The timecourse of apoptotic cell death during postnatal remodeling of the mouse cochlea and its premature onset by triiodothyronine (T3).

PubMed

Peeters, R P; Ng, L; Ma, M; Forrest, D

2015-05-15

Apoptosis underlies various forms of tissue remodeling during development. Prior to the onset of hearing, thyroid hormone (T3) promotes cochlear remodeling, which involves regression of the greater epithelial ridge (GER), a transient structure of columnar cells adjacent to the mechanosensory hair cells. We investigated the timecourse of apoptosis in the GER and the influence of ectopic T3 on apoptosis. In saline-treated mice, activated caspase 3-positive cells were detected in the GER between postnatal days 7 and 13 and appeared progressively along the cochlear duct from base to apex over developmental time. T3 given on P0 and P1 advanced the overall program of apoptosis and remodeling by ~4 days. Thyroid hormone receptor β was required for these actions, suggesting a receptor-mediated process of initiation of apoptosis. Finally, T3 given only at P0 or P1 resulted in deafness in adult mice, thus revealing a transient period of susceptibility to long-term damage in the neonatal auditory system. Published by Elsevier Ireland Ltd.

Limits on normal cochlear 'third' windows provided by previous investigations of additional sound paths into and out of the cat inner ear.

PubMed

Rosowski, John J; Bowers, Peter; Nakajima, Hideko H

2018-03-01

While most models of cochlear function assume the presence of only two windows into the mammalian cochlea (the oval and round windows), a position that is generally supported by several lines of data, there is evidence for additional sound paths into and out of the inner ear in normal mammals. In this report we review the existing evidence for and against the 'two-window' hypothesis. We then determine how existing data and inner-ear anatomy restrict transmission of sound through these additional sound pathways in cat by utilizing a well-tested model of the cat inner ear, together with anatomical descriptions of the cat cochlear and vestibular aqueducts (potential additional windows to the cochlea). We conclude: (1) The existing data place limits on the size of the cochlear and vestibular aqueducts in cat and are consistent with small volume-velocities through these ducts during ossicular stimulation of the cochlea, (2) the predicted volume velocities produced by aqueducts with diameters half the size of the bony diameters match the functional data within ±10 dB, and (3) these additional volume velocity paths contribute to the inner ear's response to non-acoustic stimulation and conductive pathology. Copyright © 2017 Elsevier B.V. All rights reserved.

Focused tight dressing does not prevent cochlear implant magnet migration under 1.5 Tesla MRI.

PubMed

Cuda, D; Murri, A; Succo, G

2013-04-01

We report a retrospective case of inner magnet migration, which occurred after 1.5 Tesla MRI scanning in an adult recipient of a bilateral cochlear implant (CI) despite a focused head dressing. The patient, bilaterally implanted with Nucleus 5 CIs (Cochlear LTD, Sydney, Australia), underwent a 1.5 Tesla cholangio-MRI scan for biliary duct pathology. In subsequent days, a focal skin alteration appeared over the left inner coil. Plain skull radiographs showed partial magnet migration on the left side. Surgical exploration confirmed magnet twisting; the magnet was effectively repositioned. Left CI performance was restored to pre-migration level. The wound healed without complications. Thus, focused dressing does not prevent magnet migration in CI recipients undergoing 1.5 Tesla MRI. All patients should be counselled on this potential complication. A minor surgical procedure is required to reposition the magnet. Nevertheless, timely diagnosis is necessary to prevent skin breakdown and subsequent device contamination. Plain skull radiograph is very effective in identifying magnet twisting; it should be performed systematically after MRI or minimally on all suspected cases.

Making connections in the inner ear: recent insights into the development of spiral ganglion neurons and their connectivity with sensory hair cells

PubMed Central

Coate, Thomas M.; Kelley, Matthew W.

2013-01-01

In mammals, auditory information is processed by the hair cells (HCs) located in the cochlea and then rapidly transmitted to the CNS via a specialized cluster of bipolar afferent connections known as the spiral ganglion neurons (SGNs). Although many anatomical aspects of SGNs are well described, the molecular and cellular mechanisms underlying their genesis, how they are precisely arranged along the cochlear duct, and the guidance mechanisms that promote the innervation of their hair cell targets are only now being understood. Building upon foundational studies of neurogenesis and neurotrophins, we review here new concepts and technologies that are helping to enrich our understanding of the development of the nervous system within the inner ear. PMID:23660234

Mutanlallemand (mtl) and Belly Spot and Deafness (bsd) Are Two New Mutations of Lmx1a Causing Severe Cochlear and Vestibular Defects

PubMed Central

Pearson, Selina; Brooker, Rachael H.; Spiden, Sarah; Kiernan, Amy E.; Guénet, Jean-Louis; Steel, Karen P.

2012-01-01

Mutanlallemand (mtl) and Belly Spot and Deafness (bsd) are two new spontaneous alleles of the Lmx1a gene in mice. Homozygous mutants show head tossing and circling behaviour, indicative of vestibular defects, and they have short tails and white belly patches of variable size. The analysis of auditory brainstem responses (ABR) showed that mtl and bsd homozygotes are deaf, whereas heterozygous and wildtype littermates have normal hearing. Paint-filled inner ears at E16.5 revealed that mtl and bsd homozygotes lack endolymphatic ducts and semicircular canals and have short cochlear ducts. These new alleles show similarities with dreher (Lmx1a) mutants. Complementation tests between mtl and dreher and between mtl and bsd suggest that mtl and bsd are new mutant alleles of the Lmx1a gene. To determine the Lmx1a mutation in mtl and bsd mutant mice we performed PCR followed by sequencing of genomic DNA and cDNA. The mtl mutation is a single point mutation in the 3′ splice site of exon 4 leading to an exon extension and the activation of a cryptic splice site 44 base pairs downstream, whereas the bsd mutation is a genomic deletion that includes exon 3. Both mutations lead to a truncated LMX1A protein affecting the homeodomain (mtl) or LIM2-domain (bsd), which is critical for LMX1A protein function. Moreover, the levels of Lmx1a transcript in mtl and bsd mutants are significantly down-regulated. Hmx2/3 and Pax2 expression are also down-regulated in mtl and bsd mutants, suggesting a role of Lmx1a upstream of these transcription factors in early inner ear morphogenesis. We have found that these mutants develop sensory patches although they are misshapen. The characterization of these two new Lmx1a alleles highlights the critical role of this gene in the development of the cochlea and vestibular system. PMID:23226461

Fluid coupling in a discrete model of cochlear mechanics.

PubMed

Elliott, Stephen J; Lineton, Ben; Ni, Guangjian

2011-09-01

A discrete model of cochlear mechanics is introduced that includes a full, three-dimensional, description of fluid coupling. This formulation allows the fluid coupling and basilar membrane dynamics to be analyzed separately and then coupled together with a simple piece of linear algebra. The fluid coupling is initially analyzed using a wavenumber formulation and is separated into one component due to one-dimensional fluid coupling and one comprising all the other contributions. Using the theory of acoustic waves in a duct, however, these two components of the pressure can also be associated with a far field, due to the plane wave, and a near field, due to the evanescent, higher order, modes. The near field components are then seen as one of a number of sources of additional longitudinal coupling in the cochlea. The effects of non-uniformity and asymmetry in the fluid chamber areas can also be taken into account, to predict both the pressure difference between the chambers and the mean pressure. This allows the calculation, for example, of the effect of a short cochlear implant on the coupled response of the cochlea. © 2011 Acoustical Society of America

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

How do the medial olivocochlear efferents influence the biomechanics of the outer hair cells and thereby the cochlear amplifier? Simulation results

NASA Astrophysics Data System (ADS)

Saremi, Amin; Stenfelt, Stefan; Verhulst, Sarah

2015-12-01

The bottom-up signal pathway, which starts from the outer ear and leads to the brain cortices, gives the classic image of the human sound perception. However, there have been growing evidences in the last six decades for existence of a functional descending network whereby the central auditory system can modulate the early auditory processing, in a top-down manner. The medial olivocochlear efferent fibers project from the superior olivary complex at the brainstem into the inner ear. They are linked to the basal poles of the hair cells by forming synaptic cisterns. This descending network can activate nicotinic cholinergic receptors (nAChR) that increase the membrane conductance of the outer hair cells and thereby modify the magnitude of the active force generated inside the cochlea. The aim of the presented work is to quantitatively investigate how the changes in the biomechanics of the outer hair cells, caused by the efferent activation, manipulate the cochlear responses. This is done by means of a frequency-domain biophysical model of the cochlea [12] where the parameters of the model convey physiological interpretations of the human cochlear structures. The simulations manifest that a doubling of the outer hair cell conductance, due to efferent activation, leads to a frequency-dependent gain reduction along the cochlear duct with its highest effect at frequencies between 1 kHz and 3.5 kHz and a maximum of approximately 10 dB gain reduction at 2 kHz. This amount of the gain inhibition and its frequency dependence reasonably agrees with the experimental data recorded from guinea pig, cat and human cochleae where the medial olivococlear efferents had been elicited by broad-band stimuli. The simulations also indicate that the efferent-induced increase of the outer hair cell conductance increases the best frequency of the cochlear responses, in the basal region. The presented simulations quantitatively confirm that activation of the medial olivocochlear efferents can biomechanically manipulate the cochlear responses, in a top-down manner, by inhibiting the gain of the cochlear amplifier as well as altering the frequency-position map (tuning pattern) of the cochlea.

Where hearing starts: the development of the mammalian cochlea.

PubMed

Basch, Martin L; Brown, Rogers M; Jen, Hsin-I; Groves, Andrew K

2016-02-01

The mammalian cochlea is a remarkable sensory organ, capable of perceiving sound over a range of 10(12) in pressure, and discriminating both infrasonic and ultrasonic frequencies in different species. The sensory hair cells of the mammalian cochlea are exquisitely sensitive, responding to atomic-level deflections at speeds on the order of tens of microseconds. The number and placement of hair cells are precisely determined during inner ear development, and a large number of developmental processes sculpt the shape, size and morphology of these cells along the length of the cochlear duct to make them optimally responsive to different sound frequencies. In this review, we briefly discuss the evolutionary origins of the mammalian cochlea, and then describe the successive developmental processes that lead to its induction, cell cycle exit, cellular patterning and the establishment of topologically distinct frequency responses along its length. © 2015 Anatomical Society.

Finite element modelling of human auditory periphery including a feed-forward amplification of the cochlea.

PubMed

Wang, Xuelin; Wang, Liling; Zhou, Jianjun; Hu, Yujin

2014-08-01

A three-dimensional finite element model is developed for the simulation of the sound transmission through the human auditory periphery consisting of the external ear canal, middle ear and cochlea. The cochlea is modelled as a straight duct divided into two fluid-filled scalae by the basilar membrane (BM) having an orthotropic material property with dimensional variation along its length. In particular, an active feed-forward mechanism is added into the passive cochlear model to represent the activity of the outer hair cells (OHCs). An iterative procedure is proposed for calculating the nonlinear response resulting from the active cochlea in the frequency domain. Results on the middle-ear transfer function, BM steady-state frequency response and intracochlear pressure are derived. A good match of the model predictions with experimental data from the literatures demonstrates the validity of the ear model for simulating sound pressure gain of middle ear, frequency to place map, cochlear sensitivity and compressive output for large intensity input. The current model featuring an active cochlea is able to correlate directly the sound stimulus in the ear canal with the vibration of BM and provides a tool to explore the mechanisms by which sound pressure in the ear canal is converted to a stimulus for the OHCs.

Water permeability of the mammalian cochlea: functional features of an aquaporin-facilitated water shunt at the perilymph-endolymph barrier.

PubMed

Eckhard, A; Müller, M; Salt, A; Smolders, J; Rask-Andersen, H; Löwenheim, H

2014-10-01

The cochlear duct epithelium (CDE) constitutes a tight barrier that effectively separates the inner ear fluids, endolymph and perilymph, thereby maintaining distinct ionic and osmotic gradients that are essential for auditory function. However, in vivo experiments have demonstrated that the CDE allows for rapid water exchange between fluid compartments. The molecular mechanism governing water permeation across the CDE remains elusive. We computationally determined the diffusional (PD) and osmotic (Pf) water permeability coefficients for the mammalian CDE based on in silico simulations of cochlear water dynamics integrating previously derived in vivo experimental data on fluid flow with expression sites of molecular water channels (aquaporins, AQPs). The PD of the entire CDE (PD = 8.18 × 10(-5) cm s(-1)) and its individual partitions including Reissner's membrane (PD = 12.06 × 10(-5) cm s(-1)) and the organ of Corti (PD = 10.2 × 10(-5) cm s(-1)) were similar to other epithelia with AQP-facilitated water permeation. The Pf of the CDE (Pf = 6.15 × 10(-4) cm s(-1)) was also in the range of other epithelia while an exceptionally high Pf was determined for an epithelial subdomain of outer sulcus cells in the cochlear apex co-expressing AQP4 and AQP5 (OSCs; Pf = 156.90 × 10(-3) cm s(-1)). The Pf/PD ratios of the CDE (Pf/PD = 7.52) and OSCs (Pf/PD = 242.02) indicate an aqueous pore-facilitated water exchange and reveal a high-transfer region or "water shunt" in the cochlear apex. This "water shunt" explains experimentally determined phenomena of endolymphatic longitudinal flow towards the cochlear apex. The water permeability coefficients of the CDE emphasise the physiological and pathophysiological relevance of water dynamics in the cochlea in particular for endolymphatic hydrops and Ménière's disease.

Mice deficient in H+-ATPase a4 subunit have severe hearing impairment associated with enlarged endolymphatic compartments within the inner ear

PubMed Central

Lorente-Cánovas, Beatriz; Ingham, Neil; Norgett, Elizabeth E.; Golder, Zoe J.; Karet Frankl, Fiona E.; Steel, Karen P.

2013-01-01

SUMMARY Mutations in the ATP6V0A4 gene lead to autosomal recessive distal renal tubular acidosis in patients, who often show sensorineural hearing impairment. A first Atp6v0a4 knockout mouse model that recapitulates the loss of H+-ATPase function seen in humans has been generated and recently reported (Norgett et al., 2012). Here, we present the first detailed analysis of the structure and function of the auditory system in Atp6v0a4−/− knockout mice. Measurements of the auditory brainstem response (ABR) showed significantly elevated thresholds in homozygous mutant mice, which indicate severe hearing impairment. Heterozygote thresholds were normal. Analysis of paint-filled inner ears and sections from E16.5 embryos revealed a marked expansion of cochlear and endolymphatic ducts in Atp6v0a4−/− mice. A regulatory link between Atp6v0a4, Foxi1 and Pds has been reported and we found that the endolymphatic sac of Atp6v0a4−/− mice expresses both Foxi1 and Pds, which suggests a downstream position of Atp6v0a4. These mutants also showed a lack of endocochlear potential, suggesting a functional defect of the stria vascularis on the lateral wall of the cochlear duct. However, the main K+ channels involved in the generation of endocochlear potential, Kcnj10 and Kcnq1, are strongly expressed in Atp6v0a4−/− mice. Our results lead to a better understanding of the role of this proton pump in hearing function. PMID:23065636

Working memory in Farsi-speaking children with normal development and cochlear implant.

PubMed

Soleymani, Zahra; Amidfar, Meysam; Dadgar, Hooshang; Jalaie, Shohre

2014-04-01

Working memory has an important role in language acquisition and development of cognition skills. The ability of encoding, storage and retrieval of phonological codes, as activities of working memory, acquired by audition sense. Children with cochlear implant experience a period that they are not able to perceive sounds. In order to assess the effect of hearing on working memory, we investigated working memory as a cognition skill in children with normal development and cochlear implant. Fifty students with normal hearing and 50 students with cochlear implant aged 5-7 years participated in this study. Children educated in the preschool, the first and second grades. Children with normal development were matched based on age, gender, and grade of education with cochlear implant. Two components of working memory including phonological loop and central executive were compared between two groups. Phonological loop assessed by nonword repetition task and forward digit span. To assess central executive component backward digit span was used. The developmental trend was studied in children with normal development and cochlear implant as well. The effect of age at implantation in children with cochlear implants on components of working memory was investigated. There are significant differences between children with normal development and cochlear implant in all tasks that assess working memory (p < 0.001). The children's age at implantation was negatively correlated with all tasks (p < 0.001). In contrast, duration of usage of cochlear implant set was positively correlated with all tasks (p < 0.001). The comparison of working memory between different grades showed significant differences both in children with normal development and in children with cochlear implant (p < 0.05). These results implied that children with cochlear implant may experience difficulties in working memory. Therefore, these children have problems in encoding, practicing, and repeating phonological units. The results also suggested working memory develops when the child grows up. In cochlear implant children, with decreasing age at implantation and increasing their experience in perceiving sound, working memory skills improved. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Cochlear implants: system design, integration, and evaluation.

PubMed

Zeng, Fan-Gang; Rebscher, Stephen; Harrison, William; Sun, Xiaoan; Feng, Haihong

2008-01-01

As the most successful neural prosthesis, cochlear implants have provided partial hearing to more than 120000 persons worldwide; half of which being pediatric users who are able to develop nearly normal language. Biomedical engineers have played a central role in the design, integration and evaluation of the cochlear implant system, but the overall success is a result of collaborative work with physiologists, psychologists, physicians, educators, and entrepreneurs. This review presents broad yet in-depth academic and industrial perspectives on the underlying research and ongoing development of cochlear implants. The introduction accounts for major events and advances in cochlear implants, including dynamic interplays among engineers, scientists, physicians, and policy makers. The review takes a system approach to address critical issues in cochlear implant research and development. First, the cochlear implant system design and specifications are laid out. Second, the design goals, principles, and methods of the subsystem components are identified from the external speech processor and radio frequency transmission link to the internal receiver, stimulator and electrode arrays. Third, system integration and functional evaluation are presented with respect to safety, reliability, and challenges facing the present and future cochlear implant designers and users. Finally, issues beyond cochlear implants are discussed to address treatment options for the entire spectrum of hearing impairment as well as to use the cochlear implant as a model to design and evaluate other similar neural prostheses such as vestibular and retinal implants.

Outcomes of cochlear implantation in deaf children of deaf parents: comparative study.

PubMed

Hassanzadeh, S

2012-10-01

This retrospective study compared the cochlear implantation outcomes of first- and second-generation deaf children. The study group consisted of seven deaf, cochlear-implanted children with deaf parents. An equal number of deaf children with normal-hearing parents were selected by matched sampling as a reference group. Participants were matched based on onset and severity of deafness, duration of deafness, age at cochlear implantation, duration of cochlear implantation, gender, and cochlear implant model. We used the Persian Auditory Perception Test for the Hearing Impaired, the Speech Intelligibility Rating scale, and the Sentence Imitation Test, in order to measure participants' speech perception, speech production and language development, respectively. Both groups of children showed auditory and speech development. However, the second-generation deaf children (i.e. deaf children of deaf parents) exceeded the cochlear implantation performance of the deaf children with hearing parents. This study confirms that second-generation deaf children exceed deaf children of hearing parents in terms of cochlear implantation performance. Encouraging deaf children to communicate in sign language from a very early age, before cochlear implantation, appears to improve their ability to learn spoken language after cochlear implantation.

What Does Music Sound Like for a Cochlear Implant User?

PubMed

Jiam, Nicole T; Caldwell, Meredith T; Limb, Charles J

2017-09-01

Cochlear implant research and product development over the past 40 years have been heavily focused on speech comprehension with little emphasis on music listening and enjoyment. The relatively little understanding of how music sounds in a cochlear implant user stands in stark contrast to the overall degree of importance the public places on music and quality of life. The purpose of this article is to describe what music sounds like to cochlear implant users, using a combination of existing research studies and listener descriptions. We examined the published literature on music perception in cochlear implant users, particularly postlingual cochlear implant users, with an emphasis on the primary elements of music and recorded music. Additionally, we administered an informal survey to cochlear implant users to gather first-hand descriptions of music listening experience and satisfaction from the cochlear implant population. Limitations in cochlear implant technology lead to a music listening experience that is significantly distorted compared with that of normal hearing listeners. On the basis of many studies and sources, we describe how music is frequently perceived as out-of-tune, dissonant, indistinct, emotionless, and weak in bass frequencies, especially for postlingual cochlear implant users-which may in part explain why music enjoyment and participation levels are lower after implantation. Additionally, cochlear implant users report difficulty in specific musical contexts based on factors including but not limited to genre, presence of lyrics, timbres (woodwinds, brass, instrument families), and complexity of the perceived music. Future research and cochlear implant development should target these areas as parameters for improvement in cochlear implant-mediated music perception.

Early Vocabulary Development in Children with Bilateral Cochlear Implants

ERIC Educational Resources Information Center

Välimaa, Taina; Kunnari, Sari; Laukkanen-Nevala, Päivi; Lonka, Eila

2018-01-01

Background: Children with unilateral cochlear implants (CIs) may have delayed vocabulary development for an extended period after implantation. Bilateral cochlear implantation is reported to be associated with improved sound localization and enhanced speech perception in noise. This study proposed that bilateral implantation might also promote…

Cochlear implants in children implanted in Jordan: A parental overview.

PubMed

Alkhamra, Rana A

2015-07-01

Exploring the perspective of parents on the cochlear implant process in Jordan. Sixty parents of deaf children were surveyed on the information gathering process prior to cochlear implant surgery, and their implant outcome expectations post-surgery. Whether child or parent characteristics may impact parents' post-surgical expectations was explored. Although parents used a variety of information sources when considering a cochlear implant, the ear, nose and throat doctor comprised their major source of information (60%). Parents received a range of information prior to cochlear implant but agreed (93.3%) on the need for a multidisciplinary team approach. Post-surgically, parents' expected major developments in the areas of spoken language (97%), and auditory skills (100%). Receiving education in mainstream schools (92%) was expected too. Parents perceived the cochlear implant decision as the best decision they can make for their child (98.3%). A significant correlation was found between parents contentment with the cochlear implant decision and expecting developments in the area of reading and writing (r=0.7). Child's age at implantation and age at hearing loss diagnosis significantly affected parents' post-implant outcome expectations (p<0.05). Despite the general satisfaction from the information quantity and quality prior to cochlear implant, parents agree on the need for a comprehensive multidisciplinary team approach during the different stages of the cochlear implant process. Parents' education about cochlear implants prior to the surgery can affect their post-surgical outcome expectations. The parental perspective presented in this study can help professionals develop better understanding of parents' needs and expectations and henceforth improve their services and support during the different stages of the cochlear implant process. Copyright © 2015. Published by Elsevier Ireland Ltd.

Parental expectations and outcomes of pediatric cochlear implantation.

PubMed

Piazza, Elizabeth; Kandathil, Cherian; Carron, Jeffrey D

2009-10-01

Cochlear implants have been used with increasing frequency over the past twenty years, including very young patients. To determine if parents are satisfied with their children's performance after cochlear implantation. Survey mailed to parents of children receiving cochlear implants. 31 questionnaires were returned out of 69 mailed (45 %). The vast majority of responding parents felt that their children benefited substantially from cochlear implant surgery. Cochlear implantation is effective in helping children develop auditory-oral communication skills. Access to auditory/oral communication programs in this state remains an obstacle in postoperative habilitation.

Computational modeling of the generation and propagation of distortion products in the inner ear

NASA Astrophysics Data System (ADS)

Bowling, Thomas; Wen, Haiqi; Meaud, Julien

2018-05-01

Distortion product otoacoustic emissions are used in both clinical and research settings to assess cochlear function although there are still questions for how the distortion products propagate in the cochlea from their generation location to the middle ear. Here, a physiologically based computational model of the gerbil ear is used to investigate distortion product propagation. The fluid is modeled in three dimensions and includes two ducts. Simulations of the distortion products in the cochlear fluid pressure and basilar membrane are compared with published experimental data. Model results are consistent with measurements from Ren and colleagues which indicated that the intracochlear distortion product is dominated by a forward traveling wave at a low primary frequency ratio, although backward traveling waves become apparent when other ratios are considered. The magnitude and phase of both basilar membrane and spatial variations of the distortion product fluid pressure are qualitatively similar to the expected response of a slowly propagating backward traveling wave. These results combined suggest that distortion products propagate primarily as a slow wave both when the cochlea is driven by intracochlear sources and an acoustic stimulus in the ear canal.

Agile Development of Advanced Prototypes

DTIC Science & Technology

2014-11-01

prostheses: retinal implants, cochlear implants, and neuroprosthetics (EEG controlled artificial limbs); an interactive, virtual experience...demonstrations allowing users to experience, from a patient’s perspective life with three different prostheses: retinal implants, cochlear implants...three experiences were researched and developed. The applications are interactive demonstrations of retinal implants, cochlear implants, and

Computer ranking of the sequence of appearance of 40 features of the brain and related structures in staged human embryos during the seventh week of development.

PubMed

O'Rahilly, R; Müller, F; Hutchins, G M; Moore, G W

1988-08-01

The sequence of events in the development of the brain in human embryos, already published for stages 8-17, is here continued for stages 18 and 19. With the aid of a computerized bubble-sort algorithm, 58 individual embryos were ranked in ascending order of the features present. The increasing structural complexity provided 40 new features in these two stages. The chief characteristics of stage 18 (approximately 44 postovulatory days) are rapidly growing basal nuclei; appearance of the extraventricular bulge of the cerebellum (flocculus), of the superior cerebellar peduncle, and of follicles in the epiphysis cerebri; and the presence of vomeronasal organ and ganglion, of the bucconasal membrane, and of isolated semicircular ducts. The main features of stage 19 (approximately 48 days) are the cochlear nuclei, the ganglion of the nervus terminalis, nuclei of the prosencephalic septum, the appearance of the subcommissural organ, the presence of villi in the choroid plexuses of the fourth and lateral ventricles, and the stria medullaris thalami.

Changing patterns of peanut agglutinin labelling in the dorsal cochlear nucleus correspond to axonal ingrowth.

PubMed Central

Riggs, G H; Schweitzer, L

1994-01-01

Various studies have suggested that glycoconjugates may influence connectivity and lamination in the developing central nervous system and may function as barriers to neuritic extension. It has been proposed that the peanut agglutinin lectin labels a glycoconjugate subserving a barrier function. We chose to investigate the distribution of this peanut-agglutinin-labelled glycoconjugate in the dorsal cochlear nucleus of the developing hamster since the development of the dorsal cochlear nucleus is well characterised and its axons obey laminar boundaries. The distribution of peanut agglutinin label throughout the cochlear nucleus delineated zones that cochlear axons fail to invade. In the dorsal cochlear nucleus, laminar differences were reduced on postnatal d 13 and virtually disappearing by postnatal d 23. Label in the molecular layer dissipated as axons and dendrites grew into this layer. These patterns of peanut agglutinin binding correspond to axonal ingrowth and are consistent with a barrier function for glycoconjugates in the molecular layer. Images Fig. 1 Fig. 2 Fig. 4 PMID:7961144

Spatiotemporal expression of Ezh2 in the developing mouse cochlear sensory epithelium.

PubMed

Chen, Yan; Li, Wenyan; Li, Wen; Chai, Renjie; Li, Huawei

2016-09-01

The enhancer of zeste 2 polycomb repressive complex 2 subunit (Ezh2) is a histone-lysine Nmethyltransferase enzyme that participates in DNA methylation. Ezh2 has also been reported to play crucial roles in stem cell proliferation and differentiation. However, the detailed expression profile of Ezh2 during mouse cochlear development has not been investigated. Here, we examined the spatiotemporal expression of Ezh2 in the cochlea during embryonic and postnatal development. Ezh2 expression began to be observed in the whole otocyst nuclei at embryonic day 9.5 (E9.5). At E12.5, Ezh2 was expressed in the nuclei of the cochlear prosensory epithelium. At E13.5 and E15.5, Ezh2 was expressed from the apical to the basal turns in the nuclei of the differentiating cochlear epithelium. At postnatal day (P) 0 and 7, the Ezh2 expression was located in the nuclei of the cochlear epithelium in all three turns and could be clearly seen in outer and inner hair cells, supporting cells, the stria vascularis, and spiral ganglion cells. Ezh2 continued to be expressed in the cochlear epithelium of adult mice. Our results provide the basic Ezh2 expression pattern and might be useful for further investigating the detailed role of Ezh2 during cochlear development.

The development of the Nucleus Freedom Cochlear implant system.

PubMed

Patrick, James F; Busby, Peter A; Gibson, Peter J

2006-12-01

Cochlear Limited (Cochlear) released the fourth-generation cochlear implant system, Nucleus Freedom, in 2005. Freedom is based on 25 years of experience in cochlear implant research and development and incorporates advances in medicine, implantable materials, electronic technology, and sound coding. This article presents the development of Cochlear's implant systems, with an overview of the first 3 generations, and details of the Freedom system: the CI24RE receiver-stimulator, the Contour Advance electrode, the modular Freedom processor, the available speech coding strategies, the input processing options of Smart Sound to improve the signal before coding as electrical signals, and the programming software. Preliminary results from multicenter studies with the Freedom system are reported, demonstrating better levels of performance compared with the previous systems. The final section presents the most recent implant reliability data, with the early findings at 18 months showing improved reliability of the Freedom implant compared with the earlier Nucleus 3 System. Also reported are some of the findings of Cochlear's collaborative research programs to improve recipient outcomes. Included are studies showing the benefits from bilateral implants, electroacoustic stimulation using an ipsilateral and/or contralateral hearing aid, advanced speech coding, and streamlined speech processor programming.

Development of a phase-sensitive Fourier domain optical coherence tomography system to measure mouse organ of Corti vibrations in two cochlear turns

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

Ramamoorthy, Sripriya; Zhang, Yuan; Jacques, Steven

In this study, we have developed a phase-sensitive Fourier-domain optical coherence tomography system to simultaneously measure the in vivo inner ear vibrations in the hook area and second turn of the mouse cochlea. This technical development will enable measurement of intra-cochlear distortion products at ideal locations such as the distortion product generation site and reflection site. This information is necessary to un-mix the complex mixture of intra-cochlear waves comprising the DPOAE and thus leads to the non-invasive identification of the local region of cochlear damage.

Cochlear Implants. National Institutes of Health Consensus Development Conference Statement (May 4, 1988). Volume 7, Number 2.

ERIC Educational Resources Information Center

National Institutes of Health (DHHS), Bethesda, MD.

This paper reports the results of a Consensus Development Conference on Cochlear Implants sponsored by the National Institutes of Health to improve the hearing of children and adults with hearing impairments. The following questions are addressed: (1) Who is a suitable candidate for a cochlear implant? (2) What are the advantages and disadvantages…

Cochlear Implants:System Design, Integration and Evaluation

PubMed Central

Rebscher, Stephen; Harrison, William V.; Sun, Xiaoan; Feng, Haihong

2009-01-01

As the most successful neural prosthesis, cochlear implants have provided partial hearing to more than 120,000 persons worldwide; half of which being pediatric users who are able to develop nearly normal language. Biomedical engineers have played a central role in the design, integration and evaluation of the cochlear implant system, but the overall success is a result of collaborative work with physiologists, psychologists, physicians, educators, and entrepreneurs. This review presents broad yet in-depth academic and industrial perspectives on the underlying research and ongoing development of cochlear implants. The introduction accounts for major events and advances in cochlear implants, including dynamic interplays among engineers, scientists, physicians, and policy makers. The review takes a system approach to address critical issues from design and specifications to integration and evaluation. First, the cochlear implant system design and specifications are laid out. Second, the design goals, principles, and methods of the subsystem components are identified from the external speech processor and radio frequency transmission link to the internal receiver, stimulator and electrode arrays. Third, system integration and functional evaluation are presented with respect to safety, reliability, and challenges facing the present and future cochlear implant designers and users. Finally, issues beyond cochlear implants are discussed to address treatment options for the entire spectrum of hearing impairment as well as to use the cochlear implant as a model to design and evaluate other similar neural prostheses such as vestibular and retinal implants. PMID:19946565

Music activities and responses of young cochlear implant recipients.

PubMed

van Besouw, Rachel M; Grasmeder, Mary L; Hamilton, Mary E; Baumann, Sarah E

2011-05-01

The development of auditory receptive skills and spoken language is often delayed in children who use cochlear implants, which may affect their appreciation of and responses to music. This in turn may be interpreted as disinterest in music. A questionnaire was developed to determine whether differences in exposure and responses to music exist between young cochlear implant recipients and their normally hearing peers. The questionnaire was developed by a multidisciplinary team and distributed to parents of preschool children with normal hearing and to parents of preschool children who had been implanted at least one year prior. The cochlear implant group comprised 23 children and was gender and age matched (within ±2 months) to a group of children with normal hearing. Young cochlear implant recipients receive similar exposure to audiovisual music media, parental singing and musical instruments at home. However, the data suggest that they receive less exposure to children's music presented without visual stimuli. Parents also reported less sophisticated responses to music for this group. The findings of this study have important implications concerning the provision of age-appropriate music habilitation materials and activities for young cochlear implant recipients.

Technical devices for hearing-impaired individuals: cochlear implants and brain stem implants - developments of the last decade

PubMed Central

Müller, Joachim

2005-01-01

Over the past two decades, the fascinating possibilities of cochlear implants for congenitally deaf or deafened children and adults developed tremendously and created a rapidly developing interdisciplinary research field. The main advancements of cochlear implantation in the past decade are marked by significant improvement of hearing and speech understanding in CI users. These improvements are attributed to the enhancement of speech coding strategies. The Implantation of more (and increasingly younger) children as well as the possibilities of the restoration of binaural hearing abilities with cochlear implants reflect the high standards reached by this development. Despite this progress, modern cochlear implants do not yet enable normal speech understanding, not even for the best patients. In particular speech understanding in noise remains problematic [1]. Until the mid 1990ies research concentrated on unilateral implantation. Remarkable and effective improvements have been made with bilateral implantation since 1996. Nowadays an increasing numbers of patients enjoy these benefits. PMID:22073052

Technical devices for hearing-impaired individuals: cochlear implants and brain stem implants - developments of the last decade.

PubMed

Müller, Joachim

2005-01-01

Over the past two decades, the fascinating possibilities of cochlear implants for congenitally deaf or deafened children and adults developed tremendously and created a rapidly developing interdisciplinary research field.The main advancements of cochlear implantation in the past decade are marked by significant improvement of hearing and speech understanding in CI users. These improvements are attributed to the enhancement of speech coding strategies.The Implantation of more (and increasingly younger) children as well as the possibilities of the restoration of binaural hearing abilities with cochlear implants reflect the high standards reached by this development. Despite this progress, modern cochlear implants do not yet enable normal speech understanding, not even for the best patients. In particular speech understanding in noise remains problematic [1]. Until the mid 1990ies research concentrated on unilateral implantation. Remarkable and effective improvements have been made with bilateral implantation since 1996. Nowadays an increasing numbers of patients enjoy these benefits.

Voice emotion perception and production in cochlear implant users.

PubMed

Jiam, N T; Caldwell, M; Deroche, M L; Chatterjee, M; Limb, C J

2017-09-01

Voice emotion is a fundamental component of human social interaction and social development. Unfortunately, cochlear implant users are often forced to interface with highly degraded prosodic cues as a result of device constraints in extraction, processing, and transmission. As such, individuals with cochlear implants frequently demonstrate significant difficulty in recognizing voice emotions in comparison to their normal hearing counterparts. Cochlear implant-mediated perception and production of voice emotion is an important but relatively understudied area of research. However, a rich understanding of the voice emotion auditory processing offers opportunities to improve upon CI biomedical design and to develop training programs benefiting CI performance. In this review, we will address the issues, current literature, and future directions for improved voice emotion processing in cochlear implant users. Copyright © 2017 Elsevier B.V. All rights reserved.

[The development of musicality in children after cochlear implantation].

PubMed

Zheng, Yan; Liu, Bo; Dong, Ruijuan; Xu, Tianqiu; Chen, Jing; Chen, Xuejing; Zhong, Yan; Meng, Chao; Wang, Hong; Chen, Xueqing

2014-08-01

The purpose of this study is to analyze the development of musicality in children after cochlear implantation, and provide a clinical database for the evaluation of their musicality. Twenty-six children with cochlear implants (CI group) participated in this research. They received cochlear implants at the age of 11 to 68 months with a mean of 35.6 months. Seventy-six infants as a control group aged from 1 to 24 months with a mean of 6.1 months participated in this study, whose hearing were considered normal by passing the case history collection, high-risk registers for hearing loss and hearing screening using DPOAE. The music and young children with CIs: Musicality Rating Scale was used to evaluate their musicality. The evaluation was performed before cochlear implantation and 1, 3, 6, 9, 12, 24 months after cochlear implantation for children with cochlear implants. The evaluation was also performed at 1, 3, 6, 9, 12, 24 months for children with normal hearing. The mean scores of musicality showed significant improvements with time of CI use for CI group (P<0.05). The mean scores of musicality also showed significant improvements with time for control group (P<0.05). There were no significant differences in mean scores between CI group and control group at 1, 3, 6, 9, 12 months of hearing age by rank sum test (P>0.05). Significant difference was noted between the two groups at 24 months (P<0.05). The musicality of children with cochlear implants improved significantly with time after cochlear implantation. The most rapid growth was found in the first year after cochlear implantation.

Intra- and Interobserver Variability of Cochlear Length Measurements in Clinical CT.

PubMed

Iyaniwura, John E; Elfarnawany, Mai; Riyahi-Alam, Sadegh; Sharma, Manas; Kassam, Zahra; Bureau, Yves; Parnes, Lorne S; Ladak, Hanif M; Agrawal, Sumit K

2017-07-01

The cochlear A-value measurement exhibits significant inter- and intraobserver variability, and its accuracy is dependent on the visualization method in clinical computed tomography (CT) images of the cochlea. An accurate estimate of the cochlear duct length (CDL) can be used to determine electrode choice, and frequency map the cochlea based on the Greenwood equation. Studies have described estimating the CDL using a single A-value measurement, however the observer variability has not been assessed. Clinical and micro-CT images of 20 cadaveric cochleae were acquired. Four specialists measured A-values on clinical CT images using both standard views and multiplanar reconstructed (MPR) views. Measurements were repeated to assess for intraobserver variability. Observer variabilities were evaluated using intra-class correlation and absolute differences. Accuracy was evaluated by comparison to the gold standard micro-CT images of the same specimens. Interobserver variability was good (average absolute difference: 0.77 ± 0.42 mm) using standard views and fair (average absolute difference: 0.90 ± 0.31 mm) using MPR views. Intraobserver variability had an average absolute difference of 0.31 ± 0.09 mm for the standard views and 0.38 ± 0.17 mm for the MPR views. MPR view measurements were more accurate than standard views, with average relative errors of 9.5 and 14.5%, respectively. There was significant observer variability in A-value measurements using both the standard and MPR views. Creating the MPR views increased variability between experts, however MPR views yielded more accurate results. Automated A-value measurement algorithms may help to reduce variability and increase accuracy in the future.

The Relationship between Cochlear Implants and Deaf Identity

ERIC Educational Resources Information Center

Chapman, Madeline; Dammeyer, Jesper

2017-01-01

The degree to which individuals with cochlear implants (CIs) experience communication difficulties has implications for social participation and identity development. However, few studies have examined the relationship between cochlear implantation, identity, and social participation. Using data from a Danish national survey of deaf adults, the…

[Audiophonological evaluation of 16 children fitted with cochlear implants for sensorineural hearing loss induced by bacterial meningitis].

PubMed

Teissier, N; Doehring, I; Noel-Petroff, N; Elmaleh-Bergès, M; Viala, P; François, M; Faye, A; Van Den Abbeele, T; Lorrot, M

2013-06-01

Bacterial meningitis (BM) is the primary etiology of acquired sensorineural hearing loss (SNHL) in children and may compromise language development. Since the 1990 s, cochlear implants (CIs) have become part of the management of children with profound SNHL with encouraging results. The aim of this study was to analyze the audiophonological performance of children before and after cochlear implantation for SNHL following bacterial meningitis. Retrospective study of all children fitted with CIs for bilateral severe to profound SNHL after bacterial meningitis in the Robert-Debré pediatric ENT department between August 1990 and March 2009. Audiophonological performance was assessed using the APCEI profile. Of the 283 children receiving implants during that period, 16 children (6%; 6 boys, 10 girls) underwent CI implantation after bacterial meningitis (Streptococcus pneumoniae in 8 cases, Neisseria meningitidis in 2 cases, and Haemophilus influenzae in 4 cases). The mean time from meningitis to SNHL was 8.3 months (median, 1.5 months; range, 1 day to 13 years). The mean time from meningitis to cochlear implantation was 2 years and 3 months (median, 7 months; range, 1 month to 13 years 3 months). Twelve children (75%) presented partial cochlear and/or vestibular ossification on presurgical CT scan. Three children received bilateral implants. Thirteen children (81%) developed early SNHL in the first 3 months, whereas 3 children developed SNHL more than 10 months after meningitis. As for the benefits of cochlear implantation, 11 children presented near to normal intelligibility and optimal use of their cochlear implant; 5 children presented partial benefits due to neurological sequelae (1), a long delay before implantation (1), technical problems (2), or a social problem in relation to low socioeconomic status (1). After bacterial meningitis, audiological evaluation must be made carefully during the first 3 months to detect early SNHL, but SNHL may also develop several years later. In case of profound SNHL and a modified signal of the labyrinth on the MRI, cochlear implantation must be performed without delay before cochlear and/or vestibular ossification. Cochlear implantation is an effective technique with good long-term audiologic results. The coexistence of neurological lesions may compromise the results, but it should not contraindicate a cochlear implantation. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

A prospective study evaluating cochlear implant management skills: development and validation of the Cochlear Implant Management Skills survey.

PubMed

Bennett, R J; Jayakody, D M P; Eikelboom, R H; Taljaard, D S; Atlas, M D

2016-02-01

To investigate the ability of cochlear implant (CI) recipients to physically handle and care for their hearing implant device(s) and to identify factors that may influence skills. To assess device management skills, a clinical survey was developed and validated on a clinical cohort of CI recipients. Survey development and validation. A prospective convenience cohort design study. Specialist hearing implant clinic. Forty-nine post-lingually deafened, adult CI recipients, at least 12 months postoperative. Survey test-retest reliability, interobserver reliability and responsiveness. Correlations between management skills and participant demographic, audiometric, clinical outcomes and device factors. The Cochlear Implant Management Skills survey was developed, demonstrating high test-retest reliability (0.878), interobserver reliability (0.972) and responsiveness to intervention (skills training) [t(20) = -3.913, P = 0.001]. Cochlear Implant Management Skills survey scores range from 54.69% to 100% (mean: 83.45%, sd: 12.47). No associations were found between handling skills and participant factors. This is the first study to demonstrate a range in cochlear implant device handling skills in CI recipients and offers clinicians and researchers a tool to systematically and objectively identify shortcomings in CI recipients' device handling skills. © 2015 John Wiley & Sons Ltd.

Glutamate co-transmission from developing medial nucleus of the trapezoid body - Lateral superior olive synapses is cochlear dependent in kanamycin-treated rats

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

Lee, Jae Ho; Pradhan, Jonu; Maskey, Dhiraj

Research highlights: {yields} Glutamate co-transmission is enhanced in kanamycin-treated rats. {yields} VGLUT3 expression is increased in kanamycin-treated rats. {yields} GlyR expression is decreased in kanamycin-treated rats. {yields} GlyR, VGLUT3 expression patterns are asymmetric in unilaterally cochlear ablated rat. -- Abstract: Cochlear dependency of glutamate co-transmission at the medial nucleus of the trapezoid body (MNTB) - the lateral superior olive (LSO) synapses was investigated using developing rats treated with high dose kanamycin. Rats were treated with kanamycin from postnatal day (P) 3 to P8. A scanning electron microscopic study on P9 demonstrated partial cochlear hair cell damage. A whole cell voltagemore » clamp experiment demonstrated the increased glutamatergic portion of postsynaptic currents (PSCs) elicited by MNTB stimulation in P9-P11 kanamycin-treated rats. The enhanced VGLUT3 immunoreactivities (IRs) in kanamycin-treated rats and asymmetric VGLUT3 IRs in the LSO of unilaterally cochlear ablated rats supported the electrophysiologic data. Taken together, it is concluded that glutamate co-transmission is cochlear-dependent and enhanced glutamate co-transmission in kanamycin-treated rats is induced by partial cochlear damage.« less

Meningitis following cochlear implantation: pathomechanisms, clinical symptoms, conservative and surgical treatments.

PubMed

Arnold, W; Bredberg, G; Gstöttner, W; Helms, J; Hildmann, H; Kiratzidis, T; Müller, J; Ramsden, R T; Roland, P; Walterspiel, J N

2002-01-01

Pneumococcal otogenic meningitis is a rare postsurgical complication that can develop following stapedectomy or after cochlear implantation. The bacterial infection can be fatal in some instances. A recent increase in the incidence of otogenic meningitis among cochlear implant wearers is of concern. The majority of meningitis cases are associated with a 2-component electrode manufactured by one cochlear implant company. The device with the added 'positioner' component has been withdrawn from the market (FDA Public Health Web Notification: Cochlear Implant Recipients may be at Greater Risk for Meningitis, Updated: August 29, 2002, www.fda.gov/cdrh/safety/cochlear.html). Not all cases have been subsequent to otitis media and symptoms have developed from less than 24 h up to a few years after implantation. The purpose of this paper is to review and discuss the pathogenesis, pathology/bacteriology and to elaborate on some clinical features of otogenic meningitis in implanted children and adults. Essential aspects of surgery, electrode design, and cochleostomy seal are discussed. Conclusions are drawn from the available data and recommendations are made for good practice in cochlear implantation and follow-up. Copyright 2002 S. Karger AG, Basel

Bilateral cochlear implantation in the ferret: A novel animal model for behavioral studies

PubMed Central

Hartley, Douglas E.H.; Vongpaisal, Tara; Xu, Jin; Shepherd, Robert K.; King, Andrew J.; Isaiah, Amal

2010-01-01

Bilateral cochlear implantation has recently been introduced with the aim of improving both speech perception in background noise and sound localization. Although evidence suggests that binaural perception is possible with two cochlear implants, results in humans are variable. To explore potential contributing factors to these variable outcomes, we have developed a behavioral animal model of bilateral cochlear implantation in a novel species, the ferret. Although ferrets are ideally suited to psychophysical and physiological assessments of binaural hearing, cochlear implantation has not been previously described in this species. This paper describes the techniques of deafening with aminoglycoside administration, surgical implantation of an intracochlear array and chronic intracochlear electrical stimulation with monitoring for electrode integrity and efficacy of stimulation. Experiments have been presented elsewhere to show that the model can be used to study behavioral and electrophysiological measures of binaural hearing in chronically implanted animals. This paper demonstrates that cochlear implantation and chronic intracochlear electrical stimulation are both safe and effective in ferrets, opening up the possibility of using this model to study potential protective effects of bilateral cochlear implantation on the developing central auditory pathway. Since ferrets can be used to assess psychophysical and physiological aspects of hearing along with the structure of the auditory pathway in the same animals, we anticipate that this model will help develop novel neuroprosthetic therapies for use in humans. PMID:20576507

Use of suprathreshold stochastic resonance in cochlear implant coding

NASA Astrophysics Data System (ADS)

Allingham, David; Stocks, Nigel G.; Morse, Robert P.

2003-05-01

In this article we discuss the possible use of a novel form of stochastic resonance, termed suprathreshold stochastic resonance (SSR), to improve signal encoding/transmission in cochlear implants. A model, based on the leaky-integrate-and-fire (LIF) neuron, has been developed from physiological data and use to model information flow in a population of cochlear nerve fibers. It is demonstrated that information flow can, in principle, be enhanced by the SSR effect. Furthermore, SSR was found to enhance information transmission for signal parameters that are commonly encountered in cochlear implants. This, therefore, gives hope that SSR may be implemented in cochlear implants to improve speech comprehension.

Importance of cochlear health for implant function.

PubMed

Pfingst, Bryan E; Zhou, Ning; Colesa, Deborah J; Watts, Melissa M; Strahl, Stefan B; Garadat, Soha N; Schvartz-Leyzac, Kara C; Budenz, Cameron L; Raphael, Yehoash; Zwolan, Teresa A

2015-04-01

Amazing progress has been made in providing useful hearing to hearing-impaired individuals using cochlear implants, but challenges remain. One such challenge is understanding the effects of partial degeneration of the auditory nerve, the target of cochlear implant stimulation. Here we review studies from our human and animal laboratories aimed at characterizing the health of the implanted cochlea and the auditory nerve. We use the data on cochlear and neural health to guide rehabilitation strategies. The data also motivate the development of tissue-engineering procedures to preserve or build a healthy cochlea and improve performance obtained by cochlear implant recipients or eventually replace the need for a cochlear implant. This article is part of a Special Issue entitled . Copyright © 2014 Elsevier B.V. All rights reserved.

Visualization and contractile activity of cochlear pericytes in the capillaries of the spiral ligament.

PubMed

Dai, Min; Nuttall, Alfred; Yang, Yue; Shi, Xiaorui

2009-08-01

Pericytes, mural cells located on microvessels, are considered to play an important role in the formation of the vasculature and the regulation of local blood flow in some organs. Little is known about the physiology of cochlear pericytes. In order to investigate the function of cochlear pericytes, we developed a method to visualize cochlear pericytes using diaminofluorescein-2 diacetate (DAF-2DA) and intravital fluorescence microscopy. This method can permit the study of the effect of vasoactive agents on pericytes under the in vivo and normal physiological condition. The specificity of the labeling method was verified by the immunofluorescence labeling of pericyte maker proteins such as desmin, neural proteoglycan (NG2), and thymocyte differentiation antigen 1 (Thy-1). Superfused K(+) and Ca(2+) to the cochlear lateral wall resulted in localized constriction of capillaries at pericyte locations both in vivo and in vitro, while there was no obvious change in cochlear capillary diameters with application of the adrenergic neurotransmitter noradrenaline. The method could be an effective way to visualize cochlear pericytes and microvessels and study lateral wall vascular physiology. Moreover, we demonstrate for the first time that cochlear pericytes have contractility, which may be important for regulation of cochlear blood flow.

Contribution of Family Environment to Pediatric Cochlear Implant Users' Speech and Language Outcomes: Some Preliminary Findings

ERIC Educational Resources Information Center

Holt, Rachael Frush; Beer, Jessica; Kronenberger, William G.; Pisoni, David B.; Lalonde, Kaylah

2012-01-01

Purpose: To evaluate the family environments of children with cochlear implants and to examine relationships between family environment and postimplant language development and executive function. Method: Forty-five families of children with cochlear implants completed a self-report family environment questionnaire (Family Environment Scale-Fourth…

Taxonomic Knowledge of Children with and without Cochlear Implants

ERIC Educational Resources Information Center

Lund, Emily; Dinsmoor, Jessica

2016-01-01

Purpose: The purpose of this study was to compare the taxonomic vocabulary knowledge and organization of children with cochlear implants to (a) children with normal hearing matched for age, and (b) children matched for vocabulary development. Method: Ten children with cochlear implants, 10 age-matched children with normal hearing, and 10…

Ischemia-reperfusion injury of the cochlea: pharmacological strategies for cochlear protection and implications of glutamate and reactive oxygen species.

PubMed

Tabuchi, Keiji; Nishimura, Bungo; Tanaka, Shuho; Hayashi, Kentaro; Hirose, Yuki; Hara, Akira

2010-06-01

A large amount of energy produced by active aerobic metabolism is necessary for the cochlea to maintain its function. This makes the cochlea vulnerable to blockade of cochlear blood flow and interruption of the oxygen supply. Although certain forms of human idiopathic sudden sensorineural hearing loss reportedly arise from ischemic injury, the pathological mechanism of cochlear ischemia-reperfusion injury has not been fully elucidated. Recent animal studies have shed light on the mechanisms of cochlear ischemia-reperfusion injury. It will help in the understanding of the pathology of cochlear ischemia-reperfusion injury to classify this injury into ischemic injury and reperfusion injury. Excitotoxicity, mainly observed during the ischemic period, aggravates the injury of primary auditory neurons. On the other hand, oxidative damage induced by hydroxyl radicals and nitric oxide enhances cochlear reperfusion injury. This article briefly summarizes the generation mechanisms of cochlear ischemia-reperfusion injury and potential therapeutic targets that could be developed for the effective management of this injury type.

Vestibular development in marsupials and monotremes

PubMed Central

Ashwell, Ken W S; Shulruf, Boaz

2014-01-01

The young of marsupials and monotremes are all born in an immature state, followed by prolonged nurturing by maternal lactation in either a pouch or nest. Nevertheless, the level of locomotor ability required for newborn marsupials and monotremes to reach the safety of the pouch or nest varies considerably: some are transferred to the pouch or nest in an egg (monotremes); others are transferred passively by gravity (e.g. dasyurid marsupials); some have only a horizontal wriggle to make (e.g. peramelid and didelphid marsupials); and others must climb vertically for a long distance to reach the maternal pouch (e.g. diprotodontid marsupials). In the present study, archived sections of the inner ear and hindbrain held in the Bolk, Hill and Hubrecht collections at the Museum für Naturkunde, Berlin, were used to test the relationship between structural maturity of the vestibular apparatus and the locomotor challenges that face the young of these different mammalian groups. A system for staging different levels of structural maturity of the vestibular apparatus was applied to the embryos, pouch young and hatchlings, and correlated with somatic size as indicated by greatest body length. Dasyurids are born at the most immature state, with the vestibular apparatus at little more than the otocyst stage. Peramelids are born with the vestibular apparatus at a more mature state (fully developed semicircular ducts and a ductus reuniens forming between the cochlear duct and saccule, but no semicircular canals). Diprotodontids and monotremes are born with the vestibular apparatus at the most mature state for the non-eutherians (semicircular canals formed, maculae present, but vestibular nuclei in the brainstem not yet differentiated). Monotremes and marsupials reach the later stages of vestibular apparatus development at mean body lengths that lie within the range of those found for laboratory rodents (mouse and rat) reaching the same vestibular stage. PMID:24298911

Guideline on cochlear implants.

PubMed

Manrique, Manuel; Ramos, Ángel; de Paula Vernetta, Carlos; Gil-Carcedo, Elisa; Lassaleta, Luis; Sanchez-Cuadrado, Isabel; Espinosa, Juan Manuel; Batuecas, Ángel; Cenjor, Carlos; Lavilla, María José; Núñez, Faustino; Cavalle, Laura; Huarte, Alicia

2018-03-26

In the last decade numerous hospitals have started to work with patients who are candidates for a cochlear implant (CI) and there have been numerous and relevant advances in the treatment of sensorineural hearing loss that extended the indications for cochlear implants. To provide a guideline on cochlear implants to specialists in otorhinolaryngology, other medical specialities, health authorities and society in general. The Scientific Committees of Otology, Otoneurology and Audiology from the Spanish Society of Otolaryngology and Head and Neck Surgery (SEORL-CCC), in a coordinated and agreed way, performed a review of the current state of CI based on the existing regulations and in the scientific publications referenced in the bibliography of the document drafted. The clinical guideline on cochlear implants provides information on: a) Definition and description of Cochlear Implant; b) Indications for cochlear implants; c) Organizational requirements for a cochlear implant programme. A clinical guideline on cochlear implants has been developed by a Committee of Experts of the SEORL-CCC, to help and guide all the health professionals involved in this field of CI in decision-making to treathearing impairment. Copyright © 2018 Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. Publicado por Elsevier España, S.L.U. All rights reserved.

ChAT-like immunoreactivity of olivocochlear fibres on rat outer hair cells during the postnatal development.

PubMed

Roth, B; Dannhof, B; Bruns, V

1991-01-01

Several studies present a great deal of information about putative efferent neurotransmitters and their distribution in the adult and developing cochlea. Anatomical mapping of outer hair cell efferent fibres during ontogeny is still not available. Using quantitative electron microscopy in combination with immunocytochemistry, the distribution of ChAT-like immunoreactivity in the developing rat was investigated. Adult-like immunoreactivity in the whole cochlea is first observed in 30-day-old rats. We localized the adult-like immunoreactivity in all efferent fibres and synapses of the outer hair cells along the entire cochlear duct. An adult-like reaction in the whole cochlea could be observed on the 25th day after birth in two out of three cases. On the 20th postnatal day, no adult-like ChAT immunoreactivity was found, with the exception of one case where labelling was seen in the basal region only. The adult-like ChAT immunoreactivity on the 30th day, 2-3 weeks after the onset of hearing, is the latest maturation of all features of the organ of Corti so far investigated. Synaptogenesis of the outer hair cell efferents reaches an adult-like appearance already on the 16th day after birth.

Cochlear implants and spoken language processing abilities: review and assessment of the literature.

PubMed

Peterson, Nathaniel R; Pisoni, David B; Miyamoto, Richard T

2010-01-01

Cochlear implants (CIs) process sounds electronically and then transmit electric stimulation to the cochlea of individuals with sensorineural deafness, restoring some sensation of auditory perception. Many congenitally deaf CI recipients achieve a high degree of accuracy in speech perception and develop near-normal language skills. Post-lingually deafened implant recipients often regain the ability to understand and use spoken language with or without the aid of visual input (i.e. lip reading). However, there is wide variation in individual outcomes following cochlear implantation, and some CI recipients never develop useable speech and oral language skills. The causes of this enormous variation in outcomes are only partly understood at the present time. The variables most strongly associated with language outcomes are age at implantation and mode of communication in rehabilitation. Thus, some of the more important factors determining success of cochlear implantation are broadly related to neural plasticity that appears to be transiently present in deaf individuals. In this article we review the expected outcomes of cochlear implantation, potential predictors of those outcomes, the basic science regarding critical and sensitive periods, and several new research directions in the field of cochlear implantation.

The effect of cochlear implantation in development of intelligence quotient of 6-9 deaf children in comparison with normal hearing children (Iran, 2009-2011).

PubMed

Hashemi, Seyed Basir; Monshizadeh, Leila

2012-06-01

Before the introduction of cochlear implant (CI) in 1980, hearing aids were the only means by which profoundly deaf children had access to auditory stimuli. Nowadays, CI is firmly established as effective option in speech and language rehabilitation of deaf children, but much of the literature regarding outcomes for children after CI are focused on development of speech and less is known about language acquisition. So, the main aim of this study is the evaluation of verbal intelligence quotient (IQ) of cochlear implanted children in comparison with normal children. 30 cochlear implanted and 30 normal hearing children with similar socio-economic level at the same age were compared by a revised version (in Persian) of WISC test (Wechsler, 1991). Then the data were analyzed through SPSS software 16. In spite of the fact that cochlear implanted children did well in different parameters of WISC test, the average scores of this group was less than normal hearing children. But in similarities (one of the parameters of WISC test) 2 group's performance was approximately the same. CI plays an important role in development of verbal IQ and language acquisition of deaf children. Different researches indicate that most of the cochlear implanted children show less language delay during the time. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Contribution of Family Environment to Pediatric Cochlear Implant Users’ Speech and Language Outcomes: Some Preliminary Findings

PubMed Central

Holt, Rachael Frush; Beer, Jessica; Kronenberger, William G.; Pisoni, David B.; Lalonde, Kaylah

2012-01-01

Purpose To evaluate the family environments of children with cochlear implants and to examine relationships between family environment and post-implant language development and executive function. Method Forty-five families of children with cochlear implants completed a self-report family environment questionnaire (FES) and an inventory of executive function (BRIEF/BRIEF-P). Children’s receptive vocabulary (PPVT-4) and global language skills (PLS-4/CELF-4) were also evaluated. Results The family environments of children with cochlear implants differed from those of normal-hearing children, but not in clinically significant ways. Language development and executive function were found to be atypical, but not uncharacteristic of this clinical population. Families with higher levels of self-reported control had children with smaller vocabularies. Families reporting a higher emphasis on achievement had children with fewer executive function and working memory problems. Finally, families reporting a higher emphasis on organization had children with fewer problems related to inhibition. Conclusions Some of the variability in cochlear implantation outcomes that have protracted periods of development is related to family environment. Because family environment can be modified and enhanced by therapy or education, these preliminary findings hold promise for future work in helping families to create robust language-learning environments that can maximize their child’s potential with a cochlear implant. PMID:22232387

Vocal Development in Young Children with Cochlear Implants: Profiles and Implications for Intervention.

ERIC Educational Resources Information Center

Ertmer, David J.; Young, Nancy; Grohne, Kristine; Mellon, Jennifer A.; Johnson, Claire; Corbett, Kristin; Saindon, Kathy

2002-01-01

This article describes prelinguistic vocal development in two prelingually deaf children who received multi-channel cochlear implants at 10 and 28 months. The older child made rapid progress in vocal development, while the other showed slower progress Use of short periods of prelinguistic input for stimulating vocal development is discussed.…

Simultaneous bilateral cochlear implantation in a five-month-old child with Usher syndrome.

PubMed

Alsanosi, A A

2015-09-01

To report a rare case of simultaneous bilateral cochlear implantation in a five-month-old child with Usher syndrome. Case report. A five-month-old boy with Usher syndrome and congenital profound bilateral deafness underwent simultaneous bilateral cochlear implantation. The decision to perform implantation in such a young child was based on his having a supportive family and the desire to foster his audiological development before his vision deteriorated. The subject experienced easily resolvable intra- and post-operative adverse events, and was first fitted with an externally worn audio processor four weeks after implantation. At 14 months of age, his audiological development was age-appropriate. Simultaneous bilateral cochlear implantation is possible, and even advisable, in children as young as five months old when performed by an experienced implantation team.

Aural rehabilitation in children with cochlear implants: a study of cognition, social communication, and motor skill development.

PubMed

Jeddi, Zahra; Jafari, Zahra; Motasaddi Zarandy, Masoud; Kassani, Aziz

2014-03-01

The purpose of this study was to investigate the benefits of aural rehabilitation on the development of cognition, social communication, and motor skills in children with cochlear implants. The study examined the development of cognition, social communication, and motor skills in 15 deaf children (7 males, 8 females; mean age 45 months 27 days) using the Newsha Developmental Scale before they received the cochlear implants, and then again 2, 4, 6, and 8 months after the implantation. The developmental age, Pretest Developmental Rate, Intervention Efficiency Index, and Proportional Change Index were calculated for each skill. There were significant differences between the preintervention and four follow-up Developmental Rate assessments for cognition, social communication, and motor skills (P < 0.0001). Significant differences were also observed between the four follow-up Proportional Change Index assessments for cognition, social communication, and motor skills (P ≤ 0.005). Cochlear implantation and aural rehabilitation may result in accelerated rates of cognition, social communication, and motor skill development in deaf children.

Executive Functioning and Speech-Language Skills Following Long-Term Use of Cochlear Implants

ERIC Educational Resources Information Center

Kronenberger, William G.; Colson, Bethany G.; Henning, Shirley C.; Pisoni, David B.

2014-01-01

Neurocognitive processes such as executive functioning (EF) may influence the development of speech-language skills in deaf children after cochlear implantation in ways that differ from normal-hearing, typically developing children. Conversely, spoken language abilities and experiences may also exert reciprocal effects on the development of EF.…

A Longitudinal Study of Pragmatic Language Development in Three Children with Cochlear Implants

ERIC Educational Resources Information Center

Dammeyer, Jesper

2012-01-01

Research has shown how cochlear implants (CIs), in children with hearing impairments, have improved speech perception and production, but very little is known about the children's pragmatic language development. During a 4-year longitudinal study of three children with CIs, certain aspects of pragmatic language development were observed in free…

Exploring the Language and Literacy Outcomes of Pediatric Cochlear Implant Users

PubMed Central

Spencer, Linda J.; Barker, Brittan A.; Tomblin, J. Bruce

2011-01-01

Objective The principal goal of this study was to investigate the relationship between language and literacy (i.e., reading and writing) skills in pediatric cochlear implant users. A peripheral objective was to identify the children's skills that were in need of remediation and subsequently to provide suggestions for remedial programming. It was predicted that the robust language skills often associated with children who have cochlear implant experience would facilitate the development of literacy skills. It was further proposed that the language and literacy skills of pediatric cochlear implant users would approximate the language and literacy skills of children with normal hearing. Design Sixteen pediatric cochlear implant users' language and literacy skills were evaluated and then compared with a reference group of 16 age-matched, normal-hearing children. All 32 participants were educated in mainstream classes within the public school system in the Midwest. The “Sentence Formulation” and “Concepts and Directions” subtests of the Clinical Evaluation of Language Fundamentals-3 test were used to evaluate receptive and expressive language skills. Reading comprehension was evaluated with the “Paragraph Comprehension” subtest of the Woodcock Reading Mastery Test. Performance measures for the writing analyses included productivity, complexity and grammaticality measures. Results Children with cochlear implants performed within 1 SD of the normal-hearing, age-matched children on measures of language comprehension, reading comprehension and writing accuracy. However, the children with cochlear implants performed significantly poorer than the children with normal hearing on the expressive “Sentence Formulation” subtest. The cochlear implant users also produced fewer words on the written narrative task than did the normal-hearing children, although there was not a significant difference between groups with respect to total words per clause. Furthermore there was a strong correlation between language performance and reading performance, as well as language performance and total words produced on the written performance measure for the children using cochlear implants. Conclusions The results of this study suggest that the language skills of pediatric cochlear implant users are related to and correlated with the development of literacy skills within these children. Consequently, the performance of the cochlear implant users, on various language and literacy measures, compared favorably to an age-matched group of children with normal hearing. There were significant differences in the ability of the cochlear implant users to correctly utilize grammatical structures such as conjunctions and correct verb forms when they were required to formulate written and oral sentences. Given this information, it would be appropriate for their educational or remedial language programs to emphasize the use and development of these structures. PMID:12799546

Spoken language development in children following cochlear implantation.

PubMed

Niparko, John K; Tobey, Emily A; Thal, Donna J; Eisenberg, Laurie S; Wang, Nae-Yuh; Quittner, Alexandra L; Fink, Nancy E

2010-04-21

Cochlear implantation is a surgical alternative to traditional amplification (hearing aids) that can facilitate spoken language development in young children with severe to profound sensorineural hearing loss (SNHL). To prospectively assess spoken language acquisition following cochlear implantation in young children. Prospective, longitudinal, and multidimensional assessment of spoken language development over a 3-year period in children who underwent cochlear implantation before 5 years of age (n = 188) from 6 US centers and hearing children of similar ages (n = 97) from 2 preschools recruited between November 2002 and December 2004. Follow-up completed between November 2005 and May 2008. Performance on measures of spoken language comprehension and expression (Reynell Developmental Language Scales). Children undergoing cochlear implantation showed greater improvement in spoken language performance (10.4; 95% confidence interval [CI], 9.6-11.2 points per year in comprehension; 8.4; 95% CI, 7.8-9.0 in expression) than would be predicted by their preimplantation baseline scores (5.4; 95% CI, 4.1-6.7, comprehension; 5.8; 95% CI, 4.6-7.0, expression), although mean scores were not restored to age-appropriate levels after 3 years. Younger age at cochlear implantation was associated with significantly steeper rate increases in comprehension (1.1; 95% CI, 0.5-1.7 points per year younger) and expression (1.0; 95% CI, 0.6-1.5 points per year younger). Similarly, each 1-year shorter history of hearing deficit was associated with steeper rate increases in comprehension (0.8; 95% CI, 0.2-1.2 points per year shorter) and expression (0.6; 95% CI, 0.2-1.0 points per year shorter). In multivariable analyses, greater residual hearing prior to cochlear implantation, higher ratings of parent-child interactions, and higher socioeconomic status were associated with greater rates of improvement in comprehension and expression. The use of cochlear implants in young children was associated with better spoken language learning than would be predicted from their preimplantation scores.

Vocabulary development in Mandarin-speaking children with cochlear implants and its relationship with speech perception abilities.

PubMed

Chen, Yuan; Wong, Lena L N; Zhu, Shufeng; Xi, Xin

2017-01-01

China has the largest population of children with hearing impairments and cochlear implantation is gaining popularity there. However, the vocabulary development in this population is largely unexplored. This study examined early vocabulary outcomes, factors influencing early vocabulary development and the relationship between speech perception and vocabulary development in Mandarin-speaking children during the first year of cochlear implant use. A battery of vocabulary tests was administered to 80 children before implantation and 3, 6, and 12 months after implantation. Demographic information was obtained to evaluate their relationships with vocabulary outcomes. The Mandarin-speaking children, who received their cochlear implants before 3 years of age, developed vocabulary at a rate faster than that of their same-aged peers with normal hearing. Better pre-implant hearing levels, younger age at implantation, and higher maternal education level contributed to the early vocabulary development. The trajectories of speech perception development highly correlated with those of vocabulary development during 3 to 12 months of CI use. and Implications: These findings imply that the vocabulary development of children implanted before 3 years of age may catch up with that of their hearing peers. Copyright © 2016 Elsevier Ltd. All rights reserved.

Developmental and cross-modal plasticity in deafness: evidence from the P1 and N1 event related potentials in cochlear implanted children.

PubMed

Sharma, Anu; Campbell, Julia; Cardon, Garrett

2015-02-01

Cortical development is dependent on extrinsic stimulation. As such, sensory deprivation, as in congenital deafness, can dramatically alter functional connectivity and growth in the auditory system. Cochlear implants ameliorate deprivation-induced delays in maturation by directly stimulating the central nervous system, and thereby restoring auditory input. The scenario in which hearing is lost due to deafness and then reestablished via a cochlear implant provides a window into the development of the central auditory system. Converging evidence from electrophysiologic and brain imaging studies of deaf animals and children fitted with cochlear implants has allowed us to elucidate the details of the time course for auditory cortical maturation under conditions of deprivation. Here, we review how the P1 cortical auditory evoked potential (CAEP) provides useful insight into sensitive period cut-offs for development of the primary auditory cortex in deaf children fitted with cochlear implants. Additionally, we present new data on similar sensitive period dynamics in higher-order auditory cortices, as measured by the N1 CAEP in cochlear implant recipients. Furthermore, cortical re-organization, secondary to sensory deprivation, may take the form of compensatory cross-modal plasticity. We provide new case-study evidence that cross-modal re-organization, in which intact sensory modalities (i.e., vision and somatosensation) recruit cortical regions associated with deficient sensory modalities (i.e., auditory) in cochlear implanted children may influence their behavioral outcomes with the implant. Improvements in our understanding of developmental neuroplasticity in the auditory system should lead to harnessing central auditory plasticity for superior clinical technique. Copyright © 2014 Elsevier B.V. All rights reserved.

