Binaural pitch fusion: Pitch averaging and dominance in hearing-impaired listeners with broad fusion.

PubMed

Oh, Yonghee; Reiss, Lina A J

2017-08-01

Both bimodal cochlear implant and bilateral hearing aid users can exhibit broad binaural pitch fusion, the fusion of dichotically presented tones over a broad range of pitch differences between ears [Reiss, Ito, Eggleston, and Wozny. (2014). J. Assoc. Res. Otolaryngol. 15(2), 235-248; Reiss, Eggleston, Walker, and Oh. (2016). J. Assoc. Res. Otolaryngol. 17(4), 341-356; Reiss, Shayman, Walker, Bennett, Fowler, Hartling, Glickman, Lasarev, and Oh. (2017). J. Acoust. Soc. Am. 143(3), 1909-1920]. Further, the fused binaural pitch is often a weighted average of the different pitches perceived in the two ears. The current study was designed to systematically measure these pitch averaging phenomena in bilateral hearing aid users with broad fusion. The fused binaural pitch of the reference-pair tone combination was initially measured by pitch-matching to monaural comparison tones presented to the pair tone ear. The averaged results for all subjects showed two distinct trends: (1) The fused binaural pitch was dominated by the lower-pitch component when the pair tone was either 0.14 octaves below or 0.78 octaves above the reference tone; (2) pitch averaging occurred when the pair tone was between the two boundaries above, with the most equal weighting at 0.38 octaves above the reference tone. Findings from two subjects suggest that randomization or alternation of the comparison ear can eliminate this asymmetry in the pitch averaging range. Overall, these pitch averaging phenomena suggest that spectral distortions and thus binaural interference may arise during binaural stimulation in hearing-impaired listeners with broad fusion.

15 CFR 744.8 - Restrictions on exports and reexports to persons designated pursuant to Executive Order 13382...

Code of Federal Regulations, 2012 CFR

2012-01-01

... constitutes authorization for purposes of the EAR as well. (ii) U.S. persons must seek authorization from BIS... for items subject to the EAR on those same parties to further the objectives of Executive Order 13382. (a) License requirement(s) and authorization—(1) EAR license requirement. A license is required for...

15 CFR 744.8 - Restrictions on exports and reexports to persons designated pursuant to Executive Order 13382...

Code of Federal Regulations, 2013 CFR

2013-01-01

... constitutes authorization for purposes of the EAR as well. (ii) U.S. persons must seek authorization from BIS... for items subject to the EAR on those same parties to further the objectives of Executive Order 13382. (a) License requirement(s) and authorization—(1) EAR license requirement. A license is required for...

15 CFR 744.8 - Restrictions on exports and reexports to persons designated pursuant to Executive Order 13382...

Code of Federal Regulations, 2014 CFR

2014-01-01

... constitutes authorization for purposes of the EAR as well. (ii) U.S. persons must seek authorization from BIS... for items subject to the EAR on those same parties to further the objectives of Executive Order 13382. (a) License requirement(s) and authorization—(1) EAR license requirement. A license is required for...

Estimation of energy and nutritional intake of young men practicing aerobic sports.

PubMed

Wierniuk, Alicja; Włodarek, Dariusz

2013-01-01

Keeping to a balanced diet plays a key role in maximizing the body's efficiency so that sports training becomes more effective. Previous studies have shown that an athletes' diet is often not properly balanced, and can thus negatively affect sporting performance. To assess the energy and nutrient intake in young men practicing aerobic sport and compare them with those recommended. Subjects were 25 male athletes, aged 19-25 years, practicing aerobic sports who were students at two Warsaw Universities; The Military University of Technology and University of Physical Education. The average body mass was 80.6 +/- 9.6 kg and average height was 187.0 +/- 7.6 cm, (BMI thus being 23.01 +/- 1.70 kg/m2). Dietary assessment was based on three-day dietary recalls consisting of two weekdays and one day of the weekend. The energy and macro/ micro-nutrient intake were evaluated using the Polish Software 'Energia' package and compared to recommendations and standards. Supplements were absent from the athletes' diets. The energy value of diets were too low in most instances; average %-age deficiency was 30.22 +/- 13.76%. Total protein intake, (mean 1.41 +/- 0.36 g per kg body weight) was inadequate in 40% of cases, whilst all showed appropriate intakes of animal protein. Most subjects' carbohydrate intake (84%) was deficient; median 3.28 g/kg body weight. Fibre intake, (median 17.17 g) was also insufficient in 76% cases. Total fat intake, (33.9% +/- 5.7 energy) was too high in 32% of cases. The %-age dietary energy obtained from saturated fatty acids was 12.18% +/- 2.53 and 5.72% +/- 1.43 from polyunsaturated fatty acids, where most subjects' diet (64%) was, as well, high in cholesterol. Furthermore, significant deficiencies were observed in the following: Vitamin A (44% of group below EAR), vitamin C (80% below EAR), vitamin D (92% below EAR), foliate (84% below EAR), calcium (52% below EAR) and magnesium (60% below EAR). Vitamin E intake was however higher than the AI level. Almost all subjects had adequate intakes of vitamins B1, B2, B6, B12, niacin and zinc. The energy value of diet and carbohydrate intake were inadequate to the athletes' requirements. Dietary deficiencies of folate, vitamins C and D, magnesium, calcium and potassium were also observed. There is therefore a need for sports nutrition counselling and education which would help athletes improve their eating habits and health, as well as for optimising their sports training performance.

[Transitory evoked otoacoustic emissions and distortion product emissions in disorders of middle ear ventilation].

PubMed

Schmuziger, N; Hauser, R; Probst, R

1996-06-01

Both the amplitude and power spectra of otoacoustic emissions are affected by the transfer properties of the middle ear. This prospective study examined the influence of eustachian tube dysfunction on transiently evoked otoacoustic emissions (TEOAEs) and distortion-product otoacoustic emissions (DPOAEs). In all, 18 ears were studied that exhibited negative middle ear pressures with or without middle ear fluid. Measurements were performed at the time of diagnosis during the recovery stage, and after the middle ear became normally ventilated. Findings showed that TEOAE and DPOAE levels increased while airbone gaps were reduced by an average of 8 dB after negative middle ear pressures returned from -400 daPa to a normal state. There was a tendency for negative middle ear pressure to affect DPOAEs more in the 1-kHz region than in higher frequencies. By contrast, TEOAEs and airbone gaps were more uniformly affected across the entire frequency range. These results for ears with eustachian tube dysfunction were somewhat different from those results of studies obtained in healthy ears tested during experimental changes in middle ear pressure.

Weather and eared grebe winter migration near the Great Salt Lake, Utah.

PubMed

Williams, Augusta A; Laird, Neil F

2018-03-01

This study provides insight from the use of weather radar observations to understand the characteristics of the eared grebe migration near the Great Salt Lake (GSL) and provides unique information on weather conditions connected to these migration events. Doppler weather radar measurements from the Salt Lake City, Utah WSR-88D radar site (KMTX), along with meteorological surface and rawinsonde data, were used to identify and examine 281 eared grebe migration events across 15 winters from 1997/1998 through 2011/2012. An average of about 19 migration events occurred each winter with considerable interannual variability, as well as large variance in the spatial area and number of birds departing the GSL during each event. The migration events typically occurred during clear sky conditions in the presence of surface high pressure and colder than average surface temperatures. Migration events began 55 min after sunset, on average across the winter seasons, and in one case we demonstrate that an extended, nonstop flight was initiated of the departing eared grebes to northern Mexico. Eared grebes leaving the GSL largely flew above the freezing level with a mean northerly tailwind at flight altitude of 3.1 m s -1 and a westerly, cross-flight wind of 5.0 m s -1 while having an average flight speed at cruising altitude of 16.9 m s -1 , or 61 km h -1 . In addition to determining the variability of meteorological conditions during migration events across the 15 winters, atmospheric conditions during the largest migration event observed are presented and discussed.

Congenital middle ear abnormalities with absence of the oval window: diagnosis, surgery, and audiometric outcomes.

PubMed

Su, Yu; Yuan, Hu; Song, Yue-shuai; Shen, Wei-dong; Han, Wei-ju; Liu, Jun; Han, Dong-yi; Dai, Pu

2014-08-01

Congenital absence of the oval window (CAOW) is a rare condition in which the stapes footplate fails to develop, resulting in a significant conductive hearing loss in the affected ear. The purpose of this study was to describe the surgical management and outcomes of patients with CAOW undergoing the oval window drill-out (OWD) procedure. A retrospective chart review of patients with CAOW between 1996 and 2011 was performed. Clinical data of patients who underwent OWD were collected. Seventy-nine patients (103 ears) were confirmed using exploratory tympanotomy as having congenital stapes anomalies and CAOW without any anomalies of the tympanic membrane and external auditory canal. Demographic data, CT findings, operative findings, complications, and preoperative/postoperative audiometry data of patients who underwent OWD were collected. The preoperative and postoperative audiologic findings were analyzed in 42 patients (56 ears) with complete data. Hearing restoration surgery was aborted for various reasons in 14 cases. Six patients underwent revision operations for worsening hearing after their first surgery. The average preoperative 4 tone air conduction threshold was 67 dB; the average 6-month postoperative four tone air conduction threshold was 49 dB, and the average postoperative hearing gain was 18 dB. For the 56 ears, the average 4 tone air conduction threshold 6 months after surgery was significantly lower than the preoperative threshold. The oval window drill-out procedure is a viable operation for patients with congenital absence of the oval window, and it is important for surgeons to develop personalized treatment programs to improve patients' hearing with minimal complications.

Weather and eared grebe winter migration near the Great Salt Lake, Utah

NASA Astrophysics Data System (ADS)

Williams, Augusta A.; Laird, Neil F.

2018-03-01

This study provides insight from the use of weather radar observations to understand the characteristics of the eared grebe migration near the Great Salt Lake (GSL) and provides unique information on weather conditions connected to these migration events. Doppler weather radar measurements from the Salt Lake City, Utah WSR-88D radar site (KMTX), along with meteorological surface and rawinsonde data, were used to identify and examine 281 eared grebe migration events across 15 winters from 1997/1998 through 2011/2012. An average of about 19 migration events occurred each winter with considerable interannual variability, as well as large variance in the spatial area and number of birds departing the GSL during each event. The migration events typically occurred during clear sky conditions in the presence of surface high pressure and colder than average surface temperatures. Migration events began 55 min after sunset, on average across the winter seasons, and in one case we demonstrate that an extended, nonstop flight was initiated of the departing eared grebes to northern Mexico. Eared grebes leaving the GSL largely flew above the freezing level with a mean northerly tailwind at flight altitude of 3.1 m s-1 and a westerly, cross-flight wind of 5.0 m s-1 while having an average flight speed at cruising altitude of 16.9 m s-1, or 61 km h-1. In addition to determining the variability of meteorological conditions during migration events across the 15 winters, atmospheric conditions during the largest migration event observed are presented and discussed.

Identifying position, visibility, dimensions, and angulation of the ear.

PubMed

Mohamed, Kasim; Christian, Jayanth; Jeyapalan, Karthigeyan; Natarajan, Shanmuganathan; Banu, Fathima; Veeravalli, Padmanabhan T

2014-01-01

We selected 254 subjects between the ages of 18 and 30 yr to assess the ear position, angulations of the ear in relation to the nose, visibility from the frontal view, and dimensions of the ear by using various anthropometric points of the face. Subjects were divided into four groups based on facial form. A reference plane indicator, facial topographical measurements, metal ruler, and digital photography were used. While considering the position of the ear, in all facial forms except square tapering, the most samples showed a tendency for the subaurale being in line with subnasale. Regression analysis showed a tendency to gnathion distance is the most dependent variable with length of the ear kept as a constant predictor, while both interalar distance and exocanthion to endocanthion distance correlate highly significantly to the width of the ear. In all subjects, the visibility of the ear when viewed from the front was an average of 1.5 mm. Regardless of facial form, ear angulation was generally less than nose angulation.

The effect of continuous positive airway pressure on middle ear pressure.

PubMed

Lin, Fred Y; Gurgel, Richard K; Popelka, Gerald R; Capasso, Robson

2012-03-01

While continuous positive airway pressure (CPAP) is commonly used for obstructive sleep apnea treatment, its effect on middle ear pressure is unknown. The purpose of this study was to measure the effect of CPAP on middle ear pressure and describe the correlation between CPAP levels and middle ear pressures. Retrospective review of normal tympanometry values and a prospective cohort evaluation of subjects' tympanometric values while using CPAP at distinct pressure levels. A total of 3,066 tympanograms were evaluated to determine the normal range of middle ear pressures. Ten subjects with no known history of eustachian tube dysfunction or obstructive sleep apnea had standard tympanometry measurements while wearing a CPAP device. Measurements were taken at baseline and with CPAP air pressures of 0, 5, 10, and 15 cm H(2)O. The percentage of normal control patients with middle ear pressures above 40 daPa was 0.03%. In the study population, prior to a swallowing maneuver to open the eustachian tube, average middle ear pressures were 21.67 daPa, 22.63 daPa, 20.42, daPa, and 21.58 daPa with CPAP pressures of 0, 5, 10, and 15 cm H(2) 0, respectively. After swallowing, average middle ear air pressures were 18.83 daPa, 46.75 daPa, 82.17 daPa, and 129.17 daPa with CPAP pressures of 0, 5, 10, and 15 cm H(2)0, respectively. The postswallow Pearson correlation coefficient correlating CPAP and middle ear pressures was 0.783 (P < 0.001). Middle ear air pressure is directly proportional to CPAP air pressure in subjects with normal eustachian tube function. Middle ear pressure reaches supraphysiologic levels at even minimal CPAP levels. Although further investigation is necessary, there may be otologic implications for patients who are chronically CPAP dependent. These findings may also influence the perioperative practice of otologic and skull base surgeons. Copyright © 2011 The American Laryngological, Rhinological, and Otological Society, Inc.

Acceleration induced water removal from ear canals.

NASA Astrophysics Data System (ADS)

Kang, Hosung; Averett, Katelee; Jung, Sunghwan

2017-11-01

Children and adults commonly experience having water trapped in the ear canals after swimming. To remove the water, individuals will shake their head sideways. Since a child's ear canal has a smaller diameter, it requires more acceleration of the head to remove the trapped water. In this study, we theoretically and experimentally investigated the acceleration required to break the surface meniscus of the water in artificial ear canals and hydrophobic-coated glass tubes. In experiments, ear canal models were 3D-printed from a CT-scanned human head. Also, glass tubes were coated with silane to match the hydrophobicity in ear canals. Then, using a linear stage, we measured the acceleration values required to forcefully eject the water from the artificial ear canals and glass tubes. A theoretical model was developed to predict the critical acceleration at a given tube diameter and water volume by using a modified Rayleigh-Taylor instability. Furthermore, this research can shed light on the potential of long-term brain injury and damage by shaking the head to push the water out of the ear canal. This research was supported by National Science Foundation Grant CBET-1604424.

Test-Retest Reliability and Minimal Detectable Change of Randomized Dichotic Digits in Learning-Disabled Children: Implications for Dichotic Listening Training.

PubMed

Mahdavi, Mohammad Ebrahim; Pourbakht, Akram; Parand, Akram; Jalaie, Shohreh

2018-03-01

Evaluation of dichotic listening to digits is a common part of many studies for diagnosis and managing auditory processing disorders in children. Previous researchers have verified test-retest relative reliability of dichotic digits results in normal children and adults. However, detecting intervention-related changes in the ear scores after dichotic listening training requires information regarding trial-to-trial typical variation of individual ear scores that is estimated using indices of absolute reliability. Previous studies have not addressed absolute reliability of dichotic listening results. To compare the results of the Persian randomized dichotic digits test (PRDDT) and its relative and absolute indices of reliability between typical achieving (TA) and learning-disabled (LD) children. A repeated measures observational study. Fifteen LD children were recruited from a previously performed study with age range of 7-12 yr. The control group consisted of 15 TA schoolchildren with age range of 8-11 yr. The Persian randomized dichotic digits test was administered on the children under free recall condition in two test sessions 7-12 days apart. We compared the average of the ear scores and ear advantage between TA and LD children. Relative indices of reliability included Pearson's correlation and intraclass correlation (ICC 2,1 ) coefficients and absolute reliability was evaluated by calculation of standard error of measurement (SEM) and minimal detectable change (MDC) using the raw ear scores. The Pearson correlation coefficient indicated that in both groups of children the ear scores of test and retest sessions were strongly and positively (greater than +0.8) correlated. The ear scores showed excellent ICC coefficient of consistency (0.78-0.82) and fair to excellent ICC coefficient of absolute agreement (0.62-0.74) in TA children and excellent ICC coefficients of consistency and absolute agreement in LD children (0.76-0.87). SEM and SEM% of the ear scores in TA children were 1.46 and 1.44% for the right ear and 4.68 and 5.47% for the left ear. SEM and SEM% of the ear scores in LD children were 4.55 and 5.88% for the right ear to 7.56 and 12.81% for the left ear. MDC and MDC% of the ear scores in TA children varied from 4.03 and 3.99% for the right ear to 12.93 and 15.13% for the left ear. MDC and MDC% of the ear scores in LD children varied from 12.57 and 16.25% for the right ear to 20.89 and 35.39% for the left ear. The LD children indicated test-retest relative reliability as high as TA children in the ear scores measured by PRDDT. However, within-subject variations of the ear scores calculated by indices of absolute reliability were considerably higher in LD children versus TA children. The results of the current study could have implications for detecting real training-related changes in the ear scores. American Academy of Audiology

15 CFR 764.2 - Violations.

Code of Federal Regulations, 2013 CFR

2013-01-01

... prohibited by or contrary to, or refrain from engaging in any conduct required by, the EAA, the EAR, or any... prohibited, or the omission of any act required, by the EAA, the EAR, or any order, license or authorization..., the EAR, or any order, license or authorization issued thereunder. (d) Conspiracy. No person may...

15 CFR 764.2 - Violations.

Code of Federal Regulations, 2014 CFR

2014-01-01

... prohibited by or contrary to, or refrain from engaging in any conduct required by, the EAA, the EAR, or any... prohibited, or the omission of any act required, by the EAA, the EAR, or any order, license or authorization..., the EAR, or any order, license or authorization issued thereunder. (d) Conspiracy. No person may...

15 CFR 764.2 - Violations.

Code of Federal Regulations, 2011 CFR

2011-01-01

... prohibited by or contrary to, or refrain from engaging in any conduct required by, the EAA, the EAR, or any... prohibited, or the omission of any act required, by the EAA, the EAR, or any order, license or authorization..., the EAR, or any order, license or authorization issued thereunder. (d) Conspiracy. No person may...

15 CFR 764.2 - Violations.

Code of Federal Regulations, 2010 CFR

2010-01-01

... prohibited by or contrary to, or refrain from engaging in any conduct required by, the EAA, the EAR, or any... prohibited, or the omission of any act required, by the EAA, the EAR, or any order, license or authorization..., the EAR, or any order, license or authorization issued thereunder. (d) Conspiracy. No person may...

15 CFR 764.2 - Violations.

Code of Federal Regulations, 2012 CFR

2012-01-01

... prohibited by or contrary to, or refrain from engaging in any conduct required by, the EAA, the EAR, or any... prohibited, or the omission of any act required, by the EAA, the EAR, or any order, license or authorization..., the EAR, or any order, license or authorization issued thereunder. (d) Conspiracy. No person may...

The effects of earphones and music on the temperature measured by infrared tympanic thermmeter: preliminary results.

PubMed

Palese, Alvisa; Pasqualini, Davide

2014-01-01

The main aim of the study was to evaluate the effect on subjects' temperature measurement readings when using the infrared tympanic thermometer after correct earphone placement and use, with or without music transmission through the earphone. A comparative study design was adopted. A sample of 39 healthy people was randomly divided into three groups. Subjects in all groups used an earphone that had been correctly placed in the right ear only: Group 1: listened to heavy metal music through the earphone (13 participants); Group 2: listened to classical music through the earphone (13 participants); Group 3: no music or sound was transmitted through the earphone (13 participants). Average differences (CI 95%) and Pearson correlations for the temperature measured in the right ear, which was exposed to the different independent variables, and the left ear which was not exposed, were calculated at different times: (1) after 10 minutes compared to the baseline measurement; (2) after 30 minutes compared to the 10 minutes measurement; and (3) after 30 minutes compared to the baseline measurement. The inter-ear temperature correlation at the baseline was Pearson r .801 (p = .01). There was a significant decrease in the correlations between right and left ear temperatures in Group 1 and in Group 3 which was demonstrated after 10 minutes of earphone use, and reached critical values after 30 minutes of use in all groups. The average warmth in the right ear, as perceived by participants after 20 minutes, was reported. Using the Numerical Rating Score the average was 3.3 +/- 1.3 for Group 1, for Group 2 was 1.9 +/- 1.3 and for Group 3 was 3.3 +/- 1.2 (p = .05). Within the limitations of the study, which involved a limited number of healthy people the results show that it is best to not measure tympanic temperature in an ear that has very recently had an earphone in place.

Wheat Ear Detection in Plots by Segmenting Mobile Laser Scanner Data

NASA Astrophysics Data System (ADS)

Velumani, K.; Oude Elberink, S.; Yang, M. Y.; Baret, F.

2017-09-01

The use of Light Detection and Ranging (LiDAR) to study agricultural crop traits is becoming popular. Wheat plant traits such as crop height, biomass fractions and plant population are of interest to agronomists and biologists for the assessment of a genotype's performance in the environment. Among these performance indicators, plant population in the field is still widely estimated through manual counting which is a tedious and labour intensive task. The goal of this study is to explore the suitability of LiDAR observations to automate the counting process by the individual detection of wheat ears in the agricultural field. However, this is a challenging task owing to the random cropping pattern and noisy returns present in the point cloud. The goal is achieved by first segmenting the 3D point cloud followed by the classification of segments into ears and non-ears. In this study, two segmentation techniques: a) voxel-based segmentation and b) mean shift segmentation were adapted to suit the segmentation of plant point clouds. An ear classification strategy was developed to distinguish the ear segments from leaves and stems. Finally, the ears extracted by the automatic methods were compared with reference ear segments prepared by manual segmentation. Both the methods had an average detection rate of 85 %, aggregated over different flowering stages. The voxel-based approach performed well for late flowering stages (wheat crops aged 210 days or more) with a mean percentage accuracy of 94 % and takes less than 20 seconds to process 50,000 points with an average point density of 16  points/cm2. Meanwhile, the mean shift approach showed comparatively better counting accuracy of 95% for early flowering stage (crops aged below 225 days) and takes approximately 4 minutes to process 50,000 points.

Long-term results of hearing preservation cochlear implant surgery in patients with residual low frequency hearing.

PubMed

Moteki, Hideaki; Nishio, Shin-Ya; Miyagawa, Maiko; Tsukada, Keita; Iwasaki, Satoshi; Usami, Shin-Ichi

2017-05-01

Differences were found between patients with stable hearing and those with progressive hearing loss in the lower frequencies with respect to the rate of progression in the contralateral ear. It is suggested that the electric acoustic stimulation (EAS) can provide improvement in hearing ability over the long-term if residual hearing might be lost to some extent. To evaluate the long-term threshold changes in the low frequency hearing of the implanted ear as compared with the non-implanted ear, and the hearing abilities with EAS along with the extent of residual hearing. Seventeen individuals were enrolled and received the EAS implant with a 24-mm FLEXeas electrode array. Hearing thresholds and speech perception were measured pre- and post-operatively for 1-5 years. Post-operative hearing preservation (HP) rates were calculated using the preservation numerical scale. The average linear regression coefficient for the decline in hearing preservation score was -6.9 for the implanted ear and the patients were subsequently categorized into two groups: those with better than average, stable hearing; and those with worse than average, progressive hearing loss. EAS showed better results than electric stimulation alone, in spite of an absence of speech perception with acoustic stimulation.

Suboptimal Vitamin B Intakes of Zambian Preschool Children: Evaluation of 24-Hour Dietary Recalls.

PubMed

Titcomb, Tyler J; Schmaelzle, Samantha T; Nuss, Emily T; Gregory, Jesse F; Tanumihardjo, Sherry A

2018-06-01

Hidden hunger affects individuals who chronically consume an inadequate intake of at least 1 micronutrient and is associated with low dietary diversity. Little data are available on dietary intake or status assessment of B vitamins among preschool children in Zambia. The aim of this study was to assess 24-hour dietary recall records obtained from Zambian children aged 3 to 7 years for B vitamin intake in relation to adequacy and change over time in the same community. Twenty-four-hour dietary recalls were collected from 2 studies that were 2 years apart in the same district of Zambia. Data were retrospectively analyzed for B vitamin intake, that is, biotin, vitamin B 12 , folate, niacin, pantothenic acid, vitamin B 6 , riboflavin, and thiamin. The estimated average requirement (EAR) cut point method was used to assess inadequacy prevalence for EARs established by the Institute of Medicine in the United States. For all B vitamins, mean values were below the EARs established for children 4 to 8 years old. Relative to the EAR, children had the highest intakes of vitamin B 6 with inadequacies of 77.9% and 60.1% in 2010 and 2012, respectively. The highest prevalence of inadequate intake was associated with folate, where ≥95% of the children had intakes below the EAR in both studies. All median vitamin B intakes were inadequate among these young children in rural Zambia. Future researchers and policy makers may need to consider B vitamin status in resource-poor areas of the country.

Correction of Congenital Auricular Deformities Using the Ear-Molding Technique.

PubMed

Woo, Taeyong; Kim, Young Seok; Roh, Tai Suk; Lew, Dae Hyun; Yun, In Sik

2016-11-01

Studies of the ear-molding technique have emphasized the importance of initiating molding early to achieve the best results. In the present study, we describe the immediate effects and long-term outcomes of this technique, focusing on children who were older than the ideal age of treatment initiation. Patients who visited our institution from July 2014 to November 2015 were included. Medical charts were reviewed to collect data on demographics, the duration of treatment, the types of deformities, and the manner of recognition of the deformity and referral to our institution. Parents were surveyed to assess the degree of improvement, the level of procedural discomfort at the end of treatment, any changes in the shape of the molded auricle, and overall satisfaction 12 months after their last follow-up visits. A review of 28 ears in 18 patients was conducted, including the following types of deformities: constricted ear (64.2%), Stahl ear (21.4%), prominent ear (7.1%), and cryptotia (7.1%). The average score for the degree of improvement, rated on a 5-point scale (1, very poor; 5, excellent), was 3.5 at the end of treatment, with a score of 2.6 for procedural discomfort (1, very mild; 5, very severe). After 12 months, the shapes of all ears were well maintained. The average overall satisfaction score was 3.6 (1, very dissatisfied; 5, very satisfied). We had reasonable outcomes in older patients. After 1 year of follow-up, these outcomes were well maintained. Patients past the ideal age at presentation can still be candidates for the molding technique.

The effects of ear acupressure, massage therapy and no therapy on symptoms of dementia: a randomized controlled trial.

PubMed

Rodríguez-Mansilla, Juan; González López-Arza, María Victoria; Varela-Donoso, Enrique; Montanero-Fernández, Jesús; González Sánchez, Blanca; Garrido-Ardila, Elisa María

2015-07-01

To assess the effectiveness of ear acupressure and massage vs. control in the improvement of pain, anxiety and depression in persons diagnosed with dementia. A pilot randomized controlled trial. Residential homes in Extremadura (Spain). A total of 120 elders with dementia institutionalized in residential homes. The participants were randomly allocated, in three groups. Control group - they continued with their routine activities; ear acupressure intervention group - they received ear acupressure treatment (pressure was applied to acupressure points on the ear); and massage therapy intervention group - they received relaxing massage therapy. The variables pain, anxiety and depression were assessed with the Doloplus2, Cornell and Campbell scales. The study was carried out during five months; three months of experimental treatment and two months with no treatment. The assessments were done at baseline, each month during the treatment and at one and two months of follow-up. In the statistical analysis the three groups were compared with each other. A total of 111 participants completed the study. Their aged ranged from 67 to 91 years old and 86 of them (77.4%) were women. The ear acupressure intervention group showed better improvements than the massage therapy intervention group in relation to pain and depression during the treatment period and at one month of follow-up. The best improvement in pain was achieved in the last (3rd) month of ear acupressure treatment (p  < 0.001) being the average improvement 8.55 (4.39) with IC 95% (7.14, 9.95). Regarding anxiety, the best results were also observed in the last month of treatment. The average improvement in anxiety was 9.63 (5.00) with IC 95% (8.02, 11.23) CONCLUSIONS: Ear acupressure and massage therapy showed better results than the control group in relation to pain, anxiety and depression. However, ear acupressure achieved more improvements. © The Author(s) 2014.

Semiautomated Middle Ear Volume Measurement as a Predictor of Postsurgical Outcomes for Congenital Aural Atresia.

PubMed

Kabadi, S J; Ruhl, D S; Mukherjee, S; Kesser, B W

2018-02-01

Middle ear space is one of the most important components of the Jahrsdoerfer grading system (J-score), which is used to determine surgical candidacy for congenital aural atresia. The purpose of this study was to introduce a semiautomated method for measuring middle ear volume and determine whether middle ear volume, either alone or in combination with the J-score, can be used to predict early postoperative audiometric outcomes. A retrospective analysis was conducted of 18 patients who underwent an operation for unilateral congenital aural atresia at our institution. Using the Livewire Segmentation tool in the Carestream Vue PACS, we segmented middle ear volumes using a semiautomated method for all atretic and contralateral normal ears on preoperative high-resolution CT imaging. Postsurgical audiometric outcome data were then analyzed in the context of these middle ear volumes. Atretic middle ear volumes were significantly smaller than those in contralateral normal ears ( P < .001). Patients with atretic middle ear volumes of >305 mm 3 had significantly better postoperative pure tone average and speech reception thresholds than those with atretic ears below this threshold volume ( P = .01 and P = .006, respectively). Atretic middle ear volume incorporated into the J-score offered the best association with normal postoperative hearing (speech reception threshold ≤ 30 dB; OR = 37.8, P = .01). Middle ear volume, calculated in a semiautomated fashion, is predictive of postsurgical audiometric outcomes, both independently and in combination with the conventional J-score. © 2018 by American Journal of Neuroradiology.

Characteristics of the swallowing sounds recorded in the ear, nose and on trachea.

PubMed

Sarraf-Shirazi, Samaneh; Baril, Jonathan-F; Moussavi, Zahra

2012-08-01

The various malfunctions and difficulties of the swallowing mechanism necessitate various diagnostic techniques to address those problems. Swallowing sounds recorded from the trachea have been suggested as a noninvasive method of swallowing assessment. However, acquiring signals from the trachea can be difficult for those with loose skin. The objective of this pilot study was to explore the viability of using the ear and nose as alternative recording locations for recording swallowing sounds. We recorded the swallowing and breathing sounds of five healthy young individuals from the ear, nose and trachea, simultaneously. We computed time-frequency features and compared them for the different locations of recording. The features included the peak and the maximum frequencies of the power spectrum density, average power at different frequency bands and the wavelet coefficients. The average power calculated over the 4 octave bands between 150 and 2,400 Hz showed a consistent trend with less than 20 dB difference for the breath sounds of all the recording locations. Thus, analyzing breath sounds recorded from the ear and nose for the purpose of aspiration detection would give similar results to those from tracheal recordings; thus, ear and nose recording may be a viable alternative when tracheal recording is not possible.

15 CFR 740.1 - Introduction.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Introduction. In this part, references to the EAR are references to 15 CFR chapter VII, subchapter C. (a) Scope... reexport under stated conditions, items subject to the Export Administration Regulations (EAR) that would... Supplement No. 1 to part 774 of the EAR and items subject to the EAR that would require a license based on...

15 CFR 740.1 - Introduction.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Introduction. In this part, references to the EAR are references to 15 CFR chapter VII, subchapter C. (a) Scope... reexport under stated conditions, items subject to the Export Administration Regulations (EAR) that would... Supplement No. 1 to part 774 of the EAR and items subject to the EAR that would require a license based on...

15 CFR 740.1 - Introduction.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Introduction. In this part, references to the EAR are references to 15 CFR chapter VII, subchapter C. (a) Scope... reexport under stated conditions, items subject to the Export Administration Regulations (EAR) that would... supplement No. 1 to part 774 of the EAR and items subject to the EAR that would require a license based on...

15 CFR 740.1 - Introduction.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Introduction. In this part, references to the EAR are references to 15 CFR chapter VII, subchapter C. (a) Scope... reexport under stated conditions, items subject to the Export Administration Regulations (EAR) that would... Supplement No. 1 to part 774 of the EAR and items subject to the EAR that would require a license based on...

Barotrauma vis-a-vis the "chronic otitis media syndrome": two conditions with middle ear gas deficiency Is secretory otitis media a contraindication to air travel?

PubMed

Sadé, Jacob; Ar, Amos; Fuchs, Camil

2003-03-01

We compared 17 patients (29 ears) with barotrauma with 171 patients suffering from "chronic ears" (secretory otitis media, atelectasis, or previously operated cholesteatoma). The patients with "chronic ears" were followed up prospectively, and none were found to suffer from barotrauma after flying on a commercial airplane. The mastoid pneumatization (seen on lateral mastoid radiographs) was significantly larger in ears with barotrauma, averaging 16.85 cm2, versus 12.9 cm2 in normal controls, whereas in "chronic ears" it was only 3.6 cm2. During flight on a commercial airplane, the middle ear has to equalize about 20% of its gas volume with the ambient pressure. This equalization must happen within 15 to 20 minutes of ascent and descent in order to avoid barotrauma. This 20% is a fivefold greater task for ears with a large mastoid pneumatization than for ears with an undeveloped pneumatization; "chronic ears" usually have an undeveloped mastoid pneumatization. The smaller the middle ear (mastoid) volume, the smaller the volume of gas needed to pass through the eustachian tube in order to equalize pressure changes during flying. This factor may explain why "chronic ears" rarely suffer from barotrauma. It also implies that eustachian tubes of secretory otitis, atelectatic, and cholesteatomatous ears have little problem in equalizing large pressure differences (over 2,000 mm H2O) within 15 to 20 minutes of landing, in contrast to what has been traditionally believed. Individuals with "chronic ears" can be advised that they can fly safely.

Inverse solution of ear-canal area function from reflectance

PubMed Central

Rasetshwane, Daniel M.; Neely, Stephen T.

2011-01-01

A number of acoustical applications require the transformation of acoustical quantities, such as impedance and pressure that are measured at the entrance of the ear canal, to quantities at the eardrum. This transformation often requires knowledge of the shape of the ear canal. Previous attempts to measure ear-canal area functions were either invasive, non-reproducible, or could only measure the area function up to a point mid-way along the canal. A method to determine the area function of the ear canal from measurements of acoustic impedance at the entrance of the ear canal is described. The method is based on a solution to the inverse problem in which measurements of impedance are used to calculate reflectance, which is then used to determine the area function of the canal. The mean ear-canal area function determined using this method is similar to mean ear-canal area functions measured by other researchers using different techniques. The advantage of the proposed method over previous methods is that it is non- invasive, fast, and reproducible. PMID:22225043

Lysine Requirements of Healthy Pregnant Women are Higher During Late Stages of Gestation Compared to Early Gestation.

PubMed

Payne, Magdalene; Stephens, Trina; Lim, Kenneth; Ball, Ronald O; Pencharz, Paul B; Elango, Rajavel

2018-01-01

Lysine is the first limiting amino acid in cereal proteins and is found mainly in animal-derived products. Current Dietary Reference Intake (DRI) recommendations extrapolate lysine requirements during pregnancy from nonpregnant adult data, and may underestimate true requirements. Our objective is to define a quantitative lysine requirement in healthy pregnant women and to determine whether requirements vary between 2 phases of gestation. Fourteen pregnant women in early (12-19 wk) and 19 women in late (33-39 wk) gestation were studied using the indicator amino acid oxidation technique. Individual lysine intakes (6-84 mg · kg-1 · d-1, deficient to excess) were tested on each study day as a crystalline amino acid mixture based on egg protein composition. Isonitrogenous diets maintained protein intake at 1.5 g · kg-1 · d-1 and calorie intake at 1.7 times resting energy expenditure during each study day. Phenylalanine and tyrosine intakes were held constant across all lysine intakes. Breath and urine samples were collected at baseline and isotopic steady state. Lysine requirements were determined by measuring the oxidation of L-[1-13C]-phenylalanine to 13CO2 (F13CO2). Biphase linear regression crossover analysis was used to determine a breakpoint (which represents the estimated average requirement, EAR) in F13CO2. The EAR for lysine during early gestation was determined to be 36.6 mg · kg-1 · d-1 (R2 = 0.484, upper 95% CI = 46.2 mg · kg-1 · d-1), similar to an earlier adult requirement of 36 mg · kg-1 · d-1. The EAR for lysine during late gestation was determined to be 50.3 mg · kg-1 · d-1 (R2 = 0.664, upper 95% CI = 60.4 mg · kg-1 · d-1), 23% higher than the current pregnancy DRI EAR recommendation of 41 mg · kg-1 · d-1. Our results suggest that lysine requirements are higher during late gestation compared to early gestation, and that current dietary lysine recommendations during late stages of pregnancy may be underestimated. The results have implications for populations consuming cereal-based diets as their primary source of protein. This trial was registered at clinicaltrials.gov as NCT01776931. © 2018 American Society for Nutrition. All rights reserved.

40 CFR 211.210-2 - Labeling requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... constant); (ii) Ear cup volume or shape; (iii) Mounting of ear cup on head band; (iv) Ear cushion; (v... tension (spring constant); (ii) Mounting of plug on head band; (iii) Shape of plug; (iv) Material...

Minimally invasive functional approach for cholesteatoma surgery.

PubMed

Hanna, Bassem M; Kivekäs, Ilkka; Wu, Yi-Hsuan; Guo, Lee J; Lin, Huang; Guidi, Jessica; Poe, Dennis

2014-10-01

Report the efficacy of a functional minimally invasive approach for cholesteatoma surgery. Retrospective review of surgical cases performed between 1996 and 2008. One hundred sixty-nine patient charts were reviewed in which ears with primary cholesteatomas that extended beyond the mesotympanum were operated on with a plan for canal wall up (CWU) mastoidectomy. The surgical approach consisted of progressive exposure from transcanal to postauricular tympanoplasty to CWU mastoidectomy, as needed, to identify and lyse the fibrous attachments that bind the capsule to the surrounding mucosa. Endoscopic guidance was employed as appropriate to minimize exposure needs. Any planned second-stage operations were attempted with a transcanal approach if appropriate and with endoscopic assistance. One hundred eighty-four ears of 169 patients were included. The median age was 32 years (range, 1-79 years). The mean follow-up was 3.2 years (range, 1-11 years). Eighty-three (45%) were planned for a second-look operation, and three (2%) required unplanned second operations. The overall recurrence rate was 24/184 (13%), and the unexpected residual rate was 5/184 (3%). The residual rate with endoscopy (5/119, 4%,) or without endoscopy (1/65, 2%), were not significantly different. Hearing results in 156 ears improved significantly, from a preoperative pure-tone average (PTA) of 41 dB to a postoperative PTA average of 29 dB (P < .0001). A functional minimally invasive approach to cholesteatoma surgery provided equivalent residual rates but higher recurrence rates compared to published canal wall down mastoidectomy. Endoscopic techniques were helpful in providing adequate views while minimizing exposure. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

Intratympanic Iodine Contrast Injection Diffuses Across the Round Window Membrane Allowing for Perilymphatic CT Volume Acquisition Imaging.

PubMed

Abt, Nicholas B; Lehar, Mohamed; Guajardo, Carolina Trevino; Penninger, Richard T; Ward, Bryan K; Pearl, Monica S; Carey, John P

2016-04-01

Whether the round window membrane (RWM) is permeable to iodine-based contrast agents (IBCA) is unknown; therefore, our goal was to determine if IBCAs could diffuse through the RWM using CT volume acquisition imaging. Imaging of hydrops in the living human ear has attracted recent interest. Intratympanic (IT) injection has shown gadolinium's ability to diffuse through the RWM, enhancing the perilymphatic space. Four unfixed human cadaver temporal bones underwent intratympanic IBCA injection using three sequentially studied methods. The first method was direct IT injection. The second method used direct RWM visualization via tympanomeatal flap for IBCA-soaked absorbable gelatin pledget placement. In the third method, the middle ear was filled with contrast after flap elevation. Volume acquisition CT images were obtained immediately postexposure, and at 1-, 6-, and 24-hour intervals. Postprocessing was accomplished using color ramping and subtraction imaging. After the third method, positive RWM and perilymphatic enhancement were observed with endolymph sparing. Gray scale and color ramp multiplanar reconstructions displayed increased signal within the cochlea compared with precontrast imaging. The cochlea was measured for attenuation differences compared with pure water, revealing a preinjection average of -1,103 HU and a postinjection average of 338 HU. Subtraction imaging shows enhancement remaining within the cochlear space, Eustachian tube, middle ear epithelial lining, and mastoid. Iohexol iodine contrast is able to diffuse across the RWM. Volume acquisition CT imaging was able to detect perilymphatic enhancement at 0.5-mm slice thickness. The clinical application of IBCA IT injection seems promising but requires further safety studies.

The effect of high flow nasal cannula oxygen therapy on middle ear pressure.

PubMed

Piastro, Kristina; Chaskes, Mark; Agarwal, Jay; Parnes, Steven

2016-01-01

To investigate the effect of high flow nasal cannula oxygen therapy (HFOT) on middle ear pressure. Ten patients (eight males and two females) with oxygen desaturations requiring HFOT were recruited with 19 ears available for our study. The study group was aged 29-90years (mean 65.3±16.5). All patients underwent a review of medical history, questioned about subjective hearing loss and underwent a standard otologic exam, with middle ear pressures measured with a GSI TympStar tympanometer. The middle ear peak pressures in our study group ranged from 25 to -200daPa (mean -13.7±56.3daPa). Volume of HFOT was delivered at 20-40L (mean 30.5±9L) and fraction of inspired oxygen required was 30-70% (mean 58±13%). There was a positive correlation between liters of oxygen delivery and middle ear pressure with a Pearson coefficient (R) of 0.436, although lacking statistical significance (p=0.06). Previous studies have shown that HFOT delivered in the range of 35-40L/min produces pharyngeal pressures at or above 5cm H2O. Since pharyngeal pressures of 5cm H2O produced via CPAP have shown to produce middle ear pressures above 40daPa, we expected HFOT to result in similar middle ear pressures of 35-40L/min. However, although our results show an increase in middle ear pressures with flow volume, HFOT did not produce significant increases in middle ear pressures. This may make HFOT an appropriate option of oxygen delivery to patients who require otologic procedures. Copyright © 2016 Elsevier Inc. All rights reserved.

The effects of listening environment and earphone style on preferred listening levels of normal hearing adults using an MP3 player.

PubMed

Hodgetts, William E; Rieger, Jana M; Szarko, Ryan A

2007-06-01

The main objective of this study was to determine the influence of listening environment and earphone style on the preferred-listening levels (PLLs) measured in users' ear canals with a commercially-available MP3 player. It was hypothesized that listeners would prefer higher levels with earbud headphones as opposed to over-the-ear headphones, and that the effects would depend on the environment in which the user was listening. A secondary objective was to use the measured PLLs to determine the permissible listening duration to reach 100% daily noise dose. There were two independent variables in this study. The first, headphone style, had three levels: earbud, over-the-ear, and over-the-ear with noise reduction (the same headphones with a noise reduction circuit). The second, environment, also had 3 levels: quiet, street noise and multi-talker babble. The dependent variable was ear canal A-weighted sound pressure level. A 3 x 3 within-subjects repeated-measures ANOVA was used to analyze the data. Thirty-eight normal hearing adults were recruited from the Faculty of Rehabilitation Medicine at the University of Alberta. Each subject listened to the same song and adjusted the level until it "sounded best" to them in each of the 9 conditions. Significant main effects were found for both the headphone style and environment factors. On average, listeners had higher preferred listening levels with the earbud headphones, than with the over-the-ear headphones. When the noise reduction circuit was used with the over-the-ear headphones, the average PLL was even lower. On average, listeners had higher PLLs in street noise than in multi-talker babble and both of these were higher than the PLL for the quiet condition. The interaction between headphone style and environment was also significant. Details of individual contrasts are explored. Overall, PLLs were quite conservative, which would theoretically allow for extended permissible listening durations. Finally, we investigated the maximum output level of the MP3 player in the ear canals of authors 1 and 3 of this paper. Levels were highest with the earbud style, followed by the over-the-ear with noise reduction. The over-the-ear headphone without noise reduction had the lowest maximum output. The majority of MP3 players are sold with the earbud style of headphones. Preferred listening levels are higher with this style of headphone compared to the over-the-ear style. Moreover, as the noise level in the environment increases, earbud users are even more susceptible to background noise and consequently increase the level of the music to overcome this. The result is an increased sound pressure level at the eardrum. However, the levels chosen by our subjects suggest that MP3 listening levels may not be as significant a concern as has been reported recently in the mainstream media.

Trends in calcium supplementation, National Health and Nutrition Examination Survey (NHANES) 1999-2014.

PubMed

Rooney, Mary R; Michos, Erin D; Hootman, Katie C; Harnack, Lisa; Lutsey, Pamela L

2018-06-01

Long-term outcomes of supplemental calcium are inadequately understood. Recent research suggests that calcium from supplements may not be entirely free from unintended health consequences. Consequently, it is important to understand patterns and trends in use of calcium supplements. To report trends in supplemental calcium intake between 1999 and 2014, using NHANES data, overall and stratified by sex, race/ethnicity and age. A total of 42,038 adult NHANES participants were included in this analysis. For each survey period, we calculated the prevalence of calcium supplement use exceeding the Estimated Average Requirement (EAR) and Tolerable Upper Intake Levels (UL), and mean daily supplemental calcium dose among calcium-containing supplement users. Sample weights were applied. Linear regression was used to examine trends. Overall, the prevalence of calcium supplement use at a dose ≥EAR increased between 1999 and 2000 and 2013-2014, from 2.5% (95% CI: 1.9-3.3%) to 4.6% (3.8-5.5%). Use ≥EAR peaked in 2003-2004 at 6.7% (5.3-8.5%) (p-quadratic trend<0.001). Mean supplemental calcium intake peaked in 2007-2008, thereafter decreasing (p-quadratic trend<0.001). The overall prevalence of intake ≥UL from supplemental calcium in 2013-2014 was 0.4% (0.2-0.8%). Use of supplemental calcium ≥UL peaked during 2007-2008 at 1.2% (0.7-2.0%). In all time periods, supplemental calcium intake tended to be greater among women, non-Hispanic whites and adults >60years. We described the prevalence of U.S. adults consuming supplemental calcium ≥UL and ≥ EAR. While few were consuming supplemental calcium ≥UL, consumption ≥EAR was not uncommon, especially among women, non-Hispanic whites and older adults. Copyright © 2018 Elsevier Inc. All rights reserved.

Quality of Life and Hearing Eight Years After Sudden Sensorineural Hearing Loss.

PubMed

Härkönen, Kati; Kivekäs, Ilkka; Rautiainen, Markus; Kotti, Voitto; Vasama, Juha-Pekka

2017-04-01

To explore long-term hearing results, quality of life (QoL), quality of hearing (QoH), work-related stress, tinnitus, and balance problems after idiopathic sudden sensorineural hearing loss (ISSNHL). Cross-sectional study. We reviewed the audiograms of 680 patients with unilateral ISSNHL on average 8 years after the hearing impairment, and then divided the patients into two study groups based on whether their ISSNHL had recovered to normal (pure tone average [PTA] ≤ 30 dB) or not (PTA > 30 dB). The inclusion criteria were a hearing threshold decrease of 30 dB or more in at least three contiguous frequencies occurring within 72 hours in the affected ear and normal hearing in the contralateral ear. Audiograms of 217 patients fulfilled the criteria. We reviewed their medical records; measured present QoL, QoH, and work-related stress with specific questionnaires; and updated the hearing status. Poor hearing outcome after ISSNHL was correlated with age, severity of hearing loss, and vertigo together with ISSNHL. Quality of life and QoH were statistically significantly better in patients with recovered hearing, and the patients had statistically significantly less tinnitus and balance problems. During the 8-year follow-up, the PTA of the affected ear deteriorated on average 7 dB, and healthy ear deteriorated 6 dB. Idiopathic sudden sensorineural hearing loss that failed to recover had a negative impact on long-term QoL and QoH. The hearing deteriorated as a function of age similarly both in the affected and the healthy ear, and there were no differences between the groups. The cumulative recurrence rate for ISSNHL was 3.5%. 4 Laryngoscope, 127:927-931, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

Natural history of hearing loss in children with enlarged vestibular aqueduct syndrome.

PubMed

Mori, Tyler; Westerberg, Brian D; Atashband, Shahnaz; Kozak, Frederick K

2008-02-01

To determine the natural history of hearing loss in children with enlarged vestibular aqueduct (EVA) syndrome. (1) Retrospective cohort study and (2) systematic literature review. Tertiary pediatric centre. (1) Charts of children assessed by one physician between 1993 and 2000 were reviewed. (2) Source articles were identified by a search of Medline, Embase, and the Cochrane Library of the English-language literature through January 2006, with manual review of references. The search was limited to English, human, and age less than 18 years. Pure-tone average. Hearing was classified as stable, progressive and fluctuating. (1) Twenty-one children (39 ears) with EVA were identified. Eighty-two percent of ears had stable hearing, and 18% of ears demonstrated progressive hearing loss. (2) Seven source articles were identified and combined with the present data for a total of 310 ears with a mean follow-up of 4 years. Bilateral EVA was found to be six times more common than unilateral EVA, and there was an equal male to female ratio. Stable hearing was found in 67% of ears and progressive hearing loss in 33% of ears. Subgroup analysis demonstrated hearing fluctuations in 50% of progressive hearing loss ears and 34% of stable ears. Stable hearing is observed in 67% of ears with EVA of which 34% will demonstrate fluctuations in hearing. Progression of hearing loss is seen in 33% of ears of which half will demonstrate fluctuations.

Relationships among Socioeconomic Status, Dietary Intake, and Stress in Breastfeeding Women.

PubMed

Aubuchon-Endsley, Nicki L; Kennedy, Tay S; Gilchrist, Megan; Thomas, David G; Grant, Stephanie

2015-06-01

As breastfeeding duration increases, it is important to understand diets of breastfeeding women and other factors salient to maternal/offspring health, including stress. It is important to further consider sociodemographic factors, given their associations with nutritional deficiencies and perceived stress. We cross-sectionally compared breastfeeding women's dietary intakes from a food frequency questionnaire (assessing from pregnancy through 3 months postpartum) with Estimated Average Requirements (EARs). We hypothesized that dietary intake was related to sociodemographic variables and parenting stress. We examined a cohort of predominately breastfeeding women. Food frequency questionnaire results were compared with EARs, the Parenting Stress Index: Short Form, and a demographic questionnaire. Participants included 101 women (of 289 recruited) who breastfed singleton, full-term infants for the first 3 months while using <28 oz formula/wk. The study included community recruitment in rural Oklahoma from 2008 to 2012. Mean and standard deviation or frequencies were reported. One-sample t tests compared EARs with mean dietary intakes over the past 12 months. Pearson correlations and one-way analyses of variance explored relationships among dietary, sociodemographic, and stress variables. Twenty-two percent of women did not meet EAR minimum energy recommendations and >40% did not meet protein recommendations. Despite widespread supplement use, some consumed less than the EAR for vitamin E (35%), calcium (22%), and vitamin C (19%). Carbohydrate consumption was positively related to the difficult child scale (r=0.19; P=0.05). Dietary riboflavin (r=-0.19; P=0.05) and vitamin D intake (r=-0.19; P=0.05) were negatively related to the parent-child dysfunction scale. Despite efforts to enhance education and counseling regarding adequate perinatal nutrition-related practices, even well-educated women may not meet EARs. This poor dietary intake may be associated with parenting stress and have potential long-term implications for child health. Copyright © 2015 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Ear surgery techniques results on hearing threshold improvement

PubMed Central

Mokhtarinejad, Farhad; Pour, Saeed Soheili; Nilforoush, Mohammad Hussein; Sepehrnejad, Mahsa; Mirelahi, Susan

2013-01-01

Background: Bone conduction (BC) threshold depression is not always by means of sensory neural hearing loss and sometimes it is an artifact caused by middle ear pathologies and ossicular chain problems. In this research, the influences of ear surgeries on bone conduction were evaluated. Materials and Methods: This study was conducted as a clinical trial study. The ear surgery performed on 83 patients classified in four categories: Stapedectomy, tympanomastoid surgery and ossicular reconstruction partially or totally; Partial Ossicular Replacement Prosthesis (PORP) and Total Ossicular Replacement Prosthesis (TORP). Bone conduction thresholds assessed in frequencies of 250, 500, 1000, 2000 and 4000 Hz pre and post the surgery. Results: In stapedectomy group, the average of BC threshold in all frequencies improved approximately 6 dB in frequency of 2000 Hz. In tympanomastoid group, BC threshold in the frequency of 500, 1000 and 2000 Hz changed 4 dB (P-value < 0.05). Moreover, In the PORP group, 5 dB enhancement was seen in 1000 and 2000 Hz. In TORP group, the results confirmed that BC threshold improved in all frequencies especially at 4000 Hz about 6.5 dB. Conclusion: In according to results of this study, BC threshold shift was seen after several ear surgeries such as stapedectomy, tympanoplasty, PORP and TORP. The average of BC improvement was approximately 5 dB. It must be considered that BC depression might happen because of ossicular chain problems. Therefore; by resolving middle ear pathologies, the better BC threshold was obtained, the less hearing problems would be faced. PMID:24381615

A study on the effect of prolonged mobile phone use on pure tone audiometry thresholds of medical students of Sikkim

PubMed Central

Das, S; Chakraborty, S; Mahanta, B

2017-01-01

Introduction: Mobile phones have become indispensable for daily activities, and people are exposed to them from an early age. There is, however, concern about the harmful effect of the electromagnetic radiation emitted from the mobile phones. Objective: The objective of the study was to study the effect of mobile phone on average pure tone audiometry (PTA) threshold of the person and to study the changes in the pure tone threshold at high frequencies such as 2 kHz, 4 kHz, and 8 kHz among the students with prolonged exposure to mobile phones. Methodology: A cross-sectional study was conducted among the medical students who have been using mobile phones for the past 5 years. The effect of mobile phones on the PTA threshold in the exposed ear and the nonexposed ear was assessed. Results: The study shows that there is a significant difference in average air conduction (AC) and bone conduction (BC) hearing threshold among the exposed and the nonexposed ears (P < 0.05). A significant rise of both AC and BC threshold at individual frequencies between the exposed and the nonexposed ear is also noted in this study. Conclusion: The study conducted shows changes in the hearing threshold of the exposed ear when compared with the nonexposed ear. There are however lot of unanswered questions which provide an interesting avenue for further research. Till concrete evidence is available the only feasible way to control its exposure is to limit the duration of usage of mobile phones. PMID:28272071

Human Action Recognition Using Wireless Wearable In-Ear Microphone

NASA Astrophysics Data System (ADS)

Nishimura, Jun; Kuroda, Tadahiro

To realize the ubiquitous eating habits monitoring, we proposed the use of sounds sensed by an in-ear placed wireless wearable microphone. A prototype of wireless wearable in-ear microphone was developed by utilizing a common Bluetooth headset. We proposed a robust chewing action recognition algorithm which consists of two recognition stages: “chew-like” signal detection and chewing sound verification stages. We also provide empirical results on other action recognition using in-ear sound including swallowing, cough, belch, and etc. The average chewing number counting error rate of 1.93% is achieved. Lastly, chewing sound mapping is proposed as a new prototypical approach to provide an additional intuitive feedback on food groups to be able to infer the eating habits in their daily life context.

21 CFR 801.420 - Hearing aid devices; professional and patient labeling.

Code of Federal Regulations, 2012 CFR

2012-04-01

.... (ii) History of active drainage from the ear within the previous 90 days. (iii) History of sudden or...). (ii) Frequency response curve. (iii) Average saturation output (HF-Average SSPL 90). (iv) Average full-on gain (HF-Average full-on gain). (v) Reference test gain. (vi) Frequency range. (vii) Total...

21 CFR 801.420 - Hearing aid devices; professional and patient labeling.

Code of Federal Regulations, 2013 CFR

2013-04-01

.... (ii) History of active drainage from the ear within the previous 90 days. (iii) History of sudden or...). (ii) Frequency response curve. (iii) Average saturation output (HF-Average SSPL 90). (iv) Average full-on gain (HF-Average full-on gain). (v) Reference test gain. (vi) Frequency range. (vii) Total...

15 CFR 746.7 - Iran.

Code of Federal Regulations, 2014 CFR

2014-01-01

... authorization is considered authorization for purposes of the EAR as well. Transactions that are not subject to... certain reexport transactions involving Iran, including transactions dealing with items subject to the EAR... addition, BIS maintains licensing requirements on exports and reexports to Iran under the EAR as described...

15 CFR 746.7 - Iran.

Code of Federal Regulations, 2013 CFR

2013-01-01

... authorization for purposes of the EAR as well. Transactions that are not subject to OFAC regulatory authority... certain reexport transactions involving Iran, including transactions dealing with items subject to the EAR... addition, BIS maintains licensing requirements on exports and reexports to Iran under the EAR as described...

Lamellar projections in the endolymphatic sac act as a relief valve to regulate inner ear pressure

PubMed Central

Swinburne, Ian A; Mosaliganti, Kishore R; Upadhyayula, Srigokul; Liu, Tsung-Li; Hildebrand, David G C; Tsai, Tony Y -C; Chen, Anzhi; Al-Obeidi, Ebaa; Fass, Anna K; Malhotra, Samir; Engert, Florian; Lichtman, Jeff W; Kirchausen, Tomas; Betzig, Eric

2018-01-01

The inner ear is a fluid-filled closed-epithelial structure whose function requires maintenance of an internal hydrostatic pressure and fluid composition. The endolymphatic sac (ES) is a dead-end epithelial tube connected to the inner ear whose function is unclear. ES defects can cause distended ear tissue, a pathology often seen in hearing and balance disorders. Using live imaging of zebrafish larvae, we reveal that the ES undergoes cycles of slow pressure-driven inflation followed by rapid deflation. Absence of these cycles in lmx1bb mutants leads to distended ear tissue. Using serial-section electron microscopy and adaptive optics lattice light-sheet microscopy, we find a pressure relief valve in the ES comprised of partially separated apical junctions and dynamic overlapping basal lamellae that separate under pressure to release fluid. We propose that this lmx1-dependent pressure relief valve is required to maintain fluid homeostasis in the inner ear and other fluid-filled cavities. PMID:29916365

Intratympanic Iodine Contrast Injection Diffuses Across the Round Window Membrane Allowing for Perilymphatic CT Volume Acquisition Imaging

PubMed Central

Abt, Nicholas B.; Lehar, Mohamed; Guajardo, Carolina Trevino; Penninger, Richard T.; Ward, Bryan K.; Pearl, Monica S.; Carey, John P.

2016-01-01

Hypothesis Whether the RWM is permeable to iodine-based contrast agents (IBCA) is unknown; therefore, our goal was to determine if IBCAs could diffuse through the RWM using CT volume acquisition imaging. Introduction Imaging of hydrops in the living human ear has attracted recent interest. Intratympanic (IT) injection has shown gadolinium's ability to diffuse through the round window membrane (RWM), enhancing the perilymphatic space. Methods Four unfixed human cadaver temporal bones underwent intratympanic IBCA injection using three sequentially studied methods. The first method was direct IT injection. The second method used direct RWM visualization via tympanomeatal flap for IBCA-soaked absorbable gelatin pledget placement. In the third method, the middle ear was filled with contrast after flap elevation. Volume acquisition CT images were obtained immediately post-exposure, and at 1, 6, and 24 hour intervals. Post-processing was accomplished using color ramping and subtraction imaging. Results Following the third method, positive RWM and perilymphatic enhancement were seen with endolymph sparing. Gray scale and color ramp multiplanar reconstructions displayed increased signal within the cochlea compared to pre-contrast imaging. The cochlea was measured for attenuation differences compared to pure water, revealing a pre-injection average of −1,103 HU and a post-injection average of 338 HU. Subtraction imaging shows enhancement remaining within the cochlear space, Eustachian tube, middle ear epithelial lining, and mastoid. Conclusions Iohexol iodine contrast is able to diffuse across the RWM. Volume acquisition CT imaging was able to detect perilymphatic enhancement at 0.5mm slice thickness. The clinical application of IBCA IT injection appears promising but requires further safety studies. PMID:26859543

Performance and retention of lightweight satellite radio tags applied to the ears of polar bears (Ursus maritimus)

USGS Publications Warehouse

Wiig, Øystein; Born, Erik W.; Laidre, Kristin L.; Dietz, Rune; Jensen, Mikkel Villum; Durner, George M.; Pagano, Anthony M.; Regehr, Eric V.; St. Martin, Michelle; Atkinson, Stephen N.; Dyck, Markus

2017-01-01

BackgroundSatellite telemetry studies provide information that is critical to the conservation and management of species affected by ecological change. Here we report on the performance and retention of two types (SPOT-227 and SPOT-305A) of ear-mounted Argos-linked satellite transmitters (i.e., platform transmitter terminal, or PTT) deployed on free-ranging polar bears in Eastern Greenland, Baffin Bay, Kane Basin, the southern Beaufort Sea, and the Chukchi Sea during 2007–2013.ResultsTransmissions from 142 out of 145 PTTs deployed on polar bears were received for an average of 69.3 days. The average functional longevity, defined as the number of days they transmitted while still attached to polar bears, for SPOT-227 was 56.8 days and for SPOT-305A was 48.6 days. Thirty-four of the 142 (24%) PTTs showed signs of being detached before they stopped transmitting, indicating that tag loss was an important aspect of tag failure. Furthermore, 10 of 26 (38%) bears that were re-observed following application of a PTT had a split ear pinna, suggesting that some transmitters were detached by force. All six PTTs that were still on bears upon recapture had lost the antenna, which indicates that antenna breakage was a significant contributor to PTT failure. Finally, only nine of the 142 (6%) PTTs—three of which were still attached to bears—had a final voltage reading close to the value indicating battery exhaustion. This suggests that battery exhaustion was not a major factor in tag performance.ConclusionsThe average functional longevity of approximately 2 months for ear-mounted PTTs (this study) is poor compared to PTT collars fitted to adult female polar bears, which can last for several years. Early failure of the ear-mounted PTTs appeared to be caused primarily by detachment from the ear or antenna breakage. We suggest that much smaller and lighter ear-mounted transmitters are necessary to reduce the risk of tissue irritation, tissue damage, and tag detachment, and with a more robust antenna design. Our results are applicable to other tag types (e.g., iridium and VHF systems) and to research on other large mammals that cannot wear radio collars.

Correction of Lying Ears by Augmentation of the Conchoscaphal Angle.

PubMed

Kim, Sung-Eun; Yeo, Chi-Ho; Kim, Taegon; Kim, Yong-Ha; Lee, Jun Ho; Chung, Kyu-Jin

2017-01-01

Lying ears are defined as ears that protrude less from the head, and in frontal view, are characterized by lateral positioning of antihelical contour relative to the helical rim. These aesthetically displeasing ears require correction in accord with the goals of otoplasty stated by McDowell. The authors present a case of lying ears treated by correcting the conchomastoid angle using Z-plasty, resection of posterior auricular muscle, and correction of the conchoscaphal angle by releasing cartilage using 2 full-thickness incisions and grafting of a conchal cartilage spacer. By combining these techniques, the authors efficiently corrected lying ears and produced aesthetically pleasing results.

[Analysis the relationship between the found ways and first diagnosis age for large vestibular aqueduct children].

PubMed

Yang, Yali; Huang, Lihui; Cheng, Xiaohua; Fu, Xinxing; Liu, Jiaxing; Ni, Tingting

2014-11-01

To explore the found ways and first diagnosis age of children with large vestibular aqueduct, and their relations with hearing loss. Medical histories of 122 cases of children diagnosed with large vestibular aqueduct by HRCT or MRI had been collected from January 2009 to April 2014 in our hospital children's hearing diagnosis center clinic. Found ways comprise of accepting universal newborn hearing screening (UNHS) group and unaccepting UNHS group. Accepting UNHS children were divided into two ears unpassing group, single ear unpassing group and passing group. The patients in unaccepting UNHS group were divided into not sensitive to sounds, speech stunting, sudden hearing loss, and other group. Analysis the relationship between the found ways and first diagnosis age and their relations with hearing loss. There are 84 cases (68.85%) accepting UNHS, the average age of first diagnosis was (17.24 ± 17.08) months; 37 cases (31.15%) are not accepting UNHS. The average age of first diagnosis was (30.92 ± 18.21) months. The average first diagnosis age of accepting UNHS group was more earlier than the unaccepting UNHS group. The difference was statistically signif- icant (P < 0.01). There were 57 cases (67.85%) whose two ears not pass UNHS; 15 cases (17.86%) single ear not pass; namely the referral rate was 85.71%; 12 cases (14.29%) pass the test. The first diagnosis age of passing UNHS group was more later than two ears unpassing group (P < 0.001). In the unaccepting UNHS group, the average first diagnosis age of not sensitive to sounds group (19.69 ± 11.16 months) was more earlier than words dysplasia group (37.13 ± 15.62 months) and sudden hearing loss group (47.40 ± 24.70 months) (P < 0.01). The difference in the degree of hearing loss between accepting UNHS and unaccepting UNHS group had no statistical significance (P > 0.05). In unaccepting UNHS group ,the average first diagnosis age of the mild-to-moderate hearing loss group was later than the very severe hearing loss group (P < 0.01). Most of large vestibular aqueduct children can be found and receive diagnosis early by UNHS. But part of these patients with late-onset or progressive hearing loss, especially these with mild-to-moderate hearing loss cannot be found early, which should arouse our attention.

Review of a single surgeon's stapedotomy cases performed with a nickel titanium prosthesis over a 14-year period.

PubMed

Justicz, Natalie; Strickland, Kaitlyn F; Motamedi, Kevin K; Mattox, Douglas E

2017-04-01

Stapes surgery with a nickel titanium prosthesis is a safe and well-tolerated procedure that leads to a significant improvement in hearing outcomes. To identify the efficacy and safety of stapedotomy procedures performed with a nickel titanium prosthesis for patients with otosclerosis. A review of 431 unique stapedotomies performed over 14 years by a single surgeon at an academic tertiary care center yielded 312 cases with nickel titanium prosthesis that met inclusion criteria of otosclerosis diagnosis, initial surgery in operative ear, and presence of pre-operative and post-operative audiograms. Pure-tone averages (PTA) at baseline and 8 weeks after surgery were calculated over four frequencies; 0.5, 1, 2, and 4 kHz. Average air-bone gaps (ABG) were calculated from pre-operative and post-operative audiograms. Average pre-operative baseline PTA was 56.7 dB in the affected ear. Post-operative PTA was 30.1 dB, a 26.6 dB improvement. Initial average ABG was 29.7 dB, while post-operative ABG averaged 5.4 dB, a 24.2 dB improvement. Surgical success (closure of ABG within 10 dB) was achieved in 263 (84%) patients. Rate of surgical success was not correlated with age, gender, race, or affected ear. Complications included recurrent conductive hearing loss (14), progressive SNHL (4), and post-operative BPPV (3).

15 CFR 746.7 - Iran.

Code of Federal Regulations, 2012 CFR

2012-01-01

... certain reexport transactions involving Iran, including transactions dealing with items subject to the EAR... addition, BIS maintains licensing requirements on exports and reexports to Iran under the EAR as described in paragraph (a)(1) of this section or elsewhere in the EAR (See, e.g., § 742.8—Anti-terrorism: Iran...

Alternative metrics for real-ear-to-coupler difference average values in children.

PubMed

Blumsack, Judith T; Clark-Lewis, Sandra; Watts, Kelli M; Wilson, Martha W; Ross, Margaret E; Soles, Lindsey; Ennis, Cydney

2014-10-01

Ideally, individual real-ear-to-coupler difference (RECD) measurements are obtained for pediatric hearing instrument-fitting purposes. When RECD measurements cannot be obtained, age-related average RECDs based on typically developing North American children are used. Evidence suggests that these values may not be appropriate for populations of children with retarded growth patterns. The purpose of this study was to determine if another metric, such as head circumference, height, or weight, can be used for prediction of RECDs in children. Design was a correlational study. For all participants, RECD values in both ears, head circumference, height, and weight were measured. The sample consisted of 68 North American children (ages 3-11 yr). Height, weight, head circumference, and RECDs were measured and were analyzed for both ears at 500, 750, 1000, 1500, 2000, 3000, 4000, and 6000 Hz. A backward elimination multiple-regression analysis was used to determine if age, height, weight, and/or head circumference are significant predictors of RECDs. For the left ear, head circumference was retained as the only statistically significant variable in the final model. For the right ear, head circumference was retained as the only statistically significant independent variable at all frequencies except at 2000 and 4000 Hz. At these latter frequencies, weight was retained as the only statistically significant independent variable after all other variables were eliminated. Head circumference can be considered as a metric for RECD prediction in children when individual measurements cannot be obtained. In developing countries where equipment is often unavailable and stunted growth can reduce the value of using age as a metric, head circumference can be considered as an alternative metric in the prediction of RECDs. American Academy of Audiology.

Current kinematics and dynamics of Africa and the East African Rift System

NASA Astrophysics Data System (ADS)

Stamps, D. S.; Flesch, L. M.; Calais, E.; Ghosh, A.

2014-06-01

Although the East African Rift System (EARS) is an archetype continental rift, the forces driving its evolution remain debated. Some contend buoyancy forces arising from gravitational potential energy (GPE) gradients within the lithosphere drive rifting. Others argue for a major role of the diverging mantle flow associated with the African Superplume. Here we quantify the forces driving present-day continental rifting in East Africa by (1) solving the depth averaged 3-D force balance equations for 3-D deviatoric stress associated with GPE, (2) inverting for a stress field boundary condition that we interpret as originating from large-scale mantle tractions, (3) calculating dynamic velocities due to lithospheric buoyancy forces, lateral viscosity variations, and velocity boundary conditions, and (4) calculating dynamic velocities that result from the stress response of horizontal mantle tractions acting on a viscous lithosphere in Africa and surroundings. We find deviatoric stress associated with lithospheric GPE gradients are ˜8-20 MPa in EARS, and the minimum deviatoric stress resulting from basal shear is ˜1.6 MPa along the EARS. Our dynamic velocity calculations confirm that a force contribution from GPE gradients alone is sufficient to drive Nubia-Somalia divergence and that additional forcing from horizontal mantle tractions overestimates surface kinematics. Stresses from GPE gradients appear sufficient to sustain present-day rifting in East Africa; however, they are lower than the vertically integrated strength of the lithosphere along most of the EARS. This indicates additional processes are required to initiate rupture of continental lithosphere, but once it is initiated, lithospheric buoyancy forces are enough to maintain rifting.

Kinematics and dynamics of Nubia-Somalia divergence along the East African rift

NASA Astrophysics Data System (ADS)

Stamps, Dorothy Sarah

Continental rifting is fundamental to the theory of plate tectonics, yet the force balance driving Earth's largest continental rift system, the East African Rift (EAR), remains debated. The EAR actively diverges the Nubian and Somalian plates spanning ˜5000 km N-S from the Red Sea to the Southwest Indian Ridge and ˜3000 km NW-SE from eastern Congo to eastern Madagascar. Previous studies suggest either lithospheric buoyancy forces or horizontal tractions dominate the force balance acting to rupture East Africa. In this work, we investigate the large-scale dynamics of Nubia-Somalia divergence along the EAR driving present-day kinematics. Because Africa is largely surrounded by spreading ridges, we assume plate-plate interactions are minimal and that the major driving forces are gradients in gravitational potential energy (GPE), which includes the effect of vertical mantle tractions, and horizontal basal tractions arising from viscous coupling to horizontal mantle flow. We quantify a continuous strain rate and velocity field based on kinematic models, an updated GPS velocity solution, and the style of earthquake focal mechanisms, which we use as an observational constraint on surface deformation. We solve the 3D force balance equations and calculate vertically averaged deviatoric stress for a 100 km thick lithosphere constrained by the CRUST2.0 crustal density and thickness model. By comparing vertically integrated deviatoric stress with integrated lithospheric strength we demonstrate forces arising from gradients in gravitational potential energy are insufficient to rupture strong lithosphere, hence weakening mechanisms are required to initiate continental rupture. The next step involves inverting for a stress field boundary condition that is the long-wavelength minimum energy deviatoric stress field required to best-fit the style of our continuous strain rate field in addition to deviatoric stress from gradients in GPE. We infer the stress field boundary condition is an estimate of basal shear stress from viscous coupling to horizontal mantle flow. The stress field boundary condition is small (˜1.6 MPa) compared to deviatoric stress from GPE gradients (8-20 MPa) and does not improve the fit to surface deformation indicators more than 8% when combined with deviatoric stress from GPE gradients. Hence we suggest the style of deformation across the EAR can be explained by forces derived from gradients in GPE. We then calculate dynamic velocities using two types of forward models to solve the instantaneous momentum equations. One method is regional and requires vertically averaged effective viscosity to define lithospheric structure with velocity boundary conditions and a free-slip basal boundary condition. The second is a global model that accounts for a brittle upper crust and viscous mantle lithosphere with velocity boundary conditions imposed at the base of the lithosphere from 5 mantle flow models. With both methods we find deformation driven by internal lithospheric buoyancy forces provides the best-fit to GPS observations of surface velocities on the Somalian plate. We find that any additional contribution from horizontal tractions results in overpredicting surface velocities. This work indicates horizontal mantle flow plays a minimal role in Nubia-Somalia divergence and the EAR is driven largely by gradients in GPE.

Development of an ear cap in chronic suppurative otitis media using additive manufacturing and TRIZ.

PubMed

Mawale, Mahesh B; Kuthe, Abhaykumar; Mawale, Anupama M; Dahake, Sandeep W

2018-06-01

The prevalence rate of chronic suppurative otitis media is high and its treatment continues to be a challenge for the otorhinolaryngologists. Due to middle ear infection, there may be pain, hearing loss and spontaneous rupture of the eardrum which results in perforation. Infections can cause a hole in the eardrum as a side effect of otitis media. The patients suffering from ear perforation or having a hole in eardrum require preventing entry of water in the ear. This article describes the development of ear cap using additive manufacturing and TRIZ (a collaborative tool) to prevent the entry of water in the ear during chronic otitis media.

Acoustical transmission-line model of the middle-ear cavities and mastoid air cells.

PubMed

Keefe, Douglas H

2015-04-01

An acoustical transmission line model of the middle-ear cavities and mastoid air cell system (MACS) was constructed for the adult human middle ear with normal function. The air-filled cavities comprised the tympanic cavity, aditus, antrum, and MACS. A binary symmetrical airway branching model of the MACS was constructed using an optimization procedure to match the average total volume and surface area of human temporal bones. The acoustical input impedance of the MACS was calculated using a recursive procedure, and used to predict the input impedance of the middle-ear cavities at the location of the tympanic membrane. The model also calculated the ratio of the acoustical pressure in the antrum to the pressure in the middle-ear cavities at the location of the tympanic membrane. The predicted responses were sensitive to the magnitude of the viscothermal losses within the MACS. These predicted input impedance and pressure ratio functions explained the presence of multiple resonances reported in published data, which were not explained by existing MACS models.

15 CFR 746.9 - Syria.

Code of Federal Regulations, 2014 CFR

2014-01-01

... medicine. The President also exercised national security waiver authority pursuant to Section 5(b) of the... for the export or reexport to Syria of all items subject to the EAR, except food and medicine classified as EAR99 (food and medicine are defined in part 772 of the EAR). A license is required for the...

15 CFR 746.9 - Syria.

Code of Federal Regulations, 2012 CFR

2012-01-01

... medicine. The President also exercised national security waiver authority pursuant to Section 5(b) of the... for the export or reexport to Syria of all items subject to the EAR, except food and medicine classified as EAR99 (food and medicine are defined in part 772 of the EAR). A license is required for the...

15 CFR 746.9 - Syria.

Code of Federal Regulations, 2013 CFR

2013-01-01

... medicine. The President also exercised national security waiver authority pursuant to Section 5(b) of the... for the export or reexport to Syria of all items subject to the EAR, except food and medicine classified as EAR99 (food and medicine are defined in part 772 of the EAR). A license is required for the...

Structural Metadata Research in the Ears Program

DTIC Science & Technology

2005-01-01

detecting structural information in the word stream (the so-called “structural MDE” portion of the EARS program); other MDE efforts on speaker ... diarization are overviewed in [13]. The rest of this paper is organized as follows. We describe the structural MDE tasks, performance measurement, and corpora...tems have only recently been introduced, with NIST reporting re- sults with the Wilcoxon signed rank test for speaker -level average score differences

Comparison of an Electromagnetic Middle Ear Implant and Hearing Aid Word Recognition Performance to Word Recognition Performance Obtained Under Earphones.

PubMed

Chang, C Y Joseph; Spearman, Michael; Spearman, Brian; McCraney, Anna; Glasscock, Michael E

2017-10-01

To report the results of patients with the Maxum middle ear implant (MEI) and compare word recognition scores (WRS) and speech perception gap (SP Gap) of Maxum versus optimally fit hearing aids (HA). Case series with chart review. Single, private otology clinic. Eleven ears, in nine adult patients (two women; average age 62.7 yr). Twelve consecutive ears with moderate to severe sensorineural hearing loss (SNHL) underwent implantation of the Maxum system. One patient was not included due to inadequate preoperative testing. Primary outcome measures included word recognition score (WRS) and SP Gap (maximum word understanding [PB max] - WRSaided) improvement compared with HAs. The average Maxum WRS was 64.7% (range, 28-94%), a 41.6% improvement (range, 10-66%) over HAs (p < 0.001). The average Maxum SP Gap was 6.6% (range, -8 to 24%), a 41.6% improvement (range, 10-66%) over HAs (p < 0.001). These data demonstrate that the Maxum provides superior WRS than HAs for patients with significant aided SP Gaps. There is a significant, very strong correlation between Maxum WRS and PB max (r = 0.85, p = 0.001). This implies that PB max may reasonably predict WRS outcomes with Maxum before implantation, and the SP Gap can reasonably predict the degree of additional potential benefit with Maxum. In advising patients who may be candidates for both a CI and MEI, PB max and SP Gap measurements will provide useful predictive information to help clinicians counsel patients on their choice of hearing technology. 4.

Can you hear me now? Understanding vertebrate middle ear development

PubMed Central

Chapman, Susan Caroline

2010-01-01

The middle ear is a composite organ formed from all three germ layers and the neural crest. It provides the link between the outside world and the inner ear, where sound is transduced and routed to the brain for processing. Extensive classical and modern studies have described the complex morphology and origin of the middle ear. Non-mammalian vertebrates have a single ossicle, the columella. Mammals have three functionally equivalent ossicles, designated the malleus, incus and stapes. In this review, I focus on the role of genes known to function in the middle ear. Genetic studies are beginning to unravel the induction and patterning of the multiple middle ear elements including the tympanum, skeletal elements, the air-filled cavity, and the insertion point into the inner ear oval window. Future studies that elucidate the integrated spatio-temporal signaling mechanisms required to pattern the middle ear organ system are needed. The longer-term translational benefits of understanding normal and abnormal ear development will have a direct impact on human health outcomes. PMID:21196256

Predicting skin deficits through surface area measurements in ear reconstruction and adult ear surface area norms.

PubMed

Yazar, Memet; Sevim, Kamuran Zeynep; Irmak, Fatih; Yazar, Sevgi Kurt; Yeşilada, Ayşin Karasoy; Karşidağğ, Semra Hacikerim; Tatlidede, Hamit Soner

2013-07-01

Ear reconstruction is one of the most challenging procedures in plastic surgery practice. Many studies and techniques have been described in the literature for carving a well-pronounced framework. However, just as important as the cartilage framework is the ample amount of delicate skin coverage of the framework. In this report, we introduce an innovative method of measuring the skin surface area of the auricle from a three-dimensional template created from the healthy ear.The study group consisted of 60 adult Turkish individuals who were randomly selected (30 men and 30 women). The participant ages ranged from 18 to 45 years (mean, 31.5 years), and they had no history of trauma or congenital anomalies. The template is created by dividing the ear into aesthetic subunits and using ImageJ software to estimate the necessary amount of total skin surface area required.Reconstruction of the auricle is a complicated process that requires experience and patience to provide the auricular details. We believe this estimate will shorten the learning curve for residents and surgeons interested in ear reconstruction and will help surgeons obtain adequate skin to drape over the well-sculpted cartilage frameworks by providing a reference list of total ear skin surface area measurements for Turkish men and women.

Bone-conduction circuit model for chinchilla part I: Defining parameters by fitting to air-conduction data

NASA Astrophysics Data System (ADS)

Bowers, Peter; Rosowski, John J.

2018-05-01

An air-conduction circuit model that will serve as the basis for a model of bone-conduction hearing is developed for chinchilla. The lumped-element model is based on the classic Zwislocki model of the human middle ear. Model parameters are fit to various measurements of chinchilla middle-ear transfer functions and impedances. The model is in agreement with studies of the effects of middle-ear cavity holes in experiments that require access to the middle-ear air space.

Dietary vitamin D dose-response in healthy children 2 to 8 y of age: a 12-wk randomized controlled trial using fortified foods.

PubMed

Brett, Neil R; Lavery, Paula; Agellon, Sherry; Vanstone, Catherine A; Maguire, Jonathon L; Rauch, Frank; Weiler, Hope A

2016-01-01

Vitamin D is fundamental for bone health. A high proportion of Canadian 2- to 8-y-olds do not meet the Estimated Average Requirement (EAR) of 400 IU/d. The objective was to determine whether vitamin D intakes consistent with the EAR or Recommended Dietary Allowance (RDA), through fortification of additional dairy products, would result in higher vitamin D status in young children. Participants aged 2-8 y (n = 77; Montreal, Canada) were randomly assigned to 1 of 3 dietary vitamin D targets (control; EAR: 400 IU/d; or RDA: 600 IU/d) for 12 wk (January to April 2014). Anthropometric measurements, demographic characteristics, dietary intakes, fasting serum parathyroid hormone, 25-hydroxyvitamin D [25(OH)D], and ionized calcium were compared by using mixed-model ANOVA. Participants' mean ± SD age was 5.1 ± 1.9 y; 54.5% were boys with body mass index z scores of 0.50 ± 0.85. Compliance was 85% overall. No differences were observed in baseline dietary vitamin D intakes or serum 25(OH)D. At 12 wk, the EAR and RDA groups had significantly higher vitamin D intakes [median (IQR): control, 227 (184-305) IU/d; EAR, 410 (363-516) IU/d; and RDA, 554 (493-653) IU/d; P < 0.05] and serum 25(OH)D concentrations (control: 55.8 ± 12.3 nmol/L; EAR: 64.1 ± 10.0 nmol/L; and RDA: 63.7 ± 12.4 nmol/L; P < 0.05) than the control group. Ninety-six percent of children in the EAR and RDA groups and 67% of the control group had 25(OH)D concentrations ≥50 nmol/L. Increasing the vitamin D intakes of young children through fortification of alternative dairy products results in significantly higher serum concentrations of 25(OH)D and a significantly greater proportion of children with serum 25(OH)D ≥50 nmol/L during periods of minimal ultraviolet B radiation exposure. This trial was registered at clinicaltrials.gov as NCT02097160 and had Health Canada Temporary Marketing Authorization Letters for both products (TM-13-0432 and TM-13-0433). © 2016 American Society for Nutrition.

24 CFR Appendix I to Subpart B of... - Definition of Acoustical Quantities

Code of Federal Regulations, 2011 CFR

2011-04-01

... National Standard Specification for Type 1 Sound Level Meters S1.4-1971. Fast time-averaging and A...), somewhat as is the ear. With fast time averaging the sound level meter responds particularly to recent... (iii) The maximum sound level obtained with fast averaging time of a sound level meter exceeds the...

24 CFR Appendix I to Subpart B of... - Definition of Acoustical Quantities

Code of Federal Regulations, 2014 CFR

2014-04-01

... National Standard Specification for Type 1 Sound Level Meters S1.4-1971. Fast time-averaging and A...), somewhat as is the ear. With fast time averaging the sound level meter responds particularly to recent... (iii) The maximum sound level obtained with fast averaging time of a sound level meter exceeds the...

24 CFR Appendix I to Subpart B of... - Definition of Acoustical Quantities

Code of Federal Regulations, 2012 CFR

2012-04-01

... National Standard Specification for Type 1 Sound Level Meters S1.4-1971. Fast time-averaging and A...), somewhat as is the ear. With fast time averaging the sound level meter responds particularly to recent... (iii) The maximum sound level obtained with fast averaging time of a sound level meter exceeds the...

24 CFR Appendix I to Subpart B of... - Definition of Acoustical Quantities

Code of Federal Regulations, 2013 CFR

2013-04-01

... National Standard Specification for Type 1 Sound Level Meters S1.4-1971. Fast time-averaging and A...), somewhat as is the ear. With fast time averaging the sound level meter responds particularly to recent... (iii) The maximum sound level obtained with fast averaging time of a sound level meter exceeds the...

Micronutrient Intake Is Inadequate for a Sample of Pregnant African-American Women.

