J Am Acad Audiol
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Maturational effects were investigated in two age groups (N = 30 per group) of children with normal hearing sensitivity, using rotary chair (RC), computerized dynamic posturography (CDP), and vestibular evoked myogenic potential (VEMP) measures. Children recruited within the younger group were three through six years of age, and children within the older group were nine through eleven years of age. ⋯ The results of this study demonstrate significant maturational effects from preschool age through adulthood and suggest that adult normative data may not be appropriate when interpreting pediatric test results. Since adult techniques should oftentimes not be utilized, a proposed test battery is described that may be efficiently utilized with pediatric patients.
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Case Reports
Simultaneous acute superior nerve neurolabyrinthitis and benign paroxysmal positional vertigo.
An acutely vertiginous 47-year-old woman presented to the emergency department with simultaneous acute left neurolabyrinthitis and left posterior canal benign paroxysmal positional vertigo (BPPV). Gaze nystagmus from the neurolabyrinthitis hampered diagnosis of the BPPV. However, once the BPPV was identified and treated, the patient's subjective vertigo improved rapidly. Concomitant BPPV should not be overlooked when a diagnosis of acute neurolabyrinthitis is made in the emergency department.
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The present study investigated the effects of gain compensation and venting on front-to-back ratios (FBRs), speech understanding in noise, and acceptance of noise in 19 listeners with hearing impairment utilizing directional hearing instruments. The participants were separated into two groups based on degree of low-frequency hearing sensitivity. ⋯ Results further demonstrated that speech understanding in noise was unaffected by venting but may be improved with the use of gain compensation for some listeners. Clinical implications are discussed.
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Comparative Study
Sensitivity of distortion product otoacoustic emissions in noise-exposed chinchillas.
The present study investigates the effect of small amounts of outer hair cell (OHC) loss on distortion product otoacoustic emission (DPOAE) levels and evoked potential permanent threshold shifts (PTS) in a population of 12 noise-exposed chinchillas. The group mean DPOAE level, which decreased by up to approximately 15 dB in the presence of less than 8 dB PTS and 15% OHC loss, indicates that DPOAEs can detect an underlying cochlear pathology (i,e., OHC damage/loss) despite the presence of normal to near normal thresholds. The sensitivity of DPOAEs in detecting OHC loss makes this test measure suited for diagnosing sensorineural hearing impairment, particularly when abnormal auditory symptoms (i.e., speech discrimination problems) are associated with a normal audiogram in the clinical setting and as part of a hearing conservation program.
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Comparative Study
Distortion product otoacoustic emissions in children at school entry: a comparison with pure-tone screening and tympanometry results.
This study examined the test performance of distortion product otoacoustic emissions (DPOAEs) when used as a screening tool in the school setting. A total of 1003 children (mean age 6.2 years, SD = 0.4) were tested with pure-tone screening, tympanometry, and DPOAE assessment. Optimal DPOAE test performance was determined in comparison with pure-tone screening results using clinical decision analysis. ⋯ When compared to pure tone plus tympanometry results, the DPOAEs showed deterioration in test performance, suggesting that the use of DPOAEs alone might miss children with subtle middle ear dysfunction. However, when the results of a test protocol, which incorporates both DPOAEs and tympanometry, were used in comparison with the gold standard of pure-tone screening plus tympanometry, test performance was enhanced. In view of its high performance, the use of a protocol that includes both DPOAEs and tympanometry holds promise as a useful tool in the hearing screening of schoolchildren, including difficult-to-test children.