Syntagmatic and paradigmatic development of cochlear implanted children in comparison with normally hearing peers up to age 7.

PubMed

Faes, Jolien; Gillis, Joris; Gillis, Steven

2015-09-01

Grammatical development is shown to be delayed in CI children. However, the literature has focussed mainly on one aspect of grammatical development, either morphology or syntax, and on standard tests instead of spontaneous speech. The aim of the present study was to compare grammatical development in the spontaneous speech of Dutch-speaking children with cochlear implants and normally hearing peers. Both syntagmatic and paradigmatic development will be assessed and compared with each other. Nine children with cochlear implants were followed yearly between ages 2 and 7. There was a cross-sectional control group of 10 normally hearing peers at each age. Syntactic development is measured by means of Mean Length of Utterance (MLU), morphological development by means of Mean Size of Paradigm (MSP). This last measure is relatively new in child language research. MLU and MSP of children with cochlear implants lag behind that of their normally hearing peers up to age 4 and up to age 6 respectively. By age 5, CI children catch up on MSP and by age 7 they caught up on MLU. Children with cochlear implants catch up with their normally hearing peers for both measures of syntax and morphology. However, it is shown that inflection is earlier age-appropriate than sentence length in CI children. Possible explanations for this difference in developmental pace are discussed. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Electric charge requirements of pediatric cochlear implant recipients enrolled in the Childhood Development After Cochlear Implantation study.

PubMed

Zwolan, Teresa A; O'Sullivan, Mary Beth; Fink, Nancy E; Niparko, John K

2008-02-01

To evaluate mapping characteristics of children with cochlear implants who are enrolled in the Childhood Development After Cochlear Implantation (CDACI) multicenter study. Longitudinal evaluation during 24 months of speech processor maps of children with cochlear implants prospectively enrolled in the study. Six tertiary referral centers. One hundred eighty-eight children enrolled in the CDACI study who were 5 years old or younger at the time of enrollment. Of these children, 184 received unilateral implants, and 4 received simultaneous bilateral implants. Children attended regular mapping sessions at their implant clinic as part of the study protocol. Maps were examined for each subject at 4 different time intervals: at device activation and 6, 12, and 24 months postactivation. Mean C/M levels (in charge per phase) were compared for 4 different time intervals, for 3 different devices, for 6 different implant centers, and for children with normal and abnormal cochleae. All 3 types of implant devices demonstrate significant increases in C/M levels between device activation and the 24-month appointment. Significant differences in mean C/M levels were noted between devices. Children with cochlear anomalies demonstrate significantly greater C/M levels than children with normal cochleae. The CDACI study has enabled us to evaluate the mapping characteristics of pediatric patients who use 3 different devices and were implanted at a variety of implant centers. Analysis of such data enables us to better understand the mapping characteristics of children with cochlear implants.

Auditory Speech Perception Development in Relation to Patient's Age with Cochlear Implant

PubMed Central

Ciscare, Grace Kelly Seixas; Mantello, Erika Barioni; Fortunato-Queiroz, Carla Aparecida Urzedo; Hyppolito, Miguel Angelo; Reis, Ana Cláudia Mirândola Barbosa dos

2017-01-01

Introduction  A cochlear implant in adolescent patients with pre-lingual deafness is still a debatable issue. Objective  The objective of this study is to analyze and compare the development of auditory speech perception in children with pre-lingual auditory impairment submitted to cochlear implant, in different age groups in the first year after implantation. Method  This is a retrospective study, documentary research, in which we analyzed 78 reports of children with severe bilateral sensorineural hearing loss, unilateral cochlear implant users of both sexes. They were divided into three groups: G1, 22 infants aged less than 42 months; G2, 28 infants aged between 43 to 83 months; and G3, 28 older than 84 months. We collected medical record data to characterize the patients, auditory thresholds with cochlear implants, assessment of speech perception, and auditory skills. Results  There was no statistical difference in the association of the results among groups G1, G2, and G3 with sex, caregiver education level, city of residence, and speech perception level. There was a moderate correlation between age and hearing aid use time, age and cochlear implants use time. There was a strong correlation between age and the age cochlear implants was performed, hearing aid use time and age CI was performed. Conclusion  There was no statistical difference in the speech perception in relation to the patient's age when cochlear implant was performed. There were statistically significant differences for the variables of auditory deprivation time between G3 - G1 and G2 - G1 and hearing aid use time between G3 - G2 and G3 - G1. PMID:28680487

Close-field electroporation gene delivery using the cochlear implant electrode array enhances the bionic ear.

PubMed

Pinyon, Jeremy L; Tadros, Sherif F; Froud, Kristina E; Y Wong, Ann C; Tompson, Isabella T; Crawford, Edward N; Ko, Myungseo; Morris, Renée; Klugmann, Matthias; Housley, Gary D

2014-04-23

The cochlear implant is the most successful bionic prosthesis and has transformed the lives of people with profound hearing loss. However, the performance of the "bionic ear" is still largely constrained by the neural interface itself. Current spread inherent to broad monopolar stimulation of the spiral ganglion neuron somata obviates the intrinsic tonotopic mapping of the cochlear nerve. We show in the guinea pig that neurotrophin gene therapy integrated into the cochlear implant improves its performance by stimulating spiral ganglion neurite regeneration. We used the cochlear implant electrode array for novel "close-field" electroporation to transduce mesenchymal cells lining the cochlear perilymphatic canals with a naked complementary DNA gene construct driving expression of brain-derived neurotrophic factor (BDNF) and a green fluorescent protein (GFP) reporter. The focusing of electric fields by particular cochlear implant electrode configurations led to surprisingly efficient gene delivery to adjacent mesenchymal cells. The resulting BDNF expression stimulated regeneration of spiral ganglion neurites, which had atrophied 2 weeks after ototoxic treatment, in a bilateral sensorineural deafness model. In this model, delivery of a control GFP-only vector failed to restore neuron structure, with atrophied neurons indistinguishable from unimplanted cochleae. With BDNF therapy, the regenerated spiral ganglion neurites extended close to the cochlear implant electrodes, with localized ectopic branching. This neural remodeling enabled bipolar stimulation via the cochlear implant array, with low stimulus thresholds and expanded dynamic range of the cochlear nerve, determined via electrically evoked auditory brainstem responses. This development may broadly improve neural interfaces and extend molecular medicine applications.

Predicting social functioning in children with a cochlear implant and in normal-hearing children: the role of emotion regulation.

PubMed

Wiefferink, Carin H; Rieffe, Carolien; Ketelaar, Lizet; Frijns, Johan H M

2012-06-01

The purpose of the present study was to compare children with a cochlear implant and normal hearing children on aspects of emotion regulation (emotion expression and coping strategies) and social functioning (social competence and externalizing behaviors) and the relation between emotion regulation and social functioning. Participants were 69 children with cochlear implants (CI children) and 67 normal hearing children (NH children) aged 1.5-5 years. Parents answered questionnaires about their children's language skills, social functioning, and emotion regulation. Children also completed simple tasks to measure their emotion regulation abilities. Cochlear implant children had fewer adequate emotion regulation strategies and were less socially competent than normal hearing children. The parents of cochlear implant children did not report fewer externalizing behaviors than those of normal hearing children. While social competence in normal hearing children was strongly related to emotion regulation, cochlear implant children regulated their emotions in ways that were unrelated with social competence. On the other hand, emotion regulation explained externalizing behaviors better in cochlear implant children than in normal hearing children. While better language skills were related to higher social competence in both groups, they were related to fewer externalizing behaviors only in cochlear implant children. Our results indicate that cochlear implant children have less adequate emotion-regulation strategies and less social competence than normal hearing children. Since they received their implants relatively recently, they might eventually catch up with their hearing peers. Longitudinal studies should further explore the development of emotion regulation and social functioning in cochlear implant children. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Comparison of auditory comprehension skills in children with cochlear implant and typically developing children.

PubMed

Mandal, Joyanta Chandra; Kumar, Suman; Roy, Sumit

2016-12-01

The main goal of this study was to obtain auditory comprehension skills of native Hindi speaking children with cochlear implant and typically developing children across the age of 3-7 years and compare the scores between two groups. A total of sixty Hindi speaking participants were selected for the study. They were divided into two groups- Group-A consisted of thirty children with normal hearing and Group-B thirty children using cochlear implants. To assess the auditory comprehension skills, Test of auditory comprehension in Hindi (TACH) was used. The participant was required to point to one of three pictures which would best correspond to the stimulus presented. Correct answers were scored as 1 and incorrect answers as 0. TACH was administered on for both groups. Independent t-test was applied and it was found that auditory comprehension scores of children using cochlear implant were significantly poorer than the score of children with normal hearing for all three subtests. Pearson's correlation coefficient revealed poor correlation between the scores of children with normal hearing and children using cochlear implant. The results of this study suggest that children using cochlear implant have poor auditory comprehension skills than children with normal hearing. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Effect of age at cochlear implantation on auditory and speech development of children with auditory neuropathy spectrum disorder.

PubMed

Liu, Yuying; Dong, Ruijuan; Li, Yuling; Xu, Tianqiu; Li, Yongxin; Chen, Xueqing; Gong, Shusheng

2014-12-01

To evaluate the auditory and speech abilities in children with auditory neuropathy spectrum disorder (ANSD) after cochlear implantation (CI) and determine the role of age at implantation. Ten children participated in this retrospective case series study. All children had evidence of ANSD. All subjects had no cochlear nerve deficiency on magnetic resonance imaging and had used the cochlear implants for a period of 12-84 months. We divided our children into two groups: children who underwent implantation before 24 months of age and children who underwent implantation after 24 months of age. Their auditory and speech abilities were evaluated using the following: behavioral audiometry, the Categories of Auditory Performance (CAP), the Meaningful Auditory Integration Scale (MAIS), the Infant-Toddler Meaningful Auditory Integration Scale (IT-MAIS), the Standard-Chinese version of the Monosyllabic Lexical Neighborhood Test (LNT), the Multisyllabic Lexical Neighborhood Test (MLNT), the Speech Intelligibility Rating (SIR) and the Meaningful Use of Speech Scale (MUSS). All children showed progress in their auditory and language abilities. The 4-frequency average hearing level (HL) (500Hz, 1000Hz, 2000Hz and 4000Hz) of aided hearing thresholds ranged from 17.5 to 57.5dB HL. All children developed time-related auditory perception and speech skills. Scores of children with ANSD who received cochlear implants before 24 months tended to be better than those of children who received cochlear implants after 24 months. Seven children completed the Mandarin Lexical Neighborhood Test. Approximately half of the children showed improved open-set speech recognition. Cochlear implantation is helpful for children with ANSD and may be a good optional treatment for many ANSD children. In addition, children with ANSD fitted with cochlear implants before 24 months tended to acquire auditory and speech skills better than children fitted with cochlear implants after 24 months. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Modulation of Mcl-1 expression reduces age-related cochlear degeneration

PubMed Central

Yang, Wei Ping; Xu, Yang; Guo, Wei Wei; Liu, Hui Zhan; Hu, Bo Hua

2013-01-01

Mcl-1 is an anti-apoptotic member of the Bcl-2 family that modulates apoptosis-related signaling pathways and promotes cell survival. We have previously demonstrated a reduction of Mcl-1 expression in aging cochleae. To investigate whether restoring Mcl-1 expression would reduce aging-related cochlear degeneration, we developed a rat model of Mcl-1 overexpression. A plasmid encoding human Mcl-1/enhanced green fluorescent protein was applied to the round window of the cochlea. This in vivo treatment transfected both the sensory and supporting cells of the cochlear sensory epithelium and enhanced Mcl-1 expression at both the mRNA and the protein level. The upregulation of Mcl-1 expression reduced the progression of age-related cochlear dysfunction and sensory cell death. Furthermore, the transfection of Mcl-1 exerted its protective effect by suppressing cochlear apoptosis at the mitochondrial level. This study demonstrates that the genetic modulation of Mcl-1 expression reduces the progression of age-related cochlear degeneration. PMID:23790646

In vivo imaging of mammalian cochlear blood flow using fluorescence microendoscopy.

PubMed

Monfared, Ashkan; Blevins, Nikolas H; Cheung, Eunice L M; Jung, Juergen C; Popelka, Gerald; Schnitzer, Mark J

2006-02-01

We sought to develop techniques for visualizing cochlear blood flow in live mammalian subjects using fluorescence microendoscopy. Inner ear microcirculation appears to be intimately involved in cochlear function. Blood velocity measurements suggest that intense sounds can alter cochlear blood flow. Disruption of cochlear blood flow may be a significant cause of hearing impairment, including sudden sensorineural hearing loss. However, inability to image cochlear blood flow in a nondestructive manner has limited investigation of the role of inner ear microcirculation in hearing function. Present techniques for imaging cochlear microcirculation using intravital light microscopy involve extensive perturbations to cochlear structure, precluding application in human patients. The few previous endoscopy studies of the cochlea have suffered from optical resolution insufficient for visualizing cochlear microvasculature. Fluorescence microendoscopy is an emerging minimally invasive imaging modality that provides micron-scale resolution in tissues inaccessible to light microscopy. In this article, we describe the use of fluorescence microendoscopy in live guinea pigs to image capillary blood flow and movements of individual red blood cells within the basal turn of the cochlea. We anesthetized eight adult guinea pigs and accessed the inner ear through the mastoid bulla. After intravenous injection of fluorescein dye, we made a limited cochleostomy and introduced a compound doublet gradient refractive index endoscope probe 1 mm in diameter into the inner ear. We then imaged cochlear blood flow within individual vessels in an epifluorescence configuration using one-photon fluorescence microendoscopy. We observed single red blood cells passing through individual capillaries in several cochlear structures, including the round window membrane, spiral ligament, osseous spiral lamina, and basilar membrane. Blood flow velocities within inner ear capillaries varied widely, with observed speeds reaching up to approximately 500 microm/s. Fluorescence microendoscopy permits visualization of cochlear microcirculation with micron-scale optical resolution and determination of blood flow velocities through analysis of video sequences.

Motion of organ of Corti structures in the gerbil cochlear apex, measured with a commercial optical coherence tomography (OCT) system

NASA Astrophysics Data System (ADS)

Ravicz, Michael E.; Cho, Nam-Hyun; Maftoon, Nima; Puria, Sunil

2018-05-01

Recent developments in Optical Coherence Tomography (OCT) allow measurements of cochlear motions through the bony cochlear wall without holes at spatial resolutions approaching about 10 µm. Measurements to date have been made with custom OCT systems with long development times. We present measurements made with a commercial OCT system driven by custom software (VibOCT) that facilitates near real-time frequency response measurements. The 905-nm wavelength laser and high-speed (100 kHz) camera provide higher axial resolution (3 µm in air) and temporal resolution than previous studies and a sub-nanometer noise floor in air. We gathered anatomical images of the gerbil cochlear apex in vivo at higher resolution than available previously, sufficient to resolve individual outer hair cells, pillar cells, tunnel of Corti and inner sulcus regions. Images from the 3rd apical turn show a bulging of Reissners membrane in vivo that flattened post-mortem with a concomitant reduction in the distance between the Henson cell border and the stria vascularis wall. Vibrometry of the organ of Corti shows a low-pass characteristic in-vivo and post-mortem with a traveling wave-like phase delay similar to a recent study rather than the sharp tuning seen more basally. This system can provide valuable information on cochlear function, which is also useful for the development of detailed cochlear models of the passive and active gerbil apex.

Speech and language development in cognitively delayed children with cochlear implants.

PubMed

Holt, Rachael Frush; Kirk, Karen Iler

2005-04-01

The primary goals of this investigation were to examine the speech and language development of deaf children with cochlear implants and mild cognitive delay and to compare their gains with those of children with cochlear implants who do not have this additional impairment. We retrospectively examined the speech and language development of 69 children with pre-lingual deafness. The experimental group consisted of 19 children with cognitive delays and no other disabilities (mean age at implantation = 38 months). The control group consisted of 50 children who did not have cognitive delays or any other identified disability. The control group was stratified by primary communication mode: half used total communication (mean age at implantation = 32 months) and the other half used oral communication (mean age at implantation = 26 months). Children were tested on a variety of standard speech and language measures and one test of auditory skill development at 6-month intervals. The results from each test were collapsed from blocks of two consecutive 6-month intervals to calculate group mean scores before implantation and at 1-year intervals after implantation. The children with cognitive delays and those without such delays demonstrated significant improvement in their speech and language skills over time on every test administered. Children with cognitive delays had significantly lower scores than typically developing children on two of the three measures of receptive and expressive language and had significantly slower rates of auditory-only sentence recognition development. Finally, there were no significant group differences in auditory skill development based on parental reports or in auditory-only or multimodal word recognition. The results suggest that deaf children with mild cognitive impairments benefit from cochlear implantation. Specifically, improvements are evident in their ability to perceive speech and in their reception and use of language. However, it may be reduced relative to their typically developing peers with cochlear implants, particularly in domains that require higher level skills, such as sentence recognition and receptive and expressive language. These findings suggest that children with mild cognitive deficits be considered for cochlear implantation with less trepidation than has been the case in the past. Although their speech and language gains may be tempered by their cognitive abilities, these limitations do not appear to preclude benefit from cochlear implant stimulation, as assessed by traditional measures of speech and language development.

Challenges in Improving Cochlear Implant Performance and Accessibility.

PubMed

Zeng, Fan-Gang

2017-08-01

Here I identify two gaps in cochlear implants that have been limiting their performance and acceptance. First, cochlear implant performance has remained largely unchanged, despite the number of publications tripling per decade in the last 30 years. Little has been done so far to address a fundamental limitation in the electrode-to-neuron interface, with the electrode size being a thousand times larger than the neuron diameter while the number of electrodes being a thousand times less. Both the small number and the large size of electrodes produce broad spatial activation and poor frequency resolution that limit current cochlear implant performance. Second, a similarly rapid growth in cochlear implant volume has not produced an expected decrease in unit price in the same period. The high cost contributes to low market penetration rate, which is about 20% in developed countries and less than 1% in developing countries. I will discuss changes needed in both research strategy and business practice to close the gap between prosthetic and normal hearing as well as that between haves and have-nots.

Comparison of Social Interaction between Cochlear-Implanted Children with Normal Intelligence Undergoing Auditory Verbal Therapy and Normal-Hearing Children: A Pilot Study.

PubMed

Monshizadeh, Leila; Vameghi, Roshanak; Sajedi, Firoozeh; Yadegari, Fariba; Hashemi, Seyed Basir; Kirchem, Petra; Kasbi, Fatemeh

2018-04-01

A cochlear implant is a device that helps hearing-impaired children by transmitting sound signals to the brain and helping them improve their speech, language, and social interaction. Although various studies have investigated the different aspects of speech perception and language acquisition in cochlear-implanted children, little is known about their social skills, particularly Persian-speaking cochlear-implanted children. Considering the growing number of cochlear implants being performed in Iran and the increasing importance of developing near-normal social skills as one of the ultimate goals of cochlear implantation, this study was performed to compare the social interaction between Iranian cochlear-implanted children who have undergone rehabilitation (auditory verbal therapy) after surgery and normal-hearing children. This descriptive-analytical study compared the social interaction level of 30 children with normal hearing and 30 with cochlear implants who were conveniently selected. The Raven test was administered to the both groups to ensure normal intelligence quotient. The social interaction status of both groups was evaluated using the Vineland Adaptive Behavior Scale, and statistical analysis was performed using Statistical Package for Social Sciences (SPSS) version 21. After controlling age as a covariate variable, no significant difference was observed between the social interaction scores of both the groups (p > 0.05). In addition, social interaction had no correlation with sex in either group. Cochlear implantation followed by auditory verbal rehabilitation helps children with sensorineural hearing loss to have normal social interactions, regardless of their sex.

A comparison of speech intonation production and perception abilities of Farsi speaking cochlear implanted and normal hearing children.

PubMed

Moein, Narges; Khoddami, Seyyedeh Maryam; Shahbodaghi, Mohammad Rahim

2017-10-01

Cochlear implant prosthesis facilitates spoken language development and speech comprehension in children with severe-profound hearing loss. However, this prosthesis is limited in encoding information about fundamental frequency and pitch that are essentially for recognition of speech prosody. The purpose of the present study is to investigate the perception and production of intonation in cochlear implant children and comparison with normal hearing children. This study carried out on 25 cochlear implanted children and 50 children with normal hearing. First, using 10 action pictures statements and questions sentences were extracted. Fundamental frequency and pitch changes were identified using Praat software. Then, these sentences were judged by 7 adult listeners. In second stage 20 sentences were played for child and he/she determined whether it was in a question form or statement one. Performance of cochlear implanted children in perception and production of intonation was significantly lower than children with normal hearing. The difference between fundamental frequency and pitch changes in cochlear implanted children and children with normal hearing was significant (P < 0/05). Cochlear implanted children performance in perception and production of intonation has significant correlation with child's age surgery and duration of prosthesis use (P < 0/05). The findings of the current study show that cochlear prostheses have limited application in facilitating the perception and production of intonation in cochlear implanted children. It should be noted that the child's age at the surgery and duration of prosthesis's use is important in reduction of this limitation. According to these findings, speech and language pathologists should consider intervention of intonation in treatment program of cochlear implanted children. Copyright © 2017 Elsevier B.V. All rights reserved.

Children's Development of Intonation during the First Year of Cochlear Implant Experience

ERIC Educational Resources Information Center

Snow, David P.; Ertmer, David J.

2012-01-01

This article describes the longitudinal development of intonation in 18 deaf children who received cochlear implants (CIs) before the age of 3 years and 12 infants with typical development (TD) who served as controls. At the time their implants were activated, the children with CIs ranged in age from 9 to 36 months. Cross-group comparisons were…

Genetic Predisposition and Sensory Experience in Language Development: Evidence from Cochlear-Implanted Children

ERIC Educational Resources Information Center

Coene, Martine; Schauwers, Karen; Gillis, Steven; Rooryck, Johan; Govaerts, Paul J.

2011-01-01

Recent neurobiological studies have advanced the hypothesis that language development is not continuously plastic but is governed by biological constraints that may be modified by experience within a particular time window. This hypothesis is tested based on spontaneous speech data from deaf cochlear-implanted (CI) children with access to…

Spoken language skills and educational placement in Finnish children with cochlear implants.

PubMed

Lonka, Eila; Hasan, Marja; Komulainen, Erkki

2011-01-01

This study reports the demographics, and the auditory and spoken language development as well as educational settings, for a total of 164 Finnish children with cochlear implants. Two questionnaires were employed: the first, concerning day care and educational placement, was filled in by professionals for rehabilitation guidance, and the second, evaluating language development (categories of auditory performance, spoken language skills, and main mode of communication), by speech and language therapists in audiology departments. Nearly half of the children were enrolled in normal kindergartens and 43% of school-aged children in mainstream schools. Categories of auditory performance were observed to grow in relation to age at cochlear implantation (p < 0.001) as well as in relation to proportional hearing age (p < 0.001). The composite scores for language development moved to more diversified ones in relation to increasing age at cochlear implantation and proportional hearing age (p < 0.001). Children without additional disorders outperformed those with additional disorders. The results indicate that the most favorable age for cochlear implantation could be earlier than 2. Compared to other children, spoken language evaluation scores of those with additional disabilities were significantly lower; however, these children showed gradual improvements in their auditory perception and language scores. Copyright © 2011 S. Karger AG, Basel.

Sensorineural hearing loss and ischemic injury: Development of animal models to assess vascular and oxidative effects.

PubMed

Olivetto, E; Simoni, E; Guaran, V; Astolfi, L; Martini, A

2015-09-01

Hearing loss may be genetic, associated with aging or exposure to noise or ototoxic substances. Its aetiology can be attributed to vascular injury, trauma, tumours, infections or autoimmune response. All these factors could be related to alterations in cochlear microcirculation resulting in hypoxia, which in turn may damage cochlear hair cells and neurons, leading to deafness. Hypoxia could underlie the aetiology of deafness, but very few data about it are presently available. The aim of this work is to develop animal models of hypoxia and ischemia suitable for study of cochlear vascular damage, characterizing them by electrophysiology and gene/protein expression analyses. The effects of hypoxia in infarction were mimicked in rat by partial permanent occlusion of the left coronary artery, and those of ischemia in thrombosis by complete temporary carotid occlusion. In our models both hypoxia and ischemia caused a small but significant hearing loss, localized at the cochlear apex. A slight induction of the coagulation cascade and of oxidative stress pathways was detected as cell survival mechanism, and cell damages were found on the cuticular plate of outer hair cells only after carotid ischemia. Based on these data, the two developed models appear suitable for in vivo studies of cochlear vascular damage. Copyright © 2015 Elsevier B.V. All rights reserved.

Pharmacokinetic Properties of Adenosine Amine Congener in Cochlear Perilymph after Systemic Administration.

PubMed

Chang, Hao; Telang, Ravindra S; Sreebhavan, Sreevalsan; Tingle, Malcolm; Thorne, Peter R; Vlajkovic, Srdjan M

2017-01-01

Noise-induced hearing loss (NIHL) is a global health problem affecting over 5% of the population worldwide. We have shown previously that acute noise-induced cochlear injury can be ameliorated by administration of drugs acting on adenosine receptors in the inner ear, and a selective A 1 adenosine receptor agonist adenosine amine congener (ADAC) has emerged as a potentially effective treatment for cochlear injury and resulting hearing loss. This study investigated pharmacokinetic properties of ADAC in rat perilymph after systemic (intravenous) administration using a newly developed liquid chromatography-tandem mass spectrometry detection method. The method was developed and validated in accordance with the USA FDA guidelines including accuracy, precision, specificity, and linearity. Perilymph was sampled from the apical turn of the cochlea to prevent contamination with the cerebrospinal fluid. ADAC was detected in cochlear perilymph within two minutes following intravenous administration and remained in perilymph above its minimal effective concentration for at least two hours. The pharmacokinetic pattern of ADAC was significantly altered by exposure to noise, suggesting transient changes in permeability of the blood-labyrinth barrier and/or cochlear blood flow. This study supports ADAC development as a potential clinical otological treatment for acute sensorineural hearing loss caused by exposure to traumatic noise.

Pharmacokinetic Properties of Adenosine Amine Congener in Cochlear Perilymph after Systemic Administration

PubMed Central

Sreebhavan, Sreevalsan; Thorne, Peter R.

2017-01-01

Noise-induced hearing loss (NIHL) is a global health problem affecting over 5% of the population worldwide. We have shown previously that acute noise-induced cochlear injury can be ameliorated by administration of drugs acting on adenosine receptors in the inner ear, and a selective A1 adenosine receptor agonist adenosine amine congener (ADAC) has emerged as a potentially effective treatment for cochlear injury and resulting hearing loss. This study investigated pharmacokinetic properties of ADAC in rat perilymph after systemic (intravenous) administration using a newly developed liquid chromatography-tandem mass spectrometry detection method. The method was developed and validated in accordance with the USA FDA guidelines including accuracy, precision, specificity, and linearity. Perilymph was sampled from the apical turn of the cochlea to prevent contamination with the cerebrospinal fluid. ADAC was detected in cochlear perilymph within two minutes following intravenous administration and remained in perilymph above its minimal effective concentration for at least two hours. The pharmacokinetic pattern of ADAC was significantly altered by exposure to noise, suggesting transient changes in permeability of the blood-labyrinth barrier and/or cochlear blood flow. This study supports ADAC development as a potential clinical otological treatment for acute sensorineural hearing loss caused by exposure to traumatic noise. PMID:28194422

Factors contributing to communication skills development in cochlear implanted children.

PubMed

Ostojić, Sanja; Djoković, Sanja; Radić-šestić, Marina; Nikolić, Mina; Mikić, Branka; Mirić, Danica

2015-08-01

Over the last 10 years more than 300 persons received cochlear implant in Serbia and more than 90% of the recipients were children under 10 years of age. The program of cochlear implantation includes postoperative rehabilitation in which cognitive, integrative and developmental methods are used. The study was conducted to reveal factors affecting communication performance (CP) of cochlear implanted (Cl) children. Special attention was focused on the influence of the duration and intensity of rehabilitation and hearing age on further development of communication skills. A group of 30 CI children (13 boys and 17 girls) aged 2 to 5 years was enrolled in the study. All of the children had average intelligence and no other developmental disorder. They lived in families and attended rehabilitative seances 3 to 5 times a week. Their parents/caregivers answered structured questionnaire about functioning after pediatric cochlear implantation (FAPCI) and the results were the subject of detailed statistical analysis. Analysis of variance did not show any difference between the boys and the girls regarding FAPCI achievements (F(1, 28) = 2.909; p = 0.099) and age aberration in CP score (F(1,28) = 0.114, p = 0.738). Correlation analysis showed a statistically significant difference in FAPCI scores related to hearing age and duration of rehabilitation. Regression analysis (enter method) showed that model consisting of indipendent variables significantly contributed to prediction of overall FAPCI scores and Adjusted R2 value could explain 32% difference in communication skills of participants in this study. Communication skills of CI children evaluated by FAPCI are falling behind normatives for normal hearing children 18.6 months on the average. Hearing age, duration and intensity of rehabilitation have positive predictive value for communication skills development. Later identification of hearing loss and later cochlear implantation lead to delayed development of communication skills.

Heat Transfer Computations of Internal Duct Flows With Combined Hydraulic and Thermal Developing Length

NASA Technical Reports Server (NTRS)

Wang, C. R.; Towne, C. E.; Hippensteele, S. A.; Poinsatte, P. E.

1997-01-01

This study investigated the Navier-Stokes computations of the surface heat transfer coefficients of a transition duct flow. A transition duct from an axisymmetric cross section to a non-axisymmetric cross section, is usually used to connect the turbine exit to the nozzle. As the gas turbine inlet temperature increases, the transition duct is subjected to the high temperature at the gas turbine exit. The transition duct flow has combined development of hydraulic and thermal entry length. The design of the transition duct required accurate surface heat transfer coefficients. The Navier-Stokes computational method could be used to predict the surface heat transfer coefficients of a transition duct flow. The Proteus three-dimensional Navier-Stokes numerical computational code was used in this study. The code was first studied for the computations of the turbulent developing flow properties within a circular duct and a square duct. The code was then used to compute the turbulent flow properties of a transition duct flow. The computational results of the surface pressure, the skin friction factor, and the surface heat transfer coefficient were described and compared with their values obtained from theoretical analyses or experiments. The comparison showed that the Navier-Stokes computation could predict approximately the surface heat transfer coefficients of a transition duct flow.

On modeling the sound propagation through a lined duct with a modified Ingard-Myers boundary condition

NASA Astrophysics Data System (ADS)

Yang, Cheng; Fang, Yi; Zhao, Chao; Zhang, Xin

2018-06-01

A duct acoustics model is an essential component of an impedance eduction technique and its computation cost determines the impedance measurement efficiency. In this paper, a model is developed for the sound propagation through a lined duct carrying a uniform mean flow. In contrast to many existing models, the interface between the liner and the duct field is defined with a modified Ingard-Myers boundary condition that takes account of the effect of the boundary layer above the liner. A mode-matching method is used to couple the unlined and lined duct segments for the model development. For the lined duct segment, the eigenvalue problem resulted from the modified boundary condition is solved by an integration scheme which, on the one hand, allows the lined duct modes to be computed in an efficient manner, and on the other hand, orders the modes automatically. The duct acoustics model developed from the solved lined duct modes is shown to converge more rapidly than the one developed from the rigid-walled duct modes. Validation against the experiment data in the literature shows that the proposed model is able to predict more accurately the liner performance measured by the two-source method. This, however, cannot be made by a duct acoustics model associated with the conventional Ingard-Myers boundary condition. The proposed model has the potential to be integrated into an impedance eduction technique for more reliable liner measurement.

Will They Catch Up? The Role of Age at Cochlear Implantation in the Spoken Language Development of Children with Severe to Profound Hearing Loss

ERIC Educational Resources Information Center

Nicholas, Johanna Grant; Geers, Ann E.

2007-01-01

Purpose: The authors examined the benefits of younger cochlear implantation, longer cochlear implant use, and greater pre-implant aided hearing to spoken language at 3.5 and 4.5 years of age. Method: Language samples were obtained at ages 3.5 and 4.5 years from 76 children who received an implant by their 3rd birthday. Hierarchical linear modeling…

Benefit and predictive factors for speech perception outcomes in pediatric bilateral cochlear implant recipients.

PubMed

Chang, Young-Soo; Hong, Sung Hwa; Kim, Eun Yeon; Choi, Ji Eun; Chung, Won-Ho; Cho, Yang-Sun; Moon, Il Joon

2018-05-18

Despite recent advancement in the prediction of cochlear implant outcome, the benefit of bilateral procedures compared to bimodal stimulation and how we predict speech perception outcomes of sequential bilateral cochlear implant based on bimodal auditory performance in children remain unclear. This investigation was performed: (1) to determine the benefit of sequential bilateral cochlear implant and (2) to identify the associated factors for the outcome of sequential bilateral cochlear implant. Observational and retrospective study. We retrospectively analyzed 29 patients with sequential cochlear implant following bimodal-fitting condition. Audiological evaluations were performed; the categories of auditory performance scores, speech perception with monosyllable and disyllables words, and the Korean version of Ling. Audiological evaluations were performed before sequential cochlear implant with the bimodal fitting condition (CI1+HA) and one year after the sequential cochlear implant with bilateral cochlear implant condition (CI1+CI2). The good Performance Group (GP) was defined as follows; 90% or higher in monosyllable and bisyllable tests with auditory-only condition or 20% or higher improvement of the scores with CI1+CI2. Age at first implantation, inter-implant interval, categories of auditory performance score, and various comorbidities were analyzed by logistic regression analysis. Compared to the CI1+HA, CI1+CI2 provided significant benefit in categories of auditory performance, speech perception, and Korean version of Ling results. Preoperative categories of auditory performance scores were the only associated factor for being GP (odds ratio=4.38, 95% confidence interval - 95%=1.07-17.93, p=0.04). The children with limited language development in bimodal condition should be considered as the sequential bilateral cochlear implant and preoperative categories of auditory performance score could be used as the predictor in speech perception after sequential cochlear implant. Copyright © 2018 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Mammary Duct Ectasia

MedlinePlus

... tenderness or inflammation of the clogged duct (periductal mastitis). Mammary duct ectasia most often occurs in women ... that's turned inward (inverted) A bacterial infection called mastitis also may develop in the affected milk duct, ...

Selective deletion of cochlear hair cells causes rapid age-dependent changes in spiral ganglion and cochlear nucleus neurons.

PubMed

Tong, Ling; Strong, Melissa K; Kaur, Tejbeer; Juiz, Jose M; Oesterle, Elizabeth C; Hume, Clifford; Warchol, Mark E; Palmiter, Richard D; Rubel, Edwin W

2015-05-20

During nervous system development, critical periods are usually defined as early periods during which manipulations dramatically change neuronal structure or function, whereas the same manipulations in mature animals have little or no effect on the same property. Neurons in the ventral cochlear nucleus (CN) are dependent on excitatory afferent input for survival during a critical period of development. Cochlear removal in young mammals and birds results in rapid death of target neurons in the CN. Cochlear removal in older animals results in little or no neuron death. However, the extent to which hair-cell-specific afferent activity prevents neuronal death in the neonatal brain is unknown. We further explore this phenomenon using a new mouse model that allows temporal control of cochlear hair cell deletion. Hair cells express the human diphtheria toxin (DT) receptor behind the Pou4f3 promoter. Injections of DT resulted in nearly complete loss of organ of Corti hair cells within 1 week of injection regardless of the age of injection. Injection of DT did not influence surrounding supporting cells directly in the sensory epithelium or spiral ganglion neurons (SGNs). Loss of hair cells in neonates resulted in rapid and profound neuronal loss in the ventral CN, but not when hair cells were eliminated at a more mature age. In addition, normal survival of SGNs was dependent on hair cell integrity early in development and less so in mature animals. This defines a previously undocumented critical period for SGN survival. Copyright © 2015 the authors 0270-6474/15/357878-14$15.00/0.

Congenitally deafblind children and cochlear implants: effects on communication.

PubMed

Dammeyer, Jesper

2009-01-01

There has been much research conducted demonstrating the positive benefits of cochlear implantation (CI) in children who are deaf. Research on CI in children who are both deaf and blind, however, is lacking. The purpose of this article is to present a study of five congenitally deafblind children who received cochlear implants between 2.2 and 4.2 years of age. Ratings of video observations were used to measure the children's early communication development with and without the use of their cochlear implants. In addition, parental interviews were used to assess the benefits parents perceived regarding their children's cochlear implants. Two examples are included in this article to illustrate the parents' perspectives about CI in their deafblind children. Benefits of CI in this cohort of children included improved attention and emotional response as well as greater use of objects in interaction with adults. The best overall outcome of CI is not spoken language but better communication.

The challenges of starting a cochlear implant programme in a developing country.

PubMed

Krishnamoorthy, Kumaresh; Samy, Ravi N; Shoman, Nael

2014-10-01

Deafness is indeed a silent disability in many parts of the world, and the majority of people who have hearing impairment live in developing countries. With rising economy and developing nations becoming hub of industrialization, hearing loss may increase in these countries. In this review, the authors have elected to focus the discussion on India to frame the challenges of cochlear implants in a developing country. This article reviews the common causes of hearing loss, the challenges faced by those with hearing impairment and why the penetration of these devices is low and also reviews some reasons for the inability of the government to support the implant programme in India. Early identification of hearing is crucial towards ensuring appropriate hearing rehabilitation; it is, however, challenged by various factors, including public awareness, absence of a national new born screening programme, accessibility to diagnostic centres, availability of trained personnel and equipment and patient affordability. Cochlear implants are a proven auditory rehabilitative option for individuals with severe to profound sensorineural hearing loss, who otherwise do not benefiting from hearing aids. Nevertheless, only a small percentage of these individuals receive cochlear implants, and cost remains a leading prohibitive factor, particularly in developing countries. For example, in India, the personal average annual income is well below US $2000, whereas these devices cost between $12,000 and $25,000, exclusive of hospital and staff fees. Hence, the technology is virtually unavailable to the masses. To overcome the cost limitation of those who would benefit from cochlear implants countries such as India and China have started to develop their own indigenous implants.

Spontaneous Language Production of Italian Children with Cochlear Implants and Their Mothers in Two Interactive Contexts

ERIC Educational Resources Information Center

Majorano, Marinella; Guidotti, Laura; Guerzoni, Letizia; Murri, Alessandra; Morelli, Marika; Cuda, Domenico; Lavelli, Manuela

2018-01-01

Background: In recent years many studies have shown that the use of cochlear implants (CIs) improves children's skills in processing the auditory signal and, consequently, the development of both language comprehension and production. Nevertheless, many authors have also reported that the development of language skills in children with CIs is…

Motor Development of Deaf Children with and without Cochlear Implants

ERIC Educational Resources Information Center

Gheysen, Freja; Loots, Gerrit; Van Waelvelde, Hilde

2008-01-01

The purpose of this study was to investigate the impact of a cochlear implant (CI) on the motor development of deaf children. The study involved 36 mainstreamed deaf children (15 boys, 21 girls; 4- to 12-years old) without any developmental problems. Of these children, 20 had been implanted. Forty-three hearing children constituted a comparison…

Slit/Robo Signaling Mediates Spatial Positioning of Spiral Ganglion Neurons during Development of Cochlear Innervation

PubMed Central

Wang, Sheng-zhi; Ibrahim, Leena A.; Kim, Young J.; Gibson, Daniel A.; Leung, Haiwen C.; Yuan, Wei; Zhang, Ke K.; Tao, Huizhong W.

2013-01-01

During the development of periphery auditory circuits, spiral ganglion neurons (SGNs) extend their neurites to innervate cochlear hair cells (HCs) with their soma aggregated into a cluster spatially segregated from the cochlear sensory epithelium. The molecular mechanisms underlying this spatial patterning remain unclear. In this study, in situ hybridization in the mouse cochlea suggests that Slit2 and its receptor, Robo1/2, exhibit apparently complementary expression patterns in the spiral ganglion and its nearby region, the spiral limbus. In Slit2 and Robo1/2 mutants, the spatial restriction of SGNs was disrupted. Mispositioned SGNs were found to scatter in the space between the cochlear epithelium and the main body of spiral ganglion, and the neurites of mispositioned SGNs were misrouted and failed to innervate HCs. Furthermore, in Robo1/2 mutants, SGNs were displaced toward the cochlear epithelium as an entirety. Examination of different embryonic stages in the mutants revealed that the mispositioning of SGNs was due to a progressive displacement to ectopic locations after their initial normal settlement at an earlier stage. Our results suggest that Slit/Robo signaling imposes a restriction force on SGNs to ensure their precise positioning for correct SGN-HC innervations. PMID:23884932

Design integration and noise studies for jet STOL aircraft. Task 7C: Augmentor wing cruise blowing valveless system. Volume 2: Small-scale development testing of augmentor wing critical ducting components

NASA Technical Reports Server (NTRS)

Runnels, J. N.; Gupfa, A.

1973-01-01

Augmentor wing ducting system studies conducted on a valveless system configuration that provides cruise thrust from the augmentor nozzles have shown that most of the duct system pressure loss would occur in the strut-wing duct y-junction and the wing duct-augmentor lobe nozzles. These components were selected for development testing over a range of duct Mach numbers and pressure ratios to provide a technical basis for predicting installed wing thrust loading and for evaluating design wing loading of a particular wing aspect ratios. The flow characteristics of ducting components with relatively high pressure loss coefficients were investigated. The turbulent pressure fluctuations associated with flows at high Mach numbers were analyzed to evaluate potential duct fatigue problems.

When Hearing Is Tricky: Speech Processing Strategies in Prelingually Deafened Children and Adolescents with Cochlear Implants Having Good and Poor Speech Performance

PubMed Central

Ortmann, Magdalene; Zwitserlood, Pienie; Knief, Arne; Baare, Johanna; Brinkheetker, Stephanie; am Zehnhoff-Dinnesen, Antoinette; Dobel, Christian

2017-01-01

Cochlear implants provide individuals who are deaf with access to speech. Although substantial advancements have been made by novel technologies, there still is high variability in language development during childhood, depending on adaptation and neural plasticity. These factors have often been investigated in the auditory domain, with the mismatch negativity as an index for sensory and phonological processing. Several studies have demonstrated that the MMN is an electrophysiological correlate for hearing improvement with cochlear implants. In this study, two groups of cochlear implant users, both with very good basic hearing abilities but with non-overlapping speech performance (very good or very poor speech performance), were matched according to device experience and age at implantation. We tested the perception of phonemes in the context of specific other phonemes from which they were very hard to discriminate (e.g., the vowels in /bu/ vs. /bo/). The most difficult pair was individually determined for each participant. Using behavioral measures, both cochlear implants groups performed worse than matched controls, and the good performers performed better than the poor performers. Cochlear implant groups and controls did not differ during time intervals typically used for the mismatch negativity, but earlier: source analyses revealed increased activity in the region of the right supramarginal gyrus (220–260 ms) in good performers. Poor performers showed increased activity in the left occipital cortex (220–290 ms), which may be an index for cross-modal perception. The time course and the neural generators differ from data from our earlier studies, in which the same phonemes were assessed in an easy-to-discriminate context. The results demonstrate that the groups used different language processing strategies, depending on the success of language development and the particular language context. Overall, our data emphasize the role of neural plasticity and use of adaptive strategies for successful language development with cochlear implants. PMID:28056017

A cochlear implant fabricated using a bulk silicon-surface micromachining process

NASA Astrophysics Data System (ADS)

Bell, Tracy Elizabeth

1999-11-01

This dissertation presents the design and fabrication of two generations of a silicon microelectrode array for use in a cochlear implant. A cochlear implant is a device that is inserted into the inner ear and uses electrical stimulation to provide sound sensations to the profoundly deaf. The first-generation silicon cochlear implant is a passive device fabricated using silicon microprobe technology developed at the University of Michigan. It contains twenty-two iridium oxide (IrO) stimulating sites that are 250 mum in diameter and spaced at 750 mum intervals. In-vivo recordings were made in guinea pig auditory cortex in response to electrical stimulation with this device, verifying its ability to electrically evoke an auditory response. Auditory thresholds as low as 78 muA were recorded. The second-generation implant is a thirty-two site, four-channel device with on-chip CMOS site-selection circuitry and integrated position sensing. It was fabricated using a novel bulk silicon surface micromachining process which was developed as a part of this dissertation work. While the use of semiconductor technology offers many advantages in fabricating cochlear implants over the methods currently used, it was felt that even further advantages could be gained by developing a new micromachining process which would allow circuitry to be distributed along the full length of the cochlear implant substrate. The new process uses electropolishing of an n+ bulk silicon sacrificial layer to undercut and release n- epitaxial silicon structures from the wafer. An extremely abrupt etch-stop between the n+ and n- silicon is obtained, with no electropolishing taking place in the n-type silicon that is doped lower than 1 x 1017 cm-3 in concentration. Lateral electropolishing rates of up to 50 mum/min were measured using this technique, allowing one millimeter-wide structures to be fully undercut in as little as 10 minutes. The new micromachining process was integrated with a standard p-well CMOS integrated circuit process to fabricate the second-generation active silicon cochlear implants.

The Relation Between Child Versus Parent Report of Chronic Fatigue and Language/Literacy Skills in School-Age Children with Cochlear Implants.

PubMed

Werfel, Krystal L; Hendricks, Alison Eisel

2016-01-01

Preliminary evidence suggests that children with hearing loss experience elevated levels of chronic fatigue compared with children with normal hearing. Chronic fatigue is associated with decreased academic performance in many clinical populations. Children with cochlear implants as a group exhibit deficits in language and literacy skills; however, the relation between chronic fatigue and language and literacy skills for children with cochlear implants is unclear. The purpose of this study was to explore subjective ratings of chronic fatigue by children with cochlear implants and their parents, as well as the relation between chronic fatigue and language and literacy skills in this population. Nineteen children with cochlear implants in grades 3 to 6 and one of their parents separately completed a subjective chronic fatigue scale, on which they rated how much the child experienced physical, sleep/rest, and cognitive fatigue over the past month. In addition, children completed an assessment battery that included measures of speech perception, oral language, word reading, and spelling. Children and parents reported different levels of chronic child physical and sleep/rest fatigue. In both cases, parents reported significantly less fatigue than did children. Children and parents did not report different levels of chronic child cognitive fatigue. Child report of physical fatigue was related to speech perception, language, reading, and spelling. Child report of sleep/rest and cognitive fatigue was related to speech perception and language but not to reading or spelling. Parent report of child fatigue was not related to children's language and literacy skills. Taken as a whole, results suggested that parents under-estimate the fatigue experienced by children with cochlear implants. Child report of physical fatigue was robustly related to language and literacy skills. Children with cochlear implants are likely more accurate at reporting physical fatigue than cognitive fatigue. Clinical practice should take fatigue into account when developing treatment plans for children with cochlear implants, and research should continue to develop a comprehensive model of fatigue in children with cochlear implants.

Identification of Pure-Tone Audiologic Thresholds for Pediatric Cochlear Implant Candidacy: A Systematic Review.

PubMed

de Kleijn, Jasper L; van Kalmthout, Ludwike W M; van der Vossen, Martijn J B; Vonck, Bernard M D; Topsakal, Vedat; Bruijnzeel, Hanneke

2018-05-24

Although current guidelines recommend cochlear implantation only for children with profound hearing impairment (HI) (>90 decibel [dB] hearing level [HL]), studies show that children with severe hearing impairment (>70-90 dB HL) could also benefit from cochlear implantation. To perform a systematic review to identify audiologic thresholds (in dB HL) that could serve as an audiologic candidacy criterion for pediatric cochlear implantation using 4 domains of speech and language development as independent outcome measures (speech production, speech perception, receptive language, and auditory performance). PubMed and Embase databases were searched up to June 28, 2017, to identify studies comparing speech and language development between children who were profoundly deaf using cochlear implants and children with severe hearing loss using hearing aids, because no studies are available directly comparing children with severe HI in both groups. If cochlear implant users with profound HI score better on speech and language tests than those with severe HI who use hearing aids, this outcome could support adjusting cochlear implantation candidacy criteria to lower audiologic thresholds. Literature search, screening, and article selection were performed using a predefined strategy. Article screening was executed independently by 4 authors in 2 pairs; consensus on article inclusion was reached by discussion between these 4 authors. This study is reported according to the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) statement. Title and abstract screening of 2822 articles resulted in selection of 130 articles for full-text review. Twenty-one studies were selected for critical appraisal, resulting in selection of 10 articles for data extraction. Two studies formulated audiologic thresholds (in dB HLs) at which children could qualify for cochlear implantation: (1) at 4-frequency pure-tone average (PTA) thresholds of 80 dB HL or greater based on speech perception and auditory performance subtests and (2) at PTA thresholds of 88 and 96 dB HL based on a speech perception subtest. In 8 of the 18 outcome measures, children with profound HI using cochlear implants performed similarly to children with severe HI using hearing aids. Better performance of cochlear implant users was shown with a picture-naming test and a speech perception in noise test. Owing to large heterogeneity in study population and selected tests, it was not possible to conduct a meta-analysis. Studies indicate that lower audiologic thresholds (≥80 dB HL) than are advised in current national and manufacturer guidelines would be appropriate as audiologic candidacy criteria for pediatric cochlear implantation.

Parametric model of the scala tympani for haptic-rendered cochlear implantation.

PubMed

Todd, Catherine; Naghdy, Fazel

2005-01-01

A parametric model of the human scala tympani has been designed for use in a haptic-rendered computer simulation of cochlear implant surgery. It will be the first surgical simulator of this kind. A geometric model of the Scala Tympani has been derived from measured data for this purpose. The model is compared with two existing descriptions of the cochlear spiral. A first approximation of the basilar membrane is also produced. The structures are imported into a force-rendering software application for system development.

Music Therapy for Preschool Cochlear Implant Recipients

PubMed Central

Gfeller, Kate; Driscoll, Virginia; Kenworthy, Maura; Van Voorst, Tanya

2010-01-01

This paper provides research and clinical information relevant to music therapy for preschool children who use cochlear implants (CI). It consolidates information from various disciplinary sources regarding (a) cochlear implantation of young prelingually-deaf children (~age 2-5), (b) patterns of auditory and speech-language development, and (c) research regarding music perception of children with CIs. This information serves as a foundation for the final portion of the article, which describes typical music therapy goals and examples of interventions suitable for preschool children. PMID:23904691

Development and evaluation of the Nurotron 26-electrode cochlear implant system.

PubMed

Zeng, Fan-Gang; Rebscher, Stephen J; Fu, Qian-Jie; Chen, Hongbin; Sun, Xiaoan; Yin, Li; Ping, Lichuan; Feng, Haihong; Yang, Shiming; Gong, Shusheng; Yang, Beibei; Kang, Hou-Yong; Gao, Na; Chi, Fanglu

2015-04-01

Although the cochlear implant has been widely acknowledged as the most successful neural prosthesis, only a fraction of hearing-impaired people who can potentially benefit from a cochlear implant have actually received one due to its limited awareness, accessibility, and affordability. To help overcome these limitations, a 26-electrode cochlear implant has been developed to receive China's Food and Drug Administration (CFDA) approval in 2011 and Conformité Européenne (CE) Marking in 2012. The present article describes design philosophy, system specification, and technical verification of the Nurotron device, which includes advanced digital signal processing and 4 current sources with multiple amplitude resolutions that not only are compatible with perceptual capability but also allow interleaved or simultaneous stimulation. The article also presents 3-year longitudinal evaluation data from 60 human subjects who have received the Nurotron device. The objective measures show that electrode impedance decreased within the first month of device use, but was stable until a slight increase at the end of two years. The subjective loudness measures show that electric stimulation threshold was stable while the maximal comfort level increased over the 3 years. Mandarin sentence recognition increased from the pre-surgical 0%-correct score to a plateau of about 80% correct with 6-month use of the device. Both indirect and direct comparisons indicate indistinguishable performance differences between the Nurotron system and other commercially available devices. The present 26-electrode cochlear implant has already helped to lower the price of cochlear implantation in China and will likely contribute to increased cochlear implant access and success in the rest of the world. This article is part of a Special Issue entitled . Copyright © 2014 The Authors. Published by Elsevier B.V. All rights reserved.

The Role of the World Health Organization's International Classification of Functioning, Health and Disability in Models of Infant Cochlear Implant Management

PubMed Central

Psarros, Colleen; Love, Sarah

2016-01-01

Newborn hearing screening has led to the early diagnosis of hearing loss in neonates and early device fitting is common, based primarily on electrophysiologic and radiologic information, with some supplementary behavioral measures. Such early fitting of hearing devices, in particular cochlear implants (CIs), has been beneficial to the majority of children implanted under the age of 12 months who meet the cochlear implant candidacy criteria. Comorbidities are common in children with hearing loss, although they may not be evident in neonates and may not emerge until later in infants. Evidence suggests that the child's outcomes are strongly influenced by a range of environmental factors including emotional and social support from the immediate and extended family. Consequently, such factors are important in service planning and service delivery for babies and children receiving CIs. The World Health Organization's International Classification of Functioning, Health and Disability (ICF) can provide a framework to facilitate the holistic management of pediatric cochlear implant recipients. The ICF also can be used to map the progress of recipients over time to highlight emerging issues that require intervention. This article will discuss our preliminary use of the ICF to establish clinical practice; develop advocacy skills among clients and their families; identify eligibility for services such as support in educational settings; enable access to modes of service delivery such as telepractice; provide a conceptual framework for policy and program development for pediatric cochlear implant recipients (i.e., in both disability and health services); and, most importantly, establish a clear pathway for the longitudinal management of the cochlear implant in a child's future. It is anticipated that this model will be applied to other populations receiving cochlear implants through our program. PMID:27489404

Effects of maternal sensitivity and cognitive and linguistic stimulation on cochlear implant users' language development over four years.

PubMed

Quittner, Alexandra L; Cruz, Ivette; Barker, David H; Tobey, Emily; Eisenberg, Laurie S; Niparko, John K

2013-02-01

To examine the effects of observed maternal sensitivity (MS), cognitive stimulation (CS), and linguistic stimulation on the 4-year growth of oral language in young, deaf children receiving a cochlear implant. Previous studies of cochlear implants have not considered the effects of parental behaviors on language outcomes. In this prospective, multisite study, we evaluated parent-child interactions during structured and unstructured play tasks and their effects on oral language development in 188 deaf children receiving a cochlear implant and 97 normal-hearing children as controls. Parent-child interactions were rated on a 7-point scale using the National Institute of Child Health and Human Development's Early Childcare Study codes, which have well-established psychometric properties. Language was assessed using the MacArthur Bates Communicative Development Inventories, the Reynell Developmental Language Scales, and the Comprehensive Assessment of Spoken Language. We used mixed longitudinal modeling to test our hypotheses. After accounting for early hearing experience and child and family demographics, MS and CS predicted significant increases in the growth of oral language. Linguistic stimulation was related to language growth only in the context of high MS. The magnitude of effects of MS and CS on the growth of language was similar to that found for age at cochlear implantation, suggesting that addressing parenting behaviors is a critical target for early language learning after implantation. Copyright © 2013 Mosby, Inc. All rights reserved.

The influence of cochlear implants on behaviour problems in deaf children.

PubMed

Jiménez-Romero, Ma Salud

2015-01-01

This study seeks to analyse the relationship between behaviour problems in deaf children and their auditory and communication development subsequent to cochlear implantation and to examine the incidence of these problems in comparison to their hearing peers. This study uses an ex post facto prospective design with a sample of 208 Spanish children, of whom 104 were deaf subjects with cochlear implants. The first objective assesses the relationships between behaviour problems, auditory integration, and social and communication skills in the group of deaf children. The second compares the frequency and intensity of behaviour problems of the group of deaf children with their hearing peers. The correlation analysis showed a significant association between the internal index of behaviour problems and auditory integration and communication skills, such that deaf children with greater auditory and communication development had no behaviour problems. When comparing behaviour problems in deaf children versus their hearing peers, behavioural disturbances are significantly more frequent in the former. According to these findings, cochlear implants may not guarantee adequate auditory and communicative development that would normalise the behaviour of deaf children.

Pre- and post-operative dizziness, tinnitus, and taste disturbances among cochlear implant recipients.

PubMed

Mikkelsen, K S; Ovesen, T; Swan, C Z

2017-04-01

To determine the pre- and post-operative prevalence of dizziness, tinnitus and taste disturbances in adult cochlear implant recipients. A questionnaire regarding pre- and post-operative dizziness, tinnitus and taste disturbances was sent to 170 cochlear implant recipients implanted between January 2003 and March 2009. Seventy-seven patients (41 per cent) responded. Pre-operatively, 20 per cent of the participants experienced dizziness, 52 per cent experienced tinnitus and 3 per cent experienced taste disturbances. Post-operative dizziness developed in 46 per cent of patients and resolved in the majority of these; however, 15 per cent reported dizziness more than six months after implantation. Tinnitus worsened in 25 per cent of patients, whereas 73 per cent reported attenuation or termination of tinnitus. Post-operatively, tinnitus developed in 12 per cent and taste disturbances developed in 17 per cent of the patients. The high prevalence of dizziness, tinnitus and taste disturbances reported by cochlear implant recipients necessitates that assessment of symptoms related to inner ear and chorda tympani damage are included when evaluating operative results.

Technical survey of the French role in multichannel cochlear implant development.

PubMed

Chouard, Claude-Henri

2015-06-01

The objective of this review is to remind the ENT community of the essential role of the French teams in the development and finalization of the multi-electrode cochlear implant (MCI), which has deliberately been neglected, and to repair the oblivion into which France was curiously cast at the end of the last century. It aims to underline significant scientific publications from the researchers who played key roles in the development of MCIs. In conclusion, the Parisian team of the ENT Lab in Saint Antoine Hospital in Paris can claim priority for its work in five regards. We were the first: (1) to plot in 1976 a frequency map of the whole length of three living human cochleas; (2) on September 22, 1976, to set up total cochlear implantation in a deaf adult male with eight electrodes; (3) on March 16, 1977, to apply for a patent for an implantable hearing aid in humans; (4) to describe sound signal processing (SSP) for a functional cochlear implant able to supply totally deaf patients with speech discrimination without the help of lip-reading; (5) in 1983, to experimentally demonstrate why it was necessary to place a cochlear implant as early as possible, in case of profound neonatal deafness. An injustice has occurred. These facts will be brought to the knowledge of the scientific community.

The contribution of short-term memory capacity to reading ability in adolescents with cochlear implants.

PubMed

Edwards, Lindsey; Aitkenhead, Lynne; Langdon, Dawn

2016-11-01

This study aimed to establish the relationship between short-term memory capacity and reading skills in adolescents with cochlear implants. A between-groups design compared a group of young people with cochlear implants with a group of hearing peers on measures of reading, and auditory and visual short-term memory capacity. The groups were matched for non-verbal IQ and age. The adolescents with cochlear implants were recruited from the Cochlear Implant Programme at a specialist children's hospital. The hearing participants were recruited from the same schools as those attended by the implanted adolescents. Participants were 18 cochlear implant users and 14 hearing controls, aged between 12 and 18 years. All used English as their main language and had no significant learning disability or neuro-developmental disorder. Short-term memory capacity was assessed in the auditory modality using Forward and Reverse Digit Span from the WISC IV UK, and visually using Forward and Reverse Memory from the Leiter-R. Individual word reading, reading comprehension and pseudoword decoding were assessed using the WIAT II UK. A series of ANOVAs revealed that the adolescents with cochlear implants had significantly poorer auditory short-term memory capacity and reading skills (on all measures) compared with their hearing peers. However, when Forward Digit Span was entered into the analyses as a covariate, none of the differences remained statistically significant. Deficits in immediate auditory memory persist into adolescence in deaf children with cochlear implants. Short-term auditory memory capacity is an important neurocognitive process in the development of reading skills after cochlear implantation in childhood that remains evident in later adolescence. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Cochlear Implantation in the Very Young Child: Issues Unique to the Under-1 Population

PubMed Central

Cosetti, Maura; Roland, J. Thomas

2010-01-01

Since the advent of cochlear implantation, candidacy criteria have slowly broadened to include increasingly younger patients. Spurred by evidence demonstrating both perioperative safety and significantly increased speech and language benefit with early auditory intervention, children younger than 12 months of age are now being successfully implanted at many centers. This review highlights the unique challenges involved in cochlear implantation in the very young child, specifically diagnosis and certainty of testing, anesthetic risk, surgical technique, intraoperative testing and postoperative programming, long-term safety, development of receptive and expressive language, and outcomes of speech perception. Overall, the current body of literature indicates that cochlear implantation prior to 1 year of age is both safe and efficacious. PMID:20483813

Electromagnetic propagation in PEC and absorbing curved S-ducts

NASA Technical Reports Server (NTRS)

Baumeister, Kenneth J.

1988-01-01

A finite-element Galerkin formulation has been developed to study transverse magnetic (TM) wave propagation in 2-D S-curved ducts with both perfectly conducting and absorbing walls. The reflection and transmission at the entrances and the exits of the curved ducts are determined by coupling the finite-element solutions in the curved ducts to the eigenfunctions of an infinite, uniform, perfectly conducting duct. Example solutions are presented for a double mitred and S-ducts of various lengths. The length of the S-duct is found to significantly effect the reflective characteristics of the duct. Also, the effect of curvature on an absorbing duct is illustrated.

Lexical and Grammatical Development in a Child with Cochlear Implant and Attention Deficit: A Case Study

ERIC Educational Resources Information Center

Moreno-Torres, Ignacio; Torres, Santiago; Santana, Rafael

2010-01-01

This is the first study to explore lexical and grammatical development in a deaf child diagnosed with Attention Deficit Hyperactivity Disorder, Inattentive sub-type (ADHDI). The child, whose family language was Spanish, was fitted with a cochlear implant (CI) when she was 18 months old. ADHDI, for which she was prescribed medication, was diagnosed…

Theory-of-Mind Development in Oral Deaf Children with Cochlear Implants or Conventional Hearing Aids

ERIC Educational Resources Information Center

Peterson, Candida C.

2004-01-01

Background: In the context of the established finding that theory-of-mind (ToM) growth is seriously delayed in late-signing deaf children, and some evidence of equivalent delays in those learning speech with conventional hearing aids, this study's novel contribution was to explore ToM development in deaf children with cochlear implants. Implants…

Outcomes and benefits of pediatric cochlear implantation in children with additional disabilities: a review and report of family influences on outcomes.

PubMed

Cejas, Ivette; Hoffman, Michael F; Quittner, Alexandra L

2015-01-01

The number of children with hearing loss with additional disabilities receiving cochlear implantation has increased dramatically over the past decade. However, little is known about their auditory and speech and language development following implantation. The purpose of this review is to evaluate the effects of cochlear implantation on the most common genetic and developmental disorders in children with hearing loss. Benefits of cochlear implantation for children with autism spectrum disorder, developmental delay, CHARGE syndrome, cerebral palsy, learning disorders, Usher syndrome, Waardenburg syndrome, and attention deficit/hyperactivity disorder are reviewed. Our review indicates that children with hearing loss and additional disabilities benefit from cochlear implantation, especially when implanted early. Thus, early interventions seem as important for these children as for deaf children without additional disabilities. Comparisons of outcomes across these disabilities indicate that children with little to no cognitive impairment (eg, Waardenburg sydrome, attention deficit hyperactivity disorder) have better outcomes than those with greater deficits in intellectual functioning (eg, autism, CHARGE syndrome). In addition, parents of children with hearing loss and additional disabilities report higher levels of parenting stress and greater child behavior problems than those without comorbid diagnoses. However, these parents are as sensitive when interacting with their children as parents with typically developing children using cochlear implantation. Given these results, it is critical to evaluate these children's developmental milestones to provide early implantation and intervention, appropriately counsel families regarding realistic expectations for the implant, and facilitate family adaptation.

Outcomes and benefits of pediatric cochlear implantation in children with additional disabilities: a review and report of family influences on outcomes

PubMed Central

Cejas, Ivette; Hoffman, Michael F; Quittner, Alexandra L

2015-01-01

The number of children with hearing loss with additional disabilities receiving cochlear implantation has increased dramatically over the past decade. However, little is known about their auditory and speech and language development following implantation. The purpose of this review is to evaluate the effects of cochlear implantation on the most common genetic and developmental disorders in children with hearing loss. Benefits of cochlear implantation for children with autism spectrum disorder, developmental delay, CHARGE syndrome, cerebral palsy, learning disorders, Usher syndrome, Waardenburg syndrome, and attention deficit/hyperactivity disorder are reviewed. Our review indicates that children with hearing loss and additional disabilities benefit from cochlear implantation, especially when implanted early. Thus, early interventions seem as important for these children as for deaf children without additional disabilities. Comparisons of outcomes across these disabilities indicate that children with little to no cognitive impairment (eg, Waardenburg sydrome, attention deficit hyperactivity disorder) have better outcomes than those with greater deficits in intellectual functioning (eg, autism, CHARGE syndrome). In addition, parents of children with hearing loss and additional disabilities report higher levels of parenting stress and greater child behavior problems than those without comorbid diagnoses. However, these parents are as sensitive when interacting with their children as parents with typically developing children using cochlear implantation. Given these results, it is critical to evaluate these children’s developmental milestones to provide early implantation and intervention, appropriately counsel families regarding realistic expectations for the implant, and facilitate family adaptation. PMID:29388595

Adequate formal language performance in unilateral cochlear implanted children: is it indicative of complete recovery in all linguistic domains? Insights from referential communication.

PubMed

Mancini, Patrizia; Dincer D'Alessandro, Hilal; Guerzoni, Letizia; Cuda, Domenico; Ruoppolo, Giovanni; Musacchio, Angela; Di Mario, Alessia; De Seta, Elio; Bosco, Ersilia; Nicastri, Maria

2015-04-01

Referential communication (RC) is a key element in achieving a successful communication. This case series aimed to evaluate RC in children with unilateral cochlear implants (CIs) with formal language skills within the normal range. A total of 31 children with CIs, with language development within the normal range, were assessed using the Pragmatic Language Skills test (MEDEA). Of the children with CIs, 83.9% reached performance levels appropriate for their chronological ages. The results confirmed a positive effect of cochlear implantation on RC development, although difficulties remained in some CI users. The outcomes emphasize the need to pay greater attention to the pragmatic aspects of language, assessing them with adequate testing in the early phase after cochlear implantation. Clear knowledge of children's communicative competence is the key in optimizing their communicative environments in order to create the basis for future successful interpersonal exchanges and social integration. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Acoustic theory of axisymmetric multisectioned ducts. [reduction of turbofan engine noise

NASA Technical Reports Server (NTRS)

Zorumski, W. E.

1974-01-01

Equations are developed for the acoustic field in a duct system which is made up of a number of connected circular and annular ducts. These equations are suitable for finding the acoustic field inside of and radiated from an aircraft turbofan engine. Acoustic modes are used as generalized coordinates in order to develop a set of matrix equations for the acoustic field. Equations for these modes are given for circular and annular ducts with uniform flow. Modal source equations are derived for point acoustic sources. General equations for mode transmission and reflection are developed and detailed equations are derived for ducts with multiple sections of acoustic treatment and for ducts with circumferential splitter rings. The general theory is applied to the special case of a uniform area circular duct with multisection liners and it is shown that the mode reflection effects are proportional to differences of the acoustic admittances of adjacent liners. A numerical example is given which shows that multisection liners may provide greater noise suppression than uniform liners.

Social participation of children and adolescents with cochlear implants: a qualitative analysis of parent, teacher, and child interviews.

PubMed

Punch, Renée; Hyde, Merv

2011-01-01

Psychosocial factors, including socioemotional well-being, peer relationships, and social inclusion with hearing and deaf peers, are increasingly becoming a focus of research investigating children with cochlear implants. The study reported here extends the largely quantitative findings of previous research through a qualitative analysis of interviews with parents, teachers, and pediatric cochlear implant users themselves in three eastern states of Australia. We interviewed 24 parents, 15 teachers, and 11 children and adolescents. The findings displayed commonalities across the three groups of participants, indicating positive experiences around the children's psychosocial development with their cochlear implants, but also ongoing difficulties communicating in groups of people and problems related to social skills. Some children had little contact with other deaf children (with or without cochlear implants) despite parents and teachers perceiving such contact beneficial. Children attending schools where there were other deaf children valued friendships with both deaf and hearing peers. Adolescence was a particularly difficult time for some as they struggled with feelings of self-consciousness about their deafness and external cochlear implant equipment and worries around friendships, dating, and their future place in the world. Recommendations for practice and further research are made.

A software tool for analyzing multichannel cochlear implant signals.

PubMed

Lai, Wai Kong; Bögli, Hans; Dillier, Norbert

2003-10-01

A useful and convenient means to analyze the radio frequency (RF) signals being sent by a speech processor to a cochlear implant would be to actually capture and display them with appropriate software. This is particularly useful for development or diagnostic purposes. sCILab (Swiss Cochlear Implant Laboratory) is such a PC-based software tool intended for the Nucleus family of Multichannel Cochlear Implants. Its graphical user interface provides a convenient and intuitive means for visualizing and analyzing the signals encoding speech information. Both numerical and graphic displays are available for detailed examination of the captured CI signals, as well as an acoustic simulation of these CI signals. sCILab has been used in the design and verification of new speech coding strategies, and has also been applied as an analytical tool in studies of how different parameter settings of existing speech coding strategies affect speech perception. As a diagnostic tool, it is also useful for troubleshooting problems with the external equipment of the cochlear implant systems.

Intraoperative cochlear nerve mapping with the mobile cochlear nerve compound action potential tracer in vestibular schwannoma surgery.