PubMed

Groth, Susan W; Stewart, Patricia A; Ossip, Deborah J; Block, Robert C; Wixom, Nellie; Fernandez, I Diana

2017-04-01

Micronutrient intake is critical for fetal development and positive pregnancy outcomes. Little is known about the adequacy of micronutrient intake in pregnant African-American women. To describe nutrient sufficiency and top food groups contributing to dietary intake of select micronutrients in low-income pregnant African-American women and determine whether micronutrient intake varies with early pregnancy body mass index (BMI) and/or gestational weight gain. Secondary analysis of data collected in a cohort study of pregnant African-American women. A total of 93 women aged 18 to 36 years, <20 weeks pregnant, with early pregnancy BMIs ≥18.5 and <40.0. The study was conducted during 2008 to 2012 with participants from university-affiliated obstetrics clinics in an urban setting in the northeastern United States. Proportion of women with dietary intakes below Estimated Average Requirement (EAR) or Adequate Intake (AI) for vitamin D, folate, iron, calcium, and choline throughout pregnancy. Top food groups from which women derived these micronutrients was also determined. Descriptive statistics included means, standard deviations, and percentages. Percent of women reaching EAR or AI was calculated. The χ 2 test was used to assess micronutrient intake differences based on early pregnancy BMI and gestational weight gain. A large percentage of pregnant women did not achieve the EAR or AI from dietary sources alone; EAR for folate (66%), vitamin D (100%), iron (89%), and AI for choline (100%). Mean micronutrient intake varied throughout pregnancy. Top food sources included reduced-fat milk, eggs, and mixed egg dishes, pasta dishes, and ready-to-eat cereal. The majority of study participants had dietary micronutrient intake levels below EAR/AI throughout pregnancy. Findings suggest that practitioners should evaluate dietary adequacy in women to avoid deficits in micronutrient intake during pregnancy. Top food sources of these micronutrients can be considered when assisting women in improving dietary intake. Copyright © 2017 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Micronutrient intake inadequate for a sample of pregnant African American women

PubMed Central

Stewart, Patricia A.; Ossip, Deborah J.; Block, Robert C.; Wixom, Nellie; Fernandez, I Diana

2016-01-01

Background Micronutrient intake is critical for fetal development and positive pregnancy outcomes. Little is known about adequacy of micronutrient intake in pregnant African American women. Objective To describe nutrient sufficiency and top food groups contributing to dietary intake of select micronutrients in low-income pregnant African American women and determine if micronutrient intake varies with early pregnancy body mass index (BMI) and/or gestational weight gain. Design Secondary analysis of data collected in a cohort study of pregnant African American women. Participants/setting A total of 93 women 18–36 years old, < 20 weeks pregnant, with early pregnancy BMIs ≥ 18.5 kg/m2 and < 40.0 kg/m2. The study was conducted during 2008–2012 with participants from university affiliated obstetrical clinics in an urban setting in Northeast USA. Main outcome measures Proportion of women with dietary intakes below Estimated Average Requirement (EAR) or Adequate Intake (AI) for vitamin D, folate, iron, calcium, and choline throughout pregnancy. Top food groups from which women derived these micronutrients. Statistical analyses performed Descriptive statistics included means, standard deviations and percentages. Percent of women reaching EAR/AI was calculated. Chi-square test was used to assess micronutrient intake differences based on early pregnancy BMI and gestational weight gain. Results A large percentage of pregnant women did not achieve the EAR/AI from dietary sources alone; EAR for folate (66%), vitamin D (100%), iron (89%), and AI for choline (100%). Mean micronutrient intake varied throughout pregnancy. Top food sources included reduced fat milk, eggs and mixed egg dishes, pasta dishes, and ready to eat cereal. Conclusions The majority of study participants had dietary micronutrient intake levels below EAR/AI throughout pregnancy. Findings suggest that practitioners should evaluate dietary adequacy in women to avoid deficits in micronutrient intake during pregnancy. Top food sources of these micronutrients can be considered when assisting women in improving dietary intake. PMID:28065633

New HRCT-based measurement of the human outer ear canal as a basis for acoustical methods.

PubMed

Grewe, Johanna; Thiele, Cornelia; Mojallal, Hamidreza; Raab, Peter; Sankowsky-Rothe, Tobias; Lenarz, Thomas; Blau, Matthias; Teschner, Magnus

2013-06-01

As the form and size of the external auditory canal determine its transmitting function and hence the sound pressure in front of the eardrum, it is important to understand its anatomy in order to develop, optimize, and compare acoustical methods. High-resolution computed tomography (HRCT) data were measured retrospectively for 100 patients who had received a cochlear implant. In order to visualize the anatomy of the auditory canal, its length, radius, and the angle at which it runs were determined for the patients’ right and left ears. The canal’s volume was calculated, and a radius function was created. The determined length of the auditory canal averaged 23.6 mm for the right ear and 23.5 mm for the left ear. The calculated auditory canal volume (Vtotal) was 0.7 ml for the right ear and 0.69 ml for the left ear. The auditory canal was found to be significantly longer in men than in women, and the volume greater. The values obtained can be employed to develop a method that represents the shape of the auditory canal as accurately as possible to allow the best possible outcomes for hearing aid fitting.

New Evaluation of the Electronically Activated Recorder (EAR): Obtrusiveness, Compliance, and Participant Self-selection Effects.

PubMed

Manson, Joseph H; Robbins, Megan L

2017-01-01

The Electronically Activated Recorder (EAR) is a method for collecting periodic brief audio snippets of participants' daily lives using a portable recording device. The EAR can potentially intrude into people's privacy, alter their natural behavior, and introduce self-selection biases greater than in other types of social science methods. Previous research (Mehl and Holleran, 2007, hereafter M&H) has shown that participant non-compliance with, and perceived obtrusiveness of, an EAR protocol are both low. However, these questions have not been addressed in jurisdictions that require the consent of all parties to recording conversations. This EAR study required participants to wear a button bearing a microphone icon and the words "This conversation may be recorded" to comply with California's all-party consent law. Results revealed self-reported obtrusiveness and non-compliance were actually lower in the present study than in the M&H study. Behaviorally assessed non-compliance did not differ between the two studies. Participants in the present study talked more about being in the study than participants in the M&H study, but such talk still comprised <2% of sampled conversations. Another potential problem with the EAR, participant self-selection bias, was addressed by comparing the EAR volunteers' HEXACO personality dimensions to a non-volunteer sample drawn from the same student population. EAR volunteers were significantly and moderately higher in Conscientiousness, and lower in Emotionality, than non-volunteers. In conclusion, the EAR method can be successfully implemented in at least one all-party consent state (California). Interested researchers are encouraged to review this procedure with their own legal counsel.

Dietary Protein Requirement of Men >65 Years Old Determined by the Indicator Amino Acid Oxidation Technique Is Higher than the Current Estimated Average Requirement.

PubMed

Rafii, Mahroukh; Chapman, Karen; Elango, Rajavel; Campbell, Wayne W; Ball, Ronald O; Pencharz, Paul B; Courtney-Martin, Glenda

2016-03-09

The current estimated average requirement (EAR) and RDA for protein of 0.66 and 0.8 g ⋅ kg -1 ⋅ d -1 , respectively, for adults, including older men, are based on nitrogen balance data analyzed by monolinear regression. Recent studies in young men and older women that used the indicator amino acid oxidation (IAAO) technique suggest that those values may be too low. This observation is supported by 2-phase linear crossover analysis of the nitrogen balance data. The main objective of this study was to determine the protein requirement for older men by using the IAAO technique. Six men aged >65 y were studied; each individual was tested 7 times with protein intakes ranging from 0.2 to 2.0 g ⋅ kg -1 ⋅ d -1 in random order for a total of 42 studies. The diets provided energy at 1.5 times the resting energy expenditure and were isocaloric. Protein was consumed hourly for 8 h as an amino acid mixture with the composition of egg protein with l-[1- 13 C]phenylalanine as the indicator amino acid. The group mean protein requirement was determined by applying a mixed-effects change-point regression analysis to F 13 CO 2 (label tracer oxidation in breath 13 CO 2 ), which identified a breakpoint in F 13 CO 2 in response to graded intakes of protein. The estimated protein requirement and RDA for older men were 0.94 and 1.24 g ⋅ kg -1 ⋅ d -1 , respectively, which are not different from values we published using the same method in young men and older women. The current intake recommendations for older adults for dietary protein of 0.66 g ⋅ kg -1 ⋅ d -1 for the EAR and 0.8 g ⋅ kg -1 ⋅ d -1 for the RDA appear to be underestimated by ∼30%. Future longer-term studies should be conducted to validate these results. This trial was registered at clinicaltrials.gov as NCT01948492. © 2016 American Society for Nutrition.

Air-Leak Effects on Ear-Canal Acoustic Absorbance

PubMed Central

Rasetshwane, Daniel M.; Kopun, Judy G.; Gorga, Michael P.; Neely, Stephen T.

2015-01-01

Objective: Accurate ear-canal acoustic measurements, such as wideband acoustic admittance, absorbance, and otoacoustic emissions, require that the measurement probe be tightly sealed in the ear canal. Air leaks can compromise the validity of the measurements, interfere with calibrations, and increase variability. There are no established procedures for determining the presence of air leaks or criteria for what size leak would affect the accuracy of ear-canal acoustic measurements. The purpose of this study was to determine ways to quantify the effects of air leaks and to develop objective criteria to detect their presence. Design: Air leaks were simulated by modifying the foam tips that are used with the measurement probe through insertion of thin plastic tubing. To analyze the effect of air leaks, acoustic measurements were taken with both modified and unmodified foam tips in brass-tube cavities and human ear canals. Measurements were initially made in cavities to determine the range of critical leaks. Subsequently, data were collected in ears of 21 adults with normal hearing and normal middle-ear function. Four acoustic metrics were used for predicting the presence of air leaks and for quantifying these leaks: (1) low-frequency admittance phase (averaged over 0.1–0.2 kHz), (2) low-frequency absorbance, (3) the ratio of compliance volume to physical volume (CV/PV), and (4) the air-leak resonance frequency. The outcome variable in this analysis was the absorbance change (Δabsorbance), which was calculated in eight frequency bands. Results: The trends were similar for both the brass cavities and the ear canals. ΔAbsorbance generally increased with air-leak size and was largest for the lower frequency bands (0.1–0.2 and 0.2–0.5 kHz). Air-leak effects were observed in frequencies up to 10 kHz, but their effects above 1 kHz were unpredictable. These high-frequency air leaks were larger in brass cavities than in ear canals. Each of the four predictor variables exhibited consistent dependence on air-leak size. Low-frequency admittance phase and CV/PV decreased, while low-frequency absorbance and the air-leak resonance frequency increased. Conclusion: The effect of air leaks can be significant when their equivalent diameter exceeds 0.01 in. The observed effects were greatest at low frequencies where air leaks caused absorbance to increase. Recommended criteria for detecting air leaks include the following: when the frequency range of interest extends as low as 0.1 kHz, low-frequency absorbance should be ≤0.20 and low-frequency admittance phase ≥61 degrees. For frequency ranges as low as 0.2 kHz, low-frequency absorbance should be ≤0.29 and low-frequency admittance phase ≥44 degrees. PMID:25170779

Air-leak effects on ear-canal acoustic absorbance.

PubMed

Groon, Katherine A; Rasetshwane, Daniel M; Kopun, Judy G; Gorga, Michael P; Neely, Stephen T

2015-01-01

Accurate ear-canal acoustic measurements, such as wideband acoustic admittance, absorbance, and otoacoustic emissions, require that the measurement probe be tightly sealed in the ear canal. Air leaks can compromise the validity of the measurements, interfere with calibrations, and increase variability. There are no established procedures for determining the presence of air leaks or criteria for what size leak would affect the accuracy of ear-canal acoustic measurements. The purpose of this study was to determine ways to quantify the effects of air leaks and to develop objective criteria to detect their presence. Air leaks were simulated by modifying the foam tips that are used with the measurement probe through insertion of thin plastic tubing. To analyze the effect of air leaks, acoustic measurements were taken with both modified and unmodified foam tips in brass-tube cavities and human ear canals. Measurements were initially made in cavities to determine the range of critical leaks. Subsequently, data were collected in ears of 21 adults with normal hearing and normal middle-ear function. Four acoustic metrics were used for predicting the presence of air leaks and for quantifying these leaks: (1) low-frequency admittance phase (averaged over 0.1-0.2 kHz), (2) low-frequency absorbance, (3) the ratio of compliance volume to physical volume (CV/PV), and (4) the air-leak resonance frequency. The outcome variable in this analysis was the absorbance change (Δabsorbance), which was calculated in eight frequency bands. The trends were similar for both the brass cavities and the ear canals. ΔAbsorbance generally increased with air-leak size and was largest for the lower frequency bands (0.1-0.2 and 0.2-0.5 kHz). Air-leak effects were observed in frequencies up to 10 kHz, but their effects above 1 kHz were unpredictable. These high-frequency air leaks were larger in brass cavities than in ear canals. Each of the four predictor variables exhibited consistent dependence on air-leak size. Low-frequency admittance phase and CV/PV decreased, while low-frequency absorbance and the air-leak resonance frequency increased. The effect of air leaks can be significant when their equivalent diameter exceeds 0.01 in. The observed effects were greatest at low frequencies where air leaks caused absorbance to increase. Recommended criteria for detecting air leaks include the following: when the frequency range of interest extends as low as 0.1 kHz, low-frequency absorbance should be ≤0.20 and low-frequency admittance phase ≥61 degrees. For frequency ranges as low as 0.2 kHz, low-frequency absorbance should be ≤0.29 and low-frequency admittance phase ≥44 degrees.

Dietary protein requirement of female adults >65 years determined by the indicator amino acid oxidation technique is higher than current recommendations.

PubMed

Rafii, Mahroukh; Chapman, Karen; Owens, Jillian; Elango, Rajavel; Campbell, Wayne W; Ball, Ronald O; Pencharz, Paul B; Courtney-Martin, Glenda

2015-01-01

Studies on protein requirements in vulnerable groups such as older adults are few, and results are conflicting. The main objective of this study was to determine the protein requirements of free-living women >65 y by measuring the oxidation of l-[1-(13)C]phenylalanine to (13)CO2 in response to graded intakes of protein. Twelve subjects participated in the study, with protein intakes ranging from 0.2 to 2.0 g · kg(-1) · d(-1) for a total of 82 studies. The diets provided energy at 1.5 times each subject's resting energy expenditure and were isocaloric. Protein was given as an amino acid mixture on the basis of the egg protein pattern, except for phenylalanine and tyrosine, which were maintained constant across the protein intake amounts. All subjects were adapted for 2 d before the study day to a protein intake of 1.0 g · kg(-1) · d(-1). The mean protein requirement was determined by applying a mixed-effects change-point regression analysis to F(13)CO2 (label tracer oxidation in (13)CO2 breath), which identified a breakpoint in the F(13)CO2 in response to graded amounts of protein. The mean estimated average requirement (EAR) and upper 95% CI (approximating the RDA) protein requirement of women >65 y were 0.96 and 1.29 g · kg(-1) · d(-1), respectively. These estimates of protein requirements for older women are higher than the current EAR and RDA based on nitrogen balance data, which are 0.66 and 0.80 g · kg(-1) · d(-1), respectively. This trial was registered at clinicaltrials.gov as NCT01604980. © 2015 American Society for Nutrition.

Iodine and Selenium Intakes of Postmenopausal Women in New Zealand.

PubMed

Brough, Louise; Gunn, Caroline A; Weber, Janet L; Coad, Jane; Jin, Ying; Thomson, Jasmine S; Mauze, Mathilde; Kruger, Marlena C

2017-03-09

Iodine and selenium are required for thyroid function. This study investigated iodine and selenium intakes in healthy, women aged 50-70 years ( n = 97) from three cities in the North Island of New Zealand, after mandatory fortification of bread with iodised salt. Iodine and selenium concentrations were determined in 24-h urine samples; daily intakes were extrapolated from amounts in urine (90% and 55% of daily intake, respectively). Three day diet diaries (3DDD) also estimated selenium and iodine (excluding iodised salt) intake. Median urinary iodine concentration (UIC) was 57 (41, 78) µg/L, indicating mild iodine deficiency. Estimated median iodine intake based on urine was 138 (100, 172) µg/day, below Recommended Dietary Intake (RDI) (150 µg/day) with 25% below Estimated Average Requirement (EAR) (100 µg/day). Estimated median selenium intake was 50 (36, 71) µg/day based on urine and 45 (36, 68) µg/day using 3DDD, below RDI (60 µg/day) with 49%-55% below EAR (50 µg/day). Median bread intakes were low at 1.8 (1.1, 2.7) serves/day; 25% consumed ≤1 serve/day. Although population iodine intakes improved following mandatory fortification, some had low intakes. Selenium intakes remain low. Further research should investigate thyroid function of low consumers of iodine fortified bread and/or selenium in New Zealand.

A Retrospective Multicentre Cohort Review of Patient Characteristics and Surgical Aspects versus the Long-Term Outcomes for Recipients of a Fully Implantable Active Middle Ear Implant

PubMed Central

Lefebvre, Philippe P.; Gisbert, Javier; Cuda, Domenico; Tringali, Stéphane; Deveze, Arnaud

2017-01-01

Objective To summarise treatment outcomes compared to surgical and patient variables for a multicentre recipient cohort using a fully implantable active middle ear implant for hearing impairment. To describe the authors' preferred surgical technique to determine microphone placement. Study Design Multicentre retrospective, observational survey. Setting Five tertiary referral centres. Patients Carina recipients (66 ears, 62 subjects) using the current Cochlear® Carina® System or the legacy device, the Otologics® Fully Implantable Middle Ear, with a T2 transducer. Methods Patient file review and routine clinical review. Patient outcomes assessed were satisfaction, daily use and feedback reports at the first fitting and ≥12 months after implantation. Descriptive and statistical analysis of correlations of variables and 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. PMID:28052264

Dietary reference intakes for vitamin D based on the revised 2010 dietary guidelines are not being met by children in Alberta, Canada.

PubMed

Munasinghe, Lalani L; Willows, Noreen; Yuan, Yan; Veugelers, Paul J

2015-11-01

Canadian children have been shown to be not meeting the revised (2010) dietary recommended intake (DRI) for vitamin D through diet alone. However, no study has evaluated whether diet and supplementation together are supporting Canadian children in meeting the DRIs for vitamin D intake. This study assessed the adequacy of vitamin D intake through diet and supplements among Albertan children and the determinants of meeting dietary guidelines. 2686 grade 5 students aged 10 to 11 years in Alberta, Canada were surveyed. We hypothesized that less than 50% of children would meet the DRI. Vitamin D intake from diet and supplements was assessed using a food frequency questionnaire. The adequacy of vitamin D intake was estimated using the Estimated Average Requirement (EAR) of 400 IU (International Units) and Recommended Dietary Allowance (RDA) of 600 IU. Random effect multiple logistic regression was used to identify correlates of meeting DRIs. Forty five percent of children met the EAR and 22% met the RDA for vitamin D. When vitamin D intake from diet alone was considered, only 16% and 2% met the EAR and RDA, respectively. Parental education, household income and physical activity were positively correlated with meeting DRIs, and students attending metropolitan area schools were more likely to meet the EAR than students attending rural area schools (OR = 1.28; P = .043). The majority of children did not meet the DRI for vitamin D. Health promotion strategies aiming to improve the vitamin D status of Albertan children are necessary given the importance of vitamin D for children's health and development. Crown Copyright © 2015. Published by Elsevier Inc. All rights reserved.

Impact of lipid-based nutrient supplementation (LNS) on children's diet adequacy in Western Uganda.

PubMed

Ickes, Scott B; Adair, Linda S; Brahe, Catherine A; Thirumurthy, Harsha; Charles, Baguma; Myhre, Jennifer A; Bentley, Margaret E; Ammerman, Alice S

2015-12-01

Lipid-based nutrient supplements (LNS) can help treat undernutrition; however, the dietary adequacy of children supplemented with LNS, and household utilisation patterns are not well understood. We assessed diet adequacy and the quality of complementary foods by conducting a diet assessment of 128 Ugandan children, ages 6-59 months, who participated in a 10-week programme for children with moderate acute malnutrition (MAM, defined as weight-for-age z-score < -2). Caregivers were given a weekly ration of 650 kcal day(-1) (126 g day(-1) ) of a peanut/soy LNS. Two 24-h dietary recalls were administered per child. LNS was offered to 86% of targeted children at least once. Among non-breastfed children, over 90% met their estimated average requirement (EAR) cut-points for all examined nutrients. Over 90% of breastfed children met EAR cut-points for nutrient density for most nutrients, except for zinc where 11.7% met cut-points. A lower proportion of both breastfed and non-breastfed children met adjusted EARs for the specific nutritional needs of MAM. Fewer than 20% of breastfed children met EAR nutrient-density guidelines for MAM for zinc, vitamin C, vitamin A and folate. Underweight status, the presence of a father in the child's home, and higher programme attendance were all associated with greater odds of feeding LNS to targeted children. Children in this community-based supplemental feeding programme who received a locally produced LNS exhibited substantial micronutrient deficiencies given the special dietary needs of this population. These results can help inform programme strategies to improve LNS targeting, and highlight potential nutrient inadequacies for consumers of LNS in community-based settings. © 2015 John Wiley & Sons Ltd.

Tissue Expansion Using Hyaluronic Acid Filler for Single-Stage Ear Reconstruction: A Novel Concept for Difficult Areas.

PubMed

Inbal, Amir; Lemelman, Benjamin T; Millet, Eran; Greensmith, Andrew

2017-10-16

Auricular reconstruction is one of the most challenging procedures in plastic surgery. An adequate skin envelope is essential for cartilage framework coverage, yet few good options exist without additional surgery. We propose a novel method for minimally invasive tissue expansion, using hyaluronic acid (HA) filler to allow for single-stage ear reconstruction. To introduce the novel concept of HA filler for tissue expansion in ear reconstruction, and as an alternative to traditional expansion techniques. Macrolane is a large particle HA gel developed for large volume restoration. Expansion of the non-hair-bearing mastoid skin was performed in our clinic weekly or every other week. Final expansion was completed one week prior to reconstructive surgery. Tissue from one patient's expanded pocket was sent for histological analysis. Ten patients underwent single-stage auricular reconstruction with preoperative expansion. Injection sessions ranged from 7 to 13 (mean, 9.7). Mean injected volume per session was 2.03 mL per patient, for an average total of 19.8 mL (range, 14.5-30 mL). There were no major complications. One minor complication required removal of exposed wire from the antihelix in the office. Hematoxylin and eosin stain revealed similar histology to that seen with traditional expanders. This novel expansion technique using serial HA injections allowed for optimized skin coverage in single-stage ear reconstruction. The concept of tissue expansion using HA filler is a new frontier for research that may be applicable to other arenas of reconstruction. 4. © 2017 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com

Vitamin D status in Montréal preschoolers is satisfactory despite low vitamin D intake.

PubMed

El Hayek, Jessy; Pham, Thu Trang; Finch, Sarah; Hazell, Tom J; Jean-Philippe, Sonia; Vanstone, Catherine A; Agellon, Sherry; Rodd, Celia; Rauch, Frank; Weiler, Hope A

2013-02-01

The 2007 to 2009 Canadian Health Measures Survey reported vitamin D status in a representative sample of Canadians (6-79 y); however, children <6 y were not assessed. Our objective was to measure vitamin D intake from food and supplements, sun exposure, and biological vitamin D status of children ages 2 through 5 y in Montréal (latitude 45°N). Preschoolers (n = 508) were recruited between June 2010 and 2011 in a random sample of licensed daycares in the regions of greater Montréal, Canada in a cross-sectional study. The total plasma 25-hydroxyvitamin D [25(OH)D] concentration was measured using a chemiluminescence assay (Liaison, Diasorin). Dietary intake was assessed during one 24-h period plus a 30-d FFQ. Socioeconomic, demographic, anthropometry, and sun exposure data were collected. Plasma 25(OH)D was ≥50 nmol/L in 88% of children, whereas 49.4% had concentrations ≥75 nmol/L during the 1-y study. Almost 95% of preschoolers had vitamin D intakes less than the Estimated Average Requirement (EAR), and 4.8% of preschoolers ≤3.9 y and 25.9% of preschoolers ≥4 y had calcium intakes less than the EAR. Plasma 25(OH)D was different across age, income, sun index, milk intake, and dietary and supplemental vitamin D intake tertiles. Despite vitamin D intakes less than the EAR, the vitamin D status of Montréal preschoolers attending daycare is mostly satisfactory even in winter, suggesting that the EAR value is too high in the context of typical exogenous intakes of vitamin D in North America.

Effect of cotton bollworm (Helicoverpa armigera Hübner) caused injury on maize grain content, especially regarding to the protein alteration.

PubMed

Keszthelyi, S; Pál-Fám, F; Kerepesi, I

2011-03-01

The cotton bollworm (Helicoverpa armigera Hübner), which migrated in the Carpathian-basin from Mediterraneum in the last decades, is becoming an increasingly serious problem for maize producers in Hungary. In several regions the damage it causes has reached the threshold of economic loss, especially in the case of the sweet maize cultivation. The aim of the research was to determine the changing of ears weights and in-kernel accumulation and alteration in grain as a function of cotton bollworm mastication.Our investigation confirmed that there is an in-kernel and protein pattern change of maize grain by cotton bollworm. Our results proved the significant damaging of each part of ears by cotton bollworm masticating (the average weight loss of ears: 13.99%; the average weight loss of grains: 14.03%; the average weight loss of cobs: 13.74%), with the exception of the increasing of the grain-cob ratio. Our examinations did not prove the water loss - that is the "forced maturing" - caused by the damage. Decreasing of raw fat (control: 2.8%; part-damaged: 2.6%; damaged: 2.4%) and starch content (control: 53.1%; part-damaged: 46.6%; damaged: 44.7%) were registered as a function of injury. In contrast, the raw protein content was increased (control: 4.7%; part-damaged: 5.3%; damaged: 7.4%) by maize ear masticating. The most conspicuous effect on protein composition changing was proved by comparison of damaged grain samples by SDS PAGE. Increased amounts of 114, 50, 46 and 35 kDa molecular mass proteins were detected which explained the more than 50% elevation of raw protein content. The statistical analysis of molecular weights proved the protein realignment as a function of the pest injuries, too.

77 FR 75011 - Revisions to Authorization Validated End-User Provisions: Requirement for Notice of Export...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-19

... Bureau of Industry and Security (BIS) amends the Export Administration Regulations (EAR) by adding a...-specific conditions under Authorization VEU no longer require a license for export or reexport or become eligible for shipment under a license exception, as set forth in the EAR, VEUs are no longer bound by the...

15 CFR 743.1 - Wassenaar Arrangement.

Code of Federal Regulations, 2012 CFR

2012-01-01

... accordance with part 762 of the EAR. This section does not require reports for reexports. Note to paragraph (a) of this section: For purposes of part 743, the term “you” has the same meaning as the term “exporter”, as defined in part 772 of the EAR. (b) Requirements. You must submit two (2) copies of each...

Association Between Hearing Loss And Cauliflower Ear in Wrestlers, a Case Control Study Employing Hearing Tests.

PubMed

Noormohammadpour, Pardis; Rostami, Mohsen; Nourian, Ruhollah; Mansournia, Mohammad Ali; Sarough Farahani, Saeed; Farahbakhsh, Farzin; Kordi, Ramin

2015-06-01

According to anecdotal findings, some wrestling coaches and wrestlers believe that cauliflower ear might lead to hearing loss. Our preliminary study showed that the prevalence of hearing loss reported by the wrestlers with cauliflower ear is significantly higher than this rate among wrestlers without cauliflower ear. To the best of our knowledge, no other study has confirmed this finding employing hearing tests. To evaluate and to compare the prevalence of hearing loss among wrestlers with and without cauliflower ears employing hearing tests. The subjects were randomly selected form 14 wrestling clubs in Tehran. Subjects were 201 wrestlers with cauliflower ears (100 wrestlers with one cauliflower ear and 101 wrestlers with two cauliflower ears) and 139 wrestlers without cauliflower ears. All the participants in this study were interviewed to collect information on demographic factors and medical history of risk factors and diseases related to hearing loss. The subjects in both groups underwent otoscopic and audiologic examinations. Audiometric examination results at the frequency range of 0.5 - 8 KHz showed that the prevalence of hearing loss among cauliflower ears was higher than this rate among non-cauliflower ears. Also, the percentage of positive history of ear infections among cauliflower ears (8.4%) was about two times more than this finding among non-cauliflower ears (4.9%). This difference tended to be significant (OR: 1.86, P = 0.06, 95% CI: 0.98 - 3.53). To the best of our knowledge, this is the first study showing that the prevalence of hearing loss among cauliflower ears is higher than this rate among non-cauliflower ears confirmed by audiological tests. This emphasizes that, more preventive measures such as mandatory ear gear for wrestlers are required.

Association Between Hearing Loss And Cauliflower Ear in Wrestlers, a Case Control Study Employing Hearing Tests

PubMed Central

Noormohammadpour, Pardis; Rostami, Mohsen; Nourian, Ruhollah; Mansournia, Mohammad Ali; Sarough Farahani, Saeed; Farahbakhsh, Farzin; Kordi, Ramin

2015-01-01

Background: According to anecdotal findings, some wrestling coaches and wrestlers believe that cauliflower ear might lead to hearing loss. Our preliminary study showed that the prevalence of hearing loss reported by the wrestlers with cauliflower ear is significantly higher than this rate among wrestlers without cauliflower ear. To the best of our knowledge, no other study has confirmed this finding employing hearing tests. Objectives: To evaluate and to compare the prevalence of hearing loss among wrestlers with and without cauliflower ears employing hearing tests. Patients and Methods: The subjects were randomly selected form 14 wrestling clubs in Tehran. Subjects were 201 wrestlers with cauliflower ears (100 wrestlers with one cauliflower ear and 101 wrestlers with two cauliflower ears) and 139 wrestlers without cauliflower ears. All the participants in this study were interviewed to collect information on demographic factors and medical history of risk factors and diseases related to hearing loss. The subjects in both groups underwent otoscopic and audiologic examinations. Results: Audiometric examination results at the frequency range of 0.5 - 8 KHz showed that the prevalence of hearing loss among cauliflower ears was higher than this rate among non-cauliflower ears. Also, the percentage of positive history of ear infections among cauliflower ears (8.4%) was about two times more than this finding among non-cauliflower ears (4.9%). This difference tended to be significant (OR: 1.86, P = 0.06, 95% CI: 0.98 - 3.53). Conclusions: To the best of our knowledge, this is the first study showing that the prevalence of hearing loss among cauliflower ears is higher than this rate among non-cauliflower ears confirmed by audiological tests. This emphasizes that, more preventive measures such as mandatory ear gear for wrestlers are required. PMID:26448842

Enzymatic recontouring of auricular cartilage in a rabbit model.

PubMed

Massengill, Phillip L; Goco, Paulino E; Norlund, L Layne; Muir-Padilla, Jeanne

2005-01-01

To evaluate the effectiveness of contouring auricular cartilage in a rabbit model using biologically active enzymes injected subcutaneously. The first phase determined the most effective volume and concentration required to affect the cartilage. To accomplish this task, we used ex vivo rabbit ears from a slaughterhouse. In the second phase, we injected 1 mL of hyaluronidase (150 U per milliliter of isotonic sodium chloride solution [saline]), elastase (1 mg per milliliter of saline), or saline into the ears of live rabbits. The study took place at the Madigan Army Medical Center (Tacoma, Wash), and included 10 animals. In each rabbit, we injected the test compound in one ear and saline in the other ear (control). We injected hyaluronidase in 5 ears and elastase in 5 ears. After injection, the ears were contoured and splinted for 4 weeks. In the third phase, we changed the injection pathway in 5 animals. At 4 weeks, 4 (80%) of the 5 ears injected with hyaluronidase showed full response and 1 (20%) had a partial response. Of the 5 ears injected with elastase, 4 (80%) showed a full response while 1 (20%) demonstrated a partial response. There was a response in all 10 of the ears injected with a test compound. Of the 10 control ears, 3 (30%) showed a partial response. At 6 weeks, approximately 6 (30%) of the ears had maintained contour demonstrating a full response. The difference between the test ears and the control ears was statistically significant (P = .006). Compared with the control ears, the results were statistically significant for elastase (P = .004) and hyaluronidase (P = .02). Overall, both agents demonstrated a subjective and objective response compared with control ears. This study demonstrates that bioactive enzymes and splinting can be effective in correcting ear deformities in a rabbit model.

High-throughput method for ear phenotyping and kernel weight estimation in maize using ear digital imaging.

PubMed

Makanza, R; Zaman-Allah, M; Cairns, J E; Eyre, J; Burgueño, J; Pacheco, Ángela; Diepenbrock, C; Magorokosho, C; Tarekegne, A; Olsen, M; Prasanna, B M

2018-01-01

Grain yield, ear and kernel attributes can assist to understand the performance of maize plant under different environmental conditions and can be used in the variety development process to address farmer's preferences. These parameters are however still laborious and expensive to measure. A low-cost ear digital imaging method was developed that provides estimates of ear and kernel attributes i.e., ear number and size, kernel number and size as well as kernel weight from photos of ears harvested from field trial plots. The image processing method uses a script that runs in a batch mode on ImageJ; an open source software. Kernel weight was estimated using the total kernel number derived from the number of kernels visible on the image and the average kernel size. Data showed a good agreement in terms of accuracy and precision between ground truth measurements and data generated through image processing. Broad-sense heritability of the estimated parameters was in the range or higher than that for measured grain weight. Limitation of the method for kernel weight estimation is discussed. The method developed in this work provides an opportunity to significantly reduce the cost of selection in the breeding process, especially for resource constrained crop improvement programs and can be used to learn more about the genetic bases of grain yield determinants.

Perception of suprasegmental speech features via bimodal stimulation: cochlear implant on one ear and hearing aid on the other.

PubMed

Most, Tova; Harel, Tamar; Shpak, Talma; Luntz, Michal

2011-04-01

The purpose of the study was to evaluate the contribution of acoustic hearing to the perception of suprasegmental features by adults who use a cochlear implant (CI) and a hearing aid (HA) in opposite ears. 23 adults participated in this study. Perception of suprasegmental features-intonation, syllable stress, and word emphasis-was assessed. All tests were administered in 2 conditions: CI alone and CI + HA (bimodal). Scores were significantly higher in the bimodal condition in comparison to scores in CI alone for all 3 tests. In both conditions, there was great variability among the individual participants. Significant negative correlations emerged between perception of suprasegmental features and the unaided pure-tone average of the contralateral ear to the CI. This study found a significant bimodal advantage for perception of all suprasegmental features, most probably due to the better low-frequency acoustic hearing that is provided by the HA. Outcomes suggest that in cases of residual hearing in the contralateral ear to the implanted ear, HA use should be encouraged.

Magnetically driven middle ear ossicles for optical measurement of vibrations in an ear with opened tympanic membrane

NASA Astrophysics Data System (ADS)

Peacock, J.; von Unge, M.; Dirckx, J.

2013-12-01

Vibrations of the middle ear ossicles are easily measured by means of laser vibrometry. However, laser vibrometry requires free visual access to the object under investigation, and acquiring free visual access to the ossicles through the ear canal requires the removal of the tympanic membrane (TM), with the result that the ossicles can no longer be stimulated acoustically. To overcome this, we devised a new setup in which the ossicles can be driven magnetically. After measuring the response of the TM to an acoustic signal, we then remove it and attach a small magnet to the exposed manubrium (a part of the most lateral auditory ossicle, the malleus, which is normally attached to the TM). An electromagnetic excitation coil is then used to drive the magnet, and the output to the coil adjusted until the vibration of the manubrium, as measured by the vibrometer, matches that measured in response to the acoustic signal. Such a setup may have uses in research on middle ear mechanics, such as the measurement of nonlinearities in their response, as well as applications in the diagnosis of middle ear conditions such as the fixation of the ossicles by otosclerosis or in chronic otitis media. We describe our setup and discuss the viability of our method and its future clinical potential by presenting some measurements on an artificially fixated ear.

Scanning Thin-Sheet Laser Imaging Microscopy Elucidates Details on Mouse Ear Development

PubMed Central

Kopecky, Benjamin; Johnson, Shane; Schmitz, Heather; Santi, Peter; Fritzsch, Bernd

2016-01-01

Background The mammalian inner ear is transformed from a flat placode into a three-dimensional (3D) structure with six sensory epithelia that allow for the perception of sound and both linear and angular acceleration. While hearing and balance problems are typically considered to be adult onset diseases, they may arise as a developmental perturbation to the developing ear. Future prevention of hearing or balance loss requires an understanding of how closely genetic mutations in model organisms reflect the human case, necessitating an objective multidimensional comparison of mouse ears with human ears that have comparable mutations in the same gene. Results Here, we present improved 3D analyses of normal murine ears during embryonic development using optical sections obtained through Thin-Sheet Laser Imaging Microscopy. We chronicle the transformation of an undifferentiated otic vesicle between mouse embryonic day 11.5 to a fully differentiated inner ear at postnatal day 15. Conclusions Our analysis of ear development provides new insights into ear development, enables unique perspectives into the complex development of the ear, and allows for the first full quantification of volumetric and linear aspects of ear growth. Our data provide the framework for future analysis of mutant phenotypes that are currently under-appreciated using only two dimensional renderings. PMID:22271591

Scanning thin-sheet laser imaging microscopy elucidates details on mouse ear development.

PubMed

Kopecky, Benjamin; Johnson, Shane; Schmitz, Heather; Santi, Peter; Fritzsch, Bernd

2012-03-01

The mammalian inner ear is transformed from a flat placode into a three-dimensional (3D) structure with six sensory epithelia that allow for the perception of sound and both linear and angular acceleration. While hearing and balance problems are typically considered to be adult onset diseases, they may arise as a developmental perturbation to the developing ear. Future prevention of hearing or balance loss requires an understanding of how closely genetic mutations in model organisms reflect the human case, necessitating an objective multidimensional comparison of mouse ears with human ears that have comparable mutations in the same gene. Here, we present improved 3D analyses of normal murine ears during embryonic development using optical sections obtained through Thin-Sheet Laser Imaging Microscopy. We chronicle the transformation of an undifferentiated otic vesicle between mouse embryonic day 11.5 to a fully differentiated inner ear at postnatal day 15. Our analysis of ear development provides new insights into ear development, enables unique perspectives into the complex development of the ear, and allows for the first full quantification of volumetric and linear aspects of ear growth. Our data provide the framework for future analysis of mutant phenotypes that are currently under-appreciated using only two dimensional renderings. Copyright © 2012 Wiley Periodicals, Inc.

Binaural Pitch Fusion in Bilateral Cochlear Implant Users.

PubMed

Reiss, Lina A J; Fowler, Jennifer R; Hartling, Curtis L; Oh, Yonghee

Binaural pitch fusion is the fusion of stimuli that evoke different pitches between the ears into a single auditory image. Individuals who use hearing aids or bimodal cochlear implants (CIs) experience abnormally broad binaural pitch fusion, such that sounds differing in pitch by as much as 3-4 octaves are fused across ears, leading to spectral averaging and speech perception interference. The goal of this study was to determine if adult bilateral CI users also experience broad binaural pitch fusion. Stimuli were pulse trains delivered to individual electrodes. Fusion ranges were measured using simultaneous, dichotic presentation of reference and comparison stimuli in opposite ears, and varying the comparison stimulus to find the range that fused with the reference stimulus. Bilateral CI listeners had binaural pitch fusion ranges varying from 0 to 12 mm (average 6.1 ± 3.9 mm), where 12 mm indicates fusion over all electrodes in the array. No significant correlations of fusion range were observed with any subject factors related to age, hearing loss history, or hearing device history, or with any electrode factors including interaural electrode pitch mismatch, pitch match bandwidth, or within-ear electrode discrimination abilities. Bilateral CI listeners have abnormally broad fusion, similar to hearing aid and bimodal CI listeners. This broad fusion may explain the variability of binaural benefits for speech perception in quiet and in noise in bilateral CI users.

New Evaluation of the Electronically Activated Recorder (EAR): Obtrusiveness, Compliance, and Participant Self-selection Effects

PubMed Central

Manson, Joseph H.; Robbins, Megan L.

2017-01-01

The Electronically Activated Recorder (EAR) is a method for collecting periodic brief audio snippets of participants’ daily lives using a portable recording device. The EAR can potentially intrude into people’s privacy, alter their natural behavior, and introduce self-selection biases greater than in other types of social science methods. Previous research (Mehl and Holleran, 2007, hereafter M&H) has shown that participant non-compliance with, and perceived obtrusiveness of, an EAR protocol are both low. However, these questions have not been addressed in jurisdictions that require the consent of all parties to recording conversations. This EAR study required participants to wear a button bearing a microphone icon and the words “This conversation may be recorded” to comply with California’s all-party consent law. Results revealed self-reported obtrusiveness and non-compliance were actually lower in the present study than in the M&H study. Behaviorally assessed non-compliance did not differ between the two studies. Participants in the present study talked more about being in the study than participants in the M&H study, but such talk still comprised <2% of sampled conversations. Another potential problem with the EAR, participant self-selection bias, was addressed by comparing the EAR volunteers’ HEXACO personality dimensions to a non-volunteer sample drawn from the same student population. EAR volunteers were significantly and moderately higher in Conscientiousness, and lower in Emotionality, than non-volunteers. In conclusion, the EAR method can be successfully implemented in at least one all-party consent state (California). Interested researchers are encouraged to review this procedure with their own legal counsel. PMID:28503162

Early-Life Exposure to Outdoor Air Pollution and Respiratory Health, Ear Infections, and Eczema in Infants from the INMA Study

PubMed Central

Pedersen, Marie; Garcia-Esteban, Raquel; Ballester, Ferran; Basterrechea, Mikel; Esplugues, Ana; Fernández-Somoano, Ana; Lertxundi, Aitana; Tardón, Adonina; Sunyer, Jordi

2012-01-01

Background: Prenatal and early-life periods may be critical windows for harmful effects of air pollution on infant health. Objectives: We studied the association of air pollution exposure during pregnancy and the first year of life with respiratory illnesses, ear infections, and eczema during the first 12–18 months of age in a Spanish birth cohort of 2,199 infants. Methods: We obtained parentally reported information on doctor-diagnosed lower respiratory tract infections (LRTI) and parental reports of wheezing, eczema, and ear infections. We estimated individual exposures to nitrogen dioxide (NO2) and benzene with temporally adjusted land use regression models. We used log-binomial regression models and a combined random-effects meta-analysis to estimate the effects of air pollution exposure on health outcomes across the four study locations. Results: A 10-µg/m3 increase in average NO2 during pregnancy was associated with LRTI [relative risk (RR) = 1.05; 95% CI: 0.98, 1.12] and ear infections (RR = 1.18; 95% CI: 0.98, 1.41). The RRs for an interquartile range (IQR) increase in NO2 were 1.08 (95% CI: 0.97, 1.21) for LRTI and 1.31 (95% CI: 0.97, 1.76) for ear infections. Compared with NO2, the association for an IQR increase in average benzene exposure was similar for LRTI (RR = 1.06; 95% CI: 0.94, 1.19) and slightly lower for ear infections (RR = 1.17; 95% CI: 0.93, 1.46). Associations were slightly stronger among infants whose mothers spent more time at home during pregnancy. Air pollution exposure during the first year was highly correlated with prenatal exposure, so we were unable to discern the relative importance of each exposure period. Conclusions: Our findings support the hypothesis that early-life exposure to ambient air pollution may increase the risk of upper and lower respiratory tract infections in infants. PMID:23221880

Evaluation of the Repeatability and Accuracy of the Wideband Real-Ear-to-Coupler Difference.

PubMed

Vaisberg, Jonathan M; Folkeard, Paula; Pumford, John; Narten, Philipp; Scollie, Susan

2018-06-01

The real-ear-to-coupler difference (RECD) is an ANSI standardized method for estimating ear canal sound pressure level (SPL) thresholds and assisting in the prediction of real-ear aided responses. It measures the difference in dB between the SPL produced in the ear canal and the SPL produced in an HA-1 2-cc coupler by the same sound source. Recent evidence demonstrates that extended high-frequency bandwidth, beyond the hearing aid bandwidth typically measured, is capable of providing additional clinical benefit. The industry has, in turn, moved toward developing hearing aids and verification equipment capable of producing and measuring extended high-frequency audible output. As a result, a revised RECD procedure conducted using a smaller, 0.4-cc coupler, known as the wideband-RECD (wRECD), has been introduced to facilitate extended high-frequency coupler-based measurements up to 12.5 kHz. This study aimed to (1) compare test-retest repeatability between the RECD and wRECD and (2) measure absolute agreement between the RECD and wRECD when both are referenced to a common coupler. RECDs and wRECDs were measured bilaterally in adult ears by calculating the dB difference in SPL between the ear canal and coupler responses. Real-ear probe microphone measures were completed twice per ear per participant for both foam-tip and customized earmold couplings using the Audioscan Verifit 1 and Verifit 2 fitting systems, followed by measurements in the respective couplers. Twenty-one adults (mean age = 67 yr, range = 19-78) with typical aural anatomy (as determined by measures of impedance and otoscopy) participated in this study, leading to a sample size of 42 ears. Repeatability within RECD and wRECD was assessed for each coupling configuration using a repeated-measures analysis of variance (ANOVA) with test-retest and frequency as within-participants factors. Repeatability between the RECD and wRECD was assessed within each configuration using a repeated-measures ANOVA with test-retest, frequency, and coupler type as within-participants factors. Agreement between the RECD and wRECD was assessed for each coupling configuration using a repeated-measures ANOVA with RECD value, coupler type, and frequency as within-participants factors. Post hoc comparisons with Bonferroni corrections were used when appropriate to locate the frequencies at which differences occurred. A 3-dB criterion was defined to locate differences of clinical significance. Average absolute test-retest differences were within ±3 dB within each coupler and coupling configuration, and between the RECD and wRECD. The RECD and wRECD were in absolute agreement following HA-1-referenced transforms, with most frequencies agreeing within ±1 dB, except at 0.2 kHz for the earmold, and 0.2-0.25 kHz for the foam tip, where the average RECD exceeded the average wRECD by slightly >3 dB. Test-retest repeatability of the RECD (up to 8 kHz) and wRECD (up to 12.5 kHz) is acceptable and similar to previously reported data. The RECD and wRECD are referenced to different couplers, but can be rendered comparable with a simple transform, producing values that are in accordance with the ANSI S3.46-2013 standard. American Academy of Audiology.

Differences in nutritional status of preschool children in the context of the maternal social characteristics.

PubMed

Potocka, Adrianna; Jacukowicz, Aleksandra

2017-07-14

It is generally accepted that maternal factors are important in maintaining the adequate nutritional status of young children. This study was aimed at verifying whether mother's socio-demographic (age and relationship status) and socio-economic features (education and professional status) differentiate the child's nutritional status. A cross-sectional study was conducted between April and October 2013. Five hundred thirty mothers of preschool children from 5 different regions of Poland were interviewed. Mothers were interviewed on their socio-demographic and socio-economic status. To assess the child's nutritional status, body mass index (BMI) z-score and the diet indicators were calculated, such as the percentage of the estimated average requirement for energy (%EAR), the percentage of energy coming from carbohydrates (%EC), fat (%ET) and proteins (%EP). Percentage of the estimated average requirement for energy, %EC, %ET and %EP was obtained from 24-h dietary recalls conducted with the mothers. The results showed that mother's education and professional status did not differentiate any of the indices of the child's nutritional status. However, maternal age and her relationship status occurred significant (ANOVA; p < 0.05). Children of younger mothers had higher BMI z-score and higher %EC as compared to children of older mothers. Moreover, %EAR was higher among children of single mothers and it was closer to the recommended nutrition standards as compared to children of mothers with a partner. When a child is diagnosed with any type of malnutrition, it is worth assessing various factors that might influence the nutritional status, such as child's social background (e.g., maternal factors). Int J Occup Med Environ Health 2017;30(5):811-821. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

15 CFR 745.1 - Advance notification and annual report of all exports of Schedule 1 chemicals to other States...

Code of Federal Regulations, 2014 CFR

2014-01-01

... plan to export any quantity of a Schedule 1 chemical controlled under the EAR and licensed by the... chemicals subject to the EAR or from the Department of State for the export of Schedule 1 chemicals subject... State Party. This is in addition to the requirement to obtain an export license under the EAR for...

15 CFR 745.1 - Advance notification and annual report of all exports of Schedule 1 chemicals to other States...

Code of Federal Regulations, 2012 CFR

2012-01-01

... plan to export any quantity of a Schedule 1 chemical controlled under the EAR and licensed by the... chemicals subject to the EAR or from the Department of State for the export of Schedule 1 chemicals subject... State Party. This is in addition to the requirement to obtain an export license under the EAR for...

15 CFR 745.1 - Advance notification and annual report of all exports of Schedule 1 chemicals to other States...

Code of Federal Regulations, 2013 CFR

2013-01-01

... plan to export any quantity of a Schedule 1 chemical controlled under the EAR and licensed by the... chemicals subject to the EAR or from the Department of State for the export of Schedule 1 chemicals subject... State Party. This is in addition to the requirement to obtain an export license under the EAR for...

The zinc finger transcription factor Gfi1, implicated in lymphomagenesis, is required for inner ear hair cell differentiation and survival

NASA Technical Reports Server (NTRS)

Wallis, Deeann; Hamblen, Melanie; Zhou, Yi; Venken, Koen J T.; Schumacher, Armin; Grimes, H. Leighton; Zoghbi, Huda Y.; Orkin, Stuart H.; Bellen, Hugo J.

2003-01-01

Gfi1 was first identified as causing interleukin 2-independent growth in T cells and lymphomagenesis in mice. Much work has shown that Gfi1 and Gfi1b, a second mouse homolog, play pivotal roles in blood cell lineage differentiation. However, neither Gfi1 nor Gfi1b has been implicated in nervous system development, even though their invertebrate homologues, senseless in Drosophila and pag-3 in C. elegans are expressed and required in the nervous system. We show that Gfi1 mRNA is expressed in many areas that give rise to neuronal cells during embryonic development in mouse, and that Gfi1 protein has a more restricted expression pattern. By E12.5 Gfi1 mRNA is expressed in both the CNS and PNS as well as in many sensory epithelia including the developing inner ear epithelia. At later developmental stages, Gfi1 expression in the ear is refined to the hair cells and neurons throughout the inner ear. Gfi1 protein is expressed in a more restricted pattern in specialized sensory cells of the PNS, including the eye, presumptive Merkel cells, the lung and hair cells of the inner ear. Gfi1 mutant mice display behavioral defects that are consistent with inner ear anomalies, as they are ataxic, circle, display head tilting behavior and do not respond to noise. They have a unique inner ear phenotype in that the vestibular and cochlear hair cells are differentially affected. Although Gfi1-deficient mice initially specify inner ear hair cells, these hair cells are disorganized in both the vestibule and cochlea. The outer hair cells of the cochlea are improperly innervated and express neuronal markers that are not normally expressed in these cells. Furthermore, Gfi1 mutant mice lose all cochlear hair cells just prior to and soon after birth through apoptosis. Finally, by five months of age there is also a dramatic reduction in the number of cochlear neurons. Hence, Gfi1 is expressed in the developing nervous system, is required for inner ear hair cell differentiation, and its loss causes programmed cell death.

Challenges in fitting a hearing aid to a severely collapsed ear canal and mixed hearing loss.

PubMed

Oeding, Kristi; Valente, Michael; Chole, Richard

2012-04-01

Collapsed ear canals typically occur when an outside force, such as a headset for audiometric testing, is present. However, when a collapsed ear canal occurs without external pressure, this creates a challenge not only for performing audiometric testing but also for coupling a hearing aid to the ear canal. This case report highlights the challenges associated with fitting a hearing aid on a patient with a severe anterior-posterior collapsed ear canal with a mixed hearing loss. A 67-yr-old female originally presented to Washington University in St. Louis School of Medicine in 1996 with a long-standing history of bilateral otosclerosis. She had chronic ear infections in the right ear and a severely collapsed ear canal in the left ear and was fit with a bone anchored hearing aid (BAHA®) on the right side in 2003. However, benefit from the BAHA started to decrease due to changes in hearing, and a different hearing solution was needed. It was proposed that a hearing aid be fit to her collapsed left ear canal; however, trying to couple a hearing aid to the collapsed ear canal required unique noncustom earmold solutions. This case study highlights some of the obstacles and potential solutions for coupling a hearing aid to a severely collapsed ear canal. American Academy of Audiology.

Development of a morphing technique for predicting the position and size of an artificial ear in hemifacial microsomia patients.

PubMed

Coward, Trevor J; Richards, Robin; Scott, Brendan J J

2014-01-01

People with hemifacial microsomia may be missing an ear on the affected side of the face. The principal aim of the study was to develop a morphing technique and to determine whether it could be used to appropriately position an artificial ear, as well as to give an indication of prosthesis size in comparison with the natural ear. Comparisons also were made between the artificial ears being worn by the patients with their natural ears. Data from stereophotogrammetry images of the faces of 10 people were converted into stereolithographic format. Anthropometric points on the face and ear of the unaffected side were plotted. By a process of scaling, the distance between facial landmarks on the unaffected side was estimated for the affected side so as to identify where the morphed ear would be positioned once generated. Generally, the morphed ears appeared to be in acceptable positions. There was a statistically significant difference between the position of the morphed and natural ears (P = .011), as well as the artificial and natural ears (P = .001), but this was unlikely to have any clinical implications. There were no significant differences among the sizes of the natural, morphed, and artificial ears (P = .072). Morphing appears to offer a more precise way of planning the positioning and construction of an artificial ear on patients with hemifacial microsomia than traditional methods. Differences in facial shape on either side of the face may impact on the process. This requires further study.

Characterizing the ear canal acoustic reflectance and impedance by pole-zero fitting

PubMed Central

Robinson, Sarah R.; Nguyen, Cac T.; Allen, Jont B.

2013-01-01

This study characterizes middle ear complex acoustic reflectance (CAR) and impedance by fitting poles and zeros to real-ear measurements. The goal of this work is to establish a quantitative connection between pole-zero locations and the underlying physical properties of CAR data. Most previous studies have analyzed CAR magnitude; while the magnitude accounts for reflected power, it does not encode latency information. Thus, an analysis that studies the real and imaginary parts of the data together could be more powerful. Pole-zero fitting of CAR data is examined using data compiled from various studies, dating back to Voss and Allen (1994). Recent CAR measurements were taken using a middle ear acoustic power analyzer (MEPA) system (HearID, Mimosa Acoustics), which makes complex acoustic impedance and reflectance measurements in the ear canal over the 0.2 to 6.0 kHz frequency range. Pole-zero fits to measurements over this range are achieved with an average RMS relative error of less than 3% using 12 poles. Factoring the reflectance fit into its all-pass and minimum-phase components approximates the effect of the ear canal, allowing for comparison across measurements. It was found that individual CAR magnitude variations for normal middle ears in the 1 to 4 kHz range often give rise to closely-placed pole-zero pairs, and that the locations of the poles and zeros in the s-plane may differ between normal and pathological middle ears. This study establishes a methodology for examining the physical and mathematical properties of CAR using a concise parametric model. Pole-zero modeling shows promise for precise parameterization of CAR data and for identification of middle ear pathologies. PMID:23524141

JPL noise control program

NASA Technical Reports Server (NTRS)

Klascius, A. F.

1975-01-01

Exposures of personnel to noise pollution at the Jet Propulsion Laboratories, Pasadena, California, were investigated. As a result of the study several protective measures were taken: (1) employees exposed to noise hazards were required to wear ear-protection devices, (2) mufflers and air diversion devices were installed around the wind tunnels; and (3) all personnel that are required to wear ear protection are given annual audimeter tests.

Development of optoelectronic monitoring system for ear arterial pressure waveforms

NASA Astrophysics Data System (ADS)

Sasayama, Satoshi; Imachi, Yu; Yagi, Tamotsu; Imachi, Kou; Ono, Toshirou; Man-i, Masando

1994-02-01

Invasive intra-arterial blood pressure measurement is the most accurate method but not practical if the subject is in motion. The apparatus developed by Wesseling et al., based on a volume-clamp method of Penaz (Finapres), is able to monitor continuous finger arterial pressure waveforms noninvasively. The limitation of Finapres is the difficulty in measuring the pressure of a subject during work that involves finger or arm action. Because the Finapres detector is attached to subject's finger, the measurements are affected by inertia of blood and hydrostatic effect cause by arm or finger motion. To overcome this problem, the authors made a detector that is attached to subject's ear and developed and optoelectronic monitoring systems for ear arterial pressure waveform (Earpres). An IR LEDs, photodiode, and air cuff comprised the detector. The detector was attached to a subject's ear, and the space adjusted between the air cuff and the rubber plate on which the LED and photodiode were positioned. To evaluate the accuracy of Earpres, the following tests were conducted with participation of 10 healthy male volunteers. The subjects rested for about five minutes, then performed standing and squatting exercises to provide wide ranges of systolic and diastolic arterial pressure. Intra- and inter-individual standard errors were calculated according to the method of van Egmond et al. As a result, average, the averages of intra-individual standard errors for earpres appeared small (3.7 and 2.7 mmHg for systolic and diastolic pressure respectively). The inter-individual standard errors for Earpres were about the same was Finapres for both systolic and diastolic pressure. The results showed the ear monitor was reliable in measuring arterial blood pressure waveforms and might be applicable to various fields such as sports medicine and ergonomics.

The newborn butterfly project: a shortened treatment protocol for ear molding.

PubMed

Doft, Melissa A; Goodkind, Alison B; Diamond, Shawn; DiPace, Jennifer I; Kacker, Ashutosh; LaBruna, Anthony N

2015-03-01

Secondary to circulating maternal estrogens, a baby's ear cartilage is unusually plastic during the first few weeks of life, providing an opportunity to correct ear deformities by molding. If molding is initiated during the first days of life with a more rigid molding system than previously described in the literature, the authors hypothesized that treatment time would be reduced and the correction rate would increase. An interdisciplinary team identified and assessed all infants born with ear deformities at New York-Presbyterian Hospital/Weill Cornell Medical Center. The authors conducted a prospective, institutional review board-approved study on the first consecutive 100 infants identified. Parents were surveyed initially, immediately after treatment, and at 6 and 12 months. One hundred fifty-eight ears in 96 patients underwent ear molding using the EarWell Infant Ear Correction System. Eighty-two percent of the children had the device placed in the newborn nursery and 95 percent had it placed before 2 weeks of life. Average treatment time was 14 days, and 96 percent of the deformities were corrected. Complications were limited to mild pressure ulcerations. Ninety-nine percent of parents stated that they would have the procedure repeated. The molding period can be reduced from 6 to 8 weeks to 2 weeks by initiating molding during the first weeks of life and using a more secure and rigid device. Through an interdisciplinary approach, the authors were able to identify patients and to correct the deformity earlier and faster than has been previously published, eliminating the need for surgical correction in many children. Therapeutic, IV.

Pressure transfer function and absorption cross section from the diffuse field to the human infant ear canal.

PubMed

Keefe, D H; Bulen, J C; Campbell, S L; Burns, E M

1994-01-01

The diffuse-field pressure transfer function from a reverberant field to the ear canal of human infants, ages 1, 3, 6, 12, and 24 months, has been measured from 125-10700 Hz. The source was a loudspeaker using pink noise, and the diffuse-field pressure and the ear-canal pressure were simultaneously measured using a spatial averaging technique in a reverberant room. The results in most subjects show a two-peak structure in the 2-6-kHz range, corresponding to the ear-canal and concha resonances. The ear-canal resonance frequency decreases from 4.4 kHz at age 1 month to 2.9 kHz at age 24 months. The concha resonance frequency decreases from 5.5 kHz at age 1 month to 4.5 kHz at age 24 months. Below 2 kHz, the diffuse-field transfer function shows effects due to the torsos of the infant and parent, and varies with how the infant is held. Comparisons are reported of the diffuse-field absorption cross section for infants relative to adults. This quantity is a measure of power absorbed by the middle ear from a diffuse sound field, and large differences are observed in infants relative to adults. The radiation efficiencies of the infant and the adult ear are small at low frequencies, near unity at midfrequencies, and decrease at higher frequencies. The process of ear-canal development is not yet complete at age 24 months. The results have implications for experiments on hearing in infants.

The EarLens System: New Sound Transduction Methods

PubMed Central

Perkins, Rodney; Fay, Jonathan P.; Rucker, Paul; Rosen, Micha; Olson, Lisa; Puria, Sunil

2010-01-01

The hypothesis is tested that an open-canal hearing device, with a microphone in the ear canal, can be designed to provide amplification over a wide bandwidth and without acoustic feedback. In the design under consideration, a transducer consisting of a thin silicone platform with an embedded magnet is placed directly on the tympanic membrane. Sound picked up by a microphone in the ear canal, including sound-localization cues thought to be useful for speech perception in noisy environments, is processed and amplified, and then used to drive a coil near the tympanic-membrane transducer. The perception of sound results from the vibration of the transducer in response the electromagnetic field produced by the coil. Sixteen subjects (ranging from normal-hearing to moderately hearing-impaired) wore this transducer for up to a ten-month period, and were monitored for any adverse reactions. Three key functional characteristics were measured: 1) the maximum equivalent pressure output (MEPO) of the transducer; 2) the feedback gain margin (GM), which describes the maximum allowable gain before feedback occurs; and 3) the tympanic-membrane damping effect (DTM), which describes the change in hearing level due to placement of the transducer on the eardrum. Results indicate that the tympanic-membrane transducer remains in place and is well tolerated. The system can produce sufficient output to reach threshold for those with as much as 60 dBHL of hearing impairment for up to 8 kHz in 86% of the study population, and up to 11.2 kHz in 50% of the population. The feedback gain margin is on average 30 dB except at the ear canal resonance frequencies of 3 and 9 kHz, where the average was reduced to 12 dB and 23 dB respectively. The average value of DTM is close to 0 dB everywhere except in the 2–4 kHz range, where it peaks at 8 dB. A new alternative system that uses photonic energy to transmit both the signal and power to a photodiode and micro-actuator on an EarLens platform is also described. PMID:20116419

Mastoid Cavity Dimensions and Shape: Method of Measurement and Virtual Fitting of Implantable Devices

PubMed Central

Handzel, Ophir; Wang, Haobing; Fiering, Jason; Borenstein, Jeffrey T.; Mescher, Mark J.; Leary Swan, Erin E.; Murphy, Brian A.; Chen, Zhiqiang; Peppi, Marcello; Sewell, William F.; Kujawa, Sharon G.; McKenna, Michael J.

2009-01-01

Temporal bone implants can be used to electrically stimulate the auditory nerve, to amplify sound, to deliver drugs to the inner ear and potentially for other future applications. The implants require storage space and access to the middle or inner ears. The most acceptable space is the cavity created by a canal wall up mastoidectomy. Detailed knowledge of the available space for implantation and pathways to access the middle and inner ears is necessary for the design of implants and successful implantation. Based on temporal bone CT scans a method for three-dimensional reconstruction of a virtual canal wall up mastoidectomy space is described. Using Amira® software the area to be removed during such surgery is marked on axial CT slices, and a three-dimensional model of that space is created. The average volume of 31 reconstructed models is 12.6 cm3 with standard deviation of 3.69 cm3, ranging from 7.97 to 23.25 cm3. Critical distances were measured directly from the model and their averages were calculated: height 3.69 cm, depth 2.43 cm, length above the external auditory canal (EAC) 4.45 cm and length posterior to EAC 3.16 cm. These linear measurements did not correlate well with volume measurements. The shape of the models was variable to a significant extent making the prediction of successful implantation for a given design based on linear and volumetric measurement unreliable. Hence, to assure successful implantation, preoperative assessment should include a virtual fitting of an implant into the intended storage space. The above-mentioned three-dimensional models were exported from Amira to a Solidworks application where virtual fitting was performed. Our results are compared to other temporal bone implant virtual fitting studies. Virtual fitting has been suggested for other human applications. PMID:19372649

Effective masking levels for 500 and 2000 Hz bone conduction auditory steady state responses in infants and adults with normal hearing.

PubMed

Small, Susan A; Smyth, Aisling; Leon, Griselle

2014-01-01

Few studies have investigated effective masking levels (EMLs) needed to isolate the test ear for bone conduction assessments in infants. The objective of this study was to determine EMLs for 500 and 2000 Hz bone conduction auditory steady state responses (ASSRs) to amplitude (AM)/frequency-modulated (FM) stimuli for infants and adults with normal hearing. Maturational factors that contribute to infant-adult differences in EMLs will also be investigated. The present study and previously published 1000 and 4000 Hz EML data will be compared to investigate EML across four frequencies. These findings will provide a starting point for implementing clinical masking for infant bone conduction testing using physiological measures. Participants were 15 infants (7 to 35 weeks) and 15 adults (21 to 56 years) with normal hearing. Bone-conducted single ASSR stimuli (research MASTER) were 100% AM and 25% FM at 85 and 101 Hz for 500 and 2000 Hz carrier frequencies, respectively. They were presented at 25 and 35 dB HL for 500 Hz and at 35 and 45 dB HL for 2000 Hz for both infants and adults (approximately 10 and 20 dB SL at each frequency for infants). Air-conducted narrowband maskers were presented to both ears simultaneously. Real-ear to coupler differences were measured to account for differences in the sound pressure developed in infant and adult ear canals as a result of ear-canal size. Data analyses were conducted for mean EMLs across frequency (500 to 4000 Hz) and between age groups. Masked and unmasked ASSR amplitudes were compared for 500 and 2000 Hz. Both infants and adults required much more masking (25 to 33 dB) to eliminate responses at 500 compared with 2000 Hz. On average, infants required 16 dB more masking at 500 Hz and similar amounts of masking at 2000 Hz compared with adults. When adjusted for ear-canal size and bone conduction sensitivity, the pattern of results did not change. Across all four frequencies, infants showed a systematic decrease in mean EMLs with an increase in frequency; all pair-wise comparisons were significant except 2000 versus 4000 Hz. Adults showed smaller frequency-dependent changes in EML (only significantly greater for 500 versus 2000 Hz and 4000 Hz). When ear-canal size and bone conduction sensitivity were taken into account, only 500 Hz required more masking than other frequencies in infants; there were no significant frequency-dependent trends for adults, although the greater EMLs at 1000 versus 2000 Hz and 4000 Hz approached significance. Unmasked and masked amplitudes tended to be larger for 2000 Hz but not for 500 Hz when comparing infants with adults. EMLs appropriate for infants for bone conduction ASSRs elicited to AM/FM stimuli are considerably higher at 500 compared with 2000 Hz. Infants also need more masking at 500 Hz compared with adults but the same amount of masking at 2000 Hz. Comparisons across four frequencies reveal a systematic decrease in EML with an increase in frequency in infants, which is not apparent in adults. Recommended EMLs for AM/FM bone-conducted ASSR stimuli presented at 35 dB HL for 500, 1000, 2000, and 4000 Hz, respectively, are: (1) infants: 81, 68, 59, and 45 dB SPL, and (2) adults: 66, 63, 59, and 55 dB SPL.

Gata2 is required for the development of inner ear semicircular ducts and the surrounding perilymphatic space.

PubMed

Haugas, Maarja; Lilleväli, Kersti; Hakanen, Janne; Salminen, Marjo

2010-09-01

Gata2 has essential roles in the development of many organs. During mouse inner ear morphogenesis, it is expressed in otic vesicle and the surrounding periotic mesenchyme from early on, but no defects in the ear development of Gata2 null mice have been observed before lethality at embryonic day (E) 10.5. Here, we used conditional gene targeting to reveal the role of Gata2 at later stages of inner ear development. We show that Gata2 is critically required from E14.5-E15.5 onward for vestibular morphogenesis. Without Gata2 the semicircular ducts fail to grow to their normal size and the surrounding mesenchymal cells are not removed properly to generate the perilymphatic space. Gata2 is the first factor known to control the clearing of the vestibular perilymphatic mesenchyme, but interestingly, it is not required for the formation of the cochlear perilymphatic areas, suggesting distinct molecular control for these processes. Developmental Dynamics 239:2452-2469, 2010. © 2010 Wiley-Liss, Inc.

Diagnosis and medical treatment of otitis externa in the dog and cat.

PubMed

Jacobson, L S

2002-12-01

Otitis externa is no longer viewed as an isolated disease of the ear canal, but is a syndrome that is often a reflection of underlying dermatological disease. Causes are classified as predisposing (increase the risk of otitis); primary (directly induce otitis), secondary (contribute to otitis only in an abnormal ear or in conjunction with predisposing factors) and perpetuating (result from inflammation and pathology in ear, prevent resolution of otitis). Common primary causes include foreign bodies, hypersensitivity (particularly atopy and food allergy), keratinisation disorders (most commonly primary idiopathic seborrhoea and hypothyroidism) and earmites, particularly in cats. A systematic diagnostic procedure is required to identify causes and contributing factors. This should include history, clinical examination, otoscopy and cytology in all cases and culture and sensitivity as well as otitis media assessment and biopsy in severe and recurrent cases. Ancillary tests may be required depending on the underlying cause. Treatment consists of identifying and addressing predisposing and primary factors; cleaning the ear canal; topical therapy; systemic therapy where necessary; client education; follow-up; and preventive and maintenance therapy as required.

Fgf8 and Fgf3 are required for zebrafish ear placode induction, maintenance and inner ear patterning.

PubMed

Léger, Sophie; Brand, Michael

2002-11-01

The vertebrate inner ear develops from initially 'simple' ectodermal placode and vesicle stages into the complex three-dimensional structure which is necessary for the senses of hearing and equilibrium. Although the main morphological events in vertebrate inner ear development are known, the genetic mechanisms controlling them are scarcely understood. Previous studies have suggested that the otic placode is induced by signals from the chordamesoderm and the hindbrain, notably by fibroblast growth factors (Fgfs) and Wnt proteins. Here we study the role of Fgf8 as a bona-fide hindbrain-derived signal that acts in conjunction with Fgf3 during placode induction, maintenance and otic vesicle patterning. Acerebellar (ace) is a mutant in the fgf8 gene that results in a non-functional Fgf8 product. Homozygous mutants for acerebellar (ace) have smaller ears that typically have only one otolith, abnormal semi-circular canals, and behavioral defects. Using gene expression markers for the otic placode, we find that ace/fgf8 and Fgf-signaling are required for normal otic placode formation and maintenance. Conversely, misexpression of fgf8 or Fgf8-coated beads implanted into the vicinity of the otic placode can increase ear size and marker gene expression, although competence to respond to the induction appears restricted. Cell transplantation experiments and expression analysis suggest that Fgf8 is required in the hindbrain in the rhombomere 4-6 area to restore normal placode development in ace mutants, in close neighbourhood to the forming placode, but not in mesodermal tissues. Fgf3 and Fgf8 are expressed in hindbrain rhombomere 4 during the stages that are critical for placode induction. Joint inactivation of Fgf3 and Fgf8 by mutation or antisense-morpholino injection causes failure of placode formation and results in ear-less embryos, mimicking the phenotype we observe after pharmacological inhibition of Fgf-signaling. Fgf8 and Fgf3 together therefore act during induction and differentiation of the ear placode. In addition to the early requirement for Fgf signaling, the abnormal differentiation of inner ear structures and mechanosensory hair cells in ace mutants, pharmacological inhibition of Fgf signaling, and the expression of fgf8 and fgf3 in the otic vesicle demonstrate independent Fgf function(s) during later development of the otic vesicle and lateral line organ. We furthermore addressed a potential role of endomesomerm by studying mzoep mutant embryos that are depleted of head endomesodermal tissue, including chordamesoderm, due to a lack of Nodal-pathway signaling. In these embryos, early placode induction proceeds largely normally, but the ear placode extends abnormally to midline levels at later stages, suggesting a role for the midline in restricting placode development to dorsolateral levels. We suggest a model of zebrafish inner ear development with several discrete steps that utilize sequential Fgf signals during otic placode induction and vesicle patterning. Copyright 2002 Elsevier Science Ireland Ltd.

Assessment of Rainfall-induced Landslide Potential and Spatial Distribution

NASA Astrophysics Data System (ADS)

Chen, Yie-Ruey; Tsai, Kuang-Jung; Chen, Jing-Wen; Chiang, Jie-Lun; Hsieh, Shun-Chieh; Chue, Yung-Sheng

2016-04-01

Recently, due to the global climate change, most of the time the rainfall in Taiwan is of short duration but with high intensity. Due to Taiwan's steep terrain, rainfall-induced landslides often occur and lead to human causalities and properties loss. Taiwan's government has invested huge reconstruction funds to the affected areas. However, after rehabilitation they still face the risk of secondary sediment disasters. Therefore, this study assesses rainfall-induced (secondary) landslide potential and spatial distribution in watershed of Southern Taiwan under extreme climate change. The study areas in this research are Baolai and Jianshan villages in the watershed of the Laonongxi River Basin in the Southern Taiwan. This study focused on the 3 years after Typhoon Morakot (2009 to 2011). During this period, the study area experienced six heavy rainfall events including five typhoons and one heavy rainfall. The genetic adaptive neural network, texture analysis and GIS were implemented in the analysis techniques for the interpretation of satellite images and to obtain surface information and hazard log data and to analyze land use change. A multivariate hazards evaluation method was applied to quantitatively analyze the weights of various natural environmental and slope development hazard factors. Furthermore, this study established a slope landslide potential assessment model and depicted a slope landslide potential diagram by using the GIS platform. The interaction between (secondary) landslide mechanism, scale, and location was analyzed using association analysis of landslide historical data and regional environmental characteristics. The results of image classification before and after six heavy rainfall events show that the values of coefficient of agreement are at medium-high level. By multivariate hazards evaluation method, geology and the effective accumulative rainfall (EAR) are the most important factors. Slope, distance from fault, aspect, land disturbance, and elevation are the secondary important factors. Under the different rainfall, the greater the average of EAR, the more the landslide occurrence and area increments. The determination coefficients of trend lines on the charts of the average of EAR versus number and area of landslide increment are 0.83 and 0.92, respectively. The relations between landslide potential level, degree of land disturbance, and the ratio of number and area of landslide increment corresponding six heavy rainfall events are positive and the determination coefficients of trend lines are 0.82 and 0.72, respectively. The relation between the average of EAR and the area of landslide increment corresponding five heavy rainfall events (excluding Morakot) is positive and the determination coefficient of trend line is 0.98. Furthermore, the relation between the area increment of secondary landslide, average of EAR or the slope disturbance is positive. Under the same slope disturbance, the greater the EAR, the more the area increment of secondary landslide. Contrarily, under the same EAR, the greater the slope disturbance, the more the area increment of secondary landslide. The results of the analysis of this study can be a reference for the government for subsequent countermeasures for slope sediment disaster sensitive area to reduce the number of casualties and significantly reduce the social cost of post-disaster.

Is it necessary to occlude the ear in bone-conduction testing at 4 kHz, in order to prevent air-borne radiation affecting the results?

PubMed

Tate Maltby, Maryanne; Gaszczyk, David

2015-01-01

To re-evaluate the current BSA recommendation that the test ear should be occluded during the bone-conduction procedure at frequencies above 2 kHz to prevent audible air-borne radiation. Pure-tone audiometry was undertaken during routine hearing tests. The audiograms of fifty-two ears met the criteria for the study and were included. Bone conduction at 4 kHz was tested in three different conditions: test ear open/occluded by earplug and occluded by circumaural earphone. Forty-four adults aged 41-77 years with average hearing levels from normal to severe loss. All complied fully with the test procedure. No audiogram had a significant conductive element. There was no significant difference in each of the three test situations. Only two audiograms showed any (5 dB) difference at 4 kHz when bone conduction was retested with the ear occluded. The errors that result in a false air-bone gap at 4 kHz would not appear to be due to air-borne radiation. Failure to occlude the ear canal at 4 kHz, where air-borne radiation is greatest, makes no significant difference to the audiometric results. It is therefore suggested that it is unnecessary to block the test ear during routine pure-tone bone-conduction testing to prevent audible air-borne radiation, and that this should no longer form part of normal clinical practice.

15 CFR 744.11 - License requirements that apply to entities acting contrary to the national security or foreign...

Code of Federal Regulations, 2013 CFR

2013-01-01

..., reexport, or transfer (in-country) any item subject to the EAR to an entity that is listed on the Entity... reexports to that party of items that are subject to the EAR are prohibited by or require a license from... United States. (1) Supporting persons engaged in acts of terror. (2) Actions that could enhance the...

[Audiological characteristics of young children with otitis media with effusion].

PubMed

Wang, Qiu-ju; Shi, Wei; Lan, Lan; Wang, Da-yong; Zhang, Ya-mei

2008-12-01

To characterize the audiological features in the infants with otitis media with effusion (OME) and to investigate the utility of variety of objective audiometry methods in diagnosis and intervention on OME. Fifty six infants (40 males and 16 females) were investigated, who were referred to our clinic at the General Hospital of Chinese People's Liberation Army by the other hospitals from December 2004 to June 2007 when the infants were diagnosed or highly suspected of OME. The ages at the initial diagnosis ranged from 42 days to three years, with an average of five months. The infants, after receiving the conventional otolaryngological exams, were subjected to the tests of auditory brainstem response (ABR), otoacoustic emission (OAE), tympanometry (226 Hz and 1000 Hz) and behaviors audiometry. Among 56 affected infants, 87 ears were diagnosed with OME, of which 31 infants were affected bilateral and 25 with monaural. For the 49 infants who received hearing screening at birth, 36 infants were referred at the initial screening. For the 52 infants who received repeated screening, all subjects were referred. Six infants without receiving hearing screening came to clinic when their parents observed their kids' hearing impairment. Among the 52 cases (104 ears) who received tympanometry test, 20 subjects (28 ears) showed B or C type tympanometry curve. Thirty-nine cases (78 ears) were given tympanometry test at 1000 Hz, of which 38 cases (55 ears) showed abnormal hearing. Among 56 infants (112 ears) with ABR test, 49 subjects (74 ears) exhibited prolonged ABR type I curve. All 56 infants (112 ears) received OAE test, of which 55 subjects (81 ears) were referred. Four infants (8 ears) accepted the behavior test and all of them showed A-B Gap. The combined tympanometry test at both 226 Hz and 1000 Hz, ABR latency or threshold test, infant's behavior test and OAE, used jointly, enable characterizing better OME in infants, thus helping early diagnosis of this hearing disorder.

Adaptive Wiener filtering for improved acquisition of distortion product otoacoustic emissions.

PubMed

Ozdamar, O; Delgado, R E; Rahman, S; Lopez, C

1998-01-01

An innovative acoustic noise canceling method using adaptive Wiener filtering (AWF) was developed for improved acquisition of distortion product otoacoustic emissions (DPOAEs). The system used one microphone placed in the test ear for the primary signal. Noise reference signals were obtained from three different sources: (a) pre-stimulus response from the test ear microphone, (b) post-stimulus response from a microphone placed near the head of the subject and (c) post-stimulus response obtained from a microphone placed in the subject's nontest ear. In order to improve spectral estimation, block averaging of a different number of single sweep responses was used. DPOAE data were obtained from 11 ears of healthy newborns in a well-baby nursery of a hospital under typical noise conditions. Simultaneously obtained recordings from all three microphones were digitized, stored and processed off-line to evaluate the effects of AWF with respect to DPOAE detection and signal-to-noise ratio (SNR) improvement. Results show that compared to standard DPOAE processing, AWF improved signal detection and improved SNR.

Why noise-induced hearing loss of industrial workers is dramatic while that of similarly assessed musicians has been described as trivial

NASA Astrophysics Data System (ADS)

Bies, David

2005-09-01

Criteria for noise exposure considered acceptable for hearing protection are based upon industrial experience, yet these same criteria do not describe the experience of musicians. Investigation of the physics of the human ear reveals a basic design compromise that explains this anomaly. Acoustic stimulation is encoded in the velocity response of the basilar membrane, which makes possible the use of damping control to achieve the dynamic range of the ear. The use of damping control for this purpose without unacceptable distortions is possible if damping is slowly varying. The ear is free running and guided by previous instruction, making it vulnerable to loud impulsive sounds. To protect the ear the aural reflex is provided, but this protection is limited to frequencies below about 1 to 2 kHz. In the natural environment this design compromise is satisfactory, but in the industrial environment loud impulsive sounds are common and the compromise fails. It is to be noted that impulsive sounds of high frequency and level for which the ear has no defense, and which are not characteristic of music, are averaged to zero using standard assessment procedures.

Sound-power collection by the auditory periphery of the Mongolian gerbil Meriones unguiculatus. I: Middle-ear input impedance.

PubMed

Ravicz, M E; Rosowski, J J; Voigt, H F

1992-07-01

This is the first paper of a series dealing with sound-power collection by the auditory periphery of the gerbil. The purpose of the series is to quantify the physiological action of the gerbil's relatively large tympanic membrane and middle-ear air cavities. To this end the middle-ear input impedance ZT was measured at frequencies between 10 Hz and 18 kHz before and after manipulations of the middle-ear cavity. The frequency dependence of ZT is consistent with that of the middle-ear transfer function computed from extant data. Comparison of the impedance and transfer function suggests a middle-ear transformer ratio of 50 at frequencies below 1 kHz, substantially smaller than the anatomical value of 90 [Lay, J. Morph. 138, 41-120 (1972)]. Below 1 kHz the data suggest a low-frequency acoustic stiffness KT for the middle ear of 970 Pa/mm3 and a stiffness of the middle-ear cavity of 720 Pa/mm3 (middle-ear volume V MEC of 195 mm3); thus the middle-ear air spaces contribute about 70% of the acoustic stiffness of the auditory periphery. Manipulations of a middle-ear model suggest that decreases in V MEC lead to proportionate increases in KT but that further increases in middle-ear cavity volume produce only limited decreases in middle-ear stiffness. The data and the model point out that the real part of the middle-ear impedance at frequencies below 100 Hz is determined primarily by losses within the middle-ear cavity. The measured impedance is comparable in magnitude and frequency dependence to the impedance in several larger mammalian species commonly used in auditory research. A comparison of low-frequency stiffness and anatomical dimensions among several species suggests that the large middle-ear cavities in gerbil act to reduce the middle-ear stiffness at low frequencies. A description of sound-power collection by the gerbil ear requires a description of the function of the external ear.

Prospective cohort study on noise levels in a pediatric cardiac intensive care unit.

PubMed

Garcia Guerra, Gonzalo; Joffe, Ari R; Sheppard, Cathy; Pugh, Jodie; Moez, Elham Khodayari; Dinu, Irina A; Jou, Hsing; Hartling, Lisa; Vohra, Sunita

2018-04-01

To describe noise levels in a pediatric cardiac intensive care unit, and to determine the relationship between sound levels and patient sedation requirements. Prospective observational study at a pediatric cardiac intensive care unit (PCICU). Sound levels were measured continuously in slow A weighted decibels dB(A) with a sound level meter SoundEarPro® during a 4-week period. Sedation requirement was assessed using the number of intermittent (PRNs) doses given per hour. Analysis was conducted with autoregressive moving average models and the Granger test for causality. 39 children were included in the study. The average (SD) sound level in the open area was 59.4 (2.5) dB(A) with a statistically significant but clinically unimportant difference between day/night hours (60.1 vs. 58.6; p-value < 0.001). There was no significant difference between sound levels in the open area/single room (59.4 vs. 60.8, p-value = 0.108). Peak noise levels were > 90 dB. There was a significant association between average (p-value = 0.030) and peak sound levels (p-value = 0.006), and number of sedation PRNs. Sound levels were above the recommended values with no differences between day/night or open area/single room. High sound levels were significantly associated with sedation requirements. Copyright © 2017 Elsevier Inc. All rights reserved.

Feasibility and acceptability of training community health workers in ear and hearing care in Malawi: a cluster randomised controlled trial.

PubMed

Mulwafu, Wakisa; Kuper, Hannah; Viste, Asgaut; Goplen, Frederik K

2017-10-11

To assess the feasibility and acceptability of training community health workers (CHWs) in ear and hearing care, and their ability to identify patients with ear and hearing disorders. Cluster randomised controlled trial (RCT). Health centres in Thyolo district, Malawi. Ten health centres participated, 5 intervention (29 CHWs) and 5 control (28 CHWs). Intervention CHWs received 3 days of training in primary ear and hearing care, while among control CHWs, training was delayed for 6 months. Both groups were given a pretest that assessed knowledge about ear and hearing care, only the intervention group was given the posttest on the third day of training. The intervention group was given 1 month to identify patients with ear and hearing disorders in their communities, and these people were screened for hearing disorders by ear, nose and throat clinical specialists. Primary outcome measure was improvement in knowledge of ear and hearing care among CHWs after the training. Secondary outcome measures were number of patients with ear or hearing disorders identified by CHWs and number recorded at health centres during routine activities, and the perceived feasibility and acceptability of the intervention. The average overall correct answers increased from 55% to 68% (95% CI 65 to 71) in the intervention group (p<0.001). A total of 1739 patients with potential ear and hearing disorders were identified by CHWs and 860 patients attended the screening camps, of whom 400 had hearing loss (73 patients determined through bilateral fail on otoacoustic emissions, 327 patients through audiometry). Where cause could be determined, the most common cause of ear and hearing disorders was chronic suppurative otitis media followed by impacted wax. The intervention was perceived as feasible and acceptable to implement. Training was effective in improving the knowledge of CHW in ear and hearing care in Malawi and allowing them to identify patients with ear and hearing disorders. This intervention could be scaled up to other CHWs in low-income and middle-income countries. Pan African Clinical Trial Registry (201705002285194); Results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Multiple enhancers located in a 1-Mb region upstream of POU3F4 promote expression during inner ear development and may be required for hearing

PubMed Central

Naranjo, Silvia; Voesenek, Krysta; de la Calle-Mustienes, Elisa; Robert-Moreno, Alex; Kokotas, Haris; Grigoriadou, Maria; Economides, John; Van Camp, Guy; Hilgert, Nele; Moreno, Felipe; Alsina, Berta; Petersen, Michael B.; Kremer, Hannie

2010-01-01

POU3F4 encodes a POU-domain transcription factor required for inner ear development. Defects in POU3F4 function are associated with X-linked deafness type 3 (DFN3). Multiple deletions affecting up to ~900-kb upstream of POU3F4 are found in DFN3 patients, suggesting the presence of essential POU3F4 enhancers in this region. Recently, an inner ear enhancer was reported that is absent in most DFN3 patients with upstream deletions. However, two indications suggest that additional enhancers in the POU3F4 upstream region are required for POU3F4 function during inner ear development. First, there is at least one DFN3 deletion that does not eliminate the reported enhancer. Second, the expression pattern driven by this enhancer does not fully recapitulate Pou3f4 expression in the inner ear. Here, we screened a 1-Mb region upstream of the POU3F4 gene for additional cis-regulatory elements and searched for novel DFN3 mutations in the identified POU3F4 enhancers. We found several novel enhancers for otic vesicle expression. Some of these also drive expression in kidney, pancreas and brain, tissues that are known to express Pou3f4. In addition, we report a new and smallest deletion identified so far in a DFN3 family which eliminates 3.9 kb, comprising almost exclusively the previous reported inner ear enhancer. We suggest that multiple enhancers control the expression of Pou3f4 in the inner ear and these may contribute to the phenotype observed in DFN3 patients. In addition, the novel deletion demonstrates that the previous reported enhancer, although not sufficient, is essential for POU3F4 function during inner ear development. Electronic supplementary material The online version of this article (doi:10.1007/s00439-010-0864-x) contains supplementary material, which is available to authorized users. PMID:20668882

Are more environmentally sustainable diets with less meat and dairy nutritionally adequate?

