. -
Balancing Everything out Fifteen Years of Research Into Dizziness, Balance and the Pathology of Ménière’S Disease
Making It Better Balancing Everything Out Fifteen years of research into dizziness, balance and the pathology of Ménière’s disease The Ménière’s Society The Page 1 www.menieres.org.ukMénière’s Society Making It Better Index of References and Sources Further details of the reference sources and research projects discussed in this paper can be found at the following locations: V Osei -Lah, B Ceranic and L M Luxon (2008). Kirby, S.E. and Yardley, L. (2009) Clinical value of tone burst vestibular evoked The contribution of symptoms of post-traumatic myogenic potentials at threshold in acute stress disorder (PTSD), health anxiety and and stable Ménière’s disease. The Journal intolerance of uncertainty to distress in Ménière’s of Laryngology & Otology, 122, pp 452 457 disease. Journal of Nervous and Mental Disease, doi:10.1017/S0022215107009152 197,(5), 324-329 www.journals.cambridge.org/action/ www.eprints.soton.ac.uk/54655 displayAbstract?fromPage=online&aid=1850772 Yardley L., Dibb B. and Osborne G. (2003) A W Morrison, M E S Bailey and G A J Morrison Factors associated with quality of life in Meniere’s (2009). Familial Ménière’s disease: clinical and disease. Clinical Otolaryngology, 28, (5), 436-441. genetic aspects. The Journal of Laryngology (doi:10.1046/j.1365-2273.2003.00740.x). & Otology, 123, pp 29-37. doi:10.1017/S0022215108002788. Yardley L, Kirby S. Evaluation of booklet-based www.journals.cambridge.org/action/ self-management of symptoms in Ménière’s displayAbstract?fromPage=online&aid=3107936 disease: a randomized controlled trial. Psychosom Med 2006;68:762–9 Clinical and cost effectiveness Sandhu, J. -
Eardrum Regeneration: Membrane Repair
OUTLINE Watch an animation at: Infographic: go.nature.com/2smjfq8 Pages S6–S7 EARDRUM REGENERATION: MEMBRANE REPAIR Can tissue engineering provide a cheap and convenient alternative to surgery for eardrum repair? DIANA GRADINARU he eardrum, or tympanic membrane, forms the interface between the outside world and the delicate bony structures Tof the middle ear — the ossicles — that conduct sound vibrations to the inner ear. At just a fraction of a millimetre thick and held under tension, the membrane is perfectly adapted to transmit even the faintest of vibrations. But the qualities that make the eardrum such a good conductor of sound come at a price: fra- gility. Burst eardrums are a major cause of conductive hearing loss — when sounds can’t pass from the outer to the inner ear. Most burst eardrums are caused by infections or trauma. The vast majority heal on their own in about ten days, but for a small proportion of people the perforation fails to heal natu- rally. These chronic ruptures cause conductive hearing loss and group (S. Kanemaru et al. Otol. Neurotol. 32, 1218–1223; 2011). increase the risk of middle ear infections, which can have serious In a commentary in the same journal, Robert Jackler, a head complications. and neck surgeon at Stanford University, California, wrote that, Surgical intervention is the only option for people with ear- should the results be replicated, the procedure represents “poten- drums that won’t heal. Tympanoplasty involves collecting graft tially the greatest advance in otology since the invention of the material from the patient to use as a patch over the perforation. -
ICD-9 Diseases of the Ear and Mastoid Process 380-389
DISEASES OF THE EAR AND MASTOID PROCESS (380-389) 380 Disorders of external ear 380.0 Perichondritis of pinna Perichondritis of auricle 380.00 Perichondritis of pinna, unspecified 380.01 Acute perichondritis of pinna 380.02 Chronic perichondritis of pinna 380.1 Infective otitis externa 380.10 Infective otitis externa, unspecified Otitis externa (acute): NOS circumscribed diffuse hemorrhagica infective NOS 380.11 Acute infection of pinna Excludes: furuncular otitis externa (680.0) 380.12 Acute swimmers' ear Beach ear Tank ear 380.13 Other acute infections of external ear Code first underlying disease, as: erysipelas (035) impetigo (684) seborrheic dermatitis (690.10-690.18) Excludes: herpes simplex (054.73) herpes zoster (053.71) 380.14 Malignant otitis externa 380.15 Chronic mycotic otitis externa Code first underlying disease, as: aspergillosis (117.3) otomycosis NOS (111.9) Excludes: candidal otitis externa (112.82) 380.16 Other chronic infective otitis externa Chronic infective otitis externa NOS 380.2 Other otitis externa 380.21 Cholesteatoma of external ear Keratosis obturans of external ear (canal) Excludes: cholesteatoma NOS (385.30-385.35) postmastoidectomy (383.32) 380.22 Other acute otitis externa Excerpted from “Dtab04.RTF” downloaded from website regarding ICD-9-CM 1 of 11 Acute otitis externa: actinic chemical contact eczematoid reactive 380.23 Other chronic otitis externa Chronic otitis externa NOS 380.3 Noninfectious disorders of pinna 380.30 Disorder of pinna, unspecified 380.31 Hematoma of auricle or pinna 380.32 Acquired -
Hearing Loss, Vertigo and Tinnitus