PubMed

Watanabe, Nobuyuki; Ishii, Takuya; Fujitsu, Kazuhiko; Kaku, Shogo; Ichikawa, Teruo; Miyahara, Kosuke; Okada, Tomu; Tanino, Shin; Uriu, Yasuhiro; Murayama, Yuichi

2018-05-18

OBJECTIVE The authors describe the usefulness and limitations of the cochlear nerve compound action potential (CNAP) mobile tracer (MCT) that they developed to aid in cochlear nerve mapping during vestibular schwannoma surgery (VSS) for hearing preservation. METHODS This MCT device requires no more than 2 seconds for stable placement on the nerve to obtain the CNAP and thus is able to trace the cochlear nerve instantaneously. Simultaneous bipolar and monopolar recording is possible. The authors present the outcomes of 18 consecutive patients who underwent preoperative useful hearing (defined as class I or II of the Gardner-Robertson classification system) and underwent hearing-preservation VSS with the use of the MCT. Mapping was considered successful when it was possible to detect and trace the cochlear nerve. RESULTS Mapping of the cochlear nerve was successful in 13 of 18 patients (72.2%), and useful hearing was preserved in 11 patients (61.1%). Among 8 patients with large tumors (Koos grade 3 or 4), the rate of successful mapping was 62.5% (5 patients). The rate of hearing preservation in patients with large tumors was 50% (4 patients). CONCLUSIONS In addition to microsurgical presumption of the arrangement of each nerve, frequent probing on and around an unidentified nerve and comparison of each waveform are advisable with the use of both more sensitive monopolar and more location-specific bipolar MCT. MCT proved to be useful in cochlear nerve mapping and may consequently be helpful in hearing preservation. The authors discuss some limitations and problems with this device.

Development of Grammatical Accuracy in English-Speaking Children with Cochlear Implants: A Longitudinal Study

ERIC Educational Resources Information Center

Guo, Ling-Yu; Spencer, Linda J.

2017-01-01

Purpose: We sought to evaluate the development of grammatical accuracy in English-speaking children with cochlear implants (CIs) over a 3-year span. Method: Ten children who received CIs before age 30 months participated in this study at 3, 4, and 5 years postimplantation. For the purpose of comparison, 10 children each at ages 3, 4, and 5 years…

Molecular characteristics and alterations during early development of the human vagina

PubMed Central

Fritsch, Helga; Richter, Elisabeth; Adam, Nadia

2012-01-01

Unresolved questions remain concerning the derivation of the vagina with respect to the relative contributions from the Müllerian ducts, the urogenital sinus, and the Wolffian ducts. Recent molecular and cellular studies in rodents have opened up a large gap between the level of understanding of vaginal development in mice and understanding of human vaginal development, which is based on histology. To compare the findings in mice with human vaginal development and to address this gap, we analysed molecular characteristics of the urogenital sinus, Wolffian ducts, and Müllerian ducts in 8–14-week-old human specimens using immunohistochemical methods. The monoclonal antibodies used were directed against cytokeratin (CK) 14, CK19, vimentin, laminin, p63, E-cadherin, caspase-3, Ki67, HOX A13, and BMP-4. The immunohistochemical analysis revealed that, during weeks 8–9, the epithelium of the Müllerian ducts became positive for p63 as p63-positive cells that originated from the sinus epithelium reached the caudal tip of the fused Müllerian ducts via the Wolffian ducts. The lumen of the fused Müllerian ducts was closed by an epithelial plug that contained both vimentin-positive and vimentin-negative cells. Subsequently, the resulting epithelial tube enlarged by proliferation of basal p63-positive cells. The first signs of squamous differentiation were detected during week 14, with the appearance of CK14-positive cells. According to our results, all three components, namely, the urogenital sinus, Wolffian ducts, and Müllerian ducts, interacted during the formation of the human vagina. The sinus epithelium provided p63-positive cells, the Wollfian ducts acted as a ‘transporter’, and the Müllerian ducts contributed the guiding structure for the vaginal anlagen. Epithelial differentiation began at the end of the period studied and extended in a caudo-cranial direction. The present study is one of the first to provide up-to-date molecular correlates for human vaginal development that can be compared with the results of cell biological studies in rodents. PMID:22256858

Building America Case Study: Compact Buried Ducts in a Hot-Humid Climate House, Lady's Island, South Carolina

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

2016-02-01

A system of compact, buried ducts provides a high-performance and cost-effective solution for delivering conditioned air throughout the building. This report outlines research activities that are expected to facilitate adoption of compact buried duct systems by builders. The results of this research would be scalable to many new house designs in most climates and markets, leading to wider industry acceptance and building code and energy program approval. The primary research question with buried ducts is potential condensation at the outer jacket of the duct insulation in humid climates during the cooling season. Current best practices for buried ducts rely onmore » encapsulating the insulated ducts with closed-cell spray polyurethane foam insulation to control condensation and improve air sealing. The encapsulated buried duct concept has been analyzed and shown to be effective in hot-humid climates. The purpose of this project is to develop an alternative buried duct system that performs effectively as ducts in conditioned space - durable, energy efficient, and cost-effective - in a hot-humid climate (IECC warm-humid climate zone 3A) with three goals that distinguish this project: 1) Evaluation of design criteria for buried ducts that use common materials and do not rely on encapsulation using spray foam or disrupt traditional work sequences, 2) Establishing design criteria for compact ducts and incorporate those with the buried duct criteria to further reduce energy losses and control installed costs, and 3) Developing HVAC design guidance for performing accurate heating and cooling load calculations for compact buried ducts.« less

Compact Buried Ducts in a Hot-Humid Climate House

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

Mallay, Dave

2016-01-07

"9A system of compact, buried ducts provides a high-performance and cost-effective solution for delivering conditioned air throughout the building. This report outlines research activities that are expected to facilitate adoption of compact buried duct systems by builders. The results of this research would be scalable to many new house designs in most climates and markets, leading to wider industry acceptance and building code and energy program approval. The primary research question with buried ducts is potential condensation at the outer jacket of the duct insulation in humid climates during the cooling season. Current best practices for buried ducts rely onmore » encapsulating the insulated ducts with closed-cell spray polyurethane foam insulation to control condensation and improve air sealing. The encapsulated buried duct concept has been analyzed and shown to be effective in hot-humid climates. The purpose of this project is to develop an alternative buried duct system that performs effectively as ducts in conditioned space - durable, energy efficient, and cost-effective - in a hot-humid climate (IECC warm-humid climate zone 3A) with three goals that distinguish this project: 1) Evaluation of design criteria for buried ducts that use common materials and do not rely on encapsulation using spray foam or disrupt traditional work sequences; 2) Establishing design criteria for compact ducts and incorporate those with the buried duct criteria to further reduce energy losses and control installed costs; 3) Developing HVAC design guidance for performing accurate heating and cooling load calculations for compact buried ducts.« less

Perception of Binaural Cues Develops in Children Who Are Deaf through Bilateral Cochlear Implantation

PubMed Central

Gordon, Karen A.; Deighton, Michael R.; Abbasalipour, Parvaneh; Papsin, Blake C.

2014-01-01

There are significant challenges to restoring binaural hearing to children who have been deaf from an early age. The uncoordinated and poor temporal information available from cochlear implants distorts perception of interaural timing differences normally important for sound localization and listening in noise. Moreover, binaural development can be compromised by bilateral and unilateral auditory deprivation. Here, we studied perception of both interaural level and timing differences in 79 children/adolescents using bilateral cochlear implants and 16 peers with normal hearing. They were asked on which side of their head they heard unilaterally or bilaterally presented click- or electrical pulse- trains. Interaural level cues were identified by most participants including adolescents with long periods of unilateral cochlear implant use and little bilateral implant experience. Interaural timing cues were not detected by new bilateral adolescent users, consistent with previous evidence. Evidence of binaural timing detection was, for the first time, found in children who had much longer implant experience but it was marked by poorer than normal sensitivity and abnormally strong dependence on current level differences between implants. In addition, children with prior unilateral implant use showed a higher proportion of responses to their first implanted sides than children implanted simultaneously. These data indicate that there are functional repercussions of developing binaural hearing through bilateral cochlear implants, particularly when provided sequentially; nonetheless, children have an opportunity to use these devices to hear better in noise and gain spatial hearing. PMID:25531107

A new computed tomography method to identify meningitis-related cochlear ossification and fibrosis before cochlear implantation.

PubMed

Ichikawa, Kazunori; Kashio, Akinori; Mori, Harushi; Ochi, Atushi; Karino, Shotaro; Sakamoto, Takashi; Kakigi, Akinobu; Yamasoba, Tatsuya

2014-04-01

To develop a new method to determine the presence of intracochlear ossification and/or fibrosis in cochlear implantation candidates with bilateral profound deafness following meningitis. Diagnostic test assessment. A university hospital. This study involved 15 ears from 13 patients with profound deafness following meningitis who underwent cochlear implantation. These ears showed normal structures, soft tissue, partial bony occlusion, and complete bony occlusion in 4, 3, 2, and 6 ears, respectively. We measured radiodensity in Hounsfield units (HU) using 0.5-mm-thick axial high-resolution computed tomography image slices at 3 different levels in the basal turn, the fenestration, and inferior and ascending segment sites, located along the electrode-insertion path. Pixel-level analysis on the DICOM viewer yielded actual computed tomography values of intracochlear soft tissues by eliminating the partial volume effect. The values were compared with the intraoperative findings. Values for ossification (n = 12) ranged from +547 HU to +1137 HU; for fibrosis (n = 11), from +154 HU to +574 HU; and for fluid (n = 22), from -49 HU to +255 HU. From these values, we developed 2 presets of window width (WW) and window level (WL): (1) WW: 1800, WL: 1100 (200 HU to 2000 HU) and (2) WW: 1500, WL: 1250 (500 HU to 2000 HU). The results using these 2 presets corresponded well to the intraoperative findings. Our new method is easy and feasible for preoperative determination of the presence of cochlear ossification and/or fibrosis that develops following meningitis.

Developmental and cell-specific expression of thyroid hormone transporters in the mouse cochlea.

PubMed

Sharlin, David S; Visser, Theo J; Forrest, Douglas

2011-12-01

Thyroid hormone is essential for the development of the cochlea and auditory function. Cochlear response tissues, which express thyroid hormone receptor β (encoded by Thrb), include the greater epithelial ridge and sensory epithelium residing inside the bony labyrinth. However, these response tissues lack direct blood flow, implying that mechanisms exist to shuttle hormone from the circulation to target tissues. Therefore, we investigated expression of candidate thyroid hormone transporters L-type amino acid transporter 1 (Lat1), monocarboxylate transporter (Mct)8, Mct10, and organic anion transporting polypeptide 1c1 (Oatp1c1) in mouse cochlear development by in situ hybridization and immunofluorescence analysis. L-type amino acid transporter 1 localized to cochlear blood vessels and transiently to sensory hair cells. Mct8 localized to the greater epithelial ridge, tympanic border cells underlying the sensory epithelium, spiral ligament fibrocytes, and spiral ganglion neurons, partly overlapping with the Thrb expression pattern. Mct10 was detected in a highly restricted pattern in the outer sulcus epithelium and weakly in tympanic border cells and hair cells. Organic anion transporting polypeptide 1c1 localized primarily to fibrocytes in vascularized tissues of the spiral limbus and spiral ligament and to tympanic border cells. Investigation of hypothyroid Tshr(-/-) mice showed that transporter expression was delayed consistent with retardation of cochlear tissue maturation but not with compensatory responses to hypothyroidism. The results demonstrate specific expression of thyroid hormone transporters in the cochlea and suggest that a network of thyroid hormone transport underlies cochlear development.

Communication Intervention for Children with Cochlear Implants: Two Case Studies.

ERIC Educational Resources Information Center

Ertmer, David J.; Leonard, Jeannette S.; Pachuilo, Michael L.

2002-01-01

This article describes the intervention programs attended and progress made by two children (ages 3 and 7) who exhibited considerable differences in benefit from their cochlear implants. Their intervention programs employed both analytical and synthetic auditory training and emphasized the development of speech production and language skills.…

Amplification, Technology, and Cochlear Implants for Infants.

ERIC Educational Resources Information Center

Adam, Arlie J.

1993-01-01

Early amplification is crucial to efficient habilitation and development of oral communication skills in hearing-impaired infants. Initial evaluation and fitting of amplification is a joint effort by the audiologist, therapist, and parents, whether the child uses traditional hearing aids or cochlear implants, and should be supplemented by a…

Speech Intelligibility and Psychosocial Functioning in Deaf Children and Teens with Cochlear Implants

ERIC Educational Resources Information Center

Freeman, Valerie; Pisoni, David B.; Kronenberger, William G.; Castellanos, Irina

2017-01-01

Deaf children with cochlear implants (CIs) are at risk for psychosocial adjustment problems, possibly due to delayed speech-language skills. This study investigated associations between a core component of spoken-language ability--speech intelligibility--and the psychosocial development of prelingually deaf CI users. Audio-transcription measures…

Children's language development after cochlear implantation: a literature review.

PubMed

Monteiro, Clarice Gomes; Cordeiro, Ana Augusta de Andrade; Silva, Hilton Justino da; Queiroga, Bianca Arruda Manchester de

2016-01-01

review the literature for studies that describe the language development of children after they receive cochlear implants. Literature review on the PubMed, Web of Science, Scopus, and Science Direct databases, tracing the selection and critical analysis stages in the journals found and selected. We selected original articles looking at children with cochlear implants, which mentioned language development after surgery. Case studies, dissertations, books chapters, editorials, and original articles that did not mention aspects of oral communication development, perception of sounds and speech, and other stages of human development, in the title, abstract, or text, were excluded. A protocol was created for this study including the following points: author, year, location, sample, type of study, objectives, methods used, main results, and conclusion. 5,052 articles were found based on the search descriptors and free terms. Of this total, 3,414 were excluded due to the title, 1,245 due to the abstract, and 358 from reading the full text; we selected 35, of which 28 were repeated. In the end, seven articles were analyzed in this review. We conclude that cochlear implant users have slower linguistic and educational development than their peers with normal hearing - though they are better than conventional prostheses users - and they are able to match them over time. There is great variability in the test methodologies, thus reducing the effectiveness and reliability of the results found.

Acoustic radiation from lined, unflanged ducts: Acoustic source distribution program

NASA Technical Reports Server (NTRS)

Beckemeyer, R. J.; Sawdy, D. T.

1971-01-01

An acoustic radiation analysis was developed to predict the far-field characteristics of fan noise radiated from an acoustically lined unflanged duct. This analysis is comprised of three modular digital computer programs which together provide a capability of accounting for the impedance mismatch at the duct exit plane. Admissible duct configurations include circular or annular, with or without an extended centerbody. This variation in duct configurations provides a capability of modeling inlet and fan duct noise radiation. The computer programs are described in detail.

The transmission of sound in nonuniform ducts. [carrying steady, compressible flow

NASA Technical Reports Server (NTRS)

Eversman, W.

1975-01-01

The method of weighted residuals in the form of a modified Galerkin method with boundary residuals was developed for the study of the transmission of sound in nonuniform ducts carrying a steady, compressible flow. In this development, the steady flow was modeled as essentially one dimensional but with a kinematic modification to force tangency of the flow at the duct walls. Three forms of the computational scheme were developed using for basis functions (1) the no-flow uniform duct modes, (2) positive running uniform duct modes, with flow, and (3) positive and negative running uniform duct modes, with flow. The formulation using the no-flow modes was the most highly developed, and has advantages primarily due to relative computational simplicity. Results using the three methods are shown to converge to known solutions for several special cases, and the most significant check case is against low frequency, one dimensional results over the complete subsonic Mach number range. Development of the method is continuing, with emphasis on assessing the relative accuracy and efficiency of the three implementations.

Parametric study of electromagnetic waves propagating in absorbing curved S ducts

NASA Technical Reports Server (NTRS)

Baumeister, Kenneth J.

1989-01-01

A finite-element Galerkin formulation has been developed to study attenuation of transverse magnetic (TM) waves propagating in two-dimensional S-curved ducts with absorbing walls. In the frequency range where the duct diameter and electromagnetic wave length are nearly equal, the effect of duct length, curvature (duct offset), and absorber wall thickness was examined. For a given offset in the curved duct, the length of the S-duct was found to significantly affect both the absorptive and reflective characteristics of the duct. For a straight and a curved duct with perfect electric conductor terminations, power attenuation contours were examined to determine electromagnetic wall properties associated with maximum input signal absorption. Offset of the S-duct was found to significantly affect the value of the wall permittivity associated with the optimal attenuation of the incident electromagnetic wave.

Biliary intraductal papillary neoplasm with metachronous multiple tumors - true multicentric tumors or intrabiliary dissemination: A case report and review of the literature.

PubMed

Yokode, Masataka; Yamashita, Yukimasa; Zen, Yoh

2017-03-01

Intraductal papillary neoplasms of the bile duct (IPNBs) are recognized as a distinct type of biliary tumor. We herein discuss the possible mechanisms underlying the development of multiple tumors in patients with IPNBs through a case presentation and literature review. A 64-year-old woman initially underwent extended right hepatectomy for IPNB in the right hepatic duct. Although the surgical margin of the common bile duct was tumor-free, recurrence was detected in the intrapancreatic bile duct 26 months later. Both tumors had similar histopathological characteristics (intestinal-type IPNB with high-grade dysplasia, but no invasive cancer). A literature review identified 9 additional cases of multiple IPNBs. Unlike conventional IPNBs, which typically affect the intrahepatic or hilar bile duct, 80% of recurrent multiple tumors developed in the extrahepatic bile duct. Although multicentric tumors have been suggested in such cases, the intrabiliary dissemination of tumor cells appears to be more likely, as the majority of recurrent tumors develop in more distal parts of the bile duct compared with the primary tumor.

The auditory nerve overlapped waveform (ANOW): A new objective measure of low-frequency hearing

NASA Astrophysics Data System (ADS)

Lichtenhan, Jeffery T.; Salt, Alec N.; Guinan, John J.

2015-12-01

One of the most pressing problems today in the mechanics of hearing is to understand the mechanical motions in the apical half of the cochlea. Almost all available measurements from the cochlear apex of basilar membrane or other organ-of-Corti transverse motion have been made from ears where the health, or sensitivity, in the apical half of the cochlea was not known. A key step in understanding the mechanics of the cochlear base was to trust mechanical measurements only when objective measures from auditory-nerve compound action potentials (CAPs) showed good preparation sensitivity. However, such traditional objective measures are not adequate monitors of cochlear health in the very low-frequency regions of the apex that are accessible for mechanical measurements. To address this problem, we developed the Auditory Nerve Overlapped Waveform (ANOW) that originates from auditory nerve output in the apex. When responses from the round window to alternating low-frequency tones are averaged, the cochlear microphonic is canceled and phase-locked neural firing interleaves in time (i.e., overlaps). The result is a waveform that oscillates at twice the probe frequency. We have demonstrated that this Auditory Nerve Overlapped Waveform - called ANOW - originates from auditory nerve fibers in the cochlear apex [8], relates well to single-auditory-nerve-fiber thresholds, and can provide an objective estimate of low-frequency sensitivity [7]. Our new experiments demonstrate that ANOW is a highly sensitive indicator of apical cochlear function. During four different manipulations to the scala media along the cochlear spiral, ANOW amplitude changed when either no, or only small, changes occurred in CAP thresholds. Overall, our results demonstrate that ANOW can be used to monitor cochlear sensitivity of low-frequency regions during experiments that make apical basilar membrane motion measurements.

A longitudinal study of the bilateral benefit in children with bilateral cochlear implants.

PubMed

Asp, Filip; Mäki-Torkko, Elina; Karltorp, Eva; Harder, Henrik; Hergils, Leif; Eskilsson, Gunnar; Stenfelt, Stefan

2015-02-01

To study the development of the bilateral benefit in children using bilateral cochlear implants by measurements of speech recognition and sound localization. Bilateral and unilateral speech recognition in quiet, in multi-source noise, and horizontal sound localization was measured at three occasions during a two-year period, without controlling for age or implant experience. Longitudinal and cross-sectional analyses were performed. Results were compared to cross-sectional data from children with normal hearing. Seventy-eight children aged 5.1-11.9 years, with a mean bilateral cochlear implant experience of 3.3 years and a mean age of 7.8 years, at inclusion in the study. Thirty children with normal hearing aged 4.8-9.0 years provided normative data. For children with cochlear implants, bilateral and unilateral speech recognition in quiet was comparable whereas a bilateral benefit for speech recognition in noise and sound localization was found at all three test occasions. Absolute performance was lower than in children with normal hearing. Early bilateral implantation facilitated sound localization. A bilateral benefit for speech recognition in noise and sound localization continues to exist over time for children with bilateral cochlear implants, but no relative improvement is found after three years of bilateral cochlear implant experience.

Developmental dysgraphia with profound hearing impairment: intervention by auditory methods enabled by cochlear implant.

PubMed

Fukushima, Kunihiro; Kawasaki, Akihiro; Nagayasu, Rie; Kunisue, Kazuya; Maeda, Yukihide; Kariya, Shin; Kataoka, Yuko; Nishizaki, Kazunori

2008-06-01

Learning disability combined with hearing impairment (LDHI) is a poor prognostic factor for the language development of hearing impaired children after educational intervention. A typical example of a child with LDHI and effective interventions provided by cochlear implants are presented in this report. A case of congenital cytomegaloviral infection that showed dysgraphia as well as profound deafness was reported and an underlying visual processing problem diagnosed in the present case caused the patient's dysgraphia. The dysgraphia could be circumvented by the use of auditory memory fairly established by a cochlear implant.

Infant-Directed Speech Enhances Attention to Speech in Deaf Infants with Cochlear Implants

ERIC Educational Resources Information Center

Wang, Yuanyuan; Bergeson, Tonya R.; Houston, Derek M.

2017-01-01

Purpose: Both theoretical models of infant language acquisition and empirical studies posit important roles for attention to speech in early language development. However, deaf infants with cochlear implants (CIs) show reduced attention to speech as compared with their peers with normal hearing (NH; Horn, Davis, Pisoni, & Miyamoto, 2005;…

Implants and Ethnocide: Learning from the Cochlear Implant Controversy

ERIC Educational Resources Information Center

Sparrow, Robert

2010-01-01

This paper uses the fictional case of the "Babel fish" to explore and illustrate the issues involved in the controversy about the use of cochlear implants in prelinguistically deaf children. Analysis of this controversy suggests that the development of genetic tests for deafness poses a serious threat to the continued flourishing of Deaf…

Changing Realities in the Classroom for Hearing-Impaired Children with Cochlear Implant

ERIC Educational Resources Information Center

Vermeulen, Anneke; De Raeve, Leo; Langereis, Margreet; Snik, Ad

2012-01-01

Auditory perception with cochlear implants (CIs) enables the majority of deaf children with normal learning potential to develop (near) age-appropriate spoken language. As a consequence, a large proportion of children now attend mainstream education from an early stage. The acoustical environment in kindergartens and schools, however, might be…

The Emergence of Productive Speech and Language in Spanish-Learning Paediatric Cochlear Implant Users

ERIC Educational Resources Information Center

Moreno-Torres, Ignacio

2014-01-01

It has been proposed that cochlear implant users may develop robust categorical perception skills, but that they show limited precision in perception. This article explores if a parallel contrast is observable in production, and if, despite acquiring typical linguistic representations, their early words are inconsistent. The participants were…

Word Learning in Children following Cochlear Implantation

ERIC Educational Resources Information Center

Houston, Derek M.; Carter, Allyson K.; Pisoni, David B.; Kirk, Karen Iler; Ying, Elizabeth A.

2005-01-01

An experimental procedure was developed to investigate word-learning skills of children who use cochlear implants (CIs). Using interactive play scenarios, 2- to 5-year olds were presented with sets of objects (Beanie Baby stuffed animals) and words for their names that corresponded to salient perceptual attributes (e.g., "horns" for a goat). Their…

Communication with Deaf Pre-School Children Using Cochlear Implants.

ERIC Educational Resources Information Center

Tvingstedt, A. L.; Preisler, G.; Ahlstrom, M.

This study evaluated the communicative, social, and emotional development of 22 deaf Swedish pre-school children with cochlear implants over a 2-year period. Video-recordings (every 3 months) and observations of the children in natural interactional settings at home and school as well as interviews with parents and teachers provided the study…

Development of HEATHER for cochlear implant stimulation using a new modeling workflow.

PubMed

Tran, Phillip; Sue, Andrian; Wong, Paul; Li, Qing; Carter, Paul

2015-02-01

The current conduction pathways resulting from monopolar stimulation of the cochlear implant were studied by developing a human electroanatomical total head reconstruction (namely, HEATHER). HEATHER was created from serially sectioned images of the female Visible Human Project dataset to encompass a total of 12 different tissues, and included computer-aided design geometries of the cochlear implant. Since existing methods were unable to generate the required complexity for HEATHER, a new modeling workflow was proposed. The results of the finite-element analysis agree with the literature, showing that the injected current exits the cochlea via the modiolus (14%), the basal end of the cochlea (22%), and through the cochlear walls (64%). It was also found that, once leaving the cochlea, the current travels to the implant body via the cranial cavity or scalp. The modeling workflow proved to be robust and flexible, allowing for meshes to be generated with substantial user control. Furthermore, the workflow could easily be employed to create realistic anatomical models of the human head for different bioelectric applications, such as deep brain stimulation, electroencephalography, and other biophysical phenomena.

Microsurgical laser Doppler probe for simultaneous intraoperative monitoring of cochlear blood flow and electrocochleography from the round window

NASA Astrophysics Data System (ADS)

Abiy, Lidet; Telischi, Fred; Parel, Jean-Marie A.; Manns, Fabrice; Saettele, Ralph; Morawski, Krzysztof; Ozdamar, Ozcan; Borgos, John; Delgado, Rafael; Miskiel, Edward; Yavuz, Erdem

2003-06-01

The aim of this project is the development of a microsurgical laser Doppler (LD) probe that simultaneously monitors blood flow and Electrocochleography (ECochG) from the round window of the ear. The device will prevent neurosensory hearing loss during acoustic neuroma surgery by preventing damage to the internal auditory nerve and to the cochlear blood flow supply. A commercially available 0.5 mm diameter Laser-Doppler velocimetry probe (LaserFlo, Vasamedics) was modified to integrate an ECochG electrode. A tube for suction and irrigation was incorporated into a sheath of the probe shaft, to facilitate cleaning of the round window (RW) and allow drug delivery to the round window membrane. The prototype microprobe was calibrated on a single vessel model and tested in vivo in a rabbit model. Preliminary results indicate that the microprobe was able to measure changes in cochlear blood flow (CBF) and ECochG potentials from the round window of rabbits in vivo. The microprobe is suitable for monitoring cochlear blood flow and auditory cochlear potentials during human surgery.

Minimally invasive surgical method to detect sound processing in the cochlear apex by optical coherence tomography

NASA Astrophysics Data System (ADS)

Ramamoorthy, Sripriya; Zhang, Yuan; Petrie, Tracy; Fridberger, Anders; Ren, Tianying; Wang, Ruikang; Jacques, Steven L.; Nuttall, Alfred L.

2016-02-01

Sound processing in the inner ear involves separation of the constituent frequencies along the length of the cochlea. Frequencies relevant to human speech (100 to 500 Hz) are processed in the apex region. Among mammals, the guinea pig cochlear apex processes similar frequencies and is thus relevant for the study of speech processing in the cochlea. However, the requirement for extensive surgery has challenged the optical accessibility of this area to investigate cochlear processing of signals without significant intrusion. A simple method is developed to provide optical access to the guinea pig cochlear apex in two directions with minimal surgery. Furthermore, all prior vibration measurements in the guinea pig apex involved opening an observation hole in the otic capsule, which has been questioned on the basis of the resulting changes to cochlear hydrodynamics. Here, this limitation is overcome by measuring the vibrations through the unopened otic capsule using phase-sensitive Fourier domain optical coherence tomography. The optically and surgically advanced method described here lays the foundation to perform minimally invasive investigation of speech-related signal processing in the cochlea.

PubMed

de Quadros, Ronice Müller; Cruz, Carina Rebello; Pizzio, Aline Lemos

2012-01-01

This study compared the performance in phonological memory tasks of bimodal bilíngual hearing children (children of deaf parents) and deaf children with cochlear implant (children of deaf parents and hearing parents), with different contexts of access to Brazilian Sign Language (Libras). We used two tests: Portuguêse Pseudowords (Santos and Bueno, 2003) and Libras Pseudosigns (developed by researchers from Development Bimodal Bilíngual Project). Moreover, we included two control groups, one of deaf children, growing up with Libras, with deaf parents, and the other of hearing adults Codas, bimodal bilínguals, with deaf parents. In the analysis of the results, initially, in regard to the performance among the groups tested, it was found that the bimodal bilíngual children had higher scores in both tests. However, when we analyzed the performance of the deaf child with cochlear implant, with deaf parents, with full access to sign language, compared to the other children with cochlear implant, with restricted access to Libras, we found that this child has a similar performance to the Coda children. The cochlear-implanted children with restricted access to Libras, therefore with more access to Portuguêse, had lower scores in both tests, being the worst score for the Portuguêse test. The results shown that children with cochlear implant can have benefits when they have access to Libras, having similar performances to hearing bimodal bilíngual children.

Developing flow in S-shaped ducts. 2: Circular cross-section duct

NASA Technical Reports Server (NTRS)

Taylor, A. M. K. P.; Whitelaw, J. H.; Yianneskis, M.

1984-01-01

Laser-Doppler velocimetry measured the laminar and turbulent streamwise flow in a S-duct. The wall pressure distribution and one component of cross-stream velocity were also obtained for the turbulent flow case. Boundary layers near the duct inlet were about 25 percent of the hydraulic diameter in the laminar flow and varied around the periphery of the pipe between 10 percent and 20 percent in turbulent flow. Pressure-driven secondary flows develop in the first half of the S-duct and are attenuated and reversed in the second half. For both Reynolds numbers there is a region near the outer wall of the second half of the duct where the sign of the radial vorticity results in an enforcement of the secondary flow which was established in the first half of the S-duct. The core flow migrates, for both Reynolds numbers, to the outside wall of the first half and lies towards the inside wall of the second half of the S-duct at the outlet. The thinner inlet boundary layers in the turbulent flow give rise to weaker secondary motion.

Ducted turbine theory with right angled ducts

NASA Astrophysics Data System (ADS)

McLaren-Gow, S.; Jamieson, P.; Graham, J. M. R.

2014-06-01

This paper describes the use of an inviscid approach to model a ducted turbine - also known as a diffuser augmented turbine - and a comparison of results with a particular one-dimensional theory. The aim of the investigation was to gain a better understanding of the relationship between a real duct and the ideal diffuser, which is a concept that is developed in the theory. A range of right angled ducts, which have a rim for a 90° exit angle, were modelled. As a result, the performance of right angled ducts has been characterised in inviscid flow. It was concluded that right angled ducts cannot match the performance of their associated ideal diffuser and that the optimum rotor loading for these turbines varies with the duct dimensions.

A Micro-Ethnographic Study of the Communication/Language Development in a Japanese Child with Profound Hearing Loss before and after Cochlear Implantation

ERIC Educational Resources Information Center

Kretschmer, Richard R.; Kretschmer, Laura; Kuwahara, Katsura; Truax, Roberta

2010-01-01

This study described the communication and spoken language development of a Japanese girl with profound hearing loss who used a cochlear implant from 19 months of age. The girl, Akiko, was born in Belgium where her family was living at that time. After she was identified as deaf at birth, she and her parents were provided with support services.…

Development of the genital ducts and external genitalia in the early human embryo.

PubMed

Sajjad, Yasmin

2010-10-01

The course of development of the human genital tract is undifferentiated to the 9th week of development. At this time two symmetrical paired ducts known as the mesonephric (MD) and paramesonephric ducts (PMD) are present, which together with the urogenital sinus provide the tissue sources for internal and external genital development. Normal differentiation of the bipotential external genitalia and reproductive ducts are dependent upon the presence or absence of certain hormones. Masculinization of the internal and external genitalia during fetal development depends on the existence of two discrete testicular hormones. Testosterone secreted from Leydig cells induces the differentiation of the mesonephric ducts into the epididymis, vasa deferentia and seminal vesicles, whereas anti-Müllerian hormone (AMH) produced by Sertoli cells induces the regression of the paramesonephric ducts. The absence of AMH action in early fetal life results in the formation of the fallopian tubes, uterus and upper third of the vagina. In some target tissues, testosterone is converted to dihydrotestosterone, which is responsible for the masculinization of the urogenital sinus and external genitalia. © 2010 The Author. Journal of Obstetrics and Gynaecology Research © 2010 Japan Society of Obstetrics and Gynecology.

Developmental and Cell-Specific Expression of Thyroid Hormone Transporters in the Mouse Cochlea

PubMed Central

Sharlin, David S.; Visser, Theo J.

2011-01-01

Thyroid hormone is essential for the development of the cochlea and auditory function. Cochlear response tissues, which express thyroid hormone receptor β (encoded by Thrb), include the greater epithelial ridge and sensory epithelium residing inside the bony labyrinth. However, these response tissues lack direct blood flow, implying that mechanisms exist to shuttle hormone from the circulation to target tissues. Therefore, we investigated expression of candidate thyroid hormone transporters L-type amino acid transporter 1 (Lat1), monocarboxylate transporter (Mct)8, Mct10, and organic anion transporting polypeptide 1c1 (Oatp1c1) in mouse cochlear development by in situ hybridization and immunofluorescence analysis. L-type amino acid transporter 1 localized to cochlear blood vessels and transiently to sensory hair cells. Mct8 localized to the greater epithelial ridge, tympanic border cells underlying the sensory epithelium, spiral ligament fibrocytes, and spiral ganglion neurons, partly overlapping with the Thrb expression pattern. Mct10 was detected in a highly restricted pattern in the outer sulcus epithelium and weakly in tympanic border cells and hair cells. Organic anion transporting polypeptide 1c1 localized primarily to fibrocytes in vascularized tissues of the spiral limbus and spiral ligament and to tympanic border cells. Investigation of hypothyroid Tshr−/− mice showed that transporter expression was delayed consistent with retardation of cochlear tissue maturation but not with compensatory responses to hypothyroidism. The results demonstrate specific expression of thyroid hormone transporters in the cochlea and suggest that a network of thyroid hormone transport underlies cochlear development. PMID:21878515

The Development of Auditory Perception in Children Following Auditory Brainstem Implantation

PubMed Central

Colletti, Liliana; Shannon, Robert V.; Colletti, Vittorio

2014-01-01

Auditory brainstem implants (ABI) can provide useful auditory perception and language development in deaf children who are not able to use a cochlear implant (CI). We prospectively followed-up a consecutive group of 64 deaf children up to 12 years following ABI implantation. The etiology of deafness in these children was: cochlear nerve aplasia in 49, auditory neuropathy in 1, cochlear malformations in 8, bilateral cochlear post-meningitic ossification in 3, NF2 in 2, and bilateral cochlear fractures due to a head injury in 1. Thirty five children had other congenital non-auditory disabilities. Twenty two children had previous CIs with no benefit. Fifty eight children were fitted with the Cochlear 24 ABI device and six with the MedEl ABI device and all children followed the same rehabilitation program. Auditory perceptual abilities were evaluated on the Categories of Auditory Performance (CAP) scale. No child was lost to follow-up and there were no exclusions from the study. All children showed significant improvement in auditory perception with implant experience. Seven children (11%) were able to achieve the highest score on the CAP test; they were able to converse on the telephone within 3 years of implantation. Twenty children (31.3%) achieved open set speech recognition (CAP score of 5 or greater) and 30 (46.9%) achieved a CAP level of 4 or greater. Of the 29 children without non-auditory disabilities, 18 (62%) achieved a CAP score of 5 or greater with the ABI. All children showed continued improvements in auditory skills over time. The long-term results of ABI implantation reveal significant auditory benefit in most children, and open set auditory recognition in many. PMID:25377987

New Criteria of Indication and Selection of Patients to Cochlear Implant

PubMed Central

Sampaio, André L. L.; Araújo, Mercêdes F. S.; Oliveira, Carlos A. C. P.

2011-01-01

Numerous changes continue to occur in cochlear implant candidacy. In general, these have been accompanied by concomitant and satisfactory changes in surgical techniques. Together, this has advanced the utility and safety of cochlear implantation. Most devices are now approved for use in patients with severe to profound unilateral hearing loss rather then the prior requirement of a bilateral profound loss. Furthermore, studies have begun utilizing short electrode arrays for shallow insertion in patients with considerable low-frequency residual hearing. This technique will allow the recipient to continue to use acoustically amplified hearing for the low frequencies simultaneously with a cochlear implant for the high frequencies. The advances in design of, and indications for, cochlear implants have been matched by improvements in surgical techniques and decrease in complications. The resulting improvements in safety and efficacy have further encouraged the use of these devices. This paper will review the new concepts in the candidacy of cochlear implant. Medline data base was used to search articles dealing with the following topics: cochlear implant in younger children, cochlear implant and hearing preservation, cochlear implant for unilateral deafness and tinnitus, genetic hearing loss and cochlear implant, bilateral cochlear implant, neuropathy and cochlear implant and neural plasticity, and the selection of patients for cochlear implant. PMID:22013448

Impact of early hearing screening and treatment on language development and education level: evaluation of 6 years of universal newborn hearing screening (ALGO) in Flanders, Belgium.

PubMed

Verhaert, N; Willems, M; Van Kerschaver, E; Desloovere, C

2008-05-01

Early intervention in hearing-impaired children may improve language outcomes and subsequent school and occupational performance. The objective of this study was to retrospectively analyze over 6 years the educational outcome and language development of a first cohort of children, detected by the Flemish universal newborn hearing screening (UNHS) program based on automated auditory brainstem response (AABR), with the oldest children being in primary school. We studied 229 hearing-impaired children from 1998 till 2003. The following variables were considered: the age during the school year 2005-2006, the degree of hearing loss, additional impairments including presence of intellectual disability, school placement and early intervention. Analysis showed that 85.4% of the children with moderate, severe or profound hearing loss and no additional disability, older than 5.5 years, reach mainstream education. Further detailed description was provided for the outcomes of children with uni- and bilateral cochlear implants. Overall results stress that 46% of all children with a cochlear implant obtain mainstream education. Of all cochlear implant (CI) children above 5.5 years, without additional handicaps, 78.9% of children attend primary mainstream school. Data on language development show that up to 45% of the children with unilateral cochlear implant and no additional disabilities had normal to slight delay on language development. These data are fulfilling the goals stated by the JCIH and the American Academy of Pediatrics (AAP) in 2000. The role and impact of additional handicaps is discussed. The importance of early hearing loss identification and hearing therapy for appropriate language development is highlighted. Finally our preliminary results on children with bilateral cochlear implants without additional handicaps present an improved language development in comparison to unilateral CI-children. A vast majority of the children detected by the UNHS program, with moderate, severe or profound hearing loss and no additional disability, older than 5.5 years, reach mainstream education. Additional disabilities have a major influence.

Children’s development of intonation during the first year of cochlear implant experience

PubMed Central

Snow, David P.; Ertmer, David J.

2012-01-01

This article describes the longitudinal development of intonation in 18 deaf children who received cochlear implants (CIs) before the age of three years and 12 infants with typical development (TD) who served as controls. At the time their implants were activated, the children with CIs ranged in age from 9 to 36 months. Cross-group comparisons were made when the children had equivalent amounts of robust hearing experience but different chronological ages. This paper reports the results for the 6-month period ending 9 months after activation of the child’s device for children with CIs, and the 6-month period ending at 12 months of age for TD infants. The findings were compared to a model of early intonation development in children with normal hearing. The results indicated that all groups progressed through 1 or more of the stages predicted by the normative model. At the end of the study period, however, children who had received a cochlear implant later than 24 months reached a more mature stage of intonation development than younger CI-recipients. Moreover, the older CI group reached the same stage of development as the TD infants who had 3 additional months of language listening experience. The findings suggest that the developmental advantage which older children had previously demonstrated shortly after activation of their CIs is maintained throughout most or all of the first year of cochlear implant use. PMID:21728834

Elevated Plasma IL-6 Associates with Increased Risk of Advanced Fibrosis and Cholangiocarcinoma in Individuals Infected by Opisthorchis viverrini

PubMed Central

Sripa, Banchob; Thinkhamrop, Bandit; Mairiang, Eimorn; Laha, Thewarach; Kaewkes, Sasithorn; Sithithaworn, Paiboon; Periago, Maria Victoria; Bhudhisawasdi, Vajarabhongsa; Yonglitthipagon, Ponlapat; Mulvenna, Jason; Brindley, Paul J.; Loukas, Alex; Bethony, Jeffrey M.

2012-01-01

Opisthorchis viverrini is considered among the most important of the food-borne trematodes due to its strong association with advanced periductal fibrosis and bile duct cancer (cholangiocarcinoma). We investigated the relationship between plasma levels of Interleukin (IL)-6 and the risk of developing advanced fibrosis and bile duct cancer from chronic Opisthorchis infection. We show that IL-6 circulates in plasma at concentrations 58 times higher in individuals with advanced fibrosis than age, sex, and nearest-neighbor matched controls and 221 times higher in individuals with bile duct cancer than controls. We also observed a dose-response relationship between increasing levels of plasma IL-6 and increasing risk of advanced fibrosis and bile duct cancer; for example, in age and sex adjusted analyses, individuals with the highest quartiles of plasma IL-6 had a 19 times greater risk of developing advanced periductal fibrosis and a 150 times greater risk of developing of bile duct cancer than individuals with no detectable level of plasma IL-6. Finally, we show that a single plasma IL-6 measurement has excellent positive predictive value for the detection of both advanced bile duct fibrosis and bile duct cancer in regions with high O. viverrini transmission. These data support our hypothesis that common mechanisms drive bile duct fibrosis and bile duct tumorogenesis from chronic O. viverrini infection. Our study also adds a unique aspect to the literature on circulating levels of IL-6 as an immune marker of hepatobiliary pathology by showing that high levels of circulating IL-6 in plasma are not related to infection with O. viverrini, but to the development of the advanced and often lethal pathologies resulting from chronic O. viverrini infection. PMID:22629477

Design and Evaluation of a Personal Digital Assistant-based Research Platform for Cochlear Implants

PubMed Central

Ali, Hussnain; Lobo, Arthur P.; Loizou, Philipos C.

2014-01-01

This paper discusses the design, development, features, and clinical evaluation of a personal digital assistant (PDA)-based platform for cochlear implant research. This highly versatile and portable research platform allows researchers to design and perform complex experiments with cochlear implants manufactured by Cochlear Corporation with great ease and flexibility. The research platform includes a portable processor for implementing and evaluating novel speech processing algorithms, a stimulator unit which can be used for electrical stimulation and neurophysio-logic studies with animals, and a recording unit for collecting electroencephalogram/evoked potentials from human subjects. The design of the platform for real time and offline stimulation modes is discussed for electric-only and electric plus acoustic stimulation followed by results from an acute study with implant users for speech intelligibility in quiet and noisy conditions. The results are comparable with users’ clinical processor and very promising for undertaking chronic studies. PMID:23674422

Spectral-Temporal Modulated Ripple Discrimination by Children With Cochlear Implants.

PubMed

Landsberger, David M; Padilla, Monica; Martinez, Amy S; Eisenberg, Laurie S

A postlingually implanted adult typically develops hearing with an intact auditory system, followed by periods of deafness (or near deafness) and adaptation to the implant. For an early implanted child whose brain is highly plastic, the auditory system matures with consistent input from a cochlear implant. It is likely that the auditory system of early implanted cochlear implant users is fundamentally different than postlingually implanted adults. The purpose of this study is to compare the basic psychophysical capabilities and limitations of these two populations on a spectral resolution task to determine potential effects of early deprivation and plasticity. Performance on a spectral resolution task (Spectral-temporally Modulated Ripple Test [SMRT]) was measured for 20 bilaterally implanted, prelingually deafened children (between 5 and 13 years of age) and 20 hearing children within the same age range. Additionally, 15 bilaterally implanted, postlingually deafened adults, and 10 hearing adults were tested on the same task. Cochlear implant users (adults and children) were tested bilaterally, and with each ear alone. Hearing listeners (adults and children) were tested with the unprocessed SMRT and with a vocoded version that simulates an 8-channel cochlear implant. For children with normal hearing, a positive correlation was found between age and SMRT score for both the unprocessed and vocoded versions. Older hearing children performed similarly to hearing adults in both the unprocessed and vocoded test conditions. However, for children with cochlear implants, no significant relationship was found between SMRT score and chronological age, age at implantation, or years of implant experience. Performance by children with cochlear implants was poorer than performance by cochlear implanted adults. It was also found that children implanted sequentially tended to have better scores with the first implant compared with the second implant. This difference was not observed for adults. An additional finding was that SMRT score was negatively correlated with age for adults with implants. Results from this study suggest that basic psychophysical capabilities of early implanted children and postlingually implanted adults differ when assessed in the sound field using their personal implant processors. Because spectral resolution does not improve with age for early implanted children, it seems likely that the sparse representation of the signal provided by a cochlear implant limits spectral resolution development. These results are supported by the finding that postlingually implanted adults, whose auditory systems matured before the onset of hearing loss, perform significantly better than early implanted children on the spectral resolution test.

Development and validation of the University of Washington Clinical Assessment of Music Perception test.

PubMed

Kang, Robert; Nimmons, Grace Liu; Drennan, Ward; Longnion, Jeff; Ruffin, Chad; Nie, Kaibao; Won, Jong Ho; Worman, Tina; Yueh, Bevan; Rubinstein, Jay

2009-08-01

Assessment of cochlear implant outcomes centers around speech discrimination. Despite dramatic improvements in speech perception, music perception remains a challenge for most cochlear implant users. No standardized test exists to quantify music perception in a clinically practical manner. This study presents the University of Washington Clinical Assessment of Music Perception (CAMP) test as a reliable and valid music perception test for English-speaking, adult cochlear implant users. Forty-two cochlear implant subjects were recruited from the University of Washington Medical Center cochlear implant program and referred by two implant manufacturers. Ten normal-hearing volunteers were drawn from the University of Washington Medical Center and associated campuses. A computer-driven, self-administered test was developed to examine three specific aspects of music perception: pitch direction discrimination, melody recognition, and timbre recognition. The pitch subtest used an adaptive procedure to determine just-noticeable differences for complex tone pitch direction discrimination within the range of 1 to 12 semitones. The melody and timbre subtests assessed recognition of 12 commonly known melodies played with complex tones in an isochronous manner and eight musical instruments playing an identical five-note sequence, respectively. Testing was repeated for cochlear implant subjects to evaluate test-retest reliability. Normal-hearing volunteers were also tested to demonstrate differences in performance in the two populations. For cochlear implant subjects, pitch direction discrimination just-noticeable differences ranged from 1 to 8.0 semitones (Mean = 3.0, SD = 2.3). Melody and timbre recognition ranged from 0 to 94.4% correct (mean = 25.1, SD = 22.2) and 20.8 to 87.5% (mean = 45.3, SD = 16.2), respectively. Each subtest significantly correlated at least moderately with both Consonant-Nucleus-Consonant (CNC) word recognition scores and spondee recognition thresholds in steady state noise and two-talker babble. Intraclass coefficients demonstrating test-retest correlations for pitch, melody, and timbre were 0.85, 0.92, and 0.69, respectively. Normal-hearing volunteers had a mean pitch direction discrimination threshold of 1.0 semitone, the smallest interval tested, and mean melody and timbre recognition scores of 87.5 and 94.2%, respectively. The CAMP test discriminates a wide range of music perceptual ability in cochlear implant users. Moderate correlations were seen between music test results and both Consonant-Nucleus-Consonant word recognition scores and spondee recognition thresholds in background noise. Test-retest reliability was moderate to strong. The CAMP test provides a reliable and valid metric for a clinically practical, standardized evaluation of music perception in adult cochlear implant users.

Scale Model Experiments on Sound Propagation From a Mach 2.5 Cold Nitrogen Jet Flowing Through a Rigid-Walled Duct With a J-Deflector

NASA Technical Reports Server (NTRS)

Kandula, Max; Vu, Bruce

2003-01-01

The Launch Systems Testbed (LST) represents the evolution of vibroacoustics research and development work performed at NASA John F. Kennedy Space Center (KSC) over the last 15 years. The LST is located at the Launch Equipment Test Facility (LETF) in the KSC industrial complex. The LETF is operated by Sierra Lobo, Inc., as a member of University-Affiliated Technology Development Contract (USTDC) to KSC Spaceport and Engineering and Technology Directorate (YA), with ASRC Aerospace Corporation as a the prime contractor. Trajectory Simulation Mechanism (TSM) is a major component of the LST, developed specifically to simulate nonstationary acoustic loads on launch pad structures, vehicles, and payloads. TSM enhances the capabilities within LST for simulating launch environments of future vehicles. The scaled launch environments will be used to predict the full-scale launch environment via an appropriate scaling procedure. Air Force Research Laboratory (AFRL) has tasked NASA KSC to perform a basic technology test program in support of developing a low-cost clean pad (incorporating passive mitigation techniques) for future launch vehicles. The overall goal of the program is to develop innovative launch exhaust management systems, which effectively reduce launch acoustic environment with innovative duct designs, while eliminating traditional sound suppression water systems. Passive techniques, such as nontraditional duct geometries, resonators, and diffusers, etc., will be investigated. The overall goals are to advance innovative concepts for a clean pad while developing ideas to reduce transmitted sound via investigation and modeling of jet exhaust acoustic and flow field characteristics. The series of tests outlined in this report represent baseline tests and are geared towards defining the acoustic load environment on the TSM pad for open and closed duct configurations. This report summarizes the cold jet acoustic testing for Mach 2.5 supersonic nitrogen jet issuing from a nozzle with 1-inch exit diameter. Acoustic data, including spectral sound power and Overall Sound Pressure Level (OASPL), are obtained both for a free jet and with the jet flowing through a rigid-walled duct with a J-deflector. The relative performance of closed duct and open duct is evaluated. The results show that the closed duct is superior to the partially open duct, and results in about 3-decibel (dB) noise reduction (near the duct axis) relative to the free jet. The location of the nozzle exit plane (NEP) relative to the duct inlet plane (DIP) has a significant effect on the acoustic field. The results suggest that the location of NEP at 10 inches above the DIP results in reduced acoustic loads relative to 5 inches above the duct inlet and 1 inch into the duct inlet.

Pipe crawler development for duct elbow removal

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

Zollinger, W.T.; Treanor, R.C.

1992-01-01

This paper describes the development of equipment for removing an elbow in a 36 inch diameter ventilation line by cutting from the inside. Radiation levels, high air flow and physical constraints preclude any manual rework of the ventilation system. A remotely operated pipe crawler was developed. Testing has been performed in a full-scale mockup which models the ventilation duct configuration with the exception of radiation levels. The results gathered from the testing are discussed, and illustrate the strengths and weaknesses of the crawler and plasma arc torch system. To date, the equipment has successfully completed the tasks of maneuvering throughmore » the duct geometry, performing the two required cuts, and backing out of the duct mockup. The elbow successfully fell away from the main duct, showing that the line would be clear of obstructions.« less

Pipe crawler development for duct elbow removal

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

Zollinger, W.T.; Treanor, R.C.

1992-11-01

This paper describes the development of equipment for removing an elbow in a 36 inch diameter ventilation line by cutting from the inside. Radiation levels, high air flow and physical constraints preclude any manual rework of the ventilation system. A remotely operated pipe crawler was developed. Testing has been performed in a full-scale mockup which models the ventilation duct configuration with the exception of radiation levels. The results gathered from the testing are discussed, and illustrate the strengths and weaknesses of the crawler and plasma arc torch system. To date, the equipment has successfully completed the tasks of maneuvering throughmore » the duct geometry, performing the two required cuts, and backing out of the duct mockup. The elbow successfully fell away from the main duct, showing that the line would be clear of obstructions.« less

Using Evoked Potentials to Match Interaural Electrode Pairs with Bilateral Cochlear Implants

PubMed Central

Delgutte, Bertrand

2007-01-01

Bilateral cochlear implantation seeks to restore the advantages of binaural hearing to the profoundly deaf by providing binaural cues normally important for accurate sound localization and speech reception in noise. Psychophysical observations suggest that a key issue for the implementation of a successful binaural prosthesis is the ability to match the cochlear positions of stimulation channels in each ear. We used a cat model of bilateral cochlear implants with eight-electrode arrays implanted in each cochlea to develop and test a noninvasive method based on evoked potentials for matching interaural electrodes. The arrays allowed the cochlear location of stimulation to be independently varied in each ear. The binaural interaction component (BIC) of the electrically evoked auditory brainstem response (EABR) was used as an assay of binaural processing. BIC amplitude peaked for interaural electrode pairs at the same relative cochlear position and dropped with increasing cochlear separation in either direction. To test the hypothesis that BIC amplitude peaks when electrodes from the two sides activate maximally overlapping neural populations, we measured multiunit neural activity along the tonotopic gradient of the inferior colliculus (IC) with 16-channel recording probes and determined the spatial pattern of IC activation for each stimulating electrode. We found that the interaural electrode pairings that produced the best aligned IC activation patterns were also those that yielded maximum BIC amplitude. These results suggest that EABR measurements may provide a method for assigning frequency–channel mappings in bilateral implant recipients, such as pediatric patients, for which psychophysical measures of pitch ranking or binaural fusion are unavailable. PMID:17225976

Using evoked potentials to match interaural electrode pairs with bilateral cochlear implants.

PubMed

Smith, Zachary M; Delgutte, Bertrand

2007-03-01

Bilateral cochlear implantation seeks to restore the advantages of binaural hearing to the profoundly deaf by providing binaural cues normally important for accurate sound localization and speech reception in noise. Psychophysical observations suggest that a key issue for the implementation of a successful binaural prosthesis is the ability to match the cochlear positions of stimulation channels in each ear. We used a cat model of bilateral cochlear implants with eight-electrode arrays implanted in each cochlea to develop and test a noninvasive method based on evoked potentials for matching interaural electrodes. The arrays allowed the cochlear location of stimulation to be independently varied in each ear. The binaural interaction component (BIC) of the electrically evoked auditory brainstem response (EABR) was used as an assay of binaural processing. BIC amplitude peaked for interaural electrode pairs at the same relative cochlear position and dropped with increasing cochlear separation in either direction. To test the hypothesis that BIC amplitude peaks when electrodes from the two sides activate maximally overlapping neural populations, we measured multiunit neural activity along the tonotopic gradient of the inferior colliculus (IC) with 16-channel recording probes and determined the spatial pattern of IC activation for each stimulating electrode. We found that the interaural electrode pairings that produced the best aligned IC activation patterns were also those that yielded maximum BIC amplitude. These results suggest that EABR measurements may provide a method for assigning frequency-channel mappings in bilateral implant recipients, such as pediatric patients, for which psychophysical measures of pitch ranking or binaural fusion are unavailable.

Fabrication and evaluation of an improved polymer-based cochlear electrode array for atraumatic insertion.

PubMed

Gwon, Tae Mok; Min, Kyou Sik; Kim, Jin Ho; Oh, Seung Ha; Lee, Ho Sun; Park, Min-Hyun; Kim, Sung June

2015-04-01

An atraumatic cochlear electrode array has become indispensable to high-performance cochlear implants such as electric acoustic stimulation (EAS), wherein the preservation of residual hearing is significant. For an atraumatic implantation, we propose and demonstrate a new improved design of a cochlear electrode array based on liquid crystal polymer (LCP), which can be fabricated by precise batch processes and a thermal lamination process, in contrast to conventional wire-based cochlear electrode arrays. Using a thin-film process of LCP-film-mounted silicon wafer and thermal press lamination, we devise a multi-layered structure with variable layers of LCP films to achieve a sufficient degree of basal rigidity and a flexible tip. A peripheral blind via and self-aligned silicone elastomer molding process can reduce the width of the array. Measuring the insertion and extraction forces in a human scala tympani model, we investigate five human temporal bone insertion trials and record electrically evoked auditory brainstem responses (EABR) acutely in a guinea pig model. The diameters of the finalized electrode arrays are 0.3 mm (tip) and 0.75 mm (base). The insertion force with a displacement of 8 mm from a round window and the maximum extraction force are 2.4 mN and 34.0 mN, respectively. The electrode arrays can be inserted from 360° to 630° without trauma at the basal turn. The EABR data confirm the efficacy of the array. A new design of LCP-based cochlear electrode array for atraumatic implantation is fabricated. Verification indicates that foretells the development of an atraumatic cochlear electrode array and clinical implant.

Sclerosing cholangitis

MedlinePlus

... gallstones in the bile duct) Infections in the liver, gallbladder, and bile ducts Symptoms The first symptoms are usually: Fatigue Itching ... varices (enlarged veins) Biliary cirrhosis (inflammation of the bile ducts) Liver failure Persistent jaundice Some people develop infections of ...

Ten-year follow-up of a consecutive series of children with multichannel cochlear implants.

PubMed

Uziel, Alain S; Sillon, Martine; Vieu, Adrienne; Artieres, Françoise; Piron, Jean-Pierre; Daures, Jean-Pierre; Mondain, Michel

2007-08-01

To assess a group of children who consecutively received implants more than 10 years after implantation with regard to speech perception, speech intelligibility, receptive language level, and academic/occupational status. A prospective longitudinal study. Pediatric referral center for cochlear implantation. Eighty-two prelingually deafened children received the Nucleus multichannel cochlear implant. Cochlear implantation with Cochlear Nucleus CI22 implant. The main outcome measures were open-set Phonetically Balanced Kindergarten word test, discrimination of sentences in noise, connective discourse tracking (CDT) using voice and telephone, speech intelligibility rating (SIR), vocabulary knowledge measured using the Peabody Picture Vocabulary Test (Revised), academic performance on French language, foreign language, and mathematics, and academic/occupational status. After 10 years of implant experience, 79 children (96%) reported that they always wear the device; 79% (65 of 82 children) could use the telephone. The mean scores were 72% for the Phonetically Balanced Kindergarten word test, 44% for word recognition in noise, 55.3 words per minute for the CDT, and 33 words per minute for the CDT via telephone. Thirty-three children (40%) developed speech intelligible to the average listener (SIR 5), and 22 (27%) developed speech intelligible to a listener with little experience of deaf person's speech (SIR 4). The measures of vocabulary showed that most (76%) of children who received implants scored below the median value of their normally hearing peers. The age at implantation was the most important factor that may influence the postimplant outcomes. Regarding educational/vocational status, 6 subjects attend universities, 3 already have a professional activity, 14 are currently at high school level, 32 are at junior high school level, 6 additional children are enrolled in a special unit for children with disability, and 3 children are still attending elementary schools. Seventeen are in further noncompulsory education studying a range of subjects at vocational level. This long-term report shows that many profoundly hearing-impaired children using cochlear implants can develop functional levels of speech perception and production, attain age-appropriate oral language, develop competency level in a language other than their primary language, and achieve satisfactory academic performance.

Profiles of Verbal Working Memory Growth Predict Speech and Language Development in Children with Cochlear Implants

ERIC Educational Resources Information Center

Kronenberger, William G.; Pisoni, David B.; Harris, Michael S.; Hoen, Helena M.; Xu, Huiping; Miyamoto, Richard T.

2013-01-01

Purpose: Verbal short-term memory (STM) and working memory (WM) skills predict speech and language outcomes in children with cochlear implants (CIs) even after conventional demographic, device, and medical factors are taken into account. However, prior research has focused on single end point outcomes as opposed to the longitudinal process of…

Educational Progress Profiles of Cochlear Implant Children.

ERIC Educational Resources Information Center

Dawson, Sarah A.

This study examined the educational development of 22 children (ages 2 to 10), under the supervision of the Cochlear Implant Team of the Medical College of Virginia, who had received implants as a result of deafness (in most cases prelingual and congenital) from 6 months to 3 years prior to the study. Data included a review of the children's case…

Orthographic Influences, Vocabulary Development, and Phonological Awareness in Deaf Children Who Use Cochlear Implants

ERIC Educational Resources Information Center

James, Deborah; Rajput, Kaukab; Brinton, Julie; Goswami, Usha

2009-01-01

In the current study, we explore the influence of orthographic knowledge on phonological awareness in children with cochlear implants and compare developmental associations to those found for hearing children matched for word reading level or chronological age. We show an influence of orthographic knowledge on syllable and phoneme awareness in…

Phonological Awareness in Deaf Children Who Use Cochlear Implants

ERIC Educational Resources Information Center

James, Deborah; Rajput, Kaukab; Brown, Tracey; Sirimanna, Tony; Brinton, Julie; Goswami, Usha

2005-01-01

A short-term longitudinal study was conducted to investigate possible benefits of cochlear implant (CI) use on the development of phonological awareness in deaf children. Nineteen CI users were tested on 2 occasions. Two groups of deaf children using hearing aids were tested once: 11 profoundly deaf and 10 severely deaf children. A battery of…

I Have a Child with a Cochlear Implant in My Preschool Classroom. Now What?

ERIC Educational Resources Information Center

Davenport, Carrie A.; Alber-Morgan, Sheila R.

2016-01-01

It is imperative that teachers have the knowledge and resources to support children who are deaf and use a cochlear implant in general education classrooms. The recommendations presented in this article provide teachers with the information necessary to promote a child's academic progress, communication needs, and social development. In order to…

Validation of the Common Objects Token (COT) Test for Children with Cochlear Implants

ERIC Educational Resources Information Center

Anderson, Ilona; Martin, Jane; Costa, Anne; Jamieson, Lyn; Bailey, Elspeth; Plant, Geoff; Pitterl, Markus

2005-01-01

Changes in selection criteria have meant that children are being provided with cochlear implants (CI) at increasingly younger ages. However, there is a paucity of measures that are appropriate for testing complex listening skills--most tests are too cognitively complex for such young children. The Common Objects Token (COT) Test was developed as a…

Mucocele of the cystic duct remnant after orthotopic liver transplant: a problem revisited.

PubMed

Chatterjee, Suvadip; Das, Debasish; Hudson, Mark; Bassendine, Margaret Fiona; Scott, John; Oppong, Kofi Ernest; Sen, Gourab; French, Jeremy J

2011-06-01

Mucocele of the cystic duct remnant is an uncommon hepatobiliary complication of a liver transplant. Current practice usually involves either excising the cystic duct, or incorporating the distal end of the transected cystic duct into the suture line of the biliary anastomosis to ensure drainage. We report a patient who developed cystic duct remnant mucocele after the latter approach was adopted. We believe that this is likely related to delayed anastomotic stricturing, which prevented draining from the remnant cystic duct. We also discuss the incidence, pathology, investigations, and treatment of this condition.

Cochlear implant challenges encountered in tuberculous otitis media.

PubMed

Chen, Cheng-Fang; Liu, Zhao-Hui; Xie, Jing; Ma, Xiao-Bo; Li, Yi; Gong, Shu-Sheng

2012-05-01

Tuberculous otitis media (TOM) is rare in ENT department, and is frequently misdiagnosed as otitis media. Thus early systemic treatment is very important for TOM. We reported a case report with TOM to highlight development of the disease and difficulties in clinical treatment in late stage of TOM. Implantation of ossified and eroded cochlea poses many unique challenges to both the surgeon and programming team. With thorough preparation and complete knowledge about characters of specific issues, implantation would be performed successfully, and patients with ossified cochlear could benefit from cochlear implantation. Copyright © 2012 Hainan Medical College. Published by Elsevier B.V. All rights reserved.

Cued Speech for Enhancing Speech Perception and First Language Development of Children With Cochlear Implants

PubMed Central

Leybaert, Jacqueline; LaSasso, Carol J.

2010-01-01

Nearly 300 million people worldwide have moderate to profound hearing loss. Hearing impairment, if not adequately managed, has strong socioeconomic and affective impact on individuals. Cochlear implants have become the most effective vehicle for helping profoundly deaf children and adults to understand spoken language, to be sensitive to environmental sounds, and, to some extent, to listen to music. The auditory information delivered by the cochlear implant remains non-optimal for speech perception because it delivers a spectrally degraded signal and lacks some of the fine temporal acoustic structure. In this article, we discuss research revealing the multimodal nature of speech perception in normally-hearing individuals, with important inter-subject variability in the weighting of auditory or visual information. We also discuss how audio-visual training, via Cued Speech, can improve speech perception in cochlear implantees, particularly in noisy contexts. Cued Speech is a system that makes use of visual information from speechreading combined with hand shapes positioned in different places around the face in order to deliver completely unambiguous information about the syllables and the phonemes of spoken language. We support our view that exposure to Cued Speech before or after the implantation could be important in the aural rehabilitation process of cochlear implantees. We describe five lines of research that are converging to support the view that Cued Speech can enhance speech perception in individuals with cochlear implants. PMID:20724357

Noise-induced cochlear synaptopathy: Past findings and future studies.

PubMed

Kobel, Megan; Le Prell, Colleen G; Liu, Jennifer; Hawks, John W; Bao, Jianxin

2017-06-01

For decades, we have presumed the death of hair cells and spiral ganglion neurons are the main cause of hearing loss and difficulties understanding speech in noise, but new findings suggest synapse loss may be the key contributor. Specifically, recent preclinical studies suggest that the synapses between inner hair cells and spiral ganglion neurons with low spontaneous rates and high thresholds are the most vulnerable subcellular structures, with respect to insults during aging and noise exposure. This cochlear synaptopathy can be "hidden" because this synaptic loss can occur without permanent hearing threshold shifts. This new discovery of synaptic loss opens doors to new research directions. Here, we review a number of recent studies and make suggestions in two critical future research directions. First, based on solid evidence of cochlear synaptopathy in animal models, it is time to apply molecular approaches to identify the underlying molecular mechanisms; improved understanding is necessary for developing rational, effective therapies against this cochlear synaptopathy. Second, in human studies, the data supporting cochlear synaptopathy are indirect although rapid progress has been made. To fully identify changes in function that are directly related this hidden synaptic damage, we argue that a battery of tests including both electrophysiological and behavior tests should be combined for diagnosis of "hidden hearing loss" in clinical studies. This new approach may provide a direct link between cochlear synaptopathy and perceptual difficulties. Copyright © 2016 Elsevier B.V. All rights reserved.

Analysis of electrically evoked compound action potential of the auditory nerve in children with bilateral cochlear implants.

PubMed

Caldas, Fernanda Ferreira; Cardoso, Carolina Costa; Barreto, Monique Antunes de Souza Chelminski; Teixeira, Marina Santos; Hilgenberg, Anacléia Melo da Silva; Serra, Lucieny Silva Martins; Bahmad Junior, Fayez

2016-01-01

The cochlear implant device has the capacity to measure the electrically evoked compound action potential of the auditory nerve. The neural response telemetry is used in order to measure the electrically evoked compound action potential of the auditory nerve. To analyze the electrically evoked compound action potential, through the neural response telemetry, in children with bilateral cochlear implants. This is an analytical, prospective, longitudinal, historical cohort study. Six children, aged 1-4 years, with bilateral cochlear implant were assessed at five different intervals during their first year of cochlear implant use. There were significant differences in follow-up time (p=0.0082) and electrode position (p=0.0019) in the T-NRT measure. There was a significant difference in the interaction between time of follow-up and electrode position (p=0.0143) when measuring the N1-P1 wave amplitude between the three electrodes at each time of follow-up. The electrically evoked compound action potential measurement using neural response telemetry in children with bilateral cochlear implants during the first year of follow-up was effective in demonstrating the synchronized bilateral development of the peripheral auditory pathways in the studied population. Copyright © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Feed-forward and feed-backward amplification model from cochlear cytoarchitecture: an interspecies comparison.

PubMed

Yoon, Yong-Jin; Steele, Charles R; Puria, Sunil

2011-01-05

The high sensitivity and wide bandwidth of mammalian hearing are thought to derive from an active process involving the somatic and hair-bundle motility of the thousands of outer hair cells uniquely found in mammalian cochleae. To better understand this, a biophysical three-dimensional cochlear fluid model was developed for gerbil, chinchilla, cat, and human, featuring an active "push-pull" cochlear amplifier mechanism based on the cytoarchitecture of the organ of Corti and using the time-averaged Lagrangian method. Cochlear responses are simulated and compared with in vivo physiological measurements for the basilar membrane (BM) velocity, V(BM), frequency tuning of the BM vibration, and Q₁₀ values representing the sharpness of the cochlear tuning curves. The V(BM) simulation results for gerbil and chinchilla are consistent with in vivo cochlea measurements. Simulated mechanical tuning curves based on maintaining a constant V(BM) value agree with neural-tuning threshold measurements better than those based on a constant displacement value, which implies that the inner hair cells are more sensitive to V(BM) than to BM displacement. The Q₁₀ values of the V(BM) tuning curve agree well with those of cochlear neurons across species, and appear to be related in part to the width of the basilar membrane. Copyright © 2011 Biophysical Society. Published by Elsevier Inc. All rights reserved.

Rotating Rake Turbofan Duct Mode Measurement System

NASA Technical Reports Server (NTRS)

Sutliff, Daniel L.

2005-01-01

An experimental measurement system was developed and implemented by the NASA Glenn Research Center in the 1990s to measure turbofan duct acoustic modes. The system is a continuously rotating radial microphone rake that is inserted into the duct. This Rotating Rake provides a complete map of the acoustic duct modes present in a ducted fan and has been used on a variety of test articles: from a low-speed, concept test rig, to a full-scale production turbofan engine. The Rotating Rake has been critical in developing and evaluating a number of noise reduction concepts as well as providing experimental databases for verification of several aero-acoustic codes. More detailed derivation of the unique Rotating Rake equations are presented in the appendix.

Pneumococcal meningitis: development of a new animal model

PubMed Central

Wei, Benjamin P.C.; Shepherd, Robert K.; Robins-Browne, Roy M.; Clark, Graeme M.; O’Leary, Stephen J.