PubMed

Seves, S Marije; Verkaik-Kloosterman, Janneke; Biesbroek, Sander; Temme, Elisabeth Hm

2017-08-01

Our current food consumption patterns, and in particular our meat and dairy intakes, cause high environmental pressure. The present modelling study investigates the impact of diets with less or no meat and dairy foods on nutrient intakes and assesses nutritional adequacy by comparing these diets with dietary reference intakes. Environmental impact and nutrient intakes were assessed for the observed consumption pattern (reference) and two replacement scenarios. For the replacement scenarios, 30 % or 100 % of meat and dairy consumption (in grams) was replaced with plant-based alternatives and nutrient intakes, greenhouse gas emissions and land use were calculated. The Netherlands. Dutch adults (n 2102) aged 19-69 years. Replacing 30 % of meat and dairy with plant-based alternatives did not substantially alter percentages below the Estimated Average Requirement (EAR) for all studied nutrients. In the 100 % replacement scenario, SFA intake decreased on average by ~35 % and Na intake by ~8 %. Median Ca intakes were below the Adequate Intake. Estimated habitual fibre, Fe and vitamin D intakes were higher; however, non-haem Fe had lower bioavailability. For Zn, thiamin and vitamin B12, 10-31 % and for vitamin A, 60 % of adults had intakes below the EAR. Diets with all meat and dairy replaced with plant-based foods lowered environmental impacts by >40 %. Estimated intakes of Zn, thiamin, vitamins A and B12, and probably Ca, were below recommendations. Replacing 30 % was beneficial for SFA, Na, fibre and vitamin D intakes, neutral for other nutrients, while reducing environmental impacts by 14 %.

The 'double headed slug flap': a simple technique to reconstruct large helical rim defects.

PubMed

Masud, D; Tzafetta, K

2012-10-01

Reconstructing partial defects of the ear can be challenging, balancing the creation of the details of the ear with scarring, morbidity and number of surgical stages. Common causes of ear defects are human bites, tumour excision and burn injuries. Reconstructing defects of the ear with tube pedicled flaps and other local flaps requires an accurate measurement of size of the defect with little room for error, particularly under estimation. We present a simple method of reconstruction for partial defects of the ear using a two-stage technique with post auricular transposition flaps. This allows for under or over estimation of size defects permitting accurate tissue usage giving good aesthetic outcomes. Copyright © 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Head circumference - a useful single parameter for skull volume development in cranial growth analysis?

PubMed

Martini, Markus; Klausing, Anne; Lüchters, Guido; Heim, Nils; Messing-Jünger, Martina

2018-01-10

The measurement of maximal head circumference is a standard procedure in the examination of childrens' cranial growth and brain development. The objective of the study was to evaluate the validity of maximal head circumference to cranial volume in the first year of life using a new method which includes ear-to-ear over the head distance and maximal cranial length measurement. 3D surface scans for cranial volume assessment were conducted in this method comparison study of 44 healthy Caucasian children (29 male, 15 female) at the ages of 4 and 12 months. Cranial volume increased from measurements made at 4 months to 12 months of age by an average of 1174 ± 106 to 1579 ± 79 ml. Maximal cranial circumference increased from 43.4 ± 9 cm to 46.9 ± 7 cm and the ear-to ear measurement increased from 26.3 ± 21 cm to 31.6 ± 18 cm at the same time points. There was a monotone association between maximal head circumference (HC) and increase in volume, yet a backwards inference from maximal circumference to the volume had a predictive value of only 78% (adjusted R 2 ). Including the additional measurement of distance from ear to ear strengthened the ability of the model to predict the true value attained to 90%. The addition of the parameter skull length appeared to be negligible. The results demonstrate that for a distinct improvement in the evaluation of a physiological cranial volume development, the additional measurement of the ear-to ear distance using a measuring tape is expedient, and, especially for cases with pathological skull changes, such as craniosynostosis, ought to be conducted.

Hemispheric dominance and cell phone use.

PubMed

Seidman, Michael D; Siegel, Bianca; Shah, Priyanka; Bowyer, Susan M

2013-05-01

A thorough understanding of why we hold a cell phone to a particular ear may be of importance when studying the impact of cell phone safety. To determine if there is an obvious association between sidedness of cell phone use and auditory hemispheric dominance (AHD) or language hemispheric dominance (LHD). It is known that 70% to 95% of the population are right-handed, and of these, 96% have left-brain LHD. We have observed that most people use their cell phones in their right ear. An Internet survey was e-mailed to individuals through surveymonkey.com. The survey used a modified Edinburgh Handedness Inventory protocol. Sample questions surveyed which hand was used to write with, whether the right or left ear was used for phone conversations, as well as whether a brain tumor was present. General community. An Internet survey was randomly e-mailed to 5000 individuals selected from an otology online group, patients undergoing Wada testing and functional magnetic resonance imaging, as well as persons on the university listserv, of which 717 surveys were completed. Determination of hemispheric dominance based on preferred ear for cell phone use. A total of 717 surveys were returned. Ninety percent of the respondents were right handed, and 9% were left handed. Sixty-eight percent of the right-handed people used the cell phone in their right ear, 25% in the left ear, and 7% had no preference. Seventy-two of the left-handed respondents used their left ear, 23% used their right ear, and 5% had no preference. Cell phone use averaged 540 minutes per month over the past 9 years. An association exists between hand dominance laterality of cell phone use (73%) and our ability to predict hemispheric dominance. Most right-handed people have left-brain LHD and use their cell phone in their right ear. Similarly, most left-handed people use their cell phone in their left ear. Our study suggests that AHD may differ from LHD owing to the difference in handedness and cell phone ear use. Literature suggests a possible relationship between cell phone use and cancer. The fact that few tumors were identified in this population does not rule out an association.

Influence of EARLI1-like genes on flowering time and lignin synthesis of Arabidopsis thaliana.

PubMed

Shi, Y; Zhang, X; Xu, Z-Y; Li, L; Zhang, C; Schläppi, M; Xu, Z-Q

2011-09-01

EARLI1 encodes a 14.7 kDa protein in the cell wall, is a member of the PRP (proline-rich protein) family and has multiple functions, including resistance to low temperature and fungal infection. RNA gel blot analyses in the present work indicated that expression of EARLI1-like genes, EARLI1, At4G12470 and At4G12490, was down-regulated in Col-FRI-Sf2 RNAi plants derived from transformation with Agrobacterium strain ABI, which contains a construct encoding a double-strand RNA targeting 8CM of EARLI1. Phenotype analyses revealed that Col-FRI-Sf2 RNAi plants of EARLI1 flowered earlier than Col-FRI-Sf2 wild-type plants. The average bolting time of Col-FRI-Sf2 and Col-FRI-Sf2 RNAi plants was 39.7 and 19.4 days, respectively, under a long-day photoperiod. In addition, there were significant differences in main stem length, internode number and rosette leaf number between Col-FRI-Sf2 and Col-FRI-Sf2 RNAi plants. RT-PCR showed that EARLI1-like genes might delay flowering time through the autonomous and long-day photoperiod pathways by maintaining the abundance of FLC transcripts. In Col-FRI-Sf2 RNAi plants, transcription of FLC was repressed, while expression of SOC1 and FT was activated. Microscopy observations showed that EARLI1-like genes were also associated with morphogenesis of leaf cells in Arabidopsis. Using histochemical staining, EARLI1-like genes were found to be involved in regulation of lignin synthesis in inflorescence stems, and Col-FRI-Sf2 and Col-FRI-Sf2 RNAi plants had 9.67% and 8.76% dry weight lignin, respectively. Expression analysis revealed that cinnamoyl-CoA reductase, a key enzyme in lignin synthesis, was influenced by EARLI1-like genes. These data all suggest that EARLI1-like genes could control the flowering process and lignin synthesis in Arabidopsis. © 2011 German Botanical Society and The Royal Botanical Society of the Netherlands.

Iodine intakes and status in Irish adults: is there cause for concern?

PubMed

McNulty, Breige A; Nugent, Anne P; Walton, Janette; Flynn, Albert; Tlustos, Christina; Gibney, Michael J

2017-02-01

I is an important mineral for health, required for the production of key thyroid hormones, which are essential for cellular metabolism, growth and physical development. Hence, adequate I is crucial at all stages of life, but imperative during pregnancy for fetal brain development and during a child's early life for neurodevelopment. Within Ireland, limited information exists on population I intakes and status. Therefore, the purposes of the present analysis were to estimate dietary I intakes and to analyse urinary iodine (UI) status using the cross-sectional National Adult Nutrition Survey 2008-2010 and the most recent Irish Total Diet Study. Median I intakes in the total population (n 1106) were adequate with only 26 % of the population being classified as below the estimated average requirement (EAR). Milk consumption was the major source of I in the diet, contributing 45 % to total intake. Likewise, median UI concentrations (107 µg/l) indicated 'optimal' I nutrition according to the WHO cut-off points. In our cohort, 77 % of women of childbearing age (18-50 years) did not meet the EAR recommendation set for pregnant women. Although I is deemed to be sufficient in the majority of adult populations resident in Ireland, any changes to the current dairy practices could significantly impact intake and status. Continued monitoring should be of priority to ensure that all subgroups of the population are I sufficient.

Ear Aesthetics: Investigation by the Use of an Online Viral Survey.

PubMed

Steele, Jessica; Farmer, Eleanor; O'Hara, Justine; Bulstrode, Neil

2017-03-01

The ear is a key facial feature and yet few studies have previously assessed ear aesthetics. This study aimed to assess the anatomical components of the ear that have the greatest impact on the perception of ear aesthetics. Three photographs of a male adult ear (close-up, lateral, posterior) were digitally manipulated such that in each, 1 anatomical element of the ear was either enlarged or reduced. A complete set of 16 photographs including a repeat of the original ear as a control were randomized and entered into an online survey that required respondents to rate the attractiveness of each ear on a scale of 1 (least attractive) to 10 (most attractive). The survey was disseminated using email and social media. A total of 248 responses were received, 155 women and 92 men. Respondents were grouped by demographics of age and occupation. Reducing (R) or enlarging (E) the helix (R, P = 0.0256; E, P = 0.003), concha (R, P = 0.0002; E, P = <0.0001) and lobule (R, P = 0.0006; E, P < 0.0001) had a significant effect on ratings of attractiveness. Altering the tragus had no significant effect (R, P = 0.448; E, P = 0.201). In lateral view, raising the height of the ear had a significant effect (P = <0.0001) but not in lowering the height (P = 0.3038). Increasing and decreasing the projection of the ears both had a significant effect (P < 0.0001). The results of this study have provided useful evidence regarding the anatomical components of the ear that have the greatest effect on ear aesthetics. Furthermore, this study has proven the usefulness of conducting research using viral online surveys.

Proposal of a Classification System for the Assessment and Treatment of Prominent Ear Deformity.

PubMed

Lee, Youngdae; Kim, Young Seok; Lee, Won Jai; Rha, Dong Kyun; Kim, Jiye

2018-06-01

Prominent ear is the most common external ear deformity. To comprehensively treat prominent ear deformity, adequate comprehension of its pathophysiology is crucial. In this article, we analyze cases of prominent ear and suggest a simple classification system and treatment algorithm according to pathophysiology. We retrospectively reviewed a total of 205 Northeast Asian patients' clinical data who underwent an operation for prominent ear deformity. Follow-up assessments were conducted 3, 6, and 12 months after surgery. Prominent ear deformities were classified by diagnostic checkpoints. Class I (simple prominent ear) includes prominent ear that developed with the absence of the antihelix without conchal hypertrophy. Class II (mixed-type prominent ear) is defined as having not only a flat antihelix, but also conchal excess. Class III (conchal-type prominent ear) has an enlarged conchal bowl with a well-developed antihelix. Among the three types of prominent ear, class I was most frequent (162 patients, 81.6%). Class II was observed in 28 patients (13.6%) and class III in 10 patients (4.8%). We used the scaphomastoid suture method for correction of antihelical effacement, the anterior approach conchal resection for correction of conchal hypertrophy, and Bauer's squid incision for lobule prominence. The complication rate was 9.2% including early hematoma, hypersensitivity, and suture extrusion. Unfavorable results occurred in 4% including partial recurrence, overcorrection, and undercorrection. To reduce unfavorable results and avoid recurrence, we propose the use of a classification and treatment algorithm in preoperative evaluation of prominent ear. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

A review of microvascular ear replantation.

PubMed

Jung, Sung Won; Lee, Junsang; Oh, Suk Joon; Koh, Sung Hoon; Chung, Chul Hoon; Lee, Jong Wook

2013-03-01

Microvascular ear replantation is a significant challenge because of the small size of the vessels and the fact that traumatic amputations are frequently avulsed. The zone of trauma is therefore extended and the primary repair of the injured vessel is rendered unlikely. The purpose of this study is to review the literature of ear replantation. A review of the relevant literature that has been published since 1980 revealed 47 cases reported in 37 publications. We present 5 cases from our own experience and analyze a total 52 cases of microvascular ear replantation. The patient's age, sex, degree of amputation, cause of injury, ischemic time, method of arterial and venous anastomosis, complications, any additional outflow used, postoperative medications, the requirement for transfusions, and the number of hospital admission days are described. Successful microvascular ear replantations require anastomosis of the vessels if possible. Rather than a vein graft, primary repair of the vessels, or at least pedicled repair of the artery, should be considered to ensure flap survival. In addition, vein repair should be considered if possible to ensure the secure drainage of blood from the replant. With secure circulation, the replant can survive, resulting in a very satisfactory outcome. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

[Revisional radical mastoidectomy surgeries--25 cases'experience].

PubMed

Li, L; Xie, J; Liu, Y; Gong, S S

2017-10-07

Objective: To analyze the risk factors of failure to dry ear after radical mastoidectomy and discuss key points in revisonal surgery. Methods: Clinical data of 25 patients(32 ears) with revisonal mastoidectomy were analyzed. The preoperative temporal bone CT findings, intra-operative findings, surgical procedures, postoperative operating cavities and aural abilities were recorded and analyzed. Results: All patients received preoperative temporal bone CT followed by revisonal radical mastoidectomy under microscope and general anesthesia. Among the revisonal surgeries, 19 ears(59.4%) presented cholesteatoma and 13 ears(40.6%) had no cholesteatoma. In addition, the inadequate opening for mastoid cavity and incompleted removal of the pathological tissues accounted for 90.6%(29/32), the insufficient drainage of surgical cavity for 90.6%(29/32), the lesions in tympanic ostium of eustachian tube for 31.2%(10/32), the improper operation procedures and selection of incision for 15.6%(5/32). As for the re-operation of the modified canal wall down mastoidectomy, tympanoplasty(Ⅱ) plus plastic repairing of cavity of concha were performed in 14 ears(43.8%), the modified canal wall down mastoidectomy, tympanoplasty(Ⅱ) plus reconstruction posterior bony wall of ear canal in 2 ears(6.2%); the modified canal wall down mastoidectomy, tympanoplasty(Ⅲ) plus plastic repairing of cavity of concha in 10 eras(31.3%), the modified canal wall down mastoidectomy, tympanoplasty(Ⅲ) plus reconstruction posterior boney wall of ear canal in 1 ear(3.1%); the radical mastoidectomy plus plastic repairing of cavity of concha in 5 ears(15.6%). Lodoform gauzes were packed in surgical cavity for 2 weeks and the antibiotic was used for 3 days after surgery. All patients had dressing of ears and their ears were dropped with ofloxacin regularly. The dry ear time ranged from 4 to 8 weeks, the average point was the 5th week. During a period of 6-18 months for follow-up, all patients got dried ears. The epithelialization of the operating cavity was well and the tympanic membranes were integrity. There was not pus in surgical cavities. Neither granulation tissue nor cholesteatoma was found to reoccur. Both pure tone air hearing thresholds and air-bone gap decreased in 27 ears after the revisional surgeries, with statistically significant different in comparison to those before the operation ( P <0.05). Conclusions: There are many factors leading to the failure of radical mastoidectomy, including not fully opening of the surgical cavity , incomplete removal of the lesion tissue, poor drainage of surgical cavity, the lesions in the tympanic ostium of eustachian tube, and the improper operation procedures. Treatment strategies were taken according to above factors to obtain dry ear in revisional surgeries.

Principles of ear nose and throat surgery for pregnant women.

PubMed

Baruah, Paramita; Jasraj, Kailey; Ahmad, Ijaz

2017-04-02

Management of the pregnant surgical patient is challenging. The surgical procedure is usually postponed until the postpartum period, although this may not be possible in emergency situations. This article highlights the optimal management of the pregnant woman requiring ear nose and throat surgery.

Hibernacula selection by Townsend's big-eared bat in Southwestern Colorado

USGS Publications Warehouse

Hayes, Mark A.; Schorr, Robert A.; Navo, Kirk W.

2011-01-01

In western United States, both mine reclamations and renewed mining at previously abandoned mines have increased substantially in the last decade. This increased activity may adversely impact bats that use these mines for roosting. Townsend's big-eared bat (Corynorhinus townsendii) is a species of conservation concern that may be impacted by ongoing mine reclamation and renewed mineral extraction. To help inform wildlife management decisions related to bat use of abandoned mine sites, we used logistic regression, Akaike's information criterion, and multi-model inference to investigate hibernacula use by Townsend's big-eared bats using 9 years of data from surveys inside abandoned mines in southwestern Colorado. Townsend's big-eared bats were found in 38 of 133 mines surveyed (29%), and occupied mines averaged 2.6 individuals per mine. The model explaining the most variability in our data included number of openings and portal temperature at abandoned mines. In southwestern Colorado, we found that abandoned mine sites with more than one opening and portal temperatures near 0°C were more likely to contain hibernating Townsend's big-eared bats. However, mines with only one opening and portal temperatures of ≥10°C were occasionally occupied by Townsend's big-eared bat. Understanding mine use by Townsend's big-eared bat can help guide decisions regarding allocation of resources and placement of bat-compatible closures at mine sites scheduled for reclamation. When feasible we believe that surveys should be conducted inside all abandoned mines in a reclamation project at least once during winter prior to making closure and reclamation recommendations.

Effect of electronic cigarettes on human middle ear.

PubMed

Song, Jae-Jun; Go, Yoon Young; Mun, Ji Yoen; Lee, Sehee; Im, Gi Jung; Kim, Yoo Yon; Lee, Jun Ho; Chang, Jiwon

2018-06-01

Electronic cigarettes (e-cigarettes) are the most commonly used electronic nicotine delivery systems and are a relatively new product designed for smoking cessation. The market scale of electronic cigarettes is growing rapidly, but the potential impact of e-cigarettes on public health has not yet been verified. In this study, we examined the effect of e-liquids on a human middle ear epithelial cell (HMEEC) line. The main components of e-liquids are propylene glycol, vegetable glycerin and flavoring agents with or without nicotine. We analyzed 73 bottles of e-liquids from 12 different manufacturers, evaluated the trace elements in e-liquids, and identified the cytotoxicity of e-liquids on HMEECs in the presence or absence of nicotine. In the trace elements analysis, nickel, arsenic, cadmium, and lead were detected in the e-liquids. E-liquids without nicotine decreased cell viability, and the average IC 50 value of total e-liquids (n = 73) was 2.48 ± 0.93%. Among the different flavors, menthol-flavored e-liquids significantly reduced cell viability, and their average IC 50 value (n = 28) was 1.85 ± 0.80%. The average IC 50 values were distinct among manufacturers and the proportion of the solvents. The present study provides evidence that e-cigarettes influence and reduce human middle ear cell viability even without the application of nicotine. Additionally, the cytotoxicity of e-liquids was affected by the flavoring agents. Copyright © 2018 Elsevier B.V. All rights reserved.

Evaluation of the Normal Cochlear Second Interscalar Ridge Angle and Depth on 3D T2-Weighted Images: A Tool for the Diagnosis of Scala Communis and Incomplete Partition Type II.

PubMed

Booth, T N; Wick, C; Clarke, R; Kutz, J W; Medina, M; Gorsage, D; Xi, Y; Isaacson, B

2018-05-01

Cochlear malformations may be be subtle on imaging studies. The purpose of this study was to evaluate the angle and depth of the lateral second interscalar ridge or notch in ears without sensorineural hearing loss (normal ears) and compare them with ears that have a documented incomplete type II partition malformation. The second interscalar ridge notch angle and depth were measured on MR imaging in normal ears by a single experienced neuroradiologist. The images of normal and incomplete partition II malformation ears were then randomly mixed for 2 novice evaluators to measure both the second interscalar ridge notch angle and depth in a blinded manner. For the mixed group, interobserver agreement was calculated, normal and abnormal ear measurements were compared, and receiver operating characteristic curves were generated. The 94 normal ears had a mean second interscalar ridge angle of 80.86° ± 11.4° and depth of 0.54 ± 0.14 mm with the 98th percentile for an angle of 101° and a depth of 0.3 mm. In the mixed group, agreement between the 2 readers was excellent, with significant differences for angle and depth found between normal and incomplete partition type II ears for angle and depth on average ( P < .001). Receiver operating characteristic cutoffs for delineating normal from abnormal ears were similar for both readers (depth, 0.31/0.34 mm; angle, 114°/104°). A measured angle of >114° and a depth of the second interscalar ridge notch of ≤0.31 mm suggest the diagnosis of incomplete partition type II malformation and scala communis. These measurements can be accurately made by novice readers. © 2018 by American Journal of Neuroradiology.

Morphological correlation between caloric tests and vestibular hydrops in Ménière's disease using intravenous Gd enhanced inner ear MRI.

PubMed

Choi, Ji Eun; Kim, Yi-Kyung; Cho, Young Sang; Lee, Kieun; Park, Hyun Woo; Yoon, Sung Hoon; Kim, Hyung-Jin; Chung, Won-Ho

2017-01-01

The purpose of this study was to prove the hypothesis that caloric response in Ménière's disease (MD) is reduced by hydropic expansion of the vestibular labyrinth, not by vestibular hypofunction, by evaluating the correlation morphologically using an intravenous Gadolinium (IV-Gd) inner ear MRI. In study I, the prevalence of abnormal video Head Impulse Test (vHIT) results among the patients with definite unilateral MD (n = 24) and vestibular neuritis (VN) (n = 22) were investigated. All patients showed abnormal canal paresis (CP) (> 26%) on caloric tests. The prevalence of abnormal vHIT in patients with abnormal CP was significantly lower in MD patients (12.5%) than that in VN patients (81.8%) (p < 0.001). In study II, morphological correlation between caloric tests and vestibular hydrops level was evaluated in unilateral MD patients (n = 16) who had normal vHIT results. Eleven patients (61%) had abnormal CP. After taking the images of IV-Gd inner ear MRI, the vestibular hydrops ratio (endolymph volume/total lymph volume = %VH) was measured. In addition, the relative vestibular hydrops ratio (%RVH = (%VHaffected ear-%VHunaffected ear) / (%VHaffected ear + %VHunaffected ear)) was calculated. Each ratio (%VH and %RVH) was compared with average peak slow phase velocity (PSPV) and CP, respectively. In the MD patients, %VH of the affected ear correlated significantly with mean PSPV on the same side (rs = -0.569, p = 0.024), while %RVH correlated significantly with CP (rs = 0.602, p = 0.014). In most MD patients (87.5%) compared to VN patients, vHIT results were normal even though the caloric function was reduced. In addition, the reduced caloric function with normal vHIT was related to the severity of the vestibular hydrops measured by the IV-Gd inner ear MRI. These findings concluded that the abnormal caloric tests with normal vHIT in MD indicated severe endolymphatic hydrops rather than vestibular hypofunction.

Animal model of cochlear third window in the scala vestibuli or scala tympani.

PubMed

Attias, Joseph; Preis, Michal; Shemesh, Rafi; Hadar, Tuvia; Nageris, Ben I

2010-08-01

The auditory impact of a cochlear third window differs by its location in the scala vestibuli or scala tympani. Pathologic third window has been investigated primarily in the vestibular apparatus of animals and humans. Dehiscence of the superior semicircular canal is the clinical model. Fat sand rats (n = 11) have a unique inner-ear anatomy that allows easy surgical access. A window was drilled in the bony labyrinth over the scala vestibuli in 1 group (12 ears) and over the scala tympani in another (7 ears) while preserving the membranous labyrinth. Auditory brain stem responses to high- and low-frequency stimuli delivered by air and bone conduction were recorded before and after the procedure. Scala vestibuli group: preoperative air-conduction thresholds to clicks and tone-bursts averaged 8.3 and 9.6 dB, respectively, and bone-conduction thresholds, 4.6 and 3.3 dB, respectively; after fenestration, air-conduction thresholds averaged 40.4 and 41.8 dB, respectively, and bone-conduction thresholds, -1 and 5.6 dB, respectively. Scala tympani group: preoperative air-conduction thresholds to clicks and tone-bursts averaged 8.6 dB each, and bone-conduction thresholds, 7.9 dB and 7.1 dB, respectively; after fenestration, air-conduction thresholds averaged 11.4 and 9.3 dB, respectively, and bone-conduction thresholds, 9.3 and 4.2 dB, respectively. The changes in air- (p = 0.0001) and bone-conduction (p = 0.04) thresholds were statistically significant only in the scala vestibuli group. The presence of a cochlear third window over the scala vestibuli, but not over the scala tympani, causes a significant increase in air-conduction auditory thresholds. These results agree with the theoretic model and clinical findings and contribute to our understanding of vestibular dehiscence.

[Basics of Ear Surgery].

PubMed

Lailach, S; Zahnert, T

2016-12-01

The present article about the basics of ear surgery is a short overview of current indications, the required diagnostics and surgical procedures of common otologic diseases. In addition to plastic and reconstructive surgery of the auricle, principles of surgery of the external auditory canal, basics of middle ear surgery and the tumor surgery of the temporal bone are shown. Additionally, aspects of the surgical hearing rehabilitation (excluding implantable hearing systems) are presented considering current study results. Georg Thieme Verlag KG Stuttgart · New York.

Age- and Gender-Specific Normative Information from Children Assessed with a Dichotic Words Test.

PubMed

Moncrieff, Deborah

2015-01-01

The most widely used assessment in the clinical auditory processing disorder (APD) battery is the dichotic listening test. New tests with normative information are helpful for assessment and cross-check of results for reliable diagnosis. The Dichotic Words Test was developed for use in the clinical test battery for diagnosis of APD. The test stimuli were common single syllable words matched for average root-mean-square amplitude and each pair was temporally aligned at both onset and offset. The study was conducted to collect performance results from typically developing children to create normative information for the test. The study follows a cross-sectional design. Typically developing children (n = 416) between the ages of 5 and 12 yr were recruited from schools in the community. There were 217 males and 199 females in the study sample. Only children who passed a hearing screening were eligible to participate. Scores for each ear were recorded during administration of the first free recall version of the test. Ear advantages based on results recorded for left and right ears were used to measure prevalence of right, left, and no ear advantages. Results for each listener's dominant and non-dominant ears and the absolute difference between them were put into the data analysis. Results were analyzed for normality and because no results were normally distributed, all further analyses were done with nonparametric statistical tests. Normative data for dominant and non-dominant ear scores and ear advantages were determined at the 95% confidence interval through bootstrapping methods with 1,000 samples. Children were divided into four age groups based on results in their dominant ears. Females generally performed better than males and the prevalence of a right-ear advantage was ∼60% across all children tested. Normative lower-bound cut-off scores were established for males and females within each age group for dominant and non-dominant ear scores. Normative upper-bound cut-off scores were established for males and females within each age group for ear advantage scores. Normative information specific to age group and gender will be useful in clinical assessment for APD. Prevalence of left-ear advantage results in the sample may have been partly due to uncontrolled influences of voice-onset time in arranging the dichotic pairs. American Academy of Audiology.

Middle ear findings and need for ventilation tubes among pediatric cleft lip and palate patients in northern Finland.

PubMed

Lehtonen, Ville; Lithovius, Riitta H; Autio, Timo J; Sándor, George K; Ylikontiola, Leena P; Harila, Virpi; Pesonen, Paula; Koskinen, Sari; Anttonen, Vuokko

2016-04-01

Middle ear problems are common in cleft patients. This study aimed to determine the need for ventilation tubes (VTs) and complications such as tympanic perforation and cholesteatoma. Data of 156 children with clefts managed in northern Finland spanning 15 years from 1997 to 2011 were collected from 6 hospitals. The following were recorded: birth date, gender, cleft type, surgery timing, surgery type, number of tube insertions, tube material, middle ear findings, and tube placement timing. Clefts were divided into 4 groups: cleft palate (CP), cleft lip and palate (CLP), cleft lip (CL), and submucous cleft palate. The prevalence of middle ear findings was reported. Mucous secretion was noted in 96.8% of CLP patients, 69.2% of CP patients, and 13.0% of CL patients. In all, 82.7% of study group had 1 or more VTs placed during follow-up. All CLP patients required more than 1 VT placement. A total of 94.5% of CP patients required VTs compared to 13.0% of CL patients. In the presence of residual oral nasal fistula, the mean number of tube insertions was 5.3. The prevalence of tympanic perforations in clefts was 35.9% and cholesteatoma in 2.6% of patients. CLP and isolated CP patients have frequent middle ear infections requiring multiple VT placements. Copyright © 2016 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Using Four-Layer Sculpted Rib Cartilage Framework to Increase Transverse Height of the Reconstructive Ear in One Operative Stage for Microtia Patients.

PubMed

Wan, Rui; Pang, Xingyuan; Ren, Jun

2018-02-01

This case study improves an operative method of ear reconstruction for microtia patients by using a four-layer rib cartilage framework to increase transverse height of the reconstructive ear to a natural level in one operative stage. The procedures of ear reconstruction were conducted from February 2014 to May 2016. The ear framework used in the procedures was fabricated from autologous rib cartilage into a four-layer spliced sculpture. Totally 23 patients with unilateral microtia were willing to be enrolled in this study. After the operation, 23 patients achieved 2.3-2.8 cm transverse height of reconstructed ears, which was basically the same as the normal side. Both patients and their families felt satisfied with the results. Follow-up was performed at 6-16 months after the procedures. Only one case showed significantly lowered transverse height of the reconstructed ear, compared to the normal one. It was due to the sleeping position of the patient (10-year-old boy), which put the reconstructed ear under pressure and reduced the transverse height of the ear. The method of four-layer sculpted autologous rib cartilage ear reconstruction has good clinical effect. It can provide a reconstructed ear that reaches normal transverse height and avoids a third operation to increase the transverse height by rib cartilage transplantation. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

15 CFR 736.1 - Introduction.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 15 Commerce and Foreign Trade 2 2010-01-01 2010-01-01 false Introduction. 736.1 Section 736.1....1 Introduction. In this part, references to the EAR are references to 15 CFR chapter VII, subchapter... the EAR regarding export clearance requirements. Also note that for short supply controls all...

Building an endoscopic ear surgery program.

PubMed

Golub, Justin S

2016-10-01

This article discusses background, operative details, and outcomes of endoscopic ear surgery. This information will be helpful for those establishing a new program. Endoscopic ear surgery is growing in popularity. The ideal benefit is in totally transcanal access that would otherwise require a larger incision. The endoscope carries a number of advantages over the microscope, as well as some disadvantages. Several key maneuvers can minimize disadvantages. There is a paucity of studies directly comparing outcomes between endoscopic and microscopic approaches for the same procedure. The endoscope is gaining acceptance as a tool for treating otologic diseases. For interested surgeons, this article can help bridge the transition from microscopic to totally transcanal endoscopic ear surgery for appropriate disease.

The Role of Zic Genes in Inner Ear Development in the Mouse: Exploring Mutant Mouse Phenotypes

PubMed Central

Chervenak, Andrew P.; Bank, Lisa M.; Thomsen, Nicole; Glanville-Jones, Hannah C; Skibo, Jonathan; Millen, Kathleen J.; Arkell, Ruth M.; Barald, Kate F.

2014-01-01

Background Murine Zic genes (Zic1-5) are expressed in the dorsal hindbrain and in periotic mesenchyme (POM) adjacent to the developing inner ear. Zic genes are involved in developmental signaling pathways in many organ systems, including the ear, although their exact roles haven't been fully elucidated. This report examines the role of Zic1, Zic2, and Zic4 during inner ear development in mouse mutants in which these Zic genes are affected Results Zic1/Zic4 double mutants don't exhibit any apparent defects in inner ear morphology. By contrast, inner ears from Zic2kd/kd and Zic2Ku/Ku mutants have severe but variable morphological defects in endolymphatic duct/sac and semicircular canal formation and in cochlear extension in the inner ear. Analysis of otocyst patterning in the Zic2Ku/Ku mutants by in situ hybridization showed changes in the expression patterns of Gbx2 and Pax2. Conclusions The experiments provide the first genetic evidence that the Zic genes are required for morphogenesis of the inner ear. Zic2 loss-of-function doesn't prevent initial otocyst patterning but leads to molecular abnormalities concomitant with morphogenesis of the endolymphatic duct. Functional hearing deficits often accompany inner ear dysmorphologies, making Zic2 a novel candidate gene for ongoing efforts to identify the genetic basis of human hearing loss. PMID:25178196

Recovery time for inflamed middle ear mucosa in chronic otitis media.

PubMed

Pakır, Onur; Dinç, Aykut Erdem; Damar, Murat; Akyıldız, İlker; Eliçora, Sultan Şevik; Erdem, Duygu

2016-01-01

The present study shows that 2-3 weeks after medical treatment the status of middle ear mucosa in draining ears is similar to that of dry ears for at least 3 months. To measure the time required for an inflamed middle ear mucosa to return into optimal state after appropriate medical treatment in chronic suppurative otitis media (CSOM). To assess optimal timing for elective surgical treatment of draining ears in uncomplicated CSOM. In this prospective study, the Eustachian tube (ET) mucociliary clearance time (MCT) was used as the method to demonstrate the status of middle ear mucosa. In group 1 (28 patients) ET-MCT was measured in ears that were free of drainage for at least 3 months. In Group 2 (21 patients), ET-MCT was measured in draining ears, who responded to 10-14 days medical treatment, at presentation, after 10 days and 1 month. The ET-MCT was 8.63 ± 1.32 min in group 1 and 28.96 ± 8.19 min in group 2 at presentation; and the difference was statistically significant (p < 0.001). The ET-MCT was 14.76 ± 5.11 min after 10 days and 9.31 ± 2.33 min after 1 month in group 2. The ET-MCT was indifferent between groups 1 and 2 after 1 month (p = 0.235).

Low-resolution electromagnetic tomography (LORETA) in children with cochlear implants: a preliminary report.

PubMed

Henkin, Yael; Kishon-Rabin, Liat; Tatin-Schneider, Simona; Urbach, Doron; Hildesheimer, Minka; Kileny, Paul R

2004-12-01

The current preliminary report describes the utilization of low-resolution electromagnetic tomography (LORETA) in a small group of highly performing children using the Nucleus 22 cochlear implant (CI) and in normal-hearing (NH) adults. LORETA current density estimations were performed on an averaged target P3 component that was elicited by non-speech and speech oddball discrimination tasks. The results indicated that, when stimulated with tones, patients with right implants and NH adults (regardless of stimulated ear) showed enhanced activation in the right temporal lobe, whereas patients with left implants showed enhanced activation in the left temporal lobe. When stimulated with speech, patients with right implants showed bilateral activation of the temporal and frontal lobes, whereas patients with left implants showed only left temporal lobe activation. NH adults (regardless of stimulated ear) showed enhanced bilateral activation of the temporal and parietal lobes. The differences in activation patterns between patients with CI and NH subjects may be attributed to the long-term exposure to degraded input conditions which may have resulted in reorganization in terms of functional specialization. The difference between patients with right versus left implants, however, is intriguing and requires further investigation.

Short-term music-induced hearing loss after sound exposure to discotheque music: the effectiveness of a break in reducing temporary threshold shift.

PubMed

Helleman, Hiske W; Dreschler, Wouter A

2015-02-01

To investigate the effect of a break in music exposure on temporary threshold shifts. A cross-over design where subjects are exposed to dance music for either two hours consecutively, or exposed to two hours of dance music with a one-hour break in between. Outcome measure was the change in hearing threshold, measured in 1-dB steps at different time points after ending the music. Eighteen normal-hearing subjects participated in this study. Changes in pure-tone threshold were observed in both conditions and were similar, regardless of the break. Threshold shifts could be averaged for 1000, 2000, and 4000 Hz. The shift immediately after the ending of the music was 1.7 dB for right ears, and 3.4 dB for left ears. The difference between left and right ears was significant. One hour after the exposure, right ears were recovered to baseline conditions whereas left ears showed a small but clinically irrelevant remaining shift of approximately 1 dB. The advice to use chill-out zones is still valid, because this helps to reduce the duration to the exposure. This study does not provide evidence that a rest period gives an additional reduction of temporary threshold shifts.

Diode laser myringotomy for chronic otitis media with effusion in adults.

PubMed

Zanetti, Diego; Piccioni, Michela; Nassif, Nader; Campovecchi, Chiara; Redaelli de Zinis, Luca O

2005-01-01

To analyze the closure time of diode laser-assisted myringotomies, the incidence of complications, and the hearing results in comparison with the "cold" procedure in adults with otitis media with effusion (OME). Prospective case-control study. Tertiary referral center, university hospital. Twenty-eight adult patients (39 ears), 13 men and 15 women, age 13 to 76 years (mean, 51.9). Inclusion criteria included 3 months (or more) history of OME resistant to medical therapy. Twenty-two control patients (34 ears) underwent cold myringotomies with knife and ventilation tubes (VT). Diode laser myringotomy performed in an office setting under local anesthesia with topical EMLA ointment. Timing of closure of the myringotomy, hearing results, incidence of complications, recurrence of OME. No intra- or postoperative pain nor complications were observed. Otomicroscopic daily monitoring documented the healing patterns of the tympanostomies, which remained patent for 7 to 25 days (average, 15.6 +/- 4.8 days). Immediate improvement of hearing was achieved in every patient. Recurrence of OME was observed in 36 ears (92.3%) within 1 month from healing. In the control group with VTs, healing of the eardrum was observed between 126 and 301 days (average, 183.2 +/- 44.8 days), and recurrence of OME was observed in 8 ears (23.5%) (p < 0.001). One month after healing, the air-bone gap was retained within 10 dB in 10.3% (4/39) of the diode laser group and in 50% (17/34) of the standard procedure group (p=0.0001). Diode laser myringotomy is a straightforward, painless procedure simplified by the thin fiberoptic cables available. Functional benefit is comparable to conventional tympanostomies plus VTs, but the duration of patency is too short to achieve long-term clearance of the effusion in "glue" ears of adult patients. Selected indications could be acute or recurrent otitis media or the prevention of barotraumas in tubal dysfunction.

Foreign body in ear, nose and oropharynx: experience from a tertiary hospital.

PubMed

Tiago, Romualdo Suzano Louzeiro; Salgado, Daniel Cauduro; Corrêa, Juliano Piotto; Pio, Márcio Ricardo Barros; Lambert, Ernani Edney

2006-01-01

The occurrence of foreign bodies in otorhinolaryngology is reason of constant searches for emergency services. To value the incidence of patients with foreign body, to analyze the clinical situation and the treatment in these cases. The prospective study was realized in 81 patients with diagnosis of foreign body of nose, ear or oropharynx in the otorhinolaryngology service of the Hospital do Servidor Público Municipal de São Paulo between april/2003 and march/2005. 57 cases of foreign body of ear, 13 cases of nose and 11 of oropharynx. These patients, 51.85% were men and 48.15% were women. The age average was 23 years old. The average of the evolution time was 18.36 days, being that 38.27% these cases were taken care in less 24 hours of evolution. Inside the total of patients, 83.95% received initial attendance in the otorhinolaryngology clinic, and 16.05% came of another service after some previous removal attempt. The most common symptom of the foreign bodies cases of oropharynx it was odinofagia present in 90.91% of the cases; in the foreign bodies of nose, the unilateral rhinorrhea and cacosmia were present in 46.15 of the cases; in the foreign bodies of ear, 38.60% evolved without symptoms and 28.07 with hipoacusia. The most frequent foreign body of oropharynx it was the fish spine (54.55%); in the nose it was the paper (30.77%); and in the ear it was the cotton (31.58%). The complications resulting of the presence of foreign body or about the manipulation of these had been found in 13 cases (16.05%). Most cases of foreign body conditions, in which a non-specialist professional or a non-professional person previously handles its removal, have a bad evolution with emerging complications. Such outcomes strengthen the fact that an otorhinolaryngologist using the proper equipment must treat patients with foreign body.

Chinchilla middle ear transmission matrix model and middle-ear flexibilitya)

PubMed Central

Ravicz, Michael E.; Rosowski, John J.

2017-01-01

The function of the middle ear (ME) in transforming ME acoustic inputs and outputs (sound pressures and volume velocities) can be described with an acoustic two-port transmission matrix. This description is independent of the load on the ME (cochlea or ear canal) and holds in either direction: forward (from ear canal to cochlea) or reverse (from cochlea to ear canal). A transmission matrix describing ME function in chinchilla, an animal commonly used in auditory research, is presented, computed from measurements of forward ME function: input admittance YTM, ME pressure gain GMEP, ME velocity transfer function HV, and cochlear input admittance YC, in the same set of ears [Ravicz and Rosowski (2012b). J. Acoust. Soc. Am. 132, 2437–2454; (2013a). J. Acoust. Soc. Am. 133, 2208–2223; (2013b). J. Acoust. Soc. Am. 134, 2852–2865]. Unlike previous estimates, these computations require no assumptions about the state of the inner ear, effectiveness of ME manipulations, or measurements of sound transmission in the reverse direction. These element values are generally consistent with physical constraints and the anatomical ME “transformer ratio.” Differences from a previous estimate in chinchilla [Songer and Rosowski (2007). J. Acoust. Soc. Am. 122, 932–942] may be due to a difference in ME flexibility between the two subject groups. PMID:28599566

Chinchilla middle ear transmission matrix model and middle-ear flexibility.

PubMed

Ravicz, Michael E; Rosowski, John J

2017-05-01

The function of the middle ear (ME) in transforming ME acoustic inputs and outputs (sound pressures and volume velocities) can be described with an acoustic two-port transmission matrix. This description is independent of the load on the ME (cochlea or ear canal) and holds in either direction: forward (from ear canal to cochlea) or reverse (from cochlea to ear canal). A transmission matrix describing ME function in chinchilla, an animal commonly used in auditory research, is presented, computed from measurements of forward ME function: input admittance Y TM , ME pressure gain G MEP , ME velocity transfer function H V , and cochlear input admittance Y C , in the same set of ears [Ravicz and Rosowski (2012b). J. Acoust. Soc. Am. 132, 2437-2454; (2013a). J. Acoust. Soc. Am. 133, 2208-2223; (2013b). J. Acoust. Soc. Am. 134, 2852-2865]. Unlike previous estimates, these computations require no assumptions about the state of the inner ear, effectiveness of ME manipulations, or measurements of sound transmission in the reverse direction. These element values are generally consistent with physical constraints and the anatomical ME "transformer ratio." Differences from a previous estimate in chinchilla [Songer and Rosowski (2007). J. Acoust. Soc. Am. 122, 932-942] may be due to a difference in ME flexibility between the two subject groups.

Reconstruction following traumatic partial amputation of the ear.

PubMed

Pearl, Robert A; Sabbagh, Walid

2011-02-01

Reconstruction following traumatic amputation of the external ear remains a unique challenge to the plastic surgeon. The authors report a series of ear reconstructions with autologous costal cartilage in patients following traumatic partial amputation of the ear. Technical points regarding the carving of the cartilage framework and methods of skin coverage are discussed. Fifty partial ear reconstructions with autologous costal cartilage were performed over a 4-year period. All patients had suffered previous traumatic amputation of part of the external auricle due to bite injuries (n = 36), road traffic accidents (n = 6), burns (n = 5), or torture (n = 3). A two-stage technique of reconstruction with autologous cartilage graft was used based on Nagata's adaptations of Brent's original technique. In nine cases, skin shortage or extensive scarring required preoperative tissue expansion (n = 4) or a temporoparietal fascial flap (n = 5) to provide adequate coverage of the cartilage framework. Forty-seven patients had a successful surgical outcome without complication. Two patients developed small areas of skin necrosis resulting in exposure of the cartilage framework. These healed with conservative management with minor loss of definition. One case of wound infection resulted in significant loss of definition of the construct, which required a further surgical procedure with additional costal cartilage graft. Reconstruction of the external ear with autologous costal cartilage following traumatic amputation can produce high-quality auricles consistently and is becoming the treatment of choice for such injuries, given access to a specialist center with exposure to a high volume of cases.

The Effects of Age at Cleft Palate Repair on Middle Ear Function and Hearing Level.

PubMed

Lou, Qun; Zhu, Hongping; Luo, Yi; Zhou, Zhibo; Ma, Lian; Ma, Xiaoran; Fu, Yuan

2018-05-01

To investigate the age effects of cleft palate repair on middle ear function and hearing level in patients who underwent cleft palate repair at different ages by audiologic examination. Medical histories were gathered in detail, and audiologic tests (ie, tympanometry and pure tone hearing threshold) were conducted in 126 patients after palatoplasty. The patients were divided into the following 4 groups according to their ages when they underwent cleft palate repair: group I (0-3 years, 73 patients), group II (4-7 years, 29 patients), group III (8-11 years, 16 patients), and group IV (12 years and older, 8 patients). The data regarding tympanograms, hearing levels, and the average hearing thresholds of each group were analyzed using chi-square tests. The prevalence of middle ear dysfunction and hearing loss in the patients who underwent palatoplasty before 3 years old (27.4% and 2.0% respectively) was significantly lower than that in patients who underwent palatopalsty at 12 years or older (75.0% and 43.7%, respectively). Linear-by-linear association revealed that the prevalences of middle ear dysfunction and hearing loss among the 4 groups were significantly different ( P < .05). The prevalence of middle ear dysfunction and hearing loss tended to increase with advancing age at the time of cleft palate repair. From an audiologist's perspective, palatoplasty at an early age is very beneficial in helping children with cleft palates acquire better middle ear function and hearing level.

The Existence of a Natural Plica at the Anatomical Base of the Antihelix and its Surgical Importance to Address Protruding Ears: An Anatomicosurgical Study.

PubMed

Oliveira, Miguel Marques; Oliveira, Daniel Sousa Marques; Oliveira, Gustavo Sousa Marques

2017-04-01

Protruding ears represent the main abnormality of the external ear, which has required numerous anatomic and surgical studies. Most studies give attention to the absence of the antihelix as the anatomic defect responsible for the clinical deformity of the lateral aspect of the ear that leads to its anteversion. The reason for this study is the controversial origin of the fold of the antihelix within the auricle framework, a field of interest for aesthetic otoplasty. The current study examined the medial surface of the cartilaginous ear frame from cadaver specimens with right morphology to investigate the starting point of the fold of the antihelix. This allowed for verification of a natural plica at the anatomic base of this antihelical fold, which to date has not had its topography described morphologically. It is acknowledged that relevant literature makes no reference to this innominate natural plica at the origin of the antihelix, whose anatomic and surgical importance is related in this report. This study aimed to show that the existence of a natural plica at the base of the antihelix in ear framing represents a landmark between normal and protruding ear morphology. For 8 years, 118 ears were carefully investigated within rigid ethical principles based on a thorough review of the pertinent literature. The study investigated 16 selected cadaver specimens and 102 protruding ears dissected by the senior author including 49 bilateral cases (26 males and 23 females) and 4 unilateral cases (2 males and 2 females). Bifacial anthropometric measurements by calipers were used for documentation. A natural plica at the base of the antihelix was found in all cadaver ears selected with right morphology, whereas it was totally absent in every surgically treated protruding ear irrespective of color, gender, age, or ethnic origin. Ambilateral measures of the antihelix eminence certify the study object in normal specimens as well as its lack in abnormal ones. Technical and topographic knowledge that a natural plica exists at the anatomic base of the antihelix is a valuable key point in recognizing the normal external ear. In addition, the making of a natural plica is the first and most effective factor in the reconstruction of the antihelical fold and its absolute absence results in the pathologic condition for protruding ears. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the A3 online Instructions to Authors. http://www.springer.com/00266 .

The bacteriology of children prior to 1st stage autologous ear reconstruction.

PubMed

Eley, Karen A; Gault, David T

2010-12-01

In virtually all surgical specialities the use of peri-operative antibiotic prophylaxis to minimise wound site infection is routine practice. Antibiotic selection is targeted towards the pathogens most commonly encountered at the surgical site. The surgical management of microtia is by autologous rib cartilage reconstruction, a process that involves at least two surgical stages. The pits and recesses of the microtia ear are difficult to clean and may shelter unusual pathogens not routinely found as skin commensals, requiring modified prophylaxis. This retrospective review of 37 patients undergoing 1st stage ear reconstruction, examines the pre-operative ear site, nose and throat swabs to determine the common pre-operative bacteria encountered in children prior to ear reconstruction, to aid in appropriate antibiotic selection. Copyright © 2010 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

[Reconstruction of the ear in the burns patient].

PubMed

Carrillo-Córdova, Jorge Raúl; Jiménez Murat, Yusef; Apellaniz-Campo, Armando; Bracho-Olvera, Hazel; Carrillo Esper, Raúl

Face burns are a singular pathology with great functional and psychological impact in the patients suffering them. The ears play a fundamental role in personal interactions and damage to this organ results in physical and emotional distress. The reconstructive treatment of the burned ear is a challenge. Multiple procedures have been described to achieve success in the reconstruction of the burned ear; immediate reconstruction with autologous rib cartilage, secondary reconstruction, alloplastic material reconstruction, tissue expansion, skin grafts and also microvascular flaps are some of the most common procedures used in this patients. All these techniques focus on giving a natural appearance to the patient. Burns to the ears affect 30% of the patients with facial burns, they require an excellent treatment given by a multidisciplinary team. Copyright © 2017 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

Nutritional adequacy of energy restricted diets for young obese women.

PubMed

O'Connor, Helen; Munas, Zahra; Griffin, Hayley; Rooney, Kieron; Cheng, Hoi Lun; Steinbeck, Katharine

2011-01-01

Energy restricted meal plans may compromise nutrient intake. This study used diet modelling to assess the nutritional adequacy of energy restricted meal plans designed for weight management in young obese women. Diet modelling of 6000 kJ/d animal protein based meal plans was performed using Australian nutrient databases with adequacy compared to the Australian Nutrient Reference Values (NRVs) for women (19-30 years). One diet plan was based on the higher carbohydrate (HC) version of the Australian Guide to Healthy Eating for women 19-60 years. An alternative higher protein (HP) plan was adapted from the CSIRO Total Wellbeing Diet. Vegan and lacto-ovo versions of these plans were also modelled and compared to the appropriate vegetarian NRVs. Both animal protein diets met the estimated average requirement (EAR) or adequate intake (AI) for all nutrients analysed. The recommended dietary intake (RDI) was also satisfied, except for iron. HC met 75±30% and HP 81±31% of the iron RDI when red meat and iron fortified cereal were both included three days a week, and remained below the RDI even when red meat was increased to seven days. Iron for the modified vegan (57±5% HC; 66±4% HP) and lacto-ovo (48±6% HC; 59±7% HP) plans was below the RDI and zinc below the EAR for the vegan (76±8% HC; 84±9% HP) plans. The 6000 kJ/d animal protein meal plans met the RDI for all nutrients except iron. Iron and zinc failed to meet the vegetarian RDI and EAR respectively for the vegan plans.

Avian dark cells

NASA Technical Reports Server (NTRS)

Hara, J.; Plymale, D. R.; Shepard, D. L.; Hara, H.; Garry, Robert F.; Yoshihara, T.; Zenner, Hans-Peter; Bolton, M.; Kalkeri, R.; Fermin, Cesar D.

2002-01-01

Dark cells (DCs) of mammalian and non-mammalian species help to maintain the homeostasis of the inner ear fluids in vivo. Although the avian cochlea is straight and the mammalian cochlea is coiled, no significant difference in the morphology and/or function of mammalian and avian DCs has been reported. The mammalian equivalent of avian DCs are marginal cells and are located in the stria vascularis along a bony sheet. Avian DCs hang free from the tegmentum vasculosum (TV) of the avian lagena between the perilymph and endolymph. Frame averaging was used to image the fluorescence emitted by several fluorochromes applied to freshly isolated dark cells (iDCs) from chickens (Gallus domesticus) inner ears. The viability of iDCs was monitored via trypan blue exclusion at each isolation step. Sodium Green, BCECF-AM, Rhodamine 123 and 9-anthroyl ouabain molecules were used to test iDC function. These fluorochromes label iDCs ionic transmembrane trafficking function, membrane electrogenic potentials and Na+/K+ ATPase pump's activity. Na+/K+ ATPase pump sites, were also evaluated by the p-nitrophenyl phosphatase reaction. These results suggest that iDCs remain viable for several hours after isolation without special culturing requirements and that the number and functional activity of Na+/K+ ATPase pumps in the iDCs were indistinguishable from in vivo DCs. Primary cultures of freshly iDCs were successfully maintained for 28 days in plastic dishes with RPMI 1640 culture medium. The preparation of iDCs overcomes the difficulty of DCs accessability in vivo and the unavoidable contamination that rupturing the inner ear microenvironments induces.

Co-existence of Benign Paroxysmal Positional Vertigo and Meniere's Syndrome.

PubMed

Yetişer, Sertaç

2017-04-01

Recent studies indicate interrelation of benign paroxysmal positional vertigo (BPPV) and Meniere's disease (MD). These two entities may have different clinical characteristics. Five hundred thirty patients with BPPV evaluated between 2009-2015 were enrolled in the study. 351 patients who had no clear problem associated with BPPV (idiopathic) and 17 patients with MD were analyzed in detail. The age, sex, site of involvement, type of BPPV, symptom duration, and treatment outcome were compared. Meniere's disease + BPPV was more common in the female population (2/15; 7.5 v 127/224; 1.8, p<0.05). Comparative analysis of average age was not statistically significant (42.82±9.94 v. 40.29±1.65, p=0.601). There was no difference in right and left ear involvement between groups. Lateral canal involvement was more common in the BPPV + MD group (9/17; 53% v. 100/351; 28%, p<0.05). BPPV was ipsilateral to the ear with MD in 75% of patients and it was present before the diagnosis of BPPV in 82.3% of patients. Comparative analysis of cure rate between idiopathic BPPV and BPPV + MD after one session was significant (64.7% v 78%, p<0.05). Benign paroxysmal positional vertigo associated with MD presented a divergent picture. It was more frequent in females. Lateral canal involvement was higher. Patients had MD before the development of BPPV and they had prolonged symptoms, which raised a question of diagnostic delay since these two problems were in the same ear in majority of patients. Finally, relief of symptoms required more attempts of repositioning maneuvers.

Continuous 24-hour measurement of middle ear pressure.

PubMed

Tideholm, B; Jönsson, S; Carlborg, B; Welinder, R; Grenner, J

1996-07-01

A new method was developed for continuous measurement of the middle ear pressure during a 24-h period. The equipment consisted of a piezo-electric pressure device and a digital memory. To allow continuous pressure recordings during normal every-day activities the equipment was made light and portable. The measurement accuracy of the equipment as well as the base-line and temperature stability were tested and found to meet to our requirements satisfactorily. In 4 volunteers with different middle ear conditions, a small perforation was made through the tympanic membrane. A rubber stopper containing a small polyethylene tube was fitted into the external ear canal. Tubal function tests were made to establish the equipment's ability to monitor fast pressure changes. The tests were well in accordance with other methods of direct pressure measurements. The equipment was carried by the volunteers for 24 h to monitor any slow or rapid dynamic pressure changes in the middle ear. Four continuous 24-h measurements are presented. The method was found to be suitable for valid measurements of dynamic pressure changes in the middle ear during normal every-day activities. It may become a useful instrument in the search for a better understanding of the development of chronic middle ear disease.

Investigation of bacterial biofilm in the human middle ear using optical coherence tomography and acoustic measurements

PubMed Central

Nguyen, Cac T.; Robinson, Sarah R.; Jung, Woonggyu; Novak, Michael A.; Boppart, Stephen A.; Allen, Jont B.

2013-01-01

Children with chronic otitis media (OM) often have conductive hearing loss which results in communication difficulties and requires surgical treatment. Recent studies have provided clinical evidence that there is a one-to-one correspondence between chronic OM and the presence of a bacterial biofilm behind the tympanic membrane (TM). Here we investigate the acoustic effects of bacterial biofilms, confirmed using optical coherence tomography (OCT), in adult ears. Non-invasive OCT images are collected to visualize the cross-sectional structure of the middle ear, verifying the presence of a biofilm behind the TM. Wideband measurements of acoustic reflectance and impedance (0.2 to 6 [kHz]) are used to study the acoustic properties of ears with confirmed bacterial biofilms. Compared to known acoustic properties of normal middle ears, each of the ears with a bacterial biofilm has an elevated power reflectance in the 1 to 3 [kHz] range, corresponding to an abnormally small resistance (real part of the impedance). These results provide assistance for the clinical diagnosis of a bacterial biofilm, which could lead to improved treatment of chronic middle ear infection and further understanding of the impact of chronic OM on conductive hearing loss. PMID:23588039

Correlation between eye and ear symptoms and lack of teeth, bruxism and other parafunctions in a population of 1006 patients in 2003-2008.

PubMed

Michalak, Maciej; Wysokińska-Miszczuk, Joanna; Wilczak, Magdalena; Paulo, Michał; Bożyk, Andrzej; Borowicz, Janusz

2012-02-29

Parafunctions (harmful habits) play a crucial role in the formation of temporo-mandibular joint (TMJ) dysfunction syndrome with disc displacement. Disorder symptoms in temporo-mandibular joints manifest themselves in the eye and ear but are usually not associated with the dysfunction of temporo-mandibular joints and that might lead to errors in diagnosis. The aim of the study was to examine the influence of missing teeth and parafunctions on the occurrence of ear and eye symptoms in patients treated in the Department of Prosthodontics of the Medical University of Lublin. The patient group consisted of 753 women and 253 men aged 10 to 82 years who had been treated in the Department of Prosthodontics, Medical University of Lublin in the years 2003-2008 due to various symptoms associated with temporo-mandibular joint dysfunction. Eye (24.84%, n = 785) and ear (33.38%, n = 785) syndromes occur on average more often in patients with parafunctions than without them (15.98%, n = 219 and 23.29%, n = 219). However, only parafunctions involving tooth contact should be taken into consideration when diagnosing eye and ear syndromes. The data presented here show that the number of missing teeth does not have a significant influence on the frequency of occurrence of parafunctions. Parafunctions have become a very important factor in the diagnosis of diseases and pathological symptoms of eye and ear as the rate at which they occur is growing. The kind of parafunction is very important. Only those involving tooth contact should be taken into consideration when diagnosing eye and ear syndromes.

Correlation between eye and ear symptoms and lack of teeth, bruxism and other parafunctions in a population of 1006 patients in 2003-2008

PubMed Central

Michalak, Maciej; Wysokińska-Miszczuk, Joanna; Paulo, Michał; Bożyk, Andrzej; Borowicz, Janusz

2012-01-01

Introduction Parafunctions (harmful habits) play a crucial role in the formation of temporo-mandibular joint (TMJ) dysfunction syndrome with disc displacement. Disorder symptoms in temporo-mandibular joints manifest themselves in the eye and ear but are usually not associated with the dysfunction of temporo-mandibular joints and that might lead to errors in diagnosis. The aim of the study was to examine the influence of missing teeth and parafunctions on the occurrence of ear and eye symptoms in patients treated in the Department of Prosthodontics of the Medical University of Lublin. Material and methods The patient group consisted of 753 women and 253 men aged 10 to 82 years who had been treated in the Department of Prosthodontics, Medical University of Lublin in the years 2003-2008 due to various symptoms associated with temporo-mandibular joint dysfunction. Results Eye (24.84%, n = 785) and ear (33.38%, n = 785) syndromes occur on average more often in patients with parafunctions than without them (15.98%, n = 219 and 23.29%, n = 219). However, only parafunctions involving tooth contact should be taken into consideration when diagnosing eye and ear syndromes. The data presented here show that the number of missing teeth does not have a significant influence on the frequency of occurrence of parafunctions. Parafunctions have become a very important factor in the diagnosis of diseases and pathological symptoms of eye and ear as the rate at which they occur is growing. Conclusions The kind of parafunction is very important. Only those involving tooth contact should be taken into consideration when diagnosing eye and ear syndromes. PMID:22457683

Chosen Listening Levels for Music With and Without the Use of Hearing Aids.

PubMed

Croghan, Naomi B H; Swanberg, Anne M; Anderson, Melinda C; Arehart, Kathryn H

2016-09-01

The objective of this study was to describe chosen listening levels (CLLs) for recorded music for listeners with hearing loss in aided and unaided conditions. The study used a within-subject, repeated-measures design with 13 adult hearing-aid users. The music included rock and classical samples with different amounts of audio-industry compression limiting. CLL measurements were taken at ear level (i.e., at input to the hearing aid) and at the tympanic membrane. For aided listening, average CLLs were 69.3 dBA at the input to the hearing aid and 80.3 dBA at the tympanic membrane. For unaided listening, average CLLs were 76.9 dBA at the entrance to the ear canal and 77.1 dBA at the tympanic membrane. Although wide intersubject variability was observed, CLLs were not associated with audiometric thresholds. CLLs for rock music were higher than for classical music at the tympanic membrane, but no differences were observed between genres for ear-level CLLs. The amount of audio-industry compression had no significant effect on CLLs. By describing the levels of recorded music chosen by hearing-aid users, this study provides a basis for ecologically valid testing conditions in clinical and laboratory settings.

Reconstruction of partially amputated external ear with costal cartilage graft: case report.

PubMed

Brunelli, A; Bottini, D J; Cervelli, V; Cervelli, G; Grimaldi, M

2004-06-01

Many causes are responsible for secondary anomalies of the outer ear, such as: car accidents, sport- or work-related accidents, assaults, bites from animals or humans, benign or malignant tumours, burns and the effects of surgical interventions of the ear (plastic surgery on the ear or attempts at correction of primary malformations of the ear). The anatomical complexity of the ear makes its reconstruction particularly complicated with post-operative results that are often disappointing. The Authors describe their experience in the reconstruction of a partially amputated outer ear following a dog bite. The therapeutic protocol required various surgical stages. Initially, a cutaneous expander was applied at the level of the mastoid in order to ensure a sufficient quantity of local skin. The second stage was to remove cartilage from the ribs, followed by construction of a cartilaginous model of the ear and its insertion into the subcutaneous mastoid region after removal of the cutaneous expander and any residual ear cartilage. The last stage was to separate the neo-formed outer ear from the mastoid skin with the insertion of a cartilage graft to the posterior region of the reconstructed ear. This graft was covered by the occipital fascia rotated at 180 degrees and by a skin graft removed from the pubis. The postoperative result was satisfactory with recuperation of a good aesthetic appearance of the ear. Aim of the present report is to describe the surgical technique employed in the reconstruction of secondary anomalies of the ear and to highlight errors committed during this procedure. These considerations have allowed us to stress some fundamental elements in the reconstruction of the ear. In particular, the watershed was the awareness that we had to create a cartilaginous model that respected, as far as possible, the anatomy of the outer ear with all its ridges, trenches and cavities. This as well as ensuring a sufficient quantity of local skin in order to cover the cartilaginous graft and, therefore, reduce the risk of exposing the cartilage and subsequent infection, to guarantee an optimal end result.

[Facial nerve monitoring during middle ear surgery: Results of a French survey].

PubMed

Mazzaschi, O; Juvanon, J-M; Mondain, M; Lavieile, J-P; Ayache, D

2014-01-01

Facial nerve injury is a rare complication of middle ear surgery. To date there is no widely accepted consensus on the use of intraoperative facial nerve monitoring during middle ear surgery, whereas its use has been proved as a valuable adjunct in neurotologic surgery. The purpose of our study was to identify introperative facial nerve monitoring practice patterns in France for middle ear surgery. A 19-item survey has been made up by three experienced otologists under the auspices of the French Otology and Neurotology Association. With the support of the French Society of Otolaryngology--Head and Neck Surgery, the survey was electronically sent by email to 1249 practicing ENT with a valid email address. Answers were analyzed two months later. Among 1249 email sent, 299 were opened (24%) and 83 answers were collected (6,6%). Of the respondents, 66% had access to intraoperative facial nerve monitoring. Otolaryngologists involved in academic setting were influenced by their teaching duty in 27%. Intraoperative facial nerve monitoring should not be required for stapes surgery, ossiculoplasty, myringoplasty for, respectively, 92%, 93 % and 98% of the respondents. In cochlear implantation, 78% of ear surgeons used facial nerve monitoring. Answers were more controversial for chronic ear surgery, ear atresia and middle ear implant. Revision surgery and CT scan can influence answers. Despite a low response rate, results of this national survey revealed interesting findings. For most of the respondents, intraoperative facial nerve monitoring was not indicated in stapes surgery, myringoplasty and ossiculoplasty. The use of intraoperative facial nerve monitoring for cochlear implantation was supported by the majority of respondents. Variations in response rate were more significant for chronic ear surgery, including middle ear cholesteatoma, and for ear atresia surgery.

[Plastic surgery to correct deformities of the ear].

PubMed

Naumann, A

2005-08-18

For the plastic-surgical correction of mild deformities of the ears, well-proven incisional and suturing techniques are available. Only in exceptional cases is skin grafting or the use of cartilage ersatz material required. In the plastic surgical treatment of moderate to severe ear deformities, in contrast, not only incisional and suturing techniques, but also free skin grafts and ersatz materials are needed. At the ENT Department of the Ludwig-Maximilian University in Munich, plastic reconstruction of moderate to severe deformities of the external ear using porous polyethylene implants instead of rib cartilage grafts has been practiced with success for the past two years or so. Porous polyethylene implants provide good results and may help to avoid pre- and postoperative morbidity at donor site defects.

Effects of hyperbaric therapy on function and morphology of Guinea pig cochlea with endolymphatic hydrops.

PubMed

Chi, Fang-Lu; Liang, Qin; Wang, Zheng-Min

2004-07-01

The objective of this study was to investigate the effect on experimental endolymphatic hydrops in guinea pigs after hyperbaric therapy. The histopathologic character of Ménière's disease is the presence of endolymphatic hydrops. Endolymphatic hypertension could be one of the factors resulting from endolymphatic hydrops. Some treatments of Ménière's disease are aimed toward preventing the endolymphatic hypertension. Exposure to pressure change has risen in recent years. Thirty-two guinea pigs were operated on the right ears to induce endolymphatic hydrops by obliterating the endolymphatic sac through an extradural posterior cranial fossa approach. After 5 weeks' survival, 12 guinea pigs were put into a chamber with an absolute atmospheric pressure of 2.2 for 3 weeks (90 minutes once a day 5 times a week). We observed the morphologic and functional changes in guinea pig cochleae of the pressure group, 4-week hydrops group (n = 10), 8-week hydrops group (n = 10), and the normal group (n = 10). We measured the hearing threshold of the auditory brainstem response, the 70-dB SPL action potential (AP) latency, the ratio of 70-dB SPL summating potential magnitude to action potential magnitude (-SP/AP) of the electrocochleogram, and the maximum scala media area (SMA) ratio, respectively. The average 70-dB SPL-SP/AP magnitude of right ears (0.29 +/- 0.09) and the average maximum SMA ratio (2.23 +/- 0.20) in the pressure group were significantly less than that in the 8-week hydrops group (0.69 +/- 0.15 and 4.04 +/- 0.52, respectively) with the same survival time (p < 0.05). The results in the pressure group were almost as similar as that in the 4-week hydrops group (0.29 +/- 0.13 and 2.22 +/- 0.20, respectively) (p > 0.05). The average hearing threshold of ABR of right ears in the pressure group (36.67 +/- 14.30-dB SPL) was lower than that of the 8-week hydrops group (44 +/-1 4.30-dB SPL), but the difference was insignificant (p > 0.05). The average 70-dB SPL AP latency of right ears in the pressure group was not significantly different from those of the 8-week hydrops group, the 4-week hydrops group, or the normal group (p > 0.05). Our findings suggest hyperbaric therapy can significantly suppress the development of endolymphatic hydrops and improve cochlear function in guinea pigs. This study provided strong evidence for the development of pressure treatment of Ménière's disease without destroying the inner ear.

15 CFR 743.1 - Wassenaar Arrangement.

Code of Federal Regulations, 2014 CFR

2014-01-01

... must be kept in accordance with part 762 of the EAR. This section does not require reports for... the Wassenaar Arrangement Munitions List that are subject to the EAR (i.e., “600 series” ECCNs), see... paragraph (a) of this section: For purposes of part 743, the term “you” has the same meaning as the term...

Long-term evaluation of the effect of middle ear effusion on the vestibular system in children.

PubMed

Pazdro-Zastawny, Katarzyna; Pośpiech, Lucyna; Zatoński, Tomasz

2018-06-01

Otitis media with effusion (OME) is one of the most common clinical conditions in childhood. Fluid accumulation in the middle ear may impact inner ear. The purpose of this random sample cohort study was to investigate whether the past history of middle ear effusion has a long-term negative impact on the vestibular system in children. The study was carried out on 22 children aged 7-15 years who had undergone drainage of the middle ear 5 years before evaluation. The control group consisted of 29 healthy children aged 4-17 years. Vestibular function was examined using sway posturography and electronystagmography (ENG). The stabilogram parameters of the study group and the control group were compared. The field of developed area (FDA) and the average body sway velocity (ASV) were analyzed. Elevated stabilogram parameters of FDA and ASV, both with eyes open and eyes closed, were found in the study group. Statistically significant values (p < 0.05) were present for ASV with eyes open and with eyes closed. The ENG recordings were analyzed in both groups. In the study group, spontaneous nystagmus was observed in 40.9% of the children and positional nystagmus occurred in 63.6% of the children. According to tests, eye tracking test was impaired in 27.3% of cases. Rotatory chair testing revealed asymmetry in 18.2% of the children. The presence of effusion in the middle ear in the past has a negative impact on the vestibular part of the inner ear. Clinicians should be aware of the possible negative impact of middle ear effusion on the vestibular function in children with a history of otitis media with effusion. With seeimingly asymptomatic children clinicians should inquire parents about symptoms of dysequlibrium and imbalance. Copyright © 2018 Elsevier B.V. All rights reserved.

Effect of low level laser therapy (LLLT) on vestibular system after gentamicin ototoxicity

NASA Astrophysics Data System (ADS)

Rhee, ChungKu; Hyun, Jai-Hwan; Suh, Myung-Whan; Ahn, Jin Chul; Jung, Jae Yun

2013-03-01

Aim: To develop a bilateral vestibulopathy animal model induced by gentamicin using RS rat and to see the effect of LLLT on this bilateral vestibulopathy model. Method: RS rats were divided into 3 groups, control group (C), laser group (L), and histology group (H). All animals in the 3 groups received gentamicin (GM) 110 mg/kg, intravenously once daily for 3 days. The animals underwent sinusoidal oscillation about a vertical axis before the GM injection, 1, 3, and 7 days post injections. Transcanal low level laser therapy (LLLT) was irradiated to left ear canal for 7 days, starting 1 day post the GM injection. The H group animals were irradiated into the left ear of L group for 3 days, starting 1 day post GM injections for 3 days. C and L groups were sacrifice on 9th day and H group was sacrificed on 7th day. Results: The gain of the C group was significantly decreased in 3 and 7 days. The gain of the right ear of L group was decreased significantly in 3 and 7 days. The gain of left ear of L group was decreased in 3 days post LLLT but the decreased gain was improved significantly comparing to the level of 7 days gain of right ear and it was much closer to the pre-GM level. The average number of cells in cupula of H group after laser treatment for 3 days was significantly lower in non laser treated right ear comparing to the laser treated left ear and ears of the normal rats. Conclusion: The present study demonstrated that LLLT restores vestibular function and vestibular hair cells in rats post gentamicin induced ototoxic damage. LLLT may have clinical implications in the treatment of various vestibular dysfunction. Further studies are essential to verify the exact mechanisms and the most effective application of LLLT to rescue vestibular dysfunction.

Fiber optically guided CO2 laser myringotomy through an otoscope: animal experimentation

NASA Astrophysics Data System (ADS)

DeRowe, Ari; Ophir, Dov; Katzir, Abraham

1992-08-01

We have developed an otoscope which contains an optical fiber capable of transmitting CO2 laser energy. Such a hand-held unit may prove useful in the treatment of acute otitis media and otitis media with effusion. We used crystalline fibers (0.9 mm diameter) capable of transmitting CO2 laser energy. Four guinea pigs were anaesthetized. In one ear a laser myringotomy was performed using 7.5 watts for 0.1 seconds. The diameter of the myringotomy was 1.5 mm. In the other ear a similar conventional myringotomy was performed. After three weeks three laser and three conventional myringotomies were closed. On the average conventional myringotomies closed 50% sooner than laser myringotomies. Temporal bones from three guinea pigs were removed and sectioned according to accepted methods. No histological differences were found between ears. This experiment has proven the feasibility of using an otoscope for fiberoptically guided CO2 laser myringotomy.

Bovine serum albumin nanoparticles as controlled release carrier for local drug delivery to the inner ear

NASA Astrophysics Data System (ADS)

Yu, Zhan; Yu, Min; Zhang, Zhibao; Hong, Ge; Xiong, Qingqing

2014-07-01

Nanoparticles have attracted increasing attention for local drug delivery to the inner ear recently. Bovine serum albumin (BSA) nanoparticles were prepared by desolvation method followed by glutaraldehyde fixation or heat denaturation. The nanoparticles were spherical in shape with an average diameter of 492 nm. The heat-denatured nanoparticles had good cytocompatibility. The nanoparticles could adhere on and penetrate through the round window membrane of guinea pigs. The nanoparticles were analyzed as drug carriers to investigate the loading capacity and release behaviors. Rhodamine B was used as a model drug in this paper. Rhodamine B-loaded nanoparticles showed a controlled release profile and could be deposited on the osseous spiral lamina. We considered that the bovine serum albumin nanoparticles may have potential applications in the field of local drug delivery in the treatment of inner ear disorders.

Cochlear implantation in adults with asymmetric hearing loss.

PubMed

Firszt, Jill B; Holden, Laura K; Reeder, Ruth M; Cowdrey, Lisa; King, Sarah

2012-01-01

Bilateral severe to profound sensorineural hearing loss is a standard criterion for cochlear implantation. Increasingly, patients are implanted in one ear and continue to use a hearing aid in the nonimplanted ear to improve abilities such as sound localization and speech understanding in noise. Patients with severe to profound hearing loss in one ear and a more moderate hearing loss in the other ear (i.e., asymmetric hearing) are not typically considered candidates for cochlear implantation. Amplification in the poorer ear is often unsuccessful because of limited benefit, restricting the patient to unilateral listening from the better ear alone. The purpose of this study was to determine whether patients with asymmetric hearing loss could benefit from cochlear implantation in the poorer ear with continued use of a hearing aid in the better ear. Ten adults with asymmetric hearing between ears participated. In the poorer ear, all participants met cochlear implant candidacy guidelines; seven had postlingual onset, and three had pre/perilingual onset of severe to profound hearing loss. All had open-set speech recognition in the better-hearing ear. Assessment measures included word and sentence recognition in quiet, sentence recognition in fixed noise (four-talker babble) and in diffuse restaurant noise using an adaptive procedure, localization of word stimuli, and a hearing handicap scale. Participants were evaluated preimplant with hearing aids and postimplant with the implant alone, the hearing aid alone in the better ear, and bimodally (the implant and hearing aid in combination). Postlingual participants were evaluated at 6 mo postimplant, and pre/perilingual participants were evaluated at 6 and 12 mo postimplant. Data analysis compared the following results: (1) the poorer-hearing ear preimplant (with hearing aid) and postimplant (with cochlear implant); (2) the device(s) used for everyday listening pre- and postimplant; and (3) the hearing aid-alone and bimodal listening conditions postimplant. The postlingual participants showed significant improvements in speech recognition after 6 mo cochlear implant use in the poorer ear. Five postlingual participants had a bimodal advantage over the hearing aid-alone condition on at least one test measure. On average, the postlingual participants had significantly improved localization with bimodal input compared with the hearing aid-alone. Only one pre/perilingual participant had open-set speech recognition with the cochlear implant. This participant had better hearing than the other two pre/perilingual participants in both the poorer and better ear. Localization abilities were not significantly different between the bimodal and hearing aid-alone conditions for the pre/perilingual participants. Mean hearing handicap ratings improved postimplant for all participants indicating perceived benefit in everyday life with the addition of the cochlear implant. Patients with asymmetric hearing loss who are not typical cochlear implant candidates can benefit from using a cochlear implant in the poorer ear with continued use of a hearing aid in the better ear. For this group of 10, the 7 postlingually deafened participants showed greater benefits with the cochlear implant than the pre/perilingual participants; however, further study is needed to determine maximum benefit for those with early onset of hearing loss.

Cochlear Implantation in Adults with Asymmetric Hearing Loss

PubMed Central

Firszt, Jill B.; Holden, Laura K.; Reeder, Ruth M.; Cowdrey, Lisa; King, Sarah

2012-01-01

Objective Bilateral severe-to-profound sensorineural hearing loss is a standard criterion for cochlear implantation. Increasingly, patients are implanted in one ear and continue to use a hearing aid in the non-implanted ear to improve abilities such as sound localization and speech understanding in noise. Patients with severe-to-profound hearing loss in one ear and a more moderate hearing loss in the other ear (i.e., asymmetric hearing) are not typically considered candidates for cochlear implantation. Amplification in the poorer ear is often unsuccessful due to limited benefit, restricting the patient to unilateral listening from the better ear alone. The purpose of this study was to determine if patients with asymmetric hearing loss could benefit from cochlear implantation in the poorer ear with continued use of a hearing aid in the better ear. Design Ten adults with asymmetric hearing between ears participated. In the poorer ear, all participants met cochlear implant candidacy guidelines; seven had postlingual onset and three had pre/perilingual onset of severe-to-profound hearing loss. All had open-set speech recognition in the better hearing ear. Assessment measures included word and sentence recognition in quiet, sentence recognition in fixed noise (four-talker babble) and in diffuse restaurant noise using an adaptive procedure, localization of word stimuli and a hearing handicap scale. Participants were evaluated pre-implant with hearing aids and post-implant with the implant alone, the hearing aid alone in the better ear and bimodally (the implant and hearing aid in combination). Postlingual participants were evaluated at six months post-implant and pre/perilingual participants were evaluated at six and 12 months post-implant. Data analysis compared results 1) of the poorer hearing ear pre-implant (with hearing aid) and post-implant (with cochlear implant), 2) with the device(s) used for everyday listening pre- and post-implant and, 3) between the hearing aid-alone and bimodal listening conditions post-implant. Results The postlingual participants showed significant improvements in speech recognition after six months cochlear implant use in the poorer ear. Five postlingual participants had a bimodal advantage over the hearing aid-alone condition on at least one test measure. On average, the postlingual participants had significantly improved localization with bimodal input compared to the hearing aid-alone. Only one pre/perilingual participant had open-set speech recognition with the cochlear implant. This participant had better hearing than the other two pre/perilingual participants in both the poorer and better ear. Localization abilities were not significantly different between the bimodal and hearing aid-alone conditions for the pre/perilingual participants. Mean hearing handicap ratings improved post-implant for all participants indicating perceived benefit in everyday life with the addition of the cochlear implant. Conclusions Patients with asymmetric hearing loss who are not typical cochlear implant candidates can benefit from using a cochlear implant in the poorer ear with continued use of a hearing aid in the better ear. For this group of ten, the seven postlingually deafened participants showed greater benefits with the cochlear implant than the pre/perilingual participants; however, further study is needed to determine maximum benefit for those with early onset of hearing loss. PMID:22441359

Fumonisin B(1)-nonproducing strains of Fusarium verticillioides cause maize (Zea mays) ear infection and ear rot.

PubMed

Desjardins, A E; Plattner, R D

2000-11-01

Fumonisins are polyketide mycotoxins produced by Fusarium verticillioides (synonym F. moniliforme), a major pathogen of maize (Zea mays) worldwide. Most field strains produce high levels of fumonisin B(1) (FB(1)) and low levels of the less-oxygenated homologues FB(2) and FB(3), but fumonisin B(1)-nonproducing field strains have been obtained by natural variation. To test the role of various fumonisins in pathogenesis on maize under field conditions, one strain producing FB(1), FB(2), and FB(3), one strain producing only FB(2), one strain producing only FB(3), and one fumonisin-nonproducing strain were applied to ears via the silk channel and on seeds at planting. Disease severity on the harvested ears was evaluated by visible symptoms and by weight percent symptomatic kernels. Fumonisin levels in kernels were determined by high-performance liquid chromatography. The presence of the applied FB(1)-nonproducing strains in kernels was determined by analysis of recovered strains for fumonisin production and other traits. All three FB(1)-nonproducing strains were able to infect ears following either silk-channel application or seed application at planting and were as effective as the FB(1)-producing strain in causing ear rot following silk-channel application. These results indicate that production of FB(1), FB(2), or FB(3) is not required for F. verticillioides to cause maize ear infection and ear rot.

Molecular mapping of QTLs for resistance to Gibberella ear rot, in corn, caused by Fusarium graminearum.

PubMed

Ali, M Liakat; Taylor, Jeff H; Jie, Liu; Sun, Genlou; William, Manilal; Kasha, Ken J; Reid, Lana M; Pauls, K Peter

2005-06-01

Gibberella ear rot, caused by the fungus Fusarium graminearum Schwabe, is a serious disease of corn (Zea mays) grown in northern climates. Infected corn is lower yielding and contains toxins that are dangerous to livestock and humans. Resistance to ear rot in corn is quantitative, specific to the mode of fungal entry (silk channels or kernel wounds), and highly influenced by the environment. Evaluations of ear rot resistance are complex and subjective; and they need to be repeated over several years. All of these factors have hampered attempts to develop F. graminearum resistant corn varieties. The aim of this study was to identify molecular markers linked to the genes for resistance to Gibberella ear rot. A recombinant inbred (RI) population, produced from a cross between a Gibberella ear rot resistant line (CO387) and a susceptible line (CG62), was field-inoculated and scored for Gibberella ear rot symptoms in the F4, F6, and F7 generations. The distributions of disease scores were continuous, indicating that resistance is probably conditioned by multiple loci. A molecular linkage map, based on segregation in the F5 RI population, contained 162 markers distributed over 10 linkage groups and had a total length of 2237 cM with an average distance between markers of 13.8 cM. Composite interval mapping identified 11 quantitative trait loci (QTLs) for Gibberella ear rot resistance following silk inoculation and 18 QTLs following kernel inoculation in 4 environments that accounted for 6.7%-35% of the total phenotypic variation. Only 2 QTLs (on linkage group 7) were detected in more than 1 test for silk resistance, and only 1 QTL (on linkage group 5) was detected in more than 1 test for kernel resistance, confirming the strong influence of the environment on these traits. The majority of the favorable alleles were derived from the resistant parent (CO387). The germplasm and markers for QTLs with significant phenotypic effects may be useful for marker-assisted selection to incorporate Gibberella ear rot resistance into commercial corn cultivars.

Missing links in some curious auditory phenomena: a tale from the middle ear.