HEARING LOSS, VERTIGO AND TINNITUS Jonathan Lara, DO April 29, 2012 Hearing Loss Facts S Men are more likely to experience hearing loss than women. S Approximately 17 percent (36 million) of American adults report some degree of hearing loss. S About 2 to 3 out of every 1,000 children in the United States are born deaf or hard-of-hearing. S Nine out of every 10 children who are born deaf are born to parents who can hear. Hearing Loss Facts S The NIDCD estimates that approximately 15 percent (26 million) of Americans between the ages of 20 and 69 have high frequency hearing loss due to exposure to loud sounds or noise at work or in leisure activities. S Only 1 out of 5 people who could benefit from a hearing aid actually wears one. S Three out of 4 children experience ear infection (otitis media) by the time they are 3 years old. Hearing Loss Facts S There is a strong relationship between age and reported hearing loss: 18 percent of American adults 45-64 years old, 30 percent of adults 65-74 years old, and 47 percent of adults 75 years old or older have a hearing impairment. S Roughly 25 million Americans have experienced tinnitus. S Approximately 4,000 new cases of sudden deafness occur each year in the United States. Hearing Loss Facts S Approximately 615,000 individuals have been diagnosed with Ménière's disease in the United States. Another 45,500 are newly diagnosed each year. S One out of every 100,000 individuals per year develops an acoustic neurinoma (vestibular schwannoma). -
Hearing Loss
Randal W. Swenson, M.D. Joshua G. Yorgason, M.D. David K. Palmer, M.D. Wesley R. Brown, M.D. John E. Butler, M.D. Nancy J. Stevenson, PA-C Justin D. Gull, M.D. ENT SPECIALISTS Kristin G. Hoopes, PA-C www.entslc.com Hearing Loss Approximately one in ten persons in the United may result from blockage of the ear canal (wax), States has some degree of hearing loss. Hearing is from a perforation (hole) in the ear drum, or from measured in decibels (dB), and a hearing level of 0- infection or disease of any of the three middle ear 25 dB is considered normal hearing. Your level is: bones. With a conductive loss only, the patient will never go deaf, but will always be able to hear, either Right ear _______ dB Left ear _______dB with reconstructive ear surgery or by use of a properly fitted hearing aid. Some patients who are Hearing Severity / % Loss not candidates for surgery, may benefit from a new 25 dB (normal).….0% 65dB(Severe)……...60% technology, the Baha (bone-anchored hearing aid). 35 dB (mild)……..15% 75dB(Severe)……...75% When there is a problem with the inner ear or 45 dB (moderate)..30% >85dB (Profound)..>90% nerve of hearing, a sensori-neural hearing loss occurs. This is most commonly from normal aging, Normal speech discrimination is 88-100%. Yours is: is usually worse in high frequencies, and can progress to total deafness. Noise exposure is another Right ear _______ % Left ear_______% common cause of high frequency hearing loss. Patients with sensori-neural hearing loss usually complain of difficulty hearing in loud environments. -
Is One Ear Good Enough? Unilateral Hearing Loss and Preschoolers’ Comprehension of the English Plural
JSLHR Research Note Is One Ear Good Enough? Unilateral Hearing Loss and Preschoolers’ Comprehension of the English Plural Benjamin Davies,a,b,c Nan Xu Rattanasone,a,b,c Aleisha Davis,b,d and Katherine Demutha,b,c Purpose: The plural is one of the first grammatical morphemes whether an auditorily presented novel word was singular acquired by English-speaking children with normal hearing (e.g., tep, koss)orplural(e.g.,teps, kosses)bytouchingthe (NH). Yet, those with hearing loss show delays in both plural appropriate novel picture. comprehension and production. However, little is known Results: Like their NH peers, children with UHL demonstrated about the effects of unilateral hearing loss (UHL) on children’s comprehension of novel singulars. However, they were acquisition of the plural, where children’s ability to perceive significantly less accurate at identifying novel plurals, fricatives (e.g., the /s/ in cats) can be compromised. This withperformanceatchance.However,thereweresigns study therefore tested whether children with UHL were able that their ability to identify novel plurals may improve with to identify the grammatical number of newly heard words, age. both singular and plural. Conclusion: While comparable to their NH peers at identifying Method: Eleven 3- to 5-year-olds with UHL participated in novel singulars, these results suggest that young children a novel word two-alternative forced choice task presented with UHL do not yet have a robust representation of plural on an iPad. Their results were compared to those of 129 NH morphology, particularly on words they have not encountered 3- to 5-year-olds. During the task, children had to choose before. -
Audiometric Test Procedures