2007-01-01

Hypothesis The rat is a suitable animal to establish a model for the study of pneumococcal meningitis post cochlear implantation Background There has been an increase in the number of cases of cochlear implant-related meningitis. The most common organism identified was Streptococcus pneumoniae. Whether cochlear implantation increases the risk of pneumococcal meningitis in healthy subjects without other risk factors remains to be determined. Previous animal studies do not focus on the pathogenesis and risk of pneumococcal meningitis post implantation and are based on relatively small animal numbers, making it difficult to assess the cause and effect relationship. There is, therefore, a need to develop a new animal model allowing direct examination of the pathogenesis of meningitis in the presence of a cochlear implant. Methods Eighteen non-implanted rats were infected with 1× 106 and 1 × 108 colony forming units (CFU) of a clinical isolate of S. pneumoniae via three different inoculation routes (middle ear, inner ear and intraperitoneal) to examine for evidence of meningitis over 24 hours. Six implanted rats were infected with the highest amount of bacteria possible for each route of inoculation (4 × 1010 CFU intraperitoneal, 3 × 108CFU middle ear, 1 × 106 CFU inner ear) to examine for evidence of meningitis with the presence of an implant. Histological pattern of cochlear infections for each of the three different inoculating routes were examined. Results Pneumococcal meningitis was evident in all 6 implanted animals for each of the three different routes of inoculation. Once in the inner ear, bacteria were found to enter the central nervous system either via the cochlear aqueduct or canaliculi perforantes of osseous spiral lamina, reaching the perineural and perivascular space then the internal acoustic meatus. The rate, extent and pattern of infection within the cochleae depended on the route of inoculation. Finally, there was no evidence of pneumococcal meningitis observed in 18 non-implanted rats inoculated at a lower concentration of S. pneumoniae when observed for 24 hours post-inoculation. Conclusion Meningitis in implanted rats following inoculation with a clinical isolate of S. pneumoniae is possible via all three potential routes of infection via the upper respiratory tract. The lack of meningitis observed in the 18 non-implanted rats suggests longer post-inoculation monitoring periods are required to ensure whether or not meningitis will develop. Based on this work we have developed a new animal model that will allow quantitative risk assessment of meningitis post cochlear implantation, and the assessment of the efficacy of potential interventional strategies in future studies. PMID:16936571

[Rare bile duct anatomy variant - Right bile duct intraparenchymal junction into the left bile duct].

PubMed

Gál, Adrián Róbert; Kalmár-Nagy, Károly; Fincsur, András; Horváth, Örs Péter; Vereczkei, András

2018-03-01

The authors present a case of a 67-year-old male patient, who previously had been diagnosed with a malignant liver tumor localized in segment II. He underwent bisegmentectomy (II and III) and partial IV segmentectomy. After the primary surgery jaundice developed, the level of bilirubin increased and after several imaging modalities reoperation was indicated. During the surgery a rare bile duct anatomy variant was found. The right hepatic duct joined the left duct in the parenchyma of the left lobe, and was ligated at the resection. As the liver hilum was not explored, the absence of the right duct was not discovered. Reconstruction of the biliary system was accomplished by a Roux-en-Y loop.

Preliminary Investigation of Curved Liner Sample in the NASA LaRC Curved Duct Test Rig

NASA Technical Reports Server (NTRS)

Gerhold, Carl H.; Jones, Michael G.; Brown, Martha C.

2007-01-01

This viewgraph presentation reviews the preliminary investigation of the curved liner sample in the NASA LaRC Curved Duct Test Rig (CDTR). It reviews the purpose of the Curved Duct Test Rig. Its purpose is to develop capability to investigate acoustic and aerodynamic properties in ducts. It has several features to accomplish that purpose: (1) Large scale (2) Flow rate to M = 0.275 (3) Higher order mode control (4) Curved flow path (5) Adaptable test section (6) Flexible test configurations. The liner has minimal effect on turbulence or boundary layer growth in duct. The curved duct sample attenuation is affected by mode scattering. In conclusion, the CDTR is valid tool for aerodynamic and acoustic evaluation of duct treatment

Type 2 iodothyronine deiodinase expression in the cochlea before the onset of hearing

PubMed Central

Campos-Barros, Angel; Amma, Lori L.; Faris, Jonathan S.; Shailam, Ranu; Kelley, Matthew W.; Forrest, Douglas

2000-01-01

Thyroid hormone signaling during a postnatal period in the mouse is essential for cochlear development and the subsequent onset of hearing. To study the control of this temporal dependency, we investigated the role of iodothyronine deiodinases, which in target tissues convert the prohormone thyroxine into triiodothyronine (T3), the active ligand for the thyroid hormone receptor (TR). Type 2 5′-deiodinase (D2) activity rose dramatically in the mouse cochlea to peak around postnatal day 7 (P7), after which activity declined by P10. This activity peak a few days before the onset of hearing suggests a role for D2 in amplifying local T3 levels at a critical stage of cochlear development. A mouse cochlear D2 cDNA was isolated and demonstrated near identity to rat D2. In situ hybridization localized D2 mRNA in periosteal connective tissue in the modiolus, the cochlear outer capsule and the septal divisions between the turns of the cochlea. Surprisingly, D2 expression in these regions that give rise to the bony labyrinth was complementary to TR expression in the sensory epithelium. Thus, the connective tissue may control deiodination of thyroxine and release of T3 to confer a paracrine-like control of TR activation. These results suggest that temporal and spatial control of ligand availability conferred by D2 provides an unexpectedly important level of regulation of the TR pathways required for cochlear maturation. PMID:10655523

Cochlear Implants.

ERIC Educational Resources Information Center

Clark, Catherine; Scott, Larry

This brochure explains what a cochlear implant is, lists the types of individuals with deafness who may be helped by a cochlear implant, describes the process of evaluating people for cochlear implants, discusses the surgical process for implanting the aid, traces the path of sound through the cochlear implant to the brain, notes the costs of…

Using Flanagan's phase vocoder to improve cochlear implant performance

NASA Astrophysics Data System (ADS)

Zeng, Fan-Gang

2004-10-01

The cochlear implant has restored partial hearing to more than 100000 deaf people worldwide, allowing the average user to talk on the telephone in quiet environment. However, significant difficulty still remains for speech recognition in noise, music perception, and tonal language understanding. This difficulty may be related to speech processing strategies in current cochlear implants that emphasized the extraction and encoding of the temporal envelope while ignoring the temporal fine structure in speech sounds. A novel strategy was developed based on Flanagan's phase vocoder [Flanagan and Golden, Bell Syst. Tech. 45, 1493-1509 (1966)], in which frequency modulation was extracted from the temporal fine structure and then added to amplitude modulation in the current cochlear implants. Acoustic simulation results showed that amplitude and frequency modulation contributed complementarily to speech perception with amplitude modulation contributing mainly to intelligibility whereas frequency modulation contributed to speaker identification and auditory grouping. The results also showed that the novel strategy significantly improved cochlear implant performance under realistic listening situations. Overall, the present result demonstrated that Flanagan's classic work on phase vocoder still shed insight on current problems of both theoretical and practical importance. [Work supported by NIH.

Accessibility to cochlear implants in Belgium: state of the art on selection, reimbursement, habilitation, and outcomes in children and adults.

PubMed

De Raeve, Leo; Wouters, Annelies

2013-03-01

Belgium, and especially the northern region called Flanders, has been a center of expertise in cochlear implants and early hearing screening for many years. Some of their surgeons and engineers were pioneers in the development of cochlear implants and in 1998 Flanders was the first region in Europe to implement a universal hearing screening program for all neonates. The Belgian National Institute for Health and Disability Insurance has reimbursed cochlear implants in children and adults since 1994 and bilateral implantation in children under the age of 12 years since February 2010. These deaf children, screened and implanted early, achieve higher auditory, speech and language outcomes and increasing numbers are going to regular schools using fewer interpreters. In 2010, 93% of severe-to-profound deaf preschool children in Flanders had received cochlear implants and 25% had bilateral implants. Although on average twice as many adults as children are implanted a year in Belgium, we have less research data available from this adult population. Also very little is published about the growth curves and minimal rehabilitation requirements (intensity, duration etc.) after implantation for both children and adults. So, there still remain many challenges for the future.

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.

Initial Stop Voicing in Bilingual Children with Cochlear Implants and Their Typically Developing Peers with Normal Hearing

ERIC Educational Resources Information Center

Bunta, Ferenc; Goodin-Mayeda, C. Elizabeth; Procter, Amanda; Hernandez, Arturo

2016-01-01

Purpose: This study focuses on stop voicing differentiation in bilingual children with normal hearing (NH) and their bilingual peers with hearing loss who use cochlear implants (CIs). Method: Twenty-two bilingual children participated in our study (11 with NH, "M" age = 5;1 [years;months], and 11 with CIs, "M" hearing age =…

Consonant Cluster Production in Children with Cochlear Implants: A Comparison with Normally Hearing Peers

ERIC Educational Resources Information Center

Faes, Jolien; Gillis, Steven

2017-01-01

In early word productions, the same types of errors are manifest in children with cochlear implants (CI) as in their normally hearing (NH) peers with respect to consonant clusters. However, the incidence of those types and their longitudinal development have not been examined or quantified in the literature thus far. Furthermore, studies on the…

Phonological Awareness, Vocabulary, and Reading in Deaf Children with Cochlear Implants

ERIC Educational Resources Information Center

Johnson, Carol; Goswami, Usha

2010-01-01

Purpose: To explore the phonological awareness skills of deaf children with cochlear implants (CIs) and relationships with vocabulary and reading development. Method: Forty-three deaf children with implants who were between 5 and 15 years of age were tested; 21 had been implanted at around 2.5 years of age (Early CI group), and 22 had been…

Peer Relationships of Deaf Children with Cochlear Implants: Predictors of Peer Entry and Peer Interaction Success

ERIC Educational Resources Information Center

Martin, Daniela; Bat-Chava, Yael; Lalwani, Anil; Waltzman, Susan B.

2011-01-01

This study investigated factors that affect the development of positive peer relationships among deaf children with cochlear implants. Ten 5- to 6-year-old deaf children with implants were observed under conditions varying peer context difficulty in a Peer Entry task. Results revealed better outcomes for deaf children interacting in one-on-one…

A physiological and behavioral system for hearing restoration with cochlear implants

PubMed Central

King, Julia; Shehu, Ina; Roland, J. Thomas; Svirsky, Mario A.

2016-01-01

Cochlear implants are neuroprosthetic devices that provide hearing to deaf patients, although outcomes are highly variable even with prolonged training and use. The central auditory system must process cochlear implant signals, but it is unclear how neural circuits adapt—or fail to adapt—to such inputs. The knowledge of these mechanisms is required for development of next-generation neuroprosthetics that interface with existing neural circuits and enable synaptic plasticity to improve perceptual outcomes. Here, we describe a new system for cochlear implant insertion, stimulation, and behavioral training in rats. Animals were first ensured to have significant hearing loss via physiological and behavioral criteria. We developed a surgical approach for multichannel (2- or 8-channel) array insertion, comparable with implantation procedures and depth in humans. Peripheral and cortical responses to stimulation were used to program the implant objectively. Animals fitted with implants learned to use them for an auditory-dependent task that assesses frequency detection and recognition in a background of environmentally and self-generated noise and ceased responding appropriately to sounds when the implant was temporarily inactivated. This physiologically calibrated and behaviorally validated system provides a powerful opportunity to study the neural basis of neuroprosthetic device use and plasticity. PMID:27281743

The age-related positional and orientational changes of the human cochlea.

PubMed

Lyu, Hui-Ying; Chen, Ke-Guang; Yang, Lin; Zhang, Tian-Yu; Dai, Pei-Dong

2015-03-01

The cochleae of children over 6 years old and adults displaced more outward, backward, and downward in comparison with those of children under 6 years. However, the cochlear orientation does not significantly change during postnatal development. Adjacent structures correlated with the cochlear position. To test whether the cochlear position and orientation, which are important in cochlea implant surgery, change during postnatal development. CT images of both ears of 76 human subjects were studied. They were divided into three groups: group A (1-6 years old), group B (7-18 years old), and group C (>18 years old). The distances from the cochlea to the median sagittal and coronal planes in group A were smaller than those in group B and group C (p < 0.05), but the distance from it to the Frankfurt plane in group A was larger than that in group C (p < 0.05). The volume of the temporal bone pneumatization and the positions of the jugular bulb and the intrapetrous internal carotid artery positively correlated with the cochlear position (p < 0.05). There were no statistically significant differences in the angles between the central axis of the cochlea and these coordinate planes among age groups.

Monitoring hypoxia induced changes in cochlear blood flow and hemoglobin concentration using a combined dual-wavelength laser speckle contrast imaging and Doppler optical microangiography system.

PubMed

Reif, Roberto; Qin, Jia; Shi, Lei; Dziennis, Suzan; Zhi, Zhongwei; Nuttall, Alfred L; Wang, Ruikang K

2012-01-01

A synchronized dual-wavelength laser speckle contrast imaging (DWLSCI) system and a Doppler optical microangiography (DOMAG) system was developed to determine several ischemic parameters in the cochlea due to a systemic hypoxic challenge. DWLSCI can obtain two-dimensional data, and was used to determine the relative changes in cochlear blood flow, and change in the concentrations of oxyhemoglobin (HbO), deoxyhemoglobin (Hb) and total hemoglobin (HbT) in mice. DOMAG can obtain three-dimensional data, and was used to determine the changes in cochlear blood flow with single vessel resolution. It was demonstrated that during a hypoxic challenge there was an increase in the concentrations of Hb, a decrease in the concentrations of HbO and cochlear blood flow, and a slight decrease in the concentration of HbT. Also, the rate of change in the concentrations of Hb and HbO was quantified during and after the hypoxic challenge. The ability to simultaneously measure these ischemic parameters with high spatio-temporal resolution will allow the detailed quantitative analysis of several hearing disorders, and will be useful for diagnosing and developing treatments.

Brief Assessment of Parental Perception (BAPP): Development and validation of a new measure for assessing paediatric outcomes after bilateral cochlear implantation.

PubMed

Samuel, V; Gamble, C; Cullington, H; Bathgate, F; Bennett, E; Coop, N; Cropper, J; Emond, A; Kentish, R; Edwards, L

2016-11-01

In contrast to previous clinical practice, current guidelines recommend bilateral cochlear implantation in children, resulting in a cohort of children who initially received one implant, but have subsequently had a second, contralateral implant. This study aimed to explore satisfaction and quality of life in children implanted simultaneously or sequentially. A novel measure of satisfaction and quality of life following paediatric bilateral cochlear implantation (the Brief Assessment of Parental Perception; BAPP) was developed and preliminary validation undertaken as part of a large, national project of bilateral implantation. Children's parents completed the measure yearly for up to three years following implantation. Children from 14 UK implant centres were recruited into the study; data were available for 410 children one year post-implantation. The BAPP was found to have good face and convergent validity, and internal consistency. Results indicated very high levels of satisfaction with the devices, and improvements in quality of life. However there was evidence that children implanted sequentially were less willing to wear their second implant in the first two years than those children receiving simultaneous implants. Simultaneous and sequential cochlear implants have a positive impact on the quality of life of deaf children.

Development of speech perception and production in children with cochlear implants.

PubMed

Kishon-Rabin, Liat; Taitelbaum, Riki; Muchnik, Chava; Gehtler, Inbal; Kronenberg, Jona; Hildesheimer, Minka

2002-05-01

The purpose of the present study was twofold: 1) to compare the hierarchy of perceived and produced significant speech pattern contrasts in children with cochlear implants, and 2) to compare this hierarchy to developmental data of children with normal hearing. The subjects included 35 prelingual hearing-impaired children with multichannel cochlear implants. The test materials were the Hebrew Speech Pattern Contrast (HeSPAC) test and the Hebrew Picture Speech Pattern Contrast (HePiSPAC) test for older and younger children, respectively. The results show that 1) auditory speech perception performance of children with cochlear implants reaches an asymptote at 76% (after correction for guessing) between 4 and 6 years of implant use; 2) all implant users perceived vowel place extremely well immediately after implantation; 3) most implanted children perceived initial voicing at chance level until 2 to 3 years after implantation, after which scores improved by 60% to 70% with implant use; 4) the hierarchy of phonetic-feature production paralleled that of perception: vowels first, voicing last, and manner and place of articulation in between; and 5) the hierarchy in speech pattern contrast perception and production was similar between the implanted and the normal-hearing children, with the exception of the vowels (possibly because of the interaction between the specific information provided by the implant device and the acoustics of the Hebrew language). The data reported here contribute to our current knowledge about the development of phonological contrasts in children who were deprived of sound in the first few years of their lives and then developed phonetic representations via cochlear implants. The data also provide additional insight into the interrelated skills of speech perception and production.

Investigation of advanced counterrotation blade configuration concepts for high speed turboprop systems. Task 2: Unsteady ducted propfan analysis computer program users manual

NASA Technical Reports Server (NTRS)

Hall, Edward J.; Delaney, Robert A.; Bettner, James L.

1991-01-01

The primary objective of this study was the development of a time-dependent three-dimensional Euler/Navier-Stokes aerodynamic analysis to predict unsteady compressible transonic flows about ducted and unducted propfan propulsion systems at angle of attack. The computer codes resulting from this study are referred to as Advanced Ducted Propfan Analysis Codes (ADPAC). This report is intended to serve as a computer program user's manual for the ADPAC developed under Task 2 of NASA Contract NAS3-25270, Unsteady Ducted Propfan Analysis. Aerodynamic calculations were based on a four-stage Runge-Kutta time-marching finite volume solution technique with added numerical dissipation. A time-accurate implicit residual smoothing operator was utilized for unsteady flow predictions. For unducted propfans, a single H-type grid was used to discretize each blade passage of the complete propeller. For ducted propfans, a coupled system of five grid blocks utilizing an embedded C-grid about the cowl leading edge was used to discretize each blade passage. Grid systems were generated by a combined algebraic/elliptic algorithm developed specifically for ducted propfans. Numerical calculations were compared with experimental data for both ducted and unducted propfan flows. The solution scheme demonstrated efficiency and accuracy comparable with other schemes of this class.

Prototype to product—developing a commercially viable neural prosthesis

NASA Astrophysics Data System (ADS)

Seligman, Peter

2009-12-01

The Cochlear implant or 'Bionic ear' is a device that enables people who do not get sufficient benefit from a hearing aid to communicate with the hearing world. The Cochlear implant is not an amplifier, but a device that electrically stimulates the auditory nerve in a way that crudely mimics normal hearing, thus providing a hearing percept. Many recipients are able to understand running speech without the help of lipreading. Cochlear implants have reached a stage of maturity where there are now 170 000 recipients implanted worldwide. The commercial development of these devices has occurred over the last 30 years. This development has been multidisciplinary, including audiologists, engineers, both mechanical and electrical, histologists, materials scientists, physiologists, surgeons and speech pathologists. This paper will trace the development of the device we have today, from the engineering perspective. The special challenges of designing an active device that will work in the human body for a lifetime will be outlined. These challenges include biocompatibility, extreme reliability, safety, patient fitting and surgical issues. It is emphasized that the successful development of a neural prosthesis requires the partnership of academia and industry.

Prototype to product-developing a commercially viable neural prosthesis.

PubMed

Seligman, Peter

2009-12-01

The Cochlear implant or 'Bionic ear' is a device that enables people who do not get sufficient benefit from a hearing aid to communicate with the hearing world. The Cochlear implant is not an amplifier, but a device that electrically stimulates the auditory nerve in a way that crudely mimics normal hearing, thus providing a hearing percept. Many recipients are able to understand running speech without the help of lipreading. Cochlear implants have reached a stage of maturity where there are now 170 000 recipients implanted worldwide. The commercial development of these devices has occurred over the last 30 years. This development has been multidisciplinary, including audiologists, engineers, both mechanical and electrical, histologists, materials scientists, physiologists, surgeons and speech pathologists. This paper will trace the development of the device we have today, from the engineering perspective. The special challenges of designing an active device that will work in the human body for a lifetime will be outlined. These challenges include biocompatibility, extreme reliability, safety, patient fitting and surgical issues. It is emphasized that the successful development of a neural prosthesis requires the partnership of academia and industry.

Excluded segmental duct bile leakage: the case for bilio-enteric anastomosis.

PubMed

Patrono, Damiano; Tandoi, Francesco; Romagnoli, Renato; Salizzoni, Mauro

2014-06-01

Excluded segmental duct bile leak is the rarest type of post-hepatectomy bile leak and presents unique diagnostic and management features. Classical management strategies invariably entail a significant loss of functioning hepatic parenchyma. The aim of this study is to report a new liver-sparing technique to handle excluded segmental duct bile leakage. Two cases of excluded segmental duct bile leak occurring after major hepatic resection were managed by a Roux-en-Y hepatico-jejunostomy on the excluded segmental duct, avoiding the sacrifice of the liver parenchyma origin of the fistula. In both cases, classical management strategies would have led to the functional loss of roughly 50 % of the liver remnant. Diagnostic and management implications are thoroughly discussed. Both cases had an uneventful postoperative course. The timing of repair was associated with a different outcome: the patient who underwent surgical repair in the acute phase developed no long-term complications, whereas the patient who underwent delayed repair developed a late stenosis requiring percutaneous dilatation. Roux-en-Y hepatico-jejunostomy on the excluded bile duct is a valuable technique in selected cases of excluded segmental duct bile leakage.

Developmentally regulated expression of ectonucleotidases NTPDase5 and NTPDase6 and UDP-responsive P2Y receptors in the rat cochlea.

PubMed

O'Keeffe, Mary G; Thorne, Peter R; Housley, Gary D; Robson, Simon C; Vlajkovic, Srdjan M

2010-04-01

Ectonucleoside triphosphate diphosphohydrolases (E-NTPDases) regulate complex extracellular P2 receptor signalling pathways in mammalian tissues by hydrolysing extracellular nucleotides to the respective nucleosides. All enzymes from this family (NTPDase1-8) are expressed in the adult rat cochlea. This study reports the changes in expression of NTPDase5 and NTPDase6 in the developing rat cochlea. These two intracellular members of the E-NTPDase family can be released in a soluble form and show preference for nucleoside 5'-diphosphates, such as UDP and GDP. Here, we demonstrate differential spatial and temporal patterns for NTPDase5 and NTPDase6 expression during cochlear development, which are indicative of both cytosolic and extracellular action via pyrimidines. NTPDase5 is noted during the early postnatal period in developing sensory hair cells and supporting Deiters' cells of the organ of Corti, and primary auditory neurons located in the spiral ganglion. In contrast, NTPDase6 is confined to the embryonic and early postnatal hair cell bundles. NTPDase6 immunolocalisation in the developing cochlea underpins its putative role in hair cell bundle development, probably via cytosolic action, whilst NTPDase5 may have a broader extracellular role in the development of sensory and neural tissues in the rat cochlea. Both NTPDase5 and NTPDase6 colocalize with UDP-preferring P2Y(4), P2Y(6) and P2Y(14) receptors during cochlear development, but this strong association was lost in the adult cochlea. Spatiotemporal topographic expression of NTPDase5 and NTPDase6 and P2Y receptors in adult and developing cochlear tissues provide strong support for the role of pyrimidinergic signalling in cochlear development.

Development of an Experimental Rig for Investigation of Higher Order Modes in Ducts

NASA Technical Reports Server (NTRS)

Gerhold, Carl H.; Cabell, Randolph H.; Brown, Martha C.

2006-01-01

Continued progress to reduce fan noise emission from high bypass ratio engine ducts in aircraft increasingly relies on accurate description of the sound propagation in the duct. A project has been undertaken at NASA Langley Research Center to investigate the propagation of higher order modes in ducts with flow. This is a two-pronged approach, including development of analytic models (the subject of a separate paper) and installation of a laboratory-quality test rig. The purposes of the rig are to validate the analytical models and to evaluate novel duct acoustic liner concepts, both passive and active. The dimensions of the experimental rig test section scale to between 25% and 50% of the aft bypass ducts of most modern engines. The duct is of rectangular cross section so as to provide flexibility to design and fabricate test duct liner samples. The test section can accommodate flow paths that are straight through or offset from inlet to discharge, the latter design allowing investigation of the effect of curvature on sound propagation and duct liner performance. The maximum air flow rate through the duct is Mach 0.3. Sound in the duct is generated by an array of 16 high-intensity acoustic drivers. The signals to the loudspeaker array are generated by a multi-input/multi-output feedforward control system that has been developed for this project. The sound is sampled by arrays of flush-mounted microphones and a modal decomposition is performed at the frequency of sound generation. The data acquisition system consists of two arrays of flush-mounted microphones, one upstream of the test section and one downstream. The data are used to determine parameters such as the overall insertion loss of the test section treatment as well as the effect of the treatment on a modal basis such as mode scattering. The methodology used for modal decomposition is described, as is a description of the mode generation control system. Data are presented which demonstrate the performance of the controller to generate the desired mode while suppressing all other cut on modes in the duct.

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.

Developmental Effects of Family Environment on Outcomes in Pediatric Cochlear Implant Recipients

PubMed Central

Holt, Rachael Frush; Beer, Jessica; Kronenberger, William G.; Pisoni, David B.

2012-01-01

Objective To examine and compare the family environment of preschool- and school-age children with cochlear implants and assess its influence on children’s executive function and spoken language skills. Study Design Retrospective between-subjects design. Setting Outpatient research laboratory. Patients Prelingually deaf children with cochlear implants and no additional disabilities, and their families. Intervention(s) Cochlear implantation and speech-language therapy. Main Outcome Measures Parents completed the Family Environment Scale and the Behavior Rating Inventory of Executive Function (or the preschool version). Children were tested using the Peabody Picture Vocabulary Test-4 and either the Preschool Language Scales-4 or the Clinical Evaluation of Language Fundamentals–4. Results The family environments of children with cochlear implants differed from normative data obtained from hearing children, but average scores were within one standard deviation of norms on all subscales. Families of school-age children reported higher levels of control than those of preschool-age children. Preschool-age children had fewer problems with emotional control when families reported higher levels of support and lower levels of conflict. School-age children had fewer problems with inhibition but more problems with shifting of attention when families reported lower levels of conflict. School-age children’s receptive vocabularies were enhanced by families with lower levels of control and higher levels of organization. Conclusions Family environment and its relation to language skills and executive function development differed across the age groups in this sample of children with cochlear implants. Because family dynamics is one developmental/environmental factor that can be altered with therapy and education, the present results have important clinical implications for family-based interventions for deaf children with cochlear implants. PMID:23151776

Using the surface panel method to predict the steady performance of ducted propellers

NASA Astrophysics Data System (ADS)

Cai, Hao-Peng; Su, Yu-Min; Li, Xin; Shen, Hai-Long

2009-12-01

A new numerical method was developed for predicting the steady hydrodynamic performance of ducted propellers. A potential based surface panel method was applied both to the duct and the propeller, and the interaction between them was solved by an induced velocity potential iterative method. Compared with the induced velocity iterative method, the method presented can save programming and calculating time. Numerical results for a JD simplified ducted propeller series showed that the method presented is effective for predicting the steady hydrodynamic performance of ducted propellers.

Mean velocity and turbulence measurements in a 90 deg curved duct with thin inlet boundary layer

NASA Technical Reports Server (NTRS)

Crawford, R. A.; Peters, C. E.; Steinhoff, J.; Hornkohl, J. O.; Nourinejad, J.; Ramachandran, K.

1985-01-01

The experimental database established by this investigation of the flow in a large rectangular turning duct is of benchmark quality. The experimental Reynolds numbers, Deans numbers and boundary layer characteristics are significantly different from previous benchmark curved-duct experimental parameters. This investigation extends the experimental database to higher Reynolds number and thinner entrance boundary layers. The 5% to 10% thick boundary layers, based on duct half-width, results in a large region of near-potential flow in the duct core surrounded by developing boundary layers with large crossflows. The turbulent entrance boundary layer case at R sub ed = 328,000 provides an incompressible flowfield which approaches real turbine blade cascade characteristics. The results of this investigation provide a challenging benchmark database for computational fluid dynamics code development.

Duct injection for SO{sub 2} control, Design Handbook, Volume 1, Process design and engineering guidelines

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

NONE

PETC developed a comprehensive program of coal-related, acid-rain research and development with a major activity area centering on flue gas cleanup and control of SO{sub 2} emissions. Particular emphasis was placed on the retrofit measures for older coal-fired power plants which predate the 1971 New Source Performance Standards. Candidate emission control technologies fall into three categories, depending upon their point of application along the fuel path (i.e., pre, during, or post combustion). The post-combustion, in-duct injection of a calcium-based chemical reagent seemed promising. Preliminary studies showed that reagent injection between the existing air heater and electrostatic precipitator (ESP) could removemore » between 50-60% of the SO{sub 2} and produce an environmentally safe, dry, solid waste that is easily disposed. Although SO{sub 2} removal efficiencies were less, the estimated capital costs for duct injection technology were low making the economics of duct injection systems seem favorable when compared to conventional wet slurry scrubbers under certain circumstances. With the promulgation of the Clean Air Act Amendments of 1990 came more incentive for the development of low capital cost flue gas desulfurization (FGD) processes. A number of technical problems had to be resolved, however, before duct injection technology could be brought to a state of commercial readiness. The Duct Injection Technology Development Program was launched as a comprehensive, four-year research effort undertaken by PETC to develop this new technology. Completed in 1992, this Duct Injection Design Handbook and the three-dimensional predictive mathematical model constitute two primary end products from this development program. The aim of this design handbook and the accompanying math model is to provide utility personnel with sufficient information to evaluate duct injection technology against competing SO{sub 2} emissions reduction strategies for an existing plant.« less

Flow behaviour in normal and Meniere’s disease of endolymphatic fluid inside the inner ear

NASA Astrophysics Data System (ADS)

Paisal, Muhammad Sufyan Amir; Azmi Wahab, Muhamad; Taib, Ishkrizat; Mat Isa, Norasikin; Ramli, Yahaya; Seri, Suzairin Md; Darlis, Nofrizalidris; Osman, Kahar; Khudzari, Ahmad Zahran Md; Nordin, Normayati

2017-09-01

Meniere’s disease is a rare disorder that affects the inner ear which might be more severe if not treated. This is due to fluctuating pressure of the fluid in the endolymphatic sac and dysfunction of cochlea which causing the stretching of vestibular membrane. However, the pattern of the flow recirculation in endolymphatic region is still not fully understood. Thus, this study aims to investigate the correlation between the increasing volume of endolymphatic fluid and flow characteristics such as velocity, pressure and wall shear stress. Three dimensional model of simplified endolymphatic region is modeled using computer aided design (CAD) software and simulated using computational fluid dynamic (CFD) software. There are three different models are investigated; normal (N) model, Meniere’s disease model with less severity (M1) and Meniere’s disease model with high severity (M2). From the observed, the pressure drop between inlet and outlet of inner ear becomes decreases as the outlet pressure along with endolymphatic volume increases. However, constant flow rate imposed at the inlet of endolymphatic showing the lowest velocity. Flow recirculation near to endolymphatic region is occurred as the volume in endolympathic increases. Overall, high velocity is monitored near to cochlear duct, ductus reuniens and endolymphatic duct. Hence, these areas show high distributions of wall shear stress (WSS) that indicating a high probability of endolymphatic wall membrane dilation. Thus, more severe conditions of Meniere’s disease, more complex of flow characteristic is occurred. This phenomenon presenting high probability of rupture is predicted at the certain area in the anatomy of vestibular system.

[Inspecting the cochlear scala tympanic with flexible and semi-flexible micro-endoscope].

PubMed

Zhang, Daoxcing; Zhang, Yankun

2006-02-01

Flexible and semi-flexible micro-endoscopes were used in cochlear scala tympani inspection , to explore their application in inner ear examination. Fifteen profound hearing loss patients preparing for cochlear implant were included in this study. During the operation, micro-endoscopy was performed after opening the cochlear scala tympani. And 1 mm diameter semi-flexible micro-endoscope could go as deep as 9 mm into the cochlear scala tympani, while 0. 5 mm diameter flexible micro-endoscope could go as deep as 25 mm. The inspecting results were compared with video recording. Using 0.5 mm flexible micro-endoscope, we canould check cochlear scala tympani with depth range of 15-25 mm, but the video imaging was not clear enough to examine the microstructure in the cochlear. With 1 mm diameter semi-flexible micro-endoscope, we could reach 9 mm deep into the cochlear. During the examination, we found 3 cases with calcification deposit in osseous spiral lamina, l case with granulation tissue in the lateral wall of scala tympani, no abnormal findings in the other 11 cases. Inspecting the cochlear scala tympani with 0.5 mm flexible micro-endoscope, even though we can reach the second circuit of the cochlear, it is difficult to find the pathology in the cochlear because of the poor video imaging. With 1 mm semi-flexible micro-endoscope, we can identify the microstructure of the cochlear clearly and find the pathologic changes, but the inserting depth was limited to 9 mm with limitation to examine the whole cochlear.

Accuracy of Noninvasive Estimation Techniques for the State of the Cochlear Amplifier

NASA Astrophysics Data System (ADS)

Dalhoff, Ernst; Gummer, Anthony W.

2011-11-01

Estimation of the function of the cochlea in human is possible only by deduction from indirect measurements, which may be subjective or objective. Therefore, for basic research as well as diagnostic purposes, it is important to develop methods to deduce and analyse error sources of cochlear-state estimation techniques. Here, we present a model of technical and physiologic error sources contributing to the estimation accuracy of hearing threshold and the state of the cochlear amplifier and deduce from measurements of human that the estimated standard deviation can be considerably below 6 dB. Experimental evidence is drawn from two partly independent objective estimation techniques for the auditory signal chain based on measurements of otoacoustic emissions.

Progress in Cochlear Physiology after Békésy

PubMed Central

Guinan, John J.; Salt, Alec; Cheatham, Mary Ann

2012-01-01

In the fifty years since Békésy was awarded the Nobel Prize, cochlear physiology has blossomed. Many topics that are now current are things Békésy could not have imagined. In this review we start by describing progress in understanding the origin of cochlear gross potentials, particularly the cochlear microphonic, an area in which Békésy had extensive experience. We then review progress in areas of cochlear physiology that were mostly unknown to Békésy, including: (1) stereocilia mechano-electrical transduction, force production, and response amplification, (2) outer hair cell (OHC) somatic motility and its molecular basis in prestin, (3) cochlear amplification and related micromechanics, including the evidence that prestin is the main motor for cochlear amplification, (4) the influence of the tectorial membrane, (5) cochlear micromechanics and the mechanical drives to inner hair cell stereocilia, (6) otoacoustic emissions, and (7) olivocochlear efferents and their influence on cochlear physiology. We then return to a subject that Békésy knew well: cochlear fluids and standing currents, as well as our present understanding of energy dependence on the lateral wall of the cochlea. Finally, we touch on cochlear pathologies including noise damage and aging, with an emphasis on where the field might go in the future. PMID:22633944

The early days of the multi channel cochlear implant: efforts and achievement in France.

PubMed

Chouard, C H

2015-04-01

On September 10th 2013, the clinical medical research Lasker award winners were rewarded for their work on multichannel cochlear implant. It has been my pleasure to see that such a major topic had caught the attention of the Members of the Jury for this prestigious award. That is why I accepted an invitation to participate in a special issue of Hearing Research devoted to the three winners. Here I highlight four scientific contributions made by the French team in late 1970s and early 1980s to modern multichannel cochlear implant development. 1) Chouard and MacLeod plotted an approximate frequency map of the whole length of the human cochlea, including its "hidden face" corresponding to speech frequencies. Moreover MacLeod suggested a sequential display of electrical stimulation as a function of each electrode, a precursor to today's electrodogram and interleaved stimulation. 2) Chouard performed total cochlear implantation in a deaf adult male with 8 electrically independent electrodes that were evenly distributed along the cochlea. 3) Chouard and MacLeod described in a patent detailed sound signal processing for a functional multichannel cochlear implant and reported speech discrimination without help of lip reading in some totally deafened patients. 4) Chouard experimentally demonstrated in the guinea pig the advantage of early cochlear implantation in treating profound neonatal deafness. This article is part of a Special Issue entitled . Copyright © 2014 Elsevier B.V. All rights reserved.

Speech Intelligibility and Prosody Production in Children with Cochlear Implants

PubMed Central

Chin, Steven B.; Bergeson, Tonya R.; Phan, Jennifer

2012-01-01

Objectives The purpose of the current study was to examine the relation between speech intelligibility and prosody production in children who use cochlear implants. Methods The Beginner's Intelligibility Test (BIT) and Prosodic Utterance Production (PUP) task were administered to 15 children who use cochlear implants and 10 children with normal hearing. Adult listeners with normal hearing judged the intelligibility of the words in the BIT sentences, identified the PUP sentences as one of four grammatical or emotional moods (i.e., declarative, interrogative, happy, or sad), and rated the PUP sentences according to how well they thought the child conveyed the designated mood. Results Percent correct scores were higher for intelligibility than for prosody and higher for children with normal hearing than for children with cochlear implants. Declarative sentences were most readily identified and received the highest ratings by adult listeners; interrogative sentences were least readily identified and received the lowest ratings. Correlations between intelligibility and all mood identification and rating scores except declarative were not significant. Discussion The findings suggest that the development of speech intelligibility progresses ahead of prosody in both children with cochlear implants and children with normal hearing; however, children with normal hearing still perform better than children with cochlear implants on measures of intelligibility and prosody even after accounting for hearing age. Problems with interrogative intonation may be related to more general restrictions on rising intonation, and the correlation results indicate that intelligibility and sentence intonation may be relatively dissociated at these ages. PMID:22717120

Assessment of Appalachian region pediatric hearing healthcare disparities and delays.

PubMed

Bush, Matthew L; Osetinsky, Mariel; Shinn, Jennifer B; Gal, Thomas J; Ding, Xiuhua; Fardo, David W; Schoenberg, Nancy

2014-07-01

The purpose of this study was to examine the timing of diagnostic and therapeutic services in cochlear implant recipients from a rural Appalachian region with healthcare disparity. Retrospective analysis. Cochlear implant recipients from a tertiary referral center born with severe congenital sensorineural hearing loss were examined. Rural status and Appalachian status of their county of origin were recorded. A log-rank test was used to examine differences in the distributions of time to definitive diagnosis of hearing loss, initial amplification fitting, and cochlear implantation in these children. Correlation analysis of the rural status of each county and the timing of services was assessed. A total of 53 children born with congenital hearing loss were included in the study (36 from rural counties and 17 from urban/suburban counties). The distribution of weeks after birth to diagnosis (P=.006), amplification (P=.030), and cochlear implantation (P=.002) was delayed in rural children compared with urban children. An analysis factoring in the effect of implementation of mandatory infant hearing screening in 2000 demonstrated a similar delay in rural children for weeks to diagnosis (P=.028), amplification (P=.087), and cochlear implantation (P<.0001). Children with severe hearing loss in very rural areas, such as Appalachia, may have significant delays in diagnostic and rehabilitative services. Further investigation is warranted to assess causative factors in delays of cochlear implantation and to develop interventions to promote timely diagnosis and care. 3b. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

A sustainable model for cochlear implantation in the developing world: perspectives from the Indian subcontinent.

PubMed

Sampath Kumar, Raghunandhan; Kameswaran, Mohan

2018-06-01

The overall prevalence of deafness in India is 0.2%, but the prevalence in the southern state of Tamil Nadu is much higher (around 0.6%) because of consanguinity. Especially in India, establishing cochlear implantation as a treatment modality for hearing loss has been a daunting task, but in the last decade, the cochlear implantation program has emerged as an unqualified success in many states, with over 20 000 cochlear implantations done till date. Several states are sponsoring free implants to children under the age of 6 years and below poverty line. Nearly 3000 cochlear implantations have been performed in Tamil Nadu under the Chief Minister's Comprehensive Health Insurance Scheme, with the goal to have a 'deafness free Tamil Nadu' by 2025. This scheme covers nearly 40 million people in rural areas. Valuable lessons have been learnt from this social experiment. One of the cornerstones of this scheme is the method to deliver habilitation via satellite centers in rural areas at the doorstep of the patient. The outcomes in peripheral centers were found to be statistically similar to those in the main center and correlated well with duration of habilitation. Opening up satellite centers for habilitation across the state of Tamil Nadu has greatly helped to improve the attendance and outcomes. The Indian model has been hugely successful and has helped start similar cochlear implantation programs in neighboring countries such as Nepal, Sri Lanka and Bangladesh.

Comparative study between unilateral and bilateral cochlear implantation in children of 1 and 2 years of age.

PubMed

Escorihuela García, Vicente; Pitarch Ribas, María Ignacia; Llópez Carratalá, Ignacio; Latorre Monteagudo, Emilia; Morant Ventura, Antonio; Marco Algarra, Jaime

2016-01-01

The studies that have evaluated the effectiveness of bilateral cochlear implantation in children suggest an improvement in hearing about sound localization and speech discrimination. In this paper we show the differences in audio-linguistic achievements with early bilateral cochlear implantation versus unilateral, and differences between simultaneous and sequential bilateral implantation. We present 88 children with bilateral profound sensorineural hearing loss, treated with bilateral cochlear implantation in 32 cases and unilateral in 56 cases, during the first 12 months (27 children) of life and between 12 and 24 months (61 children). We conducted a statistical comparison of both groups in the audiometry, IT-Mais, Nottingham, LittlEars scales and verbal tests. No significant differences in hearing thresholds and questionnaires between unilateral and bilateral implantation were detected in either the first or second year. Verbal tests do show statistically significant differences: children with bilateral cochlear implant obtain 100% recognition of disyllabic and phrases within 2-3 years after implantation whilst children with one implant do not obtain those results at 5 years after surgery. No differences between simultaneous and sequential bilateral implantation were detected. We emphasize the importance of ensuring good early audiological screening, to carry out an early and bilateral cochlear implantation with the consequent development of audio-language skills similar to normal hearing children. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

Modelling the effect of round window stiffness on residual hearing after cochlear implantation.

PubMed

Elliott, Stephen J; Ni, Guangjian; Verschuur, Carl A

2016-11-01

Preservation of residual hearing after cochlear implantation is now considered an important goal of surgery. However, studies indicate an average post-operative hearing loss of around 20 dB at low frequencies. One factor which may contribute to post-operative hearing loss, but which has received little attention in the literature to date, is the increased stiffness of the round window, due to the physical presence of the cochlear implant, and to its subsequent thickening or to bone growth around it. A finite element model was used to estimate that there is approximately a 100-fold increase in the round window stiffness due to a cochlear implant passing through it. A lumped element model was then developed to study the effects of this change in stiffness on the acoustic response of the cochlea. As the round window stiffness increases, the effects of the cochlear and vestibular aqueducts become more important. An increase of round window stiffness by a factor of 10 is predicted to have little effect on residual hearing, but increasing this stiffness by a factor of 100 reduces the acoustic sensitivity of the cochlea by about 20 dB, below 1 kHz, in reasonable agreement with the observed loss in residual hearing after implantation. It is also shown that the effect of this stiffening could be reduced by incorporating a small gas bubble within the cochlear implant. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

Wired to freedom: Life science, public politics, and the case of Cochlear Implantation.

PubMed

Jepsen, Kim Sune; Bertilsson, T Margareta

2017-02-01

Cochlear Implantation is now regarded as the most successful medical technology. It carries promises to provide deaf/hearing impaired individuals with a technological sense of hearing and an access to participate on a more equal level in social life. In this article, we explore the adoption of cochlear implantations among Danish users in order to shed more light on their social and political implications. We situate cochlear implantation in a framework of new life science advances, politics, and user experiences. Analytically, we draw upon the notion of social imaginary and explore the social dimension of life science through a notion of public politics adopted from the political theory of John Dewey. We show how cochlear implantation engages different social imaginaries on the collective and individual levels and we suggest that users share an imaginary of being "wired to freedom" that involves new access to social life, continuous communicative challenges, common practices, and experiences. In looking at their lives as "wired to freedom," we hope to promote a wider spectrum of civic participation in the benefit of future life science developments within and beyond the field of Cochlear Implantation. As our empirical observations are largely based in the Scandinavian countries (notably Denmark), we also provide some reflections on the character of the technology-friendly Scandinavian welfare states and the unintended consequences that may follow in the wake of rapid technology implementation of life science in society.

Value of intracochlear electrically evoked auditory brainstem response after cochlear implantation in patients with narrow internal auditory canal.

PubMed

Song, Mee Hyun; Bae, Mi Ran; Kim, Hee Nam; Lee, Won-Sang; Yang, Won Sun; Choi, Jae Young

2010-08-01

Cochlear implantation in patients with narrow internal auditory canal (IAC) can result in variable outcomes; however, preoperative evaluations have limitations in accurately predicting outcomes. In this study, we analyzed the outcomes of cochlear implantation in patients with narrow IAC and correlated the intracochlear electrically evoked auditory brainstem response (EABR) findings to postoperative performance to determine the prognostic significance of intracochlear EABR. Retrospective case series at a tertiary hospital. Thirteen profoundly deaf patients with narrow IAC who received cochlear implantation from 2002 to 2008 were included in this study. Postoperative performance was evaluated after at least 12 months of follow-up, and postoperative intracochlear EABR was measured to determine its correlation with outcome. The clinical significance of electrically evoked compound action potential (ECAP) was also analyzed. Patients with narrow IAC showed postoperative auditory performances ranging from CAP 0 to 4 after cochlear implantation. Intracochlear EABR measured postoperatively demonstrated prognostic value in the prediction of long-term outcomes, whereas ECAP measurements failed to show a significant correlation with outcome. Consistent with the advantages of intracochlear EABR over extracochlear EABR, this study demonstrates that intracochlear EABR has prognostic significance in predicting long-term outcomes in patients with narrow IAC. Intracochlear EABR measured either intraoperatively or in the early postoperative period may play an important role in deciding whether to continue with auditory rehabilitation using a cochlear implant or to switch to an auditory brainstem implant so as not to miss the optimal timing for language development.

Auditory Midbrain Implant: Research and Development Towards a Second Clinical Trial

PubMed Central

Lim, Hubert H.; Lenarz, Thomas

2015-01-01

The cochlear implant is considered one of the most successful neural prostheses to date, which was made possible by visionaries who continued to develop the cochlear implant through multiple technological and clinical challenges. However, patients without a functional auditory nerve or implantable cochlea cannot benefit from a cochlear implant. The focus of the paper is to review the development and translation of a new type of central auditory prosthesis for this group of patients, which is known as the auditory midbrain implant (AMI) and is designed for electrical stimulation within the inferior colliculus. The rationale and results for the first AMI clinical study using a multi-site single-shank array will be presented initially. Although the AMI has achieved encouraging results in terms of safety and improvements in lip-reading capabilities and environmental awareness, it has not yet provided sufficient speech perception. Animal and human data will then be presented to show that a two-shank AMI array can potentially improve hearing performance by targeting specific neurons of the inferior colliculus. Modifications to the AMI array design, stimulation strategy, and surgical approach have been made that are expected to improve hearing performance in the patients implanted with a two-shank array in an upcoming clinical trial funded by the National Institutes of Health. Positive outcomes from this clinical trial will motivate new efforts and developments toward improving central auditory prostheses for those who cannot sufficiently benefit from cochlear implants. PMID:25613994

Dual Language versus English-Only Support for Bilingual Children with Hearing Loss Who Use Cochlear Implants and Hearing Aids

ERIC Educational Resources Information Center

Bunta, Ferenc; Douglas, Michael; Dickson, Hanna; Cantu, Amy; Wickesberg, Jennifer; Gifford, René H.

2016-01-01

Background: There is a critical need to understand better speech and language development in bilingual children learning two spoken languages who use cochlear implants (CIs) and hearing aids (HAs). The paucity of knowledge in this area poses a significant barrier to providing maximal communicative outcomes to a growing number of children who have…

Central Auditory Development: Evidence from CAEP Measurements in Children Fit with Cochlear Implants

ERIC Educational Resources Information Center

Dorman, Michael F.; Sharma, Anu; Gilley, Phillip; Martin, Kathryn; Roland, Peter

2007-01-01

In normal-hearing children the latency of the P1 component of the cortical evoked response to sound varies as a function of age and, thus, can be used as a biomarker for maturation of central auditory pathways. We assessed P1 latency in 245 congenitally deaf children fit with cochlear implants following various periods of auditory deprivation. If…

Literacy Skills among Deaf and Hard of Hearing Students and Students with Cochlear Implants in Bilingual/bicultural Education

ERIC Educational Resources Information Center

Dammeyer, Jesper

2014-01-01

Research has shown that many deaf students do not develop age-appropriate reading and writing abilities. This study evaluates the literacy skills of deaf students, hard of hearing students, and students with cochlear implants in bilingual/bicultural schools in Denmark. The results show that 45 per cent of the students did not have any reading and…

Effect of cochlear nerve electrocautery on the adult cochlear nucleus.

PubMed

Iseli, Claire E; Merwin, William H; Klatt-Cromwell, Cristine; Hutson, Kendall A; Ewend, Matthew G; Adunka, Oliver F; Fitzpatrick, Douglas C; Buchman, Craig A

2015-04-01

Electrocauterization and subsequent transection of the cochlear nerve induce greater injury to the cochlear nucleus than sharp transection alone. Some studies show that neurofibromatosis Type 2 (NF2) patients fit with auditory brainstem implants (ABIs) fail to achieve speech perception abilities similar to ABI recipients without NF2. Reasons for these differences remain speculative. One hypothesis posits poorer performance to surgically induced trauma to the cochlear nucleus from electrocautery. Sustained electrosurgical depolarization of the cochlear nerve may cause excitotoxic-induced postsynaptic nuclear injury. Equally plausible is that cautery in the vicinity of the cochlear nucleus induces necrosis. The cochlear nerve was transected in anesthetized adult gerbils sharply with or without bipolar electrocautery at varying intensities. Gerbils were perfused at 1, 3, 5, and 7 days postoperatively; their brainstem and cochleas were embedded in paraffin and sectioned at 10 μm. Alternate sections were stained with flourescent markers for neuronal injury or Nissl substance. In additional experiments, anterograde tracers were applied directly to a sectioned eighth nerve to verify that fluorescent-labeled profiles seen were terminating auditory nerve fibers. Cochlear nerve injury was observed from 72 hours postoperatively and was identical across cases regardless of surgical technique. Postsynaptic cochlear nucleus injury was not seen after distal transection of the nerve. By contrast, proximal transection was associated with trauma to the cochlear nucleus. Distal application of bipolar electrocautery seems safe for the cochlear nucleus. Application near the root entry zone must be used cautiously because this may compromise nuclear viability needed to support ABI stimulation.

Effects of brain-derived neurotrophic factor (BDNF) on the cochlear nucleus in cats deafened as neonates.

PubMed

Kandathil, Cherian K; Stakhovskaya, Olga; Leake, Patricia A

2016-12-01

Many previous studies have shown significant neurotrophic effects of intracochlear delivery of BDNF in preventing degeneration of cochlear spiral ganglion (SG) neurons after deafness in rodents and our laboratory has shown similar results in developing cats deafened prior to hearing onset. This study examined the morphology of the cochlear nucleus (CN) in a group of neonatally deafened cats from a previous study in which infusion of BDNF elicited a significant improvement in survival of the SG neurons. Five cats were deafened by systemic injections of neomycin sulfate (60 mg/kg, SQ, SID) starting one day after birth, and continuing for 16-18 days until auditory brainstem response (ABR) testing demonstrated profound bilateral hearing loss. The animals were implanted unilaterally at about 1 month of age using custom-designed electrodes with a drug-delivery cannula connected to an osmotic pump. BDNF (94 μg/ml; 0.25 μl/hr) was delivered for 10 weeks. The animals were euthanized and studied at 14-23 weeks of age. Consistent with the neurotrophic effects of BDNF on SG survival, the total CN volume in these animals was significantly larger on the BDNF-treated side than on the contralateral side. However, total CN volume, both ipsi- and contralateral to the implants in these deafened juvenile animals, was markedly smaller than the CN in normal adult animals, reflecting the severe effects of deafness on the central auditory system during development. Data from the individual major CN subdivisions (DCN, Dorsal Cochlear Nucleus; PVCN, Posteroventral Cochlear Nucleus; AVCN, Anteroventral Cochlear Nucleus) also were analyzed. A significant difference was observed between the BDNF-treated and control sides only in the AVCN. Measurements of the cross-sectional areas of spherical cells showed that cells were significantly larger in the AVCN ipsilateral to the implant than on the contralateral side. Further, the numerical density of spherical cells was significantly lower in the AVCN ipsilateral to the implant than on the contralateral side, consistent with the larger AVCN volume observed with BDNF treatment. Together, findings indicate significant neurotrophic effects of intracochlear BDNF infusion on the developing CN. Copyright © 2016 Elsevier B.V. All rights reserved.

Investigation of Advanced Counterrotation Blade Configuration Concepts for High Speed Turboprop Systems. Task 2: Unsteady Ducted Propfan Analysis

NASA Technical Reports Server (NTRS)

Hall, Edward J.; Delaney, Robert A.; Bettner, James L.

1991-01-01

The primary objective was the development of a time dependent 3-D Euler/Navier-Stokes aerodynamic analysis to predict unsteady compressible transonic flows about ducted and unducted propfan propulsion systems at angle of attack. The resulting computer codes are referred to as Advanced Ducted Propfan Analysis Codes (ADPAC). A computer program user's manual is presented for the ADPAC. Aerodynamic calculations were based on a four stage Runge-Kutta time marching finite volume solution technique with added numerical dissipation. A time accurate implicit residual smoothing operator was used for unsteady flow predictions. For unducted propfans, a single H-type grid was used to discretize each blade passage of the complete propeller. For ducted propfans, a coupled system of five grid blocks utilizing an embedded C grid about the cowl leading edge was used to discretize each blade passage. Grid systems were generated by a combined algebraic/elliptic algorithm developed specifically for ducted propfans. Numerical calculations were compared with experimental data for both ducted and unducted flows.

Laparoscopy-guided intracorporeal ultrasound accurately delineates hepatobiliary anatomy.

PubMed

Yamamoto, M; Stiegmann, G V; Durham, J; Berguer, R; Oba, Y; Fujiyama, Y; McIntyre, R C

1993-01-01

The purpose of this study was to develop a technique and assess the ability of a laparoscopic ultrasound probe to delineate biliary antomy and to determine the presence or absence of duct stones. Five pigs had ultrasonography of biliary structures and liver at laparoscopy followed by cholangiograms and anatomical dissection. Five patients had ultrasonography of the biliary tract at laparoscopic cholecystectomy. All animals had adequate visualization of important hepatobiliary structure, and an optimal method of accessing these structures at laparoscopy was established. Patients had ultrasonography which used methods developed in the animal trial. All had adequate visualization of the entire common bile duct confirmed by cholangiography. Limitations in demonstrating the relationship of the cystic duct to the common duct were technical and can be corrected. Laparoscopic ultrasonography has significant potential for delineation of biliary anatomy and determination of presence or absence of duct calculi. Clinical implementation could minimize the risk of iatrogenic duct injury and the need for operative cholangiography.

Congenital dilatation of the intrahepatic bile ducts associated with the development of amyloidosis

PubMed Central

Fevery, J.; Tanghe, W.; Kerremans, R.; Desmet, V.; De Groote, J.

1972-01-01

Two cases of pure congenital dilatation of the intrahepatic bile ducts are presented. One patient developed amyloidosis secondary to suppuration, and had isolated cysts in the renal medulla. The position of congenital dilatation of the intrahepatic bile ducts compared with cysts in the liver and its association with `cystic' diseases of the kidneys is discussed. ImagesFig. 1Fig. 2Fig. 3Fig. 4 PMID:5077171

PMR Graphite Engine Duct Development

NASA Technical Reports Server (NTRS)

Stotler, C. L.; Yokel, S. A.

1989-01-01

The objective was to demonstrate the cost and weight advantages that could be obtained by utilizing the graphite/PMR15 material system to replace titanium in selected turbofan engine applications. The first component to be selected as a basis for evaluation was the outer bypass duct of the General Electric F404 engine. The operating environment of this duct was defined and then an extensive mechanical and physical property test program was conducted using material made by processing techniques which were also established by this program. Based on these properties, design concepts to fabricate a composite version of the duct were established and two complete ducts fabricated. One of these ducts was proof pressure tested and then run successfully on a factory test engine for over 1900 hours. The second duct was static tested to 210 percent design limit load without failure. An improved design was then developed which utilized integral composite end flanges. A complete duct was fabricated and successfully proof pressure tested. The net results of this effort showed that a composite version of the outer duct would be 14 percent lighter and 30 percent less expensive that the titanium duct. The other type of structure chosen for investigation was the F404 fan stator assembly, including the fan stator vanes. It was concluded that it was feasible to utilize composite materials for this type structure but that the requirements imposed by replacing an existing metal design resulted in an inefficient composite design. It was concluded that if composites were to be effectively used in this type structure, the design must be tailored for composite application from the outset.

The Hippo signaling functions through the Notch signaling to regulate intrahepatic bile duct development in mammals.

PubMed

Wu, Nan; Nguyen, Quy; Wan, Ying; Zhou, Tiaohao; Venter, Julie; Frampton, Gabriel A; DeMorrow, Sharon; Pan, Duojia; Meng, Fanyin; Glaser, Shannon; Alpini, Gianfranco; Bai, Haibo

2017-07-01

The Hippo signaling pathway and the Notch signaling pathway are evolutionary conserved signaling cascades that have important roles in embryonic development of many organs. In murine liver, disruption of either pathway impairs intrahepatic bile duct development. Recent studies suggested that the Notch signaling receptor Notch2 is a direct transcriptional target of the Hippo signaling pathway effector YAP, and the Notch signaling is a major mediator of the Hippo signaling in maintaining biliary cell characteristics in adult mice. However, it remains to be determined whether the Hippo signaling pathway functions through the Notch signaling in intrahepatic bile duct development. We found that loss of the Hippo signaling pathway tumor suppressor Nf2 resulted in increased expression levels of the Notch signaling pathway receptor Notch2 in cholangiocytes but not in hepatocytes. When knocking down Notch2 on the background of Nf2 deficiency in mouse livers, the excessive bile duct development induced by Nf2 deficiency was suppressed by heterozygous and homozygous deletion of Notch2 in a dose-dependent manner. These results implicated that Notch signaling is one of the downstream effectors of the Hippo signaling pathway in regulating intrahepatic bile duct development.

The Hippo signaling functions through the Notch signaling to regulate intrahepatic bile duct development in mammals

PubMed Central

Wu, Nan; Nguyen, Quy; Wan, Ying; Zhou, Tiaohao; Venter, Julie; Frampton, Gabriel A; DeMorrow, Sharon; Pan, Duojia; Meng, Fanyin; Glaser, Shannon; Alpini, Gianfranco; Bai, Haibo

2018-01-01

The Hippo signaling pathway and the Notch signaling pathway are evolutionary conserved signaling cascades that have important roles in embryonic development of many organs. In murine liver, disruption of either pathway impairs intrahepatic bile duct development. Recent studies suggested that the Notch signaling receptor Notch2 is a direct transcriptional target of the Hippo signaling pathway effector YAP, and the Notch signaling is a major mediator of the Hippo signaling in maintaining biliary cell characteristics in adult mice. However, it remains to be determined whether the Hippo signaling pathway functions through the Notch signaling in intrahepatic bile duct development. We found that loss of the Hippo signaling pathway tumor suppressor Nf2 resulted in increased expression levels of the Notch signaling pathway receptor Notch2 in cholangiocytes but not in hepatocytes. When knocking down Notch2 on the background of Nf2 deficiency in mouse livers, the excessive bile duct development induced by Nf2 deficiency was suppressed by heterozygous and homozygous deletion of Notch2 in a dose-dependent manner. These results implicated that Notch signaling is one of the downstream effectors of the Hippo signaling pathway in regulating intrahepatic bile duct development. PMID:28581486

Restudy of malformations of the internal auditory meatus, cochlear nerve canal and cochlear nerve.

PubMed

Li, Youjin; Yang, Jun; Liu, Jinfen; Wu, Hao

2015-07-01

The present study aims to restudy the correlation between the internal auditory meatus (IAM), the cochlear nerve canal (CNC), the cochlear nerve (CN) and inner ear malformations. In this retrospective study design, the abnormal diameter of the IAM, CNC and CN in patients with any kind of inner ear malformations was evaluated using multi-slice spiral computed tomography (MSCT) (37 patients) and magnetic resonance imaging (MRI) (18 patients). Of 37 MSCT-diagnosed patients, 2 had IAM atresia, 11 IAM stenosis, 22 enlarged IAM, and 2 normal IAM with an abnormal CN. MRI diagnoses of 18 patients revealed 8 cases of aplastic CN, 6 hypoplastic CN, and 4 normal CN. CNC stenosis was associated with CN hypoplasia (P < 0.001). Patients with absent or stenotic IAM had less CN development than those with normal or enlarged IAM (P = 0.001). We propose a modification of the existing classification systems with a view to distinguishing malformations of the IAM, CNC and CN.

Finite Element Analysis of Grouting Compactness Monitoring in a Post-Tensioning Tendon Duct Using Piezoceramic Transducers

PubMed Central

Jiang, Tianyong; Song, Gangbing

2017-01-01

With the development of the post-tensioning technique, prestressed concrete structures have been widely used in civil engineering. To ensure the long-term effectiveness of the prestressed tendon, the grouting quality of the tendon duct is one of the important factors. However, it is still a challenge to monitor the grouting quality of post-tensioning tendon ducts, due to the invisibility of the grouting. The authors’ previous work proposed a real-time method that employed a stress wave-based active sensing approach with piezoceramic transducers to monitor the grouting compactness of a Post-Tensioning Tendon Duct (PTTD). To further understand the piezoceramic induced stress wave propagation in the PTTD with different grouting levels, this paper develops a two-dimensional finite element model for monitoring the grouting compactness of the tendon duct with a piezoceramic transducer. A smart aggregate (SA) developed to utilize one Lead Zirconate Titanate (PZT) transducer with marble protection is installed in the center location of the tendon duct as an actuator. Two PZT patches are bonded on the bottom and top surface of the tendon duct as the sensors. The analysis results show that the finite element analysis results are in good agreement with the experimental results, which demonstrates that the finite element analysis is feasible and reliable. For the top half of the specimen, not much stress wave could be detected before the full grouting level, except for negligible signals that may propagate through the walls of the tendon duct. When the tendon duct grouting is at 100%, the stress wave propagates to the top of the specimen, and the displacements are symmetric in both left-right and top-bottom directions before the stress waves reach the boundary. The proposed two-dimensional finite element model has the potential to be implemented to simulate the stress wave propagation principle for monitoring grouting compaction of the post-tensioning tendon duct. PMID:28961173

Finite Element Analysis of Grouting Compactness Monitoring in a Post-Tensioning Tendon Duct Using Piezoceramic Transducers.

PubMed

Jiang, Tianyong; Zheng, Junbo; Huo, Linsheng; Song, Gangbing

2017-09-29

With the development of the post-tensioning technique, prestressed concrete structures have been widely used in civil engineering. To ensure the long-term effectiveness of the prestressed tendon, the grouting quality of the tendon duct is one of the important factors. However, it is still a challenge to monitor the grouting quality of post-tensioning tendon ducts, due to the invisibility of the grouting. The authors' previous work proposed a real-time method that employed a stress wave-based active sensing approach with piezoceramic transducers to monitor the grouting compactness of a Post-Tensioning Tendon Duct (PTTD). To further understand the piezoceramic induced stress wave propagation in the PTTD with different grouting levels, this paper develops a two-dimensional finite element model for monitoring the grouting compactness of the tendon duct with a piezoceramic transducer. A smart aggregate (SA) developed to utilize one Lead Zirconate Titanate (PZT) transducer with marble protection is installed in the center location of the tendon duct as an actuator. Two PZT patches are bonded on the bottom and top surface of the tendon duct as the sensors. The analysis results show that the finite element analysis results are in good agreement with the experimental results, which demonstrates that the finite element analysis is feasible and reliable. For the top half of the specimen, not much stress wave could be detected before the full grouting level, except for negligible signals that may propagate through the walls of the tendon duct. When the tendon duct grouting is at 100%, the stress wave propagates to the top of the specimen, and the displacements are symmetric in both left-right and top-bottom directions before the stress waves reach the boundary. The proposed two-dimensional finite element model has the potential to be implemented to simulate the stress wave propagation principle for monitoring grouting compaction of the post-tensioning tendon duct.

Music Perception of Cochlear Implant Recipients with Implications for Music Instruction: A Review of Literature

PubMed Central

Hsiao, Feilin; Gfeller, Kate

2013-01-01

This review of literature presents a systematic analysis of the capabilities and limitations of cochlear implant recipients regarding music perception. Specifically, it a) analyzes individual components of music (e.g., rhythm, timbre, and pitch) as they interface with the technical characteristics of cochlear implants and the perceptual abilities of cochlear implant recipients; and b) describes accommodations for music instruction that support successful participation of children with cochlear implants. This article consolidates research studies from various disciplines (audiology, hearing science, speech-language pathology, cochlear implants, and music therapy) to provide practical recommendations for educators in fostering the musical growth of children with cochlear implants. PMID:23469365

Cochlear implant revision surgeries in children.

PubMed

Amaral, Maria Stella Arantes do; Reis, Ana Cláudia Mirândola B; Massuda, Eduardo T; Hyppolito, Miguel Angelo

2018-02-16

The surgery during which the cochlear implant internal device is implanted is not entirely free of risks and may produce problems that will require revision surgeries. To verify the indications for cochlear implantation revision surgery for the cochlear implant internal device, its effectiveness and its correlation with certain variables related to language and hearing. A retrospective study of patients under 18 years submitted to cochlear implant Surgery from 2004 to 2015 in a public hospital in Brazil. Data collected were: age at the time of implantation, gender, etiology of the hearing loss, audiological and oral language characteristics of each patient before and after Cochlear Implant surgery and any need for surgical revision and the reason for it. Two hundred and sixty-five surgeries were performed in 236 patients. Eight patients received a bilateral cochlear implant and 10 patients required revision surgery. Thirty-two surgeries were necessary for these 10 children (1 bilateral cochlear implant), of which 21 were revision surgeries. In 2 children, cochlear implant removal was necessary, without reimplantation, one with cochlear malformation due to incomplete partition type I and another due to trauma. With respect to the cause for revision surgery, of the 8 children who were successfully reimplanted, four had cochlear calcification following meningitis, one followed trauma, one exhibited a facial nerve malformation, one experienced a failure of the cochlear implant internal device and one revision surgery was necessary because the electrode was twisted. The incidence of the cochlear implant revision surgery was 4.23%. The period following the revision surgeries revealed an improvement in the subject's hearing and language performance, indicating that these surgeries are valid in most cases. Copyright © 2018 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Deletion of PDZD7 disrupts the Usher syndrome type 2 protein complex in cochlear hair cells and causes hearing loss in mice.

PubMed

Zou, Junhuang; Zheng, Tihua; Ren, Chongyu; Askew, Charles; Liu, Xiao-Ping; Pan, Bifeng; Holt, Jeffrey R; Wang, Yong; Yang, Jun

2014-05-01

Usher syndrome type 2 (USH2) is the predominant form of USH, a leading genetic cause of combined deafness and blindness. PDZD7, a paralog of two USH causative genes, USH1C and USH2D (WHRN), was recently reported to be implicated in USH2 and non-syndromic deafness. It encodes a protein with multiple PDZ domains. To understand the biological function of PDZD7 and the pathogenic mechanism caused by PDZD7 mutations, we generated and thoroughly characterized a Pdzd7 knockout mouse model. The Pdzd7 knockout mice exhibit congenital profound deafness, as assessed by auditory brainstem response, distortion product otoacoustic emission and cochlear microphonics tests, and normal vestibular function, as assessed by their behaviors. Lack of PDZD7 leads to the disorganization of stereocilia bundles and a reduction in mechanotransduction currents and sensitivity in cochlear outer hair cells. At the molecular level, PDZD7 determines the localization of the USH2 protein complex, composed of USH2A, GPR98 and WHRN, to ankle links in developing cochlear hair cells, likely through its direct interactions with these three proteins. The localization of PDZD7 to the ankle links of cochlear hair bundles also relies on USH2 proteins. In photoreceptors of Pdzd7 knockout mice, the three USH2 proteins largely remain unchanged at the periciliary membrane complex. The electroretinogram responses of both rod and cone photoreceptors are normal in knockout mice at 1 month of age. Therefore, although the organization of the USH2 complex appears different in photoreceptors, it is clear that PDZD7 plays an essential role in organizing the USH2 complex at ankle links in developing cochlear hair cells. GenBank accession numbers: KF041446, KF041447, KF041448, KF041449, KF041450, KF041451.

Experience Changes How Emotion in Music Is Judged: Evidence from Children Listening with Bilateral Cochlear Implants, Bimodal Devices, and Normal Hearing

PubMed Central

Papsin, Blake C.; Paludetti, Gaetano; Gordon, Karen A.

2015-01-01

Children using unilateral cochlear implants abnormally rely on tempo rather than mode cues to distinguish whether a musical piece is happy or sad. This led us to question how this judgment is affected by the type of experience in early auditory development. We hypothesized that judgments of the emotional content of music would vary by the type and duration of access to sound in early life due to deafness, altered perception of musical cues through new ways of using auditory prostheses bilaterally, and formal music training during childhood. Seventy-five participants completed the Montreal Emotion Identification Test. Thirty-three had normal hearing (aged 6.6 to 40.0 years) and 42 children had hearing loss and used bilateral auditory prostheses (31 bilaterally implanted and 11 unilaterally implanted with contralateral hearing aid use). Reaction time and accuracy were measured. Accurate judgment of emotion in music was achieved across ages and musical experience. Musical training accentuated the reliance on mode cues which developed with age in the normal hearing group. Degrading pitch cues through cochlear implant-mediated hearing induced greater reliance on tempo cues, but mode cues grew in salience when at least partial acoustic information was available through some residual hearing in the contralateral ear. Finally, when pitch cues were experimentally distorted to represent cochlear implant hearing, individuals with normal hearing (including those with musical training) switched to an abnormal dependence on tempo cues. The data indicate that, in a western culture, access to acoustic hearing in early life promotes a preference for mode rather than tempo cues which is enhanced by musical training. The challenge to these preferred strategies during cochlear implant hearing (simulated and real), regardless of musical training, suggests that access to pitch cues for children with hearing loss must be improved by preservation of residual hearing and improvements in cochlear implant technology. PMID:26317976

Experience Changes How Emotion in Music Is Judged: Evidence from Children Listening with Bilateral Cochlear Implants, Bimodal Devices, and Normal Hearing.