PubMed

Carpenter, Michelle S; Cacace, Anthony T; Mahoney, Marty J

2012-02-01

Broadband middle ear power reflectance (BMEPR) is an emerging noninvasive electroacoustic measure that evaluates transmission/reflection properties of the middle ear in high resolution. It is applicable over the entire age continuum and is rapid to perform. However, it remains to be determined if BMEPR is just an incremental step in the evolution of middle ear assessment or a major advance in the way middle ear function can be evaluated. To evaluate effects of age, gender, ear, and frequency on BMEPR measurements in adults without a history of middle ear disease and to assess whether these factors require consideration in test development; to review how these data may influence active physiologic process within the inner ear; to consider how they reconcile with previously published results; and to suggest applications for future research. Prospective, cross-sectional, multivariate analysis to evaluate the effects of age, gender, ear, and frequency on BMEPR in humans without a history of middle ear disease and no air-bone gaps exceeding 10 dB for any frequency. Fifty-six adults in two age groups (Group 1: 18-25 yr, n = 28; Group 2: ≥50 and <66 yr, n = 28). Each age group was stratified by ear and gender in a balanced design. Pure tone air conduction and bone-conduction audiometry was conducted in a commercial sound booth, using a clinical audiometer with standard earphones enclosed in supra-aural ear cushions, and a standard bone-conduction oscillator and headband to evaluate for air-bone gaps. Broadband middle ear power reflectance was measured using a calibrated, commercially available computer-controlled system that incorporated a high quality probe assembly to transduce stimuli and record acoustic responses from the ear canal. Data were analyzed with a four-way (2 × 2 × 2 × 16) repeated measures analysis-of-variance (ANOVA) to evaluate the effects of age group (young vs. old), gender (male vs. female), ear (left vs. right), and frequency (258 to 5040 Hz) on BMEPR. The ANOVA revealed a significant main effect of frequency. There were also gender × ear, gender × frequency, and age × gender × ear interactions. The three-way, age × gender × ear interaction captured the essence of results and revealed lowest power reflectance values in younger females and for right ears. This trend partially reversed in the older age group where higher power reflectance values were observed only in right ears of older females. The significant effects of age, gender, ear, and frequency on BMEPR parallel ear- and gender-related differences in hearing sensitivity, ear, and gender differences in the prevalence of spontaneous otoacoustic emissions (OAEs), gender differences in the magnitude of transient evoked OAEs, and ear differences in transient evoked contralateral OAE suppression effects reported in the literature. While original discussions of these aforementioned effects focused primarily on endocochlear and olivocochlear mechanisms, the BMEPR measurements reported herein suggest that middle ear transmission characteristics may also play a role. American Academy of Audiology.

Amplification in the rehabilitation of unilateral deafness: speech in noise and directional hearing effects with bone-anchored hearing and contralateral routing of signal amplification.

PubMed

Lin, Li-Mei; Bowditch, Stephen; Anderson, Michael J; May, Bradford; Cox, Kenneth M; Niparko, John K

2006-02-01

Vibromechanical stimulation with a semi-implantable bone conductor (Entific BAHA device) overcomes some of the head-shadow effects in unilateral deafness. What specific rehabilitative benefits are observed when the functional ear exhibits normal hearing versus moderate sensorineural hearing loss (SNHL)? The authors conducted a prospective trial of subjects with unilateral deafness in a tertiary care center. This study comprised adults with unilateral deafness (pure-tone average [PTA] > 90 dB; Sp.D. < 20%) and either normal monaural hearing (n = 18) or moderate SNHL (PTA = 25-50 dB: Sp.D. > 75%) in the contralateral functional ear (n = 5). Subjects were fit with contralateral routing of signal (CROS) devices for 1 month and tested before (mastoid) implantation, fitting, and testing with a bone-anchored hearing aid (BAHA). Outcome measures were: 1) subjective benefit; 2) source localization tests (Source Azimuth Identification in Noise Test [SAINT]); 3) speech discrimination in quiet and in noise assessed with Hearing In Noise Test (HINT) protocols. There was consistent satisfaction with BAHA amplification and poor acceptance of CROS amplification. General directional hearing decreased with CROS use and was unchanged by BAHA and directional microphone aids. Relative to baseline and CROS, BAHA produced significantly better speech recognition in noise. Twenty-two of 23 subjects followed up in this study continue to use their BAHA device over an average follow-up period of 30.24 months (range, 51-12 months). BAHA amplification on the side of a deaf ear yields greater benefit in subjects with monaural hearing than does CROS amplification. Advantages likely related to averting the interference of speech signals delivered to the better ear, as occurs with conventional CROS amplification, while alleviating the negative head-shadow effects of unilateral deafness. The advantages of head-shadow reduction in enhancing speech recognition with noise in the hearing ear outweigh disadvantages inherent in head-shadow reduction that can occur by introducing noise from the deaf side. The level of hearing impairment correlates with incremental benefit provided by the BAHA. Patients with a moderate SNHL in the functioning ear perceived greater increments in benefit, especially in background noise, and demonstrated greater improvements in speech understanding with BAHA amplification.

Improving Measurement Efficiency of the Inner EAR Scale with Item Response Theory.

PubMed

Jessen, Annika; Ho, Andrew D; Corrales, C Eduardo; Yueh, Bevan; Shin, Jennifer J

2018-02-01

Objectives (1) To assess the 11-item Inner Effectiveness of Auditory Rehabilitation (Inner EAR) instrument with item response theory (IRT). (2) To determine whether the underlying latent ability could also be accurately represented by a subset of the items for use in high-volume clinical scenarios. (3) To determine whether the Inner EAR instrument correlates with pure tone thresholds and word recognition scores. Design IRT evaluation of prospective cohort data. Setting Tertiary care academic ambulatory otolaryngology clinic. Subjects and Methods Modern psychometric methods, including factor analysis and IRT, were used to assess unidimensionality and item properties. Regression methods were used to assess prediction of word recognition and pure tone audiometry scores. Results The Inner EAR scale is unidimensional, and items varied in their location and information. Information parameter estimates ranged from 1.63 to 4.52, with higher values indicating more useful items. The IRT model provided a basis for identifying 2 sets of items with relatively lower information parameters. Item information functions demonstrated which items added insubstantial value over and above other items and were removed in stages, creating a 8- and 3-item Inner EAR scale for more efficient assessment. The 8-item version accurately reflected the underlying construct. All versions correlated moderately with word recognition scores and pure tone averages. Conclusion The 11-, 8-, and 3-item versions of the Inner EAR scale have strong psychometric properties, and there is correlational validity evidence for the observed scores. Modern psychometric methods can help streamline care delivery by maximizing relevant information per item administered.

Estimate of the risk of radiation-induced cancers after linear-accelerator-based breast-cancer radiotherapy

NASA Astrophysics Data System (ADS)

Koh, Eui Kwan; Seo, Jungju; Baek, Tae Seong; Chung, Eun Ji; Yoon, Myonggeun; Lee, Hyun-ho

2013-07-01

The aim of this study is to assess and compare the excess absolute risks (EARs) of radiation-induced cancers following conformal (3D-CRT), fixed-field intensity-modulated (IMRT) and volumetric modulated arc (RapidArc) radiation therapy in patients with breast cancer. 3D-CRT, IMRT and RapidArc were planned for 10 breast cancer patients. The organ-specific EAR for cancer induction was estimated using the organ equivalent dose (OED) based on computed dose volume histograms (DVHs) and the secondary doses measured at various points from the field edge. The average secondary dose per Gy treatment dose from 3D-CRT, measured 10 to 50 cm from the field edge, ranged from 8.27 to 1.04 mGy. The secondary doses per Gy from IMRT and RapidArc, however, ranged between 5.86 and 0.54 mGy, indicating that IMRT and RapidArc are associated with smaller doses of secondary radiation than 3D-CRT. The organ specific EARs for out-of-field organs, such as the thyroid, liver and colon, were higher with 3D-CRT than with IMRT or RapidArc. In contrast, EARs for in-field organs were much lower with 3D-CRT than with IMRT or RapidArc. The overall estimate of EAR indicated that the radiation-induced cancer risk was 1.8-2.0 times lower with 3D-CRT than with IMRT or RapidArc. Comparisons of EARs during breast irradiation suggested that the predicted risk of secondary cancers was lower with 3D-CRT than with IMRT or RapidArc.

Influence of the educational status on the Dichotic Sentence Identification test in Brazilian Portuguese.

PubMed

Andrade, Adriana Neves de; Silva, Mariane Richetto da; Iorio, Maria Cecilia Martinelli; Gil, Daniela

2015-01-01

To compare the performance of the Dichotic Sentence Identification (DSI) test in the Brazilian Portuguese version, considering: the right and left ears and the educational status in normal-hearing individuals. This investigation assessed 200 individuals who are normal listeners and right-handed and were divided into seven groups according to the years of schooling. All the participants underwent basic audiologic evaluation and behavioral auditory processing assessment (sound localization test, memory test for verbal and nonverbal sounds in sequence, dichotic digits test, and DSI). The evaluated individuals revealed an average educational status of 13.1 years and results within normal limits in the selected tests for the audiologic and auditory processing assessments. Regarding the DSI test, the educational status showed a dependent relationship with the percentages of correct answers in each stage of the test and the evaluated ear. There was a statistically significant positive correlation between the educational status and the percentage of correct answers for all the stages of the DSI test in both the ears. There was also an effect of the educational level on the results obtained in each condition of the DSI test, with the exception of directed attention to the right ear. Comparing the performance considering the variables studied in the DSI test, we concluded that there is an advantage of the right ear and that, the better the educational level, the better the performance of the individuals.

A new QTL for resistance to Fusarium ear rot in maize.

PubMed

Li, Zhi-Min; Ding, Jun-Qiang; Wang, Rui-Xia; Chen, Jia-Fa; Sun, Xiao-Dong; Chen, Wei; Song, Wei-Bin; Dong, Hua-Fang; Dai, Xiao-Dong; Xia, Zong-Liang; Wu, Jian-Yu

2011-11-01

Understanding the inheritance of resistance to Fusarium ear rot is a basic prerequisite for an efficient resistance breeding in maize. In this study, 250 recombinant inbred lines (RILs) along with their resistant (BT-1) and susceptible (N6) parents were planted in Zhengzhou with three replications in 2007 and 2008. Each line was artificially inoculated using the nail-punch method. Significant genotypic variation in response to Fusarium ear rot was detected in both years. Based on a genetic map containing 207 polymorphic simple sequence repeat (SSR) markers with average genetic distances of 8.83 cM, the ear rot resistance quantitative trait loci (QTL) were analyzed by composite interval mapping with a mixed model (MCIM) across the environments. In total, four QTL were detected on chromosomes 3, 4, 5, and 6. The resistance allele at each of these four QTL was contributed by resistant parent BT-1, and accounted for 2.5-10.2% of the phenotypic variation. However, no significant epistasis interaction effect was detected after a two-dimensional genome scan. Among the four QTL, one QTL with the largest effect on chromosome 4 (bin 4.06) can be suggested to be a new locus for resistance to Fusarium ear rot, which broadens the genetic base for resistance to the disease and can be used for further genetic improvement in maize-breeding programs.

Effects of tubing length and coupling method on hearing threshold and real-ear to coupler difference measures.

PubMed

Gustafson, Samantha; Pittman, Andrea; Fanning, Robert

2013-06-01

This tutorial demonstrates the effects of tubing length and coupling type (i.e., foam tip or personal earmold) on hearing threshold and real-ear-to-coupler difference (RECD) measures. Hearing thresholds from 0.25 kHz through 8 kHz are reported at various tubing lengths for 28 normal-hearing adults between the ages of 22 and 31 years. RECD values are reported for 14 of the adults. All measures were made with an insert earphone coupled to a standard foam tip and with an insert earphone coupled to each participant's personal earmold. Threshold and RECD measures obtained with a personal earmold were significantly different from those obtained with a foam tip on repeated measures analyses of variance. One-sample t tests showed these differences to vary systematically with increasing tubing length, with the largest average differences (7-8 dB) occurring at 4 kHz. This systematic examination demonstrates the equal and opposite effects of tubing length on threshold and acoustic measures. Specifically, as tubing length increased, sound pressure level in the ear canal decreased, affecting both hearing thresholds and the real-ear portion of the RECDs. This demonstration shows that when the same coupling method is used to obtain the hearing thresholds and RECD, equal and accurate estimates of real-ear sound pressure level are obtained.

Effects of user training with electronically-modulated sound transmission hearing protectors and the open ear on horizontal localization ability.

PubMed

Casali, John G; Robinette, Martin B

2015-02-01

To determine if training with electronically-modulated hearing protection (EMHP) and the open ear results in auditory learning on a horizontal localization task. Baseline localization testing was conducted in three listening conditions (open-ear, in-the-ear (ITE) EMHP, and over-the-ear (OTE) EMHP). Participants then wore either an ITE or OTE EMHP for 12, almost daily, one-hour training sessions. After training was complete, participants again underwent localization testing in all three listening conditions. A computer with a custom software and hardware interface presented localization sounds and collected participant responses. Twelve participants were recruited from the student population at Virginia Tech. Audiometric requirements were 35 dBHL at 500, 1000, and 2000 Hz bilaterally, and 55 dBHL at 4000 Hz in at least one ear. Pre-training localization performance with an ITE or OTE EMHP was worse than open-ear performance. After training with any given listening condition, including open-ear, performance in that listening condition improved, in part from a practice effect. However, post-training localization performance showed near equal performance between the open-ear and training EMHP. Auditory learning occurred for the training EMHP, but not for the non-training EMHP; that is, there was no significant training crossover effect between the ITE and the OTE devices. It is evident from this study that auditory learning (improved horizontal localization performance) occurred with the EMHP for which training was performed. However, performance improvements found with the training EMHP were not realized in the non-training EMHP. Furthermore, localization performance in the open-ear condition also benefitted from training on the task.

The role of intracochlear drug delivery devices in the management of inner ear disease.

PubMed

Ayoob, Andrew M; Borenstein, Jeffrey T

2015-03-01

Diseases of the inner ear include those of the auditory and vestibular systems, and frequently result in disabling hearing loss or vertigo. Despite a rapidly expanding pipeline of potential cochlear therapeutics, the inner ear remains a challenging organ for targeted drug delivery, and new technologies are required to deliver these therapies in a safe and efficacious manner. In addition to traditional approaches for direct inner ear drug delivery, novel microfluidics-based systems are under development, promising improved control over pharmacokinetics over longer periods of delivery, ultimately with application towards hair cell regeneration in humans. Advances in the development of intracochlear drug delivery systems are reviewed, including passive systems, active microfluidic technologies and cochlear prosthesis-mediated delivery. This article provides a description of novel delivery systems and their potential future clinical applications in treating inner ear disease. Recent progresses in microfluidics and miniaturization technologies are enabling the development of wearable and ultimately implantable drug delivery microsystems. Progress in this field is being spurred by the convergence of advances in molecular biology, microfluidic flow control systems and models for drug transport in the inner ear. These advances will herald a new generation of devices, with near-term applications in preclinical models, and ultimately with human clinical use for a range of diseases of the inner ear.

Learning to perform ear reconstruction.

PubMed

Wilkes, Gordon H

2009-08-01

Learning how to perform ear reconstruction is very difficult. There are no standardized teaching methods. This has resulted in many ear reconstructions being suboptimal. Learning requires a major commitment by the surgeon. Factors to be seriously considered by those considering performing this surgery are (1) commitment, (2) aptitude, (3) training methods available, (4) surgical skills and experience, and (5) additional equipment needs. Unless all these factors are addressed in a surgeon's decision to perform this form of reconstruction, the end result will be compromised, and patient care will not be optimized. It is hoped that considering these factors and following this approach will result in a higher quality of aesthetic result. The future of ear reconstruction lies in the use of advanced digital technologies and tissue engineering. Copyright Thieme Medical Publishers.

77 FR 25932 - Revisions to the Export Administration Regulations (EAR): Control of Energetic Materials and...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-02

... the fact that they apply to the same group of destinations as missile technology controls (i.e., both... Requirements section of ECCN 1E101, consistent with the ``technology'' controls of the Nuclear Suppliers Group.... 120105018-2011-01] RIN 0694-AF53 Revisions to the Export Administration Regulations (EAR): Control of...

Pharmacokinetics of Drug Entry into Cochlear Fluids

ERIC Educational Resources Information Center

Salt, Alec N.

2005-01-01

The inner ear is exposed to aminoglycosides or other drugs either intentionally or as a side effect of clinical treatments directed at other regions of the body. An understanding of the effects of drugs on the inner ear requires knowledge of the pharmacokinetics of the drug once it reaches the cochlear fluids, specifically how much of it reaches…

A Left-Ear Disadvantage for the Presentation of Irrelevant Sound: Manipulations of Task Requirements and Changing State

ERIC Educational Resources Information Center

Hadlington, Lee J.; Bridges, Andrew M.; Beaman, C. Philip

2006-01-01

Three experiments attempted to clarify the effect of altering the spatial presentation of irrelevant auditory information. Previous research using serial recall tasks demonstrated a left-ear disadvantage for the presentation of irrelevant sounds (Hadlington, Bridges, & Darby, 2004). Experiments 1 and 2 examined the effects of manipulating the…

The quality and accuracy of internet information on the subject of ear tubes.

PubMed

McKearney, Thomas C; McKearney, Richard M

2013-06-01

The World Wide Web is a commonly used source of health information for patients. The objective of this study is to assess the quality and accuracy of information on the internet regarding ear tubes and their insertion. Websites were identified from Google, Yahoo and MSN using the search terms 'myringotomy', 'tympanostomy', 'grommet' and 'ear tubes'. The first 40 consecutive websites from each search engine using each search term were potentially eligible for the study. Quality of information was assessed using the DISCERN instrument and readability using the Flesch Readability Formula and Flesch-Kincaid Grade Level Readability Formula. As the DISCERN instrument is subjective, both authors rated each website. Specific facts related to ear tubes were identified from each website such as the indications for and complications of ear tubes which were evaluated for accuracy and consistency. Of the 480 potentially eligible websites, 84 were included in the study. The mean DISCERN score for all websites was 38.5 (range 18-64) and the mean readability score was 49.4 (range 5.7-71.6). The mean Flesch-Kincaid Grade level was 10.1 (range 6.6-12). Key facts quoted on websites regarding ear tube information such as indications for insertion and complications are very variable. Overall, internet information regarding ear tubes is of mixed quality and the readability is generally low. Certain topics such as the number of patients that require repeat ear tube insertion and advice on bathing and showering with ear tubes were poorly described. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Spectacle fitting with ear, nose and face deformities or abnormalities.

PubMed

Eng, Helen; Chiu, Roger Sin Fai

2002-11-01

Spectacle frame selection and dispensing remain significant components of optometry. Occasionally, we encounter patients who are unable to wear conventional spectacles due to abnormalities or deformities following injury and/or surgery to their nose, ears or head. In these cases, spectacle frame fitting may be more complex and customized frame adjustments may be required to account for the anatomical variations. A patient with a microtia (hypoplastic pinna) was fitted with a tailored spectacle frame. The details are presented together with a summary of different frames and modifications available for ears, nose and face abnormalities.

[Middle ear salivary gland choristoma related to branchio-oto-renal syndrome diagnosed by array-CGH].

PubMed

Amrhein, P; Sittel, C; Spaich, C; Kohlhase, J; Boppert, R; Kohlhof, P; Koitschev, A

2014-05-01

Branchio-oto-renal (BOR) syndrome is characterized by ear malformations associated with sensorineural or mixed hearing loss. In addition, preauricular tags, preauricular pits, branchial cleft fistulas and cysts, as well as renal dysplasia are seen. A genetic mutation on chromosome 8, either autosomal dominantly inherited or occuring as a spontaneous mutation, is the cause in the majority of cases. Using array-based comparative genomic hybridization (CGH), it is possible to detect even the smallest genetic changes. Salivary gland choristoma in the middle ear is very rare. Surgical removal and histological clarification are required.

Conditional Deletion of N-Myc Disrupts Neurosensory and Non-sensory Development of the Ear

PubMed Central

Kopecky, Benjamin; Santi, Peter; Johnson, Shane; Schmitz, Heather; Fritzsch, Bernd

2011-01-01

Ear development requires interactions of transcription factors for proliferation and differentiation. The proto-oncogene N-Myc is a member of the Myc family that regulate proliferation. To investigate the function of N-Myc, we conditionally knocked out N-Myc in the ear using Tg(Pax2-Cre) and Foxg 1KiCre. N-Myc CKOs had reduced growth of the ear, abnormal morphology including fused sensory epithelia, disrupted histology, and disorganized neuronal innervation. Using Thin-Sheet Laser Imaging Microscopy (TSLIM), 3D reconstruction and quantification of the cochlea revealed a greater than fifty percent size reduction. Immunochemistry and in situ hybridization showed a gravistatic organ-cochlear fusion and a “circularized” apex with no clear inner and outer hair cells. Furthermore, the abnormally developed cochlea had cross innervation from the vestibular ganglion near the basal tip. These findings are put in the context of the possible functional relationship of N-Myc with a number of other cell proliferative and fate determining genes during ear development. PMID:21448975

Interaction Between Allergy and Middle Ear Infection.

PubMed

Oh, Jeong-Hoon; Kim, Woo Jin

2016-09-01

Recent studies have attempted to identify interactions among the causes of otitis media with effusion (OME). This review discusses the interaction between allergy and infection with regard to host and environmental factors in terms of the development of OME. Protection of the upper airway against microbial invasion requires active interaction between the defense mechanisms of the respiratory epithelium, including innate and adaptive immunity, and mechanical factors. The impairment of these defenses due to allergy and/or increased bacterial resistance may lead to increased susceptibility to infectious organisms in the respiratory tract and middle ear mucosa. Recent genetic studies have provided valuable information about the association of Toll-like receptor signaling variations with clinical phenotypes and the risk of infection in the middle ear. Among the causal factors of OME, allergy not only induces an inflammatory reaction in the middle ear cavity but also facilitates the invasion of infectious pathogens. There is also evidence that allergy can affect the susceptibility of patients to infection of the upper respiratory tract, including the middle ear cavity.

Design of a dynamic sensor inspired by bat ears

NASA Astrophysics Data System (ADS)

Müller, Rolf; Pannala, Mittu; Reddy, O. Praveen K.; Meymand, Sajjad Z.

2012-09-01

In bats, the outer ear shapes act as beamforming baffles that create a spatial sensitivity pattern for the reception of the biosonar signals. Whereas technical receivers for wave-based signals usually have rigid geometries, the outer ears of some bat species, such as horseshoe bats, can undergo non-rigid deformations as a result of muscular actuation. It is hypothesized that these deformations provide the animals with a mechanism to adapt their spatial hearing sensitivity on short, sub-second time scales. This biological approach could be of interest to engineering as an inspiration for the design of beamforming devices that combine flexibility with parsimonious implementation. To explore this possibility, a biomimetic dynamic baffle was designed based on a simple shape overall geometry based on an average bat ear. This shape was augmented with three different biomimetic local shape features, a ridge on its exposed surface as well as a flap and an incision along its rim. Dynamic non-rigid deformations of the shape were accomplished through a simple actuation mechanism based on linear actuation inserted at a single point. Despite its simplicity, the prototype device was able to reproduce the dynamic functional characteristics that have been predicted for its biological paragon in a qualitative fashion.

Middle ear function and cochlear input impedance in chinchilla

PubMed Central

Slama, Michaël C. C.; Ravicz, Michael E.; Rosowski, John J.

2010-01-01

Simultaneous measurements of middle ear-conducted sound pressure in the cochlear vestibule PV and stapes velocity VS have been performed in only a few individuals from a few mammalian species. In this paper, simultaneous measurements of PV and VS in six chinchillas are reported, enabling computation of the middle ear pressure gain GME (ratio of PV to the sound pressure in the ear canal PTM), the stapes velocity transfer function SVTF (ratio of the product of VS and area of the stapes footplate AFP to PTM), and, for the first time, the cochlear input impedance ZC (ratio of PV to the product of VS and AFP) in individuals. |GME| ranged from 25 to 35 dB over 125 Hz–8 kHz; the average group delay between 200 Hz and 10 kHz was about 52 μs. SVTF was comparable to that of previous studies. ZC was resistive from the lowest frequencies up to at least 10 kHz, with a magnitude on the order of 1011 acoustic ohms. PV, VS, and the acoustic power entering the cochlea were good predictors of the shape of the audiogram at frequencies between 125 Hz and 2 kHz. PMID:20329840

The Relationship between Binaural Benefit and Difference in Unilateral Speech Recognition Performance for Bilateral Cochlear Implant Users

PubMed Central

Yoon, Yang-soo; Li, Yongxin; Kang, Hou-Yong; Fu, Qian-Jie

2011-01-01

Objective The full benefit of bilateral cochlear implants may depend on the unilateral performance with each device, the speech materials, processing ability of the user, and/or the listening environment. In this study, bilateral and unilateral speech performances were evaluated in terms of recognition of phonemes and sentences presented in quiet or in noise. Design Speech recognition was measured for unilateral left, unilateral right, and bilateral listening conditions; speech and noise were presented at 0° azimuth. The “binaural benefit” was defined as the difference between bilateral performance and unilateral performance with the better ear. Study Sample 9 adults with bilateral cochlear implants participated. Results On average, results showed a greater binaural benefit in noise than in quiet for all speech tests. More importantly, the binaural benefit was greater when unilateral performance was similar across ears. As the difference in unilateral performance between ears increased, the binaural advantage decreased; this functional relationship was observed across the different speech materials and noise levels even though there was substantial intra- and inter-subject variability. Conclusions The results indicate that subjects who show symmetry in speech recognition performance between implanted ears in general show a large binaural benefit. PMID:21696329

Evidence of hearing loss in a “normally-hearing” college-student population

PubMed Central

Le Prell, C. G.; Hensley, B.N.; Campbell, K. C. M.; Hall, J. W.; Guire, K.

2011-01-01

We report pure-tone hearing threshold findings in 56 college students. All subjects reported normal hearing during telephone interviews, yet not all subjects had normal sensitivity as defined by well-accepted criteria. At one or more test frequencies (0.25–8 kHz), 7% of ears had thresholds ≥25 dB HL and 12% had thresholds ≥20 dB HL. The proportion of ears with abnormal findings decreased when three-frequency pure-tone-averages were used. Low-frequency PTA hearing loss was detected in 2.7% of ears and high-frequency PTA hearing loss was detected in 7.1% of ears; however, there was little evidence for “notched” audiograms. There was a statistically reliable relationship in which personal music player use was correlated with decreased hearing status in male subjects. Routine screening and education regarding hearing loss risk factors are critical as college students do not always self-identify early changes in hearing. Large-scale systematic investigations of college students’ hearing status appear to be warranted; the current sample size was not adequate to precisely measure potential contributions of different sound sources to the elevated thresholds measured in some subjects. PMID:21288064

Day-roosts of female long-eared myotis in Western Oregon

USGS Publications Warehouse

Waldien, David L.; Hayes, J.P.; Arnett, Edward B.

2000-01-01

Roosts are a critical habitat component for bats and may influence their survival and fitness. We used radiotelemetry to investigate characteristics of day-roosts of female long-eared myotis (Myotis evotis) in watersheds characterized by different forest conditions and the spatial relationships between day-roosts and available water. We tracked 21 bats to 73 roosts (n = 102 occasions) from June to August 1996 and 1997 on the western slope of the Cascade Mountains, Oregon. Bats primarily used conifer stumps as day-roosts in watersheds dominated by younger forests and used conifer snags, and to a lesser extent conifer stumps, in watersheds with greater proportions of older forests. Individual long-eared myotis used different types of structures as day-roosts, and type of structure used did not differ with reproductive condition. Day-roosts were primarily located in upslope habitat and averaged 0.59 A? 0.03 km from available water and 0.66 A? 0.02 km from capture sites. Roosts were not located closer to available water than random points, but were closer than random points to captures sites. Conifer snags used as day-roosts averaged 34 A? 5 m in height and 93 A? 12 cm diameter at breast height (dbh); snags in intermediate stages of decay had highest use. Use of conifer snags was positively associated with the number of snags within 20 m and negatively associated with distance from stand edge. Conifer stumps used as day-roosts averaged 133 A? 9 cm in height and 59 A? 4 cm dbh. Western hemlock and Douglas-fir stumps were used more often than western redcedar stumps as day-roosts. Odds of a stump being used as a day-roost increased with increasing height of the stump (downhill side) and whether it was situated in a gap in vegetation. We contend that management of day-roosts for forest-dwelling bats should focus on maintaining large conifer snags across landscapes through space and time. In landscapes where there are relatively few large conifer snags, stumps appear to provide important, but ephemeral, roosts for long-eared myotis.

Daily tympanometry for high-resolution measurement of the time between onset of cold-like illness and middle ear effusion.

PubMed

Doyle, William J; Winther, Birgit; Alper, Cuneyt M

2008-06-01

Tympanometry is a simple method to assess middle ear pressure (MEP) and the presence of middle ear effusion (MEE), a marker of otitis media (OM). To determine whether daily parental tympanometry and illness sign recording in their children can be used to define the time between onsets of cold-like illness (CLI) and MEE at high resolution. Prospective, longitudinal, 7 month, daily follow-up on 169 children aged 1 through 8.6 years. Tympanograms and illness were recorded daily by a parent. Tympanograms were examined, rejected if artifactual, and MEP data were entered into a database, with "flat tympanograms" coded as -400 mm H2O = MEE. The incidence and burden of CLIs (>2 days) were calculated, and for each CLI, the presence/absence of concurrent MEE (>2 days) was determined. For each child, the average MEP for CLI and nonCLI days was calculated. Paired CLI and tympanometric results were aligned and the days between event onsets determined. Stepwise regression was used to assign risk predictors for the measured outcomes. A total of 566 CLIs were recorded, and the average CLI burden/child was 16%. Age was a significant predictor of CLI incidence/child, and age, history of colds, and daily environment were predictors of CLI-burden/child. Of the 433 evaluable CLI episodes, MEE was a complication in 37%, and MEE with a CLI was predicted by age, OM history, and environment. MEP was significantly more negative during CLI episodes, and the magnitude was predicted by age, race, and OM history. The average difference in MEE-CLI onsets was 1.2 +/- 4.0 days; approximately 32% of MEEs occurred prior to CLI onset and 17% on the same day as CLI onset. CLIs adversely affect the middle ear-ambient pressure balance and are frequently associated with MEE episodes. The distribution in onsets between those events suggests that chemoprophylaxis of a child with a newly identified CLI to prevent MEE would have a low expected efficiency.

Role of pepsin and pepsinogen: linking laryngopharyngeal reflux with otitis media with effusion in children.

PubMed

Luo, Hua-Nan; Yang, Qi-Mei; Sheng, Ying; Wang, Zheng-Hui; Zhang, Qing; Yan, Jing; Hou, Jin; Zhu, Kang; Cheng, Ying; Wang, Bo-Tao; Xu, Ying-Long; Zhang, Xiang-Hong; Ren, Xiao-Yong; Xu, Min

2014-07-01

To analyze the relationship between laryngopharyngeal reflux (LPR) represented by pepsin and pepsinogen, and pathogenesis of otitis media with effusion (OME). Prospective case-control study. Children with OME who required adenoidectomy and tympanostomy/tympanostomy tubes placement were enrolled in OME group, whereas children with adenoid hypertrophy (AH) who required adenoidectomy and individuals who required cochlear implantation (CI) were enrolled in AH and CI groups, respectively. Pepsinogen mRNA and protein levels were assessed by real-time fluorescence-based quantitative polymerase chain reaction and immunohistochemistry in adenoid specimens from the OME and AH groups. Pepsin and pepsinogen concentrations were evaluated by enzyme-linked immunosorbent assay in middle ear fluid and plasma from the OME and CI groups. The levels of pepsinogen protein expressed in cytoplasm of epithelial cells and clearance under epithelial cells in adenoid specimens from the OME group were significantly higher than those in the AH group. Furthermore, the concentrations of pepsin and pepsinogen in the OME group were 51.93±11.58 ng/mL and 728±342.6 ng/mL, respectively, which were significantly higher than those in the CI group (P<.001). In addition, the concentrations of pepsin in dry ears were significantly lower than those in serous and mucus ears in the OME group (F=22.77, P<.001).Finally, the concentration of pepsinogen in middle ear effusion was positively correlated with the expression intensity of pepsinogen protein in cytoplasm of epithelial cells (r=0.73, P<.05) in the OME group. Pepsin and pepsinogen in middle ear effusion are probably caused by LPR and may be involved in the pathogenesis of OME. 3b. © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

Single-treatment porcine zona pellucida immunocontraception associated with reduction of a population of white-tailed deer (Odocoileus virginianus).

PubMed

Rutberg, Allen T; Naugle, Ricky E; Verret, Frank

2013-12-01

Previous reports have demonstrated gradual reductions of white-tailed deer (Odocoileus virginianus) populations through immunocontraception, with stabilization occurring after 2-4 yr of treatment, and subsequent reductions of 6-10% annually. These studies employed porcine zona pellucida (PZP) vaccines that required two initial treatments and annual retreatments. From 2005 to 2010, 258 adult and yearling female deer on Fripp Island, South Carolina, were treated with one of several PZP preparations designed to produce 2+ yr of effective contraception with a single treatment. These included several preparations of SpayVac and of native PZP-adjuvant emulsion plus PZP and QA-21 in timed-release pellets. Deer were chemically immobilized, ear-tagged, and administered initial treatments by hand in February-March. Some treated deer were boosted remotely with PZP-adjuvant emulsion 1.5 - 4.5 yr after initial treatments. Ground-based distance sampling was used to estimate deer population density at Fripp Island, a resort community, and at a relatively undeveloped neighboring control site, Hunting Island. Most vaccine preparations tested reduced fawning rates by 75% to 95% for at least 1 yr. From 2005 to 2011, deer density on Fripp Island declined by 50%, from 72 deer/km(2) to 36 deer/km(2), an average annual reduction of 11%. In contrast, population density on the Hunting Island control site fluctuated between 2005 and 2011, averaging 23 deer/km(2) (range, 19-28 deer/km(2)). Population declines on Fripp Island were associated with an increase in the proportion of treated females and with a progressive decrease in winter fawn:doe ratios, from 1.21 fawns/doe in 2005 to 0.19 fawns/doe in 2010. Winter fawn:doe ratios averaged 1.36 fawns/doe (range, 0.84 - 1.62 fawns/doe) at the Hunting Island control site. Annual survivorship averaged approximately 79% among ear-tagged females. The rate at which deer populations diminished in association with PZP treatments on Fripp Island was higher than that seen at other study sites, although the reasons for the more rapid decline on Fripp Island are not well understood.

Effects of Japanese beetle (Coleoptera: Scarabaeidae) and silk clipping in field corn.

PubMed

Steckel, Sandy; Stewart, S D; Tindall, K V

2013-10-01

Japanese beetle (Popillia japonica Newman) is an emerging silk-feeding insect found in fields in the lower Corn Belt and Midsouthern United States. Studies were conducted in 2010 and 2011 to evaluate how silk clipping in corn affects pollination and yield parameters. Manually clipping silks once daily had modest effects on yield parameters. Sustained clipping by either manually clipping silks three times per day or by caging Japanese beetles onto ears affected total kernel weight if it occurred during early silking (R1 growth stage). Manually clipping silks three times per day for the first 5 d of silking affected the number of kernels per ear, total kernel weight, and the weight of individual kernels. Caged beetles fed on silks and, depending on the number of beetles caged per ear, reduced the number of kernels per ear. Caging eight beetles per ear significantly reduced total kernel weight compared with noninfested ears. Drought stress before anthesis appeared to magnify the impact of silk clipping by Japanese beetles. There was evidence of some compensation for reduced pollination by increasing the size of pollinated kernels within the ear. Our results showed that it requires sustained silk clipping during the first week of silking to have substantial impacts on pollination and yield parameters, at least under good growing conditions. Some states recommend treating for Japanese beetle when three Japanese beetles per ear are found, silks are clipped to < 13 mm, and pollination is < 50% complete, and that recommendation appears to be adequate.

Otoplasty by percutaneous anterior scoring. Another twist to the story: a long-term study of 114 patients.

PubMed

Bulstrode, N W; Huang, S; Martin, D L

2003-03-01

A large number of techniques have been described for the correction of prominent ears to improve the cosmetic outcome and reduce the complication rates. The procedure favoured by the senior author brings together a number of refinements, notably, percutaneous anterior scoring using a modified green needle, control over the degree of fold created and a simple but effective dressing. 114 consecutive patients underwent the correction of 214 ears, with a mean follow up of 3 years and 11 months (9 months to 9 years and 6 months). The senior author performed 100 of these procedures and supervised a senior trainee for the remainder. The mean patient age was 18 years 3 months (3 to 66 years). 57 males and 57 females. 56 general anaesthetic and 58 local anaesthetic. Post-operative complications were; haemorrhage, one ear (required a dressing change); infection, four ears (treated with antibiotics); hypertrophic scarring, two ears which settled (no keloid); recurrence one ear (repeated surgery); continued prominence six ears (two had repeated surgery). No prominent sutures, no anterior skin necrosis, no visible irregularity of the anterior surface of the cartilage and no haematoma occurred. We feel that the low complication rate is due to maximising the advantages and minimising the disadvantages of the different techniques and refinements. We recommend this technique for the routine correction of prominent ears due to a poorly formed antihelical fold or deep conchal bowl.

Temporal bone changes in patients with Goldenhar syndrome with special emphasis on inner ear abnormalities.

PubMed

Hennersdorf, Florian; Friese, Natascha; Löwenheim, Hubert; Tropitzsch, Anke; Ernemann, Ulrike; Bisdas, Sotirios

2014-06-01

Goldenhar syndrome is a developmental disorder presenting with orofacial and vertebral anomalies, which are also accompanied by abnormalities in other organs. We examined temporal bone changes with special emphasis on inner ear abnormalities in these patients. A retrospective review of 7 new cases in addition to a previously published series of 14 cases with clinically diagnosed Goldenhar syndrome was carried out to search for inner ear anomalies. In addition, temporal bone imaging studies from the literature were summarized and compared with our results. Departments of Neuroradiology and Otorhinolaryngology at a university hospital. In addition to the previous series of 14 patients, 7 new patients with Goldenhar syndrome were identified. Patients underwent otologic examination, audiometric studies, and high-resolution computed tomography (CT) or magnetic resonance imaging (MRI) of the temporal bone. Temporal bone changes and specifically inner ear malformations. Nineteen of 21 patients showed changes of the external and middle ear correlating with the literature. Seven of 21 patients showed inner ear abnormalities constituting one-third of all patients. These ranged from mild such as vestibular enlargement to severe defects such as cochlear hypoplasia and common cavity. Inner ear abnormalities were present in one-third of patients. Although in some cases, these might not be of clinical significance, some patients show severe defects of the inner ear requiring more complex hearing loss therapy. Therefore, imaging of the temporal bone structures is important in the care of these patients.

Protein intake trends and conformity with the Dietary Reference Intakes in the United States: analysis of the National Health and Nutrition Examination Survey, 2001-2014.

PubMed

Berryman, Claire E; Lieberman, Harris R; Fulgoni, Victor L; Pasiakos, Stefan M

2018-06-21

Systematic analysis of dietary protein intake may identify demographic groups within the American population that are not meeting the Dietary Reference Intakes (DRIs). This cross-sectional study analyzed protein intake trends (2001-2014) and evaluated recent conformity to the DRIs (2011-2014) according to age, sex, and race or ethnicity in the US population. Protein intakes and trends during 2-y cycles of NHANES 2001-2014 (n = 57,980; ≥2 y old) were calculated as absolute (grams per day) and relative [grams per kilogram of ideal body weight (IBW) per day] intakes and as a percentage of total energy. Sex and race or ethnicity [Asian, Hispanic, non-Hispanic black (NHB), and non-Hispanic white (NHW)] differences were determined for protein intake and percentage of the population below the Estimated Average Requirement (EAR) and Recommended Dietary Allowance, and above and below the Acceptable Macronutrient Distribution Range (AMDR). Usual protein intakes (mean ± SE) averaged from 55.3 ± 0.9 (children aged 2-3 y) to 88.2 ± 1.1 g/d (adults aged 19-30 y). Protein comprised 14-16% of total energy intakes. Relative protein intakes averaged from 1.10 ± 0.01 (adults aged ≥71 y) to 3.63 ± 0.07 g · kg IBW-1 · d-1 (children aged 2-3 y), and were above the EAR in all demographic groups. Asian and Hispanic populations aged >19 y consumed more relative protein (1.32 ± 0.02 and 1.32 ± 0.02 g · kg IBW-1 · d-1, respectively) than did NHB and NHW (1.18 ± 0.01 g · kg IBW-1 · d-1). Relative protein intakes did not differ by race or ethnicity in the 2-18 y population. Adolescent (aged 14-18 y) females and older (aged ≥71 y) NHB men had the largest population percentages below the EAR (11% and 13%, respectively); <1% of any demographic group had intakes above the AMDR. The majority of the US population exceeds minimum recommendations for protein intake. Protein intake remains well below the upper end of the AMDR, indicating that protein intake, as a percentage of energy intake, is not excessive in the American diet. This trial was registered at www.isrctn.com as ISRCTN76534484.

Nutrient intakes, major food sources and dietary inadequacies of Inuit adults living in three remote communities in Nunavut, Canada.

PubMed

Sharma, S; Hopping, B N; Roache, C; Sheehy, T

2013-12-01

Inuit in Nunavut, Canada, are currently undergoing a nutritional transition that may contribute to an increased prevalence of chronic disease. Information is lacking about the extent to which contemporary Inuit diets are meeting current dietary recommendations. A culturally appropriate quantitative food frequency questionnaire (QFFQ) developed and validated for Inuit in Nunavut, Canada, was used to assess food and nutrient intake in a cross-sectional sample of adults. Participants included 175 women and 36 men with mean (SD) ages of 42.4 (13.2) and 42.1 (15.0) years, respectively. The response rate for those who completed the study was 79% with 208 QFFQs included for analysis. Reported mean daily energy intakes were: men 15,171 kJ (3626 kcal); women 11,593 kJ (2771 kcal). Dietary inadequacy was expressed as the percentage of participants reporting intakes below the sex- and age-specific estimated average requirements (EARs). For nutrients without EARs, adequate intakes were used. Energy and sodium intakes exceeded the recommendations. Less than 10% of participants met recommendations for dietary fibre intake. Vitamin E intakes were below EARs for ≥97% of participants, whereas >20% reported inadequate vitamin A, folate and magnesium intakes. Among women, >50% reported inadequate calcium and vitamin D intakes. Non-nutrient-dense foods contributed 30% of energy, 73% of sugars and 22% of fat. Traditional foods contributed 56% of protein and 49% of iron. The present study demonstrates a relatively high prevalence of inadequate nutrient intakes among Inuit. The results may be used to monitor the nutrition transition among Inuit, evaluate nutritional interventions, and inform public health policy decision-making. © 2013 The Authors Journal of Human Nutrition and Dietetics © 2013 The British Dietetic Association Ltd.

Examination of iodine status in the German population: an example for methodological pitfalls of the current approach of iodine status assessment.

PubMed

Johner, S A; Thamm, M; Schmitz, R; Remer, T

2016-04-01

Preliminary iodine concentration (UIC) measurements in spot urines of the representative German adult study DEGS indicated a severe worsening of iodine status compared to previous results in German children (KiGGS study). Therefore, we aimed to evaluate adult iodine status in detail and to investigate the impact of hydration status on UIC. UIC and creatinine concentrations were measured in 6978 spot urines from the German nationwide DEGS study (2008-2011). Twenty-four-hour iodine excretions (24-h UIE) were estimated by relating iodine/creatinine ratios to age- and sex-specific 24-h creatinine reference values. Urine osmolality was measured in two subsamples of spot urines (n = 100 each) to determine the impact of hydration status on UIC. In DEGS, median UIC was 69 µg/L in men and 54 µg/L in women, lying clearly below the WHO cutoff for iodine sufficiency (100 µg/L). Estimated median 24-h UIE was 113 µg/day, accompanied by 32 % of DEGS adults, lying below the estimated average requirement (EAR) for iodine. Comparative analysis with the KiGGS data (>14,000 spot urines of children; median UIC 117 µg/L) revealed a comparable percentage

Foods, Fortificants, and Supplements: Where Do Americans Get Their Nutrients?123

PubMed Central

Fulgoni, Victor L.; Keast, Debra R.; Bailey, Regan L.; Dwyer, Johanna

2011-01-01

Limited data are available on the source of usual nutrient intakes in the United States. This analysis aimed to assess contributions of micronutrients to usual intakes derived from all sources (naturally occurring, fortified and enriched, and dietary supplements) and to compare usual intakes to the Dietary Reference Intake for U.S. residents aged ≥2 y according to NHANES 2003–2006 (n = 16,110). We used the National Cancer Institute method to assess usual intakes of 19 micronutrients by source. Only a small percentage of the population had total usual intakes (from dietary intakes and supplements) below the estimated average requirement (EAR) for the following: vitamin B-6 (8%), folate (8%), zinc (8%), thiamin, riboflavin, niacin, vitamin B-12, phosphorus, iron, copper, and selenium (<6% for all). However, more of the population had total usual intakes below the EAR for vitamins A, C, D, and E (34, 25, 70, and 60%, respectively), calcium (38%), and magnesium (45%). Only 3 and 35% had total usual intakes of potassium and vitamin K, respectively, greater than the adequate intake. Enrichment and/or fortification largely contributed to intakes of vitamins A, C, and D, thiamin, iron, and folate. Dietary supplements further reduced the percentage of the population consuming less than the EAR for all nutrients. The percentage of the population with total intakes greater than the tolerable upper intake level (UL) was very low for most nutrients, whereas 10.3 and 8.4% of the population had intakes greater than the UL for niacin and zinc, respectively. Without enrichment and/or fortification and supplementation, many Americans did not achieve the recommended micronutrient intake levels set forth in the Dietary Reference Intake. PMID:21865568

Vitamin A--fortified vegetable oil exported from Malaysia and Indonesia can significantly contribute to vitamin A intake worldwide.

PubMed

Laillou, Arnaud; Panagides, Dora; Garrett, Greg S; Moench-Pfanner, Regina

2013-06-01

Vitamin A deficiency is a public health problem worldwide, affecting approximately 190 million preschool-aged children and 19.1 million pregnant women. Fortification of vegetable oils with vitamin A is an effective, low-cost technology to improve vitamin A intake. To examine the potential contribution of fortification of vegetable oils with vitamin A in Indonesia and Malaysia to increasing vitamin A consumption in these two countries and in countries to which oil is exported. Detailed interviews were administered and a desk review was conducted. We also estimated potential vitamin A intakes from fortified vegetable oil. Malaysia and Indonesia are two of the largest producers and exporters of vegetable oil. Fortification of vegetable oil in both countries has the potential to be used as a tool for control of vitamin A deficiency. Both countries have the capacity to export fortified vegetable oil. Vegetable oil fortified at a level of 45 IU/g could provide 18.8% of the Estimated Average Requirement (EAR) for an Ethiopian woman, 30.9% and 46.9% of the EAR for a Bangladeshi child and woman, respectively, and 17.5% of the EAR for a Cambodian woman. Although concerns about obesity are valid, fortification of existing vegetable oil supplies does not promote overconsumption of oil but rather promotes consumption of vegetable oil of higher nutrient quality. Fortifying vegetable oil on a large scale in Malaysia and Indonesia can reach millions of people globally, including children less than 5 years old. The levels of fortification used are far from reaching the Tolerable Upper Intake Level (UL). Vegetable oil fortification has the potential to become a global public health intervention strategy.

Prevalence of inadequate micronutrient intakes of Canadian long-term care residents.

PubMed

Keller, Heather H; Lengyel, Christina; Carrier, Natalie; Slaughter, Susan E; Morrison, Jill; Duncan, Alison M; Steele, Catriona M; Duizer, Lisa; Brown, K Stephen; Chaudhury, Habib; Yoon, Minn N; Boscart, Veronique; Heckman, George; Villalon, Lita

2018-05-01

This study determines the prevalence of inadequate micronutrient intakes consumed by long-term care (LTC) residents. This cross-sectional study was completed in thirty-two LTC homes in four Canadian provinces. Weighed and estimated food and beverage intake were collected over 3 non-consecutive days from 632 randomly selected residents. Nutrient intakes were adjusted for intra-individual variation and compared with the Dietary Reference Intakes. Proportion of participants, stratified by sex and use of modified (MTF) or regular texture foods, with intakes below the Estimated Average Requirement (EAR) or Adequate Intake (AI), were identified. Numbers of participants that met these adequacy values with use of micronutrient supplements was determined. Mean age of males (n 197) was 85·2 (sd 7·6) years and females (n 435) was 87·4 (sd 7·8) years. In all, 33 % consumed MTF; 78·2 % (males) and 76·1 % (females) took at least one micronutrient pill. Participants on a MTF had lower intake for some nutrients (males=4; females=8), but also consumed a few nutrients in larger amounts than regular texture consumers (males=4; females =1). More than 50 % of participants in both sexes and texture groups consumed inadequate amounts of folate, vitamins B6, Ca, Mg and Zn (males only), with >90 % consuming amounts below the EAR/AI for vitamin D, E, K, Mg (males only) and K. Vitamin D supplements resolved inadequate intakes for 50-70 % of participants. High proportions of LTC residents have intakes for nine of twenty nutrients examined below the EAR or AI. Strategies to improve intake specific to these nutrients are needed.

Living status and frequency of eating out-of-home foods in relation to nutritional adequacy in 4,017 Japanese female dietetic students aged 18-20 years: A multicenter cross-sectional study.

PubMed

Kobayashi, Satomi; Asakura, Keiko; Suga, Hitomi; Sasaki, Satoshi

2017-06-01

Living status (e.g., living with family or alone) may affect dietary habits. We compared nutritional adequacy according to living status and the frequency of eating out-of-home foods in young Japanese women. Female dietetic students (aged 18-20 years; n = 4,017) participated in a cross-sectional multicenter study, which was conducted in 85 dietetic schools in 35 of 47 prefectures in Japan. Habitual dietary intake was assessed with a validated diet history questionnaire. Nutritional adequacy was determined based on the Dietary Reference Intakes for Japanese, 2015, for two goals: preventing non-communicable chronic disease (a tentative dietary goal for preventing lifestyle-related diseases [DG] that tracks five nutrients) and avoiding insufficient intake of mainly vitamins and minerals (estimated average requirement [EAR] that tracks 14 nutrients). Women living with their family were less likely to meet DG nutrient levels, but more likely to meet EAR nutrient levels compared with those living alone. In contrast, women living alone had more inadequate nutrients with EAR and fewer nutrients with not-meeting DG than those living with families. A higher frequency of eating out-of-home was significantly associated with a higher prevalence of not-meeting DG nutrient levels only in the women living with their family. The prevalence of nutritional adequacy varied based on living status. In addition, women living with their family and those with a high frequency of eating out-of-home foods had the highest prevalence of not-meeting DG. Effective ways of improving dietary quality among young Japanese women differ by living status. Copyright © 2017 The Authors. Production and hosting by Elsevier B.V. All rights reserved.

Radiative neutron capture on 242Pu in the resonance region at the CERN n_TOF-EAR1 facility

NASA Astrophysics Data System (ADS)

Lerendegui-Marco, J.; Guerrero, C.; Mendoza, E.; Quesada, J. M.; Eberhardt, K.; Junghans, A. R.; Krtička, M.; Aberle, O.; Andrzejewski, J.; Audouin, L.; Bécares, V.; Bacak, M.; Balibrea, J.; Barbagallo, M.; Barros, S.; Bečvář, F.; Beinrucker, C.; Berthoumieux, E.; Billowes, J.; Bosnar, D.; Brugger, M.; Caamaño, M.; Calviño, F.; Calviani, M.; Cano-Ott, D.; Cardella, R.; Casanovas, A.; Castelluccio, D. M.; Cerutti, F.; Chen, Y. H.; Chiaveri, E.; Colonna, N.; Cortés, G.; Cortés-Giraldo, M. A.; Cosentino, L.; Damone, L. A.; Diakaki, M.; Dietz, M.; Domingo-Pardo, C.; Dressler, R.; Dupont, E.; Durán, I.; Fernández-Domínguez, B.; Ferrari, A.; Ferreira, P.; Finocchiaro, P.; Furman, V.; Göbel, K.; García, A. R.; Gawlik, A.; Glodariu, T.; Gonçalves, I. F.; González-Romero, E.; Goverdovski, A.; Griesmayer, E.; Gunsing, F.; Harada, H.; Heftrich, T.; Heinitz, S.; Heyse, J.; Jenkins, D. G.; Jericha, E.; Käppeler, F.; Kadi, Y.; Katabuchi, T.; Kavrigin, P.; Ketlerov, V.; Khryachkov, V.; Kimura, A.; Kivel, N.; Kokkoris, M.; Leal-Cidoncha, E.; Lederer, C.; Leeb, H.; Lo Meo, S.; Lonsdale, S. J.; Losito, R.; Macina, D.; Marganiec, J.; Martínez, T.; Massimi, C.; Mastinu, P.; Mastromarco, M.; Matteucci, F.; Maugeri, E. A.; Mengoni, A.; Milazzo, P. M.; Mingrone, F.; Mirea, M.; Montesano, S.; Musumarra, A.; Nolte, R.; Oprea, A.; Patronis, N.; Pavlik, A.; Perkowski, J.; Porras, J. I.; Praena, J.; Rajeev, K.; Rauscher, T.; Reifarth, R.; Riego-Perez, A.; Rout, P. C.; Rubbia, C.; Ryan, J. A.; Sabaté-Gilarte, M.; Saxena, A.; Schillebeeckx, P.; Schmidt, S.; Schumann, D.; Sedyshev, P.; Smith, A. G.; Stamatopoulos, A.; Tagliente, G.; Tain, J. L.; Tarifeño-Saldivia, A.; Tassan-Got, L.; Tsinganis, A.; Valenta, S.; Vannini, G.; Variale, V.; Vaz, P.; Ventura, A.; Vlachoudis, V.; Vlastou, R.; Wallner, A.; Warren, S.; Weigand, M.; Weiss, C.; Wolf, C.; Woods, P. J.; Wright, T.; Žugec, P.; n TOF Collaboration

2018-02-01

The spent fuel of current nuclear reactors contains fissile plutonium isotopes that can be combined with uranium to make mixed oxide (MOX) fuel. In this way the Pu from spent fuel is used in a new reactor cycle, contributing to the long-term sustainability of nuclear energy. However, an extensive use of MOX fuels, in particular in fast reactors, requires more accurate capture and fission cross sections for some Pu isotopes. In the case of 242Pu there are sizable discrepancies among the existing capture cross-section measurements included in the evaluations (all from the 1970s) resulting in an uncertainty as high as 35% in the fast energy region. Moreover, postirradiation experiments evaluated with JEFF-3.1 indicate an overestimation of 14% in the capture cross section in the fast neutron energy region. In this context, the Nuclear Energy Agency (NEA) requested an accuracy of 8% in this cross section in the energy region between 500 meV and 500 keV. This paper presents a new time-of-flight capture measurement on 242Pu carried out at n_TOF-EAR1 (CERN), focusing on the analysis and statistical properties of the resonance region, below 4 keV. The 242Pu(n ,γ ) reaction on a sample containing 95(4) mg enriched to 99.959% was measured with an array of four C6D6 detectors and applying the total energy detection technique. The high neutron energy resolution of n_TOF-EAR1 and the good statistics accumulated have allowed us to extend the resonance analysis up to 4 keV, obtaining new individual and average resonance parameters from a capture cross section featuring a systematic uncertainty of 5%, fulfilling the request of the NEA.

Validated Smartphone-Based Apps for Ear and Hearing Assessments: A Review

PubMed Central

Pallawela, Danuk

2016-01-01

Background An estimated 360 million people have a disabling hearing impairment globally, the vast majority of whom live in low- and middle-income countries (LMICs). Early identification through screening is important to negate the negative effects of untreated hearing impairment. Substantial barriers exist in screening for hearing impairment in LMICs, such as the requirement for skilled hearing health care professionals and prohibitively expensive specialist equipment to measure hearing. These challenges may be overcome through utilization of increasingly available smartphone app technologies for ear and hearing assessments that are easy to use by unskilled professionals. Objective Our objective was to identify and compare available apps for ear and hearing assessments and consider the incorporation of such apps into hearing screening programs Methods In July 2015, the commercial app stores Google Play and Apple App Store were searched to identify apps for ear and hearing assessments. Thereafter, six databases (EMBASE, MEDLINE, Global Health, Web of Science, CINAHL, and mHealth Evidence) were searched to assess which of the apps identified in the commercial review had been validated against gold standard measures. A comparison was made between validated apps. Results App store search queries returned 30 apps that could be used for ear and hearing assessments, the majority of which are for performing audiometry. The literature search identified 11 eligible validity studies that examined 6 different apps. uHear, an app for self-administered audiometry, was validated in the highest number of peer reviewed studies against gold standard pure tone audiometry (n=5). However, the accuracy of uHear varied across these studies. Conclusions Very few of the available apps have been validated in peer-reviewed studies. Of the apps that have been validated, further independent research is required to fully understand their accuracy at detecting ear and hearing conditions. PMID:28582261

15 CFR Supplement No. 2 to Part 748 - Unique Application and Submission Requirements

Code of Federal Regulations, 2013 CFR

2013-01-01

... tools, dimensional inspection machines, direct numerical control systems, specially designed assemblies... Commerce Control List (§ 774.1 of the EAR)—see Category 5 Part 1 Notes 1 and 2 and Part 2 Note 1. License... containing computers to destinations in Country Group D:1 (See Supplement No. 1 to part 740 of the EAR), or...

15 CFR Supplement No. 2 to Part 748 - Unique Application and Submission Requirements

Code of Federal Regulations, 2010 CFR

2010-01-01

... tools, dimensional inspection machines, direct numerical control systems, specially designed assemblies... Commerce Control List (§ 774.1 of the EAR)—see Category 5 Part 1 Notes 1 and 2 and Part 2 Note 1. License... containing computers to destinations in Country Group D:1 (See Supplement No. 1 to part 740 of the EAR), or...

15 CFR Supplement No. 2 to Part 748 - Unique Application and Submission Requirements

Code of Federal Regulations, 2011 CFR

2011-01-01

... tools, dimensional inspection machines, direct numerical control systems, specially designed assemblies... Commerce Control List (§ 774.1 of the EAR)—see Category 5 Part 1 Notes 1 and 2 and Part 2 Note 1. License... containing computers to destinations in Country Group D:1 (See supplement No. 1 to part 740 of the EAR), or...

Facing the music: pre- and postconcert assessment of hearing in teenagers.

PubMed

Derebery, M Jennifer; Vermiglio, Andrew; Berliner, Karen I; Potthoff, Marilee; Holguin, Kirsten

2012-09-01

Determine the effect of exposure to a single rock/pop concert on pure-tone hearing thresholds and outer hair cell function in teenagers. Repeated measures pre- and postconcert assessment of hearing. Mobile hearing conservation test vehicle and large indoor concert venue. Twenty-nine normal-hearing teenagers and young adults ages 13 to 20 years. Attendance at a public rock/pop concert. Pre- and postconcert pure-tone thresholds in both ears from 500 Hz to 8 kHz, pure-tone average (PTA) for 2, 3, and 4 kHz, distortion product otoacoustic emissions (DPOAEs), proportion of subjects experiencing a PTA change of 10 dB or greater. Concert sound levels at the subjects' position averaged 98.5 dBA. Only 3 subjects used the hearing protection provided. Thresholds for 2 to 6 kHz increased significantly from pre- to postconcert (p ≤ 0.001). The increase in PTA (2, 3, and 4 kHz) between test intervals averaged 6.3 and 6.5 dB for the right and left ears, respectively, and 33.3% of subjects had a threshold shift of 10 dB or greater in the PTA in at least 1 ear (p ≤ 0.001). The number of subjects experiencing a reduction in DPOAE amplitude (17/25) and the change in mean amplitude were statistically significant (p ≤ 0.001 and p ≤ 0.004, respectively). Exposure to a single live-music rock/pop concert can produce a threshold shift and decrease in otoacoustic emissions amplitude indicating impact on outer hair cell function. Results clearly indicate a need for research on this public health issue regarding "safe" listening levels, especially in younger people with more years for accrual of damage.

Cryptotia correction--the post-auricular transposition flap.

PubMed

Marsh, D; Sabbagh, W; Gault, D

2011-11-01

Cryptotia is a congenital ear deformity in which the upper pole appears buried beneath mastoid skin. Here we describe our method of cryptotia correction which we have used to good effect with minimal complications. 20 patients and 24 ears were operated on. All surgery was performed by the senior authors WS and DG. Patient age range was 4-19 years and mean follow up was 2.1 years. We use a superiorly based V-shaped flap raised from the post-auricular skin. Following ear release, the flap is rotated into the defect and donor site closed directly. Our technique ensures all scars are hidden behind the ear, there are no skin grafts required. All patients had a satisfactory release of cryptotia, there were no cases of partial or total flap failure, none of wound dehiscence and no patients required revisional surgery. The post-auricular flap is a simple technique, retaining the depth of the auriculotemporal sulcus, providing a good skin colour match without the need for skin grafting and without distorting the hair line. Our results are comparable or superior to those seen with other techniques previously described. Copyright © 2011 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Automatic pose correction for image-guided nonhuman primate brain surgery planning

NASA Astrophysics Data System (ADS)

Ghafurian, Soheil; Chen, Antong; Hines, Catherine; Dogdas, Belma; Bone, Ashleigh; Lodge, Kenneth; O'Malley, Stacey; Winkelmann, Christopher T.; Bagchi, Ansuman; Lubbers, Laura S.; Uslaner, Jason M.; Johnson, Colena; Renger, John; Zariwala, Hatim A.

2016-03-01

Intracranial delivery of recombinant DNA and neurochemical analysis in nonhuman primate (NHP) requires precise targeting of various brain structures via imaging derived coordinates in stereotactic surgeries. To attain targeting precision, the surgical planning needs to be done on preoperative three dimensional (3D) CT and/or MR images, in which the animals head is fixed in a pose identical to the pose during the stereotactic surgery. The matching of the image to the pose in the stereotactic frame can be done manually by detecting key anatomical landmarks on the 3D MR and CT images such as ear canal and ear bar zero position. This is not only time intensive but also prone to error due to the varying initial poses in the images which affects both the landmark detection and rotation estimation. We have introduced a fast, reproducible, and semi-automatic method to detect the stereotactic coordinate system in the image and correct the pose. The method begins with a rigid registration of the subject images to an atlas and proceeds to detect the anatomical landmarks through a sequence of optimization, deformable and multimodal registration algorithms. The results showed similar precision (maximum difference of 1.71 in average in-plane rotation) to a manual pose correction.

Fitting and verification of frequency modulation systems on children with normal hearing.

PubMed

Schafer, Erin C; Bryant, Danielle; Sanders, Katie; Baldus, Nicole; Algier, Katherine; Lewis, Audrey; Traber, Jordan; Layden, Paige; Amin, Aneeqa

2014-06-01

Several recent investigations support the use of frequency modulation (FM) systems in children with normal hearing and auditory processing or listening disorders such as those diagnosed with auditory processing disorders, autism spectrum disorders, attention-deficit hyperactivity disorder, Friedreich ataxia, and dyslexia. The American Academy of Audiology (AAA) published suggested procedures, but these guidelines do not cite research evidence to support the validity of the recommended procedures for fitting and verifying nonoccluding open-ear FM systems on children with normal hearing. Documenting the validity of these fitting procedures is critical to maximize the potential FM-system benefit in the above-mentioned populations of children with normal hearing and those with auditory-listening problems. The primary goal of this investigation was to determine the validity of the AAA real-ear approach to fitting FM systems on children with normal hearing. The secondary goal of this study was to examine speech-recognition performance in noise and loudness ratings without and with FM systems in children with normal hearing sensitivity. A two-group, cross-sectional design was used in the present study. Twenty-six typically functioning children, ages 5-12 yr, with normal hearing sensitivity participated in the study. Participants used a nonoccluding open-ear FM receiver during laboratory-based testing. Participants completed three laboratory tests: (1) real-ear measures, (2) speech recognition performance in noise, and (3) loudness ratings. Four real-ear measures were conducted to (1) verify that measured output met prescribed-gain targets across the 1000-4000 Hz frequency range for speech stimuli, (2) confirm that the FM-receiver volume did not exceed predicted uncomfortable loudness levels, and (3 and 4) measure changes to the real-ear unaided response when placing the FM receiver in the child's ear. After completion of the fitting, speech recognition in noise at a -5 signal-to-noise ratio and loudness ratings at a +5 signal-to-noise ratio were measured in four conditions: (1) no FM system, (2) FM receiver on the right ear, (3) FM receiver on the left ear, and (4) bilateral FM system. The results of this study suggested that the slightly modified AAA real-ear measurement procedures resulted in a valid fitting of one FM system on children with normal hearing. On average, prescriptive targets were met for 1000, 2000, 3000, and 4000 Hz within 3 dB, and maximum output of the FM system never exceeded and was significantly lower than predicted uncomfortable loudness levels for the children. There was a minimal change in the real-ear unaided response when the open-ear FM receiver was placed into the ear. Use of the FM system on one or both ears resulted in significantly better speech recognition in noise relative to a no-FM condition, and the unilateral and bilateral FM receivers resulted in a comfortably loud signal when listening in background noise. Real-ear measures are critical for obtaining an appropriate fit of an FM system on children with normal hearing. American Academy of Audiology.

The clinical analysis of bilateral successive sudden sensorineural hearing loss.

PubMed

Wang, Yaowen; Zhang, Litao; Zhang, Jianhua; Zhang, Xuqun; Zhang, Weimin; Chen, Xing; Tang, Shixiong

2016-11-01

The objective of this study is to investigate the clinical characteristics of successive bilateral sudden sensorineural hearing loss (SSNHL) with an interval of more than 1 year to aid the evaluation and management of successive bilateral SSNHL (BSSNHL). 14 successive BSSNHL patients and 118 unilateral SSNHL patients with severe and profound hearing loss were reviewed retrospectively. Information about successive BSSNHL was collected included demographics, the intervals between the attacks of bilateral ears, the past medical history, inducing factors, accompanying symptoms, pure-tone tests, blood tests, b-ultrasound examinations of vertebral artery and carotid artery, and medical interventions. And the comparison of improvement rate was made between successive BSSNHL and unilateral SSNHL. SPSS 15.0 was used to analyze the data. In successive BSSNHL, there were six males and eight females; the average aged was 49.86 ± 15.45 years (20-73 years). The interval of the two attacks was 11.43 ± 12.07 years (1-50 years) on average. The onset of treatment was 18.86 ± 12.71 days. Tinnitus was seen in 100 % of the patients, followed by vertigo in 42.85 %, and ear fullness in 21.43 %. 3 of 14 patients described obvious inducing factor: tiredness. Five patients (35.71 %) had hypertension histories, three (21.43 %) had diabetes histories, two (14.29 %) had surgery histories, one (7.14 %) was with depression history, one (7.14 %) was with coronary heart disease history. 30 % (3/10) patients were with atherosclerotic plaque in carotid artery. 4 (28.57 %) patients were with high blood sugar. 8 patients (57.14 %) were with high blood lipids. Thyroid function tests were positive in 27.27 % (3/11) patients. No abnormality was found in antinuclear antibodies titer. The percentage of profound and severe hearing loss were 71.43 and 78.57 % in the recently affected ear and contralateral ear separately. The PTAs of the recently affected ear were 77.14 ± 27.12 dB before treatment and 68.84 ± 22.32 dB after treatment, the improvement rate was 28.57 %. No improvement was found in the contralateral ears. In unilateral SSNHL, the average age was 42.47 ± 14.18 years. The onset of treatment was 18.08 ± 15.84 days. The improvement rate was 57.63 %, which was much higher than that of successive BSSNHL. There was no difference in age and time of onset of treatment between successive BSSNHL and unilateral SSNHL (p > 0.05). Successive BSSNHL is rare, the hearing impairment is severe, and the outcome of treatment is poorer. It may have a completely different profile compared with the simultaneous BSSNHL and unilateral SSNHL.

Dietary Zinc Intake and Its Association with Metabolic Syndrome Indicators among Chinese Adults: An Analysis of the China Nutritional Transition Cohort Survey 2015.

PubMed

Wang, Yun; Jia, Xiao-Fang; Zhang, Bing; Wang, Zhi-Hong; Zhang, Ji-Guo; Huang, Fei-Fei; Su, Chang; Ouyang, Yi-Fei; Zhao, Jian; Du, Wen-Wen; Li, Li; Jiang, Hong-Ru; Zhang, Ji; Wang, Hui-Jun

2018-05-08

The dietary zinc consumed in Chinese households has decreased over the past decade. However, the national dietary zinc intake in the last five years has seldom been investigated. Using data from 12,028 participants 18 to 64 years old (52.9% male) in the China Nutritional Transition Cohort Survey (CNTCS) 2015, we describe the intake of dietary zinc and the contributions of major foods and we examine the relationship between the level of dietary zinc intake and metabolic syndrome indicators, including blood pressure, fasting glucose, and triglycerides (TG), in Chinese adults. We assessed dietary zinc intake using 24 h recalls on three consecutive days. The mean daily dietary zinc intake for all participants was 10.2 milligrams per day (males 11.2 mg/day, females 9.4 mg/day, p < 0.001). The mean daily dietary zinc density for all participants was 5.2 mg/day per 1000 kilocalories. Among all participants, 31.0% were at risk of zinc deficiency, with dietary zinc intakes of less than the Estimated Average Requirement (EAR) (males 49.2%, females 14.8%, p < 0.050), and 49.9% had adequate dietary zinc intakes, equal to or greater than the recommended nutrient intake (RNI) (males 30.7%, females 67.0%, p < 0.050). We found substantial gender differences in dietary zinc intake and zinc deficiency, with nearly half of the men at risk of zinc deficiency. Males of younger age, with higher education and incomes, and who consumed higher levels of meat, had higher zinc intakes, higher zinc intake densities, and higher rates of meeting the EAR. Among all participants, grains, livestock meat, fresh vegetables, legumes, and seafood were the top five food sources of zinc, and their contributions to total dietary zinc intake were 39.5%, 17.3%, 8.9%, 6.4%, and 4.8%, respectively. The groups with relatively better dietary zinc intakes consumed lower proportions of grains and higher proportions of livestock meat. For males with adequate dietary zinc intake (≥RNI), TG levels increased by 0.219 millimoles per liter (mmol/L) compared with males with deficient dietary zinc intake (

Ear reconstruction using a porous polyethylene framework and temporoparietal fascia flap.

PubMed

Reinisch, John F; Lewin, Sheryl

2009-08-01

Ear reconstruction is a difficult procedure requiring a framework and soft tissue covering. The traditional method uses a rib cartilage framework placed beneath scalp skin. This method has been used for 50 years despite inherent problems with both harvesting rib cartilage and using scalp for coverage. The authors describe a method using a porous polyethylene (PPE) framework covered by a large temporoparietal fascia (TFP) flap raised with the underlying subgaleal fascia (SGF). The entire implant is covered by the two-layered flap, which can be raised without any scalp incision. The skin grafts applied to the covered implant lie on the SGF. The trilaminar structure of the SGF allows the skin to move independently over the implant, resisting shear forces and reducing the probability of implant exposure. Ear reconstruction using the PPE framework was performed on 786 ears over an 18-year period. Initial complications were common. With improved implant design and complete coverage of the implant with both the TPF and SGF, exposure rate dropped to 7% with a 12-year follow-up. Implant fractures decreased to less than 3%. The PPE/TPF method allows earlier ear reconstruction in children with minimal scarring and discomfort. The reconstructed ear can closely mimic the shape and projection of the natural contralateral ear in fewer stages and with a shorter learning curve. Copyright Thieme Medical Publishers.

Hearing and whistling in the deep sea: depth influences whistle spectra but does not attenuate hearing by white whales (Delphinapterus leucas) (Odontoceti, Cetacea).

PubMed

Ridgway, S H; Carder, D A; Kamolnick, T; Smith, R R; Schlundt, C E; Elsberry, W R

2001-11-01

Hearing is attenuated in the aerial ear of humans and other land mammals tested in pressure chambers as a result of middle ear impedance changes that result from increased air density. We tested the hypothesis, based on recent middle ear models, that increasing the density of middle ear air at depth might attenuate whale hearing. Two white whales Delphinapterus leucas made dives to a platform at a depth of 5, 100, 200 or 300 m in the Pacific Ocean. During dives to station on the platform for up to 12 min, the whales whistled in response to 500 ms tones projected at random intervals to assess their hearing threshold at each depth. Analysis of response whistle spectra, whistle latency in response to tones and hearing thresholds showed that the increased hydrostatic pressure at depth changed each whale's whistle response at depth, but did not attenuate hearing overall. The finding that whale hearing is not attenuated at depth suggests that sound is conducted through the head tissues of the whale to the ear without requiring the usual ear drum/ossicular chain amplification of the aerial middle ear. These first ever hearing tests in the open ocean demonstrate that zones of audibility for human-made sounds are just as great throughout the depths to which these whales dive, or at least down to 300 m.

Developmental evolutionary biology of the vertebrate ear: conserving mechanoelectric transduction and developmental pathways in diverging morphologies

NASA Technical Reports Server (NTRS)

Fritzsch, B.; Beisel, K. W.; Bermingham, N. A.

2000-01-01

This brief overview shows that a start has been made to molecularly dissect vertebrate ear development and its evolutionary conservation to the development of the insect hearing organ. However, neither the patterning process of the ear nor the patterning process of insect sensory organs is sufficiently known at the moment to provide more than a first glimpse. Moreover, hardly anything is known about otocyst development of the cephalopod molluscs, another triploblast lineage that evolved complex 'ears'. We hope that the apparent conserved functional and cellular components present in the ciliated sensory neurons/hair cells will also be found in the genes required for vertebrate ear and insect sensory organ morphogenesis (Fig. 3). Likewise, we expect that homologous pre-patterning genes will soon be identified for the non-sensory cell development, which is more than a blocking of neuronal development through the Delta/Notch signaling system. Generation of the apparently unique ear could thus represent a multiplication of non-sensory cells by asymmetric and symmetric divisions as well as modification of existing patterning process by implementing novel developmental modules. In the final analysis, the vertebrate ear may come about by increasing the level of gene interactions in an already existing and highly conserved interactive cascade of bHLH genes. Since this was apparently achieved in all three lineages of triploblasts independently (Fig. 3), we now need to understand how much of the morphogenetic cascades are equally conserved across phyla to generate complex ears. The existing mutations in humans and mice may be able to point the direction of future research to understand the development of specific cell types and morphologies in the formation of complex arthropod, cephalopod, and vertebrate 'ears'.

PI3K, ERK, p38 MAPK and integrins regulate CCR3-mediated secretion of mouse and human eosinophil-associated RNases

PubMed Central

Shamri, Revital; Young, Kristen M.; Weller, Peter F.

2013-01-01

Background Eosinophils have the capacity to secrete varied cytotoxic proteins. Among the proteins are the eosinophil-associated RNases (EARs): the human eosinophil-derived neurotoxin and eosinophilic cationic protein and their murine ortholog EARs, which have been shown to be involved in host defense, tissue remodeling and immunity regulation. However, the signal transduction that regulates EARs secretion in response to physiological stimuli, such as chemokines, has been little studied in human and scarcely in mouse eosinophils, the foremost animal model for eosinophil-associated human diseases. Objective In this study we aimed to understand the signal transduction involved in the secretion of enzymatically active EARs following chemokine stimulation. Methods Fresh mouse and human eosinophils were stimulated with CCL11 and CCL24 and the secretion of enzymatically active EARs was detected using an RNase activity assay. The involvement of signaling factors or integrins was probed using specific inhibitors and blocking antibodies. Adhesion was evaluated by microscopy. Results We found that secretion of mouse EARs in response to CCL11 and CCL24 was Gαi-dependent. Both mouse and human eosinophils required the activation of PI3K, ERK and p38 MAPK. In addition, the adhesion molecules β1 and β2 integrins were found to be crucial for EAR secretion, and we suggest a mechanism in which spreading is obligatory for EAR secretion. Conclusions Collectively, these data suggest a common CCR3-mediated signaling pathway that leads to EAR secretion in both mouse and human eosinophils. These findings are applicable for eosinophil-mediated host defense and eosinophil-associated diseases. PMID:23742707

A comparison of three methods to evaluate the position of an artificial ear on the deficient side of the face from a three-dimensional surface scan of patients with hemifacial microsomia.

PubMed

Coward, Trevor J; Watson, Roger M; Richards, Robin; Scott, Brendan J J

2012-01-01

Patients with hemifacial microsomia may have a missing ear on the deficient side of the face. The fabrication of an ear for such individuals usually has been accomplished by directly measuring the ear on the normal side to construct a prosthesis based on these dimensions, and the positioning has been, to a large extent, primarily operator-dependent. The aim of the present study was to compare three methods, developed from the identification of landmarks plotted on three-dimensional surface scans, to evaluate the position of an artificial ear on the deficient side of the face compared with the position of the natural ear on the normally developed side. Laser scans were undertaken of the faces of 14 subjects with hemifacial microsomia. Landmarks on the ear and face on the normal side were identified. Three methods of mirroring the normal ear on the deficient side of the face were investigated, which used either facial landmarks from the orbital area or a zero reference point generated from the intersection of three orthogonal planes on a frame of reference. To assess the methods, landmarks were identified on the ear situated on the normal side as well as on the face. These landmarks yielded paired dimensional measurements that could be compared between the normal and deficient sides. Mean differences and 95% confidence intervals were calculated. It was possible to mirror the normal ear image on to the deficient side of the face using all three methods. Generally only small differences between the dimensional measurements on the normal and deficient sides were observed. However, two-way analysis of variance revealed statistically significant differences between the three methods (P = .005). The method of mirroring using the outer canthi was found to result in the smallest dimensional differences between the anthropometric points on the ear and face between the normally developed and deficient sides. However, the effects of the deformity can result in limitations in relation to achieving a precise alignment of the ear to the facial tissues. This requires further study.

Proton Minibeam Radiation Therapy Reduces Side Effects in an In Vivo Mouse Ear Model.

PubMed

Girst, Stefanie; Greubel, Christoph; Reindl, Judith; Siebenwirth, Christian; Zlobinskaya, Olga; Walsh, Dietrich W M; Ilicic, Katarina; Aichler, Michaela; Walch, Axel; Wilkens, Jan J; Multhoff, Gabriele; Dollinger, Günther; Schmid, Thomas E

2016-05-01

Proton minibeam radiation therapy is a novel approach to minimize normal tissue damage in the entrance channel by spatial fractionation while keeping tumor control through a homogeneous tumor dose using beam widening with an increasing track length. In the present study, the dose distributions for homogeneous broad beam and minibeam irradiation sessions were simulated. Also, in an animal study, acute normal tissue side effects of proton minibeam irradiation were compared with homogeneous irradiation in a tumor-free mouse ear model to account for the complex effects on the immune system and vasculature in an in vivo normal tissue model. At the ion microprobe SNAKE, 20-MeV protons were administered to the central part (7.2 × 7.2 mm(2)) of the ear of BALB/c mice, using either a homogeneous field with a dose of 60 Gy or 16 minibeams with a nominal 6000 Gy (4 × 4 minibeams, size 0.18 × 0.18 mm(2), with a distance of 1.8 mm). The same average dose was used over the irradiated area. No ear swelling or other skin reactions were observed at any point after minibeam irradiation. In contrast, significant ear swelling (up to fourfold), erythema, and desquamation developed in homogeneously irradiated ears 3 to 4 weeks after irradiation. Hair loss and the disappearance of sebaceous glands were only detected in the homogeneously irradiated fields. These results show that proton minibeam radiation therapy results in reduced adverse effects compared with conventional homogeneous broad-beam irradiation and, therefore, might have the potential to decrease the incidence of side effects resulting from clinical proton and/or heavy ion therapy. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Sources of DPOAEs revealed by suppression experiments, inverse fast Fourier transforms, and SFOAEs in impaired ears

NASA Astrophysics Data System (ADS)

Konrad-Martin, Dawn; Neely, Stephen T.; Keefe, Douglas H.; Dorn, Patricia A.; Cyr, Emily; Gorga, Michael P.

2002-04-01

DPOAE sources are modeled by intermodulation distortion generated near the f2 place and a reflection of this distortion near the DP place. In a previous paper, inverse fast Fourier transforms (IFFTs) of DPOAE filter functions in normal ears were consistent with this model [Konrad-Martin et al., J. Acoust. Soc. Am. 109, 2862-2879 (2001)]. In the present article, similar measurements were made in ears with specific hearing-loss configurations. It was hypothesized that hearing loss at f2 or DP frequencies would influence the relative contributions to the DPOAE from the corresponding basilar membrane places, and would affect the relative magnitudes of SFOAEs at frequencies equal to f2 and fDP. DPOAEs were measured with f2=4 kHz, f1 varied, and a suppressor near fDP. L2 was 25-55 dB SPL (L1=L2+10 dB). SFOAEs were measured at f2 and at 2.7 kHz (the average fDP produced by the f1 sweep) for stimulus levels of 20-60 dB SPL. SFOAE results supported predictions of the pattern of amplitude differences between SFOAEs at 4 and 2.7 kHz for sloping losses, but did not support predictions for the rising- and flat-loss categories. Unsuppressed IFFTs for rising losses typically had one peak. IFFTs for flat or sloping losses typically have two or more peaks; later peaks were more prominent in ears with sloping losses compared to normal ears. Specific predictions were unambiguously supported by the results for only four of ten cases, and were generally supported in two additional cases. Therefore, the relative contributions of the two DPOAE sources often were abnormal in impaired ears, but not always in the predicted manner.

A robust, high-throughput method for computing maize ear, cob, and kernel attributes automatically from images.

PubMed

Miller, Nathan D; Haase, Nicholas J; Lee, Jonghyun; Kaeppler, Shawn M; de Leon, Natalia; Spalding, Edgar P

2017-01-01

Grain yield of the maize plant depends on the sizes, shapes, and numbers of ears and the kernels they bear. An automated pipeline that can measure these components of yield from easily-obtained digital images is needed to advance our understanding of this globally important crop. Here we present three custom algorithms designed to compute such yield components automatically from digital images acquired by a low-cost platform. One algorithm determines the average space each kernel occupies along the cob axis using a sliding-window Fourier transform analysis of image intensity features. A second counts individual kernels removed from ears, including those in clusters. A third measures each kernel's major and minor axis after a Bayesian analysis of contour points identifies the kernel tip. Dimensionless ear and kernel shape traits that may interrelate yield components are measured by principal components analysis of contour point sets. Increased objectivity and speed compared to typical manual methods are achieved without loss of accuracy as evidenced by high correlations with ground truth measurements and simulated data. Millimeter-scale differences among ear, cob, and kernel traits that ranged more than 2.5-fold across a diverse group of inbred maize lines were resolved. This system for measuring maize ear, cob, and kernel attributes is being used by multiple research groups as an automated Web service running on community high-throughput computing and distributed data storage infrastructure. Users may create their own workflow using the source code that is staged for download on a public repository. © 2016 The Authors. The Plant Journal published by Society for Experimental Biology and John Wiley & Sons Ltd.

Threshold changes of ABR results in toddlers and children.

PubMed

Louza, Julia; Polterauer, Daniel; Wittlinger, Natalie; Muzaini, Hanan Al; Scheckinger, Siiri; Hempel, Martin; Schuster, Maria

2016-06-01

Auditory brainstem response (ABR) is a clinically established method to identify the hearing threshold in young children and is regularly performed after hearing screening has failed. Some studies have shown that, after the first diagnosis of hearing impairment in ABR, further development takes place in a spectrum between progression of hearing loss and, surprisingly, hearing improvement. The aim of this study is to evaluate changes over time of auditory thresholds measured by ABR among young children. For this retrospective study, 459 auditory brainstem measurements were performed and analyzed between 2010 and 2014. Hearing loss was detected and assessed according to national guidelines. 104 right ears and 101 left ears of 116 children aged between 0 and 3 years with multiple ABR measurements were included. The auditory threshold was identified using click and/or NB-chirp-stimuli in natural sleep or in general anesthesia. The frequency of differences of at least more than 10dB between the measurements was identified. In 37 (35%) measurements of right ears and 38 (38%) of left ears there was an improvement of the auditory threshold of more than 10dB; in 27 of those measurements more than 20dB improvement was found. Deterioration was seen in 12% of the right ears and 10% of the left ears. Only half of the children had stable hearing thresholds in repeated measurements. The time between the measurements was on average 5 months (0 to 31 months). Hearing threshold changes are often seen in repeated ABR measurements. Therefore multiple measurements are necessary when ABR yields abnormal. Hearing threshold changes should be taken into account for hearing aid provision. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Methodological issues when comparing hearing thresholds of a group with population standards: the case of the ferry engineers.

PubMed

Dobie, Robert A

2006-10-01

To discuss appropriate and inappropriate methods for comparing distributions of hearing thresholds of a study group with distributions in population standards and to determine whether the thresholds of Washington State Ferries engineers are different from those of men in the general population, using both frequency-by-frequency comparisons and analysis of audiometric shape. The most recent hearing conservation program audiograms of 321 noise-exposed engineers, ages 35 to 64, were compared with the predictions of Annexes A, B, and C from ANSI S3.44. There was no screening by history or otoscopy; all audiograms were included. 95% confidence intervals (95% CIs) were calculated for the engineers' median thresholds for each ear, for the better ear (defined two ways), and for the binaural average. For Annex B, where 95% CIs are also available, it was possible to calculate z scores for the differences between Annex B and the engineers' better ears. Bulge depth, an audiometric shape statistic, measured curvature between 1 and 6 kHz. Engineers' better-ear median thresholds were worse than those in Annex A but (except at 1 kHz) were as good as or better than those in Annexes B and C, which are more appropriate for comparison to an unscreened noise-exposed group like the engineers. Average bulge depth for the engineers was similar to that of the Annex B standard (no added occupational noise) and was much less than that of audiograms created by using the standard with added occupational noise between 90 and 100 dBA. Audiograms from groups that have been selected for a particular exposure, but, without regard to severity, can appropriately be compared with population standards, if certain pitfalls are avoided. For unscreened study groups with large age-sex subgroups, a simple method to assess statistical significance, taking into consideration uncertainties in both the study group and the comparison standard, is the calculation of z scores for the proportion of better-ear thresholds above the Annex B median. A less powerful method combines small age-sex subgroups after age correction. Small threshold differences, even if statistically significant, may not be due to genuine differences in hearing sensitivity between study group and standard. Audiometric shape analysis offers an independent dimension of comparison between the study group and audiograms predicted from the ANSI S3.44 standard, with and without occupational noise exposure. Important pitfalls in comparison to population standards include nonrandom selection of study groups, inappropriate choice of population standard, use of the right and left ear thresholds instead of the better-ear threshold for comparison to Annex B, and comparing means with medians. The thresholds of the engineers in this study were similar to published standards for an unscreened population.