Audiometric Test Procedures 101 This information is meant to help you better understand the various test procedures as well as some of the terms you might see on an audiometric report. By Larry Medwetsky individual could, in fact, exhibit nor- In the previous issue of Hearing mal hearing acuity across these three Loss Magazine, I provided an over- Anyone who has ever had their frequencies, yet, exhibit a significant view concerning hearing threshold hearing tested should know how hearing loss in the higher frequencies results as recorded on the audiogram to read the audiogram, but that’s (3000-8000 Hz). Thus, it is important and an explanation of the pure-tone easier said than done. Hopefully, to examine the SRT in the context of audiogram. In this article, I will after reading this article you will the other audiometric test findings. describe various test procedures have a greater understanding of the Speech Awareness Threshold that are typically administered in principles discussed and use your (SAT): an audiometric evaluation and what knowledge going forward—be it in Compound words are pre- information the tests provide. reviewing hearing test results you sented, the goal being to determine already have or when discussing your the softest level one can detect the Audiometric Test Procedures results at your next hearing test. presence of words. This test is often Pure-tone Audiometry: Tones of used when an individual’s hearing loss different frequencies are presented; the is so great that the person is unable goal is to find the softest sound level relatively flat hearing losses, and the to recognize/repeat the words, yet is which one can hear (threshold) the average of 500 and 1000 Hz for those aware that words have been presented. -
Tinnitus What Is Tinnitus? Tinnitus Is Defined As the Perception of Sound When No External Sound Is Present
Tinnitus What is tinnitus? Tinnitus is defined as the perception of sound when no external sound is present. The common vernacular is "ringing in the ears"; however, the quality of the tinnitus can range from roaring to hissing and chirping to clicking. Tinnitus can pulsate or be constant. It can be a single tone or multiple tones, and it's amplitude can vary from background noise to an excruciating experience. What causes tinnitus? Tinnitus has a variety of causes. The most common causes include wax in the ear canal, noise trauma or temporomandibular joint (TMJ) dysfunction. It can also be caused by Meniere's disease, endolymphatic hydrops, allergies, destruction of the middle ear bones, infection, nutritional deficiency, cardiovascular disease, thyroid disorders, certain medications, head injury and cervical disorders. Recently, migraine disorders have also been listed as a culprit. Regardless of the inciting etiology, it has been shown that the it is within the brain that the sound resides, persists, evolves and propagates. Tinnitus may begin with damage to the peripheral auditory system (the cochlea and auditory nerve), but its persistence is a function of the attention that it receives parietal cortex and frontal cortex), the importance that it is given (cingulate cortex, anterior insula) and it maintaining residence in the limbic system (the amygdala, hippocampus and thalamus). Ongoing research is being aggressively pursued to stop this feed-forward cycle in its tracks. Medications that may exacerbate tinnitus (adapted from Bailey's Otolaryngology - Head and Neck Surgery 4th ed.) include aspirin and aspirin-containing compounds, aminoglycoside antibiotics, nonsteroidal antiinflammatory drugs and heterocycline antidepressants. -
Lyric 24/7 Hearing: Could It Help Those with Tinnitus?
Lyric 24/7 hearing: could it help those with tinnitus? Jacob Johnson, Medical Director, Lyric, Phonak Silicone Valley; Associate Clinical About Lyric Hearing The tinnitus dilemma Professor, Department Since its launch in 2008, Lyric represents Subjective tinnitus, the phantom percep- of Otolaryngology, the first and only device of its kind estab- tion of sound with no identifiable sound Head & Neck Surgery, University of California – lishing a new category of hearing solution: source, significantly reduces an individual’s San Francisco; 24/7 extended wear. Lyric is placed several quality of life [1]. The tinnitus patient lives President, San Francisco millimetres within the ear canal, near the with a complex constellation of symptoms Audiology; Physician Partner tympanic membrane, so it is 100% invisible, including challenges to sleep, concentra- (Otolaryngologist), and worn 24 hours a day for months at a tion, and cognition that, over time, can San Francisco Otolaryngology Medical time. Lyric is worn during all daily activities include anxiety, anger, depression, and loss Group. including showering, sleeping and exer- of control [2]. Additionally, these patients cising. This frees the wearer from typical have well-characterised alterations in neur- Correspondence hassles presented by traditional hearing onal activity in auditory and non-auditory E: Jacob.Johnson@ phonak.com aids, including multiple daily device inser- pathways [3]. tions or removals, battery changes, and For the practitioner, evaluation and Declaration of cleaning. Moreover, the placement of care of tinnitus is complicated by the competing interests JJ is a Consultant with the device near the tympanic membrane diversity of clinical presentations, the lack Phonak. enables the anatomy of the ear to naturally of a single underlying cause (Table 1), transform sound before it enters the Lyric patient co-morbidities, wide promotion Article was first published in microphone for amplification (Figure 1).