PubMed

Giannantonio, Sara; Polonenko, Melissa J; Papsin, Blake C; Paludetti, Gaetano; Gordon, Karen A

2015-01-01

Children using unilateral cochlear implants abnormally rely on tempo rather than mode cues to distinguish whether a musical piece is happy or sad. This led us to question how this judgment is affected by the type of experience in early auditory development. We hypothesized that judgments of the emotional content of music would vary by the type and duration of access to sound in early life due to deafness, altered perception of musical cues through new ways of using auditory prostheses bilaterally, and formal music training during childhood. Seventy-five participants completed the Montreal Emotion Identification Test. Thirty-three had normal hearing (aged 6.6 to 40.0 years) and 42 children had hearing loss and used bilateral auditory prostheses (31 bilaterally implanted and 11 unilaterally implanted with contralateral hearing aid use). Reaction time and accuracy were measured. Accurate judgment of emotion in music was achieved across ages and musical experience. Musical training accentuated the reliance on mode cues which developed with age in the normal hearing group. Degrading pitch cues through cochlear implant-mediated hearing induced greater reliance on tempo cues, but mode cues grew in salience when at least partial acoustic information was available through some residual hearing in the contralateral ear. Finally, when pitch cues were experimentally distorted to represent cochlear implant hearing, individuals with normal hearing (including those with musical training) switched to an abnormal dependence on tempo cues. The data indicate that, in a western culture, access to acoustic hearing in early life promotes a preference for mode rather than tempo cues which is enhanced by musical training. The challenge to these preferred strategies during cochlear implant hearing (simulated and real), regardless of musical training, suggests that access to pitch cues for children with hearing loss must be improved by preservation of residual hearing and improvements in cochlear implant technology.

The acoustics of ducted propellers

NASA Astrophysics Data System (ADS)

Ali, Sherif F.

The return of the propeller to the long haul commercial service may be rapidly approaching in the form of advanced "prop fans". It is believed that the advanced turboprop will considerably reduce the operational cost. However, such aircraft will come into general use only if their noise levels meet the standards of community acceptability currently applied to existing aircraft. In this work a time-marching boundary-element technique is developed, and used to study the acoustics of ducted propeller. The numerical technique is developed in this work eliminated the inherent instability suffered by conventional approaches. The methodology is validated against other numerical and analytical results. The results show excellent agreement with the analytical solution and show no indication of unstable behavior. For the ducted propeller problem, the propeller is modeled by a rotating source-sink pairs, and the duct is modeled by rigid annular body of elliptical cross-section. Using the model and the developed technique, the effect of different parameters on the acoustic field is predicted and analyzed. This includes the effect of duct length, propeller axial location, and source Mach number. The results of this study show that installing a short duct around the propeller can reduce the noise that reaches an observer on a side line.

Development of Mandarin spoken language after pediatric cochlear implantation.

PubMed

Li, Bei; Soli, Sigfrid D; Zheng, Yun; Li, Gang; Meng, Zhaoli

2014-07-01

The purpose of this study was to evaluate early spoken language development in young Mandarin-speaking children during the first 24 months after cochlear implantation, as measured by receptive and expressive vocabulary growth rates. Growth rates were compared with those of normally hearing children and with growth rates for English-speaking children with cochlear implants. Receptive and expressive vocabularies were measured with the simplified short form (SSF) version of the Mandarin Communicative Development Inventory (MCDI) in a sample of 112 pediatric implant recipients at baseline, 3, 6, 12, and 24 months after implantation. Implant ages ranged from 1 to 5 years. Scores were expressed in terms of normal equivalent ages, allowing normalized vocabulary growth rates to be determined. Scores for English-speaking children were re-expressed in these terms, allowing direct comparisons of Mandarin and English early spoken language development. Vocabulary growth rates during the first 12 months after implantation were similar to those for normally hearing children less than 16 months of age. Comparisons with growth rates for normally hearing children 16-30 months of age showed that the youngest implant age group (1-2 years) had an average growth rate of 0.68 that of normally hearing children; while the middle implant age group (2-3 years) had an average growth rate of 0.65; and the oldest implant age group (>3 years) had an average growth rate of 0.56, significantly less than the other two rates. Growth rates for English-speaking children with cochlear implants were 0.68 in the youngest group, 0.54 in the middle group, and 0.57 in the oldest group. Growth rates in the middle implant age groups for the two languages differed significantly. The SSF version of the MCDI is suitable for assessment of Mandarin language development during the first 24 months after cochlear implantation. Effects of implant age and duration of implantation can be compared directly across languages using normalized vocabulary growth rates. These comparisons for Mandarin and English reveal comparable results, despite the diversity of these languages, underscoring the universal role of plasticity in the developing auditory system. Copyright © 2014. Published by Elsevier Ireland Ltd.

Truss-Integrated Thermoformed Ductwork Final Technical Report

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

Steven Winter; Dianne Griffiths; Ravi Gorthala

2007-08-30

This report summarizes a multi-year research effort to develop a leak-free duct system that can be readily installed within the thermal envelope. There are numerous efforts underway to improve duct system efficiency. Most of these involve modifications to current technology such as air sealing techniques like mastic and aeroseal, snap together duct connections, and greater levels of insulation. This project sought to make a more significant stride forward by introducing a duct system of a material that can be more readily sealed and can exhibit lower friction losses. The research focused on the use of smooth internal surface, low frictionmore » plastic ducts that could be easily installed with very low air leakage. The initial system concept that was proposed and researched in Phase I focused on the use of thermoformed plastic ducts installed in a recessed roof truss underneath the attic insulation. A bench top thermoformed system was developed and tested during Phase I of the project. In Phase II, a first generation duct system utilizing a resin impregnated fiberglass duct product was designed and specified. The system was installed and tested in an Atlanta area home. Following this installation research and correspondence with code officials was undertaken to alleviate the continued concern over the code acceptance of plastic ducts in above ground applications. A Committee Interpretation response was received from the International Code Council (ICC) stating that plastic ducts were allowed, but must be manufactured from materials complying with Class 0 or Class 1 rating. With assurance of code acceptance, a plastic duct system using rotomolded high density polyethylene ducts that had passed the material test requirements by impregnating the material with a fire retardant during the molding process was installed in the basement of a new ranch-style home in Madison, WI. A series of measurements to evaluate the performance benefits relative to a similar control house with a standard sheet metal installation were made.« less

Adenosine and the Auditory System

PubMed Central

Vlajkovic, Srdjan M; Housley, Gary D; Thorne, Peter R

2009-01-01

Adenosine is a signalling molecule that modulates cellular activity in the central nervous system and peripheral organs via four G protein-coupled receptors designated A1, A2A, A2B, and A3. This review surveys the literature on the role of adenosine in auditory function, particularly cochlear function and its protection from oxidative stress. The specific tissue distribution of adenosine receptors in the mammalian cochlea implicates adenosine signalling in sensory transduction and auditory neurotransmission although functional studies have demonstrated that adenosine stimulates cochlear blood flow, but does not alter the resting and sound-evoked auditory potentials. An interest in a potential otoprotective role for adenosine has recently evolved, fuelled by the capacity of A1 adenosine receptors to prevent cochlear injury caused by acoustic trauma and ototoxic drugs. The balance between A1 and A2A receptors is conceived as critical for cochlear response to oxidative stress, which is an underlying mechanism of the most common inner ear pathologies (e.g. noise-induced and age-related hearing loss, drug ototoxicity). Enzymes involved in adenosine metabolism, adenosine kinase and adenosine deaminase, are also emerging as attractive targets for controlling oxidative stress in the cochlea. Other possible targets include ectonucleotidases that generate adenosine from extracellular ATP, and nucleoside transporters, which regulate adenosine concentrations on both sides of the plasma membrane. Developments of selective adenosine receptor agonists and antagonists that can cross the blood-cochlea barrier are bolstering efforts to develop therapeutic interventions aimed at ameliorating cochlear injury. Manipulations of the adenosine signalling system thus hold significant promise in the therapeutic management of oxidative stress in the cochlea. PMID:20190966

The Development of the Ducted Fan Noise Propagation and Radiation Code CDUCT-LaRC

NASA Technical Reports Server (NTRS)

Nark, Douglas M.; Farassat, F.; Pope, D. Stuart; Vatsa, Veer

2003-01-01

The development of the ducted fan noise propagation and radiation code CDUCT-LaRC at NASA Langley Research Center is described. This code calculates the propagation and radiation of given acoustic modes ahead of the fan face or aft of the exhaust guide vanes in the inlet or exhaust ducts, respectively. This paper gives a description of the modules comprising CDUCT-LaRC. The grid generation module provides automatic creation of numerical grids for complex (non-axisymmetric) geometries that include single or multiple pylons. Files for performing automatic inviscid mean flow calculations are also generated within this module. The duct propagation is based on the parabolic approximation theory of R. P. Dougherty. This theory allows the handling of complex internal geometries and the ability to study the effect of non-uniform (i.e. circumferentially and axially segmented) liners. Finally, the duct radiation module is based on the Ffowcs Williams-Hawkings (FW-H) equation with a penetrable data surface. Refraction of sound through the shear layer between the external flow and bypass duct flow is included. Results for benchmark annular ducts, as well as other geometries with pylons, are presented and compared with available analytical data.

Drug delivery into the cochlear apex: Improved control to sequentially affect finely spaced regions along the entire length of the cochlear spiral.

PubMed

Lichtenhan, J T; Hartsock, J; Dornhoffer, J R; Donovan, K M; Salt, A N

2016-11-01

Administering pharmaceuticals to the scala tympani of the inner ear is a common approach to study cochlear physiology and mechanics. We present here a novel method for in vivo drug delivery in a controlled manner to sealed ears. Injections of ototoxic solutions were applied from a pipette sealed into a fenestra in the cochlear apex, progressively driving solutions along the length of scala tympani toward the cochlear aqueduct at the base. Drugs can be delivered rapidly or slowly. In this report we focus on slow delivery in which the injection rate is automatically adjusted to account for varying cross sectional area of the scala tympani, therefore driving a solution front at uniform rate. Objective measurements originating from finely spaced, low- to high-characteristic cochlear frequency places were sequentially affected. Comparison with existing methods(s): Controlled administration of pharmaceuticals into the cochlear apex overcomes a number of serious limitations of previously established methods such as cochlear perfusions with an injection pipette in the cochlear base: The drug concentration achieved is more precisely controlled, drug concentrations remain in scala tympani and are not rapidly washed out by cerebrospinal fluid flow, and the entire length of the cochlear spiral can be treated quickly or slowly with time. Controlled administration of solutions into the cochlear apex can be a powerful approach to sequentially effect objective measurements originating from finely spaced cochlear regions and allows, for the first time, the spatial origin of CAPs to be objectively defined. Copyright © 2016 Elsevier B.V. All rights reserved.

Drug delivery into the cochlear apex: Improved control to sequentially affect finely spaced regions along the entire length of the cochlear spiral

PubMed Central

Lichtenhan, JT; Hartsock, J; Dornhoffer, JR; Donovan, KM; Salt, AN

2016-01-01

Background Administering pharmaceuticals to the scala tympani of the inner ear is a common approach to study cochlear physiology and mechanics. We present here a novel method for in vivo drug delivery in a controlled manner to sealed ears. New method Injections of ototoxic solutions were applied from a pipette sealed into a fenestra in the cochlear apex, progressively driving solutions along the length of scala tympani toward the cochlear aqueduct at the base. Drugs can be delivered rapidly or slowly. In this report we focus on slow delivery in which the injection rate is automatically adjusted to account for varying cross sectional area of the scala tympani, therefore driving a solution front at uniform rate. Results Objective measurements originating from finely spaced, low- to high-characteristic cochlear frequency places were sequentially affected. Comparison with existing methods(s): Controlled administration of pharmaceuticals into the cochlear apex overcomes a number of serious limitations of previously established methods such as cochlear perfusions with an injection pipette in the cochlear base: The drug concentration achieved is more precisely controlled, drug concentrations remain in scala tympani and are not rapidly washed out by cerebrospinal fluid flow, and the entire length of the cochlear spiral can be treated quickly or slowly with time. Conclusions Controlled administration of solutions into the cochlear apex can be a powerful approach to sequentially effect objective measurements originating from finely spaced cochlear regions and allows, for the first time, the spatial origin of CAPs to be objectively defined. PMID:27506463

Effects of early auditory experience on the spoken language of deaf children at 3 years of age.

PubMed

Nicholas, Johanna Grant; Geers, Ann E

2006-06-01

By age 3, typically developing children have achieved extensive vocabulary and syntax skills that facilitate both cognitive and social development. Substantial delays in spoken language acquisition have been documented for children with severe to profound deafness, even those with auditory oral training and early hearing aid use. This study documents the spoken language skills achieved by orally educated 3-yr-olds whose profound hearing loss was identified and hearing aids fitted between 1 and 30 mo of age and who received a cochlear implant between 12 and 38 mo of age. The purpose of the analysis was to examine the effects of age, duration, and type of early auditory experience on spoken language competence at age 3.5 yr. The spoken language skills of 76 children who had used a cochlear implant for at least 7 mo were evaluated via standardized 30-minute language sample analysis, a parent-completed vocabulary checklist, and a teacher language-rating scale. The children were recruited from and enrolled in oral education programs or therapy practices across the United States. Inclusion criteria included presumed deaf since birth, English the primary language of the home, no other known conditions that interfere with speech/language development, enrolled in programs using oral education methods, and no known problems with the cochlear implant lasting more than 30 days. Strong correlations were obtained among all language measures. Therefore, principal components analysis was used to derive a single Language Factor score for each child. A number of possible predictors of language outcome were examined, including age at identification and intervention with a hearing aid, duration of use of a hearing aid, pre-implant pure-tone average (PTA) threshold with a hearing aid, PTA threshold with a cochlear implant, and duration of use of a cochlear implant/age at implantation (the last two variables were practically identical because all children were tested between 40 and 44 mo of age). Examination of the independent influence of these predictors through multiple regression analysis revealed that pre-implant-aided PTA threshold and duration of cochlear implant use (i.e., age at implant) accounted for 58% of the variance in Language Factor scores. A significant negative coefficient associated with pre-implant-aided threshold indicated that children with poorer hearing before implantation exhibited poorer language skills at age 3.5 yr. Likewise, a strong positive coefficient associated with duration of implant use indicated that children who had used their implant for a longer period of time (i.e., who were implanted at an earlier age) exhibited better language at age 3.5 yr. Age at identification and amplification was unrelated to language outcome, as was aided threshold with the cochlear implant. A significant quadratic trend in the relation between duration of implant use and language score revealed a steady increase in language skill (at age 3.5 yr) for each additional month of use of a cochlear implant after the first 12 mo of implant use. The advantage to language of longer implant use became more pronounced over time. Longer use of a cochlear implant in infancy and very early childhood dramatically affects the amount of spoken language exhibited by 3-yr-old, profoundly deaf children. In this sample, the amount of pre-implant intervention with a hearing aid was not related to language outcome at 3.5 yr of age. Rather, it was cochlear implantation at a younger age that served to promote spoken language competence. The previously identified language-facilitating factors of early identification of hearing impairment and early educational intervention may not be sufficient for optimizing spoken language of profoundly deaf children unless it leads to early cochlear implantation.

Examining the communication skills of a young cochlear implant pioneer.

PubMed

Connor, Carol McDonald

2006-01-01

The purpose of this longitudinal case study was to closely examine one deaf child's experience with a cochlear implant and his speech, language, and communication skills from kindergarten through middle and high school using both developmental and sociocultural frameworks. The target child was one of the first children to receive a cochlear implant in the United States in 1988, when he was 5 years of age. The developmental analysis revealed that prior to receiving a cochlear implant the child demonstrated profound delays in speech and language skill development. His speech and language skills grew slowly during the first 3-4 years following implantation, very rapidly from about 5 through 7 years postimplantation, then slowed to rates that were highly similar to same-age peers with normal hearing. The sociocultural analysis revealed that the child's communicative competence improved; that he used sign language but use of sign language decreased as his oral communication skills improved; that as his oral communication skills improved, the adults talked and directed the topic of conversation less frequently; and that topics became less concrete and more personal over time. The results of this study indicate that we may learn more about how to support children who use cochlear implants by examining what they are saying as well as how they are saying it.

Design of a Tool Integrating Force Sensing With Automated Insertion in Cochlear Implantation

PubMed Central

Schurzig, Daniel; Labadie, Robert F.; Hussong, Andreas; Rau, Thomas S.; Webster, Robert J.

2012-01-01

The quality of hearing restored to a deaf patient by a cochlear implant in hearing preservation cochlear implant surgery (and possibly also in routine cochlear implant surgery) is believed to depend on preserving delicate cochlear membranes while accurately inserting an electrode array deep into the spiral cochlea. Membrane rupture forces, and possibly, other indicators of suboptimal placement, are below the threshold detectable by human hands, motivating a force sensing insertion tool. Furthermore, recent studies have shown significant variability in manual insertion forces and velocities that may explain some instances of imperfect placement. Toward addressing this, an automated insertion tool was recently developed by Hussong et al. By following the same insertion tool concept, in this paper, we present mechanical enhancements that improve the surgeon’s interface with the device and make it smaller and lighter. We also present electomechanical design of new components enabling integrated force sensing. The tool is designed to be sufficiently compact and light that it can be mounted to a microstereotactic frame for accurate image-guided preinsertion positioning. The new integrated force sensing system is capable of resolving forces as small as 0.005 N, and we provide experimental illustration of using forces to detect errors in electrode insertion. PMID:23482414

The mechanical waveform of the basilar membrane. IV. Tone and noise stimuli

NASA Astrophysics Data System (ADS)

de Boer, Egbert; Nuttall, Alfred L.

2002-02-01

Analysis of mechanical cochlear responses to wide bands of random noise clarifies many effects of cochlear nonlinearity. The previous paper [de Boer and Nuttall, J. Acoust. Soc. Am. 107, 1497-1507 (2000)] illustrates how closely results of computations in a nonlinear cochlear model agree with responses from physiological experiments. In the present paper results for tone stimuli are reported. It was found that the measured frequency response for pure tones differs little from the frequency response associated with a noise signal. For strong stimuli, well into the nonlinear region, tones have to be presented at a specific level with respect to the noise for this to be true. In this report the nonlinear cochlear model originally developed for noise analysis was modified to accommodate pure tones. For this purpose the efficiency with which outer hair cells modify the basilar-membrane response was made into a function of cochlear location based on local excitation. For each experiment, the modified model is able to account for the experimental findings, within 1 or 2 dB. Therefore, the model explains why the type of filtering that tones undergo in the cochlea is essentially the same as that for noise signals (provided the tones are presented at the appropriate level).

Effects of carbogen on cochlear blood flow and hearing function following acute acoustic trauma in guinea pigs.

PubMed

Zhao, Jing; Sun, Jianjun; Liu, Yang

2012-10-01

Disturbances of microcirculation and hemorheological changes in the inner ear are the results of noise-induced hearing loss (NIHL). Both the disturbances of microcirculation and hemorheological changes are the etiologies of NIHL development, but they are also the results. Although previous reports that inhalation of high concentration of CO(2) may increase cochlear blood flow (CoBF), the effects of carbogen on the cochlear microcirculation and NIHL remain unclear. Changes induced by noise, carbogen and pure oxygen within the cochlear lateral wall microvasculature and in hearing thresholds were observed in guinea pigs using intravital microscopy and the auditory brainstem response. At the same time, arterial oxygen saturation and morphologic changes of cochlear hair cells were observed. Carbogen inhalation increased vessel diameters and blood flow velocities. Hearing thresholds elevation in the carbogen group was smaller than those in the control and oxygen group (p <0.05). Carbogen inhalation produced a trend toward less threshold shift after noise exposure, which reached statistical significance after day 3 (p <0.01). Respiratory acidosis was not found in our study. The segmented basal membranes of Corti in three groups indicated that no losses or discorders of hair cells were found. Carbogen inhalation can preserve hearing in animal models after acute acoustic trauma. Copyright © 2012 IMSS. All rights reserved.

Ear asymmetries in middle-ear, cochlear, and brainstem responses in human infants

PubMed Central

Keefe, Douglas H.; Gorga, Michael P.; Jesteadt, Walt; Smith, Lynette M.

2008-01-01

In 2004, Sininger and Cone-Wesson examined asymmetries in the signal-to-noise ratio (SNR) of otoacoustic emissions (OAE) in infants, reporting that distortion-product (DP)OAE SNR was larger in the left ear, whereas transient-evoked (TE)OAE SNR was larger in the right. They proposed that cochlear and brainstem asymmetries facilitate development of brain-hemispheric specialization for sound processing. Similarly, in 2006 Sininger and Cone-Wesson described ear asymmetries mainly favoring the right ear in infant auditory brainstem responses (ABRs). The present study analyzed 2640 infant responses to further explore these effects. Ear differences in OAE SNR, signal, and noise were evaluated separately and across frequencies (1.5, 2, 3, and 4 kHz), and ABR asymmetries were compared with cochlear asymmetries. Analyses of ear-canal reflectance and admittance showed that asymmetries in middle-ear functioning did not explain cochlear and brainstem asymmetries. Current results are consistent with earlier studies showing right-ear dominance for TEOAE and ABR. Noise levels were higher in the right ear for OAEs and ABRs, causing ear asymmetries in SNR to differ from those in signal level. No left-ear dominance for DPOAE signal was observed. These results do not support a theory that ear asymmetries in cochlear processing mimic hemispheric brain specialization for auditory processing. PMID:18345839

Pediatric Auditory Brainstem Implant Surgery: A New Option for Auditory Habilitation in Congenital Deafness?

PubMed

Shah, Parth V; Kozin, Elliott D; Kaplan, Alyson B; Lee, Daniel J

2016-01-01

The auditory brainstem implant (ABI) is a neuroprosthetic device that provides sound sensations to individuals with profound hearing loss who are not candidates for a cochlear implant (CI) because of anatomic constraints. Herein we describe the ABI for family physicians. PubMed was searched to identify articles relevant to the ABI, as well as articles that contain outcomes data for pediatric patients (age <18 years) who have undergone ABI surgery. The ABI was originally developed for patients with neurofibromatosis type 2 (NF2) who become deaf from bilateral vestibular schwannomas. Over the past decade, indications for an ABI have expanded to adult patients without tumors (without NF2) who cannot receive a CI and children with no cochlea or cochlear nerve. Outcomes among NF2 ABI users are modest compared to cochlear implant patients, but recent studies from Europe suggest that some non-tumor adult and pediatric ABI users achieve speech perception. The ABI is a reasonable surgical option for children with profound hearing loss due to severe cochlear or cochlear nerve deformities. Continued prospective data collection from several clinical trials in the U.S. will provide greater understanding on long term outcomes that focus on speech intelligibility. © Copyright 2016 by the American Board of Family Medicine.

Vocal singing by prelingually-deafened children with cochlear implants.

PubMed

Xu, Li; Zhou, Ning; Chen, Xiuwu; Li, Yongxin; Schultz, Heather M; Zhao, Xiaoyan; Han, Demin

2009-09-01

The coarse pitch information in cochlear implants might hinder the development of singing in prelingually-deafened pediatric users. In the present study, seven prelingually-deafened children with cochlear implants (5.4-12.3 years old) sang one song that was the most familiar to him or her. The control group consisted of 14 normal-hearing children (4.1-8.0 years old). The fundamental frequencies (F0) of each note in the recorded songs were extracted. The following five metrics were computed based on the reference music scores: (1) F0 contour direction of the adjacent notes, (2) F0 compression ratio of the entire song, (3) mean deviation of the normalized F0 across the notes, (4) mean deviation of the pitch intervals, and (5) standard deviation of the note duration differences. Children with cochlear implants showed significantly poorer performance in the pitch-based assessments than the normal-hearing children. No significant differences were seen between the two groups in the rhythm-based measure. Prelingually-deafened children with cochlear implants have significant deficits in singing due to their inability to manipulate pitch in the correct directions and to produce accurate pitch height. Future studies with a large sample size are warranted in order to account for the large variability in singing performance.

Serotonin projection patterns to the cochlear nucleus.

PubMed

Thompson, A M; Thompson, G C

2001-07-13

The cochlear nucleus is well known as an obligatory relay center for primary auditory nerve fibers. Perhaps not so well known is the neural input to the cochlear nucleus from cells containing serotonin that reside near the midline in the midbrain raphe region. Although the specific locations of the main, if not sole, sources of serotonin within the dorsal cochlear nucleus subdivision are known to be the dorsal and median raphe nuclei, sources of serotonin located within other cochlear nucleus subdivisions are not currently known. Anterograde tract tracing was used to label fibers originating from the dorsal and median raphe nuclei while fluorescence immunohistochemistry was used to simultaneously label specific serotonin fibers in cat. Biotinylated dextran amine was injected into the dorsal and median raphe nuclei and was visualized with Texas Red, while serotonin was visualized with fluorescein. Thus, double-labeled fibers were unequivocally identified as serotoninergic and originating from one of the labeled neurons within the dorsal and median raphe nuclei. Double-labeled fiber segments, typically of fine caliber with oval varicosities, were observed in many areas of the cochlear nucleus. They were found in the molecular layer of the dorsal cochlear nucleus, in the small cell cap region, and in the granule cell and external regions of the cochlear nuclei, bilaterally, of all cats. However, the density of these double-labeled fiber segments varied considerably depending upon the exact region in which they were found. Fiber segments were most dense in the dorsal cochlear nucleus (especially in the molecular layer) and the large spherical cell area of the anteroventral cochlear nucleus; they were moderately dense in the small cell cap region; and fiber segments were least dense in the octopus and multipolar cell regions of the posteroventral cochlear nucleus. Because of the presence of labeled fiber segments in subdivisions of the cochlear nucleus other than the dorsal cochlear nucleus, we concluded that the serotoninergic projection pattern to the cochlear nucleus is divergent and non-specific. Double-labeled fiber segments were also present, but sparse, in the superior olive, localized mainly in periolivary regions; this indicated that the divergence of dorsal and median raphe neurons that extends throughout regions of the cochlear nucleus also extended well beyond the cochlear nucleus to include at least the superior olivary complex as well.

24 CFR 3285.606 - Ductwork connections.

Code of Federal Regulations, 2010 CFR

2010-04-01

... URBAN DEVELOPMENT MODEL MANUFACTURED HOME INSTALLATION STANDARDS Ductwork and Plumbing and Fuel Supply... type duct, the straps must be at least 1/2″ wider than the spacing of the metal spirals encasing the duct. The ducts must be installed such that the straps cannot slip between any two spirals and arranged...

24 CFR 3285.606 - Ductwork connections.

Code of Federal Regulations, 2011 CFR

2011-04-01

... URBAN DEVELOPMENT MODEL MANUFACTURED HOME INSTALLATION STANDARDS Ductwork and Plumbing and Fuel Supply... type duct, the straps must be at least 1/2″ wider than the spacing of the metal spirals encasing the duct. The ducts must be installed such that the straps cannot slip between any two spirals and arranged...

Development of Explosive Ripper with Two-Stage Combustion

DTIC Science & Technology

1974-10-01

inch pipe duct work, the width of this duct proved to be detrimental in marginally rippable material; the duct, instead of the penetrator tip, was...marginally rippable rock. ID. Operating Requirements 2. Fuel The two-stage combustion device is designed to operate using S A 42. the same diesel

Biliary complications after right lobe living donor liver transplantation: a single-centre experience

PubMed Central

Yaprak, Onur; Dayangac, Murat; Akyildiz, Murat; Demirbas, Tolga; Guler, Necdet; Bulutcu, Fisun; Bassullu, Nuray; Akun, Elif; Yuzer, Yildiray; Tokat, Yaman

2012-01-01

Background Biliary complications that developed after right lobe liver transplantation from living donors were studied in a single centre. Methods From 2004 to 2010, 200 consecutive living donor right lobe liver transplantations were performed. The database was evaluated retrospectively. Biliary complications were diagnosed according to clinical, biochemical and radiological tests. The number of biliary ducts in the transplanted graft, the surgical techniques used for anastomosis, biliary strictures and bile leakage rates were analysed. Results Of a total of 200 grafts, 117 invloved a single bile duct, 77 had two bile ducts and in six grafts there were three bile ducts. In 166 transplants, the anastomosis was performed as a single duct to duct, in 21 transplants double duct to ducts, in one transplant, three duct to ducts and in 12 transplants as a Roux-en-Y reconstruction. In all, 40 bile leakages (20%) and 17 biliary strictures (8.5%) were observed in 49 patients resulting in a total of 57 biliary complications (28.5%). Seventeen patients were re-operated (12 as a result of bile leakages and five owing to biliary strictures). Conclusion Identification of more than one biliary orifice in the graft resulted in an increase in the complication rates. In grafts containing multiple orifices, performing multiple duct-to-duct (DD) or Roux-en-Y anastomoses led to a lower number of complications. PMID:22151451

Cholangiocarcinoma in a middle-aged patient working at a printing plant.

PubMed

Tanaka, Shogo; Fukumoto, Nobusuke; Ohno, Kohichi; Tanaka, Sayaka; Ohsawa, Masahiko; Yamamoto, Takatsugu; Nakanuma, Yasuni; Kuboo, Shoji

2014-06-01

A 39-year-old male with elevated serum transferases consulted our hospital in September 2010. Since 1999, he had worked at a printing company using organic solvents. Cholangiography revealed stenosis of the left hepatic duct with peripheral dilation, stricture of the right hepatic duct, and irregularity of the extrahepatic bile duct. As a preoperative diagnosis of sclerosing cholangitis and cholangiocarcinoma was made, extended left hepatectomy with resection of the extrahepatic bile duct and anastomosis of the anterior and posterior branches of the bile duct and the jejunum (Roux-en Y reconstruction) were performed. A histological examination showed papillary carcinoma of the medial hepatic bile duct with intraductal growth, and biliary intraepithelial neoplasia-2/3 lesions from the medial hepatic bile duct to the right hepatic and the common bile ducts. Chronic cholangitis was shown around the tumors. Postoperatively, the patient was treated with adjuvant chemo-radiation, and he is doing well 30 months after the operation, without recurrence. Unknown causes, including exposure to organic solvents, might have induced chronic bile duct injury and contributed to the development of cholangiocarcinoma.

Combined Endoscopic and Laparoscopic Management of Postcholecystectomy Mirizzi Syndrome from a Remnant Cystic Duct Stone: Case Report and Review of the Literature

PubMed Central

Amin, Arpit; Zhurov, Yuriy; Ibrahim, George; Maffei, Anthony; Giannone, Jonathan; Cerabona, Thomas; Kaul, Ashutosh

2016-01-01

Mirizzi syndrome has been defined in the literature as common bile duct obstruction resulting from calculi within Hartmann's pouch or cystic duct. We present a case of a 78-year-old female, who developed postcholecystectomy Mirizzi syndrome from a remnant cystic duct stone. Diagnosis of postcholecystectomy Mirizzi syndrome was made on endoscopic retrograde cholangiography (ERCP) performed postoperatively. The patient was treated with a novel strategy by combining advanced endoscopic and laparoscopic techniques in three stages as follows: Stage 1 (initial presentation): endoscopic sphincterotomy with common bile duct stent placement; Stage 2 (6 weeks after Stage 1): laparoscopic ultrasonography to locate the remnant cystic duct calculi followed by laparoscopic retrieval of the calculi and intracorporeal closure of cystic duct stump; Stage 3 (6 weeks after Stage 2): endoscopic removal of common bile duct stent along with performance of completion endoscopic retrograde cholangiogram. In addition, we have performed an extensive review of the various endoscopic and laparoscopic management techniques described in the literature for the treatment of postcholecystectomy syndrome occurring from retained cystic duct stones. PMID:27047698

Combined Endoscopic and Laparoscopic Management of Postcholecystectomy Mirizzi Syndrome from a Remnant Cystic Duct Stone: Case Report and Review of the Literature.

PubMed

Amin, Arpit; Zhurov, Yuriy; Ibrahim, George; Maffei, Anthony; Giannone, Jonathan; Cerabona, Thomas; Kaul, Ashutosh

2016-01-01

Mirizzi syndrome has been defined in the literature as common bile duct obstruction resulting from calculi within Hartmann's pouch or cystic duct. We present a case of a 78-year-old female, who developed postcholecystectomy Mirizzi syndrome from a remnant cystic duct stone. Diagnosis of postcholecystectomy Mirizzi syndrome was made on endoscopic retrograde cholangiography (ERCP) performed postoperatively. The patient was treated with a novel strategy by combining advanced endoscopic and laparoscopic techniques in three stages as follows: Stage 1 (initial presentation): endoscopic sphincterotomy with common bile duct stent placement; Stage 2 (6 weeks after Stage 1): laparoscopic ultrasonography to locate the remnant cystic duct calculi followed by laparoscopic retrieval of the calculi and intracorporeal closure of cystic duct stump; Stage 3 (6 weeks after Stage 2): endoscopic removal of common bile duct stent along with performance of completion endoscopic retrograde cholangiogram. In addition, we have performed an extensive review of the various endoscopic and laparoscopic management techniques described in the literature for the treatment of postcholecystectomy syndrome occurring from retained cystic duct stones.

Novel function of LHFPL2 in female and male distal reproductive tract development.

PubMed

Zhao, Fei; Zhou, Jun; Li, Rong; Dudley, Elizabeth A; Ye, Xiaoqin

2016-03-11

Congenital reproductive tract anomalies could impair fertility. Female and male reproductive tracts are developed from Müllerian ducts and Wolffian ducts, respectively, involving initiation, elongation and differentiation. Genetic basis solely for distal reproductive tract development is largely unknown. Lhfpl2 (lipoma HMGIC fusion partner-like 2) encodes a tetra-transmembrane protein with unknown functions. It is expressed in follicle cells of ovary and epithelial cells of reproductive tracts. A spontaneous point mutation of Lhfpl2 (LHFPL2(G102E)) leads to infertility in 100% female mice, which have normal ovarian development, ovulation, uterine development, and uterine response to exogenous estrogen stimulation, but abnormal upper longitudinal vaginal septum and lower vaginal agenesis. Infertility is also observed in ~70% mutant males, which have normal mating behavior and sperm counts, but abnormal distal vas deferens convolution resulting in complete and incomplete blockage of reproductive tract in infertile and fertile males, respectively. On embryonic day 15.5, mutant Müllerian ducts and Wolffian ducts have elongated but their duct tips are enlarged and fail to merge with the urogenital sinus. These findings provide a novel function of LHFPL2 and a novel genetic basis for distal reproductive tract development; they also emphasize the importance of an additional merging phase for proper reproductive tract development.

Common bile duct stricture as a late complication of upper abdominal radiotherapy.

PubMed

Cherqui, D; Palazzo, L; Piedbois, P; Charlotte, F; Duvoux, C; Duron, J J; Fagniez, P L; Valla, D

1994-06-01

We report the cases of two patients who developed symptomatic common bile duct stricture 10 years after upper abdominal radiotherapy for malignant lymphoma. Both patients were in complete remission and presented with marked obstructive jaundice. Endosonography was useful in both cases and showed segmental thickening of the bile duct wall narrowing in the lumen. Both patients underwent surgical exploration, confirming biliary obstruction due to intrinsic wall thickening, and had successful biliary drainage by Roux-en-Y hepatico-jejunostomy. Histological examination of the resected bile duct, in one case, and of a bile duct biopsy, in the other, was consistent with late irradiation injury. We conclude that stricture may be a delayed consequence of radiotherapy applied to normal bile ducts.

Dact2 is expressed in the developing ureteric bud/collecting duct system of the kidney and controls morphogenetic behavior of collecting duct cells.

PubMed

Lee, Wen-Chin; Hough, Melinda T; Liu, Weijia; Ekiert, Robert; Lindström, Nils O; Hohenstein, Peter; Davies, Jamie A

2010-10-01

The overall pattern of the developing kidney is set in large part by the developing ureteric bud/collecting duct system, and dysgenesis of this system accounts for a variety of clinically significant renal diseases. Understanding how the behavior of cells in the developing ureteric bud/collecting duct is controlled is therefore important to understanding the normal and abnormal kidney. Dact proteins have recently been identified as cytoplasmic regulators of intracellular signaling. Dact1 inhibits Wnt signaling, and Dact2 inhibits transforming growth factor (TGF)-β signaling. Here, we report that Dact2 is expressed in developing and adult mouse kidneys, specifically in the ureteric bud/collecting duct epithelium, a structure whose morphogenesis is controlled partially by TGF-β. When small interfering RNA is used to knock down Dact2 expression in collecting duct cells, they show some constitutive phospho-Smad2, undetectable in controls, and elevated phospho-Smad2 in response to TGF-β. They also show defective migration and, in a monolayer wound-healing assay, they fail to assemble a leading edge "cable" of actomyosin and advance instead as a disorganized mass of lamellipodium-bearing cells. This effect is seriously exacerbated by exogenous TGF-β, although control cells tolerate it well. In three-dimensional culture, Dact2 knockdown cells form cysts and branching tubules, but the outlines of the cysts made by knockdown cells are ragged rather than smooth and the branching tubules are decorated with many fine spikes not seen in controls. These data suggest Dact2 plays a role in regulating morphogenesis by renal collecting duct cells, probably by protecting cells from overly strong TGF-β pathway activation.

Sources of Variability in Language Development of Children with Cochlear Implants: Age at Implantation, Parental Language, and Early Features of Children's Language Construction

ERIC Educational Resources Information Center

Szagun, Gisela; Schramm, Satyam A.

2016-01-01

The aim of the present study was to analyze the relative influence of age at implantation, parental expansions, and child language internal factors on grammatical progress in children with cochlear implants (CI). Data analyses used two longitudinal corpora of spontaneous speech samples, one with twenty-two and one with twenty-six children,…

Cochlear implantation in patients with bilateral cochlear trauma.

PubMed

Serin, Gediz Murat; Derinsu, Ufuk; Sari, Murat; Gergin, Ozgül; Ciprut, Ayça; Akdaş, Ferda; Batman, Cağlar

2010-01-01

Temporal bone fracture, which involves the otic capsule, can lead to complete loss of auditory and vestibular functions, whereas the patients without fractures may experience profound sensorineural hearing loss due to cochlear concussion. Cochlear implant is indicated in profound sensorineural hearing loss due to cochlear trauma but who still have an intact auditory nerve. This is a retrospective review study. We report 5 cases of postlingually deafened patients caused by cochlear trauma, who underwent cochlear implantation. Preoperative and postoperative hearing performance will be presented. These patients are cochlear implanted after the cochlear trauma in our department between 2001 and 2006. All patients performed very well with their implants, obtained open-set speech understanding. They all became good telephone users after implantation. Their performance in speech understanding was comparable to standard postlingual adult patients implanted. Cochlear implantation is an effective aural rehabilitation in profound sensorineural hearing loss caused by temporal bone trauma. Preoperative temporal bone computed tomography, magnetic resonance imaging, and promontorium stimulation testing are necessary to make decision for the surgery and to determine the side to be implanted. Surgery could be challenging and complicated because of anatomical irregularity. Moreover, fibrosis and partial or total ossification within the cochlea must be expected. Copyright 2010. Published by Elsevier Inc.

PVDF-Based Piezoelectric Microphone for Sound Detection Inside the Cochlea: Toward Totally Implantable Cochlear Implants.

PubMed

Park, Steve; Guan, Xiying; Kim, Youngwan; Creighton, Francis Pete X; Wei, Eric; Kymissis, Ioannis John; Nakajima, Hideko Heidi; Olson, Elizabeth S

2018-01-01

We report the fabrication and characterization of a prototype polyvinylidene fluoride polymer-based implantable microphone for detecting sound inside gerbil and human cochleae. With the current configuration and amplification, the signal-to-noise ratios were sufficiently high for normally occurring sound pressures and frequencies (ear canal pressures >50-60 dB SPL and 0.1-10 kHz), though 10 to 20 dB poorer than for some hearing aid microphones. These results demonstrate the feasibility of the prototype devices as implantable microphones for the development of totally implantable cochlear implants. For patients, this will improve sound reception by utilizing the outer ear and will improve the use of cochlear implants.

PVDF-Based Piezoelectric Microphone for Sound Detection Inside the Cochlea: Toward Totally Implantable Cochlear Implants

PubMed Central

Guan, Xiying; Kim, Youngwan; Creighton, Francis (Pete) X.; Wei, Eric; Kymissis, Ioannis(John); Nakajima, Hideko Heidi; Olson, Elizabeth S.

2018-01-01

We report the fabrication and characterization of a prototype polyvinylidene fluoride polymer-based implantable microphone for detecting sound inside gerbil and human cochleae. With the current configuration and amplification, the signal-to-noise ratios were sufficiently high for normally occurring sound pressures and frequencies (ear canal pressures >50–60 dB SPL and 0.1–10 kHz), though 10 to 20 dB poorer than for some hearing aid microphones. These results demonstrate the feasibility of the prototype devices as implantable microphones for the development of totally implantable cochlear implants. For patients, this will improve sound reception by utilizing the outer ear and will improve the use of cochlear implants. PMID:29732950

Cadherin-17 is required to maintain pronephric duct integrity during zebrafish development.

PubMed

Horsfield, Julia; Ramachandran, Anassuya; Reuter, Katja; LaVallie, Edward; Collins-Racie, Lisa; Crosier, Kathryn; Crosier, Philip

2002-07-01

We have isolated a zebrafish cadherin that is orthologous to human LI-cadherin (CDH17). Zebrafish cdh17 is expressed exclusively in the pronephric ducts during embryogenesis, and in the mesonephros during larval development and adulthood. Like its mammalian ortholog, cdh17 is also expressed in liver and intestine in adult zebrafish. We show that cdh17-positive mesodermal cells do not contribute to the hematopoietic system. Consistent with a cell adhesion role for Cdh17, depletion of Cdh17 function using antisense morpholino oligonucleotides compromised cell cohesion during pronephric duct formation. Our results indicate that Cdh17 is necessary for maintaining the integrity of the pronephric ducts during zebrafish embryogenesis. This finding contrasts with the role of mammalian CDH17, which does not appear to be involved in nephric development.

Engine Structural Analysis Software

NASA Technical Reports Server (NTRS)

McKnight, R. L.; Maffeo, R. J.; Schrantz, S.; Hartle, M. S.; Bechtel, G. S.; Lewis, K.; Ridgway, M.; Chamis, Christos C. (Technical Monitor)

2001-01-01

The report describes the technical effort to develop: (1) geometry recipes for nozzles, inlets, disks, frames, shafts, and ducts in finite element form, (2) component design tools for nozzles, inlets, disks, frames, shafts, and ducts which utilize the recipes and (3) an integrated design tool which combines the simulations of the nozzles, inlets, disks, frames, shafts, and ducts with the previously developed combustor, turbine blade, and turbine vane models for a total engine representation. These developments will be accomplished in cooperation and in conjunction with comparable efforts of NASA Glenn Research Center.

Bilingualism: A Pearl to Overcome Certain Perils of Cochlear Implants

PubMed Central

Humphries, Tom; Kushalnagar, Poorna; Mathur, Gaurav; Napoli, Donna Jo; Padden, Carol; Rathmann, Christian; Smith, Scott

2014-01-01

Cochlear implants (CI) have demonstrated success in improving young deaf children’s speech and low-level speech awareness across a range of auditory functions, but this success is highly variable, and how this success correlates to high-level language development is even more variable. Prevalence on the success rate of CI as an outcome for language development is difficult to obtain because studies vary widely in methodology and variables of interest, and because not all cochlear implant technology (which continues to evolve) is the same. Still, even if the notion of treatment failure is limited narrowly to those who gain no auditory benefit from CI in that they cannot discriminate among ambient noises, the reported treatment failure rate is high enough to call into question the current lack of consideration of alternative approaches to ensure young deaf children’s language development. Recent research has highlighted the risks of delaying language input during critical periods of brain development with concomitant consequences for cognitive and social skills. As a result, we propose that before, during, and after implantation deaf children learn a sign language along with a spoken language to ensure their maximal language development and optimal long-term developmental outcomes. PMID:25419095

Hyaluronic acid enhances gene delivery into the cochlea.

PubMed

Shibata, Seiji B; Cortez, Sarah R; Wiler, James A; Swiderski, Donald L; Raphael, Yehoash

2012-03-01

Cochlear gene therapy can be a new avenue for the treatment of severe hearing loss by inducing regeneration or phenotypic rescue. One necessary step to establish this therapy is the development of a safe and feasible inoculation surgery, ideally without drilling the bony cochlear wall. The round window membrane (RWM) is accessible in the middle-ear space, but viral vectors placed on this membrane do not readily cross the membrane to the cochlear tissues. In an attempt to enhance permeability of the RWM, we applied hyaluronic acid (HA), a nontoxic and biodegradable reagent, onto the RWM of guinea pigs, prior to delivering an adenovirus carrying enhanced green fluorescent protein (eGFP) reporter gene (Ad-eGFP) at the same site. We examined distribution of eGFP in the cochlea 1 week after treatment, comparing delivery of the vector via the RWM, with or without HA, to delivery by a cochleostomy into the perilymph. We found that cochlear tissue treated with HA-assisted delivery of Ad-eGFP demonstrated wider expression of transgenes in cochlear cells than did tissue treated by cochleostomy injection. HA-assisted vector delivery facilitated expression in cells lining the scala media, which are less accessible and not transduced after perilymphatic injection. We assessed auditory function by measuring auditory brainstem responses and determined that thresholds were significantly better in the ears treated with HA-assisted Ad-eGFP placement on the RWM as compared with cochleostomy. Together, these data demonstrate that HA-assisted delivery of viral vectors provides an atraumatic and clinically feasible method to introduce transgenes into cochlear cells, thereby enhancing both research methods and future clinical application.

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.

A global patient outcomes registry: Cochlear paediatric implanted recipient observational study (Cochlear(™) P-IROS).

PubMed

Sanderson, Georgina; Ariyaratne, Thathya V; Wyss, Josephine; Looi, Valerie

2014-01-01

Currently, there is a paucity of data concerning the long-term outcomes, educational placement and quality of life of children implanted with hearing devices from large and representative samples of the population. To address this concern, a large, prospective, multicentre, multinational patient-outcomes registry for paediatric recipients of implantable hearing devices was developed. The benefits of this registry, its approach and methodology are described. The Cochlear(™) Paediatric Implanted Recipient Observational Study (Cochlear P-IROS) is a prospective international patient-outcomes registry for children who are implanted in routine clinical practice with one or more hearing devices. The study aims to collect data on patient comorbidities, device use, auditory performance, quality of life and health-related utilities, across different types of implantable hearing devices from a range of manufacturers. Patients will be evaluated with a set of standardised and non-standardised questionnaires prior to initial device activation (baseline) and at six-monthly follow-up intervals up to 24 months and annually thereafter. The Cochlear P-IROS utilises a secure web interface to administer electronic case report forms to clinicians and families of implanted children. The web interface is currently available in five languages: English, Japanese, Korean, Mandarin and Russian. The interface also provides printable versions of the case report forms translated into 22 local languages for collection of data prior to entry online; additional languages may be added, as required. Participation in the Cochlear P-IROS registry is investigator-driven and voluntary. To date, the Cochlear P-IROS has recruited implant clinics across Australia, China, India, Indonesia, Turkey and Vietnam. The registry also aims to recruit multiple clinics in Cuba, Israel, Japan, Malaysia, Singapore, South Africa, South Korea and Russia. The use of a registry such as the Cochlear P-IROS will generate valuable data to support research interests of academics and clinicians around the globe. The data generated will be relevant for a wide range of stakeholders including regulators, payers, providers, policy makers, patients and their families, each with a different perspective for the acceptance and adoption of implantable hearing devices for the treatment of hearing loss.

A speech processing study using an acoustic model of a multiple-channel cochlear implant

NASA Astrophysics Data System (ADS)

Xu, Ying

1998-10-01

A cochlear implant is an electronic device designed to provide sound information for adults and children who have bilateral profound hearing loss. The task of representing speech signals as electrical stimuli is central to the design and performance of cochlear implants. Studies have shown that the current speech- processing strategies provide significant benefits to cochlear implant users. However, the evaluation and development of speech-processing strategies have been complicated by hardware limitations and large variability in user performance. To alleviate these problems, an acoustic model of a cochlear implant with the SPEAK strategy is implemented in this study, in which a set of acoustic stimuli whose psychophysical characteristics are as close as possible to those produced by a cochlear implant are presented on normal-hearing subjects. To test the effectiveness and feasibility of this acoustic model, a psychophysical experiment was conducted to match the performance of a normal-hearing listener using model- processed signals to that of a cochlear implant user. Good agreement was found between an implanted patient and an age-matched normal-hearing subject in a dynamic signal discrimination experiment, indicating that this acoustic model is a reasonably good approximation of a cochlear implant with the SPEAK strategy. The acoustic model was then used to examine the potential of the SPEAK strategy in terms of its temporal and frequency encoding of speech. It was hypothesized that better temporal and frequency encoding of speech can be accomplished by higher stimulation rates and a larger number of activated channels. Vowel and consonant recognition tests were conducted on normal-hearing subjects using speech tokens processed by the acoustic model, with different combinations of stimulation rate and number of activated channels. The results showed that vowel recognition was best at 600 pps and 8 activated channels, but further increases in stimulation rate and channel numbers were not beneficial. Manipulations of stimulation rate and number of activated channels did not appreciably affect consonant recognition. These results suggest that overall speech performance may improve by appropriately increasing stimulation rate and number of activated channels. Future revision of this acoustic model is necessary to provide more accurate amplitude representation of speech.

Retinoic acid signaling determines the fate of uterine stroma in the mouse Müllerian duct

PubMed Central

Nakajima, Tadaaki; Iguchi, Taisen; Sato, Tomomi

2016-01-01

The Müllerian duct develops into the oviduct, uterus, and vagina, all of which are quite distinct in their morphology and function. The epithelial fate of these female reproductive organs in developing mice is determined by factors secreted from the stroma; however, how stromal differentiation occurs in the female reproductive organs derived from the Müllerian duct is still unclear. In the present study, roles of retinoic acid (RA) signaling in developing female reproductive tracts were investigated. Retinol dehydrogenase 10 (RDH10) and aldehyde dehydrogenase family 1 subfamily A2 (ALDH1A2) mRNAs and proteins and transactivation activity of endogenous RA were found in the stroma of proximal Müllerian ducts and gradually decreased from the proximal to caudal regions in fetal mice. In organ-cultured Müllerian ducts, retinaldehyde or RA treatment induced uterine epithelial differentiation, defined as a layer of columnar epithelial cells negative for oviductal and vaginal epithelial markers. In contrast, inhibition of RA receptor (RAR) signaling induced vaginal epithelial differentiation, characterized as vaginal epithelial marker genes–positive stratified epithelium. Grafting experiments of the organ-cultured Müllerian duct revealed irreversible epithelial fate determination. Although RAR did not directly bind to the homeobox A10 (Hoxa10) promoter region, RA–RAR signaling stimulated Hoxa10 expression. Thus, RA–RAR signaling in the Müllerian duct determines the fate of stroma to form the future uterus and vagina. PMID:27911779

Numerical and experimental analysis of a ducted propeller designed by a fully automated optimization process under open water condition

NASA Astrophysics Data System (ADS)

Yu, Long; Druckenbrod, Markus; Greve, Martin; Wang, Ke-qi; Abdel-Maksoud, Moustafa

2015-10-01

A fully automated optimization process is provided for the design of ducted propellers under open water conditions, including 3D geometry modeling, meshing, optimization algorithm and CFD analysis techniques. The developed process allows the direct integration of a RANSE solver in the design stage. A practical ducted propeller design case study is carried out for validation. Numerical simulations and open water tests are fulfilled and proved that the optimum ducted propeller improves hydrodynamic performance as predicted.

An unsteady Euler scheme for the analysis of ducted propellers

NASA Technical Reports Server (NTRS)

Srivastava, R.

1992-01-01

An efficient unsteady solution procedure has been developed for analyzing inviscid unsteady flow past ducted propeller configurations. This scheme is first order accurate in time and second order accurate in space. The solution procedure has been applied to a ducted propeller consisting of an 8-bladed SR7 propeller with a duct of NACA 0003 airfoil cross section around it, operating in a steady axisymmetric flowfield. The variation of elemental blade loading with radius, compares well with other published numerical results.

Cochlear implant in Hong Kong Cantonese.

PubMed

Tang, S O; Luk, W S; Lau, C C; So, K W; Wong, C M; Yiu, M L; Kwok, C L

1990-11-01

Cochlear implant surgery was performed in four Cantonese-speaking postlingually deaf Chinese adults, using the House/3M single channel device. This article outlines the methodology, including preoperative assessment and postoperative rehabilitation; and explains the necessary modifications in speech and audiologic work-up in Cantonese-speaking patients. Salient features of Cantonese phonetics, especially its tonal characteristics, are described. The findings of the study are presented. The results of the cochlear implant would suggest a performance superior to that of the hearing aid. Furthermore, the cochlear implant is able to detect tonal cues. This quality of the cochlear implant may prove to be a valuable asset to a tonal language-speaking cochlear implantee.

Active Control of Fan Noise: Feasibility Study. Volume 5; Numerical Computation of Acoustic Mode Reflection Coefficients for an Unflanged Cylindrical Duct

NASA Technical Reports Server (NTRS)

Kraft, R. E.

1996-01-01

A computational method to predict modal reflection coefficients in cylindrical ducts has been developed based on the work of Homicz, Lordi, and Rehm, which uses the Wiener-Hopf method to account for the boundary conditions at the termination of a thin cylindrical pipe. The purpose of this study is to develop a computational routine to predict the reflection coefficients of higher order acoustic modes impinging on the unflanged termination of a cylindrical duct. This effort was conducted wider Task Order 5 of the NASA Lewis LET Program, Active Noise Control of aircraft Engines: Feasibility Study, and will be used as part of the development of an integrated source noise, acoustic propagation, ANC actuator coupling, and control system algorithm simulation. The reflection coefficient prediction will be incorporated into an existing cylindrical duct modal analysis to account for the reflection of modes from the duct termination. This will provide a more accurate, rapid computation design tool for evaluating the effect of reflected waves on active noise control systems mounted in the duct, as well as providing a tool for the design of acoustic treatment in inlet ducts. As an active noise control system design tool, the method can be used preliminary to more accurate but more numerically intensive acoustic propagation models such as finite element methods. The resulting computer program has been shown to give reasonable results, some examples of which are presented. Reliable data to use for comparison is scarce, so complete checkout is difficult, and further checkout is needed over a wider range of system parameters. In future efforts the method will be adapted as a subroutine to the GEAE segmented cylindrical duct modal analysis program.

Auditory brainstem activity and development evoked by apical versus basal cochlear implant electrode stimulation in children.

PubMed

Gordon, K A; Papsin, B C; Harrison, R V

2007-08-01

The role of apical versus basal cochlear implant electrode stimulation on central auditory development was examined. We hypothesized that, in children with early onset deafness, auditory development evoked by basal electrode stimulation would differ from that evoked more apically. Responses of the auditory nerve and brainstem, evoked by an apical and a basal implant electrode, were measured over the first year of cochlear implant use in 50 children with early onset severe to profound deafness who used hearing aids prior to implantation. Responses at initial stimulation were of larger amplitude and shorter latency when evoked by the apical electrode. No significant effects of residual hearing or age were found on initial response amplitudes or latencies. With implant use, responses evoked by both electrodes showed decreases in wave and interwave latencies reflecting decreased neural conduction time through the brainstem. Apical versus basal differences persisted with implant experience with one exception; eIII-eV interlatency differences decreased with implant use. Acute stimulation shows prolongation of basally versus apically evoked auditory nerve and brainstem responses in children with severe to profound deafness. Interwave latencies reflecting neural conduction along the caudal and rostral portions of the brainstem decreased over the first year of implant use. Differences in neural conduction times evoked by apical versus basal electrode stimulation persisted in the caudal but not rostral brainstem. Activity-dependent changes of the auditory brainstem occur in response to both apical and basal cochlear implant electrode stimulation.

Analyses of radiation impedances of finite cylindrical ducts

NASA Astrophysics Data System (ADS)

Shao, W.; Mechefske, C. K.

2005-08-01

To aid in understanding the characteristics of acoustic radiation from finite cylindrical ducts with infinite flanges, mathematical expressions of generalized radiation impedances at the open ends have been developed. Newton's method is used to find the complex wavenumbers of radial modes for the absorption boundary condition. The self-radiation impedances and mutual impedances for some acoustic modes are calculated for the ducts with rigid and absorption walls. The results show that the acoustical conditions of the duct walls have a significant influence on the radiation impedance. The acoustical interaction between the two open ends of the ducts cannot be neglected, especially for plane waves. To increase the wall admittance will reduce this interference effect. This study creates the possibility for simulating the sound field inside finite ducts in future work.

De-novo cholangiocarcinoma in native common bile duct remnant following OLT for primary sclerosing cholangitis.

PubMed

Landaverde, Carmen; Ng, Vivian; Sato, Alisa; Tabibian, James; Durazo, Francisco; Busuttil, Ronald

2009-01-01

Primary sclerosing cholangitis (PSC) is a chronic, progressive, inflammatory and obstructive disease of the intra- and extra-hepatic bile ducts of unknown etiology. Currently, orthotopic liver transplantation (OLT) is the only definitive treatment for PSC-related end-stage liver disease. However, PSC has been known to recur in the grafted liver. Roux-en-Y hepaticojejunostomy is more commonly performed than choledochocholedochostomy for PSC, although choledochocholedochostomy has been found to be safe and efficacious for PSC if the distal common bile duct is uninvolved at the time of OLT. Our case is unique in that it describes a patient who developed de-novo cholangiocarcinoma in the remnant portion of the native common bile duct six years after OLT with choledochocholedochostomy for PSC-associated end-stage liver disease without having PSC recurrence. In conclusion, our case report indicates that choledochocholedochostomy may not be desirable in PSC due to an increased risk of developing cholangiocarcinoma in the native common bile duct. This risk exists as well with a Roux-en-Y hepaticojejunostomy in the remaining intra-duodenal and intra-pancreatic biliary epithelium, although in theory to a lesser extent. Therefore, the risk of developing cholangiocarcinoma in the recipient common bile duct can only be completely eliminated by performing a Whipple procedure at the time of OLT.

Sound-direction identification with bilateral cochlear implants.

PubMed

Neuman, Arlene C; Haravon, Anita; Sislian, Nicole; Waltzman, Susan B

2007-02-01

The purpose of this study was to compare the accuracy of sound-direction identification in the horizontal plane by bilateral cochlear implant users when localization was measured with pink noise and with speech stimuli. Eight adults who were bilateral users of Nucleus 24 Contour devices participated in the study. All had received implants in both ears in a single surgery. Sound-direction identification was measured in a large classroom by using a nine-loudspeaker array. Localization was tested in three listening conditions (bilateral cochlear implants, left cochlear implant, and right cochlear implant), using two different stimuli (a speech stimulus and pink noise bursts) in a repeated-measures design. Sound-direction identification accuracy was significantly better when using two implants than when using a single implant. The mean root-mean-square error was 29 degrees for the bilateral condition, 54 degrees for the left cochlear implant, and 46.5 degrees for the right cochlear implant condition. Unilateral accuracy was similar for right cochlear implant and left cochlear implant performance. Sound-direction identification performance was similar for speech and pink noise stimuli. The data obtained in this study add to the growing body of evidence that sound-direction identification with bilateral cochlear implants is better than with a single implant. The similarity in localization performance obtained with the speech and pink noise supports the use of either stimulus for measuring sound-direction identification.

Voluntary and involuntary ligature of the bile duct in iatrogenic injuries: a nonadvisable approach.

PubMed

Mercado, Miguel Angel; Chan, Carlos; Jacinto, Juan Carlos; Sanchez, Norberto; Barajas, Alexandra

2008-06-01

Bile duct injuries related to laparoscopic and/or open cholecystectomy are a frequent finding and require surgical treatment. Complete obstruction is due to either intentionally or unintentionally placed ligatures or clips. The intentional application is usually performed to "facilitate identification of the duct by bile duct dilation." Considering that we are a national referral center for such injuries, we decided to analyze our cases of voluntary and involuntary duct ligation after iatrogenic bile duct injury. We reviewed the files of patients with voluntary or involuntary bile duct ligation. Results of preoperative evaluation of the ducts, operative treatment, and postoperative results were analyzed. A total of 413 patients were included. Forty-five patients presented with complete obstruction. In 15 cases, the ligature was intentional, and in 30 cases, occlusion was involuntary. Bile duct dilation (>10 mm) was demonstrated in one case of voluntary (6%) and three cases of involuntary ligations (10%). The remaining cases in both groups had no duct dilation and developed necrosis at the blinded duct and leakage proximal to the ligature, with different degrees of bilioperitoneum and/or biloma. In all cases, a Roux-en-Y hepatojejunostomy was performed. Bile duct ligature produces dilation in a very small number of patients (less than 10%) and usually produces necrosis of the blinded stump with subsequent bile leakage. Placement of a subhepatic drain and transference of the patient to a qualified center for reconstruction is the best approach if the primary surgeon is not able to do the repair.

A multi-band environment-adaptive approach to noise suppression for cochlear implants.

PubMed

Saki, Fatemeh; Mirzahasanloo, Taher; Kehtarnavaz, Nasser

2014-01-01

This paper presents an improved environment-adaptive noise suppression solution for the cochlear implants speech processing pipeline. This improvement is achieved by using a multi-band data-driven approach in place of a previously developed single-band data-driven approach. Seven commonly encountered noisy environments of street, car, restaurant, mall, bus, pub and train are considered to quantify the improvement. The results obtained indicate about 10% improvement in speech quality measures.

Consequences of Location-Dependent Organ of Corti Micro-Mechanics

PubMed Central

Liu, Yanju; Gracewski, Sheryl M.; Nam, Jong-Hoon

2015-01-01

The cochlea performs frequency analysis and amplification of sounds. The graded stiffness of the basilar membrane along the cochlear length underlies the frequency-location relationship of the mammalian cochlea. The somatic motility of outer hair cell is central for cochlear amplification. Despite two to three orders of magnitude change in the basilar membrane stiffness, the force capacity of the outer hair cell’s somatic motility, is nearly invariant over the cochlear length. It is puzzling how actuators with a constant force capacity can operate under such a wide stiffness range. We hypothesize that the organ of Corti sets the mechanical conditions so that the outer hair cell’s somatic motility effectively interacts with the media of traveling waves—the basilar membrane and the tectorial membrane. To test this hypothesis, a computational model of the gerbil cochlea was developed that incorporates organ of Corti structural mechanics, cochlear fluid dynamics, and hair cell electro-physiology. The model simulations showed that the micro-mechanical responses of the organ of Corti are different along the cochlear length. For example, the top surface of the organ of Corti vibrated more than the bottom surface at the basal (high frequency) location, but the amplitude ratio was reversed at the apical (low frequency) location. Unlike the basilar membrane stiffness varying by a factor of 1700 along the cochlear length, the stiffness of the organ of Corti complex felt by the outer hair cell remained between 1.5 and 0.4 times the outer hair cell stiffness. The Y-shaped structure in the organ of Corti formed by outer hair cell, Deiters cell and its phalange was the primary determinant of the elastic reactance imposed on the outer hair cells. The stiffness and geometry of the Deiters cell and its phalange affected cochlear amplification differently depending on the location. PMID:26317521

Flow in out-of-plane double S-bends

NASA Technical Reports Server (NTRS)

Schmidt, M. C.; Whitelaw, J. H.; Yianneskis, M.

1987-01-01

An experimental investigation of developing flows through a combination of out-of-plane S-bend ducts was conducted to gain insight into the redirection of flow in geometries similar to those encountered in practical aircraft wing-root intake ducts. The present double S-bend was fabricated by placing previously investigated S-ducts and S-diffusers in series and with perpendicular planes of symmetry. Laser-Doppler anemometry was employed to measure the three components of mean velocity, the corresponding rms quantities, and Reynolds stresses in the rectangular cross-section ducts. Due to limited optical access, only two mean and rms velocity components were resolved in the circular cross-section ducts. The velocity measurements were complemented by wall static pressure measurements. The data indicates that the flows at the exit are complex and asymmetric. Secondary flows generated by the pressure field in the first S-duct are complemented or counteracted by the secondary flows produced by the area expansion and the curvature of the S-diffuser. The results indicate the dominance of the inlet conditions and geometry upon the development of secondary flows and demonstrate that the flows are predominantly pressure-controlled. The pressure distribution caused by the duct geometry determines the direction and magnitude of the bulk flow while the turbulence dictates the mixing characteristics and profiles in the near wall region.

Cochlear Implants Special Issue Article: Vocal Emotion Recognition by Normal-Hearing Listeners and Cochlear Implant Users

PubMed Central

Luo, Xin; Fu, Qian-Jie; Galvin, John J.

2007-01-01

The present study investigated the ability of normal-hearing listeners and cochlear implant users to recognize vocal emotions. Sentences were produced by 1 male and 1 female talker according to 5 target emotions: angry, anxious, happy, sad, and neutral. Overall amplitude differences between the stimuli were either preserved or normalized. In experiment 1, vocal emotion recognition was measured in normal-hearing and cochlear implant listeners; cochlear implant subjects were tested using their clinically assigned processors. When overall amplitude cues were preserved, normal-hearing listeners achieved near-perfect performance, whereas listeners with cochlear implant recognized less than half of the target emotions. Removing the overall amplitude cues significantly worsened mean normal-hearing and cochlear implant performance. In experiment 2, vocal emotion recognition was measured in listeners with cochlear implant as a function of the number of channels (from 1 to 8) and envelope filter cutoff frequency (50 vs 400 Hz) in experimental speech processors. In experiment 3, vocal emotion recognition was measured in normal-hearing listeners as a function of the number of channels (from 1 to 16) and envelope filter cutoff frequency (50 vs 500 Hz) in acoustic cochlear implant simulations. Results from experiments 2 and 3 showed that both cochlear implant and normal-hearing performance significantly improved as the number of channels or the envelope filter cutoff frequency was increased. The results suggest that spectral, temporal, and overall amplitude cues each contribute to vocal emotion recognition. The poorer cochlear implant performance is most likely attributable to the lack of salient pitch cues and the limited functional spectral resolution. PMID:18003871

LES of a ducted propeller with rotor and stator in crashback

NASA Astrophysics Data System (ADS)

Jang, Hyunchul; Mahesh, Krishnan

2012-11-01

A sliding interface method is developed for large eddy simulation (LES) of flow past ducted propellers with both rotor and stator. The method is developed for arbitrarily shaped unstructured elements on massively parallel computing platforms. Novel algorithms for searching sliding elements, interpolation at the sliding interface, and data structures for message passing are developed. We perform LES of flow past a ducted propeller with stator blades in the crashback mode of operation, where a marine vessel is quickly decelerated by rotating the propeller in reverse. The unsteady loads predicted by LES are in good agreement with experiments. A highly unsteady vortex ring is observed outside the duct. High pressure fluctuations are observed near the blade tips, which significantly contribute to the side-force. This work is supported by the United States Office of Naval Research.

Cochlear implant outcomes in children with motor developmental delay.

PubMed

Amirsalari, Susan; Yousefi, Jaleh; Radfar, Shokofeh; Saburi, Amin; Tavallaie, Seyed Abbas; Hosseini, Mohammad Javad; Noohi, Sima; Hassan Alifard, Mahdieh; Ajallouyean, Mohammad

2012-01-01

Multiple handicapped children and children with syndromes and conditions resulting additional disabilities such as cerebral palsy, global developmental delay and autistic spectrum disorder, are now not routinely precluded from receiving a cochlear implant. The primary focus of this study was to determine the effect of cochlear implants on the speech perception and intelligibility of deaf children with and without motor development delay. In a cohort study, we compared cochlear implant outcomes in two groups of deaf children with or without motor developmental delay (MDD). Among 262 children with pre-lingual profound hearing loss, 28 (10%) had a motor delay based on Gross Motor Function Classification (GMFC). Children with severe motor delays (classification scale levels 4 and 5) and cognitive delays were excluded. All children completed the Categories of Auditory Perception Scales (CAP) and Speech Intelligibility Rating (SIR) prior to surgery and 24 months after the device was activated. The mean age for the study population was 4.09 ± 1.86 years. In all 262 patients the mean CAP score after surgery (5.38 ± 0.043) had a marked difference in comparison with the mean score before surgery (0.482 ± 0.018) (P=0.001). The mean CAP score after surgery for MDD children was 5.03, and was 5.77 for normal motor development children (NMD). The mean SIR score after surgery for MDD children was 2.53, and was 2.66 for NMD children. The final results of CAP and SIR did not have significant difference between NMD children versus MDD children (P>0.05). Regarding to the result, we concluded that children with hearing loss and concomitant MDD as an additional disabilities can benefit from cochlear implantation similar to those of NMD. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

A novel perfusion-based method for cochlear implant electrode insertion.

PubMed

Kale, Sushrut; Cervantes, Vanessa M; Wu, Mailing R; Pisano, Dominic V; Sheth, Nakul; Olson, Elizabeth S

2014-08-01

A cochlear implant (CI) restores partial hearing to profoundly deaf individuals. CI electrodes are inserted manually in the cochlea and surgeons rely on tactile feedback from the implant to determine when to stop the insertion. This manual insertion method results in a large degree of variability in surgical outcomes and intra-cochlear trauma. Additionally, implants often span only the basal turn. In the present study we report on the development of a new method to assist CI electrode insertion. The design objectives are (1) an automated and standardized insertion technique across patients with (2) more apical insertion than is possible by the contemporary methods, while (3) minimizing insertion trauma. The method relies on a viscous fluid flow through the cochlea to carry the electrode array with it. A small cochleostomy (∼100-150 um in diameter) is made in scala vestibuli (SV) and the round window (RW) membrane is opened. A flow of diluted Sodium Hyaluronate (also known as Hyaluronic Acid, (HA)) is set up from the RW to the SV opening using a perfusion pump that sets up a unidirectional flow. Once the flow is established an implant is dropped into the ongoing flow. Here we present a proof-of-concept study where we used this technique to insert silicone implants all the way to the cochlear apex in rats and gerbils. In light-microscopic histology, the implantation occurred without cochlear trauma. To further assess the ototoxicity of the HA perfusion, we measured compound action potential (CAP) thresholds following the perfusion of HA, and found that the CAP thresholds were substantially elevated. Thus, at this point the method is promising, and requires further development to become clinically viable. Copyright © 2014 Elsevier B.V. All rights reserved.

GDP Matters: Cost Effectiveness of Cochlear Implantation and Deaf Education in Sub-Saharan Africa.