Some Remarks on Imaging of the Inner Ear: Options and Limitations.

PubMed

Giesemann, A; Hofmann, E

2015-10-01

The temporal bone has a highly complex anatomical structure, in which the sensory organs of the cochlea and the vestibular system are contained within a small space together with the sound-conducting system of the middle ear. Detailed imaging is thus required in this anatomical area. There are a great many clinical aims for which the highest-possible spatial resolution is required. These include the localization of cerebrospinal fluid fistulas, the detection of malformations of the middle and inner ear and the vestibulocochlear nerve, an aberrant course of the facial nerve and anomalies of the arterial and venous structures, the confirmation of dehiscence of the semicircular canals and finally, the verification of endolymphatic hydrops in cases of Ménière's disease. However, the term 'high resolution' is very time dependent. Two milestones in this respect have been (in 1991) the 3D visualization of the inner ear by means of maximum-intensity projection (MIP) of a T2-weighted constructive interference in steady state (CISS) sequence of a 1.5-tesla magnetic resonance imaging (MRI) scanner (Tanioka et al., Radiology 178:141-144, 1991) and (in 1997) imaging of the vestibulocochlear nerve for the diagnosis of hypoplasia inside the internal auditory canal using the same sequence (Casselman et al., Radiology 202:773-781, 1997).The objective of this article is to highlight the options for, and the challenges of, contemporary imaging with regard to some clinical issues relating to the inner ear.

Mechanisms of Cochlear Stimulation Through the Round Window

NASA Astrophysics Data System (ADS)

Lukashkin, Andrei N.; Weddell, Thomas; Russell, Ian J.

2011-11-01

The round window membrane (RW) functions as a pressure relief valve in conventional hearing allowing structures of the middle ear to move. Investigations in recent years have shown that middle ear implants can be used to stimulate the cochlea via the RW. Isolated clinical uses of this technique have been applied but more thorough theoretical and empirical studies are required. Using guinea pigs as test subjects we have investigated physiological effects of RW stimulation using a simulation of active middle ear prosthesis, a cylindrical neodymium iron boron disk magnet placed upon the RW which can be stimulated by an electromagnetic coil positioned in close proximity to the magnet.

World Health Organization and Its Initiative for Ear and Hearing Care.

PubMed

Chadha, Shelly; Cieza, Alarcos

2018-06-01

The World Health Organization (WHO) addresses ear diseases and hearing loss through its program on prevention of deafness and hearing loss. Recently, the World Health Assembly called for action at global and national levels to tackle the rising prevalence and adverse impact of unaddressed hearing loss. Following a public health approach toward this issue, WHO is focusing on i) raising awareness among policymakers and civil society; and ii) providing technical support to countries for promoting hearing care. Meeting this challenge requires a coordinated global effort with all stakeholders working together to make ear and hearing care accessible to all. Copyright © 2018 Elsevier Inc. All rights reserved.

Design, Kinematic Optimization, and Evaluation of a Teleoperated System for Middle Ear Microsurgery

PubMed Central

Miroir, Mathieu; Nguyen, Yann; Szewczyk, Jérôme; Sterkers, Olivier; Bozorg Grayeli, Alexis

2012-01-01

Middle ear surgery involves the smallest and the most fragile bones of the human body. Since microsurgical gestures and a submillimetric precision are required in these procedures, the outcome can be potentially improved by robotic assistance. Today, there is no commercially available device in this field. Here, we describe a method to design a teleoperated assistance robotic system dedicated to the middle ear surgery. Determination of design specifications, the kinematic structure, and its optimization are detailed. The robot-surgeon interface and the command modes are provided. Finally, the system is evaluated by realistic tasks in experimental dedicated settings and in human temporal bone specimens. PMID:22927789

The MOZART Project - MOZAmbique Rift Tomography

NASA Astrophysics Data System (ADS)

Fonseca, J. F.; Chamussa, J. R.; Domingues, A.; Helffrich, G. R.; Fishwick, S.; Ferreira, A. M.; Custodio, S.; Brisbourne, A. M.; Grobbelaar, M.

2012-12-01

Project MOZART (MOZAmbique Rift Tomography) is an ongoing joint effort of Portuguese, Mozambican and British research groups to investigate the geological structure and current tectonic activity of the southernmost tip of the East African Rift System (EARS) through the deployment of a network of 30 broad band seismic stations in Central and Southern Mozambique. In contrast with other stretches of the EARS to the North and with the Kapvaal craton to the West and South, the lithosphere of Mozambique was not previously studied with a dense seismographic deployment on account of past political instability, and many questions remain unanswered with respect to the location and characteristics of the EARS to the south of Tanzania. In recent years, space geodesy revealed the existence of three microplates in and off Mozambique - Victoria, Rovuma, Lwandle - whose borders provide a connection of the EARS to the South West Indian Ridge as required by plate tectonics. However, the picture is still coarse concerning the location of the rift structures. The 2006 M7 Machaze earthquake in Central Mozambique highlighted the current tectonic activity of the region and added a further clue to the location of the continental rift, prompting the MOZART deployment. Besides helping unravel the current tectonics, the project is expected to shed light on the poorly known Mesoproterozoic structure described by Arthur Holmes in 1951 as the Mozambique Belt, and on the mechanisms of transition from stable craton to rifted continental crust, through the development of a tomographic model for the lithosphere. The MOZART network is distributed South of the Zambezi river at average inter-station spaces of the order of 100 km and includes four stations across the border in South Africa. Data exchange was agreed with AfricaArray. The deployment proceeded in two phases in March 2011, and November and December 2011. Decommissioning is foreseen for August 2013. We report preliminary results for this previously unexplored region concerning the seismicity and ambient noise (see also Domingues et al, this conference), receiver function analysis, surface wave dispersion and SEM forward modelling. These preliminary results will pave the way for a tomographic model of the lithosphere, to be developed in the next stage of the project.

Infectious complications of pediatric cochlear implants are highly influenced by otitis media.

PubMed

Vila, Peter M; Ghogomu, Nsangou T; Odom-John, Audrey R; Hullar, Timothy E; Hirose, Keiko

2017-06-01

Determine the incidence of ear infections in cochlear implant patients, evaluate the contribution of otitis media to complications, describe the bacteriology of otitis media in the cochlear implant population, the treatment provided at our center, and the long term outcome. Data collected included age at implantation, history of otitis media or ear tubes, etiology of hearing loss, inner ear anatomy, postoperative infections, time to infection, route of antibiotic administration, and interventions for infections. Categories of infection were acute otitis media, otitis media with effusion, tube otorrhea, meningitis, scalp cellulitis, and infection at the implant site. Middle ear infections were diagnosed in 37% of implanted ears. Extension of middle ear infections into the implant site occurred in 2.8% of all implants (n = 16). Of the 16 infected devices, 10 were successfully treated with antibiotic therapy and did not require explantation. The retained implant group and explanted group both included some middle ear microbes such as Haemophilus influenzae and Streptococcus pneumoniae, as well as skin flora such as Staphylococcus aureus. Otitis media in pediatric cochlear implant patients is a common event and usually does not lead to complications of the cochlear implant. However, when the ear infection spreads to the scalp and the implant site, it is still possible to eliminate the infection using antibiotic therapy, particularly when treatment is directed to the specific organism that is recovered from the infected space and the duration and route of antibiotic treatment is carefully considered. Copyright © 2017 Elsevier B.V. All rights reserved.

Using the mouse grimace scale to assess pain associated with routine ear notching and the effect of analgesia in laboratory mice.

PubMed

Miller, A L; Leach, M C

2015-04-01

Social housing is recommended where possible for laboratory mice. In order to achieve this, mice must be individually identifiable. Although, various methods are available, permanent identification is often required, such as ear notching. This method is likely to be painful and to date there is limited literature on pain assessment and alleviation for this routine husbandry practice. Here we aimed to determine if the mouse grimace scale (MGS) could be used to assess pain in C57BL/6 mice following routine ear notching. Langford et al. found that very acute noxious stimuli (i.e. < 10 min in duration) did not produce a change in MGS score in comparison to baseline. Here, no significant difference was found between MGS scores at baseline and immediately post ear notching, potentially indicating that the pain associated with ear notching is either too acute to assess using the MGS tool or the practice is not painful. Studies in other species indicate that ear notching is painful, therefore, unless we can confidently conclude that the process of ear notching is not painful, we should err on the side of caution and assume it is painful due to the large number of mice ear-notched and potential welfare consequences. Alternative methods of assessing pain following this routine practice should be used in order to assess both the potential pain in mice, and the effectiveness of analgesics or local anaesthetics to relieve any associated pain. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Noninvasive in vivo optical detection of biofilm in the human middle ear.

PubMed

Nguyen, Cac T; Jung, Woonggyu; Kim, Jeehyun; Chaney, Eric J; Novak, Michael; Stewart, Charles N; Boppart, Stephen A

2012-06-12

Otitis media (OM), a middle-ear infection, is the most common childhood illness treated by pediatricians. If inadequately treated, OM can result in long-term chronic problems persisting into adulthood. Children with chronic OM or recurrent OM often have conductive hearing loss and communication difficulties and require surgical treatment. Tympanostomy tube insertion, the placement of a small drainage tube in the tympanic membrane (TM), is the most common surgical procedure performed in children under general anesthesia. Recent clinical studies have shown evidence of a direct correspondence between chronic OM and the presence of a bacterial biofilm within the middle ear. Biofilms are typically very thin and cannot be recognized using a regular otoscope. Here we report the use of optical coherent ranging techniques to noninvasively assess the middle ear to detect and quantify biofilm microstructure. This study involves adults with chronic OM, which is generally accepted as a biofilm-related disease. Based on more than 18,537 optical ranging scans and 742 images from 13 clinically infected patients and 7 normal controls using clinical findings as the gold standard, all middle ears with chronic OM showed evidence of biofilms, and all normal ears did not. Information on the presence of a biofilm, along with its structure and response to antibiotic treatment, will not only provide a better fundamental understanding of biofilm formation, growth, and eradication in the middle ear, but also may provide much-needed quantifiable data to enable early detection and quantitative longitudinal treatment monitoring of middle-ear biofilms responsible for chronic OM.

Noninvasive in vivo optical detection of biofilm in the human middle ear

PubMed Central

Jung, Woonggyu; Kim, Jeehyun; Chaney, Eric J.; Novak, Michael; Stewart, Charles N.; Boppart, Stephen A.

2012-01-01

Otitis media (OM), a middle-ear infection, is the most common childhood illness treated by pediatricians. If inadequately treated, OM can result in long-term chronic problems persisting into adulthood. Children with chronic OM or recurrent OM often have conductive hearing loss and communication difficulties and require surgical treatment. Tympanostomy tube insertion, the placement of a small drainage tube in the tympanic membrane (TM), is the most common surgical procedure performed in children under general anesthesia. Recent clinical studies have shown evidence of a direct correspondence between chronic OM and the presence of a bacterial biofilm within the middle ear. Biofilms are typically very thin and cannot be recognized using a regular otoscope. Here we report the use of optical coherent ranging techniques to noninvasively assess the middle ear to detect and quantify biofilm microstructure. This study involves adults with chronic OM, which is generally accepted as a biofilm-related disease. Based on more than 18,537 optical ranging scans and 742 images from 13 clinically infected patients and 7 normal controls using clinical findings as the gold standard, all middle ears with chronic OM showed evidence of biofilms, and all normal ears did not. Information on the presence of a biofilm, along with its structure and response to antibiotic treatment, will not only provide a better fundamental understanding of biofilm formation, growth, and eradication in the middle ear, but also may provide much-needed quantifiable data to enable early detection and quantitative longitudinal treatment monitoring of middle-ear biofilms responsible for chronic OM. PMID:22645342

Three-Dimensional Analysis of the Ear Morphology.

PubMed

Modabber, Ali; Galster, Helmut; Peters, Florian; Möhlhenrich, Stephan Christian; Kniha, Kristian; Knobe, Matthias; Hölzle, Frank; Ghassemi, Alireza

2018-06-01

For surgical treatment of the face, detailed surgical planning is necessary to avoid later unaesthetic results. Most of the studies in the literature concentrate on the ears' anatomy during childhood and adolescence. Nearly no study evaluates the anatomy of ears of people aged 50 or older. It was our aim to measure and evaluate the ear's anatomy in Caucasians between the ages of 21 and 65. Three-dimensional scans of 240 volunteers were taken. The subjects were divided into groups of males and females and each of them into three groups by age (21-35, 36-50, 51-65). Landmarks were placed in these scans. Distances, relations and angles between them were recorded. The distance between the subaurale and superaurale significantly increases (p < 0.001) during the aging process in males and females. Also, the width of the ear, measured between the preaurale and postaurale, significantly increased (p = 0.007) with advancing age. When the length of the ear is divided into four parts by anatomical landmarks, it extended the most in the lower quadrant with increasing subject age. The ear of Caucasians does not stop changing its shape during adulthood. Even after the body has stopped growing, the ear still does. With the measured values in this study, it should be possible for the surgeon to plan the operation in advance and achieve satisfactory aesthetic outcomes. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

A miniaturized laser-Doppler-system in the ear canal

NASA Astrophysics Data System (ADS)

Schmidt, T.; Gerhardt, U.; Kupper, C.; Manske, E.; Witte, H.

2013-03-01

Gathering vibrational data from the human middle ear is quite difficult. To this date the well-known acoustic probe is used to estimate audiometric parameters, e.g. otoacoustic emissions, wideband reflectance and the measurement of the stapedius reflex. An acoustic probe contains at least one microphone and one loudspeaker. The acoustic parameter determination of the ear canal is essential for the comparability of test-retest measurement situations. Compared to acoustic tubes, the ear canal wall cannot be described as a sound hard boundary. Sound energy is partly absorbed by the ear canal wall. In addition the ear canal features a complex geometric shape (Stinson and Lawton1). Those conditions are one reason for the inter individual variability in input impedance measurement data of the tympanic membrane. The method of Laser-Doppler-Vibrometry is well described in literature. Using this method, the surface velocity of vibrating bodies can be determined contact-free. Conventional Laser-Doppler-Systems (LDS) for auditory research are mounted on a surgical microscope. Assuming a free line of view to the ear drum, the handling of those laser-systems is complicated. We introduce the concept of a miniaturized vibrometer which is supposed to be applied directly in the ear canal for contact-free measurement of the tympanic membrane surface vibration. The proposed interferometer is based on a Fabry-Perot etalon with a DFB laser diode as light source. The fiber-based Fabry-Perot-interferometer is characterized by a reduced size, compared to e.g. Michelson-, or Mach-Zehnder-Systems. For the determination of the phase difference in the interferometer, a phase generated carrier was used. To fit the sensor head in the ear canal, the required shape of the probe was generated by means of the geometrical data of 70 ear molds. The suggested prototype is built up by a singlemode optical fiber with a GRIN-lens, acting as a fiber collimator. The probe has a diameter of 1.8 mm and a length of 5 mm.

Ear-Shaped Stable Auricular Cartilage Engineered from Extensively Expanded Chondrocytes in an Immunocompetent Experimental Animal Model

PubMed Central

Pomerantseva, Irina; Bichara, David A.; Tseng, Alan; Cronce, Michael J.; Cervantes, Thomas M.; Kimura, Anya M.; Neville, Craig M.; Roscioli, Nick; Vacanti, Joseph P.; Randolph, Mark A.

2016-01-01

Advancement of engineered ear in clinical practice is limited by several challenges. The complex, largely unsupported, three-dimensional auricular neocartilage structure is difficult to maintain. Neocartilage formation is challenging in an immunocompetent host due to active inflammatory and immunological responses. The large number of autologous chondrogenic cells required for engineering an adult human-sized ear presents an additional challenge because primary chondrocytes rapidly dedifferentiate during in vitro culture. The objective of this study was to engineer a stable, human ear-shaped cartilage in an immunocompetent animal model using expanded chondrocytes. The impact of basic fibroblast growth factor (bFGF) supplementation on achieving clinically relevant expansion of primary sheep chondrocytes by in vitro culture was determined. Chondrocytes expanded in standard medium were either combined with cryopreserved, primary passage 0 chondrocytes at the time of scaffold seeding or used alone as control. Disk and human ear-shaped scaffolds were made from porous collagen; ear scaffolds had an embedded, supporting titanium wire framework. Autologous chondrocyte-seeded scaffolds were implanted subcutaneously in sheep after 2 weeks of in vitro incubation. The quality of the resulting neocartilage and its stability and retention of the original ear size and shape were evaluated at 6, 12, and 20 weeks postimplantation. Neocartilage produced from chondrocytes that were expanded in the presence of bFGF was superior, and its quality improved with increased implantation time. In addition to characteristic morphological cartilage features, its glycosaminoglycan content was high and marked elastin fiber formation was present. The overall shape of engineered ears was preserved at 20 weeks postimplantation, and the dimensional changes did not exceed 10%. The wire frame within the engineered ear was able to withstand mechanical forces during wound healing and neocartilage maturation and prevented shrinkage and distortion. This is the first demonstration of a stable, ear-shaped elastic cartilage engineered from auricular chondrocytes that underwent clinical-scale expansion in an immunocompetent animal over an extended period of time. PMID:26529401

Tissue-specific roles of Tbx1 in the development of the outer, middle and inner ear, defective in 22q11DS patients

PubMed Central

Arnold, Jelena S.; Braunstein, Evan M.; Ohyama, Takahiro; Groves, Andrew K.; Adams, Joe C.; Brown, M. Christian; Morrow, Bernice E.

2007-01-01

Most 22q11.2 deletion syndrome (22q11DS) patients have middle and outer ear anomalies, whereas some have inner ear malformations. Tbx1, a gene hemizygously deleted in 22q11DS patients and required for ear development, is expressed in multiple tissues during embryogenesis. To determine the role of Tbx1 in the first pharyngeal pouch (PPI) in forming outer and middle ears, we tissue-specifically inactivated the gene using Foxg1-Cre. In the conditional mutants, PPI failed to outgrow, preventing the middle ear bone condensations from forming. Tbx1 was also inactivated in the otic vesicle (OV), resulting in the failure of inner ear sensory organ formation, and in duplication of the cochleovestibular ganglion (CVG). Consistent with the anatomical defects, the sensory genes, Otx1 and Bmp4 were downregulated, whereas the CVG genes, Fgf3 and NeuroD, were upregulated. To delineate Tbx1 cell-autonomous roles, a more selective ablation, exclusively in the OV, was performed using Pax2-Cre. In contrast to the Foxg1-Cre mutants, Pax2-Cre conditional mutant mice survived to adulthood and had normal outer and middle ears but had the same inner ear defects as the Tbx1 null mice, with the same gene expression changes. These results demonstrate that Tbx1 has non-cell autonomous roles in PPI in the formation of outer and middle ears and cell-autonomous roles in the OV. Periotic mesenchymal markers, Prx2 and Brn4 were normal in both conditional mutants, whereas they were diminished in Tbx1−/− embryos. Thus, Tbx1 in the surrounding mesenchyme in both sets of conditional mutants cannot suppress the defects in the OV that occur in the null mutants. PMID:16600992

Of mice, moles and guinea pigs: functional morphology of the middle ear in living mammals.

PubMed

Mason, Matthew J

2013-07-01

The middle ear apparatus varies considerably among living mammals. Body size, phylogeny and acoustic environment all play roles in shaping ear structure and function, but experimental studies aimed ultimately at improving our understanding of human hearing can sometimes overlook these important species differences. This review focuses on three groups of mammals, bringing together anatomical, zoological and physiological information in order to highlight unusual features of their middle ears and attempt to interpret their function. "Microtype" ears, found in species such as mice and bats, are associated with high-frequency hearing. The orbicular apophysis, the focus of some recent developmental studies on mouse ears, is characteristic of microtype mallei but is not found in humans or other "freely mobile" species. The apophysis increases ossicular inertia about the anatomical axis of rotation: its adaptive purpose in a high-frequency ear is still not clear. Subterranean mammals have convergently evolved a "freely mobile" ossicular morphology which appears to favour lower-frequency sound transmission. More unusual features found in some of these animals include acoustically coupled middle ear cavities, the loss of middle ear muscles and hypertrophied ossicles which are believed to subserve a form of inertial bone conduction. Middle ears of the rodent group Ctenohystrica (which includes guinea pigs and chinchillas, important models in hearing research) show some striking characteristics which together comprise a unique type of auditory apparatus requiring a classification of its own, referred to here as the "Ctenohystrica type". These characteristics include a distinctive malleus morphology, fusion of the malleus and incus, reduction or loss of the stapedius muscle, a synovial stapedio-vestibular articulation and, in chinchillas, enormously expanded middle ear cavities. These characteristics may be functionally linked and associated with the excellent low-frequency hearing found in these animals. The application of new experimental and imaging data into increasingly sophisticated models continues to improve our understanding of middle ear function. However, a more rigorous comparative approach and a better appreciation of the complex patterns of convergent and divergent evolution reflected in the middle ear structures of living mammals are also needed, in order to put findings from different species into the appropriate context. This article is part of a special issue entitled "MEMRO 2012". Copyright © 2012 Elsevier B.V. All rights reserved.

Benefits to Speech Perception in Noise From the Binaural Integration of Electric and Acoustic Signals in Simulated Unilateral Deafness

PubMed Central

Ma, Ning; Morris, Saffron; Kitterick, Pádraig Thomas

2016-01-01

Objectives: This study used vocoder simulations with normal-hearing (NH) listeners to (1) measure their ability to integrate speech information from an NH ear and a simulated cochlear implant (CI), and (2) investigate whether binaural integration is disrupted by a mismatch in the delivery of spectral information between the ears arising from a misalignment in the mapping of frequency to place. Design: Eight NH volunteers participated in the study and listened to sentences embedded in background noise via headphones. Stimuli presented to the left ear were unprocessed. Stimuli presented to the right ear (referred to as the CI-simulation ear) were processed using an eight-channel noise vocoder with one of the three processing strategies. An Ideal strategy simulated a frequency-to-place map across all channels that matched the delivery of spectral information between the ears. A Realistic strategy created a misalignment in the mapping of frequency to place in the CI-simulation ear where the size of the mismatch between the ears varied across channels. Finally, a Shifted strategy imposed a similar degree of misalignment in all channels, resulting in consistent mismatch between the ears across frequency. The ability to report key words in sentences was assessed under monaural and binaural listening conditions and at signal to noise ratios (SNRs) established by estimating speech-reception thresholds in each ear alone. The SNRs ensured that the monaural performance of the left ear never exceeded that of the CI-simulation ear. The advantages of binaural integration were calculated by comparing binaural performance with monaural performance using the CI-simulation ear alone. Thus, these advantages reflected the additional use of the experimentally constrained left ear and were not attributable to better-ear listening. Results: Binaural performance was as accurate as, or more accurate than, monaural performance with the CI-simulation ear alone. When both ears supported a similar level of monaural performance (50%), binaural integration advantages were found regardless of whether a mismatch was simulated or not. When the CI-simulation ear supported a superior level of monaural performance (71%), evidence of binaural integration was absent when a mismatch was simulated using both the Realistic and the Ideal processing strategies. This absence of integration could not be accounted for by ceiling effects or by changes in SNR. Conclusions: If generalizable to unilaterally deaf CI users, the results of the current simulation study would suggest that benefits to speech perception in noise can be obtained by integrating information from an implanted ear and an NH ear. A mismatch in the delivery of spectral information between the ears due to a misalignment in the mapping of frequency to place may disrupt binaural integration in situations where both ears cannot support a similar level of monaural speech understanding. Previous studies that have measured the speech perception of unilaterally deaf individuals after CI but with nonindividualized frequency-to-electrode allocations may therefore have underestimated the potential benefits of providing binaural hearing. However, it remains unclear whether the size and nature of the potential incremental benefits from individualized allocations are sufficient to justify the time and resources required to derive them based on cochlear imaging or pitch-matching tasks. PMID:27116049

Benefits to Speech Perception in Noise From the Binaural Integration of Electric and Acoustic Signals in Simulated Unilateral Deafness.

PubMed

Ma, Ning; Morris, Saffron; Kitterick, Pádraig Thomas

2016-01-01

This study used vocoder simulations with normal-hearing (NH) listeners to (1) measure their ability to integrate speech information from an NH ear and a simulated cochlear implant (CI), and (2) investigate whether binaural integration is disrupted by a mismatch in the delivery of spectral information between the ears arising from a misalignment in the mapping of frequency to place. Eight NH volunteers participated in the study and listened to sentences embedded in background noise via headphones. Stimuli presented to the left ear were unprocessed. Stimuli presented to the right ear (referred to as the CI-simulation ear) were processed using an eight-channel noise vocoder with one of the three processing strategies. An Ideal strategy simulated a frequency-to-place map across all channels that matched the delivery of spectral information between the ears. A Realistic strategy created a misalignment in the mapping of frequency to place in the CI-simulation ear where the size of the mismatch between the ears varied across channels. Finally, a Shifted strategy imposed a similar degree of misalignment in all channels, resulting in consistent mismatch between the ears across frequency. The ability to report key words in sentences was assessed under monaural and binaural listening conditions and at signal to noise ratios (SNRs) established by estimating speech-reception thresholds in each ear alone. The SNRs ensured that the monaural performance of the left ear never exceeded that of the CI-simulation ear. The advantages of binaural integration were calculated by comparing binaural performance with monaural performance using the CI-simulation ear alone. Thus, these advantages reflected the additional use of the experimentally constrained left ear and were not attributable to better-ear listening. Binaural performance was as accurate as, or more accurate than, monaural performance with the CI-simulation ear alone. When both ears supported a similar level of monaural performance (50%), binaural integration advantages were found regardless of whether a mismatch was simulated or not. When the CI-simulation ear supported a superior level of monaural performance (71%), evidence of binaural integration was absent when a mismatch was simulated using both the Realistic and the Ideal processing strategies. This absence of integration could not be accounted for by ceiling effects or by changes in SNR. If generalizable to unilaterally deaf CI users, the results of the current simulation study would suggest that benefits to speech perception in noise can be obtained by integrating information from an implanted ear and an NH ear. A mismatch in the delivery of spectral information between the ears due to a misalignment in the mapping of frequency to place may disrupt binaural integration in situations where both ears cannot support a similar level of monaural speech understanding. Previous studies that have measured the speech perception of unilaterally deaf individuals after CI but with nonindividualized frequency-to-electrode allocations may therefore have underestimated the potential benefits of providing binaural hearing. However, it remains unclear whether the size and nature of the potential incremental benefits from individualized allocations are sufficient to justify the time and resources required to derive them based on cochlear imaging or pitch-matching tasks.

Horizontal square buried sutures in a two-layered fashion enable direct primary closure for small circular wounds without dog-ears on the face.

PubMed

Matsunaga, Jun; Aiba, Setsuya

2005-05-01

Dog-ears often lead to lengthening of an excision, and it is desirable to avoid them. Facial skin, including the subepidermal connective tissue, is flexible and can be used advantageously to minimize dog-ears using a novel buried suture technique. After removing a round lesion, the first horizontal square buried suture (HSBS) was deeply placed parallel to the longitudinal direction of the defect beneath superficial fascia. After the first HSBS was tied, the defect became fusiform but was still largely open. The second HSBS was also placed parallel to the longitudinal direction of the defect but in more superficial fascia and using smaller horizontal buried loops than those of the first deep suture. After the second HSBS in the middle of the dermis was tied, the wound was almost closed without dog-ears. Consequently, few skin sutures were required to finish the operation. Using this technique, a small circular or oval defect on the face up to 1 cm in diameter can be closed without any additional excision of the skin and without creating dog-ears.

CSF otorhinorrhea in a child with inner ear dysplasia: diagnosis with T2-weighted and intrathecal contrast-enhanced MR cisternography.

PubMed

Mehdi, Elnur; Alkan, Alpay; Yetis, Huseyin; Aralasmak, Ayse; Ozdemir, Huseyin

2014-07-01

During the follow-up of recurrent pneumonia in a 9-month-old girl, rhinorrhea with discharge of a positional and intermittent nature was discovered. Radiological assessment was requested to detect any skull base openings and cerebrospinal fluid (CSF) leakage. T2-weighted MR cisternography showed bilateral inner ear dysplasia, communication of the internal auditory canal with the vestibule, and effusion in the right middle ear. Intrathecal contrast-enhanced MR cisternography revealed a CSF fistula from the right internal auditory canal to the Eustachian tube. The patient was operated upon on the right side, and the presence of a CSF leak near the oval window was confirmed. No adverse effects were seen during the short-term and long-term follow-up. Diagnosing this case required special attention, careful examination, and relevant investigations to find the site of CSF leakage in this patient with bilateral inner ear dysplasia.

Silicone impression material foreign body in the middle ear: Two case reports and literature review.

PubMed

Suzuki, Nobuyoshi; Okamura, Koji; Yano, Takuya; Moteki, Hideaki; Kitoh, Ryosuke; Takumi, Yutaka; Usami, Shin-ichi

2015-10-01

We report two cases of impression material foreign body in the middle ear. The first case had been affected with chronic otitis media. The silicone flowed into the middle ear through a tympanic membrane perforation during the process of making an ear mold. About 4 years and 8 months after, the patient had severe vertigo and deafness. We found bone erosion of the prominence of the lateral semicircular canal and diagnosed labyrinthitis caused by silicone impression material. In the second case silicone flowed into the canal wall down mastoid cavity. Both cases required surgery to remove the foreign body. The clinical courses in such cases are variable and timing of surgery is sometimes difficult. In addition to reporting these two cases, we present here a review of the literature regarding impression material foreign bodies. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Adverse effects of pesticides on central auditory functions in tobacco growers.

PubMed

França, Denise Maria Vaz Romano; Bender Moreira Lacerda, Adriana; Lobato, Diolen; Ribas, Angela; Ziliotto Dias, Karin; Leroux, Tony; Fuente, Adrian

2017-04-01

To investigate the effects of exposure to pesticides on the central auditory functions (CAF) of Brazilian tobacco growers. This was a cross-sectional study carried out between 2010 and 2012. Participants were evaluated with two behavioural procedures to investigate CAF, the random gap detection test (RGDT) and the dichotic digit test in Portuguese (DDT). A total of 22 growers exposed to pesticides (study group) and 21 subjects who were not exposed to pesticides (control group) were selected. No significant differences between groups were observed for pure-tone thresholds. A significant association between pesticide exposure and the results for RGDT and DDT was found. Significant differences between pesticide-exposed and nonexposed subjects were found for RGDT frequency average and DDT binaural average, when including age and hearing level as covariates. Age was significantly associated with RGDT frequency average, DDT left ear score, DDT binaural average and DDT right ear advantage. Hearing levels were not significantly associated with any of the test scores. The relative risk of failing the DDT and RGDT for the study group was 1.88 (95% CI: 1.10-3.20) and 1.74 (95% CI: 1.06-2.86), respectively, as compared with the control group. The results showed that tobacco growers exposed to pesticides exhibited signs of central auditory dysfunction characterised by decrements in temporal processing and binaural integration processes/abilities.

Uncomfortable loudness levels among children and adolescents seeking help for tinnitus and/or hyperacusis.

PubMed

Aazh, Hashir; McFerran, Don; Moore, Brian C J

2018-04-24

To assess the prevalence of hyperacusis and severe hyperacusis among children and adolescents seen at an audiology outpatient tinnitus and hyperacusis service. This was a retrospective study. Hyperacusis was considered as present if the average uncomfortable loudness level (ULL) at 0.25, 0.5, 1, 2, 4 and 8 kHz for the ear with the lower average ULL, which is denoted as ULLmin, was ≤77 dB HL. Severe hyperacusis was considered as present if the ULL was 30 dB HL or less for at least one of the measured frequencies for at least one ear. There were 62 young patients with an average age of 12 years (SD = 4.1 years, range 4-18 years). Eighty-five percent of patients had hyperacusis and 17% had severe hyperacusis. On average, ULLs at 8 kHz were 9.3 dB lower than ULLs at 0.25 kHz. For 33% of patients, ULLs were at least 20 dB lower at 8 than at 0.25 kHz. Among children and adolescents seen at an audiology outpatient clinic for tinnitus and hyperacusis, hyperacusis diagnosed on the basis of ULLs is very prevalent and it is often characterised by lower ULLs at 8 than at 0.25 kHz.

Cochlear third window in the scala vestibuli: an animal model.

PubMed

Preis, Michal; Attias, Joseph; Hadar, Tuvia; Nageris, Ben I

2009-08-01

Pathologic third window has been investigated in both animals and humans, with a third window located in the vestibular apparatus, specifically, dehiscence of the superior semicircular canal, serving as the clinical model. The present study sought to examine the effect of a cochlear third window in the scala vestibuli on the auditory thresholds in fat sand rats that have a unique anatomy of the inner ear that allows for easy surgical access. The experiment included 7 healthy 6-month-old fat sand rats (a total of 10 ears). A pathologic third window was induced by drilling a hole in the bony labyrinth over the scala vestibuli, with preservation of the membranous labyrinth. Auditory brainstem responses to high- and low-frequency acoustic stimuli delivered via air and bone conduction were recorded before and after the procedure. In the preoperative auditory brainstem response recordings, air-conduction thresholds (ACTs) to clicks and tone bursts averaged 9 and 10 dB, respectively, and bone-conduction thresholds averaged 4.5 and 2.9 dB, respectively. Postfenestration ACTs averaged 41 and 42.2 dB, and bone-conduction thresholds averaged 1.1 and 4.3 dB. The change in ACT was statistically significant (p < 0.01). The presence of a cochlear third window in the scala vestibuli affects auditory thresholds by causing a decrease in sensitivity to air-conducted sound stimuli. These findings agree with the theoretical model and clinical findings.

[Analyses of the factors relevant to revision tympanomastoid surgery].

PubMed

Li, Li; Fan, Zhaomin; Han, Yuechen; Xu, Lei; Chen, Dong; Wang, Haibo

2016-05-01

To analyze factors relevant to revisional tympanomastoid surgery for chronic otitis media(COM). The clinical data of 159 patients (159 ears), who exhibited either wet ear or relapsed after the initial operation, and were subjected to revisional tympanomastoid surgery, were retrospectively analyzed in this study. Of those 159 consecutive patients, 85 were males and 74 were females, aged 11-64 years, with a median age of 36 years old. The situations in terms of intra-operative findings, surgical procedures, change dressing post-operation, dry ear time, and the improvement of aural ability during the second operation, were recorded and analyzed. The second surgery found that, of those 159 patients underwent the re-operation, 67 presented with cholesteatoma and 92 had no cholesteatoma. In addition, the inadequate skeletonization and insufficient opening for mastoid cavity accounted for 70.4% (112/159) of all previous operations, the external auditory canal stenosis for 98.7% (157/159), the high facial ridge leading to insufficient drainage for 61.0% (97/159), the lesion in tympanic ostium of Eustachian tube for 34.6% (55/159), the insufficient drainage due to inappropriate post-operating dressing for 5.0% (8/159), the postauricular incision for 30.8% (49/159), and the endaural incision for 69.2% (110/159). As for the re-operation of the canal wall down mastoidectomy, tympanoplasty plus plastic repairing of cavity of concha were performed in 94 cases, the modified Bondy plus plastic repairing of cavity of concha in four cases, the radical mastoidectomy plus plastic repairing of cavity of concha in 59 cases, and the simple cleaning for mastoid cavity in two cases. Since one to two weeks after the revisional operations, the post-operating dressing was performed with aid of microscopy once a week on average. The average dry ear time ranged from 2 to 6 weeks (median=3 weeks). During a period of 6-93 months for the follow-up, all patients presented with dry ears. The epithelialization of the operating cavity was well and the tympanic membranes were integrity. Neither granulation tissue nor cholesteatoma was found to reoccur. Both pure tone hearing thresholds and air-bone gap decreased in 87 cases after the revisional operation, with statistically significant different in comparison to those two parameters before the operation (P<0.05). The primary causes responsible for the wet ear or reoccurrent cholesteatoma after tympanomastoid surgery may be related to the improper operation procedures and selection of incision, the non-standard operation, inexhaustive removal of pathological tissues, as well as the irregular postoperation change dressing, and other factors.

Effects of Smoking on Eustachian Tube and Hearing.

PubMed

Pezzoli, Matteo; Lofaro, Denise; Oliva, Alessandro; Orione, Monica; Cupi, Daniela; Albera, Andrea; Bongioannini, Guido; Albera, Roberto

2017-12-01

The purpose of this study was to evaluate the effect of tobacco use on the Eustachian tube and inner ear function. Case-control study. Thirty-one nonsmoking volunteers and 34 smoking subjects recruited in an University Hospital, submitted to an audiological evaluation including pure tone audiometry, basal tympanogram, stapedial reflexes analysis, and nine-step eustachian tube (ET) function test. Pure Tone Average (PTA) threshold at all frequencies tested was 12.5 dB in smokers and 3.7 in nonsmoking subjects. Nine smokers (27%) presented some degree of hearing loss versus none in the nonsmoker group. Linear regression analysis showed a higher degree of sensorineural hearing loss with age in smokers. Among the smokers, 20 subjects (59%) presented an impaired tubal function for the nine-step inflation/deflation tympanometric test, while only 6 (19%) subjects in the group of nonsmokers showed a tubal dysfunction. Tobacco use may reduce the ability to hear, mainly causing a sensorineural hearing loss for higher frequencies. We also found the presence of a high number of smokers suffering from tubal dysfunction. This has an important clinical relevance, not only because smoking increases the incidence of middle ear diseases, but also because tubal dysfunction may cause nonspecific symptoms characterised by ear fullness and difficulties in middle ear equalisation.

Sound attenuation in the ear of domestic chickens (Gallus gallus domesticus) as a result of beak opening

PubMed Central

Claes, Raf; Dirckx, Joris J. J.

2017-01-01

Because the quadrate and the eardrum are connected, the hypothesis was tested that birds attenuate the transmission of sound through their ears by opening the bill, which potentially serves as an additional protective mechanism for self-generated vocalizations. In domestic chickens, it was examined if a difference exists between hens and roosters, given the difference in vocalization capacity between the sexes. To test the hypothesis, vibrations of the columellar footplate were measured ex vivo with laser Doppler vibrometry (LDV) for closed and maximally opened beak conditions, with sounds introduced at the ear canal. The average attenuation was 3.5 dB in roosters and only 0.5 dB in hens. To demonstrate the importance of a putative protective mechanism, audio recordings were performed of a crowing rooster. Sound pressures levels of 133.5 dB were recorded near the ears. The frequency content of the vocalizations was in accordance with the range of highest hearing sensitivity in chickens. The results indicate a small but significant difference in sound attenuation between hens and roosters. However, the amount of attenuation as measured in the experiments on both hens and roosters is small and will provide little effective protection in addition to other mechanisms such as stapedius muscle activity. PMID:29291112

Head-Shaking Nystagmus Depends on Gravity

PubMed Central

Marti, Sarah; Straumann, Dominik

2005-01-01

In acute unilateral peripheral vestibular deficit, horizontal spontaneous nystagmus (SN) increases when patients lie on their affected ear. This phenomenon indicates an ipsilesional reduction of otolith function that normally suppresses asymmetric semicircular canal signals. We asked whether head-shaking nystagmus (HSN) in patients with chronic unilateral vestibular deficit following vestibular neuritis is influenced by gravity in the same way as SN in acute patients. Using a three-dimensional (3-D) turntable, patients (N = 7) were placed in different whole-body positions along the roll plane and oscillated (1 Hz, ±10°) about their head-fixed vertical axis. Eye movements were recorded with 3-D magnetic search coils. HSN was modulated by gravity: When patients lay on their affected ear, slow-phase eye velocity significantly increased upon head shaking and consisted of a horizontal drift toward the affected ear (average: 1.2°/s ±0.5 SD), which was added to the gravity-independent and directionally nonspecific SN. In conclusion, HSN in patients with chronic unilateral peripheral vestibular deficit is best elicited when they are lying on their affected ear. This suggests a gravity-dependent mechanism similar to the one observed for SN in acute patients, i.e., an asymmetric suppression of vestibular nystagmus by the unilaterally impaired otolith organs. PMID:15735939

Finite element analysis of auditory characteristics in patients with middle ear diseases.

PubMed

Tu, Bo; Li, Xiaoping; Nie, Zhenhua; Shi, Changzheng; Li, Hengguo

2017-07-01

This study validates that a finite element model of the human ossicular chain and tympanic membrane can be used as an effective surgical assessment tool in clinics. The present study was performed to investigate the application of a finite element model of ossicular chain and tympanic membrane for fabrication of individualized artificial ossicles. Twenty patients (20 ears) who underwent surgery for middle ear disease (n = 20) and 10 healthy controls (10 ears) were enrolled in the hospital. Computed tomography (CT) and pure tone audiometry were performed before and after surgery. A finite element model was developed using CT scans, and correlation analysis was conducted between stapes displacement and surgical methods. An audiometric test was also performed for 14 patients before and after surgery. Stapes displacement in the healthy group (average = 3.31 × 10 -5  mm) was significantly greater than that in the impaired group (average = 1.41 × 10 -6 mm) prior to surgery. After surgery, the average displacement in the impaired group was 2.55 × 10 -6 mm, which represented a significant improvement. For the patients who underwent the audiometric test, 10 improved hearing after surgery, and stapes displacement increased in nine of these 10 patients.

Retrofacial approach to access the round window for cochlear implantation of malformed ears.

PubMed

Rizk, Habib; O'Connell, Brendan; Stevens, Shawn; Meyer, Ted

2015-03-01

To report the use of the retrofacial approach for cochlear implantation in three cases of malformed ears with inaccessible round windows through the standard facial recess. Two children with bilateral profound sensorineural hearing loss who were cochlear implant candidates. One patient had bilateral sequential cochlear implantations and the other a unilateral implant. Retrofacial approach to access the posterior mesotympanum and visualize the round window. Ability to complete the surgery with full insertion of the implant and no complications such as facial nerve injury. We implanted three ears in two patients with multiple external and middle ear malformations with an aberrant facial nerve or a posteriorly displaced round window niche. The standard facial recess approach did not allow visualization of the round window. We resorted to a retrofacial approach to access the posterior mesotympanum and proceeded with the surgery through an anterior and inferior cochleostomy or through the round window. In cases with an aberrant facial nerve or inaccessible round window through the facial recess, the retrofacial approach is a good alternative but requires a certain level of expertise and familiarity with temporal bone anatomy. The decision to use an unconventional approach should be considered before surgery, but the ultimate decision may require intraoperative assessment.

The effect of cockpit noise on the temporary threshold shift of Cessna 172SP flight instructors

NASA Astrophysics Data System (ADS)

Bellini, Andrew Robert

The purpose of this thesis was to study the temporary threshold shift of general aviation flight instructors resulting from their working environment. Exposure to noise before a temporary threshold shift completely recovers can cause a permanent threshold shift with no possibility of recovery, resulting in permanent hearing loss. A result showing minimal to no temporary threshold shift would indicate that hearing personal protective equipment is working properly. This study used sound-level measurements, and audiometric testing, together with survey data to determine whether or not flight instructors were at risk for potential hearing impairment due to temporary threshold shift. Independent t-tests and descriptive statistics were used in analyzing the data. It was determined that there was a difference in temporary threshold shift based on the number of hours a flight instructor flies in a Cessna 172SP for only one frequency - 2000Hz in the left ear. All other frequencies tested in both ears showed no difference. Because there was a very low mean temporary threshold shift at 2000Hz in the left ear and no differences shown for all other frequencies in both ears, it was concluded that there was no need to improve or require additional hearing personal protective equipment, or to require decreased exposure times to aircraft noise.

Correcting Flank Skin Laxity and Dog Ear Plus Aggressive Liposuction: A Technique for Classic Abdominoplasty in Middle-Eastern Obese Women

PubMed Central

Hosseini, Seyed Nejat; Ammari, Ali; Mousavizadeh, Seyed Mehdi

2018-01-01

BACKGROUND Nowadays obesity is a common problem as it leads to abdominal deformation and people’s dissatisfaction of their own body. This study has explored using a new surgical technique based on a different incision to reform the flank skin laxity and dog ear plus aggressive liposuction on women with abdominal deformities. METHODS From May 2014 to February 2016, 25 women were chosen for this study. All women had a body mass index more than 28 kg/m2, flank folding, bulging and excess fat, abdominal and flank skin sagging and laxity. An important point of the new technique was that the paramedian perforator was preserved. RESULTS All women were between 33 and 62 years old (mean age of 47±7.2 years old). The average amount of liposuction aspirate was 2,350 mL (1700-3200 mL), and the size of average excised skin ellipse was 23.62×16.08 cm (from 19×15 to 27×18 cm). Dog ear, skin laxity, bulging and fat deposit correction were assessed and scored in two and four months after the surgery. CONCLUSION Aggressive abdominal and flank liposuction can be safely done when paramedian perforator is preserved. This has a good cosmetic result in the abdomen and flank and prevents bulging in the incision end and flank. Using this abdominoplasty technique is recommended on patients with high body mass indexes. PMID:29651396

Correcting Flank Skin Laxity and Dog Ear Plus Aggressive Liposuction: A Technique for Classic Abdominoplasty in Middle-Eastern Obese Women.

PubMed

Hosseini, Seyed Nejat; Ammari, Ali; Mousavizadeh, Seyed Mehdi

2018-01-01

Nowadays obesity is a common problem as it leads to abdominal deformation and people's dissatisfaction of their own body. This study has explored using a new surgical technique based on a different incision to reform the flank skin laxity and dog ear plus aggressive liposuction on women with abdominal deformities. From May 2014 to February 2016 , 25 women were chosen for this study. All women had a body mass index more than 28 kg/m 2 , flank folding, bulging and excess fat, abdominal and flank skin sagging and laxity. An important point of the new technique was that the paramedian perforator was preserved. All women were between 33 and 62 years old (mean age of 47±7.2 years old). The average amount of liposuction aspirate was 2,350 mL (1700-3200 mL), and the size of average excised skin ellipse was 23.62×16.08 cm (from 19×15 to 27×18 cm). Dog ear, skin laxity, bulging and fat deposit correction were assessed and scored in two and four months after the surgery. Aggressive abdominal and flank liposuction can be safely done when paramedian perforator is preserved. This has a good cosmetic result in the abdomen and flank and prevents bulging in the incision end and flank. Using this abdominoplasty technique is recommended on patients with high body mass indexes.

Eye and Ear Temperature Using Infrared Thermography Are Related to Rectal Temperature in Dogs at Rest or With Exercise.

PubMed

Zanghi, Brian M

2016-01-01

Rectal body temperature (BT) has been documented in exercising dogs to monitor thermoregulation, heat stress risk, and performance during physical activity. Eye (BT eye ) and ear (BT ear ) temperature measured with infrared thermography (IRT) were compared to rectal (BT rec ) temperature as the reference method and assess alternative sites to track hyperthermia, possibly to establish BT eye IRT as a passive and non-contact method. BT measures were recorded at 09:00, 11:30, 12:30, and 02:30 from Labrador Retrievers ( N  = 16) and Beagles ( N  = 16) while sedentary and with 30-min play-exercise (pre- and 0, 15, 30-min post-exercise). Total exercise locomotor activity counts were recorded to compare relative intensity of play-exercise between breeds. BT rec , BT eye , and BT ear were measured within 5 min of the target time. Each BT method was analyzed by analysis of variance for main effects of breed and time. Method differences were compared using Bland-Altman plots and linear regression. Sedentary BT differed by breed for BT rec ( p  < 0.0001), BT ear ( p  < 0.0001), and BT eye ( p  = 0.06) with Labs having on average 0.3-0.8°C higher BT compared to Beagles. Readings also declined over time for BT eye ( p  < 0.0001) and BT ear ( p  < 0.0001), but not for BT rec ( p  = 0.63) for both breeds. Total exercise (30-min) activity counts did not differ ( p  = 0.53) between breeds. Time and breed interaction was significant in response to exercise for both BT rec and BT ear ( p  = 0.035 and p  = 0.005, respectively), with a marginal interaction ( p  = 0.09) for BT eye . All the three methods detected hyperthermia with Labs having a higher increase compared to Beagles. Both BT ear and BT eye were significantly ( p  < 0.0001) related to BT rec in all dogs with sedentary or exercise activity. The relationship between BT eye and BT rec improved when monitoring exercise hyperthermia ( r  = 0.674) versus measures at rest ( r  = 0.381), whereas BT ear was significantly related to BT rec regardless of activity ( r  = 0.615-0.735). Although BT readings were significantly related, method bias ( p  < 0.02) was observed for BT eye to slightly underestimate BT rec , whereas no bias was observed between BT ear and BT rec . This study demonstrates that IRT technology effectively measures both ear and eye temperature and enables effective monitoring of BT changes at rest, with exercise, and between breeds. However, ear, and not eye, temperature is a better reflection of rectal temperature.

Chronic Tuberculous Otomastoiditis: A Case Report.

PubMed

Bruschini, Luca; Ciabotti, Annalisa; Berrettini, Stefano

2016-08-01

Worldwide, tuberculosis is a widespread disease, with 8.7 million new cases occurring annually. Its etiologic agent, Mycobacterium tuberculosis, essentially causes pneumonia. However, this organism affects the middle ear in rare cases, accounting for 0.04-0.09% of all chronic middle ear otitis cases in Western countries. In this report, we describe the case of a young woman affected by tuberculosis of the middle ear. In our experience, empiric therapy was not beneficial. Adequate treatment was possible only after obtaining a specific diagnosis through a difficult process requiring surgical sampling for culture examination. We consider surgical sampling to be mandatory in all cases of chronic otitis media that do not respond to prolonged systemic and local therapies.

Ear, Nose and Throat Foreign Bodies Removed under General Anaesthesia: A Retrospective Study.

PubMed

Shunyu, Neizekhotuo Brian; Akhtar, Hanifa; Karim, Habib Md Rezaul; Lyngdoh, Nari M; Yunus, Md; Jamil, Md

2017-02-01

For Otorhinolaryngologist, removal of Foreign Bodies (FB) from the ear, nose and throat is one of the common emergency procedures done. Most of the cases especially of the ear and nose can be managed without General Anaesthesia (GA). But in some cases GA may be needed. There are very few studies that address the scenario of ear, nose and throat foreign body that required GA for its removal and the complications associated with it. This study was conducted with the aim to study the patient's profile, types and distribution of FB removed under GA, and the associated complications. The present study is a hospital based retrospective, cross-sectional study conducted in the Department of Otorhinolaryngology in association with Department of Anaesthesiology and Critical Care in North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India from year 2009 to 2014. Information was collected from indoor patient file and operation record book. Those patients where foreign body was not found after examination under GA were excluded. A total of 112 cases of foreign body in ear, nose and throat removed under GA were selected. There was variation of age from youngest case being 11 months to 74 years with a slight male predominance. Two third of the patients belonged to paediatric age group. Most of the FB were inanimate with high number of inorganic type found in majority. Foreign body in food passage was found in most cases. Coin and meat bone were the common FB in children and adults respectively. We found no complications related to removal of foreign body from the food passage and nose. But some complications were seen in foreign body of ear and tracheo-bronchial tree. Ear, nose and throat FB that required GA were seen in all age groups. FB of food passage constitute the majority. Type of foreign body varies between children and adults. In children most common types were related to toys and their part and food materials. In adults, food materials were most common.

Tuboimpedance: A New Test of Eustachian Tube Function.

PubMed

Smith, Matthew E; Zou, Charlie C; Blythe, Andrew J C; Tysome, James R

2017-04-01

Objective Eustachian tube (ET) dysfunction is most frequently caused by a failure of the ET to adequately open; however, there is currently no reliable method of assessing this. Tubomanometry has recently shown good interindividual repeatability as a measure of ET function by measuring middle ear pressure after the application of regulated nasopharyngeal pressures during swallowing. We present the first reports of a novel test: middle ear impedance measurements during standard nasopharyngeal pressure application (tuboimpedance). We assess repeatability in healthy ears and any advantages over tubomanometry. Study Design Exploratory cohort diagnosis study. Setting Tertiary referral center. Subjects Twenty screened, healthy ears (10 volunteers). Methods Tubomanometry and tuboimpedance tests were performed while individuals swallowed with applied nasopharyngeal pressures of 20, 30, 40, and 50 mbar. Eustachian tube opening detection rate and test repeatability (measured by intraclass correlation coefficient [ICC]) for immediate and delayed repeats at each pressure were compared. Results ET opening was detected more frequently using tuboimpedance, with a 100% detection rate using a nasopharyngeal pressure of 30 mbar or more, compared to 88% to 96% with tubomanometry. Detection of ET opening at 20 mbar was possible with tuboimpedance. Repeatability of both tests was mostly strong (ICC >0.7) for both immediate and delayed repeats. Repeatability for the tubomanometry R value was only fair to moderate. Conclusion Tuboimpedance may provide a repeatable measure of ET opening that is easier to perform due to lower nasopharyngeal pressures required and fewer issues with poor ear-probe sealing. Further assessment in patients with different forms of ET dysfunction is required.

Foreign bodies in the ear, nose, and throat.

PubMed

Heim, Steven W; Maughan, Karen L

2007-10-15

Foreign bodies in the ear, nose, and throat are occasionally seen in family medicine, usually in children. The most common foreign bodies are food, plastic toys, and small household items. Diagnosis is often delayed because the causative event is usually unobserved, the symptoms are nonspecific, and patients often are misdiagnosed initially. Most ear and nose foreign bodies can be removed by a skilled physician in the office with minimal risk of complications. Common removal methods include use of forceps, water irrigation, and suction catheter. Pharyngeal or tracheal foreign bodies are medical emergencies requiring surgical consultation. Radiography results are often normal. Flexible or rigid endoscopy usually is required to confirm the diagnosis and to remove the foreign body. Physicians need to have a high index of suspicion for foreign bodies in children with unexplained upper airway symptoms. It is important to understand the anatomy and the indications for subspecialist referral. The evidence is inadequate to make strong recommendations for specific removal techniques.

Use of a verbal electronic audio reminder with a patient hand hygiene bundle to increase independent patient hand hygiene practices of older adults in an acute care setting.

PubMed

Knighton, Shanina C; Dolansky, Mary; Donskey, Curtis; Warner, Camille; Rai, Herleen; Higgins, Patricia A

2018-06-01

We hypothesized that the addition of a novel verbal electronic audio reminder to an educational patient hand hygiene bundle would increase performance of self-managed patient hand hygiene. We conducted a 2-group comparative effectiveness study randomly assigning participants to patient hand hygiene bundle 1 (n = 41), which included a video, a handout, and a personalized verbal electronic audio reminder (EAR) that prompted hand cleansing at 3 meal times, or patient hand hygiene bundle 2 (n = 34), which included the identical video and handout, but not the EAR. The primary outcome was alcohol-based hand sanitizer use based on weighing bottles of hand sanitizer. Participants that received the EAR averaged significantly more use of hand sanitizer product over the 3 days of the study (mean ± SD, 29.97 ± 17.13 g) than participants with no EAR (mean ± SD, 10.88 ± 9.27 g; t 73  = 5.822; P ≤ .001). The addition of a novel verbal EAR to a patient hand hygiene bundle resulted in a significant increase in patient hand hygiene performance. Our results suggest that simple audio technology can be used to improve patient self-management of hand hygiene. Future research is needed to determine if the technology can be used to promote other healthy behaviors, reduce infections, and improve patient-centered care without increasing the workload of health care workers. Published by Elsevier Inc.

Effects of injection position and transponder size on the performances of passive injectable transponders used for the electronic identification of cattle.

PubMed

Conill, C; Caja, G; Nehring, R; Ribó, O

2000-12-01

A total of 686 Tiris half-duplex passive injectable transponders (PIT) of two sizes (23 and 32 mm) were randomly injected s.c. in three positions, armpit, ear scutulum, and upper lip, in 343 fattening calves (1 to 3 mo old). Injections were performed by two trained and two untrained operators. Losses and breakages on the farm were recorded at wk 1, 3, 7, 11, and 15 in restrained animals using two types of hand-held transceivers with a stick antenna. Dynamic reading efficiency (DRE) in animals running through a raceway was also evaluated at wk 1 and 3 and monthly until slaughter, using a stationary transceiver working at 137 dB x microV x m(-1) at 3 m. The total number of PIT that fell or broke in the slaughtering line, the location method, and the recovery time were also recorded. Results on the farm showed low breakages on average (0.4%) and differences (P < 0.05) in losses according to position (armpit, 1.7%; ear, 5.2%; and lip, 14.0%). An interaction (P < 0.05) between position x size was observed, and losses were greatest using a 32-mm PIT in the lip. The DRE was affected (P < 0.05) by PIT position and size, and values were greater for the 32-mm PIT in all positions (armpit: 99.9 +/- 0.1 vs 95.8 +/- 4.9%; ear: 93.8 +/- 2.2 vs 81.9 +/- 4.6%; lip: 66.8 +/- 4.9 vs 53.4 +/- 4.7%, respectively, for 32 vs 23 mm). Recovery of PIT in the abattoir was on average 96.7, 96.7, and 99.2% for armpit, ear, and lip, respectively (P > 0.05). Most of the PIT injected in the armpit were recovered by sight or palpation, but 31.9% were recovered after cutting the muscles around the area and 10.7% were recovered on the internal side of the hide, which jeopardized carcass identification. Recovery of PIT injected in the ear was 23.4% in the hide and 76.6% in the auricular muscles of the head. The easiest recovery was in the lip, 8.9% of PIT were located in the hide and 91.1% in the head. Recovery time was affected (P < 0.05) by position: the quickest was lip (27 +/- 2 s), followed by ear (52 +/- 5 s) and armpit (78 +/- 7 s). In conclusion, taking into account retention and reading performances, injection of a 32-mm PIT into the armpit showed the best results on the farm, but a careful and longer recovery was needed in the abattoir. Improvement of recovery methodology and time would be necessary in order to recommend injection of PIT in the armpit instead of in the ear for cattle tracking or monitoring.

Earfold Implantable Clip System for Correction of Prominent Ears: Analysis of Safety in 403 Patients

PubMed Central

Sojitra, Nilesh; Glumicic, Sinisa; Vlok, Jacobus A.; O’Toole, Greg; Hannan, S. Alam; Sabbagh, Walid

2018-01-01

Background: The Earfold system, a new treatment for the correction of prominent ears, consists of 3 components: the Earfold implant, the Earfold introducer, and the Prefold positioner. Methods: This is an interim report based on an ongoing analysis of safety in a series of patients treated for prominent ears with the Earfold implant between February 2013 and September 2014. Safety was assessed based on adverse event reports and the need for implant revision; follow-up is ongoing. Results: Seven surgeons used 1,200 Earfold implants to treat 403 patients (ages, 7–70 years; 63% male); the time since the initial implant procedure now ranges from 30 to 48 months. To date, 145 patients (36%) have returned for a follow-up visit (mean, 7.7 months [range, 1–34 months]). Adverse events requiring intervention have affected 39 of 403 (9.7%) patients; these include implant revisions (n = 17 [4.2%], most often due to implant visibility), skin erosion over the implant (n = 15 [3.7%]), and infection (n = 7 [1.7%]). Bleeding, recurrence of prominence, hematoma, deformity, or adverse scarring did not occur. Conclusions: This interim analysis has shown that Earfold prominent ear correction system is associated with relatively few adverse events that require intervention; a small number of patients experienced infection, implant extrusion, or implant visibility that required revision. Most adverse events were related to either patient selection or technical errors at implantation. It is expected that with continued use of Earfold by surgeons experienced in otoplasty, the adverse event incidence will decrease. PMID:29464160

Big Stimulus, Little Ears: Safety in Administering Vestibular Evoked Myogenic Potentials (VEMP) in Children

PubMed Central

Thomas, Megan L.A.; Fitzpatrick, Denis; McCreery, Ryan; Janky, Kristen L.

2017-01-01

Background Cervical and ocular Vestibular Evoked Myogenic Potentials (VEMPs) have become common clinical vestibular assessments. However, VEMP testing requires high intensity stimuli, raising concerns regarding safety with children, where sound pressure levels may be higher due to their smaller ear canal volumes. Purpose The purpose of this study was to estimate the range of peak-to-peak equivalent sound pressure levels (peSPLs) in child and adult ears in response to high intensity stimuli (i.e., 100 dB normal hearing level (nHL)) commonly used for VEMP testing and make a determination of whether acoustic stimuli levels with VEMP testing are safe for use in children. Research Design Prospective Experimental. Study Sample Ten children (4–6 years) and ten young adults (24 – 35 years) with normal hearing sensitivity and middle ear function participated in the study. Data Collection and Analysis Probe microphone peSPL measurements of clicks and 500 Hz tonebursts (TBs) were recorded in tubes of small, medium, and large diameter, and in a Brüel & Kjær Ear Simulator Type 4157 to assess for linearity of the stimulus at high levels. The different diameter tubes were used to approximate the range of cross-sectional areas in infant, child, and adult ears, respectively. Equivalent ear canal volume and peSPL measurements were then recorded in child and adult ears. Lower intensity levels were used in the participant’s ears to limit exposure to high intensity sound. The peSPL measurements in participant ears were extrapolated using predictions from linear mixed models to determine if equivalent ear canal volume significantly contributed to overall peSPL and to estimate the mean and 95% confidence intervals of peSPLs in child and adult ears when high intensity stimulus levels (100 dB nHL) are used for VEMP testing without exposing subjects to high-intensity stimuli. Results Measurements from the coupler and tubes suggested: 1) each stimuli was linear, 2) there were no distortions or non-linearities at high levels, and 3) peSPL increased with decreased tube diameter. Measurements in participant ears suggested: 1) peSPL was approximately 3 dB larger in child compared to adult ears, and 2) peSPL was larger in response to clicks compared to 500 Hz TBs. The model predicted the following 95% confidence interval for a 100 dB nHL click: 127–136.5 dB peSPL in adult ears and 128.7–138.2 dB peSPL in child ears. The model predicted the following 95% confidence interval for a 100 dB nHL 500 Hz TB stimulus: 122.2 – 128.2 dB peSPL in adult ears and 124.8–130.8 dB peSPL in child ears. Conclusions Our findings suggest that 1) when completing VEMP testing, the stimulus is approximately 3 dB higher in a child’s ear, 2) a 500 Hz TB is recommended over a click as it has lower peSPL compared to the click, and 3) both duration and intensity should be considered when choosing VEMP stimuli. Calculating the total sound energy exposure for your chosen stimuli is recommended as it accounts for both duration and intensity. When using this calculation for children, consider adding 3 dB to the stimulus level. PMID:28534730

Big Stimulus, Little Ears: Safety in Administering Vestibular-Evoked Myogenic Potentials in Children.

PubMed

Thomas, Megan L A; Fitzpatrick, Denis; McCreery, Ryan; Janky, Kristen L

2017-05-01

Cervical and ocular vestibular-evoked myogenic potentials (VEMPs) have become common clinical vestibular assessments. However, VEMP testing requires high intensity stimuli, raising concerns regarding safety with children, where sound pressure levels may be higher due to their smaller ear canal volumes. The purpose of this study was to estimate the range of peak-to-peak equivalent sound pressure levels (peSPLs) in child and adult ears in response to high intensity stimuli (i.e., 100 dB normal hearing level [nHL]) commonly used for VEMP testing and make a determination of whether acoustic stimuli levels with VEMP testing are safe for use in children. Prospective experimental. Ten children (4-6 years) and ten young adults (24-35 years) with normal hearing sensitivity and middle ear function participated in the study. Probe microphone peSPL measurements of clicks and 500 Hz tonebursts (TBs) were recorded in tubes of small, medium, and large diameter, and in a Brüel & Kjær Ear Simulator Type 4157 to assess for linearity of the stimulus at high levels. The different diameter tubes were used to approximate the range of cross-sectional areas in infant, child, and adult ears, respectively. Equivalent ear canal volume and peSPL measurements were then recorded in child and adult ears. Lower intensity levels were used in the participant's ears to limit exposure to high intensity sound. The peSPL measurements in participant ears were extrapolated using predictions from linear mixed models to determine if equivalent ear canal volume significantly contributed to overall peSPL and to estimate the mean and 95% confidence intervals of peSPLs in child and adult ears when high intensity stimulus levels (100 dB nHL) are used for VEMP testing without exposing subjects to high-intensity stimuli. Measurements from the coupler and tubes suggested: 1) each stimuli was linear, 2) there were no distortions or nonlinearities at high levels, and 3) peSPL increased with decreased tube diameter. Measurements in participant ears suggested: 1) peSPL was approximately 3 dB larger in child compared to adult ears, and 2) peSPL was larger in response to clicks compared to 500 Hz TBs. The model predicted the following 95% confidence interval for a 100 dB nHL click: 127-136.5 dB peSPL in adult ears and 128.7-138.2 dB peSPL in child ears. The model predicted the following 95% confidence interval for a 100 dB nHL 500 Hz TB stimulus: 122.2-128.2 dB peSPL in adult ears and 124.8-130.8 dB peSPL in child ears. Our findings suggest that 1) when completing VEMP testing, the stimulus is approximately 3 dB higher in a child's ear, 2) a 500 Hz TB is recommended over a click as it has lower peSPL compared to the click, and 3) both duration and intensity should be considered when choosing VEMP stimuli. Calculating the total sound energy exposure for your chosen stimuli is recommended as it accounts for both duration and intensity. When using this calculation for children, consider adding 3 dB to the stimulus level. American Academy of Audiology

Self-reported hearing loss in baby boomers from the Busselton Healthy Ageing Study: audiometric correspondence and predictive value.

PubMed

Swanepoel, De Wet; Eikelboom, Robert H; Hunter, Michael L; Friedland, Peter L; Atlas, Marcus D

2013-06-01

The baby boomer population will become high users of the health-care system in coming years. Self-report of hearing loss at a primary health-care visit may offer timely referrals to audiological services, but there has been no population-based study of self-reported hearing loss in the baby boomer generation. To determine the clinical value and audiometric correspondence of self-reported hearing loss as a screening tool for the baby boomer population. A population-based study, Busselton Healthy Ageing Study (BHAS), surveying baby boomers born between 1946 and 1964 from the shire of Busselton, Western Australia. A randomized sample of noninstitutionalized baby-boomers listed on the electoral roll (n = 6690) and resident in the shire are eligible to participate. This study reports on data from the first 1004 attendees (53.5% female) with a mean age of 56.23 (SD = 5.43). Data from a self-report question on hearing loss and diagnostic pure tone audiometry was utilized for this study. Analysis included screening performance measures of self-report compared to audiometric cut-offs, receiver operator curve (ROC) to determine optimal level, analysis of variance to compare hearing status to self-report, and binary logistic regression to determine best audiometric predictors. Of the sample, 16% self-reported hearing loss (72.1% males). Logistic regression indicated 4000 Hz as the most important individual frequency related to self-report while the four-frequency average (500, 1000, 2000, and 4000 Hz) >25 dB in the worse ear was the most significant averaged cutoff with 68% sensitivity and 87% specificity. Of those who self-reported a hearing loss, 80% had either a four-frequency average hearing loss >25 dB in the worse ear or a high-frequency average (4000 and 8000 Hz) hearing loss greater than 35 dB in the worse ear. Baby boomer adults who self-report hearing impairment on direct inquiry are most likely to have a hearing loss. A simple question at a primary health care visit may facilitate a timely referral for audiological services in a baby boomer adult, who may be more amenable to rehabilitation. American Academy of Audiology.

Mastoiditis and facial paralysis as initial manifestations of temporal bone systemic diseases - the significance of the histopathological examination.

PubMed

Maniu, Alma Aurelia; Harabagiu, Oana; Damian, Laura Otilia; Ştefănescu, Eugen HoraŢiu; FănuŢă, Bogdan Marius; Cătană, Andreea; Mogoantă, Carmen Aurelia

2016-01-01

Several systemic diseases, including granulomatous and infectious processes, tumors, bone disorders, collagen-vascular and other autoimmune diseases may involve the middle ear and temporal bone. These diseases are difficult to diagnose when symptoms mimic acute otomastoiditis. The present report describes our experience with three such cases initially misdiagnosed. Their predominating symptoms were otological with mastoiditis, hearing loss, and subsequently facial nerve palsy. The cases were considered an emergency and the patients underwent tympanomastoidectomy, under the suspicion of otitis media with cholesteatoma, in order to remove a possible abscess and to decompress the facial nerve. The common features were the presence of severe granulation tissue filling the mastoid cavity and middle ear during surgery, without cholesteatoma. The definitive diagnoses was made by means of biopsy of the granulation tissue from the middle ear, revealing granulomatosis with polyangiitis (formerly known as Wegener's granulomatosis) in one case, middle ear tuberculosis and diffuse large B-cell lymphoma respectively. After specific associated therapy facial nerve functions improved, and atypical inflammatory states of the ear resolved. As a group, systemic diseases of the middle ear and temporal bone are uncommon, but aggressive lesions. After analyzing these cases and reviewing the literature, we would like to stress upon the importance of microscopic examination of the affected tissue, required for an accurate diagnosis and effective treatment.

Magnetically driven middle ear ossicles for optical measurement of vibrations in an ear with opened eardrum

NASA Astrophysics Data System (ADS)

Peacock, John; Von Unge, Magnus; Dirckx, Joris

2012-06-01

Vibrations of the middle ear ossicles are easily measured by means of laser vibrometry. However, exposing the ossicles requires the removal of the eardrum, with the result that the ossicles can no longer be stimulated acoustically. To overcome this we devised a new set up in which the ossicles can be driven magnetically. After measuring the response of the eardrum to an acoustic signal, we then remove the eardrum and attach a small magnet to the exposed manubrium (the part of the first auditory ossicle, the malleus, which is normally attached to the eardrum). An electromagnetic excitation coil is then used to drive the magnet, and the output to the coil adjusted until the vibration of the manubrium, as measured by the vibrometer, matches that measured in response to the acoustic signal. Such a set-up has uses in research on middle ear mechanics, such as the measurement of non-linearities in their response, as well as applications in the diagnosis of middle ear conditions such as the fixation of the ossicles by otosclerosis, or in chronic otitis media. We describe our set up in which the vibrometer unit is attached to a surgical microscope, offering accurate positioning of the laser beam. We discuss the viability of our method and its future potential by presenting some measurements on artificially fixated ears.

Not All Inner Ears are the Same: Otolith Matrix Proteins in the Inner Ear of Sub-Adult Cichlid Fish, Oreochromis Mossambicus, Reveal Insights Into the Biomineralization Process.

PubMed

Weigele, Jochen; Franz-Odendaal, Tamara A; Hilbig, Reinhard

2016-02-01

The fish ear stones (otoliths) consist mainly of calcium carbonate and have lower amounts of a proteinous matrix. This matrix consists of macromolecules, which directly control the biomineralization process. We analyzed the composition of this proteinous matrix by mass spectrometry in a shotgun approach. For this purpose, an enhanced protein purification technique was developed that excludes any potential contamination of proteins from body fluids. Using this method we identified eight proteins in the inner ear of Oreochromis mossambicus. These include the common otolith matrix proteins (OMP-1, otolin-1, neuroserpin, SPARC and otoconin), and three proteins (alpha tectorin, otogelin and transferrin) not previously localized to the otoliths. Moreover, we were able to exclude the occurrence of two matrix proteins (starmaker and pre-cerebellin-like protein) known from other fish species. In further analyses, we show that the absence of the OMP starmaker corresponds to calcitic otoliths and that pre-cerebellin-like protein is not present at any stage during the development of the otoliths of the inner ear. This study shows O. mossambicus does not have all of the known otolith proteins indicating that the matrix proteins in the inner ear of fish are not the same across species. Further functional studies of the novel proteins we identified during otolith development are required. © 2015 Wiley Periodicals, Inc.

Evolution and development of the vertebrate ear

NASA Technical Reports Server (NTRS)

Fritzsch, B.; Beisel, K. W.

2001-01-01

This review outlines major aspects of development and evolution of the ear, specifically addressing issues of cell fate commitment and the emerging molecular governance of these decisions. Available data support the notion of homology of subsets of mechanosensors across phyla (proprioreceptive mechanosensory neurons in insects, hair cells in vertebrates). It is argued that this conservation is primarily related to the specific transducing environment needed to achieve mechanosensation. Achieving this requires highly conserved transcription factors that regulate the expression of the relevant structural genes for mechanosensory transduction. While conserved at the level of some cell fate assignment genes (atonal and its mammalian homologue), the ear has also radically reorganized its development by implementing genes used for cell fate assignment in other parts of the developing nervous systems (e.g., neurogenin 1) and by evolving novel sets of genes specifically associated with the novel formation of sensory neurons that contact hair cells (neurotrophins and their receptors). Numerous genes have been identified that regulate morphogenesis, but there is only one common feature that emerges at the moment: the ear appears to have co-opted genes from a large variety of other parts of the developing body (forebrain, limbs, kidneys) and establishes, in combination with existing transcription factors, an environment in which those genes govern novel, ear-related morphogenetic aspects. The ear thus represents a unique mix of highly conserved developmental elements combined with co-opted and newly evolved developmental elements.

Microsurgical ear replantation-is venous repair necessary?-A systematic review.

PubMed

Momeni, Arash; Liu, Xiangxia; Januszyk, Michael; Wan, Derrick C; Buncke, Gregory M; Buntic, Rudolf F; Parrett, Brian M

2016-05-01

A common postoperative observation after microsurgical ear replantation has been venous congestion necessitating alternate modes of decongestion, frequently in conjunction with blood transfusion. A comprehensive literature search was performed to assess the relationship between mode of vascular reconstruction and postoperative outcome as well as postoperative transfusion requirement after microsurgical ear replantation. The search was limited to cases of microsurgical ear replantation following complete amputation. Only articles published in English and indexed in PubMed were included. The initial search retrieved 285 articles, which was narrowed down to 40 articles reporting on 60 cases that matched the aforementioned criteria. Reconstruction of the arterial and venous limb (Group 1) was performed in 63.3% of patients and artery-only anastomosis (Group 2) was performed in 31.7%. Among measurable outcomes, only the duration of surgery was significantly different between groups (2.6 hours longer in Group 1 than Group 2; P = 0.0042). In light of contemporary data demonstrating successful artery-only ear replantation, replantation should not be abandoned when unable to establish venous outflow microsurgically. © 2015 Wiley Periodicals, Inc. Microsurgery 36:345-350, 2016. © 2015 Wiley Periodicals, Inc.

78 FR 3319 - Amendments to Existing Validated End User Authorizations: Advanced Micro Devices China, Inc., Lam...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-16

...In this rule, the Bureau of Industry and Security (BIS) amends the Export Administration Regulations (EAR) to revise the existing Authorization Validated End-User (VEU) listings for four VEUs in the People's Republic of China (PRC). Specifically, BIS amends Supplement No. 7 to part 748 of the EAR to update VEU Advanced Micro Devices China Inc.'s (AMD China) current list of eligible destinations. BIS also amends the authorization of VEU Lam Research Corporation (Lam) by updating the addresses of ten eligible destinations and reformatting the list of Lam's existing eligible destinations into groups associated with specific eligible items. BIS also updates the EAR to amend the addresses and lists of eligible items for VEUs SK hynix Semiconductor (China) Ltd. and SK hynix Semiconductor (Wuxi) Ltd. Finally, BIS amends Supplement No. 7 to part 748 of the EAR to include language reminding exporters that the language in the Supplement does not supersede other requirements in the EAR. These amendments to the authorizations of the named VEUs are not the result of activities of concern. The respective changes were prompted by factors arising from the companies' normal course of business or are being done at the request of the companies.

Iodine Intakes of Victorian Schoolchildren Measured Using 24-h Urinary Iodine Excretion

PubMed Central

Beckford, Kelsey; Margerison, Claire; Skeaff, Sheila A.

2017-01-01

Mandatory fortification of bread with iodized salt was introduced in Australia in 2009, and studies using spot urine collections conducted post fortification indicate that Australian schoolchildren are now replete. However an accurate estimate of daily iodine intake utilizing 24-h urinary iodine excretion (UIE μg/day) has not been reported and compared to the estimated average requirement (EAR). This study aimed to assess daily total iodine intake and status of a sample of primary schoolchildren using 24-h urine samples. Victorian primary school children provided 24-h urine samples between 2011 and 2013, from which urinary iodine concentration (UIC, μg/L) and total iodine excretion (UIE, μg/day) as an estimate of intake was determined. Valid 24-h urine samples were provided by 650 children, mean (SD) age 9.3 (1.8) years (n = 359 boys). The mean UIE of 4–8 and 9–13 year olds was 94 (48) and 111 (57) μg/24-h, respectively, with 29% and 26% having a UIE below the age-specific EAR. The median (IQR) UIC was 124 (83,172) μg/L, with 36% of participants having a UIC < 100 μg/L. This convenience sample of Victorian schoolchildren were found to be iodine replete, based on UIC and estimated iodine intakes derived from 24-h urine collections, confirming the findings of the Australian Health Survey. PMID:28867787

Pre-season dietary intake of professional soccer players.

PubMed

Raizel, Raquel; da Mata Godois, Allan; Coqueiro, Audrey Yule; Voltarelli, Fabrício Azevedo; Fett, Carlos Alexandre; Tirapegui, Julio; de Paula Ravagnani, Fabricio Cesar; de Faria Coelho-Ravagnani, Christianne

2017-12-01

Despite the well-documented importance of nutrition in optimizing performance and health, the dietary intake of soccer players has attracted little attention. We aimed to assess the pre-season dietary intake of professional soccer players and its adequacy in macro and micronutrients. The pre-season dietary intake of 19 male athletes was assessed using a semi-structured 3-day food record. To determine dietary adequacy and excess, energy and macronutrient intake were compared with the Brazilian dietary reference values for athletes, and micronutrients were compared with the Estimated Average Requirement - EAR (minimum recommendation) and Tolerable Upper Intake Level - UL (maximum recommendation). Mean daily energy intake (40.74±12.81 kcal/kg) was adequate. However, there was a low carbohydrate intake (5.44±1.86 g/kg/day) and a high amount of protein and fat (1.91±0.75 and 1.27±0.50 g/kg/day, respectively). Sodium intake (3141.77±939.76 mg/day) was higher than UL (2300 mg/day), while the majority of players showed daily intake of vitamin A (74%), vitamin D (100%), folate (58%), calcium and magnesium (68%) below the EAR (625, 10 and 320 µg/day, 800 and 330 mg/day, respectively). The dietary intake of professional soccer players was adequate in energy, but inadequate in macro and micronutrients, which suggests the need to improve nutritional practices to sustain the physical demands of soccer during pre-season.

Facilitated citrate-dependent iron translocation increases rice endosperm iron and zinc concentrations.

PubMed

Wu, Ting-Ying; Gruissem, Wilhelm; Bhullar, Navreet K

2018-05-01

Iron deficiency affects one third of the world population. Most iron biofortification strategies have focused on genes involved in iron uptake and storage but facilitating internal long-distance iron translocation has been understudied for increasing grain iron concentrations. Citrate is a primary iron chelator, and the transporter FERRIC REDUCTASE DEFECTIVE 3 (FRD3) loads citrate into the xylem. We have expressed AtFRD3 in combination with AtNAS1 (NICOTIANAMINE SYNTHASE 1) and PvFER (FERRITIN) or with PvFER alone to facilitate long-distance iron transport together with efficient iron uptake and storage in the rice endosperm. The citrate and iron concentrations in the xylem sap of transgenic plants increased two-fold compared to control plants. Iron and zinc levels increased significantly in polished and unpolished rice grains to more than 70% of the recommended estimated average requirement (EAR) for iron and 140% of the recommended EAR for zinc in polished rice grains. Furthermore, the transformed lines showed normal phenotypic growth, were tolerant to iron deficiency and aluminum toxicity, and had grain cadmium levels similar to control plants. Together, our results demonstrate that deploying FRD for iron biofortification has no obvious anti-nutritive effects and should be considered as an effective strategy for reducing human iron deficiency anemia. Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.

A Simulation-Based Study on the Comparison of Statistical and Time Series Forecasting Methods for Early Detection of Infectious Disease Outbreaks.

PubMed

Yang, Eunjoo; Park, Hyun Woo; Choi, Yeon Hwa; Kim, Jusim; Munkhdalai, Lkhagvadorj; Musa, Ibrahim; Ryu, Keun Ho

2018-05-11

Early detection of infectious disease outbreaks is one of the important and significant issues in syndromic surveillance systems. It helps to provide a rapid epidemiological response and reduce morbidity and mortality. In order to upgrade the current system at the Korea Centers for Disease Control and Prevention (KCDC), a comparative study of state-of-the-art techniques is required. We compared four different temporal outbreak detection algorithms: the CUmulative SUM (CUSUM), the Early Aberration Reporting System (EARS), the autoregressive integrated moving average (ARIMA), and the Holt-Winters algorithm. The comparison was performed based on not only 42 different time series generated taking into account trends, seasonality, and randomly occurring outbreaks, but also real-world daily and weekly data related to diarrhea infection. The algorithms were evaluated using different metrics. These were namely, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), F1 score, symmetric mean absolute percent error (sMAPE), root-mean-square error (RMSE), and mean absolute deviation (MAD). Although the comparison results showed better performance for the EARS C3 method with respect to the other algorithms, despite the characteristics of the underlying time series data, Holt⁻Winters showed better performance when the baseline frequency and the dispersion parameter values were both less than 1.5 and 2, respectively.

[Temporal rotation skin flap combined with cartilage plasty for correcting cryptotia].

PubMed

Li, Gaofeng; Luo, Tao; Ding, Wei; Ouyang, Huawei; Liu, Wanli; Tan, Jun

2014-01-01

To explore the therapeutic effect of the temporal rotation flap combined with cartilage plasty for cryptotia correction. From January 2009 to June 2012, 8 cases with cryptotia (10 ears) were treated. After complete dissection of the cartilage adhesion, the cartilage was reshaped by suture to restore its appearance. Then the temporal triangular rotation flap was transferred to cover the wound. No hematoma, infection or flap necrosis happened. The follow-up period ranged from 3 months to 1 year, with an average of (6.88 +/- 2.85) months. The ear appearance kept stable with no recurrence and inconspicuous scar. Satisfactory result was achieved. Temporal rotation flap combined with cartilage plasty is a good option for correction of mild or moderate cryptotia.

Pressure generation during neural stimulation with infrared radiation

NASA Astrophysics Data System (ADS)

Xia, N.; Tan, X.; Xu, Y.; Richter, C.-P.

2017-02-01

This study quantifies laser evoked pressure waves in small confined volumes such as a small dish or the cochlea. The pressure was measured with custom fabricated pressure probes in front of the optical fiber. For the pressure measurements during laser stimulation the probes were inserted into scala tympani or vestibuli. At 164 μJ/pulse, the intracochlear pressure was between 96 and 106 dB (re 20 μPa). The pressure was also measured in the ear canal with a sensitive microphone. It was on average 63 dB (re 20 μPa). At radiant energies large enough to evoke an auditory compound action potential, the outer ear canal equivalent pressure was 36-56 dB (re 20 μPa).

Hearing gain with a BAHA test-band in patients with single-sided deafness.

PubMed

Kim, Do-Youn; Kim, Tae Su; Shim, Byoung Soo; Jin, In Suk; Ahn, Joong Ho; Chung, Jong Woo; Yoon, Tae Hyun; Park, Hong Ju

2014-01-01

It is assumed that preoperative use of a bone-anchored hearing aid (BAHA) test-band will give a patient lower gain compared to real post-operative gain because of the reduction of energy through the scalp when using a test-band. Hearing gains using a BAHA test-band were analyzed in patients with unilateral hearing loss. Nineteen patients with unilateral sensorineural hearing loss were enrolled. A test-band, which was connected to BAHA Intenso with full-on gain, was put on the mastoid. Conventional air-conduction (AC) pure-tone averages (PTAs) and sound-field PTAs and speech reception thresholds (SRTs) were obtained in conditions A (the better ear naked), B (the better ear plugged), and C (the better ear plugged with a test-band on the poorer mastoid). Air-conduction PTAs of the poorer and better ears were 91 ± 19 and 18 ± 8 dB HL. Sound-field PTAs in condition B were higher than those in condition A (54 vs. 26 dB HL), which means that earplugs can block the sound grossly up to 54 dB HL through the better ears. The aided PTAs (24 ± 6 dB HL) in condition C were similar to those of the better ears in condition A (26±9 dB HL), though condition C showed higher thresholds at 500 Hz and lower thresholds at 1 and 2kHz when compared to condition A. The hearing thresholds using a test-band were similar to the published results of BAHA users with the volume to most comfortable level (MCL). Our findings showed that a BAHA test-band on the poorer ear could transmit sound to the cochlea as much as the better ears can hear. The increased functional gain at 1 and 2kHz reflects the technical characteristics of BAHA processor. The reduction of energy through the scalp when using a test-band seems to be offset by the difference of output by setting the volume to full-on gain and using a high-powered speech processor. Preoperative hearing gains using a test-band with full-on gain seems to be similar to the post-operative gains of BAHA users with the volume to MCL. © 2013.