PubMed

Emmett, Susan D; Tucci, Debara L; Smith, Magteld; Macharia, Isaac M; Ndegwa, Serah N; Nakku, Doreen; Mukara, Kaitesi B; Kaitesi, Mukara B; Ibekwe, Titus S; Mulwafu, Wakisa; Gong, Wenfeng; Francis, Howard W; Saunders, James E

2015-09-01

Cochlear implantation and deaf education are cost effective in Sub-Saharan Africa. Cost effectiveness of pediatric cochlear implantation has been well established in developed countries but is unknown in low resource settings, where access to the technology has traditionally been limited. With incidence of severe-to-profound congenital sensorineural hearing loss 5 to 6 times higher in low/middle-income countries than the United States and Europe, developing cost-effective management strategies in these settings is critical. Costs were obtained from experts in Nigeria, South Africa, Kenya, Rwanda, Uganda, and Malawi using known costs and published data, with estimation when necessary. A disability adjusted life years (DALY) model was applied using 3% discounting and 10-year length of analysis. Sensitivity analysis was performed to evaluate the effect of device cost, professional salaries, annual number of implants, and probability of device failure. Cost effectiveness was determined using the WHO standard of cost-effectiveness ratio/gross domestic product per capita (CER/GDP) less than 3. Cochlear implantation was cost effective in South Africa and Nigeria, with CER/GDP of 1.03 and 2.05, respectively. Deaf education was cost effective in all countries investigated, with CER/GDP ranging from 0.55 to 1.56. The most influential factor in the sensitivity analysis was device cost, with the cost-effective threshold reached in all countries using discounted device costs that varied directly with GDP. Cochlear implantation and deaf education are equally cost effective in lower-middle and upper-middle income economies of Nigeria and South Africa. Device cost may have greater impact in the emerging economies of Kenya, Uganda, Rwanda, and Malawi.

High resolution micro-CT scanning as an innovative tool for evaluation of the surgical positioning of cochlear implant electrodes.

PubMed

Postnov, A; Zarowski, A; De Clerck, N; Vanpoucke, F; Offeciers, F E; Van Dyck, D; Peeters, S

2006-05-01

X-ray microtomography (micro-CT) is a new technique allowing for visualization of the internal structure of opaque specimens with a quasi-histological quality. Among multiple potential applications, the use of this technique in otology is very promising. Micro-CT appears to be ideally suited for in vitro visualization of the inner ear tissues as well as for evaluation of the electrode damage and/or surgical insertion trauma during implantation of the cochlear implant electrodes. This technique can greatly aid in design and development of new cochlear implant electrodes and is applicable for temporal bone studies. The main advantage of micro-CT is the practically artefact-free preparation of the samples and the possibility of evaluation of the interesting parameters along the whole insertion depth of the electrode. This paper presents the results of the first application of micro-CT for visualization of the inner ear structures in human temporal bones and for evaluation of the surgical positioning of the cochlear implant electrodes relative to the intracochlear soft tissues.

Hearing versus Listening: Attention to Speech and Its Role in Language Acquisition in Deaf Infants with Cochlear Implants

PubMed Central

Houston, Derek M.; Bergeson, Tonya R.

2013-01-01

The advent of cochlear implantation has provided thousands of deaf infants and children access to speech and the opportunity to learn spoken language. Whether or not deaf infants successfully learn spoken language after implantation may depend in part on the extent to which they listen to speech rather than just hear it. We explore this question by examining the role that attention to speech plays in early language development according to a prominent model of infant speech perception – Jusczyk’s WRAPSA model – and by reviewing the kinds of speech input that maintains normal-hearing infants’ attention. We then review recent findings suggesting that cochlear-implanted infants’ attention to speech is reduced compared to normal-hearing infants and that speech input to these infants differs from input to infants with normal hearing. Finally, we discuss possible roles attention to speech may play on deaf children’s language acquisition after cochlear implantation in light of these findings and predictions from Jusczyk’s WRAPSA model. PMID:24729634

Current understanding of auditory neuropathy.

PubMed

Boo, Nem-Yun

2008-12-01

Auditory neuropathy is defined by the presence of normal evoked otoacoustic emissions (OAE) and absent or abnormal auditory brainstem responses (ABR). The sites of lesion could be at the cochlear inner hair cells, spiral ganglion cells of the cochlea, synapse between the inner hair cells and auditory nerve, or the auditory nerve itself. Genetic, infectious or neonatal/perinatal insults are the 3 most commonly identified underlying causes. Children usually present with delay in speech and language development while adult patients present with hearing loss and disproportionately poor speech discrimination for the degree of hearing loss. Although cochlear implant is the treatment of choice, current evidence show that it benefits only those patients with endocochlear lesions, but not those with cochlear nerve deficiency or central nervous system disorders. As auditory neuropathy is a disorder with potential long-term impact on a child's development, early hearing screen using both OAE and ABR should be carried out on all newborns and infants to allow early detection and intervention.

Conservation of pancreatic tissue by combined gastric, biliary, and pancreatic duct drainage for pain from chronic pancreatitis.

PubMed

Warshaw, A L

1985-04-01

In patients with chronic pancreatitis, the sclerosing process of the pancreas may constrict not only the pancreatic duct for also the bile duct and duodenum. This study analyzes the prevalence of these obstructive lesions in 58 consecutive patients with chronic pancreatitis requiring surgery for either pain (57 patients) or for painless jaundice (1 patient). There was significant biliary obstruction in 21, 4 of whom also had symptomatic duodenal obstruction. All 21 patients with biliary and duodenal obstruction were among the 38 with a dilated pancreatic duct suitable for pancreaticojejunostomy (modified Puestow procedure). None of the 20 patients with small duct pancreatitis had biliary or duodenal obstruction. Pseudocysts were distributed evenly between the two groups (9 of 38 patients with a dilated duct versus 4 of 20 patients with small duct pancreatitis). Pancreaticojejunostomy combined with choledochoenterostomy and gastrojejunostomy in appropriately selected patients provided good to excellent long-term (mean 3.6 years) relief of pain in 30 of 36 patients (83 percent). There was no correlation between successful relief of pain and development of pancreatic exocrine or endocrine insufficiency or calcification. Stenosis of the bile duct developed some years subsequent to pancreaticojejunostomy in four patients and required a second operation for choledochoenterostomy in three. Three other patients required secondary pancreatic resections due to failure of the pancreaticojejunostomy to relieve pain. It is often possible to effect excellent relief of symptoms with maximal conservation of remaining pancreatic functions despite sclerotic obstruction of multiple organ systems.

Chimeric analysis of EGFP and DsRed2 transgenic mice demonstrates polyclonal maintenance of pancreatic acini.

PubMed

Ryu, Je-Young; Siswanto, Antoni; Harimoto, Kenichi; Tagawa, Yoh-ichi

2013-06-01

The pancreatic islet is an assembly of specific endocrine cells. There are many conflicting reports regarding whether the acinus develops from single or multiple progenitor cells. This study investigated the development and maintenance clonality of the pancreatic acinus and duct using a chimeric analysis with EGFP and DsRed2 transgenic mice. Chimeric mice (G-R mice) were obtained by the aggregation method, using 8-cell stage embryos from EGFP and DsRed2 transgenic mice. The islets from the G-R mice were chimeric and mosaic, consisting of either EGFP- or DsRed2-positive populations, as in previous reports. On the other hand, most acini developed from either EGFP or DsRed2 origin, but some were chimeric. Interestingly, these chimeric acini were clearly separated into two-color regions and were not mosaic. Some large intralobular pancreatic ducts consisting of more than 10 cells were found to be chimeric, but no small ducts made up of less than 9 cells were chimeric. Our histological observations suggest that the pancreatic acinus polyclonally and directionally is maintained by multiple progenitor cells. Pancreatic large ducts also seem to develop polyclonally and might result from the assembly of small ducts that develop from a single origin. These findings provide useful information for further understanding pancreatic maintenance.

[Cost Analysis of Cochlear Implantation in Adults].

PubMed

Raths, S; Lenarz, T; Lesinski-Schiedat, A; Flessa, S

2016-04-01

The number of implantation of cochlear implants has steadily risen in recent years. Reasons for this are an extension of indication criteria, demographic change, increased quality of life needs and greater acceptance. The consequences are rising expenditure for statutory health insurance (SHI) for cochlear implantation. A detailed calculation of lifetime costs from SHI's perspective for postlingually deafened adolescents and adults is essential in estimating future cost developments. Calculations are based on accounting data from the Hannover Medical School. With regard to further life expectancy, average costs of preoperative diagnosis, surgery, rehabilitation, follow-ups, processor upgrades and electrical maintenance were discounted to their present value at age of implantation. There is an inverse relation between cost of unilateral cochlear implantation and age of initial implantation. From SHI's perspective, the intervention costs between 36,001 and 68,970 € ($ 42,504-$ 81,429). The largest cost components are initial implantation and processor upgrades. Compared to the UK the cost of cochlear implantation in Germany seems to be significantly lower. In particular the costs of, rehabilitation and maintenance in Germany cause only a small percentage of total costs. Also, the costs during the first year of treatment seem comparatively low. With regard to future spending of SHI due to implant innovations and associated extension of indication, increasing cost may be suspected. © Georg Thieme Verlag KG Stuttgart · New York.

Evaluation of gap filling skills and reading mistakes of cochlear implanted and normally hearing students.

PubMed

Çizmeci, Hülya; Çiprut, Ayça

2018-06-01

This study aimed to (1) evaluate the gap filling skills and reading mistakes of students with cochlear implants, and to (2) compare their results with those of their normal-hearing peers. The effects of implantation age and total time of cochlear implant use were analyzed in relation to the subjects' reading skills development. The study included 19 students who underwent cochlear implantation and 20 students with normal hearing, who were enrolled at the 6th to 8th grades. The subjects' ages ranged between 12 and 14 years old. Their reading skills were evaluated by using the Informal Reading Inventory. A significant relationship were found between implanted and normal-hearing students in terms of the percentages of reading error and the percentages of gap filling scores. The average order of the reading errors of students using cochlear implants was higher than that of normal-hearing students. As for the gap filling, the performances of implanted students in the passage are lower than those of their normal-hearing peers. No significant relationship was found between the variables tested in terms of age and duration of implantation on the reading performances of implanted students. Even if they were early implanted, there were significant differences in the reading performances of implanted students compared with those of their normal-hearing peers in older classes. Copyright © 2018 Elsevier B.V. All rights reserved.

Cochlear implantation in the world's largest medical device market: utilization and awareness of cochlear implants in the United States.

PubMed

Sorkin, Donna L

2013-03-01

Provision of cochlear implants (CIs) for those within the criteria for implantation remains lower in the United States than in some other developed nations. When adults and children are grouped together, the rate of utilization/provision remains low at around 6%. For children, the provision rate is about 50% of those who could benefit from an implant, compared with figures of about 90% for the Flanders part of Belgium, the United Kingdom and other European countries. The probable reasons for this underprovision include: low awareness of the benefits of CIs among the population; low awareness among health-care professionals; the lack of specific referral pathways; some political issues relating to the Deaf Community; and financial issues related to health provision. Such financial issues result in situations which either fail to provide for access to implants or provide too low a level of the necessary funding, especially for low-income individuals covered by public health-care programs such as Medicaid. These issues might be mitigated by adoption and publication of standards for best clinical practices for CI provision, availability of current cost-effectiveness data, and the existence of an organization dedicated to cochlear implantation. Such an organization, the American Cochlear Implant Alliance (ACI Alliance), was recently organized and is described in the paper by Niparko et al. in this Supplement.

Visualization of spiral ganglion neurites within the scala tympani with a cochlear implant in situ

PubMed Central

Chikar, Jennifer A.; Batts, Shelley A.; Pfingst, Bryan E.; Raphael, Yehoash

2009-01-01

Current cochlear histology methods do not allow in situ processing of cochlear implants. The metal components of the implant preclude standard embedding and mid-modiolar sectioning, and whole mounts do not have the spatial resolution needed to view the implant within the scala tympani. One focus of recent auditory research is the regeneration of structures within the cochlea, particularly the ganglion cells and their processes, and there are multiple potential benefits to cochlear implant users from this work. To facilitate experimental investigations of auditory nerve regeneration performed in conjunction with cochlear implantation, it is critical to visualize the cochlear tissue and the implant together to determine if the nerve has made contact with the implant. This paper presents a novel histological technique that enables simultaneous visualization of the in situ cochlear implant and neurofilament – labeled nerve processes within the scala tympani, and the spatial relationship between them. PMID:19428528

Visualization of spiral ganglion neurites within the scala tympani with a cochlear implant in situ.

PubMed

Chikar, Jennifer A; Batts, Shelley A; Pfingst, Bryan E; Raphael, Yehoash

2009-05-15

Current cochlear histology methods do not allow in situ processing of cochlear implants. The metal components of the implant preclude standard embedding and mid-modiolar sectioning, and whole mounts do not have the spatial resolution needed to view the implant within the scala tympani. One focus of recent auditory research is the regeneration of structures within the cochlea, particularly the ganglion cells and their processes, and there are multiple potential benefits to cochlear implant users from this work. To facilitate experimental investigations of auditory nerve regeneration performed in conjunction with cochlear implantation, it is critical to visualize the cochlear tissue and the implant together to determine if the nerve has made contact with the implant. This paper presents a novel histological technique that enables simultaneous visualization of the in situ cochlear implant and neurofilament-labeled nerve processes within the scala tympani, and the spatial relationship between them.

Numerical study of turbulent secondary flows in curved ducts

NASA Technical Reports Server (NTRS)

Hur, N.; Thangam, S.; Speziale, C. G.

1990-01-01

The pressure driven, fully-developed turbulent flow of an incompressible viscous fluid in curved ducts of square-section is studied numerically by making use of a finite volume method. A nonlinear Kappa - Iota model is used to represent the turbulence. The results for both straight and curved ducts are presented. For the case of fully-developed turbulent flow in straight and curved ducts, the secondary flow is characterized by an eight-vortex structure for which the computed flowfield is shown to be in good agreement with available experimental data. The introduction of moderate curvature is shown to cause a substantial increase in the strength of the secondary flow and to change the secondary flow pattern to either a double-vortex or a four-vortex configuration.

Numerical study of turbulent secondary flows in curved ducts

NASA Technical Reports Server (NTRS)

Hur, N.; Thangam, S.; Speziale, C. G.

1989-01-01

The pressure driven, fully-developed turbulent flow of an incompressible viscous fluid in curved ducts of square cross-section is studied numerically by making use of a finite volume method. A nonlinear Kappa - Iota model is used to represent the turbulence. The results for both straight and curved ducts are presented. For the case of fully-developed turbulent flow in straight ducts, the secondary flow is characterized by an eight-vortex structure for which the computed flowfield is shown to be in good agreement with available experimental data. The introduction of moderate curvature is shown to cause a substantial increase in the strength of the secondary flow and to change the secondary flow pattern to either a double-vortex or a four-vortex configuration.

[Emotional response to music by postlingually-deafened adult cochlear implant users].

PubMed

Wang, Shuo; Dong, Ruijuan; Zhou, Yun; Li, Jing; Qi, Beier; Liu, Bo

2012-10-01

To assess the emotional response to music by postlingually-deafened adult cochlear implant users. Munich music questionnaire (MUMU) was used to match the music experience and the motivation of use of music between 12 normal-hearing and 12 cochlear implant subjects. Emotion rating test in Musical Sounds in Cochlear Implants (MuSIC) test battery was used to assess the emotion perception ability for both normal-hearing and cochlear implant subjects. A total of 15 pieces of music phases were used. Responses were given by selecting the rating scales from 1 to 10. "1" represents "very sad" feeling, and "10" represents "very happy feeling. In comparison with normal-hearing subjects, 12 cochlear implant subjects made less active use of music for emotional purpose. The emotion ratings for cochlear implant subjects were similar to normal-hearing subjects, but with large variability. Post-lingually deafened cochlear implant subjects on average performed similarly in emotion rating tasks relative to normal-hearing subjects, but their active use of music for emotional purpose was obviously less than normal-hearing subjects.

The cochlear size of bats and rodents derived from MRI images and histology.

PubMed

Hsiao, Chun Jen; Jen, Philip Hung-Sun; Wu, Chung Hsin

2015-05-27

From the evolutionary perspective, the ear of each animal species is built for effective processing of the biologically relevant signals used for communication and acoustically guided orientation. Because the sound pulses used by echolocating bats for orientation and rodents for communication are quite different, the basic design of the mammalian auditory system commonly shared by echolocating bats must be specialized in some manner to effectively process their species-specific sounds. The present study examines the difference in the cochlea of these animal species using MRI images and histological techniques. We report here that, although all these animal species share a similar cochlear structure, they vary in their cochlear size and turns. Bats using constant frequency-frequency-modulated pulses (CF-FM bats) and frequency-modulated pulses (FM bats) for echolocation have a larger cochlear size and more cochlear turns than rodents (mice and rats). However, CF-FM bats have the largest cochlear size and most cochlear turns. This difference in cochlear size and turns of these animal species is discussed in relation to their biologically relevant sounds and acoustic behavior.

Immunoreactivities for glutathione S-transferases and glutathione peroxidase in the lateral wall of pigmented and albino guinea pig cochlea.

PubMed

Fujimura, Takeyuki; Suzuki, Hideaki; Udaka, Tsuyoshi; Shiomori, Teruo; Mori, Takanori; Inaba, Tsuyoshi; Hiraki, Nobuaki; Kayashima, Kotaro; Doi, Yoshiaki

2008-09-01

Dark-skinned people are known to be more tolerant of ototraumatic noise than are light-skinned people, and pigmented animals are more tolerant of ototraumatic noise and aminoglycoside ototoxicity than are albino animals. Such tolerance may be dependent on the local ability of detoxification and antioxidant enzymes, including glutathione S-transferase (GST) and glutathione peroxidase (GSPx). In the present study, we examined the difference in GST/GSPx expression in the lateral wall of the cochlea between pigmented and albino guinea pigs. Eight-week-old male pigmented and albino guinea pigs were killed by transcardiac perfusion with 2% paraformaldehyde. The cochlear ducts were isolated, further fixed with 4% paraformaldehyde, decalcified, and then embedded in paraffin. Sections prepared at 5-microm thickness were incubated with anti-GST-alpha,-mu,-pi, or anti-GSPx antibody, reacted with Alexa Fluorconjugated secondary antibody, and examined under a Carl Zeiss Axioskop 2 plus fluorescence microscope. The cochlea ducts were also subjected to immunoelectron microscopy for GST-pi by the postembedment method. The stria vascularis of pigmented guinea pigs was strongly immunoreactive for GST-alpha,-mu,-pi, and GSPx, whereas no or only weak immunoreactivities were seen in the stria vascularis of albino guinea pigs. The spiral ligament showed positive but different immunoreactivities for these enzymes between the strains. Double-stained immunofluorescence micrographs for GST-pi and GSPx showed a close resemblance of localization between the two enzymes in both pigmented and albino guinea pigs. At the ultrastructural level, immunoreactivity for GST-pi was localized preferentially in the melanin cells of pigmented guinea pigs. These results suggest that correlation between pigmentation and inner ear susceptibility is, at least partially, attributed to the different distribution of GST/GSPx in the stria vascularis.

On turbulent friction in straight ducts with complex cross-section: the wall law and the hydraulic diameter

NASA Astrophysics Data System (ADS)

Pirozzoli, Sergio

2018-07-01

We develop predictive formulas for friction resistance in ducts with complex cross-sectional shape based on the use of the log law and neglect of wall shear stress nonuniformities. The traditional hydraulic diameter naturally emerges from the analysis as the controlling length scale for common duct shapes as triangles and regular polygons. The analysis also suggests that a new effective diameter should be used in more general cases, yielding corrections of a few percent to friction estimates based on the traditional hydraulic diameter. Fair but consistent predictive improvement is shown for duct geometries of practical relevance, including rectangular and annular ducts, and circular rod bundles.

Evaluation of several non-reflecting computational boundary conditions for duct acoustics

NASA Technical Reports Server (NTRS)

Watson, Willie R.; Zorumski, William E.; Hodge, Steve L.

1994-01-01

Several non-reflecting computational boundary conditions that meet certain criteria and have potential applications to duct acoustics are evaluated for their effectiveness. The same interior solution scheme, grid, and order of approximation are used to evaluate each condition. Sparse matrix solution techniques are applied to solve the matrix equation resulting from the discretization. Modal series solutions for the sound attenuation in an infinite duct are used to evaluate the accuracy of each non-reflecting boundary conditions. The evaluations are performed for sound propagation in a softwall duct, for several sources, sound frequencies, and duct lengths. It is shown that a recently developed nonlocal boundary condition leads to sound attenuation predictions considerably more accurate for short ducts. This leads to a substantial reduction in the number of grid points when compared to other non-reflecting conditions.

Preventing Post-ERCP Pancreatitis: The Role of Prophylactic Pancreatic Duct Stenting in the Rectal NSAID Era

PubMed Central

Bekkali, Noor-L-Houda; Thomas, Tom; Keane, Margaret Geraldine; Murray, Sam; Joshi, Deepak; Elsayed, Ghassan; Johnson, Gavin James; Chapman, Michael Huw; Pereira, Stephen Paul; Webster, George John Mitchell

2018-01-01

Background Rectal non-steroidal anti-inflammatory drug at endoscopic retrograde cholangiopancreatography is now the standard of care to reduce the risk of post-ERCP pancreatitis. Pancreatic duct stenting also reduces the risk of post- ERCP pancreatitis in high-risk patients, but failed pancreatic duct stenting carries an increased PEP rate (up to 35%). Study Aim To assess the impact on post-ERCP pancreatitis of successful and unsuccessful pancreatic duct stent placement in the setting of universal rectal non-steroidal anti-inflammatory drug use. Methods Between 2013–2015, all patients undergoing endoscopic retrograde cholangiopancreatographys in our tertiary referral centre (where rectal non-steroidal anti-inflammatory drugs are used routinely) were included. The electronic patient’s records were reviewed and the following parameters were analysed: indication for pancreatic duct stenting; deployment success; and adverse events. Results A total of 1633 endoscopic retrograde cholangiopancreatographys were performed, and pancreatic duct stenting was attempted in 324 cases (20%), with successful placement in 307 patients (95%). Contra-indications to non-steroidal anti-inflammatory drugs were found in 106 (6.5%) patients. Prophylactic stenting failed in 12 of 213 patients; of whom one patient developed post-ERCP pancreatitis (8%). Eighteen (9%) patients with prophylactic pancreatic duct stents developed post-ERCP pancreatitis compared to 1.4% without prophylactic stents (RR 8.4, p=0.04). Conclusion A lack of difference in post-ERCP pancreatitis in those who underwent successful, and unsuccessful, pancreatic duct stent placement may reflect the protective effect of non-steroidal anti-inflammatory drugs. This data adds to evidence suggesting that pancreatic duct stenting may be less important, even in high-risk patients, with the widespread use of non-steroidal anti-inflammatory drugs. PMID:29731700

Hepatocyte nuclear factor-4 alpha in noise-induced cochlear neuropathy.

PubMed

Groth, Jane Bjerg; Kao, Shyan-Yuan; Briët, Martijn C; Stankovic, Konstantina M

2016-12-01

Noise-induced hearing loss (NIHL) is a problem of profound clinical significance and growing magnitude. Alarmingly, even moderate noise levels, previously assumed to cause only temporary shifts in auditory thresholds ("temporary" NIHL), are now known to cause cochlear synaptopathy and subsequent neuropathy. To uncover molecular mechanisms of this neuropathy, a network analysis of genes reported to have significantly altered expression after temporary threshold shift-inducing noise exposure was performed. The transcription factor Hepatocyte Nuclear Factor-4 alpha (HNF4α), which had not previously been studied in the context of cochlear response to noise, was identified as a hub of a top-ranking network. Hnf4α expression and localization using quantitative RT-PCR and in situ hybridization, respectively, were described in adolescent and adult mice exposed to neuropathic noise levels in adolescence. Isoforms α3 and α12 in the cochlea were also identified. At every age examined, Hnf4α mRNA expression in the cochlear apex was similar to expression in the base. Hnf4α expression was evident in select cochlear cells, including spiral ganglion neurons (SGNs) and hair cells, and was significantly upregulated from 6 to 70 weeks of age, especially in SGNs. This age-related Hnf4α upregulation was inhibited by neuropathic noise exposure in adolescence. Hnf4α silencing with shRNA transfection into auditory neuroblast cells (VOT-33) reduced cell viability, as measured with the MTT assay, suggesting that Hnf4α may be involved in SGN survival. Our results motivate future studies of HNF4α in cochlear pathophysiology, especially because HNF4α mutations and polymorphisms are associated with human diseases that may include hearing loss. © 2016 Wiley Periodicals, Inc. Develop Neurobiol 76: 1374-1386, 2016. © 2016 Wiley Periodicals, Inc.

The Impact of Cochlear Implant in the Oral Language of Children with Congenital Deafness.

PubMed

Ramos, Daniela; Jorge, João Xavier; Teixeira, António; Ribeiro, Carlos; Paiva, António

2015-01-01

Children with severe to profound sensorineural deafness can acquire vocabulary and syntactic structures to communicate by oral language, after cochlear implant. Identify the linguistic skills of children with cochlear implant. Eighteen children of both gender, between 9 and 10 years, with congenital bilateral deafness, using cochlear implant, were studied. The evaluation instrument used was Observation Chart of Language-School Level. The results were compared with standard of normal-hearing children with the same hearing age. The scores registered in the linguistics structures studied, comparing implanted children and standard, was: phonology, 29.44 ± 8.4 vs. 29.68 ± 5.90, p = 0.91; semantics, 18.55 ± 8.89 vs. 19.20 ± 4.85, p = 0.76; morpho-syntax 21.89 ± 12.85 vs. 26.35 ± 10.36, p = 0.159. Regarding the tests of semantics, there was no significant difference. Concerning the tests of morpho-syntactic structure, the difference was significant in the derivation of words, 2.83 ± 2.81 vs. 4.65 ± 1.64, p = 0.014. In the phonology, a significant difference was found comparing implanted children and standard, in the discrimination of pseudo words, 6.6 ± 2.8 vs. 8.37 ± 2.32, p = 0.023. However, in syllabic segmentation, implanted children had a mean score 8.56 ± 1.6 significantly higher than standard, 5.9 ± 1.58, p < 0.001. The similarity of the scores obtained by children with cochlear implants with the standard, in the language components studied confirms that cochlear implant promotes the development of oral verbal language in children with congenital deafness. Implanted children had acquired language skills similar to normal-hearing children with the same hearing age.

Hyaluronic Acid Enhances Gene Delivery into the Cochlea

PubMed Central

Shibata, Seiji B.; Cortez, Sarah R.; Wiler, James A.; Swiderski, Donald L.

2012-01-01

Abstract Cochlear gene therapy can be a new avenue for the treatment of severe hearing loss by inducing regeneration or phenotypic rescue. One necessary step to establish this therapy is the development of a safe and feasible inoculation surgery, ideally without drilling the bony cochlear wall. The round window membrane (RWM) is accessible in the middle-ear space, but viral vectors placed on this membrane do not readily cross the membrane to the cochlear tissues. In an attempt to enhance permeability of the RWM, we applied hyaluronic acid (HA), a nontoxic and biodegradable reagent, onto the RWM of guinea pigs, prior to delivering an adenovirus carrying enhanced green fluorescent protein (eGFP) reporter gene (Ad-eGFP) at the same site. We examined distribution of eGFP in the cochlea 1 week after treatment, comparing delivery of the vector via the RWM, with or without HA, to delivery by a cochleostomy into the perilymph. We found that cochlear tissue treated with HA-assisted delivery of Ad-eGFP demonstrated wider expression of transgenes in cochlear cells than did tissue treated by cochleostomy injection. HA-assisted vector delivery facilitated expression in cells lining the scala media, which are less accessible and not transduced after perilymphatic injection. We assessed auditory function by measuring auditory brainstem responses and determined that thresholds were significantly better in the ears treated with HA-assisted Ad-eGFP placement on the RWM as compared with cochleostomy. Together, these data demonstrate that HA-assisted delivery of viral vectors provides an atraumatic and clinically feasible method to introduce transgenes into cochlear cells, thereby enhancing both research methods and future clinical application. PMID:22074321

Self-reports about tinnitus and about cochlear implants.

PubMed

Noble, W

2000-08-01

Analyze literature on self-report outcomes in two areas of audiological rehabilitation: 1) tinnitus and 2) cochlear implant hearing aids. 1) Tinnitus: survey of features in the development of self-report approaches and of formal scales used in assessment of tinnitus disability and handicaps. 2) Cochlear implants: summary of the literature using self-report approaches to cochlear implant experience that indicates points of theoretical significance. 1) Major features of tinnitus are: a) disabilities such as interference with and distortion of normal auditory perception; b) handicaps such as emotional distress, interference with sleep, and with personal and social life. Nonauditory factors-chronic depression, high self-focused attention-mediate the degree of experienced tinnitus handicap. 2) People with prelingual loss of hearing report that a cochlear implant primarily enables improved detection and discrimination of environmental sound; those with postlingual loss find that an implant in addition provides improved speech recognition. 1) Coping with tinnitus is influenced by the personal resources that can be brought to bear on the experience, highlighting a general point that any rehabilitation outcome is not only a matter of acoustical solutions. By the same token, tinnitus can be easier to cope with if its "psychoacoustic presence" can be diminished by some form of masking. 2) Cochlear implants fitted in childhood that do not provide meaningful input signals in real-world settings may be rejected in adolescence. 3) "Hearing," as a capacity, does not have a fixed worth. Different circumstances mean it will be taken as desirable or as delivering torment (extreme tinnitus, e.g.). Its value will also vary depending on the extent of a person's access to spoken language (aiding in very early childhood, e.g.).

Integrated Medical Information Technology System (IMITS): Information and Clinical Technologies for the Advancement of Healthcare

DTIC Science & Technology

2010-08-31

Teleaudiology o FY08: Remote access of cochlear implants Teleaudiology DIACAP / FDA certification o FY08: Teleaudiology DIACAP and FDA certification to conduct...remote access, monitor, and adjust cochlear implants  ECMO o FY05: Extra Corporeal Membrane Oxygenation (ECMO) o FY07 Pacific Rim ECMO/VAD...These dashboards were developed for use by appointed AFMS radiologists to monitor the flow and statistics of teleradiology. The dashboards are web

Sound propagation in and radiation from acoustically lined flow ducts: A comparison of experiment and theory

NASA Technical Reports Server (NTRS)

Plumblee, H. E., Jr.; Dean, P. D.; Wynne, G. A.; Burrin, R. H.

1973-01-01

The results of an experimental and theoretical study of many of the fundamental details of sound propagation in hard wall and soft wall annular flow ducts are reported. The theory of sound propagation along such ducts and the theory for determining the complex radiation impedance of higher order modes of an annulus are outlined, and methods for generating acoustic duct modes are developed. The results of a detailed measurement program on propagation in rigid wall annular ducts with and without airflow through the duct are presented. Techniques are described for measuring cut-on frequencies, modal phase speed, and radial and annular mode shapes. The effects of flow velocity on cut-on frequencies and phase speed are measured. Comparisons are made with theoretical predictions for all of the effects studies. The two microphone method of impedance is used to measure the effects of flow on acoustic liners. A numerical study of sound propagation in annular ducts with one or both walls acoustically lined is presented.

Structure and function of the major ampullate spinning duct of the golden orb weaver, Nephila edulis.

PubMed

Davies, G J G; Knight, D P; Vollrath, F

2013-10-01

Silks are fibres produced by spiders, some insects and even a crustacean, and are formed from protein solution by a pulltrusion process that is not well understood. Here we describe three aspects of the functional anatomy of the spinning apparatus in a spider: (i) changes in the diameter of the duct of the silk gland along its length for individuals at different stages of development, (ii) the correlation between the morphology of the duct and size and (iii) changes in the thickness of the wall of the duct. We conclude that in the distal part of the duct both the lumen's geometry and change in diameter with distance remains remarkably constant as the duct increases in length from moult to moult as the spider grows. This suggests constancy in the region where the nascent silk filament is drawn down within the lumen of the duct, which is likely to be fundamental for forming strong and tough fibres. Copyright © 2013 Elsevier Ltd. All rights reserved.

A non-local computational boundary condition for duct acoustics

NASA Technical Reports Server (NTRS)

Zorumski, William E.; Watson, Willie R.; Hodge, Steve L.

1994-01-01

A non-local boundary condition is formulated for acoustic waves in ducts without flow. The ducts are two dimensional with constant area, but with variable impedance wall lining. Extension of the formulation to three dimensional and variable area ducts is straightforward in principle, but requires significantly more computation. The boundary condition simulates a nonreflecting wave field in an infinite duct. It is implemented by a constant matrix operator which is applied at the boundary of the computational domain. An efficient computational solution scheme is developed which allows calculations for high frequencies and long duct lengths. This computational solution utilizes the boundary condition to limit the computational space while preserving the radiation boundary condition. The boundary condition is tested for several sources. It is demonstrated that the boundary condition can be applied close to the sound sources, rendering the computational domain small. Computational solutions with the new non-local boundary condition are shown to be consistent with the known solutions for nonreflecting wavefields in an infinite uniform duct.

Beneficial auditory and cognitive effects of auditory brainstem implantation in children.

PubMed

Colletti, Liliana

2007-09-01

This preliminary study demonstrates the development of hearing ability and shows that there is a significant improvement in some cognitive parameters related to selective visual/spatial attention and to fluid or multisensory reasoning, in children fitted with auditory brainstem implantation (ABI). The improvement in cognitive paramenters is due to several factors, among which there is certainly, as demonstrated in the literature on a cochlear implants (CIs), the activation of the auditory sensory canal, which was previously absent. The findings of the present study indicate that children with cochlear or cochlear nerve abnormalities with associated cognitive deficits should not be excluded from ABI implantation. The indications for ABI have been extended over the last 10 years to adults with non-tumoral (NT) cochlear or cochlear nerve abnormalities that cannot benefit from CI. We demonstrated that the ABI with surface electrodes may provide sufficient stimulation of the central auditory system in adults for open set speech recognition. These favourable results motivated us to extend ABI indications to children with profound hearing loss who were not candidates for a CI. This study investigated the performances of young deaf children undergoing ABI, in terms of their auditory perceptual development and their non-verbal cognitive abilities. In our department from 2000 to 2006, 24 children aged 14 months to 16 years received an ABI for different tumour and non-tumour diseases. Two children had NF2 tumours. Eighteen children had bilateral cochlear nerve aplasia. In this group, nine children had associated cochlear malformations, two had unilateral facial nerve agenesia and two had combined microtia, aural atresia and middle ear malformations. Four of these children had previously been fitted elsewhere with a CI with no auditory results. One child had bilateral incomplete cochlear partition (type II); one child, who had previously been fitted unsuccessfully elsewhere with a CI, had auditory neuropathy; one child showed total cochlear ossification bilaterally due to meningitis; and one child had profound hearing loss with cochlear fractures after a head injury. Twelve of these children had multiple associated psychomotor handicaps. The retrosigmoid approach was used in all children. Intraoperative electrical auditory brainstem responses (EABRs) and postoperative EABRs and electrical middle latency responses (EMLRs) were performed. Perceptual auditory abilities were evaluated with the Evaluation of Auditory Responses to Speech (EARS) battery - the Listening Progress Profile (LIP), the Meaningful Auditory Integration Scale (MAIS), the Meaningful Use of Speech Scale (MUSS) - and the Category of Auditory Performance (CAP). Cognitive evaluation was performed on seven children using the Leiter International Performance Scale - Revised (LIPS-R) test with the following subtests: Figure ground, Form completion, Sequential order and Repeated pattern. No postoperative complications were observed. All children consistently used their devices for >75% of waking hours and had environmental sound awareness and utterance of words and simple sentences. Their CAP scores ranged from 1 to 7 (average =4); with MAIS they scored 2-97.5% (average =38%); MUSS scores ranged from 5 to 100% (average =49%) and LIP scores from 5 to 100% (average =45%). Owing to associated disabilities, 12 children were given other therapies (e.g. physical therapy and counselling) in addition to speech and aural rehabilitation therapy. Scores for two of the four subtests of LIPS-R in this study increased significantly during the first year of auditory brainstem implant use in all seven children selected for cognitive evaluation.

Effect of Resin Ducts and Sap Content on Infestation and Development of Immature Stages of Anastrepha obliqua and Anastrepha ludens (Diptera: Tephritidae) in Four Mango (Sapindales: Anacardiaceae) Cultivars.

PubMed

Guillén, Larissa; Adaime, Ricardo; Birke, Andrea; Velázquez, Olinda; Angeles, Guillermo; Ortega, Fernando; Ruíz, Eliel; Aluja, Martín

2017-04-01

We determined the influence of resin ducts, sap content, and fruit physicochemical features of four mango cultivars (Criollo, Manila, Ataulfo, and Tommy Atkins) on their susceptibility to the attack of the two most pestiferous fruit fly species infesting mangoes in Mexico: Anastrepha ludens (Loew) and Anastrepha obliqua (Macquart). We performed three studies: 1) analysis of resin ducts in mango fruit exocarp to determine the density and area occupied by resin ducts in each mango cultivar, 2) assessment of mango physicochemical features including fruit sap content, and 3) a forced infestation trial under field conditions using enclosed fruit-bearing branches to expose mangoes to gravid A. ludens or A. obliqua females. Infestation rates, development time from egg to prepupae and pupae, pupal weight, and percent of adult emergence, were assessed. 'Ataulfo' and 'Tommy Atkins' cultivars exhibited the highest resin duct density and sap content, the lowest infestation rate, and had a negative effect on immature development and pupal weight. In sharp contrast, 'Manila' and 'Criollo' cultivars, with the lowest resin duct density and sap content, were highly susceptible to A. ludens and A. obliqua attack. We conclude that sap content and the number, size, and distribution of resin ducts as well as firmness in mango fruit exocarp are all involved in the resistance of mango to A. ludens and A. obliqua attack. © The Authors 2017. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Reconstruction of Bile Duct Injury and Defect with the Round Ligament.

PubMed

Dokmak, Safi; Aussilhou, Béatrice; Ragot, Emilia; Tantardini, Camille; Cauchy, François; Ponsot, Philippe; Belghiti, Jacques; Sauvanet, Alain; Soubrane, Olivier

2017-09-01

Lateral injury of the bile duct can occur after cholecystectomy, bile duct dissection, or exploration. If direct repair is not possible, conversion to bilioenteric anastomosis can be needed with the risk of long-term bile duct infections and associated complications. We developed a new surgical technique which consist of reconstructing the bile duct with the round ligament. The vascularized round ligament is completely mobilized until its origin and used for lateral reconstruction of the bile duct to cover the defect. T tube was inserted and removed after few months. Patency of the bile duct was assessed by cholangiography, the liver function test and magnetic resonance imaging (MRI). Two patients aged 33 and 59 years old underwent lateral reconstruction of the bile duct for defects secondary to choledocotomy for stone extraction or during dissection for Mirizzi syndrome. The defects measured 2 and 3 cm and occupied half of the bile duct circumference. The postoperative course was marked by low output biliary fistula resolved spontaneously. In one patient, the T tube was removed at 3 months after surgery and MRI at 9 months showed strictly normal aspect of the bile duct with normal liver function test. The second patient is going very well 2 months after surgery and the T tube is closed. Lateral reconstruction of the bile duct can be safely achieved with the vascularized round ligament. We will extend our indications to tubular reconstruction.

Isolated segmental, sectoral and right hepatic bile duct injuries

PubMed Central

Colovic, Radoje B

2009-01-01

The treatment of isolated segmental, sectoral and right hepatic bile duct injuries is controversial. Nineteen patients were treated over a 26-year period. Group one was comprised of 4 patients in whom the injury was primarily repaired during the original surgery; 3 over a T-tube, 1 with a Roux-en-Y. These patients had an uneventful recovery. The second group consisted of 5 patients in whom the duct was ligated; 4 developed infection, 3 of which required drainage and biliary repair. Two patients had good long-term outcomes; the third developed a late anastomotic stricture requiring further surgery. The fourth patient developed a small bile leak and pain which resolved spontaneously. The fifth patient developed complications from which he died. The third group was comprised of 4 patients referred with biliary peritonitis; all underwent drainage and lavage, and developed biliary fistulae, 3 of which resolved spontaneously, 1 required Roux-en-Y repair, with favorable outcomes. The fourth group consisted of 6 patients with biliary fistulae. Two patients, both with an 8-wk history of a fistula, underwent Roux-en-Y repair. Two others also underwent a Roux-en-Y repair, as their fistulae showed no signs of closure. The remaining 2 patients had spontaneous closure of their biliary fistulae. A primary repair is a reasonable alternative to ligature of injured duct. Patients with ligated ducts may develop complications. Infected ducts require further surgery. Patients with biliary peritonitis must be treated with drainage and lavage. There is a 50% chance that a biliary fistula will close spontaneously. In cases where the biliary fistula does not close within 6 to 8 wk, a Roux-en-Y anastomosis should be considered. PMID:19322912

Bilateral cochlear implantation in a patient with bilateral temporal bone fractures.

PubMed

Chung, Jae Ho; Shin, Myung Chul; Min, Hyun Jung; Park, Chul Won; Lee, Seung Hwan

2011-01-01

With the emphasis on bilateral hearing nowadays, bilateral cochlear implantation has been tried out for bilateral aural rehabilitation. Bilateral sensorineural hearing loss caused by head trauma can get help from cochlear implantation. We present the case of a 44-year-old man with bilateral otic capsule violating temporal bone fractures due to head trauma. The patient demonstrated much improved audiometric and psychoacoustic performance after bilateral cochlear implantation. We believe bilateral cochlear implantation in such patient can be a very effective tool for rehabilitation. Copyright © 2011 Elsevier Inc. All rights reserved.

Individual Differences in Effectiveness of Cochlear Implants in Children Who Are Prelingually Deaf: New Process Measures of Performance

PubMed Central

Pisoni, David B.; Cleary, Miranda; Geers, Ann E.; Tobey, Emily A.

2011-01-01

The efficacy of cochlear implants in children who are deaf has been firmly established in the literature. However, the effectiveness of cochlear implants varies widely and is influenced by demographic and experiential factors. Several key findings suggest new directions for research on central auditory factors that underlie the effectiveness of cochlear implants. First, enormous individual differences have been observed in both adults and children on a wide range of audiological outcome measures. Some patients show large increases in speech perception scores after implantation, whereas others display only modest gains on standardized tests. Second, age of implantation and length of deafness affect all outcome measures. Children implanted at younger ages do better than children implanted at older ages, and children who have been deaf for shorter periods do better than children who have been deaf for longer periods. Third, communication mode affects outcome measures. Children from “oral-only” environments do much better on standardized tests that assess phonological processing skills than children who use Total Communication. Fourth, at the present time there are no preimplant predictors of outcome performance in young children. The underlying perceptual, cognitive, and linguistic abilities and skills emerge after implantation and improve over time. Finally, there are no significant differences in audiological outcome measures among current implant devices or processing strategies. This finding suggests that the major source of variance in outcome measures lies in the neural and cognitive information processing operations that the user applies to the signal provided by the implant. Taken together, this overall pattern of results suggests that higher-level central processes such as perception, attention, learning, and memory may play important roles in explaining the large individual differences observed among users of cochlear implants. Investigations of the content and flow of information in the central nervous system and interactions between sensory input and stored knowledge may provide important new insights into the basis of individual differences. Knowledge about the underlying basis of individual differences may also help in developing new intervention strategies to improve the effectiveness of cochlear implants in children who show relatively poor development of oral/aural language skills. PMID:21666760

Important factors in the cognitive development of children with hearing impairment: case studies of candidates for cochlear implants.

PubMed

Nasralla, Heloisa Romeiro; Goffi Gomez, Maria Valéria Schimidt; Magalhaes, Ana Tereza; Bento, Ricardo Ferreira

2014-10-01

Introduction The factors that affect the development of children with and without hearing disabilities are similar, provided their innate communication abilities are taken into account. Parents need to mourn the loss of the expected normally hearing child, and it is important that parents create bonds of affection with their child. Objective To conduct a postevaluation of the development and cognition of 20 candidates for cochlear implants between 1 and 13 years of age and to observe important factors in their development. Methods The following instruments were used in accordance with their individual merits: interviews with parents; the Vineland Social Maturity Scale; the Columbia Maturity Scale; free drawings; Bender and Pre-Bender testing; and pedagogical tests. Results The results are described. Conclusion Parental acceptance of a child's deafness proved to be the starting point for the child's verbal or gestural communication development, as well as for cognitive, motor, and emotional development. If the association between deafness and fine motor skills (with or without multiple disabilities) undermines the development of a child's speech, it does not greatly affect communication when the child interacts with his or her peers and receives maternal stimulation. Overprotection and poor sociability make children less independent, impairs their development, and causes low self-esteem. Further observational studies are warranted to determine how cochlear implants contribute to patient recovery.

Important Factors in the Cognitive Development of Children with Hearing Impairment: Case Studies of Candidates for Cochlear Implants

PubMed Central

Nasralla, Heloisa Romeiro; Goffi Gomez, Maria Valéria Schimidt; Magalhaes, Ana Tereza; Bento, Ricardo Ferreira

2014-01-01

Introduction The factors that affect the development of children with and without hearing disabilities are similar, provided their innate communication abilities are taken into account. Parents need to mourn the loss of the expected normally hearing child, and it is important that parents create bonds of affection with their child. Objective To conduct a postevaluation of the development and cognition of 20 candidates for cochlear implants between 1 and 13 years of age and to observe important factors in their development. Methods The following instruments were used in accordance with their individual merits: interviews with parents; the Vineland Social Maturity Scale; the Columbia Maturity Scale; free drawings; Bender and Pre-Bender testing; and pedagogical tests. Results The results are described. Conclusion Parental acceptance of a child's deafness proved to be the starting point for the child's verbal or gestural communication development, as well as for cognitive, motor, and emotional development. If the association between deafness and fine motor skills (with or without multiple disabilities) undermines the development of a child's speech, it does not greatly affect communication when the child interacts with his or her peers and receives maternal stimulation. Overprotection and poor sociability make children less independent, impairs their development, and causes low self-esteem. Further observational studies are warranted to determine how cochlear implants contribute to patient recovery. PMID:25992122

Acoustic imaging of a duct spinning mode by the use of an in-duct circular microphone array.

PubMed

Wei, Qingkai; Huang, Xun; Peers, Edward

2013-06-01

An imaging method of acoustic spinning modes propagating within a circular duct simply with surface pressure information is introduced in this paper. The proposed method is developed in a theoretical way and is demonstrated by a numerical simulation case. Nowadays, the measurements within a duct have to be conducted using in-duct microphone array, which is unable to provide information of complete acoustic solutions across the test section. The proposed method can estimate immeasurable information by forming a so-called observer. The fundamental idea behind the testing method was originally developed in control theory for ordinary differential equations. Spinning mode propagation, however, is formulated in partial differential equations. A finite difference technique is used to reduce the associated partial differential equations to a classical form in control. The observer method can thereafter be applied straightforwardly. The algorithm is recursive and, thus, could be operated in real-time. A numerical simulation for a straight circular duct is conducted. The acoustic solutions on the test section can be reconstructed with good agreement to analytical solutions. The results suggest the potential and applications of the proposed method.

Mucoepidermoid carcinoma in a salivary duct cyst of the parotid gland. Contribution to the development of tumours in salivary gland cysts.

PubMed

Seifert, G

1996-12-01

Concerning the hypothesis that distinct types of salivary gland cysts may be the starting point of a salivary gland tumour, a histological examination of 1,661 salivary gland cysts was performed in order to analyse the cell types and their proliferative activity. Epithelial alterations were found especially in salivary duct cysts of parotid gland and in mucous retention cysts of minor salivary glands. Characteristic cellular changes were epithelial metaplasias (goblet cells, clear cells, squamous cells) and focal epithelial proliferations with plump or papillary plaques projecting into the cyst lumen. Only in one case had a mucoepidermoid carcinoma developed in the wall of a parotid duct cyst. The epithelial metaplasia and focal proliferative activity in salivary duct cysts is comparable to similar alterations in odontogenic cysts as possible early manifestation of a tumour, especially of an ameloblastoma or mucoepidermoid carcinoma. The differential diagnosis of salivary duct cysts must take primarily cystadenomas and cystic mucoepidermoid carcinomas of well-differentiated type into account.

Computing simulated endolymphatic flow thermodynamics during the caloric test using normal and hydropic duct models.

PubMed

Rey-Martinez, Jorge; McGarvie, Leigh; Pérez-Fernández, Nicolás

2017-03-01

The obtained simulations support the underlying hypothesis that the hydrostatic caloric drive is dissipated by local convective flow in a hydropic duct. To develop a computerized model to simulate and predict the internal fluid thermodynamic behavior within both normal and hydropic horizontal ducts. This study used a computational fluid dynamics software to simulate the effects of cooling and warming of two geometrical models representing normal and hydropic ducts of one semicircular horizontal canal during 120 s. Temperature maps, vorticity, and velocity fields were successfully obtained to characterize the endolymphatic flow during the caloric test in the developed models. In the normal semicircular canal, a well-defined endolymphatic linear flow was obtained, this flow has an opposite direction depending only on the cooling or warming condition of the simulation. For the hydropic model a non-effective endolymphatic flow was predicted; in this model the velocity and vorticity fields show a non-linear flow, with some vortices formed inside the hydropic duct.

A time dependent difference theory for sound propagation in ducts with flow. [characteristic of inlet and exhaust ducts of turbofan engines

NASA Technical Reports Server (NTRS)

Baumeister, K. J.

1979-01-01

A time dependent numerical solution of the linearized continuity and momentum equation was developed for sound propagation in a two dimensional straight hard or soft wall duct with a sheared mean flow. The time dependent governing acoustic difference equations and boundary conditions were developed along with a numerical determination of the maximum stable time increments. A harmonic noise source radiating into a quiescent duct was analyzed. This explicit iteration method then calculated stepwise in real time to obtain the transient as well as the steady state solution of the acoustic field. Example calculations were presented for sound propagation in hard and soft wall ducts, with no flow and plug flow. Although the problem with sheared flow was formulated and programmed, sample calculations were not examined. The time dependent finite difference analysis was found to be superior to the steady state finite difference and finite element techniques because of shorter solution times and the elimination of large matrix storage requirements.

Social skills and developmental delay: importance in predicting the auditory and speech outcomes after cochlear implantation in children.

PubMed

Chang, Young-Soo; Moon, Il Joon; Kim, Eun Yeon; Ahn, Jungmin; Chung, Won-Ho; Cho, Yang-Sun; Hong, Sung Hwa

2015-02-01

Preoperative evaluation of social interaction and global development levels using the Vineland Social Maturity Scale (VSMS) and Bayley Scales of Infant Development-2nd edition (BSID-II) may be beneficial in predicting the postoperative outcome in pediatric cochlear implant recipients. In particular, cautious preoperative counseling regarding the poor postoperative prognosis may be necessary in children with low social skills and developmental status. To determine the clinical benefit of preoperative evaluation of social interaction and global development levels using VSMS and BSID-II in predicting the postoperative outcome in pediatric cochlear implant recipients. A total of 65 deaf children who underwent cochlear implantation (CI) were included in this study. Age at the time of implantation ranged from 12 to 76 months. All of the children underwent a comprehensive preimplant psychological assessment by a clinical psychologist. The VSMS and BSID-II were used for evaluating social skills and a child's development preoperatively. A social quotient (SQ) was calculated by using the VSMS for each subject using the following formula: (social age/chronological age) × 100. The auditory perception and speech production abilities were evaluated using the Categories of Auditory Performance (CAP) scale and the Korean version of the Ling's stage (K-Ling), respectively, at 1 year after CI. The associations between the preoperative SQ/developmental levels and the postoperative auditory/speech outcomes were evaluated. The mean SQ was significantly decreased in the enrolled children (90.6 ± 26.1). The improvement in CAP score at 1 year after CI was correlated with preoperative SQ. The improvements in phonemic and phonologic levels of K-Ling were correlated with preoperative VSMS and BSID-II scores.

New developments in endoscopic treatment of chronic pancreatitis.

PubMed

Didden, P; Bruno, M; Poley, J W

2012-12-01

The aim of endoscopic therapy of chronic pancreatitis (CP) is to treat pain by draining the pancreatic duct or managing loco-regional complications. Recent decennia were characterized by continuous improvement of endoscopic techniques and devices, resulting in a better clinical outcome. Novel developments now also provide the opportunity to endoscopically treat refractory CP-related complications. Especially suboptimal surgical candidates could potentially benefit from these new developments, consequently avoiding invasive surgery. The use of fully covered self-expandable metal stents (SEMS) has been explored in pancreatic and CP-related biliary duct strictures, resistant to conventional treatment with plastic endoprotheses. Furthermore, endosonography-guided transmural drainage of the main pancreatic duct via duct-gastrostomy is an alternative treatment option in selected cases. Pancreatic pseudocysts represent an excellent indication for endoscopic therapy with some recent case series demonstrating effective drainage with the use of a fully covered SEMS. Although results of these new endoscopic developments are promising, high quality randomized trials are required to determine their definite role in the management of chronic pancreatitis.

Bile duct anastomotic stricture after pediatric living donor liver transplantation.

PubMed

Chok, Kenneth S H; Chan, See Ching; Chan, Kwong Leung; Sharr, William W; Tam, Paul K H; Fan, Sheung Tat; Lo, Chung Mau

2012-07-01

Hepaticojejunostomy is a well-accepted method, whereas duct-to-duct anastomosis is gaining popularity for bile duct reconstruction in pediatric living donor liver transplantation (LDLT). Biliary complications, especially biliary anastomotic stricture (BAS), are not clearly defined. The aim of the present study is to determine the rate of BAS and its associated risk factors. The study included 78 pediatric patients (<18 years old) who underwent LDLT during the period from end of September 1993 to end of November 2010. The diagnosis of BAS was based on clinical, biochemical, histologic, and radiologic results. All patients received left-side grafts. Thirteen patients (16.7%) developed BAS after LDLT. Among them, 3 patients (23.1%) had duct-to-duct anastomosis during LDLT. The median follow-up period for the BAS group and the non-BAS group was 57.8 and 79.5 months, respectively (P = .683). Ten of the patients with BAS required percutaneous transhepatic biliary drainage with or without dilatation for treating the stricture. Multivariable analysis showed that hepatic artery thrombosis and duct-to-duct anastomosis were 2 risk factors associated with BAS. In pediatric LDLT, hepaticojejunostomy is the preferred method for bile duct reconstruction, but more large-scale research needs to be done to reconfirm this result. Copyright © 2012 Elsevier Inc. All rights reserved.

Investigation of the interference effects of mixed flow long duct nacelles on a DC-10 wing

NASA Technical Reports Server (NTRS)

Patel, S. P.; Donelson, J. E.

1982-01-01

Wind tunnel test results utilizing a 4.7 percent scale semispan model in the 11 foot transonic wind tunnel are presented. A low drag long duct nacelle installation for the DC-10 jet transport was developed. A long duct nacelle representative of a CF6-50 mixed flow configuration was investigated on the DC-10-30. The results showed that the long duct nacelle installation located in the same position as the current short duct nacelle and with the current production symmetrical pylon is a relatively low risk installation for the DC-10 aircraft. Tuft observations and analytical boundary layer analysis confirmed that the flow on the nacelle afterbody was attached. A small pylon fairing was evaluated and found to reduce channel peak suction pressures, which resulted in a small drag improvement. The test also confirmed that the optimum nacelle incidence angle is the same as for the short duct nacelle, thus the same engine mount as for the production short duct nacelle can be used for the long duct nacelle installation. Comparison of the inboard wing pylon nacelle channel pressure distributions, with flow through and powered long duct nacelles showed that the power effects did not change the flow mechanism; hence, power effects can be considered negligible.

Long duct nacelle aerodynamic development for DC-10 derivatives

NASA Technical Reports Server (NTRS)

Patel, S. P.; Donelson, J. E.

1980-01-01

The results are presented of a wind tunnel test utilizing a 4.7-percent-scale semispan model of the DC-10 in the Calspan 8-foot transonic wind tunnel. The effect of a revised long-duct nacelle shape on the channel velocities, the incremental drag relative to the baseline long-duct nacelle, and channel velocities for the baseline long-duct nacelle were determined and compared with data obtained at Ames. The baseline and the revised long-duct nacelles are representative of a CF6-50 mixed-flow configuration and were evaluated on a model of a proposed DC-10 stretched-fuselage configuration. The results showed that the revised long-duct nacelle has an appreciable effect on the inboard channel velocities, resulting in an increased channel Mach number. However, the pressure recovery on the nacelle afterbody was about the same for both nacelles. The lift curves for both long-duct nacelle configurations were the same. The channel pressures measured at Calspan were in good agreement with those measured at Ames for the baseline long-duct nacelle. The incremental drag for the revised nacelle was measured as two to four counts (three counts is approximately equal to one percent of the airplane drag) higher than that of the baseline long-duct nacelle.

Design and evaluation of a low nitrogen oxides natural gas-fired conical wire-mesh duct burner for a micro-cogeneration unit

NASA Astrophysics Data System (ADS)

Ramadan, Omar Barka Ab

A novel low NOx conical wire-mesh duct burner was designed, built and tested in the present research. This thesis documents the design process and the in-depth evaluation of this novel duct burner for the development of a more efficient micro-cogeneration unit. This duct burner provides the thermal energy necessary to raise the microturbine exhaust gases temperature to increase the heat recovery capability. The duct burner implements both lean-premixed and surface combustion techniques to achieve low NOx and CO emissions. The design of the duct burner was supported by a qualitative flow visualization study for the duct burner premixer to provide insight into the premixer flow field (mixing process). Different premixer geometries were used to control the homogeneity of the fuel-oxidant mixture at the exit of the duct burner premixer. Laser sheet illumination (LSI) technique was used to capture images of the mixing process, for each configuration studied. A quasi-quantitative analysis technique was developed to rank the different premixer geometries in terms of mixing effectiveness. The premixer geometries that provided better mixing were selected and used for the combustion tests. The full-scale gas-fired duct burner was installed in the exhaust duct of a micro-cogeneration unit for the evaluation. Three wire-mesh burners with different pressure drops were used. Each burner has a conical shape made from FeCrAL alloy mat and was designed based on a heat release per unit area of 2500 kW/m2 and a total heat release of 240kW at 100 percent excess air. The local momentum of the gaseous mixture introduced through the wire-mesh was adjusted so that the flame stabilized outside the burner mesh (surface combustion). Cold flow tests (i.e., the duct burner was off, but the microturbine was running) were conducted to measure the effect of different duct burner geometrical parameters on flow split between the combustion zone and the bypass channel, and on pressure drop across the duct burner. A considerable amount of detailed parametric experimental data was collected to investigate the performance characteristics of the duct burner. The variables studied (firing rate, mass flow ratio, conical burner pressure drop, blockage ratio, conical burner shield length, premixer geometry and inlet conditions) were all found to play an important role on emissions (NOx and CO), overall duct burner pressure drop and flame stability. The range of firing rates at which surface combustion was maintained for the duct burner was defined by direct observation of the burner surface and monitoring of the temperature in the combustion zone. Flame images were captured for qualitative assessment. The combustion tests results presented in this thesis proved that the design procedures that were implemented to design this novel microturbine conical wire-mesh duct burner were successful. During the course of the combustion tests, the duct burner displayed stable, low emissions operation throughout the surface firing rate range of 148 kW to 328 kW (1574 kW/m 2 to 3489 kW/m2). Emissions of less than 5 ppm (corrected to 15 percent 02) for NOx and CO emissions were recorded, while the duct burner successfully raised the microturbine exhaust gases temperature from about 227°C to as high as 700°C. The overall duct burner pressure drop throughout was consistently below the design limit of 249 Pa.

Remote programming of cochlear implants: a telecommunications model.

PubMed

McElveen, John T; Blackburn, Erin L; Green, J Douglas; McLear, Patrick W; Thimsen, Donald J; Wilson, Blake S

2010-09-01

Evaluate the effectiveness of remote programming for cochlear implants. Retrospective review of the cochlear implant performance for patients who had undergone mapping and programming of their cochlear implant via remote connection through the Internet. Postoperative Hearing in Noise Test and Consonant/Nucleus/Consonant word scores for 7 patients who had undergone remote mapping and programming of their cochlear implant were compared with the mean scores of 7 patients who had been programmed by the same audiologist over a 12-month period. Times required for remote and direct programming were also compared. The quality of the Internet connection was assessed using standardized measures. Remote programming was performed via a virtual private network with a separate software program used for video and audio linkage. All 7 patients were programmed successfully via remote connectivity. No untoward patient experiences were encountered. No statistically significant differences could be found in comparing postoperative Hearing in Noise Test and Consonant/Nucleus/Consonant word scores for patients who had undergone remote programming versus a similar group of patients who had their cochlear implant programmed directly. Remote programming did not require a significantly longer programming time for the audiologist with these 7 patients. Remote programming of a cochlear implant can be performed safely without any deterioration in the quality of the programming. This ability to remotely program cochlear implant patients gives the potential to extend cochlear implantation to underserved areas in the United States and elsewhere.

Protective role of hydrogen sulfide against noise-induced cochlear damage: a chronic intracochlear infusion model.

PubMed

Li, Xu; Mao, Xiao-Bo; Hei, Ren-Yi; Zhang, Zhi-Bin; Wen, Li-Ting; Zhang, Peng-Zhi; Qiu, Jian-Hua; Qiao, Li

2011-01-01

A reduction in cochlear blood flow plays an essential role in noise-induced hearing loss (NIHL). The timely regulation of cochlear perfusion determines the progression and prognosis of NIHL. Hydrogen sulfide (H(2)S) has attracted increasing interest as a vasodilator in cardiovascular systems. This study identified the role of H(2)S in cochlear blood flow regulation and noise protection. The gene and protein expression of the H(2)S synthetase cystathionine-γ-lyase (CSE) in the rat cochlea was examined using immunofluorescence and real-time PCR. Cochlear CSE mRNA levels varied according to the duration of noise exposure. A chronic intracochlear infusion model was built and artificial perilymph (AP), NaHS or DL-propargylglycine (PPG) were locally administered. Local sodium hydrosulfide (NaHS) significantly increased cochlear perfusion post-noise exposure. Cochlear morphological damage and hearing loss were alleviated in the NaHS group as measured by conventional auditory brainstem response (ABR), cochlear scanning electron microscope (SEM) and outer hair cell (OHC) count. The highest percentage of OHC loss occurred in the PPG group. Our results suggest that H(2)S plays an important role in the regulation of cochlear blood flow and the protection against noise. Further studies may identify a new preventive and therapeutic perspective on NIHL and other blood supply-related inner ear diseases.

Cochlear Patency After Transmastoid Labyrinthectomy for Ménière's Syndrome.

PubMed

Sargent, Eric W; Liao, Eric; Gonda, Roger L

2016-08-01

Labyrinthectomy is considered the "gold standard" in the treatment of intractable vertigo attacks because of Ménière's Disease (MD) but sacrifices all residual hearing. Interest in auditory rehabilitation has lead to cochlear implantation in some patients. Concern remains that the cochlear lumen may fill with tissue or bone after surgery. This study sought to determine the incidence of obliteration of the cochlea after transmastoid labyrinthectomy. Retrospective observational study. Tertiary referral center. Eighteen patients with intractable vertigo from MD who underwent surgery. Transmastoid labyrinthectomy between 2008 and 2013. Cochleas were imaged with unenhanced, heavily T2-weighted magnetic resonance imaging (MRI). Presence of symmetrical cochlear fluid signals on MRI. There was no loss of fluid signal in the cochleas of operated ear compared with the contralateral, unoperated ear in any subject an average of 3 years (standard deviation [SD]: 1.2) after surgery. Five of 18 patients had the vestibule blocked with bone wax at the time of surgery. Blocking the vestibule with bone wax did not change the cochlear fluid signal. The risk of cochlear obstruction after labyrinthectomy for MD is very low. The significance of this finding is that patients with MD who undergo labyrinthectomy will likely remain candidates for cochlear implantation in the labyrinthectomized ear long after surgery if this becomes needed. Immediate cochlear implantation or placement of a cochlear lumen keeper during labyrinthectomy for MD is probably not necessary.

Nondestructive Evaluation of the J-2X Direct Metal Laser Sintered Gas Generator Discharge Duct

NASA Technical Reports Server (NTRS)

Esther, Elizabeth A.; Beshears, Ronald D.; Lash, Rhonda K.

2012-01-01

The J-2X program at NASA's Marshall Space Flight Center (MSFC) procured a direct metal laser sintered (DMLS) gas generator discharge duct from Pratt & Whitney Rocketdyne and Morris Technologies for a test program that would evaluate the material properties and durability of the duct in an engine-like environment. DMLS technology was pursued as a manufacturing alternative to traditional techniques, which used off nominal practices to manufacture the gas generator duct's 180 degree turn geometry. MSFC's Nondestructive Evaluation (NDE) Team performed radiographic, ultrasonic, computed tomographic, and fluorescent penetrant examinations of the duct. Results from the NDE examinations reveal some shallow porosity but no major defects in the as-manufactured material. NDE examinations were also performed after hot-fire testing the gas generator duct and yielded similar results pre and post-test and showed no flaw growth or development.

A multi-modal solution for the transmission of sound in nonuniform ducts

NASA Technical Reports Server (NTRS)

Eversman, W.

1976-01-01

The method of weighted residuals in the form of a modified Galerkin method with boundary residuals is developed for the study of the transmission of sound in nonuniform ducts carrying a steady compressible flow. In this formulation the steady flow is modeled as essentially one-dimensional but with a kinematic modification to force tangency of the flow at the duct walls. Good agreement has been obtained with known results for transmission and reflection coefficients in hard walled ducts up to near sonic velocities. In ducts with acoustically compliant boundaries good comparisons have been more difficult to achieve except at low Mach numbers. The problem of transmission in a straight, acoustically treated duct with a uniform flow has been formulated and the Galerkin method used with basis functions derived from the case when flow is absent. Results indicate that favorable comparisons with exact computations can be obtained if care is taken in choosing the basis functions.

Advanced Duct Sealing Testing

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

Sherman, Max H.; Walker, Iain S.

Duct leakage has been identified as a major source of energy loss in residential buildings. Most duct leakage occurs at the connections to registers, plenums or branches in the duct system. At each of these connections a method of sealing the duct system is required. Typical sealing methods include tapes or mastics applied around the joints in the system. Field examinations of duct systems have typically shown that these seals tend to fail over extended periods of time. The Lawrence Berkeley National Laboratory has been testing sealant durability for several years. Typical duct tape (i.e. fabric backed tapes with naturalmore » rubber adhesives) was found to fail more rapidly than all other duct sealants. This report summarizes the results of duct sealant durability testing of five UL 181B-FX listed duct tapes (three cloth tapes, a foil tape and an Oriented Polypropylene (OPP) tape). One of the cloth tapes was specifically developed in collaboration with a tape manufacturer to perform better in our durability testing. The first test involved the aging of common ''core-to-collar joints'' of flexible duct to sheet metal collars, and sheet metal ''collar-to-plenum joints'' pressurized with 200 F (93 C) air. The second test consisted of baking duct tape specimens in a constant 212 F (100 C) oven following the UL 181B-FX ''Temperature Test'' requirements. Additional tests were also performed on only two tapes using sheet metal collar-to-plenum joints. Since an unsealed flexible duct joint can have a variable leakage depending on the positioning of the flexible duct core, the durability of the flexible duct joints could not be based on the 10% of unsealed leakage criteria. Nevertheless, the leakage of the sealed specimens prior to testing could be considered as a basis for a failure criteria. Visual inspection was also documented throughout the tests. The flexible duct core-to-collar joints were inspected monthly, while the sheet metal collar-to-plenum joints were inspected weekly. The baking test specimens were visually inspected weekly, and the durability was judged by the observed deterioration in terms of brittleness, cracking, flaking and blistering (the terminology used in the UL 181B-FX test procedure).« less

Music mixing preferences of cochlear implant recipients: a pilot study.

PubMed

Buyens, Wim; van Dijk, Bas; Moonen, Marc; Wouters, Jan

2014-05-01

Music perception and appraisal are generally poor in cochlear implant recipients. Simple musical structures, lyrics that are easy to follow, and clear rhythm/beat have been reported among the top factors to enhance music enjoyment. The present study investigated the preference for modified relative instrument levels in music with normal-hearing and cochlear implant subjects. In experiment 1, test subjects were given a mixing console and multi-track recordings to determine their most enjoyable audio mix. In experiment 2, a preference rating experiment based on the preferred relative level settings in experiment 1 was performed. Experiment 1 was performed with four postlingually deafened cochlear implant subjects, experiment 2 with ten normal-hearing and ten cochlear implant subjects. A significant difference in preference rating was found between normal-hearing and cochlear implant subjects. The latter preferred an audio mix with larger vocals-to-instruments ratio. In addition, given an audio mix with clear vocals and attenuated instruments, cochlear implant subjects preferred the bass/drum track to be louder than the other instrument tracks. The original audio mix in real-world music might not be suitable for cochlear implant recipients. Modifying the relative instrument level settings potentially improves music enjoyment.

Betahistine metabolites, aminoethylpyridine, and hydroxyethylpyridine increase cochlear blood flow in guinea pigs in vivo.

PubMed

Bertlich, Mattis; Ihler, Fritz; Sharaf, Kariem; Weiss, Bernhard G; Strupp, Michael; Canis, Martin

2014-10-01

Betahistine is a histamine-like drug that is used in the treatment of Ménière's disease. It is commonly believed that betahistine increases cochlear blood flow and thus decreases the endolymphatic hydrops that is the cause of Ménière's. Despite common clinical use, there is little understanding of the kinetics or effects of its metabolites. This study investigated the effect of the betahistine metabolites aminoethylpyridine, hydroxyethylpyridine, and pyridylacetic acid on cochlear microcirculation. Guinea pigs were randomly assigned to one of the groups: placebo, betahistine, or equimolar amounts of aminoethylpyridine, hydroxyethylpyridine, or pyridylacetic acid. Cochlear blood flow and mean arterial pressure were recorded for three minutes before and 15 minutes after treatment. Thirty Dunkin-Hartley guinea pigs assigned to one of five groups with six guinea pigs per group. Betahistine, aminoethylpyridine, and hydroxyethylpyridine caused a significant increase in cochlear blood flow in comparison to placebo. The effect seen under aminoethylpyridin was greatest. The group treated with pyridylacetic acid showed no significant effect on cochlear blood flow. Aminoethylpyridine and hydroxyethylpyridine are, like betahistine, able to increase cochlear blood flow significantly. The effect of aminoethylpyridine was greatest. Pyridylacetic acid had no effect on cochlear microcirculation.