Caloric Analysis of Patients with Benign Paroxysmal Positional Vertigo.

PubMed

Yetişer, Sertaç; İnce, Dilay

2017-12-01

The aim of this study is to compare nystagmus characteristics after caloric irrigation in patients with lateral canal (LC) and posterior canal (PC) benign paroxysmal positional vertigo (BPPV) and to analyze the role of symptom duration. A prospective study was conducted in 65 patients with BPPV (20 LC and 45 PC) who were subjected to caloric testing. Average slow-phase velocity and nystagmus duration were analyzed. Caloric hypo-excitability was 20.4%. It was more evident in patients with apogeotropic-type LC-BPPV. The comparison of average slow-phase velocity of the nystagmus and nystagmus duration between selected types of BPPV for pathologic, non-pathologic, and the control ears after warm and cold stimulation was not statistically significant (p>0.05). No correlation was found between caloric results and symptom duration (p>0.05). Some patients presented caloric hypo-excitability. Reliability of caloric testing to differentiate the ear with normal and abnormal vestibular function in different types of BPPV was low. No difference was found in the analysis of the impact of symptom duration. Caloric testing is not an ideal tool to study BPPV.

The effect of mobile phone to audiologic system.

PubMed

Kerekhanjanarong, Virachai; Supiyaphun, Pakpoom; Naratricoon, Jantra; Laungpitackchumpon, Prinya

2005-09-01

Mobile phones have come into widespread use. There are a lot of possible adverse effect to health. Use of mobile phone generate potentially harmful radiofrequency electromagnetic field (EMF) particularly for the hearing aspect. 98 subjects underwent hearing evaluations at Department of Otolaryngology, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University. 31 males and 67females, mean age was 30.48 +/- 9.51 years old, all subjects were investigated the hearing level by audiometry, tympanometry, otoacoustic emission (OAE) and auditory brain stem evoked response (ABR). The average of using time were 32.54 +/- 27.64 months, 57 subjects usually used the right side and 41 the left side. Average time of use per day was 26.31 +/- 30.91 minutes (range from 3 to 180 mins). When the authors compared the audiogram, both pure tone and speech audiometry, between the dominant and nondominant side, it indicated that there is no significant different. When the authors focused on the 8 subjects that used the mobile phone more than 60 mins per day. It indicated that the hearing threshold of the dominant ears was worse than the nondominant ears.

Fetal development of the elastic-fiber-mediated enthesis in the human middle ear.

PubMed

Takanashi, Yoshitaka; Shibata, Shunichi; Katori, Yukio; Murakami, Gen; Abe, Shinichi; Rodríguez-Vázquez, Jose Francisco; Kawase, Tetsuaki

2013-10-01

In the human middle ear, the annular ligament of the incudostapedial joint and the insertions of the tensor tympani and stapedius muscles contain abundant elastic fibers; i.e., the elastic-fiber-mediated entheses. Hyaluronan also coexists with the elastic fibers. In the present study using immunohistochemistry, we demonstrated the distribution of elastin not only in the incudostapedial joint but also in the other two joints of the middle ear in adults and fetuses. In adults, the expression of elastin did not extend out of the annular ligament composed of mature elastic fibers but clearly overlapped with it. Electron microscopic observations of the annular ligament demonstrated a few microfibrils along the elastic fibers. Thus, in contrast to the vocal cord, the middle ear entheses seemed not to contain elaunin and oxytalan fibers. In mid-term fetuses (at approximately 15-16 weeks of gestation) before opening of the external acoustic meatus, the incudostapedial joint showed abundant elastic fibers, but the incudomalleolar and stapediovestibular joints did not. At this stage, hyaluronan was not colocalized, but distributed diffusely in loose mesenchymal tissues surrounding the ear ossicles. Therefore, fetal development of elastin and elastic fibers in the middle ear entheses is unlikely to require acoustic oscillation. In late-stage fetuses (25-30 weeks), whose ear ossicles were almost the same size as those in adults, we observed bundling and branching of elastic fibers. However, hyaluronan expression was not as strong as in adults. Colocalization between elastic fibers and hyaluronan appeared to be a result of postnatal maturation of the entheses. Copyright © 2013 Elsevier GmbH. All rights reserved.

Isolation and characterization of the progenitor cells from the blastema tissue formed at experimentally-created rabbit ear hole.

PubMed

Baghaban Eslaminejad, Mohamadreza; Bordbar, Sima

2013-02-01

Objective(s) : Throughout evolution, mammalians have increasingly lost their ability to regenerate structures however rabbits are exceptional since they develop a blastema in their ear wound for regeneration purposes. Blastema consists of a group of undifferentiated cells capable of dividing and differentiating into the ear tissue. The objective of the present study is to isolate, culture expand, and characterize blastema progenitor cells in terms of their in vitro differentiation capacity. Five New Zealand white male rabbits were used in the present study. Using a punching apparatus, a 4-mm hole was created in the animal ears. Following 4 days, the blastema ring which was created in the periphery of primary hole in the ears was removed and cultivated. The cells migrated from the blastema were expanded through 3 successive subcultures and characterized in terms of their potential differentiation, growth characteristics, and culture requirements. The primary cultures tended to be morphologically heterogeneous having spindly-shaped fibroblast-like cells as well as flattened cells. Fibroblast-like cells survived and dominated the cultures. These cells tended to have the osteogenic, chondrogenic, and adipogenic differentiation potentials. They were highly colonogenic and maximum proliferation was achieved when the cells were plated at density of 100 cells/cm2 in a medium which contained 10% fetal bovine serum (FBS). Taken together, blastema tissue-derived stem cells from rabbit ear are of mesenchymal stem cell-like population. Studies similar to this will assist scientist better understanding the nature of blastema tissue formed at rabbit ear to regenerate the wound.

Prevalence of otitis media and risk-factors for sensorineural hearing loss among infants attending Child Welfare Clinics in the Solomon Islands.

PubMed

Kaspar, Annette; Newton, Obiga; Kei, Joseph; Driscoll, Carlie; Swanepoel, De Wet; Goulios, Helen

2018-08-01

The present study aimed to assess the prevalence of otitis media and risk-factors for sensorineural hearing loss among infants in the Solomon Islands, in order to recommend an Infant Ear and Hearing Program that would be suitable to the Pacific Island context. Ear examinations and the JCIH Risk-Factor Questionnaire were administered to 288 infants attending Child Welfare Clinics in the Solomon Islands. Overall, 150 infants (52.084%) presented with bilateral normal ear examinations and no risk-factors for SNHL. There were 73 infants (25.34%) with ear pathology in at least one ear, 13 (4.5%) of whom required referral to the ENT Clinic for medical management. The most common pathology was otitis media with effusion (OME) (21.87%). Infants aged 7-12 months were significantly more likely to present with OME (p<0.001) and a history of otitis media (p=0.017) than infants aged 0-6 months. There were 71 infants (24.65%) with at least one risk-factor for sensorineural hearing loss. The most common risk-factors were ototoxicity (8.3%), non-elective caesarean delivery (6.59%), and possible in-utero syphilis infection (5.55%). The prevalence of otitis media and risk-factors for sensorineural hearing loss indicate the importance of initiating Infant Ear and Hearing Programs in the Solomon Islands. Program should facilitate early education on prevention of ear disease, as well as early diagnosis and management of children with hearing loss. Copyright © 2018. Published by Elsevier B.V.

Cochlear Implant Outcomes and Genetic Mutations in Children with Ear and Brain Anomalies

PubMed Central

Busi, Micol; Rosignoli, Monica; Minazzi, Federica; Trevisi, Patrizia; Aimoni, Claudia; Calzolari, Ferdinando; Martini, Alessandro

2015-01-01

Background. Specific clinical conditions could compromise cochlear implantation outcomes and drastically reduce the chance of an acceptable development of perceptual and linguistic capabilities. These conditions should certainly include the presence of inner ear malformations or brain abnormalities. The aims of this work were to study the diagnostic value of high resolution computed tomography (HRCT) and magnetic resonance imaging (MRI) in children with sensorineural hearing loss who were candidates for cochlear implants and to analyse the anatomic abnormalities of the ear and brain in patients who underwent cochlear implantation. We also analysed the effects of ear malformations and brain anomalies on the CI outcomes, speculating on their potential role in the management of language developmental disorders. Methods. The present study is a retrospective observational review of cochlear implant outcomes among hearing-impaired children who presented ear and/or brain anomalies at neuroimaging investigations with MRI and HRCT. Furthermore, genetic results from molecular genetic investigations (GJB2/GJB6 and, additionally, in selected cases, SLC26A4 or mitochondrial-DNA mutations) on this study group were herein described. Longitudinal and cross-sectional analysis was conducted using statistical tests. Results. Between January 1, 1996 and April 1, 2012, at the ENT-Audiology Department of the University Hospital of Ferrara, 620 cochlear implantations were performed. There were 426 implanted children at the time of the present study (who were <18 years). Among these, 143 patients (64 females and 79 males) presented ear and/or brain anomalies/lesions/malformations at neuroimaging investigations with MRI and HRCT. The age of the main study group (143 implanted children) ranged from 9 months and 16 years (average = 4.4; median = 3.0). Conclusions. Good outcomes with cochlear implants are possible in patients who present with inner ear or brain abnormalities, even if central nervous system anomalies represent a negative prognostic factor that is made worse by the concomitant presence of cochlear malformations. Common cavity and stenosis of the internal auditory canal (less than 2 mm) are negative prognostic factors even if brain lesions are absent. PMID:26236732

Cochlear Implant Outcomes and Genetic Mutations in Children with Ear and Brain Anomalies.

PubMed

Busi, Micol; Rosignoli, Monica; Castiglione, Alessandro; Minazzi, Federica; Trevisi, Patrizia; Aimoni, Claudia; Calzolari, Ferdinando; Granieri, Enrico; Martini, Alessandro

2015-01-01

Specific clinical conditions could compromise cochlear implantation outcomes and drastically reduce the chance of an acceptable development of perceptual and linguistic capabilities. These conditions should certainly include the presence of inner ear malformations or brain abnormalities. The aims of this work were to study the diagnostic value of high resolution computed tomography (HRCT) and magnetic resonance imaging (MRI) in children with sensorineural hearing loss who were candidates for cochlear implants and to analyse the anatomic abnormalities of the ear and brain in patients who underwent cochlear implantation. We also analysed the effects of ear malformations and brain anomalies on the CI outcomes, speculating on their potential role in the management of language developmental disorders. The present study is a retrospective observational review of cochlear implant outcomes among hearing-impaired children who presented ear and/or brain anomalies at neuroimaging investigations with MRI and HRCT. Furthermore, genetic results from molecular genetic investigations (GJB2/GJB6 and, additionally, in selected cases, SLC26A4 or mitochondrial-DNA mutations) on this study group were herein described. Longitudinal and cross-sectional analysis was conducted using statistical tests. Between January 1, 1996 and April 1, 2012, at the ENT-Audiology Department of the University Hospital of Ferrara, 620 cochlear implantations were performed. There were 426 implanted children at the time of the present study (who were <18 years). Among these, 143 patients (64 females and 79 males) presented ear and/or brain anomalies/lesions/malformations at neuroimaging investigations with MRI and HRCT. The age of the main study group (143 implanted children) ranged from 9 months and 16 years (average = 4.4; median = 3.0). Good outcomes with cochlear implants are possible in patients who present with inner ear or brain abnormalities, even if central nervous system anomalies represent a negative prognostic factor that is made worse by the concomitant presence of cochlear malformations. Common cavity and stenosis of the internal auditory canal (less than 2 mm) are negative prognostic factors even if brain lesions are absent.

Ear-lobe keloids: treatment by a protocol of surgical excision and immediate postoperative adjuvant radiotherapy.

PubMed

Ragoowansi, R; Cornes, P G; Glees, J P; Powell, B W; Moss, A L

2001-09-01

There is no universally agreed policy for treating keloid scars of the ear lobe following piercing. We treated 35 patients (34 women) for high-risk ear-lobe keloids; the average age was 24 years (range: 16-44 years). All had failed to respond to prior treatment with massage and silicone, and corticosteroid injection. The keloids were excised extralesionally and the defects were closed with interrupted prolene sutures. The operative scar was covered with topical 2% lignocaine-0.25% chlorhexidine sterile lubricant gel under a transparent adhesive dressing. Adjuvant postoperative radiotherapy of 10 Gy, applied as 100 kV photons (4 mm high-voltage therapy (HVT) Al), was given within 24 h of surgery. All keloid scars were controlled at 4 weeks' follow-up. At 1 year, three out of 34 cases followed up had relapsed (probability of control: 91.2%). At 5 years, a further four out of the remaining 31 patients had relapsed (cumulative probability of control at 5 years: 79.4%). There were no cases of serious toxicity. Copyright 2001 The British Association of Plastic Surgeons.

On the frequency dependence of the otoacoustic emission latency in hypoacoustic and normal ears

NASA Astrophysics Data System (ADS)

Sisto, R.; Moleti, A.

2002-01-01

Experimental measurements of the otoacoustic emission (OAE) latency of adult subjects have been obtained, as a function of frequency, by means of wavelet time-frequency analysis based on the iterative application of filter banks. The results are in agreement with previous OAE latency measurements by Tognola et al. [Hear. Res. 106, 112-122 (1997)], as regards both the latency values and the frequency dependence, and seem to be incompatible with the steep 1/f law that is predicted by scale-invariant full cochlear models. The latency-frequency relationship has been best fitted to a linear function of the cochlear physical distance, using the Greenwood map, and to an exponential function of the cochlear distance, for comparison with derived band ABR latency measurements. Two sets of ears [94 audiometrically normal and 42 impaired with high-frequency (f>3 kHz) hearing loss] have been separately analyzed. Significantly larger average latencies were found in the impaired ears in the mid-frequency range. Theoretical implications of these findings on the transmission of the traveling wave are discussed.

Use of rapid prototyping in prosthetic auricular restoration.

PubMed

Turgut, Gursel; Sacak, Bulent; Kiran, Kazim; Bas, Lutfu

2009-03-01

Reconstructing auricular defects is a challenging task for facial reconstructive surgeons. Although autologous reconstruction is the first choice for reconstruction, there may be circumstances of inconvenience such as previously attempted surgery, radiotherapy, systemic conditions, or patient's wish. Auricular restorations with facial prosthesis have produced promising results, but there are still problems to be tackled for improved results. Rapid prototyping in the production of an auricular prosthesis uses the mirror image of contralateral ear and produces excellent forms, eliminating the subjective perception of the prosthodontist. Rapid prototyping also lowers the production costs by reducing the need for several sessions in the process of producing the prostheses. Between 2004 and 2007, 10 patients applied to our department with the absence of an ear on a single side. All patients were male, with an average age of 23.1 years. The etiology for the loss of the ear was mostly tumors, followed by congenital deformities and trauma, respectively. In this study, we present our application of rapid prototyping technique and report our case series of 10 patients, two of which are presented in detail.

Long-term consequences of Sox9 depletion on inner ear development

PubMed Central

Park, Byung-Yong; Saint-Jeannet, Jean-Pierre

2010-01-01

The transcription factor Sox9 has been implicated in inner ear formation in several species. To investigate the long-term consequences of Sox9 depletion on inner ear development we analyzed the inner ear architecture of Sox9-depleted Xenopus tadpoles generated by injection of increasing amounts of Sox9 morpholino antisense oligonucleotides. We found that Sox9-depletion resulted in major defects in the development of vestibular structures, semicircular canals and utricle, while the ventrally located saccule was less severely affected in these embryos. Consistent with this phenotype we observed a specific loss of the dorsal expression of Wnt3a expression in the otic vesicle of Sox9 morphants, associated with an increase in cell death and a reduction in cell proliferation in the region of the presumptive otic epithelium. We propose that in addition to its early role in placode specification, Sox9 is also required for the maintenance of progenitors in the otic epithelium. PMID:20201105

Canal wall reconstruction and preservation in the surgical management of cholesteatoma in children with Down's syndrome.

PubMed

Nash, Robert; Possamai, Victoria; Maskell, Scott; Bailey, Martin; Albert, David

2014-10-01

Down's syndrome is associated with poor Eustachian tube function, and an increased incidence of cholesteatoma. The only previously published case series suggests that 'canal wall preserving' procedures are only rarely suitable for the management of cholesteatoma in this population. We conducted a retrospective review of the hospital's clinical records database to identify patients with Down's syndrome and cholesteatoma. These patients' notes were then reviewed. We identified nine patients with Down's syndrome who had undergone surgical management of cholesteatoma over a twelve year period. Three patients had bilateral disease, meaning twelve ears were treated. Seven ears were initially treated with 'canal wall down' procedures. Four out of five of the remaining ears were successfully treated using 'canal wall preservation' or 'canal wall reconstruction', with one ear requiring subsequent conversion to a 'canal wall down' approach. Canal wall preservation/reconstruction is feasible in patients with Down's syndrome, even when cholesteatoma extends into the mastoid. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Analysis of Output Levels of an MP3 Player: Effects of Earphone Type, Music Genre, and Listening Duration.

PubMed

Shim, Hyunyong; Lee, Seungwan; Koo, Miseung; Kim, Jinsook

2018-02-26

To prevent noise induced hearing losses caused by listening to music with personal listening devices for young adults, this study was aimed to measure output levels of an MP3 and to identify preferred listening levels (PLLs) depending on earphone types, music genres, and listening durations. Twenty-two normal hearing young adults (mean=18.82, standard deviation=0.57) participated. Each participant was asked to select his or her most PLLs when listened to Korean ballade or dance music with an earbud or an over-the-ear earphone for 30 or 60 minutes. One side of earphone was connected to the participant's better ear and the other side was connected to a sound level meter via a 2 or 6 cc-couplers. Depending on earphone types, music genres, and listening durations, loudness A-weighted equivalent (LAeq) and loudness maximum time-weighted with A-frequency sound levels in dBA were measured. Neither main nor interaction effects of the PLLs among the three factors were significant. Overall output levels of earbuds were about 10-12 dBA greater than those of over-the-ear earphones. The PLLs were 1.73 dBA greater for earbuds than over-the-ear earphones. The average PLL for ballad was higher than for dance music. The PLLs at LAeq for both music genres were the greatest at 0.5 kHz followed by 1, 0.25, 2, 4, 0.125, 8 kHz in the order. The PLLs were not different significantly when listening to Korean ballad or dance music as functions of earphone types, music genres, and listening durations. However, over-the-ear earphones seemed to be more suitable to prevent noise induce hearing loss when listening to music, showing lower PLLs, possibly due to isolation from the background noise by covering ears.

Proton Minibeam Radiation Therapy Reduces Side Effects in an In Vivo Mouse Ear Model

DOE Office of Scientific and Technical Information (OSTI.GOV)

Girst, Stefanie, E-mail: stefanie.girst@unibw.de; Greubel, Christoph; Reindl, Judith

Purpose: Proton minibeam radiation therapy is a novel approach to minimize normal tissue damage in the entrance channel by spatial fractionation while keeping tumor control through a homogeneous tumor dose using beam widening with an increasing track length. In the present study, the dose distributions for homogeneous broad beam and minibeam irradiation sessions were simulated. Also, in an animal study, acute normal tissue side effects of proton minibeam irradiation were compared with homogeneous irradiation in a tumor-free mouse ear model to account for the complex effects on the immune system and vasculature in an in vivo normal tissue model. Methods andmore » Materials: At the ion microprobe SNAKE, 20-MeV protons were administered to the central part (7.2 × 7.2 mm{sup 2}) of the ear of BALB/c mice, using either a homogeneous field with a dose of 60 Gy or 16 minibeams with a nominal 6000 Gy (4 × 4 minibeams, size 0.18 × 0.18 mm{sup 2}, with a distance of 1.8 mm). The same average dose was used over the irradiated area. Results: No ear swelling or other skin reactions were observed at any point after minibeam irradiation. In contrast, significant ear swelling (up to fourfold), erythema, and desquamation developed in homogeneously irradiated ears 3 to 4 weeks after irradiation. Hair loss and the disappearance of sebaceous glands were only detected in the homogeneously irradiated fields. Conclusions: These results show that proton minibeam radiation therapy results in reduced adverse effects compared with conventional homogeneous broad-beam irradiation and, therefore, might have the potential to decrease the incidence of side effects resulting from clinical proton and/or heavy ion therapy.« less

[Effect of the middle ear status on the recording of vestibular evoked myogenic potential--VEMP].

PubMed

Kurzyna, Agnieszka; Hassmann-Poznańska, Elzbieta; Topolska, Małgorzata Maria

2004-01-01

The aim of this study was to assess the effect of age on the recording of air- and bone-conducted vestibular evoked myogenic potential. Forty six young subjects were included in the study, ranging in age from 4 to 18 years. All of them underwent otoscopy, pure tone audiometry, tympanometry and air- and bone-conducted VEMP in response to click. Eighty six ears with normal hearing (pure tone average 20 dB) and type A and C1 tympanogram were studied. There were 2 groups according to age: group I--children aged 4-10 years--52 ears, group II--young subjects aged 11-18 years--34 ears. The threshold, the presence of correct waveform morphology of the response and the latency were evaluated. Above parameters were examined at 95 dB and 100 dB (nHL) air conducted click intensity and 60 dB (nHL) bone conducted click intensity. The age has no significant effect on the percentage of the recording of VEMP and the level of the response threshold with air stimulation, based on the performed studies. However, the age has effect on the prolongation of latency p13 and n23 both with air and bone stimulation. We paid attention to the lower percentage of the recording of bone-conducted VEMP in young subjects aged 11-18 years.

Trends in cochlear implants.

PubMed

Zeng, Fan-Gang

2004-01-01

More than 60,000 people worldwide use cochlear implants as a means to restore functional hearing. Although individual performance variability is still high, an average implant user can talk on the phone in a quiet environment. Cochlear-implant research has also matured as a field, as evidenced by the exponential growth in both the patient population and scientific publication. The present report examines current issues related to audiologic, clinical, engineering, anatomic, and physiologic aspects of cochlear implants, focusing on their psychophysical, speech, music, and cognitive performance. This report also forecasts clinical and research trends related to presurgical evaluation, fitting protocols, signal processing, and postsurgical rehabilitation in cochlear implants. Finally, a future landscape in amplification is presented that requires a unique, yet complementary, contribution from hearing aids, middle ear implants, and cochlear implants to achieve a total solution to the entire spectrum of hearing loss treatment and management.

[Reference values of folic acid for the Venezuelan population].

PubMed

García-Casal, María Nieves; Carias, Diamela; Soto de Sanabria, Ingrid; Victoria López, Ana

2013-12-01

The review on folic acid requirements for Venezuela comprise the definitions adopted worldwide known as Dietary Reference Intakes (DRIs) that include Recommended Dietary Allowance (RDA), Estimated Average Requirement (EAR), Adequate Intake (AI) and Tolerable Upper Intake Levels (UL). In contrast with the situation in some countries, that required adjustments in fortification policies in order to avoid excessive folic acid consumption, in Venezuela several studies show an elevated prevalence of deficiency. National evidence at this point is insufficient to establish the recommendation, and as in the 2000 review of the Venezuelan RDAs, the actual recommendations are based on the reported for the United States population. The Recommended Dietary Allowances for Venezuela are 65-80 microg/day for infants less than 1 year old, 150-300 microg/day for children and 400 microg/day for adolescents and adults, increasing to 600 microg/day during pregnancy and to 500 microg/day during lactation. The estimated average requirement is 120-250 microg/day for children, 330 microg/day for adolescents, 320 microg/day for adults, 520 microg/day for pregnancy and 450 microg/day during lactation. The tolerable upper intake levels for folic acid are 300-600 microg/day for children, 800 microg/day for adolescents and 1000 microg/day for adults. During pregnancy and lactation the UL is 800 microg/day for pregnant and lactating women between 14 and 18 years of age, and 1000 microg/day for older pregnant and lactating women. The continuous evaluation of folic acid status is important to design adequate and efficient policies to control both, the deficiency and the excess of folic acid consumption.

Diabetes and Hearing Impairment in the United States: Audiometric Evidence from the National Health and Nutrition Examination Surveys, 1999–2004

PubMed Central

Bainbridge, Kathleen E.; Hoffman, Howard J.; Cowie, Catherine C.

2008-01-01

Background The vasculature and neural system of the inner ear may be affected by diabetes. Objective To determine whether hearing impairment is more prevalent among U.S. adults with diabetes than among those without diabetes. Design Cross-sectional analysis of nationally representative data. Setting National Health and Nutrition Examination Survey, 1999–2004. Participants 5140 non-institutionalized adults aged 20–69 years who underwent audiometric testing. Measurements Hearing impairment assessed from the pure tone average of thresholds over low/mid frequencies (500, 1000, 2000 Hz) and high frequencies (3000, 4000, 6000, 8000 Hz), and defined for mild or greater severity (pure tone average > 25 decibels hearing level (dB HL)) and moderate or greater severity (pure tone average > 40 dB HL). Results For low/mid frequency hearing impairment of mild or greater severity assessed in the worse ear, age-adjusted prevalence estimates (95% confidence limits) were 21.3% (15.0, 27.5) among 399 adults with diabetes and 9.4% (8.2, 10.5) among 4741 adults without diabetes. For high frequency hearing impairment of mild or greater severity assessed in the worse ear, age-adjusted prevalence estimates were 54.1% (45.9, 62.3) among those with diabetes and 32.0% (30.5, 33.5) among those without. Adjusted odds ratios (95% confidence limits) of 1.82 (1.27, 2.60) and 2.16 (1.47, 3.18) for the low/mid frequency and high frequency impairments, respectively, indicated that differences in socio-demographic characteristics, noise exposure, ototoxic medication use, and smoking did not account for the association between diabetes and hearing impairment. Limitations Diagnosed diabetes was based on self-report and does not distinguish between type 1 and type 2 diabetes. Noise exposure assessments were based on participant recall. Conclusion Adults with diabetes have a higher occurrence of hearing impairment than those without diabetes. Screening for this problem would allow for interventions to improve hearing. PMID:18559825

The LuxS/AI-2 Quorum-Sensing System of Streptococcus pneumoniae Is Required to Cause Disease, and to Regulate Virulence- and Metabolism-Related Genes in a Rat Model of Middle Ear Infection.

PubMed

Yadav, Mukesh K; Vidal, Jorge E; Go, Yoon Y; Kim, Shin H; Chae, Sung-Won; Song, Jae-Jun

2018-01-01

Objective: Streptococcus pneumoniae colonizes the nasopharynx of children, and from nasopharynx it could migrate to the middle ear and causes acute otitis media (AOM). During colonization and AOM, the pneumococcus forms biofilms. In vitro biofilm formation requires a functional LuxS/AI-2 quorum-sensing system. We investigated the role of LuxS/AI-2 signaling in pneumococcal middle ear infection, and identified the genes that are regulated by LuxS/AI-2 during pneumococcal biofilm formation. Methods: Streptococcus pneumoniae D39 wild-type and an isogenic D39Δ luxS strain were utilized to evaluate in vitro biofilm formation, and in vivo colonization and epithelial damage using a microtiter plate assay and a rat model of pneumococcal middle ear infection, respectively. Biofilm structures and colonization and epithelial damage were evaluated at the ultrastructural level by scanning electron microscopy and confocal microscopy. Microarrays were used to investigate the global genes that were regulated by LuxS/AI-2 during biofilm formation. Results: The biofilm biomass and density of D39Δ luxS were significantly ( p < 0.05) lower than those of D39 wild-type. SEM and confocal microscopy revealed that D39Δ luxS formed thin biofilms in vitro compared with D39 wild-type. The in vivo model of middle ear infection showed that D39Δ luxS resulted in ~60% less ( p < 0.05) bacterial colonization than the wild-type. SEM analysis of the rat middle ears revealed dense biofilm-like cell debris deposited on the cilia in wild-type D39-infected rats. However, little cell debris was deposited in the middle ears of the D39Δ luxS -inoculated rats, and the cilia were visible. cDNA-microarray analysis revealed 117 differentially expressed genes in D39Δ luxS compared with D39 wild-type. Among the 66 genes encoding putative proteins and previously characterized proteins, 60 were significantly downregulated, whereas 6 were upregulated. Functional annotation revealed that genes involved in DNA replication and repair, ATP synthesis, capsule biosynthesis, cell division, the cell cycle, signal transduction, transcription regulation, competence, virulence, and carbohydrate metabolism were downregulated in the absence of LuxS/AI-2. Conclusion: The S. pneumoniae LuxS/AI-2 quorum-sensing system is necessary for biofilm formation and the colonization of the ear epithelium, and caused middle ear infection in the rat model. LuxS/AI-2 regulates the expression of the genes involved in virulence and bacterial fitness during pneumococcal biofilm formation.

Hair cell regeneration

PubMed Central

Edge, Albert SB; Chen, Zheng-Yi

2017-01-01

The mammalian inner ear largely lacks the capacity to regenerate hair cells, the sensory cells required for hearing and balance. Recent studies in both lower vertebrates and mammals have uncovered genes and pathways important in hair cell development and have suggested ways that the sensory epithelia could be manipulated to achieve hair cell regeneration. These approaches include the use of inner ear stem cells, transdifferentiation of nonsensory cells, and induction of a proliferative response in the cells that can become hair cells. PMID:18929656

Requirement for Jagged1-Notch2 signaling in patterning the bones of the mouse and human middle ear.

PubMed

Teng, Camilla S; Yen, Hai-Yun; Barske, Lindsey; Smith, Bea; Llamas, Juan; Segil, Neil; Go, John; Sanchez-Lara, Pedro A; Maxson, Robert E; Crump, J Gage

2017-05-31

Whereas Jagged1-Notch2 signaling is known to pattern the sensorineural components of the inner ear, its role in middle ear development has been less clear. We previously reported a role for Jagged-Notch signaling in shaping skeletal elements derived from the first two pharyngeal arches of zebrafish. Here we show a conserved requirement for Jagged1-Notch2 signaling in patterning the stapes and incus middle ear bones derived from the equivalent pharyngeal arches of mammals. Mice lacking Jagged1 or Notch2 in neural crest-derived cells (NCCs) of the pharyngeal arches display a malformed stapes. Heterozygous Jagged1 knockout mice, a model for Alagille Syndrome (AGS), also display stapes and incus defects. We find that Jagged1-Notch2 signaling functions early to pattern the stapes cartilage template, with stapes malformations correlating with hearing loss across all frequencies. We observe similar stapes defects and hearing loss in one patient with heterozygous JAGGED1 loss, and a diversity of conductive and sensorineural hearing loss in nearly half of AGS patients, many of which carry JAGGED1 mutations. Our findings reveal deep conservation of Jagged1-Notch2 signaling in patterning the pharyngeal arches from fish to mouse to man, despite the very different functions of their skeletal derivatives in jaw support and sound transduction.

15 CFR 762.4 - Original records required.

Code of Federal Regulations, 2012 CFR

2012-01-01

... to rely on that record to meet the recordkeeping requirements of the EAR, that person must retain the... print out of the complete document is deemed to be an original record for purposes of this section. [61...

15 CFR 762.4 - Original records required.

Code of Federal Regulations, 2011 CFR

2011-01-01

... to rely on that record to meet the recordkeeping requirements of the EAR, that person must retain the... print out of the complete document is deemed to be an original record for purposes of this section. [61...

15 CFR 762.4 - Original records required.

Code of Federal Regulations, 2013 CFR

2013-01-01

... to rely on that record to meet the recordkeeping requirements of the EAR, that person must retain the... print out of the complete document is deemed to be an original record for purposes of this section. [61...

15 CFR 762.4 - Original records required.

Code of Federal Regulations, 2014 CFR

2014-01-01

... to rely on that record to meet the recordkeeping requirements of the EAR, that person must retain the... print out of the complete document is deemed to be an original record for purposes of this section. [61...

Protein requirements of healthy pregnant women during early and late gestation are higher than current recommendations.

PubMed

Stephens, Trina V; Payne, Magdalene; Ball, Ronald O; Pencharz, Paul B; Elango, Rajavel

2015-01-01

Adequate maternal dietary protein intake is necessary for healthy pregnancy. However, current protein intake recommendations for healthy pregnant women are based on factorial calculations of nitrogen balance data derived from nonpregnant adults. Thus, an estimate of protein requirements based on pregnancy-specific data is needed. The objective of this study was to determine protein requirements of healthy pregnant women at 11-20 (early) and 31-38 (late) wk of gestation through use of the indicator amino acid oxidation method. Twenty-nine healthy women (24-37 y) each randomly received a different test protein intake (range: 0.22-2.56 g · kg(-1) · d(-1)) during each study day in early (n = 35 observations in 17 women) and late (n = 43 observations in 19 women) gestation; 7 women participated in both early and late gestation studies. The diets were isocaloric and provided energy at 1.7 × resting energy expenditure. Protein was given as a crystalline amino acid mixture based on egg protein composition, except phenylalanine and tyrosine, which were maintained constant across intakes. Protein requirements were determined by measuring the oxidation rate of L-[1-(13)C]phenylalanine to (13)CO2 (F(13)CO2). Breath and urine samples were collected at baseline and isotopic steady state. Linear regression crossover analysis identified a breakpoint (requirement) at minimal F(13)CO2 in response to different protein intakes. The estimated average requirement (EAR) for protein in early and late gestation was determined to be 1.22 (R(2) = 0.60; 95% CI: 0.79, 1.66 g · kg(-1) · d(-1)) and 1.52 g · kg(-1) · d(-1) (R(2) = 0.63; 95% CI: 1.28, 1.77 g · kg(-1) · d(-1)), respectively. These estimates are considerably higher than the EAR of 0.88 g · kg(-1) · d(-1) currently recommended by the Dietary Reference Intakes. To our knowledge, this study is the first to directly estimate gestational stage-specific protein requirements in healthy pregnant women and suggests that current recommendations based on factorial calculations underestimate requirements. This trial was registered at clinicaltrials.gov as NCT01784198. © 2015 American Society for Nutrition.

The effect of light intensity on image quality in endoscopic ear surgery.

PubMed

McCallum, R; McColl, J; Iyer, A

2018-05-16

Endoscopic ear surgery is a rapidly developing field with many advantages. But endoscopes can reach temperatures of over 110°C at the tip, raising safety concerns. Reducing the intensity of the light source reduces temperatures produced. However, quality of images at lower light intensities has not yet been studied. We set out to study the effect of light intensity on image quality in EES. Prospective study of patients undergoing EES from April to October 2016. Consecutive images of the same operative field at 10%, 30%, 50% and 100% light intensities were taken. Eight international experts were asked to each evaluate 100 anonymised, randomised images. District General Hospital. Twenty patients. Images were evaluated on a 5-point Likert scale (1 = significantly worse than average; 5 = significantly better than average) for detail of anatomy; colour contrast; overall quality; and suitability for operating. Mean scores for photographs at 10%, 30%, 50% and 100% light intensity were 3.22 (SD 0.93), 3.15 (SD 0.84), 3.08 (SD 0.88) and 3.10 (SD 0.86), respectively. In ANOVA models for the scores on each of the scales (anatomy, colour contrast, overall quality and suitability for operating), the effects of rater and patient were highly significant (P < .0005) but light intensity was non-significant (P = .34, .32, .21, .15, respectively). Images taken during surgery by our endoscope and operative camera have no loss of quality when taken at lower light intensities. We recommend the surgeon considers use of lower light intensities in endoscopic ear surgery. © 2018 John Wiley & Sons Ltd.

Human auditory steady state responses to binaural and monaural beats.

PubMed

Schwarz, D W F; Taylor, P

2005-03-01

Binaural beat sensations depend upon a central combination of two different temporally encoded tones, separately presented to the two ears. We tested the feasibility to record an auditory steady state evoked response (ASSR) at the binaural beat frequency in order to find a measure for temporal coding of sound in the human EEG. We stimulated each ear with a distinct tone, both differing in frequency by 40Hz, to record a binaural beat ASSR. As control, we evoked a beat ASSR in response to both tones in the same ear. We band-pass filtered the EEG at 40Hz, averaged with respect to stimulus onset and compared ASSR amplitudes and phases, extracted from a sinusoidal non-linear regression fit to a 40Hz period average. A 40Hz binaural beat ASSR was evoked at a low mean stimulus frequency (400Hz) but became undetectable beyond 3kHz. Its amplitude was smaller than that of the acoustic beat ASSR, which was evoked at low and high frequencies. Both ASSR types had maxima at fronto-central leads and displayed a fronto-occipital phase delay of several ms. The dependence of the 40Hz binaural beat ASSR on stimuli at low, temporally coded tone frequencies suggests that it may objectively assess temporal sound coding ability. The phase shift across the electrode array is evidence for more than one origin of the 40Hz oscillations. The binaural beat ASSR is an evoked response, with novel diagnostic potential, to a signal that is not present in the stimulus, but generated within the brain.

A comparison of teaching three common ear, nose, and throat conditions to medical students through video podcasts and written handouts: a pilot study.

PubMed

Edmond, Mark; Neville, Francesca; Khalil, Hisham S

2016-01-01

This pilot study conducted at the Peninsula Medical School is one of very few studies to compare the use of video podcasts to traditional learning resources for medical students. We developed written handouts and video podcasts for three common ear, nose, and throat conditions; epistaxis, otitis media, and tonsillitis. Forty-one second-year students were recruited via email. Students completed a 60-item true or false statement test written by the senior author (20 questions per subject). Students were subsequently randomized to podcast or handouts. Students were able to access their resource via their unique university login on the university homepage and were given 3 weeks to use their resource. They then completed the same 60-item test. Both podcasts and handouts demonstrated a statistically significant increase in student scores (podcasts mean increase in scores 4.7, P=0.004, 95% confidence interval =0.07). Handout mean increase in scores 5.3, P=0.015, 95% confidence interval =0.11). However, there was no significant difference (P=0.07) between the two, with the handout group scoring fractionally higher (podcasts average post-exposure score =37.3 vs handout 37.8) with a larger average improvement. A 5-point Likert scale questionnaire demonstrated that medical students enjoy using reusable learning objects such as podcasts and feel that they should be used more in their curriculum. Podcasts are as good as traditional handouts in teaching second-year medical students three core ear, nose, and throat conditions and enhance their learning experience.

Middle ear gentamicin-soaked pledgets in the treatment of Ménière's disease.

PubMed

MacKeith, Samuel A C; Whiteside, Olivia J H; Mawby, Thomas; Bottrill, Ian D

2014-02-01

Assess the relative efficacy and results of the round window hyaluronic acid pledget depot method for intratympanic gentamicin delivery in Ménière's disease. Retrospective case review. Tertiary referral hospital. Prospective symptomatic and audiologic data were collected on 28 patients undergoing intratympanic gentamicin therapy for Ménière's disease refractory to medical treatment between 2003 and 2009. All patients had the round window membrane exposed via a tympanomeatal flap, and any adhesions were removed. Hyaluronic acid pledgets soaked in 40 mg/ml of gentamicin were then packed into the round window niche and posterior mesotympanum, and the tympanomeatal flap was replaced. Patients audiologic and vertigo symptom outcome scores were recorded at follow-up according to the AAO-HNS 1995 guidelines for reporting results in Ménière's disease. Complete or substantial improvement in vertigo (class A or B) was achieved in 88.5% (23/26) of patients. Hearing loss, defined as greater than 10 dB (PTA average at 0.5, 1, 2, and 4 kHz) was noted in 12 (50%) of 24 patients including 4 patients who had developed "dead ears" (16%). The average hearing loss for all patients excluding the 4 patients with dead ears was 10.7 dB. Round window hyaluronic acid pledget technique used as a sustained delivery vehicle for intratympanic gentamicin treatment for Ménière's disease produces similar rates of vertigo control compared with other techniques but a greater risk of hearing loss. We would recommend the intratympanicinjection titration technique as first line for most patients.

Short-term results using Kurz titanium ossicular implants.

PubMed

Vassbotn, Flemming S; Møller, Per; Silvola, Juha

2007-01-01

The efficiency of titanium middle ear prosthesis for ossicular reconstruction in chronic ear disease is investigated in a Scandinavian two-center retrospective study from a Norwegian tertiary otology referral center and a Finnish otology referral center. Retrospective chart reviews were performed for procedures involving 73 titanium prostheses between 1999 and 2004. All patients that underwent surgery including the Kurz Vario titanium prosthesis were included in the study, 38 procedures including the partial ossicular replacement prosthesis (PORP) and 35 procedures including the total ossicular replacement prosthesis (TORP). Mean follow-up was 14 months. The ossiculoplasty was performed alone (29 patients) or in combination with other chronic ear surgery procedures (34 patients). Comparisons of preoperative and postoperative pure tone averages (0.5, 1, 2, and 3 kHz) according to AAO-HNS guidelines are presented, as well as data for different PTA definitions. Otosurgery procedures, complications, revisions, and extrusion rates are reported. A postoperative air-bone gap (ABG) of

Accurate Measurements of the Skin Surface Area of the Healthy Auricle and Skin Deficiency in Microtia Patients

PubMed Central

van Doremalen, Rob F. M.; Melchels, Ferry P. W.; Kolodzynski, Michail N.; Pouran, Behdad; Malda, Jos; Kon, Moshe; Breugem, Corstiaan C.

2016-01-01

Background: The limited cranial skin covering auricular implants is an important yet underrated factor in auricular reconstruction for both reconstruction surgery and tissue engineering strategies. We report exact measurements on skin deficiency in microtia patients and propose an accessible preoperative method for these measurements. Methods: Plaster ear models (n = 11; male:female = 2:1) of lobular-type microtia patients admitted to the University Medical Center Utrecht in The Netherlands were scanned using a micro-computed tomographic scanner or a cone-beam computed tomographic scanner. The resulting images were converted into mesh models from which the surface area could be calculated. Results: The mean total skin area of an adult-size healthy ear was 47.3 cm2, with 49.0 cm2 in men and 44.3 cm2 in women. Microtia ears averaged 14.5 cm2, with 15.6 cm2 in men and 12.6 cm2 in women. The amount of skin deficiency was 25.4 cm2, with 26.7 cm2 in men and 23.1 cm2 in women. Conclusions: This study proposes a novel method to provide quantitative data on the skin surface area of the healthy adult auricle and the amount of skin deficiency in microtia patients. We demonstrate that the microtia ear has less than 50% of skin available compared with healthy ears. Limited skin availability in microtia patients can lead to healing problems after auricular reconstruction and poses a significant challenge in the development of tissue-engineered cartilage implants. The results of this study could be used to evaluate outcomes and investigate new techniques with regard to tissue-engineered auricular constructs. PMID:28293505

Hearing loss associated with enlarged vestibular aqueduct and zero or one mutant allele of SLC26A4.

PubMed

Rose, Jane; Muskett, Julie A; King, Kelly A; Zalewski, Christopher K; Chattaraj, Parna; Butman, John A; Kenna, Margaret A; Chien, Wade W; Brewer, Carmen C; Griffith, Andrew J

2017-07-01

To characterize the severity and natural history of hearing loss, and the prevalence of having a cochlear implant in a maturing cohort of individuals with enlarged vestibular aqueduct (EVA) and zero or one mutant allele of SLC26A4. Prospective cohort study of subjects ascertained between 1998 and 2015 at the National Institutes of Health Clinical Center. Study subjects were 127 individuals (median age, 8 years; range, 0-59 years) with EVA in at least one ear. Ears with EVA and zero or one mutant allele of SLC26A4 had mean 0.5/1/2/4-kHz pure-tone averages of 62.6 and 52.9 dB HL, respectively, in contrast to EVA ears with two mutant alleles of SLC26A4 (88.1 dB HL; P < .01). This association was independent of age, sex, or side of EVA (P < .001). Natural history of hearing loss was not associated with number of mutant alleles (P = .94). The prevalence of having a cochlear implant was nine (12%) of 76, two (13%) of 15, and 12 (38%) of 32 subjects with zero, one, and two mutant alleles, respectively (P = .00833). This association was not independent (P = .534) but reflected underlying correlations with age at time of first audiogram (P = .003) or severity of hearing loss (P = .000). Ears with EVA and zero or one mutant allele of SLC26A4 have less severe hearing loss, no difference in prevalence of fluctuation, and a lower prevalence of cochlear implantation in comparison to ears with two mutant alleles of SLC26A4. NA Laryngoscope, 127:E238-E243, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

[Effects on hearing due to the occupational noise exposure of marble industry workers in the Federal District, Brazil].

PubMed

Harger, Marília Rabelo Holanda Camarano; Barbosa-Branco, Anadergh

2004-01-01

To evaluate the prevalence of hearing loss, its degree and type, among workers in the marble industry in the Brazilian Federal District (FD). Workers from eight marble industries in the FD were evaluated by means of a cross sectional epidemiological study. An audiometry screening test (air conduction) was performed. Workers with hearing loss were submitted to liminal tonal audiometry air & bone conduction and speech audiometry tests using an audiometer AD-28 (Interacoustics). All subjects studied were submitted to a visual inspection of the external acoustic meatus. One hundred and fifty two workers were examined; mean age was 32 years (SD = 8.6); average occupational noise exposure was of 8.3 years (SD = 6.8). Audiometries demonstrated that 48.0% (n = 73) had some type of hearing loss. Among the workers with hearing loss, 50.0% had results compatible with noise-induced hearing loss (NIHL); 41.0% with incipient noise induced hearing loss, 5.0% with sensorineural hearing loss (all except NIHL) and 4.0% with conductive and mixed hearing losses. Among workers with NIHL, 57.1% had bilateral involvement, 17.1% in the right ear and 25.7% in the left ear. Among those with incipient NIHL, 13.9% were bilateral, 19.4% were only in the right ear and 66.7% were only in the left ear. Abnormal audiograms were found in 48.0% of the sample. Among those with hearing loss, the predominant cause was NIHL, followed by those classified as having incipient noise induced hearing loss. Hearing loss usually started at 6 kHz, frequently in the left ear.

The audiological and take results of perichondrium attached cartilage island graft in tympanoplasty: PACIT.

PubMed

Solmaz, F; Akduman, D; Haksever, M; Gündoğdu, E; Yanılmaz, M; Mescioğlu, A

2016-08-01

Cartilage is one of the most preferable grafts for tympanoplasty (TPL). The anatomical and audiological results and take rates of perichondrium attached cartilage island graft in tympanoplasty (PACIT) are presented herein. One hundred ninety four ears of 191 patients (108 male, 83 female) were evaluated retrospectively in terms of the type of surgery, graft take rate and hearing results. Type I, II, and III TPL were performed in 127 (65.46%), 45 (23.20%), and 22 (11.34%) ears, respectively. The overall mean preoperative pure tone average-air bone gaps (PTA-ABGs) for TPL types were 33.74 ± 9.60, 52.58 ± 9.07, and 56.58 ± 10.27 dB HL, respectively; postoperative mean values for TPL groups were 18.55 ± 9.25, 31.21 ± 4.36, and 44.84 ± 12.45 dB HL. Postoperative hearing results showed an improvement (≥ 10 dB) in 76.81% of ears with a mean gain of 20 dB HL (range 10-40 dB). However, 19.07% of ears showed no change (< 10, ≥ 0 dB) in hearing, and hearing worsened in 4.12% of ears (< 0 dB) postoperatively. Overall, graft take was 91.24% at least 13 months (mean 68.64) after surgery with a graft failure rate of 8.76%. Graft take was successful in TPL groups. Postoperative PTA-ABG results demonstrated significant improvement. The long-term eligibility of perichondrium attached cartilage island graft in TPL is emphasised with this study. © Copyright by Società Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale, Rome, Italy.

Perilymph pharmacokinetics of markers and dexamethasone applied and sampled at the lateral semi-circular canal.

PubMed

Salt, Alec N; Hartsock, Jared J; Gill, Ruth M; Piu, Fabrice; Plontke, Stefan K

2012-12-01

Perilymph pharmacokinetics was investigated by a novel approach, in which solutions containing drug or marker were injected from a pipette sealed into the perilymphatic space of the lateral semi-circular canal (LSCC). The cochlear aqueduct provides the outlet for fluid flow so this procedure allows almost the entire perilymph to be exchanged. After wait times of up to 4 h the injection pipette was removed and multiple, sequential samples of perilymph were collected from the LSCC. Fluid efflux at this site results from cerebrospinal fluid (CSF) entry into the basal turn of scala tympani (ST) so the samples allow drug levels from different locations in the ear to be defined. This method allows the rate of elimination of substances from the inner ear to be determined more reliably than with other delivery methods in which drug may only be applied to part of the ear. Results were compared for the markers trimethylphenylammonium (TMPA) and fluorescein and for the drug dexamethasone (Dex). For each substance, the concentration in fluid samples showed a progressive decrease as the delay time between injection and sampling was increased. This is consistent with the elimination of substance from the ear with time. The decline with time was slowest for fluorescein, was fastest for Dex, with TMPA at an intermediate rate. Simulations of the experiments showed that elimination occurred more rapidly from scala tympani (ST) than from scala vestibuli (SV). Calculated elimination half-times from ST averaged 54.1, 24.5 and 22.5 min for fluorescein, TMPA and Dex respectively and from SV 1730, 229 and 111 min respectively. The elimination of Dex from ST occurred considerably faster than previously appreciated. These pharmacokinetic parameters provide an important foundation for understanding of drug treatments of the inner ear.

Effect of hearing aids on auditory function in infants with perinatal brain injury and severe hearing loss.

PubMed

Moreno-Aguirre, Alma Janeth; Santiago-Rodríguez, Efraín; Harmony, Thalía; Fernández-Bouzas, Antonio

2012-01-01

Approximately 2-4% of newborns with perinatal risk factors present with hearing loss. Our aim was to analyze the effect of hearing aid use on auditory function evaluated based on otoacoustic emissions (OAEs), auditory brain responses (ABRs) and auditory steady state responses (ASSRs) in infants with perinatal brain injury and profound hearing loss. A prospective, longitudinal study of auditory function in infants with profound hearing loss. Right side hearing before and after hearing aid use was compared with left side hearing (not stimulated and used as control). All infants were subjected to OAE, ABR and ASSR evaluations before and after hearing aid use. The average ABR threshold decreased from 90.0 to 80.0 dB (p = 0.003) after six months of hearing aid use. In the left ear, which was used as a control, the ABR threshold decreased from 94.6 to 87.6 dB, which was not significant (p>0.05). In addition, the ASSR threshold in the 4000-Hz frequency decreased from 89 dB to 72 dB (p = 0.013) after six months of right ear hearing aid use; the other frequencies in the right ear and all frequencies in the left ear did not show significant differences in any of the measured parameters (p>0.05). OAEs were absent in the baseline test and showed no changes after hearing aid use in the right ear (p>0.05). This study provides evidence that early hearing aid use decreases the hearing threshold in ABR and ASSR assessments with no functional modifications in the auditory receptor, as evaluated by OAEs.

Effect of Hearing Aids on Auditory Function in Infants with Perinatal Brain Injury and Severe Hearing Loss

PubMed Central

Moreno-Aguirre, Alma Janeth; Santiago-Rodríguez, Efraín; Harmony, Thalía; Fernández-Bouzas, Antonio

2012-01-01

Background Approximately 2–4% of newborns with perinatal risk factors present with hearing loss. Our aim was to analyze the effect of hearing aid use on auditory function evaluated based on otoacoustic emissions (OAEs), auditory brain responses (ABRs) and auditory steady state responses (ASSRs) in infants with perinatal brain injury and profound hearing loss. Methodology/Principal Findings A prospective, longitudinal study of auditory function in infants with profound hearing loss. Right side hearing before and after hearing aid use was compared with left side hearing (not stimulated and used as control). All infants were subjected to OAE, ABR and ASSR evaluations before and after hearing aid use. The average ABR threshold decreased from 90.0 to 80.0 dB (p = 0.003) after six months of hearing aid use. In the left ear, which was used as a control, the ABR threshold decreased from 94.6 to 87.6 dB, which was not significant (p>0.05). In addition, the ASSR threshold in the 4000-Hz frequency decreased from 89 dB to 72 dB (p = 0.013) after six months of right ear hearing aid use; the other frequencies in the right ear and all frequencies in the left ear did not show significant differences in any of the measured parameters (p>0.05). OAEs were absent in the baseline test and showed no changes after hearing aid use in the right ear (p>0.05). Conclusions/Significance This study provides evidence that early hearing aid use decreases the hearing threshold in ABR and ASSR assessments with no functional modifications in the auditory receptor, as evaluated by OAEs. PMID:22808289

Consumption of various forms of apples is associated with a better nutrient intake and improved nutrient adequacy in diets of children: National Health and Nutrition Examination Survey 2003–2010

PubMed Central

Nicklas, Theresa A.; O'Neil, Carol E.; Fulgoni, Victor L.

2015-01-01

Background Consumption of fruit has been associated with a variety of health benefits, yet, 75% of children have usual intakes of total fruit below minimum recommended amounts. Apples are the second most commonly consumed fruit in the United States; however, no studies have examined the impact of apple consumption on nutrient intake and adequacy in children's diets. Objective The purpose of this study is to examine the association between apple (various forms) consumption with nutrient intake and nutrient adequacy in a nationally representative sample of children. Design Participants were children aged 2–18 years (n=13,339), from the National Health and Nutrition Examination Survey 2003–2010. Least square means of total energy and nutrient intake, and the percentage of the population below the estimated average requirement (EAR) or above the adequate intake (AI) among apple consumers and non-consumers were examined. Results Consumers of total apple products had higher (p<0.01) total intakes of fiber, magnesium, and potassium and lower intakes of total fat, saturated fatty acids, monounsaturated fatty acid, and sodium than non-consumers. Apple consumers had higher (p<0.01) total sugar intake, but lower intake of added sugars compared to non-consumers. A lower (p<0.01) percentage of apple consumers were below the EAR for 13 of the 16 nutrients studied. Apple consumers had approximately a 10 percentage unit difference below the EAR for calcium and magnesium, and vitamins A, C, D, and E, than non-consumers. The percentage above the AI for fiber was significantly (p<0.0001) higher among total apple consumers (6.24±0.45 g) compared to non-consumers (0.57±0.07 g). The results were similar for individual apple products (i.e. apple juice, applesauce, and whole apples). Conclusion Consumption of any forms of apples provided valuable nutrients in the diets of children. PMID:26445211

Consumption of various forms of apples is associated with a better nutrient intake and improved nutrient adequacy in diets of children: National Health and Nutrition Examination Survey 2003-2010.

PubMed

Nicklas, Theresa A; O'Neil, Carol E; Fulgoni, Victor L

2015-01-01

Consumption of fruit has been associated with a variety of health benefits, yet, 75% of children have usual intakes of total fruit below minimum recommended amounts. Apples are the second most commonly consumed fruit in the United States; however, no studies have examined the impact of apple consumption on nutrient intake and adequacy in children's diets. The purpose of this study is to examine the association between apple (various forms) consumption with nutrient intake and nutrient adequacy in a nationally representative sample of children. Participants were children aged 2-18 years (n=13,339), from the National Health and Nutrition Examination Survey 2003-2010. Least square means of total energy and nutrient intake, and the percentage of the population below the estimated average requirement (EAR) or above the adequate intake (AI) among apple consumers and non-consumers were examined. Consumers of total apple products had higher (p<0.01) total intakes of fiber, magnesium, and potassium and lower intakes of total fat, saturated fatty acids, monounsaturated fatty acid, and sodium than non-consumers. Apple consumers had higher (p<0.01) total sugar intake, but lower intake of added sugars compared to non-consumers. A lower (p<0.01) percentage of apple consumers were below the EAR for 13 of the 16 nutrients studied. Apple consumers had approximately a 10 percentage unit difference below the EAR for calcium and magnesium, and vitamins A, C, D, and E, than non-consumers. The percentage above the AI for fiber was significantly (p<0.0001) higher among total apple consumers (6.24±0.45 g) compared to non-consumers (0.57±0.07 g). The results were similar for individual apple products (i.e. apple juice, applesauce, and whole apples). Consumption of any forms of apples provided valuable nutrients in the diets of children.

Vitamin D Intake among Premenopausal Women Living in Jeddah: Food Sources and Relationship to Demographic Factors and Bone Health

PubMed Central

Jackson, Robert T.; Alkahtani, Abdulkareem A.

2018-01-01

Background Saudi women depend on food sources to maintain their serum 25(OH) D concentrations because covering by traditional clothing and time spent indoors limit their sun exposure. Little is known about vitamin D intake and its main food sources in Saudi Arabia. In addition, the association between vitamin D and calcium intake and bone mineral density (BMD) in young women is not well researched. Objectives To assess the adequacy of vitamin D intake among Saudi women as compared to the estimated average requirements (EARs), to identify dietary vitamin D sources, to examine potential determinants of vitamin D intake, and to assess bone health and the association of calcium and vitamin D intake with BMD. Methods This cross-sectional study was conducted in 257 premenopausal women aged 20–50 years in Jeddah, Saudi Arabia. Dietary vitamin D and calcium were assessed by the Semiquantitative Food Frequency Questionnaire. BMD was measured using dual-energy X-ray absorptiometry (DXA) in a subset of women (n=102) at the lumbar spine and femur neck. Results Sixty-five percent of women were below the EAR for vitamin D, and 61% fell below the EAR for calcium. Dairy products, supplements, and fish contributed most to vitamin D intake. Increased age was an independent determinant of sufficient vitamin D intake (p < 0.001). The prevalence of osteopenia was 33% in the lumbar spine and 30% in the femur neck. There was a significant positive association between calcium intake and BMD at the lumbar spine (p=0.043) after controlling for body mass index and energy intake. Vitamin D intake was not significantly different between women with low and normal bone mass. Conclusion Premenopausal women in Jeddah have insufficient vitamin D and calcium intakes. Public health strategies to improve nutrition in young women are needed, and expanding fortification programs to include all dairy products would be useful. PMID:29750126

A New Test of Attention in Listening (TAIL) Predicts Auditory Performance

PubMed Central

Zhang, Yu-Xuan; Barry, Johanna G.; Moore, David R.; Amitay, Sygal

2012-01-01

Attention modulates auditory perception, but there are currently no simple tests that specifically quantify this modulation. To fill the gap, we developed a new, easy-to-use test of attention in listening (TAIL) based on reaction time. On each trial, two clearly audible tones were presented sequentially, either at the same or different ears. The frequency of the tones was also either the same or different (by at least two critical bands). When the task required same/different frequency judgments, presentation at the same ear significantly speeded responses and reduced errors. A same/different ear (location) judgment was likewise facilitated by keeping tone frequency constant. Perception was thus influenced by involuntary orienting of attention along the task-irrelevant dimension. When information in the two stimulus dimensions were congruent (same-frequency same-ear, or different-frequency different-ear), response was faster and more accurate than when they were incongruent (same-frequency different-ear, or different-frequency same-ear), suggesting the involvement of executive control to resolve conflicts. In total, the TAIL yielded five independent outcome measures: (1) baseline reaction time, indicating information processing efficiency, (2) involuntary orienting of attention to frequency and (3) location, and (4) conflict resolution for frequency and (5) location. Processing efficiency and conflict resolution accounted for up to 45% of individual variances in the low- and high-threshold variants of three psychoacoustic tasks assessing temporal and spectral processing. Involuntary orientation of attention to the irrelevant dimension did not correlate with perceptual performance on these tasks. Given that TAIL measures are unlikely to be limited by perceptual sensitivity, we suggest that the correlations reflect modulation of perceptual performance by attention. The TAIL thus has the power to identify and separate contributions of different components of attention to auditory perception. PMID:23300934

Relationships among measures of physical activity and hearing in African Americans: The Jackson Heart Study.

PubMed

Haas, Patrick J; Bishop, Charles E; Gao, Yan; Griswold, Michael E; Schweinfurth, John M

2016-10-01

To evaluate the relationships among measures of physical activity and hearing in the Jackson Heart Study. Prospective cohort study. We assessed hearing on 1,221 Jackson Heart Study participants who also had validated physical activity questionnaire data on file. Hearing thresholds were measured across frequency octaves from 250 to 8,000 Hz, and various frequency pure-tone averages (PTAs) were constructed, including PTA4 (average of 500, 1,000, 2,000, and 4,000 Hz), PTA-high (average of 4,000 and 8,000 Hz), PTA-mid (average of 1,000 and 2,000 Hz), and PTA-low (average of 250 and 500 Hz). Hearing loss was defined for pure tones and pure-tone averages as >25 dB HL in either ear and averaged between the ears. Associations between physical activity and hearing were estimated using linear regression, reporting changes in decibel hearing level, and logistic regression, reporting odds ratios (OR) of hearing loss. Physical activity exhibited a statistically significant but small inverse relationship with PTA4, -0.20 dB HL per doubling of activity (95% confidence interval [CI]: -0.35, -0.04; P = .016), as well as with PTA-low and pure tones at 250, 2,000, and 4,000 Hz in adjusted models. Multivariable logistic regression modeling supported a decrease in the odds of high-frequency hearing loss among participants who reported at least some moderate weekly physical activity (PTA-high, OR: 0.69 [95% CI: 0.52, 0.92]; P = .011 and 4000 Hz, OR: 0.75 [95% CI: 0.57, 0.99]; P = .044). Our study provides further evidence that physical activity is related to better hearing; however, the clinical significance of this relationship cannot be estimated given the nature of the cross-sectional study design. 2b Laryngoscope, 126:2376-2381, 2016. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

Live Attenuated Influenza Virus Increases Pneumococcal Translocation and Persistence Within the Middle Ear

PubMed Central

Mina, Michael J.; Klugman, Keith P.; Rosch, Jason W.; McCullers, Jonathan A.

2015-01-01

Background. Infection with influenza A virus (IAV) increases susceptibility to respiratory bacterial infections, resulting in increased bacterial carriage and complications such acute otitis media, pneumonia, bacteremia, and meningitis. Recently, vaccination with live attenuated influenza virus (LAIV) was reported to enhance subclinical bacterial colonization within the nasopharynx, similar to IAV. Although LAIV does not predispose to bacterial pneumonia, whether it may alter bacterial transmigration toward the middle ear, where it could have clinically relevant implications, has not been investigated. Methods. BALB/c mice received LAIV or phosphate-buffered saline 1 or 7 days before or during pneumococcal colonization with either of 2 clinical isolates, 19F or 7F. Middle ear bacterial titers were monitored daily via in vivo imaging. Results. LAIV increased bacterial transmigration to and persistence within the middle ear. When colonization followed LAIV inoculation, a minimum LAIV incubation period of 4 days was required before bacterial transmigration commenced. Conclusions. While LAIV vaccination is safe and effective at reducing IAV and coinfection with influenza virus and bacteria, LAIV may increase bacterial transmigration to the middle ear and could thus increase the risk of clinically relevant acute otitis media. These data warrant further investigations into interactions between live attenuated viruses and naturally colonizing bacterial pathogens. PMID:25505300

Generation and characterization of Atoh1-Cre knock-in mouse line

PubMed Central

Yang, Hua; Xie, Xiaoling; Deng, Min; Chen, Xiaowei; Gan, Lin

2010-01-01

Summary Atoh1 encodes a basic helix-loop-helix (bHLH) transcription factor required for the development of the inner ear sensory epithelia, the dorsal spinal cord, brainstem, cerebellum, and intestinal secretory cells. In this study to create a genetic tool for the research on gene function in the ear sensory organs, we generated an Atoh1-Cre knock-in mouse line by replacing the entire Atoh1 coding sequences with the Cre coding sequences. Atoh1Cre/+mice were viable, fertile, and displayed no visible defects whereas the Atoh1Cre/Cremice died perinatally. The spatiotemporal activities of Cre recombinase were examined by crossing Atoh1-Cre mice with the R26R-lacZ conditional reporter mice. Atoh1-Cre activities were detected in the developing inner ear, the hindbrain, the spinal cord, and the intestine. In the inner ear, Atoh1-Cre activities were confined to the sensory organs in which lacZ expression is detected in nearly all of the hair cells and in many supporting cells. Thus, Atoh1-Cre mouse line serves as a useful tool for the functional study of genes in the inner ear. In addition, our results demonstrate that Atoh1 is expressed in the common progenitors destined for both hair and supporting cells. PMID:20533400

Listening to the ear

NASA Astrophysics Data System (ADS)

Shera, Christopher A.

Otoacoustic emissions demonstrate that the ear creates sound while listening to sound, offering a promising acoustic window on the mechanics of hearing in awake, listening human beings. That window is clouded, however, by an incomplete knowledge of wave reflection and transmission, both forth and back within the cochlea and through the middle ear. This thesis "does windows," addressing wave propagation and scattering on both sides of the middle ear. A summary of highlights follows. Measurements of the cochlear input impedance in cat are used to identify a new symmetry in cochlear mechanics-termed "tapering symmetry" after its geometric interpretation in simple models-that guarantees that the wavelength of the traveling wave changes slowly with position near the stapes. Waves therefore propagate without reflection through the basal turns of the cochlea. Analytic methods for solving the cochlear wave equations using a perturbative scattering series are given and used to demonstrate that, contrary to common belief, conventional cochlear models exhibit negligible internal reflection whether or not they accurately represent the tapering symmetries of the inner ear. Frameworks for the systematic "deconstruction" of eardrum and middle-ear transduction characteristics are developed and applied to the analysis of noninvasive measurements of middle-ear and cochlear mechanics. A simple phenomenological model of inner-ear compressibility that correctly predicts hearing thresholds in patients with missing or disarticulated middle-ear ossicles is developed and used to establish an upper bound on cochlear compressibility several orders of magnitude smaller than that provided by direct measurements. Accurate measurements of stimulus frequency evoked otoacoustic emissions are performed and used to determine the form and frequency variation of the cochlear traveling-wave ratio noninvasively. Those measurements are inverted to obtain the spatial distribution of mechanical inhomogeneities responsible for evoked emission. Although current models require that the periodicities found in emission spectra and threshold hearing curves originate in a corresponding corrugation in the mechanics of the cochlea, it is shown that the observed spectral periodicities can arise spontaneously through the dynamics of wave propagation and reflection and that the organ of Corti, as suggested by the anatomy, need manifest no particular translational symmetries.

Listening to the Ear

NASA Astrophysics Data System (ADS)

Shera, Christopher Alan

Otoacoustic emissions demonstrate that the ear creates sound while listening to sound, offering a promising acoustic window on the mechanics of hearing in awake, listening human beings. That window is clouded, however, by an incomplete knowledge of wave reflection and transmission, both forth and back within the cochlea and through the middle ear. This thesis "does windows," addressing wave propagation and scattering on both sides of the middle ear. A summary of highlights follows. Measurements of the cochlear input impedance in cat are used to identify a new symmetry in cochlear mechanics--termed "tapering symmetry" after its geometric interpretation in simple models--that guarantees that the wavelength of the traveling wave changes slowly with position near the stapes. Waves therefore propagate without reflection through the basal turns of the cochlea. Analytic methods for solving the cochlear wave equations using a perturbative scattering series are given and used to demonstrate that, contrary to common belief, conventional cochlear models exhibit negligible internal reflection whether or not they accurately represent the tapering symmetries of the inner ear. Frameworks for the systematic "deconstruction" of eardrum and middle-ear transduction characteristics are developed and applied to the analysis of noninvasive measurements of middle-ear and cochlear mechanics. A simple phenomenological model of inner-ear compressibility that correctly predicts hearing thresholds in patients with missing or disarticulated middle-ear ossicles is developed and used to establish an upper bound on cochlear compressibility several orders of magnitude smaller than that provided by direct measurements. Accurate measurements of stimulus -frequency evoked otoacoustic emissions are performed and used to determine the form and frequency variation of the cochlear traveling-wave ratio noninvasively. Those measurements are inverted to obtain the spatial distribution of mechanical inhomogeneities responsible for evoked emission. Although current models require that the periodicities found in emission spectra and threshold hearing curves originate in a corresponding corrugation in the mechanics of the cochlea, it is shown that the observed spectral periodicities can arise spontaneously through the dynamics of wave propagation and reflection and that the organ of Corti, as suggested by the anatomy, need manifest no particular translational symmetries.

Computational estimation of magnetically induced electric fields in a rotating head

NASA Astrophysics Data System (ADS)

Ilvonen, Sami; Laakso, Ilkka

2009-01-01

Change in a magnetic field, or similarly, movement in a strong static magnetic field induces electric fields in human tissues, which could potentially cause harmful effects. In this paper, the fields induced by different rotational movements of a head in a strong homogeneous magnetic field are computed numerically. Average field magnitudes near the retinas and inner ears are studied in order to gain insight into the causes of phosphenes and vertigo-like effects, which are associated with extremely low-frequency (ELF) magnetic fields. The induced electric fields are calculated in four different anatomically realistic head models using an efficient finite-element method (FEM) solver. The results are compared with basic restriction limits by IEEE and ICNIRP. Under rotational movement of the head, with a magnetic flux rate of change of 1 T s-1, the maximum IEEE-averaged electric field and maximum ICNIRP-averaged current density were 337 mV m-1 and 8.84 mA m-2, respectively. The limits by IEEE seem significantly stricter than those by ICNIRP. The results show that a magnetic flux rate of change of 1 T s-1 may induce electric field in the range of 50 mV m-1 near retinas, and possibly even larger values near the inner ears. These results provide information for approximating the threshold electric field values of phosphenes and vertigo-like effects.

Human ear detection in the thermal infrared spectrum

NASA Astrophysics Data System (ADS)

Abaza, Ayman; Bourlai, Thirimachos

2012-06-01

In this paper the problem of human ear detection in the thermal infrared (IR) spectrum is studied in order to illustrate the advantages and limitations of the most important steps of ear-based biometrics that can operate in day and night time environments. The main contributions of this work are two-fold: First, a dual-band database is assembled that consists of visible and thermal profile face images. The thermal data was collected using a high definition middle-wave infrared (3-5 microns) camera that is capable of acquiring thermal imprints of human skin. Second, a fully automated, thermal imaging based ear detection method is developed for real-time segmentation of human ears in either day or night time environments. The proposed method is based on Haar features forming a cascaded AdaBoost classifier (our modified version of the original Viola-Jones approach1 that was designed to be applied mainly in visible band images). The main advantage of the proposed method, applied on our profile face image data set collected in the thermal-band, is that it is designed to reduce the learning time required by the original Viola-Jones method from several weeks to several hours. Unlike other approaches reported in the literature, which have been tested but not designed to operate in the thermal band, our method yields a high detection accuracy that reaches ~ 91.5%. Further analysis on our data set yielded that: (a) photometric normalization techniques do not directly improve ear detection performance. However, when using a certain photometric normalization technique (CLAHE) on falsely detected images, the detection rate improved by ~ 4%; (b) the high detection accuracy of our method did not degrade when we lowered down the original spatial resolution of thermal ear images. For example, even after using one third of the original spatial resolution (i.e. ~ 20% of the original computational time) of the thermal profile face images, the high ear detection accuracy of our method remained unaffected. This resulted also in speeding up the detection time of an ear image from 265 to 17 milliseconds per image. To the best of our knowledge this is the first time that the problem of human ear detection in the thermal band is being investigated in the open literature.

Identification of neonatal hearing impairment: ear-canal measurements of acoustic admittance and reflectance in neonates.

PubMed

Keefe, D H; Folsom, R C; Gorga, M P; Vohr, B R; Bulen, J C; Norton, S J

2000-10-01

1) To describe broad bandwidth measurements of acoustic admittance (Y) and energy reflectance (R) in the ear canals of neonates. 2) To describe a means for evaluating when a YR response is valid. 3) To describe the relations between these YR measurements and age, gender, left/right ear, and selected risk factors. YR responses were obtained at four test sites in well babies without risk indicators, well babies with at least one risk indicator, and graduates of neonatal intensive care units. YR responses were measured using a chirp stimulus at moderate levels over a frequency range from 250 to 8000 Hz. The system was calibrated based on measurements in a set of cylindrical tubes. The probe assembly was inserted in the ear canal of the neonate, and customized software was used for data acquisition. YR responses were measured in over 4000 ears, and half of the responses were used in exploratory data analyses. The particular YR variables chosen for analysis were energy reflectance, equivalent volume and acoustic conductance. Based on the view that unduly large negative equivalent volumes at low frequencies were physically impossible, it was concluded that approximately 13% of the YR responses showed evidence of improper probe seal in the ear canal. To test how these outliers influenced the overall pattern of YR responses, analyses were conducted both on the full data set (N = 2081) and the data set excluding outliers (N = 1825). The YR responses averaged over frequency varied with conceptional age (conception to date of test), gender, left/right ear, and selected risk factors; in all cases, significant effects were observed more frequently in the data set excluding outliers. After excluding outliers and controlling for conceptional age effects, the dichotomous risk factors accounting for the greatest variance in the YR responses were, in rank order, cleft lip and palate, aminoglycoside therapy, low birth weight, history of ventilation, and low APGAR scores. In separate analyses, YR responses varied in the first few days after birth. An analysis showed that the use of a YR test criterion to assess the quality of probe seal may help control the false-positive rate in evoked otoacoustic emission testing. This is the first report of wideband YR responses in neonates. Data were acquired in a few seconds, but the responses are highly sensitive to whether the probe is fully sealed in the ear canal. A real-time acoustic test of probe fit is proposed to better address the probe seal problem. The YR responses provide information on middle-ear status that varies over the neonatal age range and that is sensitive to the presence or absence of risk factors, ear, and gender differences. Thus, a YR test may have potential for use in neonatal screening tests for hearing loss.

Pure-Tone Audiometry With Forward Pressure Level Calibration Leads to Clinically-Relevant Improvements in Test-Retest Reliability.

PubMed

Lapsley Miller, Judi A; Reed, Charlotte M; Robinson, Sarah R; Perez, Zachary D

2018-02-21

Clinical pure-tone audiometry is conducted using stimuli delivered through supra-aural headphones or insert earphones. The stimuli are calibrated in an acoustic (average ear) coupler. Deviations in individual-ear acoustics from the coupler acoustics affect test validity, and variations in probe insertion and headphone placement affect both test validity and test-retest reliability. Using an insert earphone designed for otoacoustic emission testing, which contains a microphone and loudspeaker, an individualized in-the-ear calibration can be calculated from the ear-canal sound pressure measured at the microphone. However, the total sound pressure level (SPL) measured at the microphone may be affected by standing-wave nulls at higher frequencies, producing errors in stimulus level of up to 20 dB. An alternative is to calibrate using the forward pressure level (FPL) component, which is derived from the total SPL using a wideband acoustic immittance measurement, and represents the pressure wave incident on the eardrum. The objective of this study is to establish test-retest reliability for FPL calibration of pure-tone audiometry stimuli, compared with in-the-ear and coupler sound pressure calibrations. The authors compared standard audiometry using a modern clinical audiometer with TDH-39P supra-aural headphones calibrated in a coupler to a prototype audiometer with an ER10C earphone calibrated three ways: (1) in-the-ear using the total SPL at the microphone, (2) in-the-ear using the FPL at the microphone, and (3) in a coupler (all three are derived from the same measurement). The test procedure was similar to that commonly used in hearing-conservation programs, using pulsed-tone test frequencies at 0.5, 1, 2, 3, 4, 6, and 8 kHz, and an automated modified Hughson-Westlake audiometric procedure. Fifteen adult human participants with normal to mildly-impaired hearing were selected, and one ear from each was tested. Participants completed 10 audiograms on each system, with test-order randomly varied and with headphones and earphones refitted by the tester between tests. Fourteen of 15 ears had standing-wave nulls present between 4 and 8 kHz. The mean intrasubject SD at 6 and 8 kHz was lowest for the FPL calibration, and was comparable with the low-frequency reliability across calibration methods. This decrease in variability translates to statistically-derived significant threshold shift criteria indicating that 15 dB shifts in hearing can be reliably detected at 6 and 8 kHz using FPL-calibrated ER10C earphones, compared with 20 to 25 dB shifts using standard TDH-39P headphones with a coupler calibration. These results indicate that reliability is better with insert earphones, especially with in-the-ear FPL calibration, compared with a standard clinical audiometer with supra-aural headphones. However, in-the-ear SPL calibration should not be used due to its sensitivity to standing waves. The improvement in reliability is clinically meaningful, potentially allowing hearing-conservation programs to more confidently determine significant threshold shifts at 6 kHz-a key frequency for the early detection of noise-induced hearing loss.

Cochlear implantation with hearing preservation yields significant benefit for speech recognition in complex listening environments.

PubMed

Gifford, René H; Dorman, Michael F; Skarzynski, Henryk; Lorens, Artur; Polak, Marek; Driscoll, Colin L W; Roland, Peter; Buchman, Craig A

2013-01-01

The aim of this study was to assess the benefit of having preserved acoustic hearing in the implanted ear for speech recognition in complex listening environments. The present study included a within-subjects, repeated-measures design including 21 English-speaking and 17 Polish-speaking cochlear implant (CI) recipients with preserved acoustic hearing in the implanted ear. The patients were implanted with electrodes that varied in insertion depth from 10 to 31 mm. Mean preoperative low-frequency thresholds (average of 125, 250, and 500 Hz) in the implanted ear were 39.3 and 23.4 dB HL for the English- and Polish-speaking participants, respectively. In one condition, speech perception was assessed in an eight-loudspeaker environment in which the speech signals were presented from one loudspeaker and restaurant noise was presented from all loudspeakers. In another condition, the signals were presented in a simulation of a reverberant environment with a reverberation time of 0.6 sec. The response measures included speech reception thresholds (SRTs) and percent correct sentence understanding for two test conditions: CI plus low-frequency hearing in the contralateral ear (bimodal condition) and CI plus low-frequency hearing in both ears (best-aided condition). A subset of six English-speaking listeners were also assessed on measures of interaural time difference thresholds for a 250-Hz signal. Small, but significant, improvements in performance (1.7-2.1 dB and 6-10 percentage points) were found for the best-aided condition versus the bimodal condition. Postoperative thresholds in the implanted ear were correlated with the degree of electric and acoustic stimulation (EAS) benefit for speech recognition in diffuse noise. There was no reliable relationship among measures of audiometric threshold in the implanted ear nor elevation in threshold after surgery and improvement in speech understanding in reverberation. There was a significant correlation between interaural time difference threshold at 250 Hz and EAS-related benefit for the adaptive speech reception threshold. The findings of this study suggest that (1) preserved low-frequency hearing improves speech understanding for CI recipients, (2) testing in complex listening environments, in which binaural timing cues differ for signal and noise, may best demonstrate the value of having two ears with low-frequency acoustic hearing, and (3) preservation of binaural timing cues, although poorer than observed for individuals with normal hearing, is possible after unilateral cochlear implantation with hearing preservation and is associated with EAS benefit. The results of this study demonstrate significant communicative benefit for hearing preservation in the implanted ear and provide support for the expansion of CI criteria to include individuals with low-frequency thresholds in even the normal to near-normal range.

Cochlear implantation with hearing preservation yields significant benefit for speech recognition in complex listening environments

PubMed Central

Gifford, René H.; Dorman, Michael F.; Skarzynski, Henryk; Lorens, Artur; Polak, Marek; Driscoll, Colin L. W.; Roland, Peter; Buchman, Craig A.

2012-01-01

Objective The aim of this study was to assess the benefit of having preserved acoustic hearing in the implanted ear for speech recognition in complex listening environments. Design The current study included a within subjects, repeated-measures design including 21 English speaking and 17 Polish speaking cochlear implant recipients with preserved acoustic hearing in the implanted ear. The patients were implanted with electrodes that varied in insertion depth from 10 to 31 mm. Mean preoperative low-frequency thresholds (average of 125, 250 and 500 Hz) in the implanted ear were 39.3 and 23.4 dB HL for the English- and Polish-speaking participants, respectively. In one condition, speech perception was assessed in an 8-loudspeaker environment in which the speech signals were presented from one loudspeaker and restaurant noise was presented from all loudspeakers. In another condition, the signals were presented in a simulation of a reverberant environment with a reverberation time of 0.6 sec. The response measures included speech reception thresholds (SRTs) and percent correct sentence understanding for two test conditions: cochlear implant (CI) plus low-frequency hearing in the contralateral ear (bimodal condition) and CI plus low-frequency hearing in both ears (best aided condition). A subset of 6 English-speaking listeners were also assessed on measures of interaural time difference (ITD) thresholds for a 250-Hz signal. Results Small, but significant, improvements in performance (1.7 – 2.1 dB and 6 – 10 percentage points) were found for the best-aided condition vs. the bimodal condition. Postoperative thresholds in the implanted ear were correlated with the degree of EAS benefit for speech recognition in diffuse noise. There was no reliable relationship among measures of audiometric threshold in the implanted ear nor elevation in threshold following surgery and improvement in speech understanding in reverberation. There was a significant correlation between ITD threshold at 250 Hz and EAS-related benefit for the adaptive SRT. Conclusions Our results suggest that (i) preserved low-frequency hearing improves speech understanding for CI recipients (ii) testing in complex listening environments, in which binaural timing cues differ for signal and noise, may best demonstrate the value of having two ears with low-frequency acoustic hearing and (iii) preservation of binaural timing cues, albeit poorer than observed for individuals with normal hearing, is possible following unilateral cochlear implantation with hearing preservation and is associated with EAS benefit. Our results demonstrate significant communicative benefit for hearing preservation in the implanted ear and provide support for the expansion of cochlear implant criteria to include individuals with low-frequency thresholds in even the normal to near-normal range. PMID:23446225

Wideband reflectance in Down syndrome.

PubMed

Soares, Jordana Costa; Urosas, Juliana Granja; Calarga, Karenina Santos; Pichelli, Tathiany Silva; Limongi, Suelly Cecília Olivan; Shahnaz, Navid; Carvallo, Renata Mota Mamede

2016-08-01

Children with Down syndrome (DS) have a high incidence of middle ear disorders and congenital abnormalities of the external, middle and inner ear. Energy reflectance (ER), a wideband acoustic immittance (WAI) measurement parameter, can measure the sound energy reflected or absorbed in the ear canal over a wider range of frequencies more efficiently and faster than conventional single-tone 226 Hz tympanometry. The aim of the present study was to compare the WAI measurements of children with DS with those of typically developing, normal-hearing children according to their tympanometric findings. Four groups of children with Down syndrome (age range: 2 years and 4 months to 16 years and 3 months; mean age: 8.5 yr) with normal tympanograms (19 ears), flat tympanograms (13 ears), mild negative pressure tympanograms (6 ears between -100 and -199 daPa at the admittance peak) and severe negative pressure tympanograms (4 ears at -200 daPa or lower at the admittance peak) were assessed. All findings were compared with data obtained from 21 ears of a healthy control group (age range: 3 years and 1 month to 13 years and 11 months; mean age: 7.9 yr). The subjects underwent tympanometry with a 226-Hz probe tone frequency and ER measurements along the 200-6,000 Hz range with a chirp stimulus using the Middle-Ear Power Analyzer (MEPA3 - HearID) by Mimosa Acoustics (Champaign, IL), software, version 3.3 [38]. Statistically significant differences were observed in the ER curves for some comparisons between the studied groups. There was also a negative correlation between the static acoustic admittance at the tympanic membrane level and ER measured with a chirp stimulus at 500 and 1,000 Hz. The discriminant analysis technique, which used a chirp stimulus at 1,000 and 1,600 Hz to classify the participants' data based on ER values, achieved a correct classification rate of 59.52% for participants with DS. While groups with abnormal middle ear status, as indicated by tympanometry, showed higher ER values compared to the DS tymp A group and the control group, similar reflectance curves were observed between control group and the DS tymp A group. WAI shows promise as a clinical diagnostic tool in investigating the impact of middle ear disorders in DS group. However, further research is required to investigate this issue in narrower age range group and a larger sample size. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Total serum bilirubin levels and sensorineural hearing loss in the US adolescents: NHANES 2007-2010.

PubMed

Zhou, Guoli; Fu, Wenjiang

2018-02-01

We aimed to investigate whether current levels of total serum bilirubin are associated with different subtypes of sensorineural hearing loss (SNHL) in adolescents. A set of cross-sectional data from the National Health and Nutrition Examination Survey (NHANES) (2007-2010) was used. A subset of 1404 adolescents was sampled for measurements of total serum bilirubin, tympanometry, and average pure tone threshold at low-frequencies (LPTA: 500, 1000, 2000 Hz) or high-frequencies (HPTA: 3000, 4000, 6000, and 8000 Hz). SNHL was defined as the hearing loss that had type A tympanograms with a peak admittance of 0.3 ml or greater. Associations between serum bilirubin (square-root transformed) and different subtypes of SNHL were evaluated using binary or multinomial logistic regression models with 4-year sampling weights. The bootstrap method was used for estimation of variance and 10-fold cross-validation for assessment of overfitting issue. Total serum bilirubin levels were found to be associated with any high-frequency (HPTA>15 dB in at least one ear, adjusted odds-ratio (OR a )(bootstrap 95% confidence interval) = 3.29(1.31-8.19), p = 0.011), but not with any low-frequency (LPTA>15 dB in at least one ear), SNHL in the US adolescents. Furthermore, high-frequency SNHL with HPTA>15 dB in both ears (bilateral) or HPTA≥25 dB in at least one ear, compared to that with HPTA>15 dB in one ear only (unilateral) or HPTA = 15-25 dB in at least one ear, had a stronger association with total serum bilirubin levels (OR a  = 5.37(1.27-22.65), p = 0.022 for bilateral; OR a  = 2.64(0.84-8.25), p = 0.094 for unilateral; OR a  = 5.00(0.95-26.58), p = 0.058 for HPTA≥25 dB in at least one ear; as well as OR a  = 3.06(1.15-8.25), p = 0.025 for HPTA = 15-25 dB in at least one ear). No severe overfitting problems were found. Our findings suggest that current levels of total serum bilirubin may be informative in predicting and/or targeting high-frequency SNHL in the US adolescents. Copyright © 2017 Elsevier B.V. All rights reserved.

Signatures from Tissue-specific MPSS Libraries Identify Transcripts Preferentially Expressed in the Mouse Inner Ear

PubMed Central

Peters, Linda M.; Belyantseva, Inna A.; Lagziel, Ayala; Battey, James F.; Friedman, Thomas B.; Morell, Robert J.

2007-01-01

Specialization in cell function and morphology is influenced by the differential expression of mRNAs, many of which are expressed at low abundance and restricted to certain cell types. Detecting such transcripts in cDNA libraries may require sequencing millions of clones. Massively parallel signature sequencing (MPSS) is well-suited for identifying transcripts that are expressed in discrete cell types and in low abundance. We have made MPSS libraries from microdissections of three inner ear tissues. By comparing these MPSS libraries to those of 87 other tissues included in the Mouse Reference Transcriptome (MRT) online resource, we have identified genes that are highly enriched in, or specific to, the inner ear. We show by RT-PCR and in situ hybridization that signatures unique to the inner ear libraries identify transcripts with highly specific cell-type localizations. These transcripts serve to illustrate the utility of a resource that is available to the research community. Utilization of these resources will increase the number of known transcription units and expand our knowledge of the tissue-specific regulation of the transcriptome. PMID:17049805

Fluorescence imaging spectroscopy (FIS) for comparing spectra from corn ears naturally and artificially infected with aflatoxin producing fungus.

PubMed

Hruska, Zuzana; Yao, Haibo; Kincaid, Russell; Darlington, Dawn; Brown, Robert L; Bhatnagar, Deepak; Cleveland, Thomas E

2013-08-01

In an effort to address the problem of rapid detection of aflatoxin in grain, particularly oilseeds, the current study assessed the spectral differences of aflatoxin production in kernels from a cornfield inoculated with spores from 2 different strains of toxigenic Aspergillus flavus. Aflatoxin production in corn from the same field due to natural infestation was also assessed. A small corn plot in Baton Rouge, La., U.S.A., was used during the 2008-growing season. Two groups of 400 plants were inoculated with 2 different inocula and 1 group of 400 plants was designated as controls. Any contamination detected in the controls was attributed to natural infestation. A subset of each group was imaged with a visible near infra red (VNIR) hyperspectral system under ultra violet (UV) excitation and subsequently analyzed for aflatoxin using affinity column fluorometry. Group differences were statistically analyzed. Results indicate that when all the spectral data across all groups were averaged, any potential differences between groups (treated and untreated) were obscured. However, spectral analysis based on contaminated "hot" pixel classification showed a distinct spectral shift/separation between contaminated and clean ears with fluorescence peaks at 501 and 478 nm, respectively. All inoculated and naturally infected control ears had fluorescence peaks at 501 nm that differed from uninfected corn ears. Results from this study may be useful in evaluating rapid, noninvasive instrumentation and/or methodology for aflatoxin detection in grain. © 2013 Institute of Food Technologists®

Long-term Results of Troublesome CWD Cavity Reconstruction by Mastoid and Epitympanic Bony Obliteration (CWR-BOT) in Adults.

PubMed

Vercruysse, Jean-Philippe; van Dinther, Joost J S; De Foer, Bert; Casselman, Jan; Somers, Thomas; Zarowski, Andrzej; Cremers, Cor C; Offeciers, Erwin

2016-07-01

To present the long-term surgical outcome of the bony mastoid and epitympanic obliteration technique with canal wall reconstruction (CWR-BOT) in adults with an unstable cavity after previous canal wall-down surgery for extensive cholesteatoma. Retrospective study. Therapeutic. Tertiary referral center. Fifty consecutive adult patients undergoing a CWR-BOT between 1998 and 2009. (A) Recurrence and residual rates of cholesteatoma, (B) postoperative hygienic status of the ear, including postoperative aspect of the tympanic membrane and external ear canal integrity (EAC), (C) functional outcome, and (D) long-term safety issues. (A) The percentage of ears remaining safe without recurrent or residual disease after CWR-BOT was 96% after a mean follow-up time of 101.8 months. Recurrent cholesteatoma occurred in 2% (n = 1) and a residual cholesteatoma was detected in 2% (n = 1) of the patients. (B) A safe dry, and trouble-free graft and selfcleaning EAC was achieved in 94%. (C) The postoperative hearing results showed a gain of 1.7 dB on pure-tone average air-conduction. (D) Nonecho planar diffusion-weighted imaging (non-EP DW magnetic resonance imaging) documented the residual (n = 1) and recurrent cholesteatoma (n = 1). The 1- and 5-year imaging follow-up revealed no other recurrent or residual disease. The CWR-BOT is a safe and very effective option for treatment of problematic unstable canal wall-down mastoid cavities, resulting in dry trouble-free ears.

15 CFR 732.6 - Steps for other requirements.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 15 Commerce and Foreign Trade 2 2010-01-01 2010-01-01 false Steps for other requirements. 732.6...) BUREAU OF INDUSTRY AND SECURITY, DEPARTMENT OF COMMERCE EXPORT ADMINISTRATION REGULATIONS STEPS FOR USING THE EAR § 732.6 Steps for other requirements. Sections 732.1 through 732.4 of this part are useful in...

[Dietary reference intakes of trace elements for Japanese and problems in clinical fields].

PubMed

Inoue, Yoshifumi

2016-07-01

In the dietary reference intakes, EAR(estimated average requirement), RDA(recommended dietary allowance), AL(adequate intake), DG(tentative dietary goal for preventing life style related diseases) and UL(tolerable upper intake level) of eight types of trace elements (iron: Fe, zinc: Zn, copper: Cu, manganese: Mn, iodine: I, selenium: Se, chromium: Cr, molybdenum: Mo) have been set. However, in the meals of hospitals, only iron of which has been taken into account. The content of these trace elements in the enteral nutrient released after 2000 was determined by considering the content of dietary reference intakes of trace elements for Japanese and considered so not fall into deficiency. However, enteral nutrient must be used considering the content of Zn, Cu and the Zn/Cu ratio, the selenium content, and the route of administration, in order to avoid falling into deficiency.

Trends in Cochlear Implants

PubMed Central

Zeng, Fan-Gang

2004-01-01

More than 60,000 people worldwide use cochlear implants as a means to restore functional hearing. Although individual performance variability is still high, an average implant user can talk on the phone in a quiet environment. Cochlear-implant research has also matured as a field, as evidenced by the exponential growth in both the patient population and scientific publication. The present report examines current issues related to audiologic, clinical, engineering, anatomic, and physiologic aspects of cochlear implants, focusing on their psychophysical, speech, music, and cognitive performance. This report also forecasts clinical and research trends related to presurgical evaluation, fitting protocols, signal processing, and postsurgical rehabilitation in cochlear implants. Finally, a future landscape in amplification is presented that requires a unique, yet complementary, contribution from hearing aids, middle ear implants, and cochlear implants to achieve a total solution to the entire spectrum of hearing loss treatment and management. PMID:15247993

The Oral Referential Communication Skills of Hearing-Impaired Children

ERIC Educational Resources Information Center

Lloyd, Julian; Lieven, Elena; Arnold, Paul

2005-01-01

This paper focuses on the oral referential communication skills of hearing-impaired (HI) children. A task based on that used with language impaired children by Leinonen and Letts (1997) was used to assess the speaking and listening skills of 20 HI children (mean age=10;2 years; mean better ear average hearing loss=88.85 dBHL). Their performance…

Comparisons of transient evoked otoacoustic emissions using chirp and click stimuli

PubMed Central

Keefe, Douglas H.; Feeney, M. Patrick; Hunter, Lisa L.; Fitzpatrick, Denis F.

2016-01-01

Transient-evoked otoacoustic emission (TEOAE) responses (0.7–8 kHz) were measured in normal-hearing adult ears using click stimuli and chirps whose local frequency increased or decreased linearly with time over the stimulus duration. Chirp stimuli were created by allpass filtering a click with relatively constant incident pressure level over frequency. Chirp TEOAEs were analyzed as a nonlinear residual signal by inverse allpass filtering each chirp response into an equivalent click response. Multi-window spectral and temporal averaging reduced noise levels compared to a single-window average. Mean TEOAE levels using click and chirp stimuli were similar with respect to their standard errors in adult ears. TEOAE group delay, group spread, instantaneous frequency, and instantaneous bandwidth were similar overall for chirp and click conditions, except for small differences showing nonlinear interactions differing across stimulus conditions. These results support the theory of a similar generation mechanism on the basilar membrane for both click and chirp conditions based on coherent reflection within the tonotopic region. TEOAE temporal fine structure was invariant across changes in stimulus level, which is analogous to the intensity invariance of click-evoked basilar-membrane displacement data. PMID:27914441

Comparisons of transient evoked otoacoustic emissions using chirp and click stimuli.

PubMed

Keefe, Douglas H; Feeney, M Patrick; Hunter, Lisa L; Fitzpatrick, Denis F

2016-09-01

Transient-evoked otoacoustic emission (TEOAE) responses (0.7-8 kHz) were measured in normal-hearing adult ears using click stimuli and chirps whose local frequency increased or decreased linearly with time over the stimulus duration. Chirp stimuli were created by allpass filtering a click with relatively constant incident pressure level over frequency. Chirp TEOAEs were analyzed as a nonlinear residual signal by inverse allpass filtering each chirp response into an equivalent click response. Multi-window spectral and temporal averaging reduced noise levels compared to a single-window average. Mean TEOAE levels using click and chirp stimuli were similar with respect to their standard errors in adult ears. TEOAE group delay, group spread, instantaneous frequency, and instantaneous bandwidth were similar overall for chirp and click conditions, except for small differences showing nonlinear interactions differing across stimulus conditions. These results support the theory of a similar generation mechanism on the basilar membrane for both click and chirp conditions based on coherent reflection within the tonotopic region. TEOAE temporal fine structure was invariant across changes in stimulus level, which is analogous to the intensity invariance of click-evoked basilar-membrane displacement data.

Texture analysis with statistical methods for wheat ear extraction

NASA Astrophysics Data System (ADS)

Bakhouche, M.; Cointault, F.; Gouton, P.

2007-01-01

In agronomic domain, the simplification of crop counting, necessary for yield prediction and agronomic studies, is an important project for technical institutes such as Arvalis. Although the main objective of our global project is to conceive a mobile robot for natural image acquisition directly in a field, Arvalis has proposed us first to detect by image processing the number of wheat ears in images before to count them, which will allow to obtain the first component of the yield. In this paper we compare different texture image segmentation techniques based on feature extraction by first and higher order statistical methods which have been applied on our images. The extracted features are used for unsupervised pixel classification to obtain the different classes in the image. So, the K-means algorithm is implemented before the choice of a threshold to highlight the ears. Three methods have been tested in this feasibility study with very average error of 6%. Although the evaluation of the quality of the detection is visually done, automatic evaluation algorithms are currently implementing. Moreover, other statistical methods of higher order will be implemented in the future jointly with methods based on spatio-frequential transforms and specific filtering.

The effect of head protection on the hearing of rugby players.

PubMed

Kieran, S M; Dunne, J; Hughes, J P; Fenton, J E

2008-09-01

Professional rugby players utilise various methods of head protection to prevent against the development of a pinna haematoma. This study tests the hypothesis that these measures, whilst preventing injury, decrease the wearers' hearing threshold and therefore their performance. Eight patients had free field audiometry performed in a soundproof room, with warble tones. All patients were young men (mean 24.75 years (range 22-34)). No participant had ear symptomatology or a past history of ear surgery. Three separate audiological assessments were performed on each patient: normal free field audiometry in a sound field room, following application of adhesive tape and whilst wearing a scrum cap. All measurements were performed by a single audiological scientist. A significant clinical drop in hearing threshold was defined as an increase of 10 dB. No patient demonstrated a significant drop in hearing threshold following the application of either tape or a scrum cap, nor was there a significant difference in the mean (SD) warble tone average: air 7.03 (5.47); tape 7.19 (6.40); scrum cap 6.56 (5.58). Theoretical concerns that "ear taping" and scrum caps affect hearing of rugby players are unfounded and should not discourage their use.

Hearing in nonprofessional pop/rock musicians.

PubMed

Schmuziger, Nicolas; Patscheke, Jochen; Probst, Rudolf

2006-08-01

The purpose of this study was to evaluate the hearing and subjective auditory symptoms in a group of nonprofessional pop/rock musicians who had experienced repeated exposures to intense sound levels during at least 5 yr of musical activity. An evaluation of both ears in 42 nonprofessional pop/rock musicians included pure-tone audiometry in the conventional and extended high-frequency range, the measurement of uncomfortable loudness levels, and an assessment of tinnitus and hypersensitivity to sound. Exclusion criteria were (a) the occurrence of acoustic trauma, (b) excessive noise exposure during occupational activities, (c) a history of recurrent otitis media, (d) previous ear surgery, (e) a fracture of the cranium, (f) ingestion of potentially ototoxic drugs, and (g) reported hearing difficulties within the immediate family. These audiometric results were then compared with a control group of 20 otologically normal young adults with no history of long-term noise exposure. After adjusting for age and gender, relative to ISO 7029, the mean hearing threshold in the frequency range of 3 to 8 kHz was 6 dB in the musicians and 1.5 dB in the control group. This difference was statistically significant (Mann-Whitney rank sum test, p < 0.001). A significant difference was also observed between musicians using regular hearing protection during their activities (average 3 to 8 kHz thresholds = 2.4 dB) and musicians who never used such hearing protection (average 3 to 8 kHz thresholds = 8.2 dB), after adjusting for age and gender (Mann-Whitney rank sum test, p = 0.006). Eleven of the musicians (26%) were found to be hypersensitive to sound, and seven (17%) presented with tinnitus. Tinnitus assessment, however, did not reveal any clinically significant psychological distress in these individuals. Tinnitus and hypersensitivity to sound were observed in a significant minority within a group of nonprofessional pop/rock musicians who had experienced repeated exposure to intense sound levels over at least 5 yr but with minimal impact on their lives. Moreover, hearing loss was minimal in the subjects who always used ear protection, being only 0.9 dB higher than the control group. In contrast, hearing loss was significantly more pronounced, at 6.7 dB higher than the control group, in those musicians who never used ear protection. Continued education about the risk to hearing and the benefits of the persistent use of ear protection is warranted for musicians who are exposed frequently to intense sound levels.

Perspective: The Case for an Evidence-Based Reference Interval for Serum Magnesium: The Time Has Come.

PubMed

Costello, Rebecca B; Elin, Ronald J; Rosanoff, Andrea; Wallace, Taylor C; Guerrero-Romero, Fernando; Hruby, Adela; Lutsey, Pamela L; Nielsen, Forrest H; Rodriguez-Moran, Martha; Song, Yiqing; Van Horn, Linda V

2016-11-01

The 2015 Dietary Guidelines Advisory Committee indicated that magnesium was a shortfall nutrient that was underconsumed relative to the Estimated Average Requirement (EAR) for many Americans. Approximately 50% of Americans consume less than the EAR for magnesium, and some age groups consume substantially less. A growing body of literature from animal, epidemiologic, and clinical studies has demonstrated a varied pathologic role for magnesium deficiency that includes electrolyte, neurologic, musculoskeletal, and inflammatory disorders; osteoporosis; hypertension; cardiovascular diseases; metabolic syndrome; and diabetes. Studies have also demonstrated that magnesium deficiency is associated with several chronic diseases and that a reduced risk of these diseases is observed with higher magnesium intake or supplementation. Subclinical magnesium deficiency can exist despite the presentation of a normal status as defined within the current serum magnesium reference interval of 0.75-0.95 mmol/L. This reference interval was derived from data from NHANES I (1974), which was based on the distribution of serum magnesium in a normal population rather than clinical outcomes. What is needed is an evidenced-based serum magnesium reference interval that reflects optimal health and the current food environment and population. We present herein data from an array of scientific studies to support the perspective that subclinical deficiencies in magnesium exist, that they contribute to several chronic diseases, and that adopting a revised serum magnesium reference interval would improve clinical care and public health. © 2016 American Society for Nutrition.

Perspective: The Case for an Evidence-Based Reference Interval for Serum Magnesium: The Time Has Come12345

PubMed Central

Elin, Ronald J; Rosanoff, Andrea; Lutsey, Pamela L; Nielsen, Forrest H; Rodriguez-Moran, Martha

2016-01-01

The 2015 Dietary Guidelines Advisory Committee indicated that magnesium was a shortfall nutrient that was underconsumed relative to the Estimated Average Requirement (EAR) for many Americans. Approximately 50% of Americans consume less than the EAR for magnesium, and some age groups consume substantially less. A growing body of literature from animal, epidemiologic, and clinical studies has demonstrated a varied pathologic role for magnesium deficiency that includes electrolyte, neurologic, musculoskeletal, and inflammatory disorders; osteoporosis; hypertension; cardiovascular diseases; metabolic syndrome; and diabetes. Studies have also demonstrated that magnesium deficiency is associated with several chronic diseases and that a reduced risk of these diseases is observed with higher magnesium intake or supplementation. Subclinical magnesium deficiency can exist despite the presentation of a normal status as defined within the current serum magnesium reference interval of 0.75–0.95 mmol/L. This reference interval was derived from data from NHANES I (1974), which was based on the distribution of serum magnesium in a normal population rather than clinical outcomes. What is needed is an evidenced-based serum magnesium reference interval that reflects optimal health and the current food environment and population. We present herein data from an array of scientific studies to support the perspective that subclinical deficiencies in magnesium exist, that they contribute to several chronic diseases, and that adopting a revised serum magnesium reference interval would improve clinical care and public health. PMID:28140318

22q11.2 microduplication syndrome with congenital aural atresia: a family report.

PubMed

Boudewyns, An; van den Ende, Jenneke; Boiy, Tine; Van de Heyning, Paul; Declau, Frank

2012-06-01

22q11.2 microduplication syndrome is characterized by a large phenotypic variability including facial dysmorphism, developmental delay, and hearing loss. We describe a family in whom 5 of 11 children were affected by a unilateral or bilateral congenital aural atresia. Four of these 5 carried a 22q11.2 microduplication and had typical dysmorphic features. Computed tomography with 3-D reconstructions allowed for a detailed examination of the middle ear structures and classification of the atresia type. Audiometry revealed a moderately severe conductive hearing loss in accordance with the clinical and computed tomography findings. Detailed examination of the ear is warranted in patients with a 22q11.2 microduplication. When outer ear abnormalities are encountered, an additional workup including audiometry and computed tomography with 3-D reconstructions is required.

The Mediterranean Diet and Nutritional Adequacy: A Review

PubMed Central

Castro-Quezada, Itandehui; Román-Viñas, Blanca; Serra-Majem, Lluís

2014-01-01

The Mediterranean dietary pattern, through a healthy profile of fat intake, low proportion of carbohydrate, low glycemic index, high content of dietary fiber, antioxidant compounds, and anti-inflammatory effects, reduces the risk of certain pathologies, such as cancer or Cardiovascular Disease (CVD). Nutritional adequacy is the comparison between the nutrient requirement and the intake of a certain individual or population. In population groups, the prevalence of nutrient inadequacy can be assessed by the probability approach or using the Estimated Average Requirement (EAR) cut-point method. However, dietary patterns can also be used as they have moderate to good validity to assess adequate intakes of some nutrients. The objective of this study was to review the available evidence on the Nutritional Adequacy of the Mediterranean Diet. The inclusion of foods typical of the Mediterranean diet and greater adherence to this healthy pattern was related to a better nutrient profile, both in children and adults, with a lower prevalence of individuals showing inadequate intakes of micronutrients. Therefore, the Mediterranean diet could be used in public health nutrition policies in order to prevent micronutrient deficiencies in the most vulnerable population groups. PMID:24394536

Audio-visual speech intelligibility benefits with bilateral cochlear implants when talker location varies.

PubMed

van Hoesel, Richard J M

2015-04-01

One of the key benefits of using cochlear implants (CIs) in both ears rather than just one is improved localization. It is likely that in complex listening scenes, improved localization allows bilateral CI users to orient toward talkers to improve signal-to-noise ratios and gain access to visual cues, but to date, that conjecture has not been tested. To obtain an objective measure of that benefit, seven bilateral CI users were assessed for both auditory-only and audio-visual speech intelligibility in noise using a novel dynamic spatial audio-visual test paradigm. For each trial conducted in spatially distributed noise, first, an auditory-only cueing phrase that was spoken by one of four talkers was selected and presented from one of four locations. Shortly afterward, a target sentence was presented that was either audio-visual or, in another test configuration, audio-only and was spoken by the same talker and from the same location as the cueing phrase. During the target presentation, visual distractors were added at other spatial locations. Results showed that in terms of speech reception thresholds (SRTs), the average improvement for bilateral listening over the better performing ear alone was 9 dB for the audio-visual mode, and 3 dB for audition-alone. Comparison of bilateral performance for audio-visual and audition-alone showed that inclusion of visual cues led to an average SRT improvement of 5 dB. For unilateral device use, no such benefit arose, presumably due to the greatly reduced ability to localize the target talker to acquire visual information. The bilateral CI speech intelligibility advantage over the better ear in the present study is much larger than that previously reported for static talker locations and indicates greater everyday speech benefits and improved cost-benefit than estimated to date.

Receiver function imaging of mantle transition zone discontinuities beneath the Tanzania Craton and the Eastern and Western Branches of the East African Rift System

NASA Astrophysics Data System (ADS)

Sun, M.; Liu, K. H.; Fu, X.; Gao, S. S.

2017-12-01

To investigate the mechanism of initiation and development of the Eastern African Rifting System (EARS) circumfluent the Tanzania Craton (TC), over 7,100 P-to-S radial receiver functions (RFs) recorded by 87 broadband seismic stations are stacked to map the topography of mantle transition zone (MTZ) discontinuities beneath the TC and the Eastern and Western Branches of the EARS. After time-depth conversion using the 1-D IASP91 Earth model, the resulting 410 km (d410) and 660 km (d660) discontinuity apparent depths are found to be greater than the global averages beneath the whole study area, implying slower than normal upper mantle velocities. The mean thickness of the MTZ beneath the Western Branch and TC is about 252 km, which is comparable to the global average and is inconsistent with the existence of present-day thermal upwelling originating from the lower mantle. In contrast, beneath the Eastern Branch, an 30 km thinning of the MTZ is observed from an up to 50 km and 20 km apparent depression of the d410 and d660, respectively. On the basis of previous seismic tomographic results and empirical relationships between velocity and thermal anomalies, we propose that the most plausible explanation for the observations beneath the volcanic Eastern Branch is the existence of a low-velocity layer extending from the surface to the upper MTZ, probably caused by decompression partial melting associated with continental rifting. The observations are in general agreement with an upper mantle origin for the initiation and development of both the Western and Eastern Branches of the EARS beneath the study area.

The sound exposure of the audience at a music festival.

PubMed

Mercier, V; Luy, D; Hohmann, B W

2003-01-01

During the Paleo Festival in Nyon, Switzerland, which took place from 24th to 29th July 2001, ten volunteers were equipped each evening with small sound level meters which continuously monitored their sound exposure as they circulated among the various festival events. Sound levels at the mixing console and at the place where people are most heavily exposed (in front of the speakers) were measured simultaneously. In addition, a sample of 601 people from the audience were interviewed over the six days of the festival and asked their opinion of sound level and quality, as well as provide details of where in the arena they preferred to listen to the concerts, whether they used ear plugs, if they had experienced any tinnitus, and if so how long it had persisted. The individual sound exposure during a typical evening was on average 95 dB(A) although 8% of the volunteers were exposed to sound levels higher then 100 dB(A). Only 5% of the audience wore ear plugs throughout the concert while 34% used them occasionally. While some 36% of the people interviewed reported that they had experienced tinnitus after listening to loud music, the majority found both the music quality and the sound level good. The sound level limit of 100 dB(A) at the place where the people are most heavily exposed seems to be a good compromise between the public heath issue, the demands of artists and organisers, and the expectations of the public. However, considering the average sound levels to which the public are exposed during a single evening, it is recommended that ear plugs be used by concert-goers who attend more than one day of the festival.

Transtympanic injections of N-acetylcysteine for the prevention of cisplatin-induced ototoxicity: a feasible method with promising efficacy.

PubMed

Riga, Maria G; Chelis, Leonidas; Kakolyris, Stylianos; Papadopoulos, Stergios; Stathakidou, Sofia; Chamalidou, Eleni; Xenidis, Nikolaos; Amarantidis, Kyriakos; Dimopoulos, Prokopios; Danielides, Vasilios

2013-02-01

Ototoxicity is a common and irreversible adverse effect of cisplatin treatment with great impact on the patients' quality of life. N-acetylcysteine is a low-molecular-weight agent which has shown substantial otoprotective activity. The role of transtympanic infusions of N-acetylcysteine was examined in a cohort of patients treated with cisplatin-based regimens. Twenty cisplatin-treated patients were subjected, under local anesthesia, to transtympanic N-acetylcysteine (10%) infusions in 1 ear, during the hydration procedure preceding intravenous effusion of cisplatin. The contralateral ear was used as control. The number of transtympanic infusions was respective to the number of administered cycles. Hearing acuity was evaluated before each cycle with pure tone audiometry by an audiologist blinded to the treated ear. A total of 84 transtympanic infusions were performed. In treated ears, no significant changes in auditory thresholds were recorded. In the control ears cisplatin induced a significant decrease of auditory thresholds at the 8000 Hz frequency band (P=0.008). At the same frequency (8000 Hz), the changes in auditory thresholds were significantly larger for the control ears than the treated ones (P=0.005). An acute pain starting shortly after the injection and lasting for a few minutes seemed to be the only significant adverse effect. Transtympanic injections of N-acetylcysteine seem to be a feasible and effective otoprotective strategy for the prevention of cisplatin-induced ototoxicity. Additional studies are required to further clarify the efficiency of this treatment and determine the optimal dosage and protocol.

Prevention and management of vascular complications in middle ear and cochlear implant surgery.

PubMed

Di Lella, Filippo; Falcioni, Maurizio; Piccinini, Silvia; Iaccarino, Ilaria; Bacciu, Andrea; Pasanisi, Enrico; Cerasti, Davide; Vincenti, Vincenzo

2017-11-01

The objective of this study is to illustrate prevention strategies and management of vascular complications from the jugular bulb (JB) and internal carotid artery (ICA) during middle ear surgery or cochlear implantation. The study design is retrospective case series. The setting is tertiary referral university hospital. Patients were included if presented pre- or intraoperative evidence of high-risk anatomical anomalies of ICA or JB during middle ear or cochlear implant surgery, intraoperative vascular injury, or revision surgery after the previous iatrogenic vascular lesions. The main outcome measures are surgical outcomes and complications rate. Ten subjects were identified: three underwent cochlear implant surgery and seven underwent middle ear surgery. Among the cochlear implant patients, two presented with anomalies of the JB impeding access to the cochlear lumen and one underwent revision surgery for incorrect positioning of the array in the carotid canal. Subtotal petrosectomy was performed in all cases. Anomalies of the JB were preoperatively identified in two patients with attic and external auditory canal cholesteatoma, respectively. In a patient, a high and dehiscent JB was found during myringoplasty, while another underwent revision surgery after iatrogenic injury of the JB. A dehiscent ICA complicated middle ear effusion in one case, while in another case, a carotid aneurysm determined a cholesterol granuloma. Rupture of a pseudoaneurysm of the ICA occurred in a child during second-stage surgery and required permanent balloon occlusion without neurological complications. Knowledge of normal anatomy and its variants and preoperative imaging are the basis for prevention of vascular complications during middle ear or cochlear implant surgery.

Vitamin D Requirements for the Future-Lessons Learned and Charting a Path Forward.

PubMed

Cashman, Kevin D

2018-04-25

Estimates of dietary requirements for vitamin D or Dietary Reference Values (DRV) are crucial from a public health perspective in providing a framework for prevention of vitamin D deficiency and optimizing vitamin D status of individuals. While these important public health policy instruments were developed with the evidence-base and data available at the time, there are some issues that need to be clarified or considered in future iterations of DRV for vitamin D. This is important as it will allow for more fine-tuned and truer estimates of the dietary requirements for vitamin D and thus provide for more population protection. The present review will overview some of the confusion that has arisen in relation to the application and/or interpretation of the definitions of the Estimated Average Requirement (EAR) and Recommended Dietary Allowance (RDA). It will also highlight some of the clarifications needed and, in particular, how utilization of a new approach in terms of using individual participant-level data (IPD), over and beyond aggregated data, from randomised controlled trials with vitamin D may have a key role in generating these more fine-tuned and truer estimates, which is of importance as we move towards the next iteration of vitamin D DRVs.

Binaural beats at high frequencies.

PubMed

McFadden, D; Pasanen, E G

1975-10-24

Binaural beats have long been believed to be audible only at low frequencies, but an interaction reminiscent of a binaural beat can sometimes be heard when different two-tone complexes of high frequency are presented to the two ears. The primary requirement is that the frequency separation in the complex at one ear be slightly different from that in the other--that is, that there be a small interaural difference in the envelope periodicities. This finding is in accord with other recent demonstrations that the auditory system is not deaf to interaural time differences at high frequencies.

Effectiveness of Ear Splint Therapy for Ear Deformities

PubMed Central

2017-01-01

Objective To present our experience with ear splint therapy for babies with ear deformities, and thereby demonstrate that this therapy is an effective and safe intervention without significant complications. Methods This was a retrospective study of 54 babies (35 boys and 19 girls; 80 ears; age ≤3 months) with ear deformities who had received ear splint therapy at the Center for Torticollis, Department of Physical Medicine and Rehabilitation, Ajou University Hospital between December 2014 and February 2016. Before the initiation of ear splint therapy, ear deformities were classified with reference to the standard terminology. We compared the severity of ear deformity before and after ear splint therapy by using the physician's ratings. We also compared the physician's ratings and the caregiver's ratings on completion of ear splint therapy. Results Among these 54 babies, 41 children (58 ears, 72.5%) completed the ear splint therapy. The mean age at initiation of therapy was 52.91±18.26 days and the treatment duration was 44.27±32.06 days. Satyr ear, forward-facing ear lobe, Darwinian notch, overfolded ear, and cupped ear were the five most common ear deformities. At the completion of therapy, the final physician's ratings of ear deformities were significantly improved compared to the initial ratings (8.28±1.44 vs. 2.51±0.92; p<0.001). There was no significant difference between the physician's ratings and the caregiver's ratings at the completion of ear splint therapy (8.28±1.44 vs. 8.0±1.61; p=0.297). Conclusion We demonstrated that ear splint therapy significantly improved ear deformities in babies, as measured by quantitative rating scales. Ear splint therapy is an effective and safe intervention for babies with ear deformities. PMID:28289646

Time Average Holography Study of Human Tympanic Membrane with Altered Middle Ear Ossicular Chain

NASA Astrophysics Data System (ADS)

Cheng, Jeffrey T.; Ravicz, Michael E.; Rosowski, John J.; Hulli, Nesim; Hernandez-Montes, Maria S.; Furlong, Cosme

2009-02-01

Computer-assisted time average holographic interferometry was used to study the vibration of the human tympanic membrane (TM) in cadaveric temporal bones before and after alterations of the ossicular chain. Simultaneous laser Doppler vibrometer measurements of stapes velocity were performed to estimate the conductive hearing loss caused by ossicular alterations. The quantified TM motion described from holographic images was correlated with stapes velocity to define relations between TM motion and stapes velocity in various ossicular disorders. The results suggest that motions of the TM are relatively uncoupled from stapes motion at frequencies above 1000 Hz.

Live attenuated influenza virus increases pneumococcal translocation and persistence within the middle ear.

PubMed

Mina, Michael J; Klugman, Keith P; Rosch, Jason W; McCullers, Jonathan A

2015-07-15

Infection with influenza A virus (IAV) increases susceptibility to respiratory bacterial infections, resulting in increased bacterial carriage and complications such acute otitis media, pneumonia, bacteremia, and meningitis. Recently, vaccination with live attenuated influenza virus (LAIV) was reported to enhance subclinical bacterial colonization within the nasopharynx, similar to IAV. Although LAIV does not predispose to bacterial pneumonia, whether it may alter bacterial transmigration toward the middle ear, where it could have clinically relevant implications, has not been investigated. BALB/c mice received LAIV or phosphate-buffered saline 1 or 7 days before or during pneumococcal colonization with either of 2 clinical isolates, 19F or 7F. Middle ear bacterial titers were monitored daily via in vivo imaging. LAIV increased bacterial transmigration to and persistence within the middle ear. When colonization followed LAIV inoculation, a minimum LAIV incubation period of 4 days was required before bacterial transmigration commenced. While LAIV vaccination is safe and effective at reducing IAV and coinfection with influenza virus and bacteria, LAIV may increase bacterial transmigration to the middle ear and could thus increase the risk of clinically relevant acute otitis media. These data warrant further investigations into interactions between live attenuated viruses and naturally colonizing bacterial pathogens. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

A challenge for the seed mixture refuge strategy in Bt maize: impact of cross-pollination on an ear-feeding pest, corn earworm.

PubMed

Yang, Fei; Kerns, David L; Head, Graham P; Leonard, B Rogers; Levy, Ronnie; Niu, Ying; Huang, Fangneng

2014-01-01

To counter the threat of insect resistance, Bacillus thuringiensis (Bt) maize growers in the U.S. are required to plant structured non-Bt maize refuges. Concerns with refuge compliance led to the introduction of seed mixtures, also called RIB (refuge-in-the-bag), as an alternative approach for implementing refuge for Bt maize products in the U.S. Maize Belt. A major concern in RIB is cross-pollination of maize hybrids that can cause Bt proteins to be present in refuge maize kernels and negatively affect refuge insects. Here we show that a mixed planting of 5% nonBt and 95% Bt maize containing the SmartStax traits expressing Cry1A.105, Cry2Ab2 and Cry1F did not provide an effective refuge for an important above-ground ear-feeding pest, the corn earworm, Helicoverpa zea (Boddie). Cross-pollination in RIB caused a majority (>90%) of refuge kernels to express ≥ one Bt protein. The contamination of Bt proteins in the refuge ears reduced neonate-to-adult survivorship of H. zea to only 4.6%, a reduction of 88.1% relative to larvae feeding on ears of pure non-Bt maize plantings. In addition, the limited survivors on refuge ears had lower pupal mass and took longer to develop to adults.

Roles of an anti-tuberculosis medication and surgery in patients with tuberculous otitis media.

PubMed

Kwon, Minsu; Choi, Seung Hyo; Chung, Jong Woo

2010-06-01

The standard treatment for tuberculous otitis media (TOM) without complications consists of anti-tuberculosis (anti-TB) medication, with which we experienced good treatment outcomes. However, surgery is required for recovery of anatomy and hearing function. To determine the clinical characteristics of TOM that might optimize diagnosis and to evaluate the differences in clinical courses between patients treated with and without surgery. We analyzed 14 patients (16 ears) who had been diagnosed and treated for TOM. Radiologic findings, laboratory data, and audiometry results were also evaluated. Patients were divided into a chemotherapy group and a surgery group according to treatment modality. Temporal bone CT (TBCT) showed total occupation of the tympanic cavity by soft tissue and little evidence of ossicular erosion. In the chemotherapy group, dry ears were obtained in all but one patient (14 ears) after treatment. Normalized tympanic membrane (TM) was found in 50% in the chemotherapy group and in 75% in the surgery group. The air-bone gap (ABG) changed from 40.3 +/- 2.5 dB to 47.0 +/- 19.2 dB in the chemotherapy group and from 35.2 +/- 7.6 dB to 30.2 +/- 11.4 dB in the surgery group. After treatment, ABG improved by > 10 dB in one ear in the chemotherapy group and in four ears in the surgery group.

Pseudomonas aeruginosa necrotizing chondritis complicating high helical ear piercing case report: clinical and public health perspectives.

PubMed

Sandhu, Amonpreet; Gross, Melissa; Wylie, John; Van Caeseele, Paul; Plourde, Pierre

2007-01-01

Auricular or high helical ear piercing is an increasingly widespread fashion trend that is associated with an increased risk of potentially serious post-piercing complications such as auricular perichondritis. An 11-year-old girl developed severe auricular perichondritis following piercing of the upper helical cartilage of her ear at a hairdressing salon. Four days post piercing, she returned to the same salon for a haircut during which the pierced site was manipulated. She presented to her family physician and was treated unsuccessfully with oral cephalexin. She was then referred to an infectious diseases consultant and received antipseudomonal intravenous antibiotics with subsequent resolution. She also required debridement and removal of necrotic cartilage. Public health investigation evaluated potential sources of infection including the piercing gun, disinfectant solutions, and hair cutting spray water bottles. Final culture results of the ear helical aspirate grew Pseudomonas aeruginosa. Pseudomonas aeruginosa was also cultured from one of the water bottles used to wet her hair during the haircut. Although the pseudomonal strains from the water bottle were different than the infecting one, this contamination presents a potential source of wound infection. Damage to the helical cartilage caused by the piercing gun may also have contributed to this infection. Initial empiric antibiotic therapy for these kinds of infection must include anti-pseudomonal coverage. Auricular or high helical ear piercing using a piercing gun is not recommended.

Development of a novel clinical scoring system for on-farm diagnosis of bovine respiratory disease in pre-weaned dairy calves.

PubMed

Love, William J; Lehenbauer, Terry W; Kass, Philip H; Van Eenennaam, Alison L; Aly, Sharif S

2014-01-01

Several clinical scoring systems for diagnosis of bovine respiratory disease (BRD) in calves have been proposed. However, such systems were based on subjective judgment, rather than statistical methods, to weight scores. Data from a pair-matched case-control study on a California calf raising facility was used to develop three novel scoring systems to diagnose BRD in preweaned dairy calves. Disease status was assigned using both clinical signs and diagnostic test results for BRD-associated pathogens. Regression coefficients were used to weight score values. The systems presented use nasal and ocular discharge, rectal temperature, ear and head carriage, coughing, and respiratory quality as predictors. The systems developed in this research utilize fewer severity categories of clinical signs, require less calf handling, and had excellent agreement (Kappa > 0.8) when compared to an earlier scoring system. The first scoring system dichotomized all clinical predictors but required inducing a cough. The second scoring system removed induced cough as a clinical abnormality but required distinguishing between three levels of nasal discharge severity. The third system removed induced cough and forced a dichotomized variable for nasal discharge. The first system presented in this study used the following predictors and assigned values: coughing (induced or spontaneous coughing, 2 points), nasal discharge (any discharge, 3 points), ocular discharge (any discharge, 2 points), ear and head carriage (ear droop or head tilt, 5 points), fever (≥39.2°C or 102.5°F, 2 points), and respiratory quality (abnormal respiration, 2 points). Calves were categorized "BRD positive" if their total score was ≥4. This system correctly classified 95.4% cases and 88.6% controls. The second presented system categorized the predictors and assigned weights as follows: coughing (spontaneous only, 2 points), mild nasal discharge (unilateral, serous, or watery discharge, 3 points), moderate to severe nasal discharge (bilateral, cloudy, mucoid, mucopurlent, or copious discharge, 5 points), ocular discharge (any discharge, 1 point), ear and head carriage (ear droop or head tilt, 5 points), fever (≥39.2°C, 2 points), and respiratory quality (abnormal respiration, 2 points). Calves were categorized "BRD positive" if their total score was ≥4. This system correctly classified 89.3% cases and 92.8% controls. The third presented system used the following predictors and scores: coughing (spontaneous only, 2 points), nasal discharge (any, 4 points), ocular discharge (any, 2 points), ear and head carriage (ear droop or head tilt, 5 points), fever (≥39.2°C, 2 points), and respiratory quality (abnormal respiration, 2 points). Calves were categorized "BRD positive" if their total score was ≥5. This system correctly classified 89.4% cases and 90.8% controls. Each of the proposed systems offer few levels of clinical signs and data-based weights for on-farm diagnosis of BRD in dairy calves.

Development of a novel clinical scoring system for on-farm diagnosis of bovine respiratory disease in pre-weaned dairy calves

PubMed Central

Love, William J.; Lehenbauer, Terry W.; Kass, Philip H.; Van Eenennaam, Alison L.

2014-01-01

Several clinical scoring systems for diagnosis of bovine respiratory disease (BRD) in calves have been proposed. However, such systems were based on subjective judgment, rather than statistical methods, to weight scores. Data from a pair-matched case-control study on a California calf raising facility was used to develop three novel scoring systems to diagnose BRD in preweaned dairy calves. Disease status was assigned using both clinical signs and diagnostic test results for BRD-associated pathogens. Regression coefficients were used to weight score values. The systems presented use nasal and ocular discharge, rectal temperature, ear and head carriage, coughing, and respiratory quality as predictors. The systems developed in this research utilize fewer severity categories of clinical signs, require less calf handling, and had excellent agreement (Kappa > 0.8) when compared to an earlier scoring system. The first scoring system dichotomized all clinical predictors but required inducing a cough. The second scoring system removed induced cough as a clinical abnormality but required distinguishing between three levels of nasal discharge severity. The third system removed induced cough and forced a dichotomized variable for nasal discharge. The first system presented in this study used the following predictors and assigned values: coughing (induced or spontaneous coughing, 2 points), nasal discharge (any discharge, 3 points), ocular discharge (any discharge, 2 points), ear and head carriage (ear droop or head tilt, 5 points), fever (≥39.2°C or 102.5°F, 2 points), and respiratory quality (abnormal respiration, 2 points). Calves were categorized “BRD positive” if their total score was ≥4. This system correctly classified 95.4% cases and 88.6% controls. The second presented system categorized the predictors and assigned weights as follows: coughing (spontaneous only, 2 points), mild nasal discharge (unilateral, serous, or watery discharge, 3 points), moderate to severe nasal discharge (bilateral, cloudy, mucoid, mucopurlent, or copious discharge, 5 points), ocular discharge (any discharge, 1 point), ear and head carriage (ear droop or head tilt, 5 points), fever (≥39.2°C, 2 points), and respiratory quality (abnormal respiration, 2 points). Calves were categorized “BRD positive” if their total score was ≥4. This system correctly classified 89.3% cases and 92.8% controls. The third presented system used the following predictors and scores: coughing (spontaneous only, 2 points), nasal discharge (any, 4 points), ocular discharge (any, 2 points), ear and head carriage (ear droop or head tilt, 5 points), fever (≥39.2°C, 2 points), and respiratory quality (abnormal respiration, 2 points). Calves were categorized “BRD positive” if their total score was ≥5. This system correctly classified 89.4% cases and 90.8% controls. Each of the proposed systems offer few levels of clinical signs and data-based weights for on-farm diagnosis of BRD in dairy calves. PMID:24482759

Effects of dynamic range compression on spatial selective auditory attention in normal-hearing listeners.

PubMed

Schwartz, Andrew H; Shinn-Cunningham, Barbara G

2013-04-01

Many hearing aids introduce compressive gain to accommodate the reduced dynamic range that often accompanies hearing loss. However, natural sounds produce complicated temporal dynamics in hearing aid compression, as gain is driven by whichever source dominates at a given moment. Moreover, independent compression at the two ears can introduce fluctuations in interaural level differences (ILDs) important for spatial perception. While independent compression can interfere with spatial perception of sound, it does not always interfere with localization accuracy or speech identification. Here, normal-hearing listeners reported a target message played simultaneously with two spatially separated masker messages. We measured the amount of spatial separation required between the target and maskers for subjects to perform at threshold in this task. Fast, syllabic compression that was independent at the two ears increased the required spatial separation, but linking the compressors to provide identical gain to both ears (preserving ILDs) restored much of the deficit caused by fast, independent compression. Effects were less clear for slower compression. Percent-correct performance was lower with independent compression, but only for small spatial separations. These results may help explain differences in previous reports of the effect of compression on spatial perception of sound.

15 CFR 742.3 - Nuclear nonproliferation.

Code of Federal Regulations, 2012 CFR

2012-01-01

...) BUREAU OF INDUSTRY AND SECURITY, DEPARTMENT OF COMMERCE EXPORT ADMINISTRATION REGULATIONS CONTROL POLICY-CCL BASED CONTROLS § 742.3 Nuclear nonproliferation. (a) License requirements. Section 309(c) of the Nuclear Non-Proliferation Act of 1978 requires BIS to identify items subject to the EAR that could be of...

15 CFR 742.3 - Nuclear nonproliferation.

Code of Federal Regulations, 2014 CFR

2014-01-01

...) BUREAU OF INDUSTRY AND SECURITY, DEPARTMENT OF COMMERCE EXPORT ADMINISTRATION REGULATIONS CONTROL POLICY-CCL BASED CONTROLS § 742.3 Nuclear nonproliferation. (a) License requirements. Section 309(c) of the Nuclear Non-Proliferation Act of 1978 requires BIS to identify items subject to the EAR that could be of...

15 CFR 742.3 - Nuclear nonproliferation.

Code of Federal Regulations, 2011 CFR

2011-01-01

...) BUREAU OF INDUSTRY AND SECURITY, DEPARTMENT OF COMMERCE EXPORT ADMINISTRATION REGULATIONS CONTROL POLICY-CCL BASED CONTROLS § 742.3 Nuclear nonproliferation. (a) License requirements. Section 309(c) of the Nuclear Non-Proliferation Act of 1978 requires BIS to identify items subject to the EAR that could be of...

15 CFR 742.3 - Nuclear nonproliferation.

Code of Federal Regulations, 2010 CFR

2010-01-01

...) BUREAU OF INDUSTRY AND SECURITY, DEPARTMENT OF COMMERCE EXPORT ADMINISTRATION REGULATIONS CONTROL POLICY-CCL BASED CONTROLS § 742.3 Nuclear nonproliferation. (a) License requirements. Section 309(c) of the Nuclear Non-Proliferation Act of 1978 requires BIS to identify items subject to the EAR that could be of...

15 CFR 742.3 - Nuclear nonproliferation.

Code of Federal Regulations, 2013 CFR

2013-01-01

...) BUREAU OF INDUSTRY AND SECURITY, DEPARTMENT OF COMMERCE EXPORT ADMINISTRATION REGULATIONS CONTROL POLICY-CCL BASED CONTROLS § 742.3 Nuclear nonproliferation. (a) License requirements. Section 309(c) of the Nuclear Non-Proliferation Act of 1978 requires BIS to identify items subject to the EAR that could be of...

Cauliflower Ear

MedlinePlus

... of headgear are recommended or required (like football, baseball, hockey, boxing, or wrestling). If someone receives a ... Taking Care of Your Skin Stitches Stay Safe: Baseball What's a Bruise? View more About Us Contact ...

Analysis of subtle auditory dysfunctions in young normal-hearing subjects affected by Williams syndrome.

PubMed

Paglialonga, Alessia; Barozzi, Stefania; Brambilla, Daniele; Soi, Daniela; Cesarani, Antonio; Spreafico, Emanuela; Tognola, Gabriella

2014-11-01

To assess if young subjects affected by Williams syndrome (WS) with normal middle ear functionality and normal hearing thresholds might have subtle auditory dysfunctions that could be detected by using clinically available measurements. Otoscopy, acoustic reflexes, tympanometry, pure-tone audiometry, and distortion product otoacoustic emissions (DPOAEs) were measured in a group of 13 WS subjects and in 13 age-matched, typically developing control subjects. Participants were required to have normal otoscopy, A-type tympanogram, normal acoustic reflex thresholds, and pure-tone thresholds≤15 dB HL at 0.5, 1, and 2 kHz bilaterally. To limit the possible influence of middle ear status on DPOAE recordings, we analyzed only data from ears with pure-tone thresholds≤15 dB HL across all octave frequencies in the range 0.25-8 kHz, middle ear pressure (MEP)>-50 daPa, static compliance (SC) in the range 0.3-1.2 cm3, and ear canal volume (ECV) in the range 0.2-2 ml, and we performed analysis of covariance to remove the possible effects of middle ear variables on DPOAEs. No differences in mean hearing thresholds, SC, ECV, and gradient were observed between the two groups, whereas significantly lower MEP values were found in WS subjects as well as significantly decreased DPOAEs up to 3.2 kHz after adjusting for differences in middle ear status. Results revealed that WS subjects with normal hearing thresholds (≤15 dB HL) and normal middle ear functionality (MEP>-50 daPa, SC in the range 0.3-1.2 cm3, ECV in the range 0.2-2 ml) might have subtle auditory dysfunctions that can be detected by using clinically available methods. Overall, this study points out the importance of using otoacoustic emissions as a complement to routine audiological examinations in individuals with WS to detect, before the onset of hearing loss, possible subtle auditory dysfunctions so that patients can be early identified, better monitored, and promptly treated. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

A-Weighted Sound Levels in Cockpits of Fixed- and Rotary-Wing Aircraft.

DTIC Science & Technology

fixed-wing vehicles and from 98 to 106 dB for helicopters. Means and standard deviations are reported by octave-bands, all-pass (flat), A - levels , and...preferred speech interference levels (PSIL, average of 500, 1000 and 2000 Hz). Also, at-the-ear A - levels are reported for generalized amounts of attenuation provided by headsets commonly worn in aircraft. (Author)

Long-range transcriptional control of an operon necessary for virulence-critical ESX-1 secretion in Mycobacterium tuberculosis.

PubMed

Hunt, Debbie M; Sweeney, Nathan P; Mori, Luisa; Whalan, Rachael H; Comas, Iñaki; Norman, Laura; Cortes, Teresa; Arnvig, Kristine B; Davis, Elaine O; Stapleton, Melanie R; Green, Jeffrey; Buxton, Roger S

2012-05-01

The ESX-1 secretion system of Mycobacterium tuberculosis has to be precisely regulated since the secreted proteins, although required for a successful virulent infection, are highly antigenic and their continued secretion would alert the immune system to the infection. The transcription of a five-gene operon containing espACD-Rv3613c-Rv3612c, which is required for ESX-1 secretion and is essential for virulence, was shown to be positively regulated by the EspR transcription factor. Thus, transcription from the start site, found to be located 67 bp upstream of espA, was dependent upon EspR enhancer-like sequences far upstream (between 884 and 1,004 bp), which we term the espA activating region (EAR). The EAR contains one of the known binding sites for EspR, providing the first in vivo evidence that transcriptional activation at the espA promoter occurs by EspR binding to the EAR and looping out DNA between this site and the promoter. Regulation of transcription of this operon thus takes place over long regions of the chromosome. This regulation may differ in some members of the M. tuberculosis complex, including Mycobacterium bovis, since deletions of the intergenic region have removed the upstream sequence containing the EAR, resulting in lowered espA expression. Consequent differences in expression of ESX-1 in these bacteria may contribute to their various pathologies and host ranges. The virulence-critical nature of this operon means that transcription factors controlling its expression are possible drug targets.

Automatic detection of the inner ears in head CT images using deep convolutional neural networks

NASA Astrophysics Data System (ADS)

Zhang, Dongqing; Noble, Jack H.; Dawant, Benoit M.

2018-03-01

Cochlear implants (CIs) use electrode arrays that are surgically inserted into the cochlea to stimulate nerve endings to replace the natural electro-mechanical transduction mechanism and restore hearing for patients with profound hearing loss. Post-operatively, the CI needs to be programmed. Traditionally, this is done by an audiologist who is blind to the positions of the electrodes relative to the cochlea and relies on the patient's subjective response to stimuli. This is a trial-and-error process that can be frustratingly long (dozens of programming sessions are not unusual). To assist audiologists, we have proposed what we call IGCIP for image-guided cochlear implant programming. In IGCIP, we use image processing algorithms to segment the intra-cochlear anatomy in pre-operative CT images and to localize the electrode arrays in post-operative CTs. We have shown that programming strategies informed by image-derived information significantly improve hearing outcomes for both adults and pediatric populations. We are now aiming at deploying these techniques clinically, which requires full automation. One challenge we face is the lack of standard image acquisition protocols. The content of the image volumes we need to process thus varies greatly and visual inspection and labelling is currently required to initialize processing pipelines. In this work we propose a deep learning-based approach to automatically detect if a head CT volume contains two ears, one ear, or no ear. Our approach has been tested on a data set that contains over 2,000 CT volumes from 153 patients and we achieve an overall 95.97% classification accuracy.

Hearing Loss and Quality of Life (QOL) among Human Immunodeficiency Virus (HIV)-Infected and Uninfected Adults

PubMed Central

Duong, N; Torre, P; Springer, G; Cox, C; Plankey, MW

2017-01-01

Objective Research has established that human immunodeficiency virus (HIV) causes hearing loss. Studies have yet to evaluate the impact on quality of life (QOL). This project evaluates the effect of hearing loss on QOL by HIV status. Methods The study participants were from the Multicenter AIDS Cohort Study (MACS) and the Women's Interagency HIV study (WIHS). A total of 248 men and 127 women participated. Pure-tone air conduction thresholds were collected for each ear at frequencies from 250 through 8000 Hz. Pure-tone averages (PTAs) for each ear were calculated as the mean of air conduction thresholds in low frequencies (i.e., 250, 500, 1000 and 2000 Hz) and high frequencies (i.e., 3000, 4000, 6000 and 8000 Hz). QOL data were gathered with the Short Form 36 Health Survey and Medical Outcome Study (MOS)-HIV instrument in the MACS and WIHS, respectively. A median regression analysis was performed to test the association of PTAs with QOL by HIV status. Results There was no significant association between hearing loss and QOL scores at low and high pure tone averages in HIV positive and negative individuals. HIV status, HIV biomarkers and treatment did not change the lack of association of low and high pure tone averages with poorer QOL. Conclusion Although we did not find a statistically significant association of hearing loss with QOL by HIV status, testing for hearing loss with aging and recommending treatment may offset any presumed later life decline in QOL. PMID:28217403

3D finite element model of the chinchilla ear for characterizing middle ear functions

PubMed Central

Wang, Xuelin; Gan, Rong Z.

2016-01-01

Chinchilla is a commonly used animal model for research of sound transmission through the ear. Experimental measurements of the middle ear transfer function in chinchillas have shown that the middle ear cavity greatly affects the tympanic membrane (TM) and stapes footplate (FP) displacements. However, there is no finite element (FE) model of the chinchilla ear available in the literature to characterize the middle ear functions with the anatomical features of the chinchilla ear. This paper reports a recently completed 3D FE model of the chinchilla ear based on X-ray micro-computed tomography images of a chinchilla bulla. The model consisted of the ear canal, TM, middle ear ossicles and suspensory ligaments, and the middle ear cavity. Two boundary conditions of the middle ear cavity wall were simulated in the model as the rigid structure and the partially flexible surface, and the acoustic-mechanical coupled analysis was conducted with these two conditions to characterize the middle ear function. The model results were compared with experimental measurements reported in the literature including the TM and FP displacements and the middle ear input admittance in chinchilla ear. An application of this model was presented to identify the acoustic role of the middle ear septa - a unique feature of chinchilla middle ear cavity. This study provides the first 3D FE model of the chinchilla ear for characterizing the middle ear functions through the acoustic-mechanical coupled FE analysis. PMID:26785845

Requirements for FGF3 and FGF10 during inner ear formation.

PubMed

Alvarez, Yolanda; Alonso, Maria Teresa; Vendrell, Victor; Zelarayan, Laura Cecilia; Chamero, Pablo; Theil, Thomas; Bösl, Michael R; Kato, Shigeaki; Maconochie, Mark; Riethmacher, Dieter; Schimmang, Thomas

2003-12-01

Members of the fibroblast growth factor (FGF) gene family control formation of the body plan and organogenesis in vertebrates. FGF3 is expressed in the developing hindbrain and has been shown to be involved in inner ear development of different vertebrate species, including zebrafish, Xenopus, chick and mouse. In the mouse, insertion of a neomycin resistance gene into the Fgf3 gene via homologous recombination results in severe developmental defects during differentiation of the otic vesicle. We have addressed the precise roles of FGF3 and other FGF family members during formation of the murine inner ear using both loss- and gain-of-function experiments. We generated a new mutant allele lacking the entire FGF3-coding region but surprisingly found no evidence for severe defects either during inner ear development or in the mature sensory organ, suggesting the functional involvement of other FGF family members during its formation. Ectopic expression of FGF10 in the developing hindbrain of transgenic mice leads to the formation of ectopic vesicles, expressing some otic marker genes and thus indicating a role for FGF10 during otic vesicle formation. Expression analysis of FGF10 during mouse embryogenesis reveals a highly dynamic pattern of expression in the developing hindbrain, partially overlapping with FGF3 expression and coinciding with formation of the inner ear. However, FGF10 mutant mice have been reported to display only mild defects during inner ear differentiation. We thus created double mutant mice for FGF3 and FGF10, which form severely reduced otic vesicles, suggesting redundant roles of these FGFs, acting in combination as neural signals for otic vesicle formation.

In Vivo Laser Cartilage Reshaping with Carbon Dioxide Spray Cooling in a Rabbit Ear Model: A Pilot Study

PubMed Central

Kuan, Edward C.; Hamamoto, Ashley A.; Sun, Victor; Nguyen, Tony; Manuel, Cyrus T.; Protsenko, Dmitry E.; Wong, Brian J.F.; Nelson, J. Stuart; Jia, Wangcun

2014-01-01

BACKGROUND/OBJECTIVES Similar to conventional cryogen spray cooling, carbon dioxide (CO2) spray may be used in combination with laser cartilage reshaping (LCR) to produce cartilage shape change while minimizing cutaneous thermal injury. Recent ex vivo evaluation of LCR with CO2 cooling in a rabbit model has identified a promising initial parameter space for in vivo safety and efficacy evaluation. This pilot study aimed to evaluate shape change and cutaneous injury following LCR with CO2 cooling in 5 live rabbits. STUDY DESIGN/MATERIALS AND METHODS The midportion of live rabbit ears were irradiated with a 1.45 μm wavelength diode laser (12 J/cm2) with simultaneous CO2 spray cooling (85 ms duration, 4 alternating heating/cooling cycles per site, 5 to 6 irradiation sites per row for 3 rows per ear). Experimental and control ears (no LCR) were splinted in the flexed position for 30 days following exposure. A total of 5 ears each were allocated to the experimental and control groups. RESULTS Shape change was observed in all irradiated ears (mean 70 ± 3°), which was statistically different from control (mean 37 ± 11 °, p = 0.009). No significant thermal cutaneous injury was observed, with preservation of the full thickness of skin, microvasculature, and adnexal structures. Confocal microscopy and histology demonstrated an intact and viable chondrocyte population surrounding irradiated sites. CONCLUSIONS LCR with CO2 spray cooling can produce clinically significant shape change in the rabbit auricle while minimizing thermal cutaneous and cartilaginous injury and frostbite. This pilot study lends support for the potential use of CO2 spray as an adjunct to existing thermal-based cartilage reshaping modalities. An in vivo systematic evaluation of optimal laser dosimetry and cooling parameters is required. PMID:25557008

Optimization of gene delivery methods in Xenopus laevis kidney (A6) and Chinese hamster ovary (CHO) cell lines for heterologous expression of Xenopus inner ear genes

PubMed Central

Ramirez-Gordillo, Daniel; Trujillo-Provencio, Casilda; Knight, V. Bleu; Serrano, Elba E.

2014-01-01

The Xenopus inner ear provides a useful model for studies of hearing and balance because it shares features with the mammalian inner ear, and because amphibians are capable of regenerating damaged mechanosensory hair cells. The structure and function of many proteins necessary for inner ear function have yet to be elucidated and require methods for analysis. To this end, we seek to characterize Xenopus inner ear genes outside of the animal model through heterologous expression in cell lines. As part of this effort, we aimed to optimize physical (electroporation), chemical (lipid-mediated; Lipofectamine™ 2000, Metafectene® Pro), and biological (viral-mediated; BacMam virus Cellular Lights™ Tubulin-RFP) gene delivery methods in amphibian (Xenopus; A6) cells and mammalian (Chinese hamster ovary (CHO)) cells. We successfully introduced the commercially available pEGFP-N3, pmCherry-N1, pEYFP-Tubulin, and Cellular Lights™ Tubulin-RFP fluorescent constructs to cells and evaluated their transfection or transduction efficiencies using the three gene delivery methods. In addition, we analyzed the transfection efficiency of a novel construct synthesized in our laboratory by cloning the Xenopus inner ear calcium-activated potassium channel β1 subunit, then subcloning the subunit into the pmCherry-N1 vector. Every gene delivery method was significantly more effective in CHO cells. Although results for the A6 cell line were not statistically significant, both cell lines illustrate a trend towards more efficient gene delivery using viral-mediated methods; however the cost of viral transduction is also much higher. Our findings demonstrate the need to improve gene delivery methods for amphibian cells and underscore the necessity for a greater understanding of amphibian cell biology. PMID:21959846

Small Tympanic Membrane Perforations in the Inferior Quadrants Do Not Impact the Manubrium Vibration in Guinea Pigs

PubMed Central

Zhang, Xiuling; Dai, Yanhong; Zhang, Shuyi; She, Wandong; Du, Xiaoping; Shui, Xiuji

2012-01-01

Background It has been believed that location of the perforation has a significant impact on hearing loss. However, recent studies have demonstrated that the perforation sites had no impact on hearing loss. We measured the velocity and pattern of the manubrium vibration in guinea pigs with intact and perforated eardrum using a laser Doppler vibrometer in order to determine the effects of different location perforations on the middle ear transfer functions. Methods Two bullas from 2 guinea pigs were used to determine stability of the umbo velocities, and 12 bullas from six guinea pigs to determine the effects of different location perforations on sound transmission. The manubrium velocity was measured at three points on the manubrium in the frequencies of 0.5–8 kHz before and after a perforation was made. The sites of perforations were in anterior-inferior (AI) quadrants of left ears and posterior-inferior (PI) quadrants of right ears. Results The manubrium vibration velocity losses were noticed in the perforated ears only below 1.5 kHz. The maximum velocity loss was about 7 dB at 500 Hz with the PI perforation. No significant difference in the velocity loss was found between AI and PI perforations. The average ratio of short process velocity to the umbo velocity was approximately 0.5 at all frequencies. No significant differences were found before and after perforation at all frequencies (p>0.05) except 7 kHz (p = 0.004) for both AI and PI perforations. Conclusions The manubrium vibration velocity losses from eardrum perforation were frequency-dependent and the largest losses occur at low frequencies. Manubrium velocity losses caused by small acute inferior perforations in guinea pigs have no significant impact on middle ear sound transmission at any frequency tested. The manubrium vibration axis may be perpendicular to the manubrium below 8 kHz in guinea pigs. PMID:22238584

Transcultural adaptation to Spanish of the instrument "Effectiveness of Auditory Rehabilitation" for the assessment of quality of life in patients using hearing aids.

PubMed

Cardemil, Felipe; Esquivel, Patricia; Aguayo, Lorena; Barría, Tamara; Fuente, Adrian; Carvajal, Rocío; Fromín, Rose; Villalobos, Iván; Yueh, Bevan

2013-01-01

It is becoming increasingly important to have reliable and valid questionnaires. This becomes especially important when evaluating hearing loss. the "Effectiveness of Auditory Rehabilitation" (EAR) questionnaire for the Spanish-speaking population. This instrument assesses quality of life and hearing aspects in patients using hearing aids. Cross-sectional validation study. A cultural adaptation through the use of English to Spanish translations and re-translations was carried out. The validity and reliability of the newly adapted instrument were evaluated. A total of 69 individuals (44 older adults and 25 younger adults) were examined. The pure-tone averages (PTA, 500, 1,000 and 2,000 Hz) were 47.3 dB HL and 47.1 dB HL for the left and right ears, respectively. The mean maximum speech discrimination in silence for monosyllables were 83.3% and 82.9% for the left and right ears, respectively. Internal consistency presented Cronbach alpha values of 0.85 and 0.77 for the internal and external dimensions, respectively. The intraclass correlation coefficients were 0.80 for the internal module and 0.85 for the external module. Construct validity reported a correlation coefficient of 0.71 at baseline and 0.76 at 3 months after the initial assessment for the internal module, and 0.62 at baseline and 0.74 at 3 months after the initial assessment for the external module. The size effects were 1.3 and 1.1 for the internal and external modules, respectively. The Spanish version of the EAR questionnaire seems to be a reliable and valid instrument. The evaluation of audiological aspects, as well as aspects relating to aesthetics and comfort are the main strengths of this instrument. Finally, the EAR scale is more sensitive to change than other scales. Copyright © 2013 Elsevier España, S.L. All rights reserved.

Nitrogen Source and Rate Management Improve Maize Productivity of Smallholders under Semiarid Climates.

PubMed

Amanullah; Iqbal, Asif; Ali, Ashraf; Fahad, Shah; Parmar, Brajendra

2016-01-01

Nitrogen is one of the most important factor affecting maize ( Zea mays L.) yield and income of smallholders under semiarid climates. Field experiments were conducted to investigate the impact of different N-fertilizer sources [urea, calcium ammonium nitrate (CAN), and ammonium sulfate (AS)] and rates (50, 100, 150, and 200 kg ha -1 ) on umber of rows ear -1 (NOR ear -1 ), number of seeds row -1 (NOS row -1 ), number of seeds ear -1 (NOS ear -1 ), number of ears per 100 plants (NOEP 100 plants -1 ), grain yield plant -1 , stover yield (kg ha -1 ), and shelling percentage (%) of maize genotypes "Local cultivars (Azam and Jalal) vs. hybrid (Pioneer-3025)." The experiment was conducted at the Agronomy Research Farm of the University of Agriculture Peshawar during summers of 2008 (year one) and 2010 (year two). The results revealed that the N treated (rest) plots (the average of all the experimental plots treated with N) had produced higher yield and yield components, and shelling percentage over N-control plots (plots where N was not applied). Application of nitrogen at the higher rate increased yield and yield components in maize (200 > 150 > 100 > 50 kg N ha -1 ). Application of AS and CAN had more beneficial impact on yield and yield components of maize as compared to urea (AS > CAN > urea). Hybrid maize (P-3025) produced significantly higher yield and yield components as well as higher shelling percentage than the two local cultivars (P-3025 > Jalal = Azam). Application of ammonium sulfate at the rate of 200 kg N ha -1 to hybrid maize was found most beneficial in terms of higher productivity and grower's income in the study area. For the two local cultivars, application of 150 kg N ha -1 was found more beneficial over 120 kg N ha -1 (recommended N rate) in terms of greater productivity and growers income.

Field incidence of mycotoxins in commercial popcorn and potential environmental influences.

PubMed

Dowd, Patrick F; Johnson, Eric T

2010-02-01

Popcorn ear damage by insects and mycotoxin levels in kernels were monitored in several commercial popcorn fields in central Illinois over a 4-year period. Aflatoxin was rare, but fumonisin and deoxynivalenol (DON) were commonly encountered each year, and occurred at mean levels in fields up to 1.7 mg/kg (sample max. 2.77 mg/kg) and 1.9 mg/kg (sample max. 2.66 mg/kg), respectively. Neither fumonisin nor DON levels were significantly correlated with the percent of ears with visibly moldy insect-damaged kernels. Significant correlations were noted for the percent of ears with early caterpillar damage and both fumonisin and DON levels overall for some years and at specific sites in other years. Fumonisin levels were generally more highly correlated with insect damage than DON levels. Insect damaged kernels had 100- to 500-fold or greater levels of fumonisin compared to noninsect-damaged kernels, while DON levels were closer to 10- to 30-fold higher in insect damaged versus nondamaged kernels. A high percentage of DON-contaminated kernels were not insect damaged in 2007 and 2008. In some cases, differing mycotoxin levels for the same hybrid and same year planted at different locations appeared to be due to the prior crop. Higher DON levels in 2008 than other years were most likely associated with higher levels of rainfall and cooler temperatures than average during ear fill. While kernel sorters are reported to remove mycotoxin-contaminated popcorn kernels to acceptible levels, consideration of environmental factors that promote mycotoxins in popcorn should result in more effective control measures in the field.

Imaging prevalence of sigmoid sinus dehiscence among patients with and without pulsatile tinnitus.

PubMed

Schoeff, Stephen; Nicholas, Brian; Mukherjee, Sugoto; Kesser, Bradley W

2014-05-01

Define the radiographic prevalence of sigmoid sinus diverticulum or dehiscence (SSDD) in patients with and without pulsatile tinnitus (PT). Case series with chart review. Tertiary care university medical center. Patients imaged between January 1, 2003, and December 31, 2012. Two groups were evaluated for SSDD. The first ("PT") included patients whose radiology report indicated a clinical history of PT (n = 37 symptomatic ears in 30 patients). The second ("non-PT") included all patients undergoing temporal bone high resolution CT (HRCT) between November 2011 and November 2012 (n = 308 ears in 164 patients) for reasons other than pulsatile tinnitus. Primary outcome measure was the radiographic presence of SSDD. Covariates including age, gender, body mass index (BMI), and audiometric data were analyzed by independent t tests and Fisher's exact test. Within the PT group, SSDD was identified in 24% of ears (9/37) and 23% of patients (7/30); all SSDD patients were female (P = .024). Patients with SSDD were significantly younger (P = .037). SSDD more frequently caused objective tinnitus (P = .016). There was no difference in average BMI between those with and those without SSDD. In the non-PT group, SSDD was identified in 2 (both female) of 164 patients (1.2%; 0.6% of ears). The difference in SSDD prevalence between groups was significant (P < .0001). The prevalence of SSDD in patients with PT was 23%. Among patients with PT, those with SSDD were younger, exclusively female, and presented with objective tinnitus. The prevalence of SSDD among asymptomatic patients in 1 year was 1.2%.

Power capacity from earcanal dynamic motion

NASA Astrophysics Data System (ADS)

Carioli, Johan; Delnavaz, Aidin; Zednik, Ricardo J.; Voix, Jérémie

2016-12-01

In-ear devices, such as a hearing aids, electronic earplugs, and wearables, need electrical power to operate. Batteries are the current solution, but unfortunately they also create other problems. For example, several hundred million users, mostly elderly, must change their hearing aid batteries on a weekly basis, which represents not only significant financial costs but a negative environmental impact. A promising alternative involves harvesting energy by converting the dynamic jaw movements into electrical energy via the earcanal. The extent that jaw movements distort the earcanal is still unknown, making it difficult to design the appropriate energy harvesting system for the earplug. Moreover, the finite element methods are barely capable to model the behavior of the earcanal distortion because of the complexity of mechanisms that deform the earcanal. However, this paper presents an alternative method, based on analytical considerations, to understand in-ear mechanical quasi-static deformations using earcanal point clouds. This model quantifies the bending and compressive movements of the earcanal. It can therefore be used to select an appropriate deformation mode for harvesting energy from the earcanal's dynamic motion. The value of this approach was illustrated by calculating the obtainable mechanical energy from 12 human subjects. On average, the bending energy in a human earcanal was found to be three times greater than the radial compression energy. This key finding will need to be considered in the design of future in-ear energy harvesting devices. Such an energy harvesting device has the potential to revolutionize the market for in-ear wearable devices and hearing aids by complementing or replacing battery technology.

3D-printed pediatric endoscopic ear surgery simulator for surgical training.

PubMed

Barber, Samuel R; Kozin, Elliott D; Dedmon, Matthew; Lin, Brian M; Lee, Kyuwon; Sinha, Sumi; Black, Nicole; Remenschneider, Aaron K; Lee, Daniel J

2016-11-01

Surgical simulators are designed to improve operative skills and patient safety. Transcanal Endoscopic Ear Surgery (TEES) is a relatively new surgical approach with a slow learning curve due to one-handed dissection. A reusable and customizable 3-dimensional (3D)-printed endoscopic ear surgery simulator may facilitate the development of surgical skills with high fidelity and low cost. Herein, we aim to design, fabricate, and test a low-cost and reusable 3D-printed TEES simulator. The TEES simulator was designed in computer-aided design (CAD) software using anatomic measurements taken from anthropometric studies. Cross sections from external auditory canal samples were traced as vectors and serially combined into a mesh construct. A modified tympanic cavity with a modular testing platform for simulator tasks was incorporated. Components were fabricated using calcium sulfate hemihydrate powder and multiple colored infiltrants via a commercial inkjet 3D-printing service. All components of a left-sided ear were printed to scale. Six right-handed trainees completed three trials each. Mean trial time (n = 3) ranged from 23.03 to 62.77 s using the dominant hand for all dissection. Statistically significant differences between first and last completion time with the dominant hand (p < 0.05) and average completion time for junior and senior residents (p < 0.05) suggest construct validity. A 3D-printed simulator is feasible for TEES simulation. Otolaryngology training programs with access to a 3D printer may readily fabricate a TEES simulator, resulting in inexpensive yet high-fidelity surgical simulation. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Remodelling of the pinna in myxoid degeneration of the ear.

PubMed

Kean, J; Stewart, K J

2010-07-01

Idiopathic deformation of the pinna is not widely reported in the current literature. We present a series of cases in which patients have required surgery for spontaneous thickening and deformation of the auricular cartilage, and a description of a technique for surgical correction. Four cases of idiopathic deformation of the pinna are reported. Our preferred technique of scaphoid rim incision and anterior carving of the cartilage is described, with intra-operative photographs. Each patient reported spontaneous swelling of the upper poles of the ears beginning in the second or third decade of life. In 3 cases the deformity was bilateral, although in each of these cases one side was more severely affected than the other. Histology for these cases was reported as myxoid degeneration of the ear. All of the reported patients were pleased with the aesthetic outcome of their auricular remodelling. Currently, there are no typical patient demographics for idiopathic myxoid degeneration of the ear. We have achieved good aesthetic results by hand carving the anterior aspect of the deformed cartilage via scaphoid rim incisions. Copyright 2009 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

The frequency range of TMJ sounds.

PubMed

Widmalm, S E; Williams, W J; Djurdjanovic, D; McKay, D C

2003-04-01

There are conflicting opinions about the frequency range of temporomandibular joint (TMJ) sounds. Some authors claim that the upper limit is about 650 Hz. The aim was to test the hypothesis that TMJ sounds may contain frequencies well above 650 Hz but that significant amounts of their energy are lost if the vibrations are recorded using contact sensors and/or travel far through the head tissues. Time-frequency distributions of 172 TMJ clickings (three subjects) were compared between recordings with one microphone in the ear canal and a skin contact transducer above the clicking joint and between recordings from two microphones, one in each ear canal. The energy peaks of the clickings recorded with a microphone in the ear canal on the clicking side were often well above 650 Hz and always in a significantly higher area (range 117-1922 Hz, P < 0.05 or lower) than in recordings obtained with contact sensors (range 47-375 Hz) or in microphone recordings from the opposite ear canal (range 141-703 Hz). Future studies are required to establish normative frequency range values of TMJ sounds but need methods also capable of recording the high frequency vibrations.

Cost comparison and safety of emergency department conscious sedation for the removal of ear foreign bodies.

PubMed

Olson, Michael D; Saw, Jessica; Visscher, Sue L; Balakrishnan, Karthik

2018-07-01

The purpose of this study is to investigate the relative cost and safety of ear foreign body (FB) removal via conscious sedation in the emergency department. A retrospective review of patients presenting from 2000 to 2015 to the emergency department at Mayo Clinic, Rochester, Minnesota was performed. 63 patients requiring sedation for ear foreign body removal were identified. Descriptive data, safety data, and costs were obtained for the study. There were no appreciable differences in patient safety outcomes and otologic outcomes in patients who received sedation in the emergency department or anesthesia in the operating room for FB removal. Cost analysis demonstrated increased cost associated with operating room utilization verses conscious sedation in the emergency department, with the greatest cost increase being in patients evaluated first in the emergency department and then sent to the operating room. Ear foreign body removal in the emergency department is shows a similar safety profile to removal in the operating room, but at a markedly lower cost. Emergency department conscious sedation should be considered a viable option in appropriately selected patients with this common problem given these results. Copyright © 2018. Published by Elsevier B.V.

Pressure equilibration in the penguin middle ear.

PubMed

Sadé, Jacob; Handrich, Yves; Bernheim, Joelle; Cohen, David

2008-01-01

King penguins have a venous structure in the form of a corpus cavernosum (CC) in their middle ear (ME) submucosa. The CC may be viewed as a special organelle that can change ME volume for pressure equilibration during deep-sea diving it is a pressure regulating organelle (PRO). A similar CC and muscles also surround the external ear (EE) and may constrict it, isolating the tympanic membrane from the outside. A CC was previously found also in the ME of marine diving mammals and can be expected to exist in other deep diving animals, such as marine turtles. Marine animals require equalization of middle ear (ME) pressure when diving hundreds or thousands of meters to catch prey. We investigated what mechanism enables king penguins to protect their ME when they dive to great depths. Biopsies and serial sections of the ME and the EE of the deep diving king penguin (Aptenodytes patagonicus) were examined microscopically. It was demonstrated that the penguin ME has an extensive network of small and large submucosal venous sinuses. This venous formation, a corpus cavernosum, can expand and potentially 'flood' the ME almost completely on diving, thus elevating ME pressure and reducing the ME space. The EE has a similar protective mechanism.

Hearing Loss, Dizziness, and Carbohydrate Metabolism

PubMed Central

Albernaz, Pedro L. Mangabeira

2015-01-01

Introduction  Metabolic activity of the inner ear is very intense, and makes it sensitive to changes in the body homeostasis. This study involves a group of patients with inner ear disorders related to carbohydrate metabolism disturbances, including hearing loss, tinnitus, dizziness, and episodes of vertigo. Objectives  To describe the symptoms of metabolic inner ear disorders and the examinations required to establish diagnoses. These symptoms are often the first to allow for an early diagnosis of metabolic disorders and diabetes. Methods  Retrospective study of 376 patients with inner ear symptoms suggestive of disturbances of carbohydrate metabolism. The authors present patientś clinical symptoms and clinical evaluations, with emphasis on the glucose and insulin essays. Results  Authors based their conclusions on otolaryngological findings, diagnostic procedures and treatment principles. They found that auditory and vestibular symptoms usually occur prior to other manifestations of metabolic changes, leading to an early diagnosis of hyperinsulinemia, intestinal sugar malabsorption or diabetes. Previously undiagnosed diabetes mellitus type II was found in 39 patients. Conclusions  The identification of carbohydrate metabolism disturbances is important not only to minimize the patients' clinical symptoms, but also to help maintain their general health. PMID:27413410

Evidence-based guidelines for recommending cochlear implantation for postlingually deafened adults.

PubMed

Leigh, Jaime R; Moran, Michelle; Hollow, Rodney; Dowell, Richard C

2016-01-01

Adult selection criteria for cochlear implantation have been developed based on analysis of the post-operative performance of a large group of postlingually deafened adults. Original criteria published in 2004 were reviewed and amended to reflect outcomes currently being achieved by implant recipients. Retrospective review of 12-month post-operative speech perception performance of adults implanted at the Eye and Ear Hospital, Melbourne, Australia. A total of 382 postlingually deafened adults, using a Freedom, Nucleus 5, or CI422 Slim Straight cochlear implant were used to create a comparative set of data. Revised guidelines suggest that adults with postlingual hearing loss can now be considered cochlear implant candidates if they obtain scores of up to 55% for open-set phonemes in quiet in the ear to be implanted. Functional benefit may vary depending on the recipients' contralateral hearing. This study supports the provision of cochlear implants to candidates with significant residual hearing when at least one ear meets the criterion outlined above. Patient-specific counseling is required to ensure the potential to benefit predicted by the current model is acceptable to the individual patient and their family. Counseling regarding functional benefit must take into consideration hearing in the contralateral ear.

Laser myringotomy with the CO2 Otoscan laser

NASA Astrophysics Data System (ADS)

Sedlmaier, Benedikt W.; Jivanjee, Antonio; Schoenfeld, Uwe; Jovanovic, Sergije

2000-06-01

Tympanic ventilation is the treatment of choice for otitis media with effusion (OME). CO2 laser myringotomy has already proven its value and is finding increasing clinical application. The ventilation time in the middle ear is essentially determined by the size of the laser perforation. Perforations exceeding 2 mm in diameter enable tympanic ventilation for about three weeks and thus compete with the ventilation tube in the treatment of OME. IN a prospective study, laser myringotomy is performed in 84 children with OME with the new CO2 laser otoscope Otoscan. The closure time was 17 days in average for a preformation diameter of 2 mm. In the further clinical course, the ear-drums healed without atrophic scar formation. In an observation period of six month the recurrency rate of effusion was approximately 10 percent. Laser myringotomy seems to be an useful method in the operative therapy of secretory otitis media.

Intravital imaging of a spheroid-based orthotopic model of melanoma in the mouse ear skin

PubMed Central

Chan, Keefe T.; Jones, Stephen W.; Brighton, Hailey E.; Bo, Tao; Cochran, Shelly D.; Sharpless, Norman E.; Bear, James E.

2017-01-01

Multiphoton microscopy is a powerful tool that enables the visualization of fluorescently tagged tumor cells and their stromal interactions within tissues in vivo. We have developed an orthotopic model of implanting multicellular melanoma tumor spheroids into the dermis of the mouse ear skin without the requirement for invasive surgery. Here, we demonstrate the utility of this approach to observe the primary tumor, single cell actin dynamics, and tumor-associated vasculature. These methods can be broadly applied to investigate an array of biological questions regarding tumor cell behavior in vivo. PMID:28748125

Hyperspectral imaging system for whole corn ear surface inspection

NASA Astrophysics Data System (ADS)

Yao, Haibo; Kincaid, Russell; Hruska, Zuzana; Brown, Robert L.; Bhatnagar, Deepak; Cleveland, Thomas E.

2013-05-01

Aflatoxin is a mycotoxin produced mainly by Aspergillus flavus (A.flavus) and Aspergillus parasitiucus fungi that grow naturally in corn. Very serious health problems such as liver damage and lung cancer can result from exposure to high toxin levels in grain. Consequently, many countries have established strict guidelines for permissible levels in consumables. Conventional chemical-based analytical methods used to screen for aflatoxin such as thin-layer chromatography (TLC) and high performance liquid chromatography (HPLC) are time consuming, expensive, and require the destruction of samples as well as proper training for data interpretation. Thus, it has been a continuing effort within the research community to find a way to rapidly and non-destructively detect and possibly quantify aflatoxin contamination in corn. One of the more recent developments in this area is the use of spectral technology. Specifically, fluorescence hyperspectral imaging offers a potential rapid, and non-invasive method for contamination detection in corn infected with toxigenic A.flavus spores. The current hyperspectral image system is designed for scanning flat surfaces, which is suitable for imaging single or a group of corn kernels. In the case of a whole corn cob, it is preferred to be able to scan the circumference of the corn ear, appropriate for whole ear inspection. This paper discusses the development of a hyperspectral imaging system for whole corn ear imaging. The new instrument is based on a hyperspectral line scanner using a rotational stage to turn the corn ear.

Middle cranial fossa approach for the repair of spontaneous cerebrospinal fluid leaks to the middle ear.

PubMed

Altuna, Xabier; Navarro, Juan José; García, Leire; Ugarte, Ane; Thomas, Izaskun

Spontaneous cerebrospinal fluid (CSF) leaks to the middle ear due to tegmen tympani defects can result in hearing loss or hypoacusis and predispose to meningitis as well as other neurological complications. Surgical repair of the defect can be performed through a middle cranial fossa (MCF) approach or a transmastoid approach. We conducted a retrospective study of the patients in our Department due to a spontaneous CSF leak to the middle ear treated using a MCF approach during a 6-year period (2009-2014). Thirteen patients with spontaneous CSF leak to the middle ear were treated with this approach. The primary and first symptom in all of them was conductive hearing loss. In all cases, the defect or defects were closed in a multilayer manner using muscle, temporalis fascia and cortical bone. Minimum follow-up in this series was 14 months, with successful closure in all but one patient (who required reintervention). We found no intra- or postoperative complications due to the craniotomy, and the audiometry improved and normalised in all cases except for the failed case. The MCF approach with a multilayer closure of the defect is an effective technique for repairing spontaneous CSF leaks to the middle ear and for restoring hearing in these patients. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

Why Cannot We have an Etiological Classification for the Patients with Granular Myringitis?

PubMed

Bansal, Mohan

2017-09-01

Though granular myringitis (GM) is not a very rare disease it does not have any classification. Its exact etiology is not known. The granulations on tympanic membrane also occur in association with other lesions of external auditory canal (EAC) and middle ear. The aims of this study were to know the etiological factors of GM and classify the disease according to its etiological factors and associated disorders of EAC and middle ear. Data were retrieved from the search of four electronic databases: PubMed, EMBASE, Cochrane Library, and Google scholar. Relevant articles were also sought by a hand search review of reference books. The databases were searched using the key words otitis externa, external otitis, granular myringitis, granular otitis externa and myringitis. Data were extracted using a pre-defined data-extraction form. The following data were recorded (1) etiological and predisposing conditions; (2) pathological features; (3) associated disorders of external and middle ear. The study proposes the etiological classification of GM. It suggests two major groups: primary and secondary. The primary GM is basically idiopathic and these patients do no have evidences of any other types of otitis media and otitis externa. In the secondary GM the cause is obvious and the patients usually have associated otitis media and/or lesions of external ear canal. Author speculates that habit of self ear cleaning/scratching is a specific etiological factor in cases of primary GM but more studies are required to confirm this theory.

Do high sound pressure levels of crowing in roosters necessitate passive mechanisms for protection against self-vocalization?