Histaminergic H3-Heteroreceptors as a Potential Mediator of Betahistine-Induced Increase in Cochlear Blood Flow.

PubMed

Bertlich, Mattis; Ihler, Friedrich; Freytag, Saskia; Weiss, Bernhard G; Strupp, Michael; Canis, Martin

2015-01-01

Betahistine is a histamine-like drug that is considered beneficial in Ménière's disease by increasing cochlear blood flow. Acting as an agonist at the histamine H1-receptor and as an inverse agonist at the H3-receptor, these receptors as well as the adrenergic α2-receptor were investigated for betahistine effects on cochlear blood flow. A total of 54 Dunkin-Hartley guinea pigs were randomly assigned to one of nine groups treated with a selection of H1-, H3- or α2-selective agonists and antagonists together with betahistine. Cochlear blood flow and mean arterial pressure were recorded for 3 min before and 15 min after infusion. Blockage of the H3- or α2-receptors caused a suppression of betahistine-mediated typical changes in cochlear blood flow or blood pressure. Activation of H3-receptors caused a drop in cochlear blood flow and blood pressure. H1-receptors showed no involvement in betahistine-mediated changes of cochlear blood flow. Betahistine most likely affects cochlear blood flow through histaminergic H3-heteroreceptors. © 2015 S. Karger AG, Basel.

Fingolimod (FTY-720) is Capable of Reversing Tumor Necrosis Factor Induced Decreases in Cochlear Blood Flow.

PubMed

Bertlich, Mattis; Ihler, Friedrich; Weiss, Bernhard G; Freytag, Saskia; Jakob, Mark; Strupp, Michael; Pellkofer, Hannah; Canis, Martin

2017-09-01

The potential of Fingolimod (FTY-720), a sphingosine-1-phosphate analogue, to revoke the changes in cochlear blood flow induced by tumor necrosis factor (TNF) was investigated. Impairment of cochlear blood flow has often been considered as the common final pathway of various inner ear pathologies. TNF, an ubiquitous cytokine, plays a major role in these pathologies, reducing cochlear blood flow via sphingosine-1-phosphate-signaling. Fifteen Dunkin-Hartley guinea pigs were randomly assigned to one of three groups (placebo/placebo, TNF/placebo, TNF/FTY-720). Cochlear microcirculation was quantified over 60 minutes by in vivo fluorescence microscopy before and after topical application of placebo or TNF (5 ng/ml) and after subsequent application of placebo or FTY-720 (200 μg/ml). Treatment with TNF led to a significant decrease of cochlear blood flow.Following this, application of placebo caused no significant changes while application of FTY-720 caused a significant rise in cochlear blood flow. FTY-720 is capable of reversing changes in cochlear blood flow induced by application of TNF. This makes FTY-720 a valid candidate for potential treatment of numerous inner ear pathologies.

[Cochlear implantation in patients with Waardenburg syndrome type II].

PubMed

Wan, Liangcai; Guo, Menghe; Chen, Shuaijun; Liu, Shuangriu; Chen, Hao; Gong, Jian

2010-05-01

To describe the multi-channel cochlear implantation in patients with Waardenburg syndrome including surgeries, pre and postoperative hearing assessments as well as outcomes of speech recognition. Multi-channel cochlear implantation surgeries have been performed in 12 cases with Waardenburg syndrome type II in our department from 2000 to 2008. All the patients received multi-channel cochlear implantation through transmastoid facial recess approach. The postoperative outcomes of 12 cases were compared with 12 cases with no inner ear malformation as a control group. The electrodes were totally inserted into the cochlear successfully, there was no facial paralysis and cerebrospinal fluid leakage occurred after operation. The hearing threshold in this series were similar to that of the normal cochlear implantation. After more than half a year of speech rehabilitation, the abilities of speech discrimination and spoken language of all the patients were improved compared with that of preoperation. Multi-channel cochlear implantation could be performed in the cases with Waardenburg syndrome, preoperative hearing and images assessments should be done.

[Cochlear implantation through the middle fossa approach].

PubMed

Szyfter, W; Colletti, V; Pruszewicz, A; Kopeć, T; Szymiec, E; Kawczyński, M; Karlik, M

2001-01-01

The inner part of cochlear implant is inserted into inner ear during surgery through mastoid and middle ear. It is a classical method, used in the majority cochlear centers in the world. This is not a suitable method in case of chronic otitis media and middle ear malformation. In these cases Colletti proposed the middle fossa approach and cochlear implant insertion omitting middle ear structures. In patient with bilateral chronic otitis media underwent a few ears operations without obtaining dry postoperative cavity. Cochlear implantation through the middle fossa approach was performed in this patient. The bone fenster was cut, temporal lobe was bent and petrosus pyramid upper surface was exposed. When the superficial petrosal greater nerve, facial nerve and arcuate eminence were localised, the cochlear was open in the basal turn and electrode were inserted. The patient achieves good results in the postoperative speech rehabilitation. It confirmed Colletti tesis that deeper electrode insertion in the cochlear implantation through the middle fossa approach enable use of low and middle frequencies, which are very important in speech understanding.

United Kingdom national paediatric bilateral cochlear implant audit: preliminary results.

PubMed

Cullington, Helen; Bele, Devyanee; Brinton, Julie; Lutman, Mark

2013-11-01

Prior to 2009, United Kingdom (UK) public funding was mainly only available for children to receive unilateral cochlear implants. In 2009, the National Institute for Health and Care Excellence published guidance for cochlear implantation following their review. According to these guidelines, all suitable children are eligible to have simultaneous bilateral cochlear implants or a sequential bilateral cochlear implant if they had received the first before the guidelines were published. Fifteen UK cochlear implant centres formed a consortium to carry out a multi-centre audit. The audit involves collecting data from simultaneously and sequentially implanted children at four intervals: before bilateral cochlear implants or before the sequential implant, 1, 2, and 3 years after bilateral implants. The measures include localization, speech recognition in quiet and background noise, speech production, listening, vocabulary, parental perception, quality of life, and surgical data including complications. The audit has now passed the 2-year point, and data have been received on 850 children. This article provides a first view of some data received up until March 2012.

Musical ear syndrome in adult cochlear implant patients.

PubMed

Low, W-K; Tham, C A; D'Souza, V-D; Teng, S-W

2013-09-01

Except for a single case report, musical ear syndrome in cochlear implantees has not been studied. We aimed to study the prevalence and nature of musical ear syndrome among adult cochlear implant patients, as well as the effect on their emotional well-being. STUDY DESIGN, PATIENTS AND INTERVENTION: A cross-sectional survey of patients aged 18 years and above who had received cochlear implants for profound hearing loss between 1997 and 2010. Of the 82 patients studied, 18 (22 per cent) were found to have experienced musical ear syndrome. Seven and 11 patients had musical ear syndrome prior to and after cochlear implantation, respectively. The character of musical ear syndrome symptoms was described as instrumental music (n = 2), singing (6) or both (10). Fourteen patients reported an adverse emotional effect, with three expressing ‘intolerance’. In this study, 22 per cent of cochlear implantees experienced musical ear syndrome. These symptoms affected patients’ emotional state, but most coped well. Musical ear syndrome can occur prior to and after cochlear implantation.

Patent vitellointestinal duct

PubMed Central

Agrawal, Sanwar; Memon, Ameen

2010-01-01

During the 3rd week of intrauterine life there is a communication between the intraembryonic gut and the yolk sac. As the development proceeds this communication narrows into a tube known as the vitellointestinal duct (VID). With the establishment of placental nutrition this duct usually becomes obliterated by the end of the 7th week of intrauterine life. In about 2% of humans this duct persists and gives rise to a group of anomalies of which Meckel's diverticulum is the commonest and complete patency of the duct is the rarest.1 We report a case of a 4-month-old infant who presented with umbilical polyp, discharge from the umbilicus, significant dehydration and failure to thrive because of complete patency of the VID PMID:22778111

The influence of cochlear shape on low-frequency hearing.

PubMed

Manoussaki, Daphne; Chadwick, Richard S; Ketten, Darlene R; Arruda, Julie; Dimitriadis, Emilios K; O'Malley, Jen T

2008-04-22

The conventional theory about the snail shell shape of the mammalian cochlea is that it evolved essentially and perhaps solely to conserve space inside the skull. Recently, a theory proposed that the spiral's graded curvature enhances the cochlea's mechanical response to low frequencies. This article provides a multispecies analysis of cochlear shape to test this theory and demonstrates that the ratio of the radii of curvature from the outermost and innermost turns of the cochlear spiral is a significant cochlear feature that correlates strongly with low-frequency hearing limits. The ratio, which is a measure of curvature gradient, is a reflection of the ability of cochlear curvature to focus acoustic energy at the outer wall of the cochlear canal as the wave propagates toward the apex of the cochlea.

Modified duval procedure for small-duct chronic pancreatitis without head dominance.

PubMed

Oida, Takatsugu; Aramaki, Osamu; Kano, Hisao; Mimatsu, Kenji; Kawasaki, Atsushi; Kuboi, Youichi; Fukino, Nobutada; Kida, Kazutoshi; Amano, Sadao

2011-01-01

In the case of small-duct chronic pancreatitis, surgery for pain relief is broadly divided into resection and drainage procedures. These procedures should be selected according to the location of dominant lesion, diameter of the pancreatic duct and extent of the disease. The appropriate procedure for the treatment of small-duct chronic pancreatitis, especially small-duct chronic pancreatitis without head dominance, remains controversial. We developed the modified Duval procedure for the treatment of small-duct chronic pancreatitis without head dominance and determined the efficacy of this procedure. We retrospectively studied 14 patients who underwent surgical drainage with or without pancreatic resection for chronic pancreatitis with small pancreatic duct (<7mm) without head dominance. These patients were divided into 2 groups; the modified Puestow procedure group and the modified Duval procedure group. No complications occurred in the modified Duval group. In the modified Puestow procedure group, complete and partial pain relief were observed in 62.5%, and 37.5% of patients respectively. In contrast, complete pain relief was observed in all the patients in the modified Duval procedure group. Our modified Duval procedure is useful and should be considered the appropriate surgical technique for the treatment of small-duct chronic pancreatitis without head dominance.

Analysis of sound propagation in ducts using the wave envelope concept

NASA Technical Reports Server (NTRS)

Baumeister, K. J.

1974-01-01

A finite difference formulation is presented for sound propagation in a rectangular two-dimensional duct without steady flow for plane wave input. Before the difference equations are formulated, the governing Helmholtz equation is first transformed to a form whose solution does not oscillate along the length of the duct. This transformation reduces the required number of grid points by an order of magnitude, and the number of grid points becomes independent of the sound frequency. Physically, the transformed pressure represents the amplitude of the conventional sound wave. Example solutions are presented for sound propagation in a one-dimensional straight hard-wall duct and in a two-dimensional straight soft-wall duct without steady flow. The numerical solutions show evidence of the existence along the duct wall of a developing acoustic pressure diffusion boundary layer which is similar in nature to the conventional viscous flow boundary layer. In order to better illustrate this concept, the wave equation and boundary conditions are written such that the frequency no longer appears explicitly in them. The frequency effects in duct propagation can be visualized solely as an expansion and stretching of the suppressor duct.

Sound attenuation of fiberglass lined ventilation ducts

NASA Astrophysics Data System (ADS)

Albright, Jacob

Sound attenuation is a crucial part of designing any HVAC system. Most ventilation systems are designed to be in areas occupied by one or more persons. If these systems do not adequately attenuate the sound of the supply fan, compressor, or any other source of sound, the affected area could be subject to an array of problems ranging from an annoying hum to a deafening howl. The goals of this project are to quantify the sound attenuation properties of fiberglass duct liner and to perform a regression analysis to develop equations to predict insertion loss values for both rectangular and round duct liners. The first goal was accomplished via insertion loss testing. The tests performed conformed to the ASTM E477 standard. Using the insertion loss test data, regression equations were developed to predict insertion loss values for rectangular ducts ranging in size from 12-in x 18-in to 48-in x 48-in in lengths ranging from 3ft to 30ft. Regression equations were also developed to predict insertion loss values for round ducts ranging in diameters from 12-in to 48-in in lengths ranging from 3ft to 30ft.

Outcomes after resection of occupational cholangiocarcinoma.

PubMed

Kubo, Shoji; Takemura, Shigekazu; Tanaka, Shogo; Shinkawa, Hiroji; Kinoshita, Masahiko; Hamano, Genya; Ito, Tokuji; Koda, Masaki; Aota, Takanori; Yamamoto, Takatsugu; Terajima, Hiroaki; Tachiyama, Gorou; Yamada, Terumasa; Nakamori, Shoji; Arimoto, Akira; Fujikawa, Masahiro; Tomimaru, Yoshito; Sugawara, Yasuhiko; Nakagawa, Kei; Unno, Michiaki; Mizuguchi, Toru; Takenaka, Kenji; Kimura, Koichi; Shirabe, Ken; Saiura, Akio; Uesaka, Katsuhiko; Taniguchi, Hiroki; Fukuda, Akira; Chong, Ja-Mun; Kuwae, Yuko; Ohsawa, Masahiko; Sato, Yasunori; Nakanuma, Yasuni

2016-09-01

Cholangiocarcinoma caused by exposure to 1,2-dichloropropane and/or dichloromethane is recognized as occupational cholangiocarcinoma. The aim of this study was to investigate the outcomes after resection of occupational cholangiocarcinoma to establish a treatment strategy for this disease. Clinicopathological findings and outcomes after surgical intervention in 20 patients with occupational cholangiocarcinoma were investigated. Of 20 the patients, curative resection was performed in 16 patients. Three patients underwent radiation at the stump of the bile ducts. Adjuvant chemotherapy was performed in 12 patients. Biliary intraepithelial neoplasia, intraductal papillary neoplasm of the bile duct, and/or chronic bile duct injury was detected in most subjects. Intraabdominal infection developed after surgery in nine patients. Cholangiocarcinoma recurred in 12 of the 20 patients. The recurrent tumors in five patients developed at a different part of the bile duct from the primary tumor and a second resection was performed in four of these five patients. The incidence of postoperative complications including intraabdominal infection was high in patients with occupational cholangiocarcinoma. Multicentric recurrence occurred not infrequently after surgery because the bile ducts had a high potential for the development of carcinoma. The aggressive treatment including second resection for the multicentric recurrence appeared to be effective. © 2016 Japanese Society of Hepato-Biliary-Pancreatic Surgery.

Physiopathology of the cochlear microcirculation.

PubMed

Shi, Xiaorui

2011-12-01

Normal blood supply to the cochlea is critically important for establishing the endocochlear potential and sustaining production of endolymph. Abnormal cochlear microcirculation has long been considered an etiologic factor in noise-induced hearing loss, age-related hearing loss (presbycusis), sudden hearing loss or vestibular function, and Meniere's disease. Knowledge of the mechanisms underlying the pathophysiology of cochlear microcirculation is of fundamental clinical importance. A better understanding of cochlear blood flow (CoBF) will enable more effective management of hearing disorders resulting from aberrant blood flow. This review focuses on recent discoveries and findings related to the physiopathology of the cochlear microvasculature. Published by Elsevier B.V.

Physiopathology of the Cochlear Microcirculation

PubMed Central

Shi, Xiaorui

2011-01-01

Normal blood supply to the cochlea is critically important for establishing the endocochlear potential and sustaining production of endolymph. Abnormal cochlear microcirculation has long been considered an etiologic factor in noise-induced hearing loss, age-related hearing loss (presbycusis), sudden hearing loss or vestibular function, and Meniere's disease. Knowledge of the mechanisms underlying the pathophysiology of cochlear microcirculation is of fundamental clinical importance. A better understanding of cochlear blood flow (CoBF) will enable more effective management of hearing disorders resulting from aberrant blood flow. This review focuses on recent discoveries and findings related to the physiopathology of the cochlear microvasculature. PMID:21875658

Sexually Dimorphic Expression of Secreted Frizzled-Related (SFRP) Genes in the Developing Mouse Müllerian Duct

PubMed Central

COX, SAM; SMITH, LEE; BOGANI, DEBORA; CHEESEMAN, MICHAEL; SIGGERS, PAM; GREENFIELD, ANDY

2007-01-01

In developing male embryos, the female reproductive tract primordia (Müllerian ducts) regress due to the production of testicular anti-Müllerian hormone (AMH). Because of the association between secreted frizzled-related proteins (SFRPs) and apoptosis, their reported developmental expression patterns and the role of WNT signaling in female reproductive tract development, we examined expression of Sfrp2 and Sfrp5 during development of the Müllerian duct in male (XY) and female (XX) mouse embryos. We show that expression of both Sfrp2 and Sfrp5 is dynamic and sexually dimorphic. In addition, the male-specific expression observed for both genes prior to the onset of regression is absent in mutant male embryos that fail to undergo Müllerian duct regression. We identified ENU-induced point mutations in Sfrp5 and Sfrp2 that are predicted to severely disrupt the function of these genes. Male embryos and adults homozygous for these mutations, both individually and in combination, are viable and apparently fertile with no overt abnormalities of reproductive tract development. PMID:16700072

Dynamic expression of Lgr6 in the developing and mature mouse cochlea

PubMed Central

Zhang, Yanping; Chen, Yan; Ni, Wenli; Guo, Luo; Lu, Xiaoling; Liu, Liman; Li, Wen; Sun, Shan; Wang, Lei; Li, Huawei

2015-01-01

The Wnt/β-catenin signaling pathway plays important roles in mammalian inner ear development. Lgr5, one of the downstream target genes of the Wnt/β-catenin signaling pathway, has been reported to be a marker for inner ear hair cell progenitors. Lgr6 shares approximately 50% sequence homology with Lgr5 and has been identified as a stem cell marker in several organs. However, the detailed expression profiles of Lgr6 have not yet been investigated in the mouse inner ear. Here, we first used Lgr6-EGFP-Ires-CreERT2 mice to examine the spatiotemporal expression of Lgr6 protein in the cochlear duct during embryonic and postnatal development. Lgr6-EGFP was first observed in one row of prosensory cells in the middle and basal turn at embryonic day 15.5 (E15.5). From E18.5 to postnatal day 3 (P3), the expression of Lgr6-EGFP was restricted to the inner pillar cells (IPCs). From P7 to P15, the Lgr6-EGFP expression level gradually decreased in the IPCs and gradually increased in the inner border cells (IBCs). At P20, Lgr6-EGFP was only expressed in the IBCs, and by P30 Lgr6-EGFP expression had completely disappeared. Next, we demonstrated that Wnt/β-catenin signaling is required to maintain the Lgr6-EGFP expression in vitro. Finally, we demonstrated that the Lgr6-EGFP-positive cells isolated by flow cytometry could differentiate into myosin 7a-positive hair cells after 10 days in-culture, and this suggests that the Lgr6-positive cells might serve as the hair cell progenitor cells in the cochlea. PMID:26029045

Endoscopic therapy of posttransplant biliary stenoses after right-sided adult living donor liver transplantation.

PubMed

Zoepf, Thomas; Maldonado-Lopez, Evelyn J; Hilgard, Philip; Schlaak, Joerg; Malago, Massimo; Broelsch, Christoph E; Treichel, Ulrich; Gerken, Guido

2005-11-01

Endoscopic treatment of biliary strictures after liver transplantation is a therapeutic challenge. In particular, outcomes of endoscopic therapy of biliary complications in the case of duct-to-duct anastomosis after living related liver transplantation are limited. The aim of this study was to evaluate the feasibility and success of an endoscopic treatment approach to posttransplant biliary strictures (PTBS) after right-sided living donor liver transplantation (RLDLT) with duct-to-duct anastomosis. Ninety patients who received adult-to-adult RLDLT in our center were screened retrospectively with respect to endoscopic treatment of PTBS. Therapy was judged as successful when cholestasis parameters returned to normal and bile duct narrowing was reduced significantly after the completion of therapy. Forty of 90 RLDLT patients received duct-to-duct anastomosis, 12 (30%) showed PTBS. Seven of 12 patients were treated successfully by endoscopy; the remaining 5 patients were treated primarily by surgery. Most patients were treated by balloon dilatation followed by insertion of endoprostheses. A median of 2.5 dilatation sessions were necessary and the median treatment duration was 8 months. One patient developed endoscopy-treatable recurrent stenosis, no surgical intervention was necessary. Mild pancreatitis occurred in 7.9% and cholangitis in 5.3% of the procedures. One minor bleeding episode occurred during sphincterotomy. Bleeding was managed endoscopically. Endoscopic therapy of adult-to-adult right living related liver transplantation with duct-to-duct anastomosis is feasible and frequently is successful. The duct-to-duct anastomosis offers the possibility of endoscopic treatment. Endoscopic treatment of posttransplant biliary strictures is safe, with a low specific complication rate.

Understanding minds: early cochlear implantation and the development of theory of mind in children with profound hearing impairment.

PubMed

Sundqvist, Annette; Lyxell, Björn; Jönsson, Radoslava; Heimann, Mikael

2014-03-01

The present study investigates how auditory stimulation from cochlear implants (CI) is associated with the development of Theory of Mind (ToM) in severely and profoundly hearing impaired children with hearing parents. Previous research has shown that deaf children of hearing parents have a delayed ToM development. This is, however, not always the case with deaf children of deaf parents, who presumably are immersed in a more vivid signing environment. Sixteen children with CI (4.25 to 9.5 years of age) were tested on measures of cognitive and emotional ToM, language and cognition. Eight of the children received their first implant relatively early (before 27 months) and half of them late (after 27 months). The two groups did not differ in age, gender, language or cognition at entry of the study. ToM tests included the unexpected location task and a newly developed Swedish social-emotional ToM test. The tests aimed to test both cognitive and emotional ToM. A comparison group of typically developing hearing age matched children was also added (n=18). Compared to the comparison group, the early CI-group did not differ in emotional ToM. The late CI-group differed significantly from the comparison group on both the cognitive and emotional ToM tests. The results revealed that children with early cochlear implants solved ToM problems to a significantly higher degree than children with late implants, although the groups did not differ on language or cognitive measures at baseline. The outcome suggests that early cochlear implantation for deaf children in hearing families, in conjunction with early social and communicative stimulation in a language that is native to the parents, can provide a foundation for a more normalized ToM development. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Consonant Acquisition in Young Cochlear Implant Recipients and Their Typically Developing Peers

PubMed Central

Jung, Jongmin; Ertmer, David J.

2017-01-01

Purpose Consonant acquisition was examined in 13 young cochlear implant (CI) recipients and 11 typically developing (TD) children. Method A longitudinal research design was implemented to determine the rate and nature of consonant acquisition during the first 2 years of robust hearing experience. Twenty-minute adult–child (typically a parent) interactions were video and audio recorded at 3-month intervals following implantation until 24 months of robust hearing experience was achieved. TD children were similarly recorded between 6 and 24 months of age. Consonants that were produced twice within a 50-utterance sample were considered “established” within a child's consonant inventory. Results Although the groups showed similar trajectories, the CI group produced larger consonant inventories than the TD group at each interval except for 21 and 24 months. A majority of children with CIs also showed more rapid acquisition of consonants and more diverse consonant inventories than TD children. Conclusions These results suggest that early auditory deprivation does not significantly affect consonant acquisition for most CI recipients. Tracking early consonant development appears to be a useful way to assess the effectiveness of cochlear implantation in young recipients. PMID:28474085

Cultural Identity of Young Deaf Adults with Cochlear Implants in Comparison to Deaf without Cochlear Implants and Hard-of-Hearing Young Adults.

PubMed

Goldblat, Ester; Most, Tova

2018-07-01

This study examined the relationships between cultural identity, severity of hearing loss (HL), and the use of a cochlear implant (CI). One hundred and forty-one adolescents and young adults divided into three groups (deaf with CI, deaf without CI, and hard-of-hearing (HH)) and 134 parents participated. Adolescents and young adults completed questionnaires on cultural identity (hearing, Deaf, marginal, bicultural-hearing, and bicultural-deaf) and communication proficiencies (hearing, spoken language, and sign language). Parents completed a speech quality questionnaire. Deaf participants without CI and those with CI differed in all identities except marginal identity. CI users and HH participants had similar identities except for a stronger bicultural-deaf identity among CI users. Three clusters of participants evolved: participants with a dominant bicultural-deaf identity, participants with a dominant bicultural-hearing identity and participants without a formed cultural identity. Adolescents and young adults who were proficient in one of the modes of communication developed well-established bicultural identities. Adolescents and young adults who were not proficient in one of the modes of communication did not develop a distinguished cultural identity. These results suggest that communication proficiencies are crucial for developing defined identities.

Magnetic stem cell targeting to the inner ear

NASA Astrophysics Data System (ADS)

Le, T. N.; Straatman, L.; Yanai, A.; Rahmanian, R.; Garnis, C.; Häfeli, U. O.; Poblete, T.; Westerberg, B. D.; Gregory-Evans, K.

2017-12-01

Severe sensorineural deafness is often accompanied by a loss of auditory neurons in addition to injury of the cochlear epithelium and hair cell loss. Cochlear implant function however depends on a healthy complement of neurons and their preservation is vital in achieving optimal results. We have developed a technique to target mesenchymal stem cells (MSCs) to a deafened rat cochlea. We then assessed the neuroprotective effect of systematically delivered MSCs on the survival and function of spiral ganglion neurons (SGNs). MSCs were labeled with superparamagnetic nanoparticles, injected via the systemic circulation, and targeted using a magnetized cochlea implant and external magnet. Neurotrophic factor concentrations, survival of SGNs, and auditory function were assessed at 1 week and 4 weeks after treatments and compared against multiple control groups. Significant numbers of magnetically targeted MSCs (>30 MSCs/section) were present in the cochlea with accompanied elevation of brain-derived neurotrophic factor and glial cell-derived neurotrophic factor levels (p < 0.001). In addition we saw improved survival of SGNs (approximately 80% survival at 4 weeks). Hearing threshold levels in magnetically targeted rats were found to be significantly better than those of control rats (p < 0.05). These results indicate that magnetic targeting of MSCs to the cochlea can be accomplished with a magnetized cochlear permalloy implant and an external magnet. The targeted stem cells release neurotrophic factors which results in improved SGN survival and hearing recovery. Combining magnetic cell-based therapy and cochlear implantation may improve cochlear implant function in treating deafness.

Cytomegalovirus (CMV) Infection Causes Degeneration of Cochlear Vasculature and Hearing Loss in a Mouse Model.

PubMed

Carraro, Mattia; Almishaal, Ali; Hillas, Elaine; Firpo, Matthew; Park, Albert; Harrison, Robert V

2017-04-01

Cytomegalovirus (CMV) infection is one of the most common causes of congenital hearing loss in children. We have used a murine model of CMV infection to reveal functional and structural cochlear pathogenesis. The cerebral cortex of Balb/c mice (Mus musculus) was inoculated with 2000 pfu (plaque forming units) of murine CMV on postnatal day 3. At 6 weeks of age, cochlear function was monitored using auditory brainstem response (ABR) and distortion product otoacoustic emission (DPOAE) measures. Histological assessment of cochlear vasculature using a corrosion cast technique was made at 8 weeks. Vascular casts of mCMV-damaged cochleas, and those of untreated control animals, were examined using scanning electron microscopy. We find very large variations in the degree of vascular damage in animals given identical viral injections (2000 pfu). The primary lesion caused by CMV infection is to the stria vascularis and to the adjacent spiral limbus capillary network. Capillary beds of the spiral ligament are generally less affected. The initial vascular damage is found in the mid-apical turn and appears to progress to more basal cochlear regions. After viral migration to the inner ear, the stria vascularis is the primary affected structure. We suggest that initial auditory threshold losses may relate to the poor development or maintenance of the endocochlear potential caused by strial dysfunction. Our increased understanding of the pathogenesis of CMV-related hearing loss is important for defining methods for early detection and treatment.

Comparison of learning preferences of Turkish children who had been applied cochlear implantation in Turkey and Germany according to theory of multiple intelligence.

PubMed

Sahli, Sanem; Laszig, Roland; Aschendorff, Antje; Kroeger, Stefanie; Wesarg, Thomas; Belgin, Erol

2011-12-01

The aim of the study is to determinate the using dominant multiple intelligence types and compare the learning preferences of Turkish cochlear implanted children aged four to ten in Turkey and Germany according to Theory of multiple intelligence. The study has been conducted on a total of 80 children and four groups in Freiburg/Germany and Ankara/Turkey. The applications have been done in University of Freiburg, Cochlear Implant Center in Germany, and University of Hacettepe, ENT Department, Audiology and Speech Pathology Section in Turkey. In this study, the data have been collected by means of General Information Form and Cochlear Implant Information Form applied to parents. To determine the dominant multiple intelligence types of children, the TIMI (Teele Inventory of Multiple Intelligences) which was developed by Sue Teele have been used. The study results exposed that there was not a statistically significant difference on dominant intelligence areas and averages of scores of multiple intelligence types in control groups (p>0.05). Although, the dominant intelligence areas were different (except for first dominant intelligence) in cochlear implanted children in Turkey and Germany, there was not a statistically significant difference on averages of scores of dominant multiple intelligence types. Every hearing impaired child who started training, should be evaluated in terms of multiple intelligence areas and identified strengths and weaknesses. Multiple intelligence activities should be used in their educational programs. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Defining the Hook Region Anatomy of the Guinea Pig Cochlea for Modeling of Inner Ear Surgery.

PubMed

Lo, Jonathon; Sale, Phillip; Wijewickrema, Sudanthi; Campbell, Luke; Eastwood, Hayden; O'leary, Stephen John

2017-07-01

The aim of this study was to describe the hook region anatomy of the guinea pig cochlea to identify the optimal surgical approach for cochlear implantation and to determine what anatomical structures are at risk. Animal studies investigating hearing loss after cochlear implantation surgery are currently constrained by the lack of a reproducible implantation model. Guinea pig cochleae were imaged using thin-sheet laser imaging microscopy. Images were stitched, reconstructed, and segmented for analysis. Insertion vectors were determined by tracing their paths to the outer wall and converting to Cartesian coordinates. Spherical surface and multiplane views were generated to analyze outer wall and radial forces of the insertion vector. Thin-sheet laser imaging microscopy enabled quantitative, whole specimen analysis of the soft and bony tissue relationships of the complex cochlear hook region in any desired plane without loss of image quality. Round window or cochleostomy approaches in the anteroinferior plane avoided direct damage to cochlear structures. Cochleostomy approach had large interindividual variability of angular depth and outer wall forces but predictable radial force. The guinea pig hook region and lower basal turn have similar structural relationships to humans. Careful cochleostomy placement is essentially for minimizing cochlear trauma and for ensuring a straight insertion vector that successfully advances around the outer wall. Experiments with guinea pigs that control for the surgical approach are likely to provide useful insights into the aetiology and the development of therapies directed at postimplantation hearing loss.

Searching for cochlear implant information on the internet maze: implications for parents and professionals.

PubMed

Zaidman-Zait, Anat; Jamieson, Janet R

2004-01-01

The present study has three purposes: (a) to determine who disseminates information on cochlear implants on the Web; (b) to describe a representative sample of Web sites that disseminate information on cochlear implants, with a focus on the content topics and their relevance to parents of deaf children; and (c) to discuss the practical issues of Web-based information and its implications for professionals working with parents of deaf children. Using the terms "cochlear implants" and "children," the first 10 sites generated by the four most popular search engines (Google, Yahoo, Microsoft's MSN, and America Online) at two points in time were selected for analysis, resulting in a sample of 31 Web sites. The majority of Web sites represented medically oriented academic departments and government organizations, although a wide variety of other sources containing information about cochlear implants were also located. Qualitative analysis revealed that the content tended to fall into eight categories; however, the important issues of educational concerns, habilitation following surgery, and communication methods were either addressed minimally or neglected completely. Using analytical tools that had been developed to evaluate "user friendliness" in other domains, each Web site was assessed for its stability, service/design features and ease of use. In general, wide variability was noted across the Web sites for each of these factors. The strong recommendation is made that professionals understand and enhance their knowledge of both the advantages and limitations of incorporating the new technology into their work with parents.

Cochlear compression: perceptual measures and implications for normal and impaired hearing.

PubMed

Oxenham, Andrew J; Bacon, Sid P

2003-10-01

This article provides a review of recent developments in our understanding of how cochlear nonlinearity affects sound perception and how a loss of the nonlinearity associated with cochlear hearing impairment changes the way sounds are perceived. The response of the healthy mammalian basilar membrane (BM) to sound is sharply tuned, highly nonlinear, and compressive. Damage to the outer hair cells (OHCs) results in changes to all three attributes: in the case of total OHC loss, the response of the BM becomes broadly tuned and linear. Many of the differences in auditory perception and performance between normal-hearing and hearing-impaired listeners can be explained in terms of these changes in BM response. Effects that can be accounted for in this way include poorer audiometric thresholds, loudness recruitment, reduced frequency selectivity, and changes in apparent temporal processing. All these effects can influence the ability of hearing-impaired listeners to perceive speech, especially in complex acoustic backgrounds. A number of behavioral methods have been proposed to estimate cochlear nonlinearity in individual listeners. By separating the effects of cochlear nonlinearity from other aspects of hearing impairment, such methods may contribute towards identifying the different physiological mechanisms responsible for hearing loss in individual patients. This in turn may lead to more accurate diagnoses and more effective hearing-aid fitting for individual patients. A remaining challenge is to devise a behavioral measure that is sufficiently accurate and efficient to be used in a clinical setting.

Lack of financial barriers to pediatric cochlear implantation: impact of socioeconomic status on access and outcomes.

PubMed

Chang, David T; Ko, Alvin B; Murray, Gail S; Arnold, James E; Megerian, Cliff A

2010-07-01

(1) To analyze if socioeconomic status influences access to cochlear implantation in an environment with adequate Medicaid reimbursement. (2) To determine the impact of socioeconomic status on outcomes after unilateral cochlear implantation. Retrospective cohort study. University Hospitals Case Medical Center and Rainbow Babies and Children's Hospital (tertiary referral center), Cleveland, Ohio. Pediatric patients (age range, newborn to 18 years) who received unilateral cochlear implantation during the period 1996 to 2008. Access to cochlear implantation after referral to a cochlear implant center, postoperative complications, compliance with follow-up appointments, and access to sequential bilateral cochlear implantation. A total of 133 pediatric patients were included in this study; 64 were Medicaid-insured patients and 69 were privately insured patients. There was no statistical difference in the odds of initial cochlear implantation, age at referral, or age at implantation between the 2 groups. The odds of prelingual Medicaid-insured patients receiving sequential bilateral cochlear implantation was less than half that of the privately insured group (odds ratio [OR], 0.43; P = .03). The odds of complications in Medicaid-insured children were almost 5-fold greater than the odds for privately insured children (OR, 4.6; P = .03). There were 10 complications in 51 Medicaid-insured patients (19.6%) as opposed to 3 in 61 privately insured patients (4.9%). Medicaid-insured patients missed substantially more follow-up appointments overall (35% vs 23%) and more consecutive visits (1.9 vs 1.1) compared with privately insured patients. In an environment with adequate Medicaid reimbursement, eligible children have equal access to cochlear implantation, regardless of socioeconomic background. However, lower socioeconomic background is associated with higher rates of postoperative complications, worse follow-up compliance, and lower rates of sequential bilateral implantation, observed herein in Medicaid-insured patients. These findings present opportunities for cochlear implant centers to create programs to address such downstream disparities.

The Role of MRI in Diagnosing Neurovascular Compression of the Cochlear Nerve Resulting in Typewriter Tinnitus.

PubMed

Bae, Y J; Jeon, Y J; Choi, B S; Koo, J-W; Song, J-J

2017-06-01

Typewriter tinnitus, a symptom characterized by paroxysmal attacks of staccato sounds, has been thought to be caused by neurovascular compression of the cochlear nerve, but the correlation between radiologic evidence of neurovascular compression of the cochlear nerve and symptom presentation has not been thoroughly investigated. The purpose of this study was to examine whether radiologic evidence of neurovascular compression of the cochlear nerve is pathognomonic in typewriter tinnitus. Fifteen carbamazepine-responding patients with typewriter tinnitus and 8 control subjects were evaluated with a 3D T2-weighted volume isotropic turbo spin-echo acquisition sequence. Groups 1 (16 symptomatic sides), 2 (14 asymptomatic sides), and 3 (16 control sides) were compared with regard to the anatomic relation between the vascular loop and the internal auditory canal and the presence of neurovascular compression of the cochlear nerve with/without angulation/indentation. The anatomic location of the vascular loop was not significantly different among the 3 groups (all, P > .05). Meanwhile, neurovascular compression of the cochlear nerve on MR imaging was significantly higher in group 1 than in group 3 ( P = .032). However, considerable false-positive (no symptoms with neurovascular compression of the cochlear nerve on MR imaging) and false-negative (typewriter tinnitus without demonstrable neurovascular compression of the cochlear nerve) findings were also observed. Neurovascular compression of the cochlear nerve was more frequently detected on the symptomatic side of patients with typewriter tinnitus compared with the asymptomatic side of these patients or on both sides of control subjects on MR imaging. However, considering false-positive and false-negative findings, meticulous history-taking and the response to the initial carbamazepine trial should be regarded as more reliable diagnostic clues than radiologic evidence of neurovascular compression of the cochlear nerve. © 2017 by American Journal of Neuroradiology.

Cochlear implantation in patient with Dandy-walker syndrome.

PubMed

de Oliveira, Adriana Kosma Pires; Hamerschmidt, Rogerio; Mocelin, Marcos; Rezende, Rodrigo K

2012-07-01

 Dandy Walker Syndrome is a congenital abnormality in the central nervous system, characterized by a deficiency in the development of middle cerebelar structures, cystic dilatation of the posterior pit communicating with the fourth ventricle and upward shift of the transverse sinuses, tentorium and dyes. Among the clinical signs are occipital protuberances, a progressive increase of the skull, bowing before the fontanels, papilledema, ataxia, gait disturbances, nystagmus, and intellectual impairment.  To describe a case of female patient, 13 years old with a diagnosis of this syndrome and bilateral hearing loss underwent cochlear implant surgery under local anesthesia and sedation.  CGS, 13 years old female was referred to the Otolaryngological Department of Otolaryngology Institute of Parana with a diagnosis of "Dandy-Walker syndrome" for Otolaryngological evaluation for bilateral hearing loss with no response to the use of hearing aids. Final Comments: The field of cochlear implants is growing rapidly. We believe that the presence of Dandy-Walker syndrome cannot be considered a contraindication to the performance of cochlear implant surgery, and there were no surgical complications due to neurological disorders with very favorable results for the patient who exhibits excellent discrimination. It has less need for lip reading with improvement in speech quality.

Divergence of fine and gross motor skills in prelingually deaf children: implications for cochlear implantation.

PubMed

Horn, David L; Pisoni, David B; Miyamoto, Richard T

2006-08-01

The objective of this study was to assess relations between fine and gross motor development and spoken language processing skills in pediatric cochlear implant users. The authors conducted a retrospective analysis of longitudinal data. Prelingually deaf children who received a cochlear implant before age 5 and had no known developmental delay or cognitive impairment were included in the study. Fine and gross motor development were assessed before implantation using the Vineland Adaptive Behavioral Scales, a standardized parental report of adaptive behavior. Fine and gross motor scores reflected a given child's motor functioning with respect to a normative sample of typically developing, normal-hearing children. Relations between these preimplant scores and postimplant spoken language outcomes were assessed. In general, gross motor scores were found to be positively related to chronologic age, whereas the opposite trend was observed for fine motor scores. Fine motor scores were more strongly correlated with postimplant expressive and receptive language scores than gross motor scores. Our findings suggest a disassociation between fine and gross motor development in prelingually deaf children: fine motor skills, in contrast to gross motor skills, tend to be delayed as the prelingually deaf children get older. These findings provide new knowledge about the links between motor and spoken language development and suggest that auditory deprivation may lead to atypical development of certain motor and language skills that share common cortical processing resources.

Active Control of Fan Noise: Feasibility Study. Volume 6; Theoretical Analysis for Coupling of Active Noise Control Actuator Ring Sources to an Annular Duct with Flow

NASA Technical Reports Server (NTRS)

Kraft, R. E.

1996-01-01

The objective of this effort is to develop an analytical model for the coupling of active noise control (ANC) piston-type actuators that are mounted flush to the inner and outer walls of an annular duct to the modes in the duct generated by the actuator motion. The analysis will be used to couple the ANC actuators to the modal analysis propagation computer program for the annular duct, to predict the effects of active suppression of fan-generated engine noise sources. This combined program will then be available to assist in the design or evaluation of ANC systems in fan engine annular exhaust ducts. An analysis has been developed to predict the modes generated in an annular duct due to the coupling of flush-mounted ring actuators on the inner and outer walls of the duct. The analysis has been combined with a previous analysis for the coupling of modes to a cylindrical duct in a FORTRAN computer program to perform the computations. The method includes the effects of uniform mean flow in the duct. The program can be used for design or evaluation purposes for active noise control hardware for turbofan engines. Predictions for some sample cases modeled after the geometry of the NASA Lewis ANC Fan indicate very efficient coupling in both the inlet and exhaust ducts for the m = 6 spinning mode at frequencies where only a single radial mode is cut-on. Radial mode content in higher order cut-off modes at the source plane and the required actuator displacement amplitude to achieve 110 dB SPL levels in the desired mode were predicted. Equivalent cases with and without flow were examined for the cylindrical and annular geometry, and little difference was found for a duct flow Mach number of 0.1. The actuator ring coupling program will be adapted as a subroutine to the cylindrical duct modal analysis and the exhaust duct modal analysis. This will allow the fan source to be defined in terms of characteristic modes at the fan source plane and predict the propagation to the arbitrarily-located ANC source plane. The actuator velocities can then be determined to generate the anti-phase mode. The resulting combined fan source/ANC pressure can then be calculated at any desired wall sensor position. The actuator velocities can be determined manually or using a simulation of a control system feedback loop. This will provide a very useful ANC system design and evaluation tool.

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.

Response Properties of Cochlear Nucleus Neurons in Monkeys

PubMed Central

Roth, G. Linn; Recio, A.

2009-01-01

Much of what is known about how the cochlear nuclei participate in mammalian hearing comes from studies of non-primate mammalian species. To determine to what extent the cochlear nuclei of primates resemble those of other mammalian orders, we have recorded responses to sound in three primate species: marmosets, Cynomolgus macaques, and squirrel monkeys. These recordings show that the same types of temporal firing patterns are found in primates that have been described in other mammals. Responses to tones of neurons in the ventral cochlear nucleus have similar tuning, latencies, post-stimulus time and interspike interval histograms as those recorded in non-primate cochlear nucleus neurons. In the dorsal cochlear nucleus, too, responses were similar. From these results it is evident that insights gained from non-primate studies can be applied to the peripheral auditory system of primates. PMID:19531377

Effects of residual hearing on cochlear implant outcomes in children: A systematic-review.

PubMed

Chiossi, Julia Santos Costa; Hyppolito, Miguel Angelo

2017-09-01

to investigate if preoperative residual hearing in prelingually deafened children can interfere on cochlear implant indication and outcomes. a systematic-review was conducted in five international databases up to November-2016, to locate articles that evaluated cochlear implantation in children with some degree of preoperative residual hearing. Outcomes were auditory, language and cognition performances after cochlear implant. The quality of the studies was assessed and classified according to the Oxford Levels of Evidence table - 2011. Risk of biases were also described. From the 30 articles reviewed, two types of questions were identified: (a) what are the benefits of cochlear implantation in children with residual hearing? (b) is the preoperative residual hearing a predictor of cochlear implant outcome? Studies ranged from 04 to 188 subjects, evaluating populations between 1.8 and 10.3 years old. The definition of residual hearing varied between studies. The majority of articles (n = 22) evaluated speech perception as the outcome and 14 also assessed language and speech production. There is evidence that cochlear implant is beneficial to children with residual hearing. Preoperative residual hearing seems to be valuable to predict speech perception outcomes after cochlear implantation, even though the mechanism of how it happens is not clear. More extensive researches must be conducted in order to make recommendations and to set prognosis for cochlear implants based on children preoperative residual hearing. Copyright © 2017 Elsevier B.V. All rights reserved.

Comprehensive analysis of cochlear implant failure: usefulness of clinical symptom-based algorithm combined with in situ integrity testing.

PubMed

Yamazaki, Hiroshi; O'Leary, Stephen; Moran, Michelle; Briggs, Robert

2014-04-01

Accurate diagnosis of cochlear implant failures is important for management; however, appropriate strategies to assess possible device failures are not always clear. The purpose of this study is to understand correlation between causes of device failure and the presenting clinical symptoms as well as results of in situ integrity testing and to propose effective strategies for diagnosis of device failure. Retrospective case review. Cochlear implant center at a tertiary referral hospital. Twenty-seven cases with suspected device failure of Cochlear Nucleus systems (excluding CI512 failures) on the basis of deterioration in auditory perception from January 2000 to September 2012 in the Melbourne cochlear implant clinic. Clinical presentations and types of abnormalities on in situ integrity testing were compared with modes of device failure detected by returned device analysis. Sudden deterioration in auditory perception was always observed in cases with "critical damage": either fracture of the integrated circuit or most or all of the electrode wires. Subacute or gradually progressive deterioration in auditory perception was significantly associated with a more limited number of broken electrode wires. Cochlear implant mediated auditory and nonauditory symptoms were significantly associated with an insulation problem. An algorithm based on the time course of deterioration in auditory perception and cochlear implant-mediated auditory and nonauditory symptoms was developed on the basis of these retrospective analyses, to help predict the mode of device failure. In situ integrity testing, which included close monitoring of device function in routine programming sessions as well as repeating the manufacturer's integrity test battery, was sensitive enough to detect malfunction in all suspected device failures, and each mode of device failure showed a characteristic abnormality on in situ integrity testing. Our clinical manifestation-based algorithm combined with in situ integrity testing may be useful for accurate diagnosis and appropriate management of device failure. Close monitoring of device function in routine programming sessions as well as repeating the manufacturer's integrity test battery is important if the initial in situ integrity testing is inconclusive because objective evidence of failure in the implanted device is essential to recommend explantation/reimplantation.

[Test set for the evaluation of hearing and speech development after cochlear implantation in children].

PubMed

Lamprecht-Dinnesen, A; Sick, U; Sandrieser, P; Illg, A; Lesinski-Schiedat, A; Döring, W H; Müller-Deile, J; Kiefer, J; Matthias, K; Wüst, A; Konradi, E; Riebandt, M; Matulat, P; Von Der Haar-Heise, S; Swart, J; Elixmann, K; Neumann, K; Hildmann, A; Coninx, F; Meyer, V; Gross, M; Kruse, E; Lenarz, T

2002-10-01

Since autumn 1998 the multicenter interdisciplinary study group "Test Materials for CI Children" has been compiling a uniform examination tool for evaluation of speech and hearing development after cochlear implantation in childhood. After studying the relevant literature, suitable materials were checked for practical applicability, modified and provided with criteria for execution and break-off. For data acquisition, observation forms for preparation of a PC-version were developed. The evaluation set contains forms for master data with supplements relating to postoperative processes. The hearing tests check supra-threshold hearing with loudness scaling for children, speech comprehension in silence (Mainz and Göttingen Test for Speech Comprehension in Childhood) and phonemic differentiation (Oldenburg Rhyme Test for Children), the central auditory processes of detection, discrimination, identification and recognition (modification of the "Frankfurt Functional Hearing Test for Children") and audiovisual speech perception (Open Paragraph Tracking, Kiel Speech Track Program). The materials for speech and language development comprise phonetics-phonology, lexicon and semantics (LOGO Pronunciation Test), syntax and morphology (analysis of spontaneous speech), language comprehension (Reynell Scales), communication and pragmatics (observation forms). The MAIS and MUSS modified questionnaires are integrated. The evaluation set serves quality assurance and permits factor analysis as well as controls for regularity through the multicenter comparison of long-term developmental trends after cochlear implantation.

The Coxsackievirus and Adenovirus Receptor: a new adhesion protein in cochlear development.

PubMed

Excoffon, Katherine J D A; Avenarius, Matthew R; Hansen, Marlan R; Kimberling, William J; Najmabadi, Hossein; Smith, Richard J H; Zabner, Joseph

2006-05-01

The Coxsackievirus and Adenovirus Receptor (CAR) is an essential regulator of cell growth and adhesion during development. The gene for CAR, CXADR, is located within the genomic locus for Usher syndrome type 1E (USH1E). Based on this and a physical interaction with harmonin, the protein responsible for USH1C, we hypothesized that CAR may be involved in cochlear development and that mutations in CXADR may be responsible for USH1E. The expression of CAR in the cochlea was determined by PCR and immunofluorescence microscopy. We found that CAR expression is highly regulated during development. In neonatal mice, CAR is localized to the junctions of most cochlear cell types but is restricted to the supporting and strial cells in adult cochlea. A screen of two populations consisting of non-syndromic deaf and Usher 1 patients for mutations in CXADR revealed one haploid mutation (P356S). Cell surface expression, viral receptor activity, and localization of the mutant form of CAR were indistinguishable from wild-type CAR. Although we were unable to confirm a role for CAR in autosomal recessive, non-syndromic deafness, or Usher syndrome type 1, based on its regulation, localization, and molecular interactions, CAR remains an attractive candidate for genetic deafness.

New experimental method to study acid/base transporters and their regulation in lacrimal gland ductal epithelia.

PubMed

Tóth-Molnár, Edit; Venglovecz, Viktória; Ozsvári, Béla; Rakonczay, Zoltán; Varró, András; Papp, Julius G; Tóth, András; Lonovics, János; Takács, Tamás; Ignáth, Imre; Iványi, Béla; Hegyi, Péter

2007-08-01

The main function of the lacrimal gland is to produce the most aqueous component of the tear film covering the surfaces of the cornea and the conjunctiva. Studies have been conducted that characterize the mixed fluid and protein secretion of isolated acini, but no methods have been developed to characterize lacrimal gland ductal cell (LGDC) secretion. Secretory mechanisms of ductal epithelia may play physiological roles in the maintenance of the standard environments for the cornea and the conjunctiva. In this study, the authors developed a rapid method to isolate large quantities of intact lacrimal ducts. The preparation of isolated intact lacrimal gland ducts for the first time enabled the performance of real-time functional experiments on cleaned ducts. Electron microscopy and fluorescence measurements were used to evaluate the viability of lacrimal ducts. Fluorescence measurements showed that LGDCs express functionally active Na(+)/H(+) exchanger (NHE) and Cl(-)/HCO(3)(-) exchanger (AE). Parasympathomimetic stimulation by carbachol stimulated NHE and AE through the elevation of intracellular calcium concentration. This mechanism can play a role in the regulation of ion and water secretion by LGDCs. The authors have described a lacrimal gland duct isolation technique in which the intact ducts remain viable and the role of duct cells in tear film secretion can be characterized. These data combined with the novel isolation facilitated understanding of the regulation mechanisms of ductal cell secretion at cellular and molecular levels under normal and pathologic conditions.

[From Langenbuch to Strasberg: the spectrum of bile duct injuries].

PubMed

Mercado, Miguel Angel

2004-01-01

Bile duct injuries are the main serious complication of laparoscopy cholecystectomy. The frequency of this type of injuries rangers, between 1 to 3 in 1,000 cases and although this rate remains stables, their frequency has increased because of the increasing expansion of the indication of cholecystectomy. Each lesion is the individual in it's features as well as the scenario in which the surgeon faces it. Several classifications have been developed, but that developed by Strasberg most used nowadays. Intraoperative cholangiography has shown evidence in meta analytic studies that diminishes the frequency of lesions but does not abolish them. Conversion from laparoscope's to the open approach with ample and convincent dissection is probably the best maneuver to reduce the frequency of lesions, when any anatomical or technical doubt appears. No patient should be operated in critical condition. In this situation, biliary reconstruction has a secondary role and only drainage of the ducts (percutaneous or surgical) is indicated. Roux en Y hepatoyeyunostomy is the procedure of choice for almost all cases, leaving other types of procedures for selected cases. Transhepatic transanastomotical stents should be used according to the individual status of the patient when small, scared or inflamed ducts are found. High quality anastomosis is obtained when proper ducts are found. Sometimes high dissection of the ducts is needed in order to obtain adequate ducts. Nine of each ten cases are completely rehabilitated, obtaining a good quality of life.

Implicit sequence learning in deaf children with cochlear implants.

PubMed

Conway, Christopher M; Pisoni, David B; Anaya, Esperanza M; Karpicke, Jennifer; Henning, Shirley C

2011-01-01

Deaf children with cochlear implants (CIs) represent an intriguing opportunity to study neurocognitive plasticity and reorganization when sound is introduced following a period of auditory deprivation early in development. Although it is common to consider deafness as affecting hearing alone, it may be the case that auditory deprivation leads to more global changes in neurocognitive function. In this paper, we investigate implicit sequence learning abilities in deaf children with CIs using a novel task that measured learning through improvement to immediate serial recall for statistically consistent visual sequences. The results demonstrated two key findings. First, the deaf children with CIs showed disturbances in their visual sequence learning abilities relative to the typically developing normal-hearing children. Second, sequence learning was significantly correlated with a standardized measure of language outcome in the CI children. These findings suggest that a period of auditory deprivation has secondary effects related to general sequencing deficits, and that disturbances in sequence learning may at least partially explain why some deaf children still struggle with language following cochlear implantation. © 2010 Blackwell Publishing Ltd.

The effects of familiarity and complexity on appraisal of complex songs by cochlear implant recipients and normal hearing adults.

PubMed

Gfeller, Kate; Christ, Aaron; Knutson, John; Witt, Shelley; Mehr, Maureen

2003-01-01

The purposes of this study were (a) to develop a test of complex song appraisal that would be suitable for use with adults who use a cochlear implant (assistive hearing device) and (b) to compare the appraisal ratings (liking) of complex songs by adults who use cochlear implants (n = 66) with a comparison group of adults with normal hearing (n = 36). The article describes the development of a computerized test for appraisal, with emphasis on its theoretical basis and the process for item selection of naturalistic stimuli. The appraisal test was administered to the 2 groups to determine the effects of prior song familiarity and subjective complexity on complex song appraisal. Comparison of the 2 groups indicates that the implant users rate 2 of 3 musical genres (country western, pop) as significantly more complex than do normal hearing adults, and give significantly less positive ratings to classical music than do normal hearing adults. Appraisal responses of implant recipients were examined in relation to hearing history, age, performance on speech perception and cognitive tests, and musical background.

Towards a consensus on a hearing preservation classification system.

PubMed

Skarzynski, Henryk; van de Heyning, P; Agrawal, S; Arauz, S L; Atlas, M; Baumgartner, W; Caversaccio, M; de Bodt, M; Gavilan, J; Godey, B; Green, K; Gstoettner, W; Hagen, R; Han, D M; Kameswaran, M; Karltorp, E; Kompis, M; Kuzovkov, V; Lassaletta, L; Levevre, F; Li, Y; Manikoth, M; Martin, J; Mlynski, R; Mueller, J; O'Driscoll, M; Parnes, L; Prentiss, S; Pulibalathingal, S; Raine, C H; Rajan, G; Rajeswaran, R; Rivas, J A; Rivas, A; Skarzynski, P H; Sprinzl, G; Staecker, H; Stephan, K; Usami, S; Yanov, Y; Zernotti, M E; Zimmermann, K; Lorens, A; Mertens, G

2013-01-01

The comprehensive Hearing Preservation classification system presented in this paper is suitable for use for all cochlear implant users with measurable pre-operative residual hearing. If adopted as a universal reporting standard, as it was designed to be, it should prove highly beneficial by enabling future studies to quickly and easily compare the results of previous studies and meta-analyze their data. To develop a comprehensive Hearing Preservation classification system suitable for use for all cochlear implant users with measurable pre-operative residual hearing. The HEARRING group discussed and reviewed a number of different propositions of a HP classification systems and reviewed critical appraisals to develop a qualitative system in accordance with the prerequisites. The Hearing Preservation Classification System proposed herein fulfills the following necessary criteria: 1) classification is independent from users' initial hearing, 2) it is appropriate for all cochlear implant users with measurable pre-operative residual hearing, 3) it covers the whole range of pure tone average from 0 to 120 dB; 4) it is easy to use and easy to understand.

Speech perception of young children using nucleus 22-channel or CLARION cochlear implants.

PubMed

Young, N M; Grohne, K M; Carrasco, V N; Brown, C

1999-04-01

This study compares the auditory perceptual skill development of 23 congenitally deaf children who received the Nucleus 22-channel cochlear implant with the SPEAK speech coding strategy, and 20 children who received the CLARION Multi-Strategy Cochlear Implant with the Continuous Interleaved Sampler (CIS) speech coding strategy. All were under 5 years old at implantation. Preimplantation, there were no significant differences between the groups in age, length of hearing aid use, or communication mode. Auditory skills were assessed at 6 months and 12 months after implantation. Postimplantation, the mean scores on all speech perception tests were higher for the Clarion group. These differences were statistically significant for the pattern perception and monosyllable subtests of the Early Speech Perception battery at 6 months, and for the Glendonald Auditory Screening Procedure at 12 months. Multiple regression analysis revealed that device type accounted for the greatest variance in performance after 12 months of implant use. We conclude that children using the CIS strategy implemented in the Clarion implant may develop better auditory perceptual skills during the first year postimplantation than children using the SPEAK strategy with the Nucleus device.

Locating and Quantifying Broadband Fan Sources Using In-Duct Microphones

NASA Technical Reports Server (NTRS)

Dougherty, Robert P.; Walker, Bruce E.; Sutliff, Daniel L.

2010-01-01

In-duct beamforming techniques have been developed for locating broadband noise sources on a low-speed fan and quantifying the acoustic power in the inlet and aft fan ducts. The NASA Glenn Research Center's Advanced Noise Control Fan was used as a test bed. Several of the blades were modified to provide a broadband source to evaluate the efficacy of the in-duct beamforming technique. Phased arrays consisting of rings and line arrays of microphones were employed. For the imaging, the data were mathematically resampled in the frame of reference of the rotating fan. For both the imaging and power measurement steps, array steering vectors were computed using annular duct modal expansions, selected subsets of the cross spectral matrix elements were used, and the DAMAS and CLEAN-SC deconvolution algorithms were applied.

A novel speech-processing strategy incorporating tonal information for cochlear implants.

PubMed

Lan, N; Nie, K B; Gao, S K; Zeng, F G

2004-05-01

Good performance in cochlear implant users depends in large part on the ability of a speech processor to effectively decompose speech signals into multiple channels of narrow-band electrical pulses for stimulation of the auditory nerve. Speech processors that extract only envelopes of the narrow-band signals (e.g., the continuous interleaved sampling (CIS) processor) may not provide sufficient information to encode the tonal cues in languages such as Chinese. To improve the performance in cochlear implant users who speak tonal language, we proposed and developed a novel speech-processing strategy, which extracted both the envelopes of the narrow-band signals and the fundamental frequency (F0) of the speech signal, and used them to modulate both the amplitude and the frequency of the electrical pulses delivered to stimulation electrodes. We developed an algorithm to extract the fundatmental frequency and identified the general patterns of pitch variations of four typical tones in Chinese speech. The effectiveness of the extraction algorithm was verified with an artificial neural network that recognized the tonal patterns from the extracted F0 information. We then compared the novel strategy with the envelope-extraction CIS strategy in human subjects with normal hearing. The novel strategy produced significant improvement in perception of Chinese tones, phrases, and sentences. This novel processor with dynamic modulation of both frequency and amplitude is encouraging for the design of a cochlear implant device for sensorineurally deaf patients who speak tonal languages.

Management of late biliary complications in patients with gallbladder stones in situ after endoscopic papillary balloon dilation.

PubMed

Tsujino, Takeshi; Kawabe, Takao; Isayama, Hiroyuki; Yashima, Yoko; Yagioka, Hiroshi; Kogure, Hirofumi; Sasaki, Takashi; Arizumi, Toshihiko; Togawa, Osamu; Ito, Yukiko; Matsubara, Saburo; Nakai, Yousuke; Sasashira, Naoki; Hirano, Kenji; Tada, Minoru; Omata, Masao

2009-04-01

Patients with untreated gallbladder stones in situ are at high risk for late biliary complications after endoscopic papillary balloon dilation (EPBD) and bile duct stone extraction. Few data exist on the short-term and long-term results in these patients after the recurrence of bile duct stones and acute cholecystitis. The aim of this study was to evaluate the outcome of late biliary complications in patients with gallbladder stones in situ after EPBD. Fifty-six patients who developed late biliary complications, including bile duct stone recurrence (n=43) and acute cholecystitis (n=13), were managed at our institutions. We investigated the short-term and long-term outcomes after the management of late biliary complications. Complete removal of recurrent bile duct stones was achieved in 38 of 43 patients (88%) by repeated EPBD alone. Pancreatitis after repeated EPBD occurred in two patients (5%). After successful bile duct stone extraction by EPBD, none of the 16 patients who underwent cholecystectomy developed late biliary complications (mean follow-up period of 5.2 years), wheras re-recurrent bile duct stones occurred in three of the 21 patients (14%) with gallbladder stones left in situ (mean follow-up period of 4.4 years)(P=0.1148). Re-recurrent bile duct stones were successfully treated endoscopically. One of the eight patients who did not undergo cholecystectomy for acute cholecystitis had a recurrence of cholecystitis, which was managed conservatively. The long-term outcomes of late biliary complications are favorable when patients with concomitant gallbladder stones undergo cholecystectomy. Re-recurrent bile duct stones are considerable when gallbladder stones are left in situ, but should be treated endoscopically.

Management of late biliary complications in patients with gallbladder stones in situ after endoscopic papillary balloon dilation.

PubMed

Tsujino, Takeshi; Kawabe, Takao; Isayama, Hiroyuki; Yashima, Yoko; Yagioka, Hiroshi; Kogure, Hirofumi; Sasaki, Takashi; Arizumi, Toshihiko; Togawa, Osamu; Ito, Yukiko; Matsubara, Saburo; Nakai, Yousuke; Sasashira, Naoki; Hirano, Kenji; Tada, Minoru; Omata, Masao

2009-04-01

Patients with untreated gallbladder stones in situ are at high risk for late biliary complications after endoscopic papillary balloon dilation (EPBD) and bile duct stone extraction. Few data exist on the short-term and long-term results in these patients after the recurrence of bile duct stones and acute cholecystitis. The aim of this study was to evaluate the outcome of late biliary complications in patients with gallbladder stones in situ after EPBD. Fifty-six patients who developed late biliary complications, including bile duct stone recurrence (n=43) and acute cholecystitis (n=13), were managed at our institutions. We investigated the short-term and long-term outcomes after the management of late biliary complications. Complete removal of recurrent bile duct stones was achieved in 38 of 43 patients (88%) by repeated EPBD alone. Pancreatitis after repeated EPBD occurred in two patients (5%). After successful bile duct stone extraction by EPBD, none of the 16 patients who underwent cholecystectomy developed late biliary complications (mean follow-up period of 5.2 years), whereas re-recurrent bile duct stones occurred in three of the 21 patients (14%) with gallbladder stones left in situ (mean follow-up period of 4.4 years)(P=0.1148). Re-recurrent bile duct stones were successfully treated endoscopically. One of the eight patients who did not undergo cholecystectomy for acute cholecystitis had a recurrence of cholecystitis, which was managed conservatively. The long-term outcomes of late biliary complications are favorable when patients with concomitant gallbladder stones undergo cholecystectomy. Re-recurrent bile duct stones are considerable when gallbladder stones are left in situ, but should be treated endoscopically.

Round-window delivery of neurotrophin 3 regenerates cochlear synapses after acoustic overexposure.

PubMed

Suzuki, Jun; Corfas, Gabriel; Liberman, M Charles

2016-04-25

In acquired sensorineural hearing loss, such as that produced by noise or aging, there can be massive loss of the synaptic connections between cochlear sensory cells and primary sensory neurons, without loss of the sensory cells themselves. Because the cell bodies and central projections of these cochlear neurons survive for months to years, there is a long therapeutic window in which to re-establish functional connections and improve hearing ability. Here we show in noise-exposed mice that local delivery of neurotrophin-3 (NT-3) to the round window niche, 24 hours after an exposure that causes an immediate loss of up to 50% loss of synapses in the cochlear basal region, can regenerate pre- and post-synaptic elements at the hair cell / cochlear nerve interface. This synaptic regeneration, as documented by confocal microscopy of immunostained cochlear sensory epithelia, was coupled with a corresponding functional recovery, as seen in the suprathreshold amplitude of auditory brainstem response Wave 1. Cochlear delivery of neurotrophins in humans is likely achievable as an office procedure via transtympanic injection, making our results highly significant in a translational context.

Cochlear implant – state of the art

PubMed Central

Lenarz, Thomas

2018-01-01

Cochlear implants are the treatment of choice for auditory rehabilitation of patients with sensory deafness. They restore the missing function of inner hair cells by transforming the acoustic signal into electrical stimuli for activation of auditory nerve fibers. Due to the very fast technology development, cochlear implants provide open-set speech understanding in the majority of patients including the use of the telephone. Children can achieve a near to normal speech and language development provided their deafness is detected early after onset and implantation is performed quickly thereafter. The diagnostic procedure as well as the surgical technique have been standardized and can be adapted to the individual anatomical and physiological needs both in children and adults. Special cases such as cochlear obliteration might require special measures and re-implantation, which can be done in most cases in a straight forward way. Technology upgrades count for better performance. Future developments will focus on better electrode-nerve interfaces by improving electrode technology. An increased number of electrical contacts as well as the biological treatment with regeneration of the dendrites growing onto the electrode will increase the number of electrical channels. This will give room for improved speech coding strategies in order to create the bionic ear, i.e. to restore the process of natural hearing by means of technology. The robot-assisted surgery will allow for high precision surgery and reliable hearing preservation. Biological therapies will support the bionic ear. Methods are bio-hybrid electrodes, which are coded by stem cells transplanted into the inner ear to enhance auto-production of neurotrophins. Local drug delivery will focus on suppression of trauma reaction and local regeneration. Gene therapy by nanoparticles will hopefully lead to the preservation of residual hearing in patients being affected by genetic hearing loss. Overall the cochlear implant is a very powerful tool to rehabilitate patients with sensory deafness. More than 1 million of candidates in Germany today could benefit from this high technology auditory implant. Only 50,000 are implanted so far. In the future, the procedure can be done under local anesthesia, will be minimally invasive and straight forward. Hearing preservation will be routine. PMID:29503669

Comparing the effect of auditory-only and auditory-visual modes in two groups of Persian children using cochlear implants: a randomized clinical trial.

PubMed

Oryadi Zanjani, Mohammad Majid; Hasanzadeh, Saeid; Rahgozar, Mehdi; Shemshadi, Hashem; Purdy, Suzanne C; Mahmudi Bakhtiari, Behrooz; Vahab, Maryam

2013-09-01

Since the introduction of cochlear implantation, researchers have considered children's communication and educational success before and after implantation. Therefore, the present study aimed to compare auditory, speech, and language development scores following one-sided cochlear implantation between two groups of prelingual deaf children educated through either auditory-only (unisensory) or auditory-visual (bisensory) modes. A randomized controlled trial with a single-factor experimental design was used. The study was conducted in the Instruction and Rehabilitation Private Centre of Hearing Impaired Children and their Family, called Soroosh in Shiraz, Iran. We assessed 30 Persian deaf children for eligibility and 22 children qualified to enter the study. They were aged between 27 and 66 months old and had been implanted between the ages of 15 and 63 months. The sample of 22 children was randomly assigned to two groups: auditory-only mode and auditory-visual mode; 11 participants in each group were analyzed. In both groups, the development of auditory perception, receptive language, expressive language, speech, and speech intelligibility was assessed pre- and post-intervention by means of instruments which were validated and standardized in the Persian population. No significant differences were found between the two groups. The children with cochlear implants who had been instructed using either the auditory-only or auditory-visual modes acquired auditory, receptive language, expressive language, and speech skills at the same rate. Overall, spoken language significantly developed in both the unisensory group and the bisensory group. Thus, both the auditory-only mode and the auditory-visual mode were effective. Therefore, it is not essential to limit access to the visual modality and to rely solely on the auditory modality when instructing hearing, language, and speech in children with cochlear implants who are exposed to spoken language both at home and at school when communicating with their parents and educators prior to and after implantation. The trial has been registered at IRCT.ir, number IRCT201109267637N1. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Clinical Presentations and Outcomes of Bile Duct Loss caused by Drugs and Herbal and Dietary Supplements

PubMed Central

Bonkovsky, Herbert L.; Kleiner, David E.; Gu, Jiezhun; Odin, Joseph A.; Russo, Mark W.; Navarro, Victor M.; Fontana, Robert J.; Ghabril, Marwan S.; Barnhart, Huiman; Hoofnagle, Jay H.

2016-01-01

Bile duct loss during the course of drug induced liver injury is uncommon but can be an indication of vanishing bile duct syndrome. In this work we assess the frequency, causes, clinical features and outcomes of cases of drug induced liver injury with histologically proven bile duct loss. All cases of drug induced liver injury enrolled into a prospective database over a ten year period that had undergone liver biopsies (n=363) were scored for the presence of bile duct loss and assessed for clinical and laboratory features, causes and outcomes. 26 of the 363 patients (7%) with drug, herbal or dietary supplement associated liver injury had bile duct loss on liver biopsy which was moderate to severe (<50% of portal areas with bile ducts) in 14 and mild (50–75%) in 12. The presenting clinical features of the 26 cases varied, but the most common clinical pattern was a severe cholestatic hepatitis. The implicated agents included amoxicillin/clavulanate (n=3), temozolomide (n=3), various herbal products (n=3), azithromycin (n=2) and 15 other medications or dietary supplements. Compared to those without, those with bile duct loss were more likely to develop chronic liver injury (94% vs 47%), which was usually cholestatic and sometimes severe. Five patients died and two others underwent liver transplantation for progressive cholestasis despite treatment with corticosteroids and ursodiol. The most predictive factor of poor outcome was the degree of bile duct loss on liver biopsy. Conclusions Bile duct loss during acute cholestatic hepatitis is an ominous early indicator of possible vanishing bile duct syndrome, for which at present there are no known means of prevention or therapy. PMID:27981596

Partial corrosion casting to assess cochlear vasculature in mouse models of presbycusis and CMV infection.