PubMed

Claes, Raf; Muyshondt, Pieter G G; Dirckx, Joris J J; Aerts, Peter

2018-02-01

High sound pressure levels (>120dB) cause damage or death of the hair cells of the inner ear, hence causing hearing loss. Vocalization differences are present between hens and roosters. Crowing in roosters is reported to produce sound pressure levels of 100dB measured at a distance of 1m. In this study we measured the sound pressure levels that exist at the entrance of the outer ear canal. We hypothesize that roosters may benefit from a passive protective mechanism while hens do not require such a mechanism. Audio recordings at the level of the entrance of the outer ear canal of crowing roosters, made in this study, indeed show that a protective mechanism is needed as sound pressure levels can reach amplitudes of 142.3dB. Audio recordings made at varying distances from the crowing rooster show that at a distance of 0.5m sound pressure levels already drop to 102dB. Micro-CT scans of a rooster and chicken head show that in roosters the auditory canal closes when the beak is opened. In hens the diameter of the auditory canal only narrows but does not close completely. A morphological difference between the sexes in shape of a bursa-like slit which occurs in the outer ear canal causes the outer ear canal to close in roosters but not in hens. Copyright © 2017 Elsevier GmbH. All rights reserved.

The genetics of hair-cell function in zebrafish.

PubMed

Nicolson, Teresa

2017-09-01

Our ears are remarkable sensory organs, providing the important senses of balance and hearing. The complex structure of the inner ear, or 'labyrinth', along with the assorted neuroepithelia, have evolved to detect head movements and sounds with impressive sensitivity. The rub is that the inner ear is highly vulnerable to genetic lesions and environmental insults. According to National Institute of Health estimates, hearing loss is one of the most commonly inherited or acquired sensorineural diseases. To understand the causes of deafness and balance disorders, it is imperative to understand the underlying biology of the inner ear, especially the inner workings of the sensory receptors. These receptors, which are termed hair cells, are particularly susceptible to genetic mutations - more than two dozen genes are associated with defects in this cell type in humans. Over the past decade, a substantial amount of progress has been made in working out the molecular basis of hair-cell function using vertebrate animal models. Given the transparency of the inner ear and the genetic tools that are available, zebrafish have become an increasingly popular animal model for the study of deafness and vestibular dysfunction. Mutagenesis screens for larval defects in hearing and balance have been fruitful in finding key components, many of which have been implicated in human deafness. This review will focus on the genes that are required for hair-cell function in zebrafish, with a particular emphasis on mechanotransduction. In addition, the generation of new tools available for the characterization of zebrafish hair-cell mutants will be discussed.

The Use of Temporoparietal Fascial Flap to Eliminate Wound Breakdown in Subtotal Petrosectomy for Chronic Discharging Ears.

PubMed

Yung, Matthew

2016-03-01

To find out if the use of the vascularized temporo-parietal fascial flap (TPFF) reduces postoperative infection or wound breakdown in subtotal petrosectomy for chronic discharging ears. A retrospective review on 26 subtotal petrosectomies with blind pit closures on chronic discharging ears performed by a single surgeon between 2000 and 2015 was performed. All patients had a minimum follow-up period of 6 months. Eleven mastoid cavities were obliterated with abdominal fat, and 15 cavities were obliterated with TPFF. There was no concomitant cochlear implant or middle ear implant. All postoperative wound infections or delay in wound healing were recorded into a database. The complication rates of the fat obliteration group were compared using Fisher's exact test with those for the TPFF obliteration group. In the fat obliteration group, 4 out of 11 patients had documented postoperative complications. Three had wound breakdown with exposure of the fat that required revision surgery. Another patient had postauricular abscess without the wound actually broken down. On the other hand, all the ears in the TPFF obliteration group (100%) were completely free of wound infection, wound breakdown, or any complication. The difference between the two groups was statistically significant (p = 0.022). Many authors have encountered postoperative infection or wound breakdown in subtotal petrosectomy with fat obliteration in the treatment of chronic otitis media. Using a richly vascularized temporo-temporal fascial flap to protect the blind pit closure in such patients reduces postoperative infection and wound breakdown.

Ear molding in newborn infants with auricular deformities.

PubMed

Byrd, H Steve; Langevin, Claude-Jean; Ghidoni, Lorraine A

2010-10-01

A review of a single physician's experience in managing over 831 infant ear deformities (488 patients) is presented. The authors' methods of molding have advanced from the use of various tapes, glues, and stents, to a comprehensive yet simple system that shapes the antihelix, the triangular fossa, the helical rim, and the overly prominent conchal-mastoid angle (EarWell Infant Ear Correction System). The types of deformities managed, and their relative occurrence, are as follows: (1) prominent/cup ear, 373 ears (45 percent); (2) lidding/lop ear, 224 ears (27 percent); (3) mixed ear deformities, 83 ears (10 percent) (all had associated conchal crus); (4) Stahl's ear, 66 ears (8 percent); (5) helical rim abnormalities, 58 ears (7 percent); (6) conchal crus, 25 ears (3 percent); and (7) cryptotia, two ears (0.2 percent). Bilateral deformities were present in 340 patients (70 percent), with unilateral deformities in 148 patients (30 percent). Fifty-eight infant ears (34 patients) were treated using the final version of the EarWell Infant Ear Correction System with a success rate exceeding 90 percent (good to excellent results). The system was found to be most successful when begun in the first week of the infant's life. When molding was initiated after 3 weeks from birth, only approximately half of the infants had a good response. Congenital ear deformities are common and only approximately 30 percent self-correct. These deformities can be corrected by initiating appropriate molding in the first week of life. Neonatal molding reduces the need for surgical correction with results that often exceed what can be achieved with the surgical alternative.

Effect of target-masker similarity on across-ear interference in a dichotic cocktail-party listening task.

PubMed

Brungart, Douglas S; Simpson, Brian D

2007-09-01

Similarity between the target and masking voices is known to have a strong influence on performance in monaural and binaural selective attention tasks, but little is known about the role it might play in dichotic listening tasks with a target signal and one masking voice in the one ear and a second independent masking voice in the opposite ear. This experiment examined performance in a dichotic listening task with a target talker in one ear and same-talker, same-sex, or different-sex maskers in both the target and the unattended ears. The results indicate that listeners were most susceptible to across-ear interference with a different-sex within-ear masker and least susceptible with a same-talker within-ear masker, suggesting that the amount of across-ear interference cannot be predicted from the difficulty of selectively attending to the within-ear masking voice. The results also show that the amount of across-ear interference consistently increases when the across-ear masking voice is more similar to the target speech than the within-ear masking voice is, but that no corresponding decline in across-ear interference occurs when the across-ear voice is less similar to the target than the within-ear voice. These results are consistent with an "integrated strategy" model of speech perception where the listener chooses a segregation strategy based on the characteristics of the masker present in the target ear and the amount of across-ear interference is determined by the extent to which this strategy can also effectively be used to suppress the masker in the unattended ear.

Otitis

MedlinePlus

Ear infection; Infection - ear ... of the ear. The condition can be: Acute ear infection. Starts suddenly and lasts for a short period of time. It is often painful. Chronic ear infection. Occurs when the ear infection does not go ...

In vitro tympanic membrane position identification with a co-axial fiber-optic otoscope

NASA Astrophysics Data System (ADS)

Sundberg, Mikael; Peebo, Markus; Strömberg, Tomas

2011-09-01

Otitis media diagnosis can be assisted by measuring the shape of the tympanic membrane. We have developed an ear speculum for an otoscope, including spatially distributed source and detector optical fibers, to generate source-detector intensity matrices (SDIMs), representing the curvature of surfaces. The surfaces measured were a model ear with a latex membrane and harvested temporal bones including intact tympanic membranes. The position of the tympanic membrane was shifted from retracted to bulging by air pressure and that of the latex membrane by water displacement. The SDIM was normalized utilizing both external (a sheared flat plastic cylinder) and internal references (neutral position of the membrane). Data was fitted to a two-dimensional Gaussian surface representing the shape by its amplitude and offset. Retracted and bulging surfaces were discriminated for the model ear by the sign of the Gaussian amplitude for both internal and external reference normalization. Tympanic membranes were separated after a two-step normalization: first to an external reference, adjusted for the distance between speculum and the surfaces, and second by comparison with an average normally positioned SDIM from tympanic membranes. In conclusion, we have shown that the modified otoscope can discriminate between bulging and retracted tympanic membranes in a single measurement, given a two-step normalization.

Effects of consecutive trials and test-retest reliability of 1000-Hz tympanometry in adults.

PubMed

Carazo, Carla Dominguez; Sun, Xiao-Ming

2015-04-01

To investigate the effect of consecutive 1000-Hz tympanometry testing on admittance measures, and examine test-retest reliability. Repeated measures with eight trials of 1000-Hz Y(a) and B(a)/G(a) tympanometry, respectively, in two ears of each subject, followed by repeated 226-Hz tympanometry. Twenty-seven normal-hearing young adults. For single-peak tympanograms, peak Y(tm) and G(tm) systematically increased across trials with a mean change of 8% and 15% at Trial 8, respectively, whereas B(tm) increased marginally. For notched tympanograms, peak Y(tm) and B(tm) decreased by 23% and 162% at Trial 8, and G(tm) in two cases also decreased (10% on average). Trial 2 and 3 contributed 50% to 70% of the total changes. Test-retest differences of subsequently acquired 1000- and 226-Hz tympanograms were smaller than previously reported. Consecutive testing significantly alters middle-ear admittance in 1000-Hz tympanometry. The outcome is contingent on tympanogram pattern and admittance component: Increase of peak Y(tm) and G(tm) in single-peak tympanograms and decrease of all measures in notched tympanograms. The present results complement previous studies on our understanding of the mechanism underlying this effect: a decrease of middle-ear stiffness. The effect of repetitive tympanometry should be accounted for in research involving sequential testing.

Development of an infection screening system for entry inspection at airport quarantine stations using ear temperature, heart and respiration rates.

PubMed

Sun, Guanghao; Abe, Nobujiro; Sugiyama, Youhei; Nguyen, Quang Vinh; Nozaki, Kohei; Nakayama, Yosuke; Takei, Osamu; Hakozaki, Yukiya; Abe, Shigeto; Matsui, Takemi

2013-01-01

After the outbreak of severe acute respiratory syndrome (SARS) in 2003, many international airport quarantine stations conducted fever-based screening to identify infected passengers using infrared thermography for preventing global pandemics. Due to environmental factors affecting measurement of facial skin temperature with thermography, some previous studies revealed the limits of authenticity in detecting infectious symptoms. In order to implement more strict entry screening in the epidemic seasons of emerging infectious diseases, we developed an infection screening system for airport quarantines using multi-parameter vital signs. This system can automatically detect infected individuals within several tens of seconds by a neural-network-based discriminant function using measured vital signs, i.e., heart rate obtained by a reflective photo sensor, respiration rate determined by a 10-GHz non-contact respiration radar, and the ear temperature monitored by a thermography. In this paper, to reduce the environmental effects on thermography measurement, we adopted the ear temperature as a new screening indicator instead of facial skin. We tested the system on 13 influenza patients and 33 normal subjects. The sensitivity of the infection screening system in detecting influenza were 92.3%, which was higher than the sensitivity reported in our previous paper (88.0%) with average facial skin temperature.

Intracochlear Drug Delivery Systems

PubMed Central

Borenstein, Jeffrey T.

2011-01-01

Introduction Advances in molecular biology and in the basic understanding of the mechanisms associated with sensorineural hearing loss and other diseases of the inner ear, are paving the way towards new approaches for treatments for millions of patients. However, the cochlea is a particularly challenging target for drug therapy, and new technologies will be required to provide safe and efficacious delivery of these compounds. Emerging delivery systems based on microfluidic technologies are showing promise as a means for direct intracochlear delivery. Ultimately, these systems may serve as a means for extended delivery of regenerative compounds to restore hearing in patients suffering from a host of auditory diseases. Areas covered in this review Recent progress in the development of drug delivery systems capable of direct intracochlear delivery is reviewed, including passive systems such as osmotic pumps, active microfluidic devices, and systems combined with currently available devices such as cochlear implants. The aim of this article is to provide a concise review of intracochlear drug delivery systems currently under development, and ultimately capable of being combined with emerging therapeutic compounds for the treatment of inner ear diseases. Expert Opinion Safe and efficacious treatment of auditory diseases will require the development of microscale delivery devices, capable of extended operation and direct application to the inner ear. These advances will require miniaturization and integration of multiple functions, including drug storage, delivery, power management and sensing, ultimately enabling closed-loop control and timed-sequence delivery devices for treatment of these diseases. PMID:21615213

The efficacy of the Eustachian Tube Dysfunction Questionnaire (ETDQ-7) for patulous Eustachian tube patient.

PubMed

Ikeda, Ryoukichi; Kikuchi, Toshiaki; Miyazaki, Hiromitsu; Hidaka, Hiroshi; Kawase, Tetsuaki; Katori, Yukio; Kobayashi, Toshimitsu

2018-01-01

To assess the efficacy of the Eustachian Tube Dysfunction Questionnaire (ETDQ-7) for patulous Eustachian tube (PET) patients. A prospective survey of medical records identified 36 patients and 47 ears with PET, and 15 patients and 15 ears as control. The ETDQ-7, patulous Eustachian tube handicap inventory-10 (PHI-10) and Likert scale were evaluated. PET patients were divided into two groups based on severity of symptoms using the PHI score. The Cronbach α value of the PET group was 0.765. The average total score of the ETDQ-7 in the control group was 7.6 ± 1.1 and 22.5 ± 10.0 in the PET group (p < .01). No correlation was found between ETDQ-7 and Likert scale (r = 0.248, p = .09). The average total score of the ETDQ-7 in the mild or moderate PET group was 19.9 ± 9.0 and 25.3 ± 11.1 in the severe PET group and this was not statistically different (p = .08). The highest ETDQ-7 score was also observed in PET patients and in ET dysfunction patients. These findings necessitate careful discrimination between ET dysfunction and PET in balloon dilation Eustachian tuboplasty (BET) based on ETDQ-7.

Audiological characteristics of infants with abnormal transient evoked otoacoustic emission and normal auditory brainstem response.

PubMed

Huang, Lihui; Han, Demin; Guo, Ying; Liu, Sha; Cui, Xiaoyan; Mo, Lingyan; Qi, Beier; Cai, Zhenghua; Liu, Hui; En, Hui; Guo, Liansheng

2008-10-01

Audiological characteristics were investigated in 81 ears of 53 infants with abnormal transient evoked otoacoustic emission (TEOAE) and normal auditory brainstem response (ABR). The relationship between ABR and other hearing testing methods, including 40Hz auditory event-related potential (40Hz-AERP), auditory steady state response (ASSR), distortion product otoacoustic emission (DPOAE), tympanometry, and acoustic reflex, was analyzed. Of the 81 ears, 18 ears (22.2%) were normal, while 63 ears (77.8%) were abnormal according to the tests. Testing of the 40 Hz AERP (36 ears) and ASSR (45 ears) revealed that 14 ears (38.9%) and 27 ears (60.0%) were abnormal, respectively. Testing of DPOAE in 68 ears revealed that 50 ears (73.5%) were abnormal. Testing of tympanometry in 50 ears and acoustic reflex in 47 ears revealed that 9 ears (18%) and 27 ears (57.4%) were abnormal, respectively. The present data suggests that the hearing of infants cannot be sufficiently evaluated with ABR only and that it must be evaluated with integrative audiological testing methods.

Middle ear impedance measurements in large vestibular aqueduct syndrome.

PubMed

Bilgen, Cem; Kirkim, Günay; Kirazli, Tayfun

2009-06-01

To assess the effect of inner ear pressure on middle ear impedance in patients with large vestibular aqueduct syndrome (LVAS). Data from admittance tympanometry and multifrequency tympanometry on 8 LVAS patients and control subjects were studied. Static acoustic compliance (SAC) values for the ears with stable sensorineural hearing loss (SNHL) were within the limits of the mean values of control groups except for two ears. The resonance frequency (RF) values of the ears with stable SNHL were lower than the mean values of control groups except for three ears. SAC values for the two ears with fluctuating SNHL were lower and the RF values were higher than the mean values of control groups. Decreased SAC values and increased RF values found in the ears with fluctuating SNHL might be an indirect indicator of increased inner ear pressure, while low RF values in the ears with stable SNHL might reflect the decreased inner ear impedance.

Determination of the tolerable upper intake level of leucine in acute dietary studies in young men.

PubMed

Elango, Rajavel; Chapman, Karen; Rafii, Mahroukh; Ball, Ronald O; Pencharz, Paul B

2012-10-01

Leucine has been suggested to improve athletic performance. Therefore, the branched-chain amino acids (BCAAs), especially leucine, are popular as dietary supplements in strength-training athletes; however, the intake of leucine in excess of requirements raises concerns regarding adverse effects. Currently, the tolerable upper intake level (UL) for leucine is unknown. The objective of the current study was to determine the UL for leucine in adult men under acute dietary conditions. Five healthy adults (20-35 y) each received graded stepwise increases in leucine intakes of 50, 150, 250, 500, 750, 1000, and 1250 mg · kg⁻¹ · d⁻¹, which corresponded to the Estimated Average Requirement (EAR) and the EAR ×3, ×5, ×10, ×15, ×20, and ×25 in a total of 29 studies. The UL of leucine was identified by the measurement of plasma and urinary biochemical variables and changes in leucine oxidation by using l-[1-¹³C]-leucine. A significant increase in blood ammonia concentrations above normal values, plasma leucine concentrations, and urinary leucine excretion were observed with leucine intakes >500 mg · kg⁻¹ · d⁻¹. The oxidation of l-[1-¹³C]-leucine expressed as label tracer oxidation in breath (F¹³CO₂), leucine oxidation, and α-ketoisocaproic acid (KIC) oxidation led to different results: a plateau in F¹³CO₂ observed after 500 mg · kg⁻¹ · d⁻¹, no clear plateau observed in leucine oxidation, and KIC oxidation appearing to plateau after 750 mg · kg⁻¹ · d⁻¹. On the basis of plasma and urinary variables, the UL for leucine in healthy adult men can be suggested at 500 mg · kg⁻¹ · d⁻¹ or ~35 g/d as a cautious estimate under acute dietary conditions.

Comparison of user volume control settings for portable music players with three earphone configurations in quiet and noisy environments.

PubMed

Henry, Paula; Foots, Ashley

2012-03-01

Listening to music is one of the most common forms of recreational noise exposure. Previous investigators have demonstrated that maximum output levels from headphones can exceed safe levels. Although preferred listening levels (PLL) in quiet environments may be at acceptable levels, the addition of background noise will add to the overall noise exposure of a listener. Use of listening devices that block out some of the background noise would potentially allow listeners to select lower PLLs for their music. Although one solution is in-the-ear earphones, an alternative solution is the use of earmuffs in conjunction with earbuds. There were two objectives to this experiment. The first was to determine if an alternative to in-the-ear earphones for noise attenuation (the addition of earmuffs to earbuds) would allow for lower PLLs through a portable media player (PMP) than earbuds. The second was to determine if a surrounding background noise would yield different PLLs than a directional noise source. This was an experimental study. Twenty-four adults with normal hearing. PLLs were measured for three earphone configurations in three listening conditions. The earphone configurations included earbuds, canal earphones, and earbuds in combination with hearing protection devices (HPDs). The listening conditions included quiet, noise from one loudspeaker, and noise from four surrounding loudspeakers. Participants listened in each noise and earphone combination for as long as they needed to determine their PLL for that condition. Once the participant determined their PLL, investigators made a 5 sec recording of the music through a probe tube microphone. The average PLLs in each noise and earphone combination were used as the dependent variable. Ear canal level PLLs were converted to free-field equivalents to compare to noise exposure standards and previously published data. The average PLL as measured in the ear canal was 74 dBA in the quiet conditions and 84 dBA in the noise conditions. Paired comparisons of the PLL in the presence of background noise for each pair of earphone configurations indicated significant differences for each comparison. An inverse relationship was observed between attenuation and PLL whereby the greater the attenuation, the lower the PLL. A comparison of the single noise source condition versus the surrounding noise condition did not result in a significant effect. The present work suggests that earphones that take advantage of noise attenuation can reduce the level at which listeners set music in the presence of background noise. An alternative to in-the-ear earphones for noise attenuation is the addition of earmuffs to earbuds. American Academy of Audiology.

Occupational injury and illness recording and reporting requirements. Final rule.

PubMed

2001-10-12

The Occupational Safety and Health Administration (OSHA) is delaying the effective date of three provisions of the Occupational Injury and Illness Recording and Reporting Requirements rule published January 19, 2001 (66 FR 5916-6135) and is establishing interim criteria for recording cases of work-related hearing loss. The provisions being delayed are sections 1904.10 (a) and (b), which specify recording criteria for cases involving occupational hearing loss, section 1904.12, which defines "musculoskeletal disorder (MSD)" and requires employers to check the MSD column on the OSHA Log if an employee experiences a work-related musculoskeletal disorder, and section 1904.29(b)(7)(vi), which states that MSDs are not considered privacy concern cases. The effective date of these provisions is delayed from January 1, 2002 until January 1, 2003. OSHA will continue to evaluate sections 1904.10 and 1904.12 over the next year. OSHA is also adding a new paragraph(c) to section 1904.10, establishing criteria for recording cases of work-related hearing loss during calendar year 2002. Section 1904.10(c) codifies the enforcement policy in effect since 1991, under which employers must record work related shifts in hearing of an average of 25 dB or more at 2000, 3000 and 4000 hertz in either ear.

Nonsurgical correction of congenital ear abnormalities in the newborn: Case series.

PubMed

Smith, Wg; Toye, Jw; Reid, A; Smith, Rw

2005-07-01

To determine whether a simple, nonsurgical treatment for congenital ear abnormalities (lop-ear, Stahl's ear, protruding ear, cryptotia) improved the appearance of ear abnormalities in newborns at six weeks of age. This is a descriptive case series. All newborns with identified abnormalities were referred by their family physician to one paediatrician (WGS) in a small level 2 perinatal centre. The ears were waxed and taped in a standard manner within 10 days of birth. Pictures were taken before taping and at the end of taping (one month). All patients and pictures were assessed by one plastic surgeon (JWT) at six weeks of age and scored using a standard scoring system. A telephone survey of the nontreatment group was conducted. The total number of ears assessed was 90. Of this total, 69 ears were taped and fully evaluated in the study (77%). The refusal rate was 23%. In the treatment group, 59% had lop-ear, 19% had Stahl's ear, 17% had protruding ear and 3% had cryptotia. Overall correction (excellent/improved) for the treatment group was 90% (100% for lop-ear, 100% for Stahl's ear, 67% for protruding ear and 0% for cryptotia). In the nontreatment (refusal) group, 67% of the ears failed to correct spontaneously. No complications were recognized by the authors or parents by six weeks. The percentage of newborns in one year in the perinatal centre with recognized ear abnormalities was 6% (90 of 1600). A simple, nonsurgical treatment in a Caucasian population appeared to be very effective in correcting congenital ear abnormalities with no complications and high patient/parent satisfaction.

Selective attention reduces physiological noise in the external ear canals of humans. I: Auditory attention

PubMed Central

Walsh, Kyle P.; Pasanen, Edward G.; McFadden, Dennis

2014-01-01

In this study, a nonlinear version of the stimulus-frequency OAE (SFOAE), called the nSFOAE, was used to measure cochlear responses from human subjects while they simultaneously performed behavioral tasks requiring, or not requiring, selective auditory attention. Appended to each stimulus presentation, and included in the calculation of each nSFOAE response, was a 30-ms silent period that was used to estimate the level of the inherent physiological noise in the ear canals of our subjects during each behavioral condition. Physiological-noise magnitudes were higher (noisier) for all subjects in the inattention task, and lower (quieter) in the selective auditory-attention tasks. These noise measures initially were made at the frequency of our nSFOAE probe tone (4.0 kHz), but the same attention effects also were observed across a wide range of frequencies. We attribute the observed differences in physiological-noise magnitudes between the inattention and attention conditions to different levels of efferent activation associated with the differing attentional demands of the behavioral tasks. One hypothesis is that when the attentional demand is relatively great, efferent activation is relatively high, and a decrease in the gain of the cochlear amplifier leads to lower-amplitude cochlear activity, and thus a smaller measure of noise from the ear. PMID:24732069

The Boron Efflux Transporter ROTTEN EAR Is Required for Maize Inflorescence Development and Fertility[C][W][OPEN

PubMed Central

Chatterjee, Mithu; Tabi, Zara; Galli, Mary; Malcomber, Simon; Buck, Amy; Muszynski, Michael; Gallavotti, Andrea

2014-01-01

Although boron has a relatively low natural abundance, it is an essential plant micronutrient. Boron deficiencies cause major crop losses in several areas of the world, affecting reproduction and yield in diverse plant species. Despite the importance of boron in crop productivity, surprisingly little is known about its effects on developing reproductive organs. We isolated a maize (Zea mays) mutant, called rotten ear (rte), that shows distinct defects in vegetative and reproductive development, eventually causing widespread sterility in its inflorescences, the tassel and the ear. Positional cloning revealed that rte encodes a membrane-localized boron efflux transporter, co-orthologous to the Arabidopsis thaliana BOR1 protein. Depending on the availability of boron in the soil, rte plants show a wide range of phenotypic defects that can be fully rescued by supplementing the soil with exogenous boric acid, indicating that rte is crucial for boron transport into aerial tissues. rte is expressed in cells surrounding the xylem in both vegetative and reproductive tissues and is required for meristem activity and organ development. We show that low boron supply to the inflorescences results in widespread defects in cell and cell wall integrity, highlighting the structural importance of boron in the formation of fully fertile reproductive organs. PMID:25035400

Informational masking of speech in children: Effects of ipsilateral and contralateral distracters

NASA Astrophysics Data System (ADS)

Wightman, Frederic L.; Kistler, Doris J.

2005-11-01

Using a closed-set speech recognition paradigm thought to be heavily influenced by informational masking, auditory selective attention was measured in 38 children (ages 4-16 years) and 8 adults (ages 20-30 years). The task required attention to a monaural target speech message that was presented with a time-synchronized distracter message in the same ear. In some conditions a second distracter message or a speech-shaped noise was presented to the other ear. Compared to adults, children required higher target/distracter ratios to reach comparable performance levels, reflecting more informational masking in these listeners. Informational masking in most conditions was confirmed by the fact that a large proportion of the errors made by the listeners were contained in the distracter message(s). There was a monotonic age effect, such that even the children in the oldest age group (13.6-16 years) demonstrated poorer performance than adults. For both children and adults, presentation of an additional distracter in the contralateral ear significantly reduced performance, even when the distracter messages were produced by a talker of different sex than the target talker. The results are consistent with earlier reports from pure-tone masking studies that informational masking effects are much larger in children than in adults.

Sonographic Measurement of Fetal Ear Length in Turkish Women with a Normal Pregnancy

PubMed Central

Özdemir, Mucize Eriç; Uzun, Işıl; Karahasanoğlu, Ayşe; Aygün, Mehmet; Akın, Hale; Yazıcıoğlu, Fehmi

2014-01-01

Background: Abnormal fetal ear length is a feature of chromosomal disorders. Fetal ear length measurement is a simple measurement that can be obtained during ultrasonographic examinations. Aims: To develop a nomogram for fetal ear length measurements in our population and investigate the correlation between fetal ear length, gestational age, and other standard fetal biometric measurements. Study Design: Cohort study. Methods: Ear lengths of the fetuses were measured in normal singleton pregnancies. The relationship between gestational age and fetal ear length in millimetres was analysed by simple linear regression. In addition, the correlation of fetal ear length measurements with biparietal diameter, head circumference, abdominal circumference, and femur length were evaluated.Ear length measurements were obtained from fetuses in 389 normal singleton pregnancies ranging between 16 and 28 weeks of gestation. Results: A nomogram was developed by linear regression analysis of the parameters ear length and gestational age. Fetal ear length (mm) = y = (1.348 X gestational age)−12.265), where gestational ages is in weeks. A high correlation was found between fetal ear length and gestational age, and a significant correlation was also found between fetal ear length and the biparietal diameter (r=0.962; p<0.001). Similar correlations were found between fetal ear length and head circumference, and fetal ear length and femur length. Conclusion: The results of this study provide a nomogram for fetal ear length. The study also demonstrates the relationship between ear length and other biometric measurements. PMID:25667783

Transcanal microscope-assisted endoscopic myringoplasty in children.

PubMed

Migirov, Lela; Wolf, Michael

2015-04-01

Myringoplasty can be technically difficult in the pediatric patients due to the narrowness of the external auditory canal and the generally small size of the ear. Moreover, temporalis fascia grafts and myringoplasties for anterior perforations are more likely to fail in children. Surgical management of anterior perforations requires total exposure of the anterior angle however a microscope may fail to provide a view of the anterior edge in most of perforations. Recently, different endoscopes are used in the performance of ear surgery in general and myringoplasty in particular. Current study aimed to investigate the outcome of transcanal microscope-assisted endoscopic myringoplasty in homogenous group of children. The medical records of 22 children were retrospectively reviewed for age, perforation size and location, surgical and audiological findings, and outcome. All myringoplasties were performed by first author with a chondro-perichondrial graft that has been harvested from the tragus and placed medial to the tympanic membrane remnants, utilizing the underlay technique and 14-mm length, 3-mm diameter, 0° and 30° endoscopes. A microscope was occasionally used for removal of the sclerotic plaques and releasing adhesions surrounding the ossicles when bimanual manipulations were needed. Surgical success was defined as a tympanic membrane with no perforation, retraction, or graft lateralization for at least 18 months following surgery. Thirteen large-, 8 medium- and 1 small-sized perforations (defined as 75, 50 or 25%, respectively, of the tympanic membrane area), of which 14 were anterior, 2 central and 6 posterior marginal, were repaired. The edges of the defect could not be visualized under a microscope due to bone overhanging or a curved or narrow EAC in 8 anterior perforations. Intact tympanic membranes and dry ears were achieved in all operated children. The audiometric air conduction level (average of 0.5-3 kHz) for the entire cohort ranged between 10-51.3 dB (mean 32.8) preoperatively and between 5-35 dB (mean 18.2) postoperatively. The transcanal microscope-assisted endoscopic myringoplasty had a 100% rate of surgical success in children. This technique can be especially appropriate for patients with narrow external canals, anterior defects and bone overhang making the perforation margins barely visible under a microscope.

Increasing Plant Based Foods or Dairy Foods Differentially Affects Nutrient Intakes: Dietary Scenarios Using NHANES 2007-2010.

PubMed

Cifelli, Christopher J; Houchins, Jenny A; Demmer, Elieke; Fulgoni, Victor L

2016-07-11

Diets rich in plant foods and lower in animal-based products have garnered increased attention among researchers, dietitians and health professionals in recent years for their potential to, not only improve health, but also to lessen the environmental impact. However, the potential effects of increasing plant-based foods at the expense of animal-based foods on macro- and micronutrient nutrient adequacy in the U.S. diet is unknown. In addition, dairy foods are consistently under consumed, thus the impact of increased dairy on nutrient adequacy is important to measure. Accordingly, the objective of this study was to use national survey data to model three different dietary scenarios to assess the effects of increasing plant-based foods or dairy foods on macronutrient intake and nutrient adequacy. Data from the National Health and Nutrition Examination Survey (NHANES) 2007-2010 for persons two years and older (n = 17,387) were used in all the analyses. Comparisons were made of usual intake of macronutrients and shortfall nutrients of three dietary scenarios that increased intakes by 100%: (i) plant-based foods; (ii) protein-rich plant-based foods (i.e., legumes, nuts, seeds, soy); and (iii) milk, cheese and yogurt. Scenarios (i) and (ii) had commensurate reductions in animal product intake. In both children (2-18 years) and adults (≥19 years), the percent not meeting the Estimated Average Requirement (EAR) decreased for vitamin C, magnesium, vitamin E, folate and iron when plant-based foods were increased. However the percent not meeting the EAR increased for calcium, protein, vitamin A, and vitamin D in this scenario. Doubling protein-rich plant-based foods had no effect on nutrient intake because they were consumed in very low quantities in the baseline diet. The dairy model reduced the percent not meeting the EAR for calcium, vitamin A, vitamin D, magnesium, and protein, while sodium and saturated fat levels increased. Our modeling shows that increasing plant-based foods could lead to unintended dietary outcomes without simultaneous changes in the types and amounts of plant foods currently consumed. Increasing dairy foods, which are currently under-consumed, could assist in improving the intakes of many nutrients of concern.

Speech perception with combined electric-acoustic stimulation and bilateral cochlear implants in a multisource noise field.

PubMed

Rader, Tobias; Fastl, Hugo; Baumann, Uwe

2013-01-01

The aim of the study was to measure and compare speech perception in users of electric-acoustic stimulation (EAS) supported by a hearing aid in the unimplanted ear and in bilateral cochlear implant (CI) users under different noise and sound field conditions. Gap listening was assessed by comparing performance in unmodulated and modulated Comité Consultatif International Téléphonique et Télégraphique (CCITT) noise conditions, and binaural interaction was investigated by comparing single source and multisource sound fields. Speech perception in noise was measured using a closed-set sentence test (Oldenburg Sentence Test, OLSA) in a multisource noise field (MSNF) consisting of a four-loudspeaker array with independent noise sources and a single source in frontal position (S0N0). Speech simulating noise (Fastl-noise), CCITT-noise (continuous), and OLSA-noise (pseudo continuous) served as noise sources with different temporal patterns. Speech tests were performed in two groups of subjects who were using either EAS (n = 12) or bilateral CIs (n = 10). All subjects in the EAS group were fitted with a high-power hearing aid in the opposite ear (bimodal EAS). The average group score on monosyllable in quiet was 68.8% (EAS) and 80.5% (bilateral CI). A group of 22 listeners with normal hearing served as controls to compare and evaluate potential gap listening effects in implanted patients. Average speech reception thresholds in the EAS group were significantly lower than those for the bilateral CI group in all test conditions (CCITT 6.1 dB, p = 0.001; Fastl-noise 5.4 dB, p < 0.01; Oldenburg-(OL)-noise 1.6 dB, p < 0.05). Bilateral CI and EAS user groups showed a significant improvement of 4.3 dB (p = 0.004) and 5.4 dB (p = 0.002) between S0N0 and MSNF sound field conditions respectively, which signifies advantages caused by bilateral interaction in both groups. Performance in the control group showed a significant gap listening effect with a difference of 6.5 dB between modulated and unmodulated noise in S0N0, and a difference of 3.0 dB in MSNF. The ability to "glimpse" into short temporal masker gaps was absent in both groups of implanted subjects. Combined EAS in one ear supported by a hearing aid on the contralateral ear provided significantly improved speech perception compared with bilateral cochlear implantation. Although the scores for monosyllable words in quiet were higher in the bilateral CI group, the EAS group performed better in different noise and sound field conditions. Furthermore, the results indicated that binaural interaction between EAS in one ear and residual acoustic hearing in the opposite ear enhances speech perception in complex noise situations. Both bilateral CI and bimodal EAS users did not benefit from short temporal masker gaps, therefore the better performance of the EAS group in modulated noise conditions could be explained by the improved transmission of fundamental frequency cues in the lower-frequency region of acoustic hearing, which might foster the grouping of auditory objects.

Understanding speech in noise after correction of congenital unilateral aural atresia: effects of age in the emergence of binaural squelch but not in use of head-shadow.

PubMed

Gray, Lincoln; Kesser, Bradley; Cole, Erika

2009-09-01

Unilateral hearing loss causes difficulty hearing in noise (the "cocktail party effect") due to absence of redundancy, head-shadow, and binaural squelch. This study explores the emergence of the head-shadow and binaural squelch effects in children with unilateral congenital aural atresia undergoing surgery to correct their hearing deficit. Adding patients and data from a similar study previously published, we also evaluate covariates such as the age of the patient, surgical outcome, and complexity of the task that might predict the extent of binaural benefit--patients' ability to "use" their new ear--when understanding speech in noise. Patients with unilateral congenital aural atresia were tested for their ability to understand speech in noise before and again 1 month after surgery to repair their atresia. In a sound-attenuating booth participants faced a speaker that produced speech signals with noise 90 degrees to the side of the normal (non-atretic) ear and again to the side of the atretic ear. The Hearing in Noise Test (HINT for adults or HINT-C for children) was used to estimate the patients' speech reception thresholds. The speech-in-noise test (SPIN) or the Pediatric Speech Intelligibility (PSI) Test was used in the previous study. There was consistent improvement, averaging 5dB regardless of age, in the ability to take advantage of head-shadow in understanding speech with noise to the side of the non-atretic (normal) ear. There was, in contrast, a strong negative linear effect of age (r(2)=.78, selecting patients over 8 years) in the emergence of binaural squelch to understand speech with noise to the side of the atretic ear. In patients over 8 years, this trend replicated over different studies and different tests. Children less than 8 years, however, showed less improvement in the HINT-C than in the PSI after surgery with noise toward their atretic ear (effect size=3). No binaural result was correlated with degree of hearing improvement after surgery. All patients are able to take advantage of a favorable signal-to-noise ratio in their newly opened ear; that is with noise toward the side of the normal ear (but this physical, bilateral, head-shadow effect need not involve true central binaural processing). With noise toward the atretic ear, the emergence of binaural squelch replicates between two studies for all but the youngest patients. Approximately 2dB of binaural gain is lost for each decade that surgery is delayed, and zero (or poorer) binaural benefit is predicted after 38 years of age. Older adults do more poorly, possibly secondary to their long period of auditory deprivation. At the youngest ages, however, binaural results are different in open- and closed-set speech tests; the more complex hearing tasks may involve a greater cognitive load. Other cognitive abilities (late evoked potentials, grey matter in auditory cortex, and multitasking) show similar effects of age, peaking at the same late-teen/young-adult period. Longer follow-up is likely critical for the understanding of these data. Getting a new ear may be--like multitasking--challenging for the youngest and oldest subjects.

The effects of V2 antagonist (OPC-31260) on endolymphatic hydrops.

PubMed

Takeda, Taizo; Sawada, Shoichi; Takeda, Setsuko; Kitano, Hiroya; Suzuki, Mikio; Kakigi, Akinobu; Takeuchi, Shunji

2003-08-01

In the present study, two experiments were performed to investigate the influence of OPC-31260 on experimentally induced endolymphatic hydrops in guinea pigs and the regulation of aquaporin-2 (AQP2) mRNA expression in the rat inner ear. In morphological studies, the increases in the ratios of the length of Reissner's membrane (IR-L) and the cross-sectional area of the scala media (IR-S) were quantitatively assessed among normal guinea pigs (normal ears) and three groups with hydropic ears: hydropic ears with no infusion (non-infusion hydropic ears), hydropic ears with an infusion of physiological saline into the scala tympani (saline-infused hydropic ears) and hydropic ears with infusion of 0.3% OPC-31260 into the scala tympani (OPC-infused hydropic ears). IR-Ls in the experimental groups were markedly larger than in the normal ear group, but there was no significant difference among the groups of non-infusion hydropic ears, saline-infused hydropic ears and OPC-infused hydropic ears. The IR-Ss of non-infusion hydropic ears and saline-infused hydropic ears (48.8-49.3%) were statistically different from that of normal ears (6.5%) (Dunnet multiple comparison test, P<0.01). However, IR-S of the OPC-infused hydropic ears (-14.8%) was significantly smaller than those of non-infusion hydropic ears and saline-infused hydropic ears (one-way ANOVA, P<0.01). In the quantitative polymerase chain reaction study, a comparison of the ratio of AQP2 and beta-actin mRNA (MAQP2/Mbeta-actin) was made between water-injected and OPC-31260-injected rats. An intravenous injection of OPC-31260 resulted in a significant decrease in MAQP2/Mbeta-actin both in the cochlea and in the endolymphatic sac (t-test, P<0.001). These results indicate that water homeostasis in the inner ear is regulated via the vasopressin-AQP2 system, and that the vasopressin type-2 antagonist OPC-31260 is a promising drug in the treatment of Meniere's disease.

Minerals Intake Distributions in a Large Sample of Iranian at-Risk Population Using the National Cancer Institute Method: Do They Meet Their Requirements?

PubMed

Heidari, Zahra; Feizi, Awat; Azadbakht, Leila; Sarrafzadegan, Nizal

2015-01-01

Minerals are required for the body's normal function. The current study assessed the intake distribution of minerals and estimated the prevalence of inadequacy and excess among a representative sample of healthy middle aged and elderly Iranian people. In this cross-sectional study, the second follow up to the Isfahan Cohort Study (ICS), 1922 generally healthy people aged 40 and older were investigated. Dietary intakes were collected using 24 hour recalls and two or more consecutive food records. Distribution of minerals intake was estimated using traditional (averaging dietary intake days) and National Cancer Institute (NCI) methods, and the results obtained from the two methods, were compared. The prevalence of minerals intake inadequacy or excess was estimated using the estimated average requirement (EAR) cut-point method, the probability approach and the tolerable upper intake levels (UL). There were remarkable differences between values obtained using traditional and NCI methods, particularly in the lower and upper percentiles of the estimated intake distributions. A high prevalence of inadequacy of magnesium (50 - 100 %), calcium (21 - 93 %) and zinc (30 - 55 % for males > 50 years) was observed. Significant gender differences were found regarding inadequate intakes of calcium (21 - 76 % for males vs. 45 - 93 % for females), magnesium (92 % vs. 100 %), iron (0 vs. 15 % for age group 40 - 50 years) and zinc (29 - 55 % vs. 0 %) (all; p < 0.05). Severely imbalanced intakes of magnesium, calcium and zinc were observed among the middle-aged and elderly Iranian population. Nutritional interventions and population-based education to improve healthy diets among the studied population at risk are needed.

Surgical management of polyotia.

PubMed

Pan, Bo; Qie, Shuyan; Zhao, Yanyong; Tang, Xiaojun; Lin, Lin; Yang, Qinghua; Zhuang, Hongxing; Jiang, Haiyue

2010-08-01

Polyotia is an extremely rare type of congenital external ear malformation, which is defined as an accessory ear that is large enough to resemble an additional pinna. The terms 'mirror ear' or 'accessory ear' are sometime used. We present our methods in correcting this malformation and summarise the aetiology. The posterior part of the polyotia may presents with a normal ear, a constricted ear or a microtic ear. Free auricular composite tissue transplantation was used to correct the constricted ear. Ear reconstruction was applied in cases of microtia. The anterior auricle was mainly used to form the tragus. 7 cases polyotia were treated between 2004 and 2008. After free auricular composite tissue transplantation the size of the constricted ear and the contralateral ear was similar. In microtia cases the reconstructed ears were natural looking and had a satisfactory three-dimensional contour. The extra tissue of the anterior ear was excised and the tragus was reconstructed. Through operative intervention tailored to the individual case natural-looking and symmetric ears were acquired. The aetiology of polyotia probably relates to abnormal migration of neural crest cell. Copyright 2009 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Noise exposure and auditory thresholds of German airline pilots: a cross-sectional study

PubMed Central

Müller, Reinhard; Schneider, Joachim

2017-01-01

Objective The cockpit workplace of airline pilots is a noisy environment. This study examines the hearing thresholds of pilots with respect to ambient noise and communication sound. Methods The hearing of 487 German pilots was analysed by audiometry in the frequency range of 125 Hz–16 kHz in varying age groups. Cockpit noise (free-field) data and communication sound (acoustic manikin) measurements were evaluated. Results The ambient noise levels in cockpits were found to be between 74 and 80 dB(A), and the sound pressure levels under the headset were found to be between 84 and 88 dB(A). The left–right threshold differences at 3, 4 and 6 kHz show evidence of impaired hearing at the left ear, which worsens by age. In the age groups <40/≥40 years the mean differences at 3 kHz are 2/3 dB, at 4 kHz 2/4 dB and at 6 kHz 1/6 dB. In the pilot group which used mostly the left ear for communication tasks (43 of 45 are in the older age group) the mean difference at 3 kHz is 6 dB, at 4 kHz 7 dB and at 6 kHz 10 dB. The pilots who used the headset only at the right ear also show worse hearing at the left ear of 2 dB at 3 kHz, 3 dB at 4 kHz and at 6 kHz. The frequency-corrected exposure levels under the headset are 7–11 dB(A) higher than the ambient noise with an averaged signal-to-noise ratio for communication of about 10 dB(A). Conclusions The left ear seems to be more susceptible to hearing loss than the right ear. Active noise reduction systems allow for a reduced sound level for the communication signal below the upper exposure action value of 85 dB(A) and allow for a more relaxed working environment for pilots. PMID:28559452

Anomalies of the middle and inner ear.

PubMed

Rodriguez, Kimsey; Shah, Rahul K; Kenna, Margaret

2007-02-01

The development of the middle and inner ear highlights the intricacy of embryology. As early as 3 weeks after fertilization, the inner ear begins taking form. This process, along with development of the middle ear, continues throughout gestation. At birth, the middle ear, inner ear, and associated structures are almost adult size. An understanding of the embryologic development of the ear serves as a foundation for evaluating and managing congenital malformations of these structures. The focus of this article is the normal, abnormal, and arrested development of the middle and inner ear, with a clinical emphasis on malformed middle and inner ear structures and a discussion of associated syndromes.

A New Approach for the Correction of Prominent Ear Deformity: The Distally Based Perichondrio-Adipo-Dermal Flap Technique.

PubMed

Cihandide, Ercan; Kayiran, Oguz; Aydin, Elif Eren; Uzunismail, Adnan

2016-06-01

Otoplasty techniques are generally divided into 2 categories as cartilage-cutting and cartilage-sparing. The cartilage-cutting techniques have been criticized because of their high risk of hematoma, skin necrosis, and ear deformity. As a result, suture-based cartilage-sparing methods like Mustardé and Furnas-type suture techniques have become increasingly popular. However, with these techniques postauricular suture extrusion may be seen and recurrence rates of up to 25% have been reported. In this study, cartilage-sparing otoplasty is redefined by introduction of the distally based perichondrio-adipo-dermal flap which is elevated from the postauricular region. Thirty-seven ears (17 bilateral and 3 unilateral) in 20 patients (14 females and 6 males) have been operated with the defined technique by the same surgeon. The distally based perichondrio-adipo-dermal flap is advanced posteriorly to correct the deformity, also acting as a strong postauricular support to prevent recurrence. In addition to the resultant natural-looking antihelical fold, the posterior advancement of the flap corrects both the otherwise wide conchoscaphal and conchomastoid angles. The operative technique is explained in detail with results and the literature is reviewed. There were no hematomas. After an average follow-up of 8.3 months (2-16 months), recurrence was seen in only 1 patient who requested no further surgery. No patients developed suture extrusion or granuloma. The authors introduce a simple and safe procedure to correct prominent ears with benefits including a resultant natural-looking antihelical fold and less tissue trauma. The distally based perichondrio-adipo-dermal flap seems to prevent suture extrusion and may also help to reduce recurrence rates. By forming neochondrogenesis which is stimulated by elevation of the perichondrium, this flap gives the promise of longer durability of the newly formed antihelical fold.

Prevalence and causes of hearing impairment in Fundong Health District, North-West Cameroon.

PubMed

Ferrite, Silvia; Mactaggart, Islay; Kuper, Hannah; Oye, Joseph; Polack, Sarah

2017-04-01

To estimate the prevalence and causes of hearing impairment in Fundong Health District, North-West Cameroon. We selected 51 clusters of 80 people (all ages) through probability proportionate to size sampling. Initial hearing screening was undertaken through an otoacoustic emission (OAE) test. Participants aged 4+ years who failed this test in both ears or for whom an OAE reading could not be taken underwent a manual pure-tone audiometry (PTA) screening. Cases of hearing impairment were defined as those with pure-tone average ≥41 dBHL in adults and ≥35 dBHL in children in the better ear, or children under age 4 who failed the OAE test in both ears. Each case with hearing loss was examined by an ear, nose and throat nurse who indicated the main likely cause. We examined 3567 (86.9%) of 4104 eligible people. The overall prevalence of hearing impairment was 3.6% (95% confidence interval [CI]: 2.8-4.6). The prevalence was low in people aged 0-17 (1.1%, 0.7-1.8%) and 18-49 (1.1%, 0.5-2.6%) and then rose sharply in people aged 50+ (14.8%, 11.7-19.1%). Among cases, the majority were classified as moderate (76%), followed by severe (15%) and profound (9%). More than one-third of cases of hearing impairment were classified as unknown (37%) or conductive (37%) causes, while sensorineural causes were less common (26%). Prevalence of hearing impairment in North-West Cameroon is in line with the WHO estimate for sub-Saharan Africa. The majority of cases with known causes are treatable, with impacted wax playing a major role. © 2017 John Wiley & Sons Ltd.

Hearing loss in children with growth hormone deficiency.

PubMed

Muus, John S; Weir, Forest W; Kreicher, Kathryn L; Bowlby, Deborah A; Discolo, Christopher M; Meyer, Ted A

2017-09-01

Although insulin-like growth factor 1 (IGF-1) has been shown to be important for inner-ear development in animal models, little is known about the otologic and audiologic findings of children with growth hormone deficiency (GHD). The goal of this study is to evaluate the prevalence, type, and severity of hearing impairment in children with GHD. Audiologic, otologic, and demographic data were recorded for children with a diagnosis of GHD in the AudGen database. Data for each patient were selected based on the first encounter with available complete audiometric data or the first encounter with a type of hearing loss documented. The patients were then stratified by type and severity of hearing loss, and otologic issues were documented. A separate cohort comprised of children with GHD without hearing loss was compared as a control. 209 children with GHD met inclusion criteria. 173 (83%) of these patients had hearing loss. 79% of losses were bilateral and 21% were unilateral (309 total ears with hearing loss). 293 of the 309 ears with hearing loss had audiograms with ear-specific thresholds; 47 had conductive, 24 had sensorineural, 65 had mixed and 157 had undefined hearing loss with incomplete audiograms. Pure-tone averages (PTA) were higher among patients with mixed hearing loss compared to patients with all other loss types. Hearing loss is prevalent in children with GHD with a predisposition to be bilateral. These findings suggest the need for increased awareness and routine hearing screening for patients with GHD. Further studies may elucidate the etiology of the hearing impairment in children with GHD to better aid pediatricians, endocrinologists, otolaryngologists and audiologists when assessing and managing these children. Copyright © 2017 Elsevier B.V. All rights reserved.

Monaural and binaural contributions to interaural-level-difference sensitivity in human auditory cortex.

PubMed

Stecker, G Christopher; McLaughlin, Susan A; Higgins, Nathan C

2015-10-15

Whole-brain functional magnetic resonance imaging was used to measure blood-oxygenation-level-dependent (BOLD) responses in human auditory cortex (AC) to sounds with intensity varying independently in the left and right ears. Echoplanar images were acquired at 3 Tesla with sparse image acquisition once per 12-second block of sound stimulation. Combinations of binaural intensity and stimulus presentation rate were varied between blocks, and selected to allow measurement of response-intensity functions in three configurations: monaural 55-85 dB SPL, binaural 55-85 dB SPL with intensity equal in both ears, and binaural with average binaural level of 70 dB SPL and interaural level differences (ILD) ranging ±30 dB (i.e., favoring the left or right ear). Comparison of response functions equated for contralateral intensity revealed that BOLD-response magnitudes (1) generally increased with contralateral intensity, consistent with positive drive of the BOLD response by the contralateral ear, (2) were larger for contralateral monaural stimulation than for binaural stimulation, consistent with negative effects (e.g., inhibition) of ipsilateral input, which were strongest in the left hemisphere, and (3) also increased with ipsilateral intensity when contralateral input was weak, consistent with additional, positive, effects of ipsilateral stimulation. Hemispheric asymmetries in the spatial extent and overall magnitude of BOLD responses were generally consistent with previous studies demonstrating greater bilaterality of responses in the right hemisphere and stricter contralaterality in the left hemisphere. Finally, comparison of responses to fast (40/s) and slow (5/s) stimulus presentation rates revealed significant rate-dependent adaptation of the BOLD response that varied across ILD values. Copyright © 2015. Published by Elsevier Inc.

Comparative Anatomy of the Bony Labyrinth (Inner Ear) of Placental Mammals

PubMed Central

Ekdale, Eric G.

2013-01-01

Background Variation is a naturally occurring phenomenon that is observable at all levels of morphology, from anatomical variations of DNA molecules to gross variations between whole organisms. The structure of the otic region is no exception. The present paper documents the broad morphological diversity exhibited by the inner ear region of placental mammals using digital endocasts constructed from high-resolution X-ray computed tomography (CT). Descriptions cover the major placental clades, and linear, angular, and volumetric dimensions are reported. Principal Findings The size of the labyrinth is correlated to the overall body mass of individuals, such that large bodied mammals have absolutely larger labyrinths. The ratio between the average arc radius of curvature of the three semicircular canals and body mass of aquatic species is substantially lower than the ratios of related terrestrial taxa, and the volume percentage of the vestibular apparatus of aquatic mammals tends to be less than that calculated for terrestrial species. Aspects of the bony labyrinth are phylogenetically informative, including vestibular reduction in Cetacea, a tall cochlear spiral in caviomorph rodents, a low position of the plane of the lateral semicircular canal compared to the posterior canal in Cetacea and Carnivora, and a low cochlear aspect ratio in Primatomorpha. Significance The morphological descriptions that are presented add a broad baseline of anatomy of the inner ear across many placental mammal clades, for many of which the structure of the bony labyrinth is largely unknown. The data included here complement the growing body of literature on the physiological and phylogenetic significance of bony labyrinth structures in mammals, and they serve as a source of data for future studies on the evolution and function of the vertebrate ear. PMID:23805251

7-T magnetic resonance imaging of the inner ear's anatomy by using dual four-element radiofrequency coil arrays and the VIBE sequence

NASA Astrophysics Data System (ADS)

Kim, Kyoung-Nam; Heo, Phil; Kim, Young-Bo; Han, Gyu-Cheol

2015-02-01

An ultra-high-field magnetic resonance (MR) scanner and a specially-optimized radiofrequency (RF) coil and sequence protocol are required to obtain high-resolution images of the inner ear that can noninvasively confirm pathologic diagnoses. In phantom studies, the MR signal distribution of the gradient echo MR images generated by using a customized RF coil was compared with that of a commercial volume coil. The MR signal intensity of the customized RF coil decreases rapidly from near the RF coil plane toward the exterior of the phantom. However, the signal sensitivity of this coil is superior on both sides of the phantom, corresponding to the petrous pyramid. In in-vivo 7-T MR imaging, a customized RF coil and a volumetric-interpolated breath-hold examination imaging sequence are employed for visualization of the inner ear's structure. The entire membranous portion of the cochlear and the three semicircular canals, including the ductus reunions, oval window, and round window with associated nervous tissue, were clearly depicted with sufficient spatial coverage for adequate inspection of the surrounding anatomy. Developments from a new perspective to inner ear imaging using the 7-T modality could lead to further improved image sensitivity and, thus, enable ultra-structural MR imaging.

Early experience in microtia reconstruction: the first 100 cases.

PubMed

Sabbagh, Walid

2011-04-01

Auricular reconstruction in Microtia is a challenging operation with a steep learning curve. In view its rarity attaining a high standard for new surgeons is extremely difficult. This study analyses the first 100 microtia cases looking at complications, technique, pattern of progress and aesthetic outcome. The author performed 100 autologous ear reconstructions for microtia over a period of 4 years utilizing the two stage technique popularised by Nagata and Firmin. In 11 cases a temroparietal fascial flap was utilised because of either a low hairline or scarring. Follow up ranged from 3 to 36 months. Data was collected prospectively. There were 7 cases of partial skin necrosis, 3 of which healed with conservative management. In early cases deficiencies were seen in the proportions of the reconstructed ear and the quality of definition. Better shape and definition were evident as more surgical experience was gained. This occurred as a result of increased appreciation of the ear proportions and improved framework carving. Although two stages were planned 21 cases required further procedures. The series demonstrates the early learning curve in microtia reconstruction and underlines the importance of appropriate training and case availability in achieving high quality results in autologous ear reconstruction. Copyright © 2010 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

High-resolution x-ray computed tomography to understand ruminant phylogeny

NASA Astrophysics Data System (ADS)

Costeur, Loic; Schulz, Georg; Müller, Bert

2014-09-01

High-resolution X-ray computed tomography has become a vital technique to study fossils down to the true micrometer level. Paleontological research requires the non-destructive analysis of internal structures of fossil specimens. We show how X-ray computed tomography enables us to visualize the inner ear of extinct and extant ruminants without skull destruction. The inner ear, a sensory organ for hearing and balance has a rather complex three-dimensional morphology and thus provides relevant phylogenetical information what has been to date essentially shown in primates. We made visible the inner ears of a set of living and fossil ruminants using the phoenix x-ray nanotom®m (GE Sensing and Inspection Technologies GmbH). Because of the high absorbing objects a tungsten target was used and the experiments were performed with maximum accelerating voltage of 180 kV and a beam current of 30 μA. Possible stem ruminants of the living families are known in the fossil record but extreme morphological convergences in external structures such as teeth is a strong limitation to our understanding of the evolutionary history of this economically important group of animals. We thus investigate the inner ear to assess its phylogenetical potential for ruminants and our first results show strong family-level morphological differences.

The imprints of the last jets in core collapse supernovae

NASA Astrophysics Data System (ADS)

Bear, Ealeal; Grichener, Aldana; Soker, Noam

2017-12-01

We analyse the morphologies of three core collapse supernova remnants (CCSNRs) and the energy of jets in other CCSNRs and in Super Luminous Supernovae (SLSNe) of type Ib/Ic/IIb, and conclude that these properties are well explained by the last jets' episode as expected in the jet feedback explosion mechanism of core collapse supernovae (CCSNe). The presence of two opposite protrusions, termed ears, and our comparison of the CCSNR morphologies with morphologies of planetary nebulae strengthen the claim that jets play a major role in the explosion mechanism of CCSNe. We crudely estimate the energy that was required to inflate the ears in two CCSNRs and assume that the ears were inflated by jets. We find that the energies of the jets which inflated ears in 11 CCSNRs span a range that is similar to that of jets in some energetic CCSNe (SLSNe) and that this energy, only of the last jets' episode, is much less than the explosion energy. This finding is compatible with the jet feedback explosion mechanism of CCSNe, where only the last jets, which carry a small fraction of the total energy carried by earlier jets, are expected to influence the outer parts of the ejecta. We reiterate our call for a paradigm shift from neutrino-driven to jet-driven explosion models of CCSNe.

Perfusion-decellularization of human ear grafts enables ECM-based scaffolds for auricular vascularized composite tissue engineering.

PubMed

Duisit, Jérôme; Amiel, Hadrien; Wüthrich, Tsering; Taddeo, Adriano; Dedriche, Adeline; Destoop, Vincent; Pardoen, Thomas; Bouzin, Caroline; Joris, Virginie; Magee, Derek; Vögelin, Esther; Harriman, David; Dessy, Chantal; Orlando, Giuseppe; Behets, Catherine; Rieben, Robert; Gianello, Pierre; Lengelé, Benoît

2018-06-01

Human ear reconstruction is recognized as the emblematic enterprise in tissue engineering. Up to now, it has failed to reach human applications requiring appropriate tissue complexity along with an accessible vascular tree. We hereby propose a new method to process human auricles in order to provide a poorly immunogenic, complex and vascularized ear graft scaffold. 12 human ears with their vascular pedicles were procured. Perfusion-decellularization was applied using a SDS/polar solvent protocol. Cell and antigen removal was examined by histology and DNA was quantified. Preservation of the extracellular matrix (ECM) was assessed by conventional and 3D-histology, proteins and cytokines quantifications. Biocompatibility was assessed by implantation in rats for up to 60 days. Adipose-derived stem cells seeding was conducted on scaffold samples and with human aortic endothelial cells whole graft seeding in a perfusion-bioreactor. Histology confirmed cell and antigen clearance. DNA reduction was 97.3%. ECM structure and composition were preserved. Implanted scaffolds were tolerated in vivo, with acceptable inflammation, remodeling, and anti-donor antibody formation. Seeding experiments demonstrated cell engraftment and viability. Vascularized and complex auricular scaffolds can be obtained from human source to provide a platform for further functional auricular tissue engineered constructs, hence providing an ideal road to the vascularized composite tissue engineering approach. The ear is emblematic in the biofabrication of tissues and organs. Current regenerative medicine strategies, with matrix from donor tissues or 3D-printed, didn't reach any application for reconstruction, because critically missing a vascular tree for perfusion and transplantation. We previously described the production of vascularized and cell-compatible scaffolds, from porcine ear grafts. In this study, we ---- applied findings directly to human auricles harvested from postmortem donors, providing a perfusable matrix that retains the ear's original complexity and hosts new viable cells after seeding. This approach unlocks the ability to achieve an auricular tissue engineering approach, associated with possible clinical translation. Copyright © 2018 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

Marine Fuel Cell Technology Verification Trainer Program: Operator Curriculum Development

DTIC Science & Technology

2004-06-01

collection of tnormiratin is estimiate to average 1 hour per response, Including the time INr reviewing InatruCtlona. ear-ching existing =ata aourcas...guidelines and standards are provided. With the anticipation that up to several years’ delay will occur between the time of this report and the maturity of...reference only, given as foundation sources available at the time of this project. The supplemental references to published materials are considered the

Weightlessness - A case history. [for Skylab 2 crewmen

NASA Technical Reports Server (NTRS)

Kerwin, J. P.

1975-01-01

A review of the average bodily systems functioning aboard Skylab II after 20 days of weightlessness is presented. Condition of eyes, ears, nose and throat, gastrointestinal tract, vestibular organs, cardiovascular system, musculoskeletal system, sleep, general appearance, skin, abdomen, and extremities is summarized. The general health of the crewmen is good, although there are some slight anomalies, such as weight loss, dry skin, nasal speech, and paresthesia of the soles of the feet.

Middle-ear microsurgery simulation to improve new robotic procedures.

PubMed

Kazmitcheff, Guillaume; Nguyen, Yann; Miroir, Mathieu; Péan, Fabien; Ferrary, Evelyne; Cotin, Stéphane; Sterkers, Olivier; Duriez, Christian

2014-01-01

Otological microsurgery is delicate and requires high dexterity in bad ergonomic conditions. To assist surgeons in these indications, a teleoperated system, called RobOtol, is developed. This robot enhances gesture accuracy and handiness and allows exploration of new procedures for middle ear surgery. To plan new procedures that exploit the capacities given by the robot, a surgical simulator is developed. The simulation reproduces with high fidelity the behavior of the anatomical structures and can also be used as a training tool for an easier control of the robot for surgeons. In the paper, we introduce the middle ear surgical simulation and then we perform virtually two challenging procedures with the robot. We show how interactive simulation can assist in analyzing the benefits of robotics in the case of complex manipulations or ergonomics studies and allow the development of innovative surgical procedures. New robot-based microsurgical procedures are investigated. The improvement offered by RobOtol is also evaluated and discussed.

Middle-Ear Microsurgery Simulation to Improve New Robotic Procedures

PubMed Central

Kazmitcheff, Guillaume; Nguyen, Yann; Miroir, Mathieu; Péan, Fabien; Ferrary, Evelyne; Cotin, Stéphane; Sterkers, Olivier; Duriez, Christian

2014-01-01

Otological microsurgery is delicate and requires high dexterity in bad ergonomic conditions. To assist surgeons in these indications, a teleoperated system, called RobOtol, is developed. This robot enhances gesture accuracy and handiness and allows exploration of new procedures for middle ear surgery. To plan new procedures that exploit the capacities given by the robot, a surgical simulator is developed. The simulation reproduces with high fidelity the behavior of the anatomical structures and can also be used as a training tool for an easier control of the robot for surgeons. In the paper, we introduce the middle ear surgical simulation and then we perform virtually two challenging procedures with the robot. We show how interactive simulation can assist in analyzing the benefits of robotics in the case of complex manipulations or ergonomics studies and allow the development of innovative surgical procedures. New robot-based microsurgical procedures are investigated. The improvement offered by RobOtol is also evaluated and discussed. PMID:25157373

[Equivalent Lever Principle of Ossicular Chain and Amplitude Reduction Effect of Internal Ear Lymph].

PubMed

Zhao, Xiaoyan; Qin, Renjia

2015-04-01

This paper makes persuasive demonstrations on some problems about the human ear sound transmission principle in existing physiological textbooks and reference books, and puts forward the authors' view to make up for its literature. Exerting the knowledge of lever in physics and the acoustics theory, we come up with an equivalent simplified model of manubrium mallei which is to meet the requirements as the long arm of the lever. We also set up an equivalent simplified model of ossicular chain--a combination of levers of ossicular chain. We disassemble the model into two simple levers, and make full analysis and demonstration on them. Through the calculation and comparison of displacement amplitudes in both external auditory canal air and internal ear lymph, we may draw a conclusion that the key reason, which the sound displacement amplitude is to be decreased to adapt to the endurance limit of the basement membrane, is that the density and sound speed in lymph is much higher than those in the air.

Swimmer's Ear (For Parents)

MedlinePlus

... scratching the ear canal, vigorous ear cleaning with cotton swabs, or putting foreign objects like bobby pins ... Also, never put objects into kids' ears, including cotton-tipped swabs. How Is Swimmer's Ear Treated? Treatment ...

Numerical analysis of ossicular chain lesion of human ear

NASA Astrophysics Data System (ADS)

Liu, Yingxi; Li, Sheng; Sun, Xiuzhen

2009-04-01

Lesion of ossicular chain is a common ear disease impairing the sense of hearing. A comprehensive numerical model of human ear can provide better understanding of sound transmission. In this study, we propose a three-dimensional finite element model of human ear that incorporates the canal, tympanic membrane, ossicular bones, middle ear suspensory ligaments/muscles, middle ear cavity and inner ear fluid. Numerical analysis is conducted and employed to predict the effects of middle ear cavity, malleus handle defect, hypoplasia of the long process of incus, and stapedial crus defect on sound transmission. The present finite element model is shown to be reasonable in predicting the ossicular mechanics of human ear.

Evidence for a Right-Ear Advantage in Newborn Hearing Screening Results.

PubMed

Ari-Even Roth, Daphne; Hildesheimer, Minka; Roziner, Ilan; Henkin, Yael

2016-12-06

The aim of the present study was to investigate the effect of ear asymmetry, order of testing, and gender on transient-evoked otoacoustic emission (TEOAE) pass rates and response levels in newborn hearing screening. The screening results of 879 newborns, of whom 387 (study group) passed screening successfully in only one ear in the first TEOAE screening, but passed screening successfully in both ears thereafter, and 492 (control group) who passed screening successfully in both ears in the first TEOAE, were retrospectively examined for pass rates and TEOAE characteristics. Results indicated a right-ear advantage, as manifested by significantly higher pass rates in the right ear (61% and 39% for right and left ears, respectively) in the study group, and in 1.75 dB greater TEOAE response amplitudes in the control group. The right-ear advantage was enhanced when the first tested ear was the right ear (76%). When the left ear was tested first, pass rates were comparable in both ears. The right-ear advantage in pass rates was similar in females versus males, but manifested in 1.5 dB higher response amplitudes in females compared with males, regardless of the tested ear and order of testing in both study and control groups. The study provides further evidence for the functional lateralization of the auditory system at the cochlear level already apparent soon after birth in both males and females. While order of testing plays a significant role in the asymmetry in pass rates, the innate right-ear advantage seems to be a more dominant contributor. © The Author(s) 2016.

Anthropometric growth study of the ear in a Chinese population.

PubMed

Zhao, Shichun; Li, Dianguo; Liu, Zhenzhong; Wang, Yibiao; Liu, Lei; Jiang, Duyin; Pan, Bo

2018-04-01

A large number of anthropometric studies of the auricle have been reported in different nations, but little data were available in the Chinese population. The aim of this study was to analyze growth changes in the ear by measuring the width and length of ears in a Chinese population. A total of 480 participants were enrolled and classified into 1-, 3-, 5-, 7-, 9-, 12-, 14-, and 18-year groups (half were boys and half were girls in each group). Ear length, ear width, body weight, and body length were measured and recorded; ear index was calculated according to ear length and ear width. The growth of auricle and differences between genders were analyzed. Growth of ear in relation to body height and weight and the degree of emphasis on the length and width of the auricle were also analyzed. Ear length and width increased with age. Ear length achieved its mature size in both 14-year-old males and females. Ear width reached its mature size in males at 7 years and in females at 5 years. Different trends of ear index were shown between males and females. People in this population paid more attention to the length than the width of the auricle. The data indicated that ear development followed increase in age. There were gender and ethnic difference in the development of ear. These results may have potential implications for the diagnosis of congenital malformations, syndromes, and planning of ear reconstruction surgery. Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Evidence for a Right-Ear Advantage in Newborn Hearing Screening Results

PubMed Central

Hildesheimer, Minka; Roziner, Ilan; Henkin, Yael

2016-01-01

The aim of the present study was to investigate the effect of ear asymmetry, order of testing, and gender on transient-evoked otoacoustic emission (TEOAE) pass rates and response levels in newborn hearing screening. The screening results of 879 newborns, of whom 387 (study group) passed screening successfully in only one ear in the first TEOAE screening, but passed screening successfully in both ears thereafter, and 492 (control group) who passed screening successfully in both ears in the first TEOAE, were retrospectively examined for pass rates and TEOAE characteristics. Results indicated a right-ear advantage, as manifested by significantly higher pass rates in the right ear (61% and 39% for right and left ears, respectively) in the study group, and in 1.75 dB greater TEOAE response amplitudes in the control group. The right-ear advantage was enhanced when the first tested ear was the right ear (76%). When the left ear was tested first, pass rates were comparable in both ears. The right-ear advantage in pass rates was similar in females versus males, but manifested in 1.5 dB higher response amplitudes in females compared with males, regardless of the tested ear and order of testing in both study and control groups. The study provides further evidence for the functional lateralization of the auditory system at the cochlear level already apparent soon after birth in both males and females. While order of testing plays a significant role in the asymmetry in pass rates, the innate right-ear advantage seems to be a more dominant contributor. PMID:27927982

Coordinating High-Resolution Traffic Cameras : Developing Intelligent, Collaborating Cameras for Transportation Security and Communications

DOT National Transportation Integrated Search

2015-08-01

Cameras are used prolifically to monitor transportation incidents, infrastructure, and congestion. Traditional camera systems often require human monitoring and only offer low-resolution video. Researchers for the Exploratory Advanced Research (EAR) ...

15 CFR 748.15 - Authorization Validated End-User (VEU).

Code of Federal Regulations, 2013 CFR

2013-01-01

... People's Republic of China. (2) India. (c) Item restrictions. Items controlled under the EAR for missile... items no longer require a license for export or reexport to the PRC or India, as applicable, or become...

Why should disorders of the ear, nose and throat be treated by the same specialty? Can this situation persist?

PubMed

Yalamanchili, S

2009-04-01

The surgical specialty of otorhinolaryngology has its origins in the nineteenth century. Subsequently, the specialty also incorporated allied disciplines such as plastics and head and neck surgery. Following World War II, the survival of the specialty was threatened by the advent of antibiotics and the rise of the general surgeon. Despite this, the specialty of ENT was strengthened by strong post-war leadership and robust training.Today, with ENT knowledge ever increasing, the subspecialties have again begun to subdivide. Specialisation brings improved efficiency and outcomes; however, there remains a great need for the ENT generalist. Not all cases require subspecialist attention, and the generalist remains the basis of competent emergency cover. The natural development of otorhinolaryngology has brought the invaluable synergistic knowledge required to comprehensively treat disorders of the ear, nose and throat, knowledge that must not be overlooked when shaping the future of the specialty.

Modeling spring habitat requirements of the endangered brown eared pheasant Crossoptilon mantchuricum in the Huanglong Mountains, Shaanxi Province, China.

PubMed

Li, Hongqun; Yue, Bisong; Lian, Zhenmin; Zhao, Hongfeng; Zhao, Delong; Xiao, Xiangming

2012-09-01

A detailed understanding of the habitat needs of brown eared pheasants (Crossoptilon mantchuricum) is essential for conserving the species. We carried out field surveys in the Huanglong Mountains of Shaanxi Province, China, from March to June in 2007 and 2008. We arrayed a total of 206 grid plots (200 × 200 m) along transects in 2007 and 2008 and quantified a suite of environmental variables for each one. In the optimal logistic regression model, the most important variables for brown eared pheasants were slope degree, tree cover, distance to nearest water, cover and depth of fallen leaves. Hosmer and Leweshow goodness-of-fit tests explained that logistic models for the species were good fits. The model suggested that spring habitat selection of the brown eared pheasant was negatively related to distance to nearest water and slope degree, and positively to cover of trees and cover and depth of fallen leaves. In addition, the observed detected and undetected grids in 2007 did not show significant differences with predictions based on the model. These results showed that the model could well predict the habitat selection of brown eared pheasants. Based on these predictive models, we suggest that habitat management plans incorporating this new information can now focus more effectively on restrictions on the number of tourists entering the nature reserve, prohibition of firewood collection, livestock grazing, and medicinal plant harvesting by local residents in the core areas, protection of mixed forest and sources of the permanent water in the reserve, and use of alternatives to firewood.

Audiovisual distraction reduces pain perception during aural microsuction.

PubMed

Choudhury, N; Amer, I; Daniels, M; Wareing, M J

2013-01-01

Aural microsuction is a common ear, nose and throat procedure used in the outpatient setting. Some patients, however, find it difficult to tolerate owing to discomfort, pain or noise. This study evaluated the effect of audiovisual distraction on patients' pain perception and overall satisfaction. A prospective study was conducted for patients attending our aural care clinic requiring aural toileting of bilateral mastoid cavities over a three-month period. All microsuction was performed by a single clinical nurse specialist. Any patients with active infection were excluded. For each patient, during microsuction of one ear, they watched the procedure on a television screen while for the other ear they did not view the procedure. All patients received the same real time explanations during microsuction of both ears. After the procedure, each patient completed a visual analogue scale (VAS) to rate the pain they experienced for each ear, with and without access to the television screen. They also documented their preference and reasons why. A total of 37 patients were included in the study. The mean pain score for patients viewing the procedure was 2.43 compared with a mean of 3.48 for patients with no television view. This difference in patients' pain perception was statistically lower in the group who observed the procedure on the television (p=0.003), consistent with the majority of patients reporting a preference to viewing their procedure (65%). Audiovisual distraction significantly lowered patients' VAS pain scores during aural microsuction. This simple intervention can therefore reduce patients' perceived pain and help improve acceptance of this procedure.

The visible ear simulator: a public PC application for GPU-accelerated haptic 3D simulation of ear surgery based on the visible ear data.

PubMed

Sorensen, Mads Solvsten; Mosegaard, Jesper; Trier, Peter

2009-06-01

Existing virtual simulators for middle ear surgery are based on 3-dimensional (3D) models from computed tomographic or magnetic resonance imaging data in which image quality is limited by the lack of detail (maximum, approximately 50 voxels/mm3), natural color, and texture of the source material.Virtual training often requires the purchase of a program, a customized computer, and expensive peripherals dedicated exclusively to this purpose. The Visible Ear freeware library of digital images from a fresh-frozen human temporal bone was segmented, and real-time volume rendered as a 3D model of high-fidelity, true color, and great anatomic detail and realism of the surgically relevant structures. A haptic drilling model was developed for surgical interaction with the 3D model. Realistic visualization in high-fidelity (approximately 125 voxels/mm3) and true color, 2D, or optional anaglyph stereoscopic 3D was achieved on a standard Core 2 Duo personal computer with a GeForce 8,800 GTX graphics card, and surgical interaction was provided through a relatively inexpensive (approximately $2,500) Phantom Omni haptic 3D pointing device. This prototype is published for download (approximately 120 MB) as freeware at http://www.alexandra.dk/ves/index.htm.With increasing personal computer performance, future versions may include enhanced resolution (up to 8,000 voxels/mm3) and realistic interaction with deformable soft tissue components such as skin, tympanic membrane, dura, and cholesteatomas-features some of which are not possible with computed tomographic-/magnetic resonance imaging-based systems.

Seasonal movements of the Short-eared Owl (Asio flammeus) in western North America as revealed by satellite telemetry

USGS Publications Warehouse

Johnson, James A.; Booms, Travis L.; DeCicco, Lucas H.; Douglas, David C.

2017-01-01

The Short-eared Owl (Asio flammeus) is a widespread raptor whose abundance and distribution fluctuates in response to the varying amplitudes of its prey, which are predominately microtines. Previous efforts to describe the seasonal movements of Short-eared Owls have been hindered by few band recoveries and the species' cryptic and irruptive behavior. We attached satellite transmitters to adult Short-eared Owls at breeding areas in western and interior Alaska in June 2009 and July 2010, and tracked their movements for up to 19 mo. Owls initiated long-distance southward movements from Alaska and most followed a corridor east of the Rocky Mountains into the Prairie provinces and Great Plains states. Four owls followed a coastal route west of the Rocky Mountains, including one owl that crossed the Gulf of Alaska. Completed autumn migration distances ranged from 3205–6886 km (mean = 4722 ± 1156 km [SD]). Wintering areas spanned 21° of latitude from central Montana to southern Texas, and 24° of longitude from central California to western Kansas. Subsequent seasonal migrations were generally northward in spring and southward in autumn; these movements were comparatively short-distance (mean = 767.5 ± 517.4 km [SD]) and the owls exhibited low site fidelity. The Short-eared Owls we tracked from two relatively local breeding areas in Alaska used a patchwork of diverse open habitats across a large area of North America, which highlights that effective conservation of this species requires a collaborative, continental-scale focus.

Indicator Amino Acid-Derived Estimate of Dietary Protein Requirement for Male Bodybuilders on a Nontraining Day Is Several-Fold Greater than the Current Recommended Dietary Allowance.

PubMed

Bandegan, Arash; Courtney-Martin, Glenda; Rafii, Mahroukh; Pencharz, Paul B; Lemon, Peter Wr

2017-05-01

Background: Despite a number of studies indicating increased dietary protein needs in bodybuilders with the use of the nitrogen balance technique, the Institute of Medicine (2005) has concluded, based in part on methodologic concerns, that "no additional dietary protein is suggested for healthy adults undertaking resistance or endurance exercise." Objective: The aim of the study was to assess the dietary protein requirement of healthy young male bodybuilders ( with ≥3 y training experience) on a nontraining day by measuring the oxidation of ingested l-[1- 13 C]phenylalanine to 13 CO 2 in response to graded intakes of protein [indicator amino acid oxidation (IAAO) technique]. Methods: Eight men (means ± SDs: age, 22.5 ± 1.7 y; weight, 83.9 ± 11.6 kg; 13.0% ± 6.3% body fat) were studied at rest on a nontraining day, on several occasions (4-8 times) each with protein intakes ranging from 0.1 to 3.5 g · kg -1 · d -1 , for a total of 42 experiments. The diets provided energy at 1.5 times each individual's measured resting energy expenditure and were isoenergetic across all treatments. Protein was fed as an amino acid mixture based on the protein pattern in egg, except for phenylalanine and tyrosine, which were maintained at constant amounts across all protein intakes. For 2 d before the study, all participants consumed 1.5 g protein · kg -1 · d -1 On the study day, the protein requirement was determined by identifying the breakpoint in the F 13 CO 2 with graded amounts of dietary protein [mixed-effects change-point regression analysis of F 13 CO 2 (labeled tracer oxidation in breath)]. Results: The Estimated Average Requirement (EAR) of protein and the upper 95% CI RDA for these young male bodybuilders were 1.7 and 2.2 g · kg -1 · d -1 , respectively. Conclusion: These IAAO data suggest that the protein EAR and recommended intake for male bodybuilders at rest on a nontraining day exceed the current recommendations of the Institute of Medicine by ∼2.6-fold. This trial was registered at clinicaltrials.gov as NCT02621294. © 2017 American Society for Nutrition.

Radiation risk models for all solid cancers other than those types of cancer requiring individual assessments after a nuclear accident.

PubMed

Walsh, Linda; Zhang, Wei

2016-03-01

In the assessment of health risks after nuclear accidents, some health consequences require special attention. For example, in their 2013 report on health risk assessment after the Fukushima nuclear accident, the World Health Organisation (WHO) panel of experts considered risks of breast cancer, thyroid cancer and leukaemia. For these specific cancer types, use was made of already published excess relative risk (ERR) and excess absolute risk (EAR) models for radiation-related cancer incidence fitted to the epidemiological data from the Japanese A-bomb Life Span Study (LSS). However, it was also considered important to assess all other types of solid cancer together and the WHO, in their above-mentioned report, stated "No model to calculate the risk for all other solid cancer excluding breast and thyroid cancer risks is available from the LSS data". Applying the LSS models for all solid cancers along with the models for the specific sites means that some cancers have an overlap in the risk evaluations. Thus, calculating the total solid cancer risk plus the breast cancer risk plus the thyroid cancer risk can overestimate the total risk by several per cent. Therefore, the purpose of this paper was to publish the required models for all other solid cancers, i.e. all solid cancers other than those types of cancer requiring special attention after a nuclear accident. The new models presented here have been fitted to the same LSS data set from which the risks provided by the WHO were derived. Although it is known already that the EAR and ERR effect modifications by sex are statistically significant for the outcome "all solid cancer", it is shown here that sex modification is not statistically significant for the outcome "all solid cancer other than thyroid and breast cancer". It is also shown here that the sex-averaged solid cancer risks with and without the sex modification are very similar once breast and thyroid cancers are factored out. Some other notable model differences between those already published for all solid cancers and those presented here for all other solid cancers are also given here. The models presented here can be used to improve on the methodology adopted by WHO after Fukushima and could contribute to emergency preparedness for future nuclear accidents.

Binaural Interaction Effects of 30-50 Hz Auditory Steady State Responses.

PubMed

Gransier, Robin; van Wieringen, Astrid; Wouters, Jan

Auditory stimuli modulated by modulation frequencies within the 30 to 50 Hz region evoke auditory steady state responses (ASSRs) with high signal to noise ratios in adults, and can be used to determine the frequency-specific hearing thresholds of adults who are unable to give behavioral feedback reliably. To measure ASSRs as efficiently as possible a multiple stimulus paradigm can be used, stimulating both ears simultaneously. The response strength of 30 to 50Hz ASSRs is, however, affected when both ears are stimulated simultaneously. The aim of the present study is to gain insight in the measurement efficiency of 30 to 50 Hz ASSRs evoked with a 2-ear stimulation paradigm, by systematically investigating the binaural interaction effects of 30 to 50 Hz ASSRs in normal-hearing adults. ASSRs were obtained with a 64-channel EEG system in 23 normal-hearing adults. All participants participated in one diotic, multiple dichotic, and multiple monaural conditions. Stimuli consisted of a modulated one-octave noise band, centered at 1 kHz, and presented at 70 dB SPL. The diotic condition contained 40 Hz modulated stimuli presented to both ears. In the dichotic conditions, the modulation frequency of the left ear stimulus was kept constant at 40 Hz, while the stimulus at the right ear was either the unmodulated or modulated carrier. In case of the modulated carrier, the modulation frequency varied between 30 and 50 Hz in steps of 2 Hz across conditions. The monaural conditions consisted of all stimuli included in the diotic and dichotic conditions. Modulation frequencies ≥36 Hz resulted in prominent ASSRs in all participants for the monaural conditions. A significant enhancement effect was observed (average: ~3 dB) in the diotic condition, whereas a significant reduction effect was observed in the dichotic conditions. There was no distinct effect of the temporal characteristics of the stimuli on the amount of reduction. The attenuation was in 33% of the cases >3 dB for ASSRs evoked with modulation frequencies ≥40 Hz and 50% for ASSRs evoked with modulation frequencies ≤36 Hz. Binaural interaction effects as observed in the diotic condition are similar to the binaural interaction effects of middle latency responses as reported in the literature, suggesting that these responses share a same underlying mechanism. Our data also indicated that 30 to 50 Hz ASSRs are attenuated when presented dichotically and that this attenuation is independent of the stimulus characteristics as used in the present study. These findings are important as they give insight in how binaural interaction affects the measurement efficiency. The 2-ear stimulation paradigm of the present study was, for the most optimal modulation frequencies (i.e., ≥40 Hz), more efficient than a 1-ear sequential stimulation paradigm in 66% of the cases.

Light-Driven Contact Hearing Aid for Broad-Spectrum Amplification: Safety and Effectiveness Pivotal Study.

PubMed

Gantz, Bruce J; Perkins, Rodney; Murray, Michael; Levy, Suzanne Carr; Puria, Sunil

2017-03-01

Demonstrate safety and effectiveness of the light-driven contact hearing aid to support FDA clearance. A single-arm, open-label investigational-device clinical trial. Two private-practice and one hospital-based ENT clinics. Forty-three subjects (86 ears) with mild-to-severe bilateral sensorineural hearing impairment. Bilateral amplification delivered via a light-driven contact hearing aid comprising a Tympanic Lens (Lens) with a customized platform to directly drive the umbo and a behind-the-ear sound processor (Processor) that encodes sound into light pulses to wirelessly deliver signal and power to the Lens. The primary safety endpoint was a determination of "no change" (PTA4 < 10 dB) in residual unaided hearing at the 120-day measurement interval. The primary efficacy endpoint was improvement in word recognition using NU-6 at the 30-day measurement interval over the baseline unaided case. Secondary efficacy endpoints included functional gain from 2 to 10 kHz and speech-in-noise improvement over the baseline unaided case using both omnidirectional and directional microphones. The results for the 86 ears in the study determined a mean change of -0.40 dB in PTA4, indicating no change in residual hearing (p < 0.0001). There were no serious device- or procedure-related adverse events, or unanticipated adverse events. Word recognition aided with the Earlens improved significantly (p < 0.0001) over the unaided performance, by 35% rationalized arcsine units on average. Mean functional gain was 31 dB across 2 to 10 kHz. The average speech-recognition threshold improvement over the unaided case for the Hearing in Noise Test was 0.75 dB (p = 0.028) and 3.14 dB (p < 0.0001) for the omnidirectional and directional microphone modes, respectively. The safety and effectiveness data supported a de novo 510(k) submission that received clearance from the FDA.