PubMed

Carraro, Mattia; Park, Albert H; Harrison, Robert V

2016-02-01

Some forms of sensorineural hearing loss involve damage or degenerative changes to the stria vascularis and/or other vascular structures in the cochlea. In animal models, many methods for anatomical assessment of cochlear vasculature exist, each with advantages and limitations. One methodology, corrosion casting, has proved useful in some species, however in the mouse model this technique is difficult to achieve because digestion of non vascular tissue results in collapse of the delicate cast specimen. We have developed a partial corrosion cast method that allows visualization of vasculature along much of the cochlear length but maintains some structural integrity of the specimen. We provide a detailed step-by-step description of this novel technique. We give some illustrative examples of the use of the method in mouse models of presbycusis and cytomegalovirus (CMV) infection. Copyright © 2015 Elsevier B.V. All rights reserved.

Peer relationships of deaf children with cochlear implants: predictors of peer entry and peer interaction success.

PubMed

Martin, Daniela; Bat-Chava, Yael; Lalwani, Anil; Waltzman, Susan B

2011-01-01

This study investigated factors that affect the development of positive peer relationships among deaf children with cochlear implants. Ten 5- to 6-year-old deaf children with implants were observed under conditions varying peer context difficulty in a Peer Entry task. Results revealed better outcomes for deaf children interacting in one-on-one situations compared to interactions including two other hearing children and better performance among girls than boys. In addition, longer duration of implant use and higher self-esteem were associated with better performance on the Peer Task, which was in turn related to parental reports of children's social functioning outside the experimental situation. These findings contribute to the growing literature describing the benefits of cochlear implantation in the areas of communication and socialization, while pointing to interventions that may enhance deaf children's social competence.

A mathematical model of medial consonant identification by cochlear implant users.

PubMed

Svirsky, Mario A; Sagi, Elad; Meyer, Ted A; Kaiser, Adam R; Teoh, Su Wooi

2011-04-01

The multidimensional phoneme identification model is applied to consonant confusion matrices obtained from 28 postlingually deafened cochlear implant users. This model predicts consonant matrices based on these subjects' ability to discriminate a set of postulated spectral, temporal, and amplitude speech cues as presented to them by their device. The model produced confusion matrices that matched many aspects of individual subjects' consonant matrices, including information transfer for the voicing, manner, and place features, despite individual differences in age at implantation, implant experience, device and stimulation strategy used, as well as overall consonant identification level. The model was able to match the general pattern of errors between consonants, but not the full complexity of all consonant errors made by each individual. The present study represents an important first step in developing a model that can be used to test specific hypotheses about the mechanisms cochlear implant users employ to understand speech.

Drug discovery for hearing loss: Phenotypic screening of chemical compounds on primary cultures of the spiral ganglion.

PubMed

Whitlon, Donna S

2017-06-01

In the United States there are, at present, no drugs that are specifically FDA approved to treat hearing loss. Although several clinical trials are ongoing, including one testing D-methionine that is supported by the US Army, none of these trials directly address the effect of noise exposure on cochlear spiral ganglion neurons. We recently published the first report of a systematic chemical compound screen using primary, mammalian spiral ganglion cultures in which we were able to detect a compound and others in its class that increased neurite elongation, a critical step in restoring cochlear synapses after noise induced hearing loss. Here we discuss the issues, both pro and con, that influenced the development of our approach. These considerations may be useful for future compound screens that target the same or other attributes of cochlear spiral ganglion neurons. Copyright © 2016 Elsevier B.V. All rights reserved.

Intrinsic regenerative potential of murine cochlear supporting cells.

PubMed

Sinkkonen, Saku T; Chai, Renjie; Jan, Taha A; Hartman, Byron H; Laske, Roman D; Gahlen, Felix; Sinkkonen, Wera; Cheng, Alan G; Oshima, Kazuo; Heller, Stefan

2011-01-01

The lack of cochlear regenerative potential is the main cause for the permanence of hearing loss. Albeit quiescent in vivo, dissociated non-sensory cells from the neonatal cochlea proliferate and show ability to generate hair cell-like cells in vitro. Only a few non-sensory cell-derived colonies, however, give rise to hair cell-like cells, suggesting that sensory progenitor cells are a subpopulation of proliferating non-sensory cells. Here we purify from the neonatal mouse cochlea four different non-sensory cell populations by fluorescence-activated cell sorting (FACS). All four populations displayed proliferative potential, but only lesser epithelial ridge and supporting cells robustly gave rise to hair cell marker-positive cells. These results suggest that cochlear supporting cells and cells of the lesser epithelial ridge show robust potential to de-differentiate into prosensory cells that proliferate and undergo differentiation in similar fashion to native prosensory cells of the developing inner ear.

Automatic identification of cochlear implant electrode arrays for post-operative assessment

NASA Astrophysics Data System (ADS)

Noble, Jack H.; Schuman, Theodore A.; Wright, Charles G.; Labadie, Robert F.; Dawant, Benoit M.

2011-03-01

Cochlear implantation is a procedure performed to treat profound hearing loss. Accurately determining the postoperative position of the implant in vivo would permit studying the correlations between implant position and hearing restoration. To solve this problem, we present an approach based on parametric Gradient Vector Flow snakes to segment the electrode array in post-operative CT. By combining this with existing methods for localizing intra-cochlear anatomy, we have developed a system that permits accurate assessment of the implant position in vivo. The system is validated using a set of seven temporal bone specimens. The algorithms were run on pre- and post-operative CTs of the specimens, and the results were compared to histological images. It was found that the position of the arrays observed in the histological images is in excellent agreement with the position of their automatically generated 3D reconstructions in the CT scans.

A mathematical model of medial consonant identification by cochlear implant users

PubMed Central

Svirsky, Mario A.; Sagi, Elad; Meyer, Ted A.; Kaiser, Adam R.; Teoh, Su Wooi

2011-01-01

The multidimensional phoneme identification model is applied to consonant confusion matrices obtained from 28 postlingually deafened cochlear implant users. This model predicts consonant matrices based on these subjects’ ability to discriminate a set of postulated spectral, temporal, and amplitude speech cues as presented to them by their device. The model produced confusion matrices that matched many aspects of individual subjects’ consonant matrices, including information transfer for the voicing, manner, and place features, despite individual differences in age at implantation, implant experience, device and stimulation strategy used, as well as overall consonant identification level. The model was able to match the general pattern of errors between consonants, but not the full complexity of all consonant errors made by each individual. The present study represents an important first step in developing a model that can be used to test specific hypotheses about the mechanisms cochlear implant users employ to understand speech. PMID:21476674

Prevention of Noise Damage to Cochlear Synapses

DTIC Science & Technology

2015-10-01

AWARD NUMBER: W81XWH-14-1-0494 TITLE: Prevention of Noise Damage to Cochlear Synapses PRINCIPAL INVESTIGATOR: Steven Green CONTRACTING...to Cochlear Synapses 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-14-1-0494 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Steven Green 5d. PROJECT...ABSTRACT Noise-induced synaptopathy is the result of excitotoxic trauma to cochlear synapses due to glutamate released from the hair cells. Excitotoxic

Preventing Ototoxic Synergy of Prior Noise Trauma During Aminoglycoside Therapy

DTIC Science & Technology

2015-12-01

cochlear blood flow . Hearing Research 313, 38-46 (2014). 12. Koo, J.-W. et al. Endotoxemia-mediated inflammation potentiates cochlear uptake of...event in response to a need for higher cochlear blood flow . A 3.7% dilation was adequate for a 20% increase of blood flow 10. On the contrary...summation of the two insults. We have found that prior sound exposure enhances cochlear uptake of aminoglycosides, providing a mechanistic basis for the

Scala vestibuli cochlear implantation in patients with partially ossified cochleas.

PubMed

Berrettini, Stefano; Forli, Francesca; Neri, Emanuele; Segnini, Giovanni; Franceschini, Stefano Sellari

2002-11-01

Partial cochlear obstruction is a relatively common finding in candidates for cochlear implants and frequently involves the inferior segment of the scala tympani in the basal turn of the cochlea. In such patients, the scala vestibuli is often patent and offers an alternative site for implantation. The current report describes two patients with such partial obstruction of the inferior segment of the basal cochlear turn, caused in one case by systemic vasculitis (Takayasu's disease) and in the other by obliterative otosclerosis. A scala vestibuli implantation allowed for complete insertion of the electrode array. No problems were encountered during the surgical procedures and the good post-operative hearing and communicative outcomes achieved were similar to those reported in patients without cochlear ossification. The importance of accurate pre-operative radiological study of the inner ear is underscored, to disclose the presence and define the features of the cochlear ossification and ultimately to properly plan the surgical approach.

Hearing rehabilitation with a binaural cochlear implant in a patient with Erdheim-Chester disease.

PubMed

Querat, Charlotte; Thai-Van, Hung; Durand, Denis Vital; Cotton, François; Gallego, Stéphane; Truy, Eric

2015-09-01

Erdheim-Chester disease (ECD) is a rare non-Langerhans form of histiocytosis. This paper reports an exceptional case of bilateral neural involvement, responsible for profound hearing loss. Bilateral cochlear implantation was performed. We present a 57-year-old man affected by ECD with profound bilateral hearing loss. The patient underwent cochlear implantation with a binaural Digisonic(®) cochlear implant, 7 years after the initial diagnosis. Speech intelligibility rose to a plateau after about 6 months of cochlear implant use. The average outcome of speech intelligibility over time was 55% for dissyllabic words without lip reading, and 70% for sentences. Perception score decreased before the patient died from ECD. A description of the ECD and its otological manifestations is presented. This paper reports the effective hearing rehabilitation of profound bilateral hearing loss by the means of a binaural Digisonic(®) cochlear implant.

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

Ion flow in cochlear hair cells and the regulation of hearing sensitivity.

PubMed

Patuzzi, Robert

2011-10-01

This paper discusses how ion transport proteins in the hair cells of the mammalian cochlea work to produce a sensitive but stable hearing organ. The transport proteins in the inner and outer hair cells are summarized (including their current voltage characteristics), and the roles of these proteins in determining intracellular Ca(2+), membrane potential, and ultimately cochlear sensitivity are discussed. The paper also discusses the role of the Ca(2+) sequestration sacs in outer hair cells in the autoregulation of hair cell membrane potential and cochlear gain, and how the underdamped control of Ca(2+) within these sacs may produce the observed slow oscillations in cochlear sensitivity and otoacoustic emissions after cochlear perturbations, including perilymphatic perfusions and prolonged low-frequency tones. The relative insensitivity of cochlear gain to short-term changes in the endocochlear potential is also discussed. Copyright © 2011 Elsevier B.V. All rights reserved.

The Hearing Outcomes of Cochlear Implantation in Waardenburg Syndrome.

PubMed

Koyama, Hajime; Kashio, Akinori; Sakata, Aki; Tsutsumiuchi, Katsuhiro; Matsumoto, Yu; Karino, Shotaro; Kakigi, Akinobu; Iwasaki, Shinichi; Yamasoba, Tatsuya

2016-01-01

Objectives. This study aimed to determine the feasibility of cochlear implantation for sensorineural hearing loss in patients with Waardenburg syndrome. Method. A retrospective chart review was performed on patients who underwent cochlear implantation at the University of Tokyo Hospital. Clinical classification, genetic mutation, clinical course, preoperative hearing threshold, high-resolution computed tomography of the temporal bone, and postoperative hearing outcome were assessed. Result. Five children with Waardenburg syndrome underwent cochlear implantation. The average age at implantation was 2 years 11 months (ranging from 1 year 9 months to 6 years 3 months). Four patients had congenital profound hearing loss and one patient had progressive hearing loss. Two patients had an inner ear malformation of cochlear incomplete partition type 2. No surgical complication or difficulty was seen in any patient. All patients showed good hearing outcome postoperatively. Conclusion. Cochlear implantation could be a good treatment option for Waardenburg syndrome.

The Hearing Outcomes of Cochlear Implantation in Waardenburg Syndrome

PubMed Central

Koyama, Hajime; Kashio, Akinori; Sakata, Aki; Tsutsumiuchi, Katsuhiro; Matsumoto, Yu; Karino, Shotaro; Kakigi, Akinobu; Iwasaki, Shinichi; Yamasoba, Tatsuya

2016-01-01

Objectives. This study aimed to determine the feasibility of cochlear implantation for sensorineural hearing loss in patients with Waardenburg syndrome. Method. A retrospective chart review was performed on patients who underwent cochlear implantation at the University of Tokyo Hospital. Clinical classification, genetic mutation, clinical course, preoperative hearing threshold, high-resolution computed tomography of the temporal bone, and postoperative hearing outcome were assessed. Result. Five children with Waardenburg syndrome underwent cochlear implantation. The average age at implantation was 2 years 11 months (ranging from 1 year 9 months to 6 years 3 months). Four patients had congenital profound hearing loss and one patient had progressive hearing loss. Two patients had an inner ear malformation of cochlear incomplete partition type 2. No surgical complication or difficulty was seen in any patient. All patients showed good hearing outcome postoperatively. Conclusion. Cochlear implantation could be a good treatment option for Waardenburg syndrome. PMID:27376080

Should children who use cochlear implants wear hearing aids in the opposite ear?

PubMed

Ching, T Y; Psarros, C; Hill, M; Dillon, H; Incerti, P

2001-10-01

The aim of this study was to investigate 1) whether a hearing aid needs to be adjusted differently depending on whether a child wears a cochlear implant or another hearing aid in the contralateral ear; 2) whether the use of a hearing aid and a cochlear implant in opposite ears leads to binaural interference; and 3) whether the use of a hearing aid and a cochlear implant in opposite ears leads to binaural benefits in speech perception, localization, and communicative functioning in real life. Sixteen children participated in this study. All children used a Nucleus 22 or Nucleus 24 cochlear implant system programmed with the SPEAK strategy in one ear. The hearing aid amplification requirements in the nonimplanted ear of these children were determined using two procedures. A paired comparison technique was used to identify the frequency response that was best for speech intelligibility in quiet, and a loudness balancing technique was used to match the loudness of speech in the ear with a hearing aid to that with a cochlear implant. Eleven of the 16 children participated in the investigation of binaural effects. Performance in speech perception, localization, and communicative functioning was assessed under four aided conditions: cochlear implant with hearing aid as worn, cochlear implant alone, hearing aid alone, and cochlear implant with hearing aid adjusted according to individual requirements. Fifteen of the 16 children whose amplification requirements were determined preferred a hearing aid frequency response that was within +/-6 dB/octave of the NAL-RP prescription. On average, the children required 6 dB more gain than prescribed to balance the loudness of the implanted ear for a speech signal presented at 65 dB SPL. For all 11 children whose performance was evaluated for investigating binaural effects, there was no indication of significantly poorer performance under bilaterally aided conditions compared with unilaterally aided conditions. On average, there were significant benefits in speech perception, localization, and aural/oral function when the children used cochlear implants with adjusted hearing aids than when they used cochlear implants alone. All individuals showed benefits in at least one of the measures. Hearing aids for children who also use cochlear implants can be selected using the NAL-RP prescription. Adjustment of hearing aid gain to match loudness in the implanted ear can facilitate integration of signals from both ears, leading to better speech perception. Given that there are binaural advantages from using cochlear implants with hearing aids in opposite ears, clinicians should advise parents and other professionals about these potential advantages, and facilitate bilateral amplification by adjusting hearing aids after stable cochlear implant MAPs are established.

Development and testing of thermal energy storage modules for use in active solar heating and cooling systems

NASA Technical Reports Server (NTRS)

Parker, J. C.

1981-01-01

The project development requirements and criteria are presented along with technical data for the modules. Performance tests included: ducting, temperature, pressure and air flow measurements, dry and wet bulb temperature; duct pressure measurements; and air conditioning apparatus checks; installation, operation, and maintenance instructions are included.

Generation of Higher Order Modes in a Rectangular Duct

NASA Technical Reports Server (NTRS)

Gerhold, Carl H.; Cabell, Randolph H.; Brown, Donald E.

2004-01-01

Advanced noise control methodologies to reduce sound emission from aircraft engines take advantage of the modal structure of the noise in the duct. This noise is caused by the interaction of rotor wakes with downstream obstructions such as exit guide vanes. Mode synthesis has been accomplished in circular ducts and current active noise control work has made use of this capability to cancel fan noise. The goal of the current effort is to examine the fundamental process of higher order mode propagation through an acoustically treated, curved duct. The duct cross-section is rectangular to permit greater flexibility in representation of a range of duct curvatures. The work presented is the development of a feedforward control system to generate a user-specified modal pattern in the duct. The multiple-error, filtered-x LMS algorithm is used to determine the magnitude and phase of signal input to the loudspeakers to produce a desired modal pattern at a set of error microphones. Implementation issues, including loudspeaker placement and error microphone placement, are discussed. Preliminary results from a 9-3/8 inch by 21 inch duct, using 12 loudspeakers and 24 microphones, are presented. These results demonstrate the ability of the control system to generate a user-specified mode while suppressing undesired modes.

Hearing-in-Noise Benefits After Bilateral Simultaneous Cochlear Implantation Continue to Improve 4 Years After Implantation

PubMed Central

Eapen, Rose J.; Buss, Emily; Adunka, Marcia Clark; Pillsbury, Harold C.; Buchman, Craig A.

2012-01-01

Objective The purpose of this 4-year longitudinal study was to assess the stability of the binaural benefits of head shadow, summation, and squelch for bilateral cochlear implant recipients and to quantify these benefits for the understanding of speech in noise. Design This is a prospective study of 9 patients who received simultaneous bilateral insertion of MED-EL COMBI +40 cochlear implants in a single-stage operation at the University of North Carolina, Chapel Hill, NC. Each patient had postlingual deafness of short duration before insertion of the device. Each year, the patients were tested for word recognition using consonant-nucleus-consonant words in quiet and speech perception in noise using City University of New York sentences. These tests were administered using direct audio input to the implants. Head-related transfer functions were used to simulate speech in noise testing in a spatial environment. Speech was always presented at midline (0), and the noise masker was presented at either side or midline (−90, 0, +90 degrees). Results The binaural benefits of head shadow and summation effects developed early in the postoperative period and remained stable throughout the follow-up period. Squelch developed more slowly and was first demonstrated at 12 months after implantation but continued to increase beyond the first year of follow-up. Conclusion Benefits of head shadow and summation emerge early and remain stable. However, squelch has the most protracted period of development, with increasing benefit after a year or more of implant experience. These data support the idea that binaural integration continues several years after insertion of bilateral cochlear implant devices. PMID:19180675

Deafness in the developing world: the place of cochlear implantation.

PubMed

Tarabichi, M B; Todd, C; Khan, Z; Yang, X; Shehzad, B; Tarabichi, M M

2008-09-01

This paper attempts to review changes in the lives of hearing-impaired patients within the developing world, brought about by globalisation and development. The paper also explores limitations to improved care and addresses the collective moral responsibility of developed nations. Analysis of literature. Within developing nations, large populations have emerged with a similar pattern of problems, access to information and aspirations as those living in developed nations. However, marked differences in income have persisted. These trends have resulted in a relative increase in the proportion of the hearing-impaired population in need of cochlear implantation, while at the same time restricting their access to such treatment. The emergence of global markets and media and a shared sense of destiny amongst the people of this planet should translate into a concerted, worldwide effort to assist the deaf in developing countries. Much more can be done within existing resources and frameworks to improve the quality of these peoples' lives.

Modal propagation angles in a cylindrical duct with flow and their relation to sound radiation

NASA Technical Reports Server (NTRS)

Rice, E. J.; Heidmann, M. F.; Sofrin, T. G.

1979-01-01

The main emphasis is upon the propagation angle with respect to the duct axis and its relation to the far-field acoustic radiation pattern. When the steady flow Mach number is accounted for in the duct, the propagation angle in the duct is shown to be coincident with the angle of the principal lobe of far-field radiation obtained using the Wiener-Hopf technique. Different Mach numbers are allowed within the duct and in the external field. For static tests with a steady flow in an inlet but with no external Mach number the far-field radiation pattern is shifted considerably toward the inlet axis when compared to zero Mach number radiation theory. As the external Mach number is increased the noise radiation pattern is shifted away from the inlet axis. The theory is developed using approximations for sound propagation in circular ducts. An exact analysis using Hankel function solutions for the zero Mach number case is given to provide a check of the simpler approximate theory.

Conceptual design study of advanced acoustic-composite nacelles

NASA Technical Reports Server (NTRS)

Nordstrom, K. E.; Marsh, A. H.; Sargisson, D. F.

1975-01-01

Conceptual studies were conducted to assess the impact of incorporating advanced technologies in the nacelles of a current wide-bodied transport and an advanced technology transport. The improvement possible in the areas of fuel consumption, flyover noise levels, airplane weight, manufacturing costs, and airplane operating cost were evaluated for short and long-duct nacelles. Use of composite structures for acoustic duct linings in the fan inlet and exhaust ducts was considered as well as for other nacelle components. For the wide-bodied transport, the use of a long-duct nacelle with an internal mixer nozzle in the primary exhaust showed significant improvement in installed specific fuel consumption and airplane direct operating costs compared to the current short-duct nacelle. The long-duct mixed-flow nacelle is expected to achieve significant reductions in jet noise during takeoff and in turbo-machinery noise during landing approach. Recommendations were made of the technology development needed to achieve the potential fuel conservation and noise reduction benefits.

Effects of central nervous system residua on cochlear implant results in children deafened by meningitis.

PubMed

Francis, Howard W; Pulsifer, Margaret B; Chinnici, Jill; Nutt, Robert; Venick, Holly S; Yeagle, Jennifer D; Niparko, John K

2004-05-01

This study explored factors associated with speech recognition outcomes in postmeningitic deafness (PMD). The results of cochlear implantation may vary in children with PMD because of sequelae that extend beyond the auditory periphery. To determine which factors might be most determinative of outcome of cochlear implantation in children with PMD. Retrospective chart review. A referral center for pediatric cochlear implantation and rehabilitation. Thirty children with cochlear implants who were deafened by meningitis were matched with subjects who were deafened by other causes based on the age at diagnosis, age at cochlear implantation, age at which hearing aids were first used, and method of communication used at home or in the classroom. Speech perception performance within the first 2 years after cochlear implantation and its relationship with presurgical cognitive measures and medical history. There was no difference in the overall cognitive or postoperative speech perception performance between the children with PMD and those deafened by other causes. The presence of postmeningitic hydrocephalus, however, posed greater challenges to the rehabilitation process, as indicated by significantly smaller gains in speech perception and a predilection for behavioral problems. By comparison, cochlear scarring and incomplete electrode insertion had no impact on speech perception results. Although the results demonstrated no significant delay in cognitive or speech perception performance in the PMD group, central nervous system residua, when present, can impede the acquisition of speech perception with a cochlear implant. Central effects associated with PMD may thus impact language learning potential; cognitive and behavioral therapy should be considered in rehabilitative planning and in establishing expectations of outcome.

A Preliminary Investigation of the Air-Bone Gap: Changes in Intracochlear Sound Pressure With Air- and Bone-conducted Stimuli After Cochlear Implantation.

PubMed

Banakis Hartl, Renee M; Mattingly, Jameson K; Greene, Nathaniel T; Jenkins, Herman A; Cass, Stephen P; Tollin, Daniel J

2016-10-01

A cochlear implant electrode within the cochlea contributes to the air-bone gap (ABG) component of postoperative changes in residual hearing after electrode insertion. Preservation of residual hearing after cochlear implantation has gained importance as simultaneous electric-acoustic stimulation allows for improved speech outcomes. Postoperative loss of residual hearing has previously been attributed to sensorineural changes; however, presence of increased postoperative ABG remains unexplained and could result in part from altered cochlear mechanics. Here, we sought to investigate changes to these mechanics via intracochlear pressure measurements before and after electrode implantation to quantify the contribution to postoperative ABG. Human cadaveric heads were implanted with titanium fixtures for bone conduction transducers. Velocities of stapes capitulum and cochlear promontory between the two windows were measured using single-axis laser Doppler vibrometry and fiber-optic sensors measured intracochlear pressures in scala vestibuli and tympani for air- and bone-conducted stimuli before and after cochlear implant electrode insertion through the round window. Intracochlear pressures revealed only slightly reduced responses to air-conducted stimuli consistent with previous literature. No significant changes were noted to bone-conducted stimuli after implantation. Velocities of the stapes capitulum and the cochlear promontory to both stimuli were stable after electrode placement. Presence of a cochlear implant electrode causes alterations in intracochlear sound pressure levels to air, but not bone, conducted stimuli and helps to explain changes in residual hearing noted clinically. These results suggest the possibility of a cochlear conductive component to postoperative changes in hearing sensitivity.

Cochlear-Meningitis Vaccination

MedlinePlus

... Programs Professional Development Home AcademyU Home Study Course Maintenance of Certification Conferences & Events Practice Management Home Resources Quality Clinical Data Registry Research Reimbursement ...

Propagation of high amplitude higher order sounds in slightly soft rectangular ducts, carrying mean flow

NASA Technical Reports Server (NTRS)

Wang, K. S.; Vaidya, P. G.

1975-01-01

The resonance expansion method, developed to study the propagation of sound in rigid rectangular ducts is applied to the case of slightly soft ducts. Expressions for the generation and decay of various harmonics are obtained. The effect of wall admittance is seen through a dissipation function in the system of nonlinear differential equations, governing the generation of harmonics. As the wall admittance increases, the resonance is reduced. For a given wall admittance this phenomenon is stronger at higher input intensities. Both the first and second order solutions are obtained and the results are extended to the case of ducts having mean flow.

Embolization for Thoracic Duct Collateral Leakage in High-Output Chylothorax After Thoracic Surgery

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

Kariya, Shuji, E-mail: kariyas@hirakata.kmu.ac.jp; Nakatani, Miyuki, E-mail: nakatanm@hirakata.kmu.ac.jp; Yoshida, Rie, E-mail: yagir@hirakata.kmu.ac.jp

PurposeThis study was designed to investigate thoracic duct collateral leakage and the supply route of lymphatic fluid by lymphangiography and transcatheter thoracic ductography and to evaluate the results of embolization for thoracic duct collateral leakage performed to cut off this supply route.MethodsData were retrospectively collected from five patients who underwent embolization for thoracic duct collateral leakage in persistent high-output chylothorax after thoracic surgery. Extravasation of lipiodol at the ruptured thoracic duct collaterals was confirmed in all patients on lymphangiography. Transcatheter thoracic ductography was used to identify extravasation of iodinated contrast agent and to identify communication between the thoracic duct andmore » leakage site. Thoracic duct embolization (TDE) was performed using the percutaneous transabdominal approach to cut off the supply route using N-butyl cyanoacrylate (NBCA) mixed with lipiodol (1:5–1:20).ResultsClinical success (drainage volume ≤10 mL/kg/day within 7 days after TDE) was achieved in all patients. The collateral routes developed as consequence of surgical thoracic duct ligation. In three patients, NBCA-Lipiodol reached the leakage site through direct communication between the thoracic duct and the ruptured lymphatic duct. In the other two patients, direct communication and extravasation was not detected on thoracic ductography, and NBCA-Lipiodol did not reach the leakage site. However, NBCA-Lipiodol did reach the cisterna chyli, lumbar trunks, and some collateral routes via the cisterna chyli or lumbar lymphatics. As a result, leakage was stopped.ConclusionsTDE was effective for the management of leakage of the collaterals in high-output chylothorax after thoracic surgery.« less

Lesions of the segmental and lobar hepatic ducts.

PubMed Central

Longmire, W P; Tompkins, R K

1975-01-01

Despite reports to the contrary, unobstructed drainage of 50% of an otherwise normal liver through either the right or left uninfected hepatic duct is adequate to restore normal liver function, even if the obstructed lobe remains in place. An undrained liver lobe, if present, may require no further treatment. As long as it is completely obstructed and uninfected, it will undergo a progressive asymptomatic atrophy. Cholangitis invariably develops behind a partial lobar ductal obstruction, producing jaundice, pruritis, and fever. Unless unobstructed, uninfected biliary flow can be achieved through a segmental or lobar duct, it is better that the duct be completely obstructed and the affected liver parenchyma allowed to atrophy, provided there is normal biliary flow from the residual 50% of liver. This concept is important in the management of injured anomalous segmental or lobar hepatic duct and in the palliative treatment of bile duct carcinoma. Localized intrahepatic infections communicating with abnormal biliary ducts will require hepatic resection of the infected parenchyma and ducts for cure. The abnormality may be saccular dilatation of the intrahepatic ductal system with abscess formation or intrahepatic abscess associated with stenosis of the ductal system from trauma to the duct, to the duct and liver, or to retained intrahepatic stones. Diffusely situated intrahepatic abscesses secondary to ductal abnormalities can be treated with systemic antibiotics, local drainage of a dmoninant abscess, and efforts to improve biliary drainage. Images Fig. 4. Fig. 5. Fig. 6. Fig. 8. Fig. 9. Fig. 10. Figs. 11A and B Figs. 12A and B. Fig. 13. Fig. 14. Fig. 15. Fig. 16. Fig. 17. PMID:1180585

A Pilot Study of Common Bile Duct Reconstruction with CorMatrix Extracellular Matrix in Swine (Sus scrofa)

DTIC Science & Technology

2015-02-06

additional pages if necessary.) PROTOCOL#: FDG20140008A DATE: 6 February 2015 PROTOCOL TITLE: A Pilot Study of Common Bile Duct Reconstruction with...obstruction or bile peritonitis. This was reported to the IACUC chair. 9. REDUCTION, REFINEMENT, OR REPLACEMENT OF ANIMAL USE; REPLACEMENT...benefit the DoD/USAF? We developed a porcine model of common bile duct injury and interposition grafting, gained experience managing these patients

Biliary Stenosis and Gastric Outlet Obstruction: Late Complications After Acute Pancreatitis With Pancreatic Duct Disruption.

PubMed

Sugimoto, Motokazu; Sonntag, David P; Flint, Greggory S; Boyce, Cody J; Kirkham, John C; Harris, Tyler J; Carr, Sean M; Nelson, Brent D; Bell, Don A; Barton, Joshua G; Traverso, L William

2018-07-01

Pancreatic duct disruption (PDD) after acute pancreatitis can cause pancreatic collections in the early phase and biliary stenosis (BS) or gastric outlet obstruction (GOO) in the late phase. We aimed to document those late complications after moderate or severe acute pancreatitis. Between September 2010 and August 2014, 141 patients showed pancreatic collections on computed tomography. Percutaneous drainage was primarily performed for patients with signs or symptoms of uncontrolled pancreatic juice leakage. Pancreatic duct disruption was defined as persistent amylase-rich drain fluid or a pancreatic duct cut-off on imaging. Clinical course of the patients who developed BS or GOO was investigated. Among the 141 patients with collections, 33 patients showed PDD in the pancreatic head/neck area. Among them, 9 patients (27%) developed BS 65 days after onset and required stenting for 150 days, and 5 patients (15%) developed GOO 92 days after onset and required gastric decompression and jejunal tube feeding for 147 days (days shown in median). All 33 patients recovered successfully without requiring surgical intervention. Anatomic proximity of the bile duct or duodenum to the site of PDD and severe inflammation seemed to contribute to the late onset of BS or GOO. Conservative management successfully reversed these complications.

A Case Study Assessing the Auditory and Speech Development of Four Children Implanted with Cochlear Implants by the Chronological Age of 12 Months

PubMed Central

2013-01-01

Children with severe hearing loss most likely receive the greatest benefit from a cochlear implant (CI) when implanted at less than 2 years of age. Children with a hearing loss may also benefit greater from binaural sensory stimulation. Four children who received their first CI under 12 months of age were included in this study. Effects on auditory development were determined using the German LittlEARS Auditory Questionnaire, closed- and open-set monosyllabic word tests, aided free-field, the Mainzer and Göttinger speech discrimination tests, Monosyllabic-Trochee-Polysyllabic (MTP), and Listening Progress Profile (LiP). Speech production and grammar development were evaluated using a German language speech development test (SETK), reception of grammar test (TROG-D) and active vocabulary test (AWST-R). The data showed that children implanted under 12 months of age reached open-set monosyllabic word discrimination at an age of 24 months. LiP results improved over time, and children recognized 100% of words in the MTP test after 12 months. All children performed as well as or better than their hearing peers in speech production and grammar development. SETK showed that the speech development of these children was in general age appropriate. The data suggests that early hearing loss intervention benefits speech and language development and supports the trend towards early cochlear implantation. Furthermore, the data emphasizes the potential benefits associated with bilateral implantation. PMID:23509653

A case study assessing the auditory and speech development of four children implanted with cochlear implants by the chronological age of 12 months.

PubMed

May-Mederake, Birgit; Shehata-Dieler, Wafaa

2013-01-01

Children with severe hearing loss most likely receive the greatest benefit from a cochlear implant (CI) when implanted at less than 2 years of age. Children with a hearing loss may also benefit greater from binaural sensory stimulation. Four children who received their first CI under 12 months of age were included in this study. Effects on auditory development were determined using the German LittlEARS Auditory Questionnaire, closed- and open-set monosyllabic word tests, aided free-field, the Mainzer and Göttinger speech discrimination tests, Monosyllabic-Trochee-Polysyllabic (MTP), and Listening Progress Profile (LiP). Speech production and grammar development were evaluated using a German language speech development test (SETK), reception of grammar test (TROG-D) and active vocabulary test (AWST-R). The data showed that children implanted under 12 months of age reached open-set monosyllabic word discrimination at an age of 24 months. LiP results improved over time, and children recognized 100% of words in the MTP test after 12 months. All children performed as well as or better than their hearing peers in speech production and grammar development. SETK showed that the speech development of these children was in general age appropriate. The data suggests that early hearing loss intervention benefits speech and language development and supports the trend towards early cochlear implantation. Furthermore, the data emphasizes the potential benefits associated with bilateral implantation.

Cochlear implants in Waardenburg syndrome.

PubMed

Cullen, Robert D; Zdanski, Carlton; Roush, Patricia; Brown, Carolyn; Teagle, Holly; Pillsbury, Harold C; Buchman, Craig

2006-07-01

Waardenburg syndrome is an autosomal-dominant syndrome characterized by dystopia canthorum, hyperplasia of the eyebrows, heterochromia irides, a white forelock, and sensorineural hearing loss in 20% to 55% of patients. This patient population accounts for approximately 2% of congenitally deaf children. The purpose of this retrospective case review was to describe the outcomes for those children with Waardenburg syndrome who have undergone cochlear implantation. Pediatric cochlear implant recipients with documented evidence of Waardenburg syndrome underwent retrospective case review. All patients received their cochlear implants at the study institution followed by outpatient auditory habilitation. Charts were reviewed for etiology and duration of deafness, age at time of cochlear implantation, perioperative complications, duration of use, and performance outcomes. Results of standard tests batteries for speech perception and production administered as a part of the patients' auditory habilitation were reviewed. Seven patients with Waardenburg syndrome and cochlear implants were identified. The average age at implantation was 37 months (range, 18-64 months) and the average duration of use was 69 months (range, 12-143 months). All of these patients are active users of their devices and perform very well after implantation. There were no major complications in this small group of patients. Children with congenital sensorineural hearing loss without other comorbidities (e.g., developmental delay, inner ear malformations) perform well when they receive cochlear implantation and auditory habilitation. Patients with Waardenburg syndrome can be expected to have above-average performance after cochlear implantation.

Transmission of wave energy in curved ducts

NASA Technical Reports Server (NTRS)

Rostafinski, W.

1973-01-01

A formation of wave energy flow was developed for motion in curved ducts. A parametric study over a range of frequencies determined the ability of circular bends to transmit energy for the case of perfectly rigid walls.

A tool for hearing aid and cochlear implant users to judge the usability of cellular telephones in field conditions

NASA Astrophysics Data System (ADS)

Deer, Maria Soledad

The auditory experience of using a hearing aid or a cochlear implant simultaneously with a cell phone is driven by a number of factors. These factors are: radiofrequency and baseband interference, speech intelligibility, sound quality, handset design, volume control and signal strength. The purpose of this study was to develop a tool to be used by hearing aid and cochlear implant users in retail stores as they try cell phones before buying them. This tool is meant to be an efficient, practical and systematic consumer selection tool that will capture and document information on all the domains that play a role in the auditory experience of using a cell phone with a hearing aid or cochlear implant. The development of this consumer tool involved three steps as follows: preparation, verification and measurement of success according to a predefined criterion. First, the consumer tool, consisting of a comparison chart and speech material, was prepared. Second, the consumer tool was evaluated by groups of subjects in a two-step verification process. Phase I was conducted in a controlled setting and it was followed by Phase II which took place in real world (field) conditions. In order to perform a systematic evaluation of the consumer tool two questionnaires were developed: one questionnaire for each phase. Both questionnaires involved five quantitative variables scored with the use of ratings scales. These ratings were averaged yielding an Overall Consumer Performance Score. A qualitative performance category corresponding to the Mean Opinion Score (MOS) was allocated to each final score within a scale ranging from 1 to 5 (where 5 = excellent and 1 = bad). Finally, the consumer tool development was determined to be successful if at least 80% of the participants in verification Phase II rated the comparison chart as excellent or good according to the qualitative MOS score. The results for verification Phase II (field conditions) indicated that the Overall Consumer Performance score for 92% of the subjects (11/12) was 3.7 and above corresponding to Good and Excellent MOS qualitative categories. It was concluded that this is a practical and efficient tool for hearing aid/cochlear implant users as they approach a cell phone selection process.

Selected winglet and mixed flow long duct nacelle development for DC-10 derivative aircraft

NASA Technical Reports Server (NTRS)

Taylor, A. B.

1980-01-01

The high speed cruise drag effects of the installation of winglets and a wing tip extension and a mixed flow long duct nacelle are investigated. The winglet program utilized a 4.7 percent semispan model in an eight foot transonic wind tunnel. Winglets provided approximately twice the cruise drag reduction of wing tip extensions for about the same increase in bending moment at the wing-fuselage juncture. The long duct nacelle interference drag program utilized the same model, without the winglets, in the 11 foot transonic wind tunnel. The long duct nacelle, installed in the same position as the current short duct nacelle and with the current production symmetric pylon, was a relatively low risk installation. A pylon with an addition small rearward fairing was also tested and showed some drag reduction potential over the current pylon.

Performance prediction of a ducted rocket combustor

NASA Astrophysics Data System (ADS)

Stowe, Robert

2001-07-01

The ducted rocket is a supersonic flight propulsion system that takes the exhaust from a solid fuel gas generator, mixes it with air, and burns it to produce thrust. To develop such systems, the use of numerical models based on Computational Fluid Dynamics (CFD) is increasingly popular, but their application to reacting flow requires specific attention and validation. Through a careful examination of the governing equations and experimental measurements, a CFD-based method was developed to predict the performance of a ducted rocket combustor. It uses an equilibrium-chemistry Probability Density Function (PDF) combustion model, with a gaseous and a separate stream of 75 nm diameter carbon spheres to represent the fuel. After extensive validation with water tunnel and direct-connect combustion experiments over a wide range of geometries and test conditions, this CFD-based method was able to predict, within a good degree of accuracy, the combustion efficiency of a ducted rocket combustor.

Surgical Management of the Pediatric Cochlear Implant Patient.

ERIC Educational Resources Information Center

Cohen, Seth M.; Haynes, David S.

2003-01-01

This article discusses the surgical management of children receiving cochlear implants. It identifies preoperative considerations to select patients likely to benefit, contraindications, some new surgical techniques, complications, special considerations (otitis media, meningitis, head growth, inner ear malformations, and cochlear obstruction).…

Periods of sensitivity to thyroid hormone during the development of the organ of Corti.

PubMed

Uziel, A

1986-01-01

Cochlear structures are sensitive to the morphogenetic effect of thyroid hormone during the whole duration of maturation. For each structure, there exists a period of maximal sensitivity to thyroid hormone which corresponds to the period of development during which the structure of interest undergoes its main morphological changes (6 to 13 days for the inner sulcus epithelium, 6 to 10 days for the pillars, the 2nd and a part of the 3rd postnatal week for OHCs and their efferent innervation in rats). These periods of sensitivity can be considered as critical periods because cochlear structures are maximally vulnerable to thyroid deficiency during these periods.

Cochlear potential difference between endolymph fluid and the hair cell's interior: a retold interpretation based on the Goldman equation.

PubMed

Kurbel, Sven; Borzan, Vladimir; Golem, Hilda; Dinjar, Kristijan

2017-02-01

Reported cochlear potential values of near 150 mV are often attributed to endolymph itself, although membrane potentials result from ion fluxes across the adjacent semipermeable membranes due to concentration gradients. Since any two fluids separated by a semipermeable membrane develop potential due to differences in solute concentrations, a proposed interpretation here is that positive potential emanates from the Reissner membrane due to small influx of sodium from perilymph to endolymph. Basolateral hair cell membranes leak potassium into the interstitial fluid and this negative potential inside hair cells further augments the electric gradient of cochlear potential. Taken together as a sum, these two potentials are near the reported values of cochlear potential. This is based on reported data for cochlear fluids used for the calculation of Nernst and Goldman potentials. The reported positive potential of Reissner membrane can be explained almost entirely by the traffic of Na+ that enters endolymph through this membrane. At the apical membrane of hair cells, acoustic stimulation modulates stereocillia permeability to potassium. Potassium concentration gradients on the apical membrane are low (the calculated Nernst value is <+3 mV), suggesting that the potassium current is not caused by the local potassium concentration gradient, but an electric field between the positive sodium generated potential on the Reissner membrane and negative inside hair cells. Potassium is forced by this overall electric field to enter hair cells when stereocilia are permeable due to mechanical bending. Copyright© by the Medical Assotiation of Zenica-Doboj Canton.

Development of the mouse cochlea database (MCD).

PubMed

Santi, Peter A; Rapson, Ian; Voie, Arne

2008-09-01

The mouse cochlea database (MCD) provides an interactive, image database of the mouse cochlea for learning its anatomy and data mining of its resources. The MCD website is hosted on a centrally maintained, high-speed server at the following URL: (http://mousecochlea.umn.edu). The MCD contains two types of image resources, serial 2D image stacks and 3D reconstructions of cochlear structures. Complete image stacks of the cochlea from two different mouse strains were obtained using orthogonal plane fluorescence optical microscopy (OPFOS). 2D images of the cochlea are presented on the MCD website as: viewable images within a stack, 2D atlas of the cochlea, orthogonal sections, and direct volume renderings combined with isosurface reconstructions. In order to assess cochlear structures quantitatively, "true" cross-sections of the scala media along the length of the basilar membrane were generated by virtual resectioning of a cochlea orthogonal to a cochlear structure, such as the centroid of the basilar membrane or the scala media. 3D images are presented on the MCD website as: direct volume renderings, movies, interactive QuickTime VRs, flythrough, and isosurface 3D reconstructions of different cochlear structures. 3D computer models can also be used for solid model fabrication by rapid prototyping and models from different cochleas can be combined to produce an average 3D model. The MCD is the first comprehensive image resource on the mouse cochlea and is a new paradigm for understanding the anatomy of the cochlea, and establishing morphometric parameters of cochlear structures in normal and mutant mice.

Cochlear implantation in chronic demyelinating inflammatory polyneuropathy.

PubMed

Mowry, Sarah E; King, Sarah

2017-03-01

To describe a case of chronic inflammatory demyelinating polyneuropathy (CDIP) with bilateral sudden sensorineural hearing loss who subsequently benefited from unilateral cochlear implantation. case history review and review of the literature for the terms CDIP, hearing loss, cochleovestibular dysfunction, and cochlear implantation. A 49-year-old woman presented with bilateral rapidly progressive sensorineural hearing loss (SNHL) 1 month after an upper respiratory tract infection. Hearing loss was not responsive to high-dose steroids and there were no other laboratory abnormalities or physical findings. Within 1 month, she developed ascending motor palsy, requiring long-term ventilator support. This neurologic condition was diagnosed as CDIP and she was successfully treated with plasmapheresis and intravenous immunoglobulin. Her hearing never recovered. At the time of cochlear implant, she had no response at the limits of the audiometer and obtained 0% on AzBio testing. No ABR could be recorded preoperatively. She underwent uneventful cochlear implantation with a perimodilar electrode. One year after activation, she had a PTA of 20 dB and 40% on AzBio sentence testing. Her eABR demonstrated a neuropathy pattern. Only two other cases of CDIP associated with dysfunction of the eighth nerve have been described, and neither had documented profound hearing loss. Severe SNHL associated with CDIP is rare. Although this patient has good access to sound, speech discrimination is poor at 1-year post implantation. This outcome may be due to incomplete recovery of myelination of the eighth nerve. Other possibilities include loss of peripheral nerve fibers due to the initial viral upper respiratory infection, which may lead to less neural substrate to stimulate.

Cochlear implant surgery in patients more than seventy-nine years old.

PubMed

Eshraghi, Adrien A; Rodriguez, Michael; Balkany, Thomas J; Telischi, Fred F; Angeli, Simon; Hodges, Annelle V; Adil, Eelam

2009-06-01

To evaluate the surgical complications, auditory performance, and hearing handicap following cochlear implantation in patients greater than 79 years of age. Retrospective trial, tertiary referral center. The study group was comprised of 21 patients implanted after 79 years of age from 1996 through 2006 with follow-ups past their 8th decade. Pre-op evaluation consisted of pure-tone audiometry and speech discrimination scores (Hearing in Noise Test and City University of New York sentence test). The results of these tests were compared to similar tests taken post-op. A validated hearing handicap questionnaire was used to evaluate the outcome. There were no permanent medical or surgical complications. However, two patients developed exacerbations of previous comorbid conditions (i.e., urinary retention and acute delirium). Implanted patients experienced a significant improvement in audiologic performance, post-op pure tone average, and post-op speech scores (P < .001). A majority of them were able to use the phone and reported that the cochlear implant was of great benefit to them. The post-op hearing handicap inventory for the elderly demonstrated a significant decrease of hearing handicap scores. This is the first study to focus on a patient group this advanced in age. With increasing life expectancy, we should begin to stratify risk versus benefit of cochlear implantation in this age group. Cochlear implantation improved audiologic performance and the quality of life in patients older than 79 years old. There were no permanent medical or surgical complications. Chronic pain and temporary vertigo were the most common complications reported in this elderly group. Laryngoscope, 2009.

Introducing music as a means of habilitation for children with cochlear implants.

PubMed

Abdi, S; Khalessi, M H; Khorsandi, M; Gholami, B

2001-06-07

To investigate the feasibility, methods and the primary results of utilizing music as a means of habilitation of children with cochlear implant. A habilitation program based on music training is developed. The results are presented as a case-series. Music Training Program is introduced as a new habilitation program. Methods of training (based on Orff method) and measuring the outcomes are introduced in this paper. Effects of this program on other habilitation programs and overall hearing related skills of children were also investigated by open questioning of the parents and the habilitation staff. Twenty-three children, (age: 2.5-12.5 years) were selected. All children showed appreciable progress in playing a musical instrument. The effects on other habilitation processes were significant and all parents expressed their satisfaction with the program, as they perceived its benefits. The necessity of adding Music Training Program to the routine habilitation may be summarized as follows: Music is a feature of sound, which should be mastered. The psychological effects of being able to accomplish a hearing-related task can add to the self-esteem of children and help prevent and reduce anxiety. Music is a habilitation method: Introducing new concepts of sound, like temporal and frequency-related characteristics, is a crucial part of the habilitation of a child with cochlear implant. Practising new concepts needs motivation, too. We emphasize on using all means of rehabilitation and encourage teaching music to cochlear implant children between 4 and 5 years of age having approximately 4 months of experience with cochlear implant.

Ventilation duct with concurrent acoustic feed-forward and decentralised structural feedback active control

NASA Astrophysics Data System (ADS)

Rohlfing, J.; Gardonio, P.

2014-02-01

This paper presents theoretical and experimental work on concurrent active noise and vibration control for a ventilation duct. The active noise control system is used to reduce the air-borne noise radiated via the duct outlet whereas the active vibration control system is used to both reduce the structure-borne noise radiated by the duct wall and to minimise the structural feed-through effect that reduces the effectiveness of the active noise control system. An elemental model based on structural mobility functions and acoustic impedance functions has been developed to investigate the principal effects and limitations of feed-forward active noise control and decentralised velocity feedback vibration control. The principal simulation results have been contrasted and validated with measurements taken on a laboratory duct set-up, equipped with an active noise control system and a decentralised vibration control system. Both simulations and experimental results show that the air-borne noise radiated from the duct outlet can be significantly attenuated using the feed-forward active noise control. In the presence of structure-borne noise the performance of the active noise control system is impaired by a structure-borne feed-through effect. Also the sound radiation from the duct wall is increased. In this case, if the active noise control is combined with a concurrent active vibration control system, the sound radiation by the duct outlet is further reduced and the sound radiation from the duct wall at low frequencies reduces noticeably.

Benefits of Localization and Speech Perception with Multiple Noise Sources in Listeners with a Short-electrode Cochlear Implant

PubMed Central

Dunn, Camille C.; Perreau, Ann; Gantz, Bruce; Tyler, Richard

2009-01-01

Background Research suggests that for individuals with significant low-frequency hearing, implantation of a short-electrode cochlear implant may provide benefits of improved speech perception abilities. Because this strategy combines acoustic and electrical hearing within the same ear while at the same time preserving low-frequency residual acoustic hearing in both ears, localization abilities may also be improved. However, very little research has focused on the localization and spatial hearing abilities of users with a short-electrode cochlear implant. Purpose The purpose of this study was to evaluate localization abilities for listeners with a short-electrode cochlear implant who continue to wear hearing aids in both ears. A secondary purpose was to document speech perception abilities using a speech in noise test with spatially-separate noise sources. Research Design Eleven subjects that utilized a short-electrode cochlear implant and bilateral hearing aids were tested on localization and speech perception with multiple noise locations using an eight-loudspeaker array. Performance was assessed across four listening conditions using various combinations of cochlear implant and/or hearing aid use. Results Results for localization showed no significant difference between using bilateral hearing aids and bilateral hearing aids plus the cochlear implant. However, there was a significant difference between the bilateral hearing aid condition and the implant plus use of a contralateral hearing aid for all eleven subjects. Results for speech perception showed a significant benefit when using bilateral hearing aids plus the cochlear implant over use of the implant plus only one hearing aid. Conclusion Combined use of both hearing aids and the cochlear implant show significant benefits for both localization and speech perception in noise for users with a short-electrode cochlear implant. These results emphasize the importance of low-frequency information in two ears for the purpose of localization and speech perception in noise. PMID:20085199

Benefits of localization and speech perception with multiple noise sources in listeners with a short-electrode cochlear implant.

PubMed

Dunn, Camille C; Perreau, Ann; Gantz, Bruce; Tyler, Richard S

2010-01-01

Research suggests that for individuals with significant low-frequency hearing, implantation of a short-electrode cochlear implant may provide benefits of improved speech perception abilities. Because this strategy combines acoustic and electrical hearing within the same ear while at the same time preserving low-frequency residual acoustic hearing in both ears, localization abilities may also be improved. However, very little research has focused on the localization and spatial hearing abilities of users with a short-electrode cochlear implant. The purpose of this study was to evaluate localization abilities for listeners with a short-electrode cochlear implant who continue to wear hearing aids in both ears. A secondary purpose was to document speech perception abilities using a speech-in-noise test with spatially separate noise sources. Eleven subjects that utilized a short-electrode cochlear implant and bilateral hearing aids were tested on localization and speech perception with multiple noise locations using an eight-loudspeaker array. Performance was assessed across four listening conditions using various combinations of cochlear implant and/or hearing aid use. Results for localization showed no significant difference between using bilateral hearing aids and bilateral hearing aids plus the cochlear implant. However, there was a significant difference between the bilateral hearing aid condition and the implant plus use of a contralateral hearing aid for all 11 subjects. Results for speech perception showed a significant benefit when using bilateral hearing aids plus the cochlear implant over use of the implant plus only one hearing aid. Combined use of both hearing aids and the cochlear implant show significant benefits for both localization and speech perception in noise for users with a short-electrode cochlear implant. These results emphasize the importance of low-frequency information in two ears for the purpose of localization and speech perception in noise.

Quantitative polarized light microscopy of unstained mammalian cochlear sections

NASA Astrophysics Data System (ADS)

Kalwani, Neil M.; Ong, Cheng Ai; Lysaght, Andrew C.; Haward, Simon J.; McKinley, Gareth H.; Stankovic, Konstantina M.

2013-02-01

Hearing loss is the most common sensory deficit in the world, and most frequently it originates in the inner ear. Yet, the inner ear has been difficult to access for diagnosis because of its small size, delicate nature, complex three-dimensional anatomy, and encasement in the densest bone in the body. Evolving optical methods are promising to afford cellular diagnosis of pathologic changes in the inner ear. To appropriately interpret results from these emerging technologies, it is important to characterize optical properties of cochlear tissues. Here, we focus on that characterization using quantitative polarized light microscopy (qPLM) applied to unstained cochlear sections of the mouse, a common animal model of human hearing loss. We find that the most birefringent cochlear materials are collagen fibrils and myelin. Retardance of the otic capsule, the spiral ligament, and the basilar membrane are substantially higher than that of other cochlear structures. Retardance of the spiral ligament and the basilar membrane decrease from the cochlear base to the apex, compared with the more uniform retardance of other structures. The intricate structural details revealed by qPLM of unstained cochlear sections ex vivo strongly motivate future application of polarization-sensitive optical coherence tomography to human cochlea in vivo.

Quantitative polarized light microscopy of unstained mammalian cochlear sections

PubMed Central

Kalwani, Neil M.; Ong, Cheng Ai; Lysaght, Andrew C.; Haward, Simon J.; McKinley, Gareth H.

2013-01-01

Abstract. Hearing loss is the most common sensory deficit in the world, and most frequently it originates in the inner ear. Yet, the inner ear has been difficult to access for diagnosis because of its small size, delicate nature, complex three-dimensional anatomy, and encasement in the densest bone in the body. Evolving optical methods are promising to afford cellular diagnosis of pathologic changes in the inner ear. To appropriately interpret results from these emerging technologies, it is important to characterize optical properties of cochlear tissues. Here, we focus on that characterization using quantitative polarized light microscopy (qPLM) applied to unstained cochlear sections of the mouse, a common animal model of human hearing loss. We find that the most birefringent cochlear materials are collagen fibrils and myelin. Retardance of the otic capsule, the spiral ligament, and the basilar membrane are substantially higher than that of other cochlear structures. Retardance of the spiral ligament and the basilar membrane decrease from the cochlear base to the apex, compared with the more uniform retardance of other structures. The intricate structural details revealed by qPLM of unstained cochlear sections ex vivo strongly motivate future application of polarization-sensitive optical coherence tomography to human cochlea in vivo. PMID:23407909

Acute hyperfibrinogenemia impairs cochlear blood flow and hearing function in guinea pigs in vivo.

PubMed

Ihler, Fritz; Strieth, Sebastian; Pieri, Nicos; Göhring, Peter; Canis, Martin

2012-03-01

Impairment of microcirculation is a possible cause of sudden sensorineural hearing loss (SSNHL). Fibrinogen is known as a risk factor for both microvascular dysfunction and SSNHL. Therefore, the aim of this study was to investigate the effect of elevated serum levels of fibrinogen on cochlear blood flow and hearing function in vivo. One group of guinea pigs received two consecutive injections of 100 mg fibrinogen while a control group received equimolar doses of albumin. Measurements of cochlear microcirculation by intravital microscopy and of hearing thresholds by auditory brainstem response (ABR) recordings were carried out before, after first and after second injection. Ten healthy guinea pigs were randomly assigned to a treatment group or a control group of five animals each. Serum fibrinogen levels were elevated after the first and second injections of fibrinogen compared to basal values and control group respectively. Increasing levels of fibrinogen were paralleled by decreasing cochlear blood flow as well as increasing hearing thresholds. Hearing threshold correlated negatively with cochlear blood flow. The effect of microcirculatory impairment on hearing function could be explained by a malfunction of the cochlear amplifier. Further investigation is needed to quantify cochlear potentials under elevated serum fibrinogen levels.

Use of a gentamicin-impregnated collagen sheet (Collatamp(®)) in the management of major soft tissue complications in pediatric cochlear implants.

PubMed

Benito-González, Fernando; Benito, Jose; Sánchez, Luis Alberto Guardado; Estevez Alonso, Santiago; Muñoz Herrera, Angel; Batuecas-Caletrio, Angel

2014-09-01

The objective was to report the effectiveness of salvage treatment in soft tissue infection around cochlear implants with an absorbable gentamicin collagen sheet and a periosteum and skin rotation flaps. Three patients with cochlear implant and persistent surrounding soft tissue infection are included. All of them underwent antibiotic treatment prior to surgery without any response. In this study preoperative and postoperative audiograms were practiced. Surgical excision of infectious skin and a periosteum and skin rotation flaps were performed. The cochlear implant was refixed in the temporal bone and a gentamicin-impregnated collagen sheet was located covering the cochlear implant. headings In all patients with soft tissue infection around the cochlear implant, infection was completely resolved. It was not necessary to remove the device in any case. The use of an absorbable gentamicin-impregnated collagen sheet is not described for the management of soft tissue complications in pediatric cochlear implant patients. The local application of high concentrations of antibiotic administered by this sheet may be effective against resistant bacteria and, in conjunction with surgery, may resolve this type of complications.

Outcome of gallbladder preservation in surgical management of primary bile duct stones.

PubMed

Tian, Ming-Guo; Shi, Wei-Jin; Wen, Xin-Yuan; Yu, Hai-Wen; Huo, Jing-Shan; Zhou, Dong-Feng

2003-08-01

To evaluate the methods and outcome of gallbladder preservation in surgical treatment of primary bile duct stones. Thirty-five patients with primary bile duct stones and intact gallbladders received stone extraction by two operative approaches, 23 done through the intrahepatic duct stump (RBD-IDS, the RBD-IDS group) after partial hepatectomy and 12 through the hepatic parenchyma by retrograde puncture (RBD-RP, the RBD-RP group). The gallbladders were preserved and the common bile duct (CBD) incisions were primarily closed. The patients were examined postoperatively by direct cholangiography and followed up by ultrasonography once every six months. In the RBD-IDS group, residual bile duct stones were found in three patients, which were cleared by a combination of fibrocholedochoscopic extraction and lithotripsy through the drainage tracts. The tubes were removed on postoperative day 22 (range: 16-42 days). In the RBD-RP group, one patient developed hemobilia and was cured by conservative therapy. The tubes were removed on postoperative day 8 (range: 7-11 days). Postoperative cholangiography showed that all the gallbladders were well opacified, contractile and smooth. During 54 (range: 6-120 months) months of follow-up, six patients had mildly thickened cholecystic walls without related symptoms and further changes, two underwent laparotomies because of adhesive intestinal obstruction and gastric cancer respectively, three died of cardiopulmonary diseases. No stones were found in all the preserved gallbladders. The intact gallbladders preserved after surgical extraction of primary bile duct stones will not develop gallstones. Retrograde biliary drainage is an optimal approach for gallbladder preservation.

Investigation of Counter-Flow in a Heat Pipe-Thermoelectric Generator (HPTEG)

NASA Astrophysics Data System (ADS)

Remeli, Muhammad Fairuz; Singh, Baljit; Affandi, Nor Dalila Nor; Ding, Lai Chet; Date, Abhijit; Akbarzadeh, Aliakbar

2017-05-01

This study explores a method of generating electricity while recovering waste heat through the integration of heat pipes and thermoelectric generators (i.e. HPTEG system). The simultaneous waste heat recovery and power generation processes are achieved without the use of any moving parts. The HPTEG system consists of bismuth telluride thermoelectric generators (TEG), which are sandwiched between two finned pipes to achieve a temperature gradient across the TEG for electricity generation. A counter-flow heat exchanger was built using two separate air ducts. The air ducts were thermally coupled using the HPTEG modules. The evaporator section of the heat pipe absorbed the waste heat in a hot air duct. The heat was then transferred across the TEG surfaces. The condenser section of the HPTEG collected the excess heat from the TEG cold side before releasing it to the cold air duct. A 2-kW electrical heater was installed in the hot air duct to simulate the exhaust gas. An air blower was installed at the inlet of each duct to direct the flow of air into the ducts. A theoretical model was developed for predicting the performance of the HPTEG system using the effectiveness-number of transfer units method. The developed model was able to predict the thermal and electrical output of the HPTEG, along with the rate of heat transfer. The results showed that by increasing the cold air velocity, the effectiveness of the heat exchanger was able to be increased from approximately 52% to 58%. As a consequence of the improved heat transfer, maximum power output of 4.3 W was obtained.

Development and Demonstration of Active Noise Control Concepts

NASA Technical Reports Server (NTRS)

Kraft, R.; Hu, Z.; Sommerfeldt, S.; Walker, B.; Hersh, A.; Luo, H.; Spencer, M.; Hallman, D.; Mitchell, C.; Sutliff, D.

2000-01-01

This report details design methods for and feasibility of an Active Noise Control (ANC) system using flush-wall-mounted sensors and actuators to reduce turbofan engine rotor-stator interaction noise. ANC concepts capable of suppressing discrete-tone spinning modes containing several cut-on radial mode were identified, developed analytically, and evaluated. Separate ANC systems that suppressed at least three radial modes in a cylindrical inlet duct and three radial modes in an exhaust annulus were developed. These designs resulted in inlet duct and exhaust duct tests that were performed at NASA on the 4-ft ANC Fan in the NASA Glenn AAPL facility. Effective suppression of 2-BPF spinning mode m = 2 tone noise was achieved over a range of fan speeds 1800 to 2450 rpm, where up to 4 radials were present. In the inlet duct, up to 12 dB reduction was obtained for 3 radial modes, and up to 4 dB was obtained with 4 radial modes. In the exhaust duct, up to 15 dB PWL reduction was obtained with either two or three radial modes present. Thus, the ability to suppress multiple radial modes for tones in both the inlet and exhaust ducts has been successfully demonstrated. Implications of ANC system design requirements on installation and system integration issues for ANC systems capable of suppressing higher order radial mode content when applied to a 767 using twin CF6 engines were evaluated analytically. The analytical results indicated an ANC system must be part of an integrated design to be effective.

Cochlear Implantation after Bilateral Transverse Temporal Bone Fractures

PubMed Central

Shin, Jong-Heon; Park, SooChan; Baek, Sam-Hyun

2008-01-01

Patients deafened by a severe head injury are rarely encountered. We report a case of a 65-yr-old man with bilateral transverse temporal bone fractures due to head injury. He underwent cochlear implant and achieved a satisfactory auditory rehabilitation. Imaging studies of temporal bone before performing a cochlear implantation provide important information on a patient with bilateral temporal bone fractures. Cochlear implantations with careful planning in such a patient may be a very effective method for aural rehabilitation. PMID:19434252

[Roentgenomorphological substantiation of drainage of the thoracic duct in patients with liver cirrhosis].

PubMed

Riabukhin, I A; Nazyrov, F G; Vorozheĭkin, V M; Khamidov, P M; Kirichenko, I P

1983-04-01

On the basis of an analysis of rentgeno-morphological investigations of the thoracic lymphatic duct (TLD) in 115 patients with complications of hepatocirrhosis and 50 postmortem observations the authors make a conclusion that one of the main factors of the development of insufficiency of TLD in hepatocirrhosis is an excess of lymph resulting in congestion in the duct. It may be considered as a cause for drainage of the TLD in patients with hepatocirrhosis.

Overview of Lung Development in the Newborn Human.

PubMed

Warburton, David

2017-01-01

In human neonates rapid adaptation from an aqueous intrauterine environment to permanent air breathing is the rate-limiting step for extrauterine life, failure of which justifies the existence of neonatal intensive care units. The lung develops at about 4-6 weeks' gestation in humans as a ventral outpouching of the primitive foregut into the surrounding ventral mesenchyme, termed the laryngotracheal groove. At its posterior end lie progenitor cells that form a pair of bronchial tubes, from which arise all the distal epithelial structures of the lung. In humans, formation of the distal gas exchange surfaces begins in utero at about 20 weeks' gestation and is substantially established by term. Stereotypic branching of the proximal airway ends relatively early at 16-18 weeks at the bronchoalveolar duct junctions. Distally, about 5 finger-like alveolar ducts arise from each bronchoalveolar duct junction and ramify outwards towards the pleura. The majority of alveolar air sacs arise from the sides of the alveolar ducts and each of these alveoli can have up to 5 daughter alveoli arising from the outer surface as subsequent buds. At the end of each alveolar duct lie the mouths of 5 interconnected alveoli. Each family of alveoli arising from each bronchoalveolar duct junction has a different shape depending upon the limitations imposed by the pleural surface as well as the interstitial fascial planes. © 2017 S. Karger AG, Basel.

A preliminary investigation of the air-bone gap: Changes in intracochlear sound pressure with air- and bone-conducted stimuli after cochlear implantation

PubMed Central

Banakis Hartl, Renee M.; Mattingly, Jameson K.; Greene, Nathaniel T.; Jenkins, Herman A.; Cass, Stephen P.; Tollin, Daniel J.

2016-01-01

Hypothesis A cochlear implant electrode within the cochlea contributes to the air-bone gap (ABG) component of postoperative changes in residual hearing after electrode insertion. Background Preservation of residual hearing after cochlear implantation has gained importance as simultaneous electric-acoustic stimulation allows for improved speech outcomes. Postoperative loss of residual hearing has previously been attributed to sensorineural changes; however, presence of increased postoperative air-bone gap remains unexplained and could result in part from altered cochlear mechanics. Here, we sought to investigate changes to these mechanics via intracochlear pressure measurements before and after electrode implantation to quantify the contribution to postoperative air-bone gap. Methods Human cadaveric heads were implanted with titanium fixtures for bone conduction transducers. Velocities of stapes capitulum and cochlear promontory between the two windows were measured using single-axis laser Doppler vibrometry and fiber-optic sensors measured intracochlear pressures in scala vestibuli and tympani for air- and bone-conducted stimuli before and after cochlear implant electrode insertion through the round window. Results Intracochlear pressures revealed only slightly reduced responses to air-conducted stimuli consistent with prior literature. No significant changes were noted to bone-conducted stimuli after implantation. Velocities of the stapes capitulum and the cochlear promontory to both stimuli were stable following electrode placement. Conclusion Presence of a cochlear implant electrode causes alterations in intracochlear sound pressure levels to air, but not bone, conducted stimuli and helps to explain changes in residual hearing noted clinically. These results suggest the possibility of a cochlear conductive component to postoperative changes in hearing sensitivity. PMID:27579835

Recognition and localization of speech by adult cochlear implant recipients wearing a digital hearing aid in the nonimplanted ear (bimodal hearing).

PubMed

Potts, Lisa G; Skinner, Margaret W; Litovsky, Ruth A; Strube, Michael J; Kuk, Francis

2009-06-01

The use of bilateral amplification is now common clinical practice for hearing aid users but not for cochlear implant recipients. In the past, most cochlear implant recipients were implanted in one ear and wore only a monaural cochlear implant processor. There has been recent interest in benefits arising from bilateral stimulation that may be present for cochlear implant recipients. One option for bilateral stimulation is the use of a cochlear implant in one ear and a hearing aid in the opposite nonimplanted ear (bimodal hearing). This study evaluated the effect of wearing a cochlear implant in one ear and a digital hearing aid in the opposite ear on speech recognition and localization. A repeated-measures correlational study was completed. Nineteen adult Cochlear Nucleus 24 implant recipients participated in the study. The participants were fit with a Widex Senso Vita 38 hearing aid to achieve maximum audibility and comfort within their dynamic range. Soundfield thresholds, loudness growth, speech recognition, localization, and subjective questionnaires were obtained six-eight weeks after the hearing aid fitting. Testing was completed in three conditions: hearing aid only, cochlear implant only, and cochlear implant and hearing aid (bimodal). All tests were repeated four weeks after the first test session. Repeated-measures analysis of variance was used to analyze the data. Significant effects were further examined using pairwise comparison of means or in the case of continuous moderators, regression analyses. The speech-recognition and localization tasks were unique, in that a speech stimulus presented from a variety of roaming azimuths (140 degree loudspeaker array) was used. Performance in the bimodal condition was significantly better for speech recognition and localization compared to the cochlear implant-only and hearing aid-only conditions. Performance was also different between these conditions when the location (i.e., side of the loudspeaker array that presented the word) was analyzed. In the bimodal condition, the speech-recognition and localization tasks were equal regardless of which side of the loudspeaker array presented the word, while performance was significantly poorer for the monaural conditions (hearing aid only and cochlear implant only) when the words were presented on the side with no stimulation. Binaural loudness summation of 1-3 dB was seen in soundfield thresholds and loudness growth in the bimodal condition. Measures of the audibility of sound with the hearing aid, including unaided thresholds, soundfield thresholds, and the Speech Intelligibility Index, were significant moderators of speech recognition and localization. Based on the questionnaire responses, participants showed a strong preference for bimodal stimulation. These findings suggest that a well-fit digital hearing aid worn in conjunction with a cochlear implant is beneficial to speech recognition and localization. The dynamic test procedures used in this study illustrate the importance of bilateral hearing for locating, identifying, and switching attention between multiple speakers. It is recommended that unilateral cochlear implant recipients, with measurable unaided hearing thresholds, be fit with a hearing aid.

Neural preservation underlies speech improvement from auditory deprivation in young cochlear implant recipients.

PubMed

Feng, Gangyi; Ingvalson, Erin M; Grieco-Calub, Tina M; Roberts, Megan Y; Ryan, Maura E; Birmingham, Patrick; Burrowes, Delilah; Young, Nancy M; Wong, Patrick C M

2018-01-30

Although cochlear implantation enables some children to attain age-appropriate speech and language development, communicative delays persist in others, and outcomes are quite variable and difficult to predict, even for children implanted early in life. To understand the neurobiological basis of this variability, we used presurgical neural morphological data obtained from MRI of individual pediatric cochlear implant (CI) candidates implanted younger than 3.5 years to predict variability of their speech-perception improvement after surgery. We first compared neuroanatomical density and spatial pattern similarity of CI candidates to that of age-matched children with normal hearing, which allowed us to detail neuroanatomical networks that were either affected or unaffected by auditory deprivation. This information enables us to build machine-learning models to predict the individual children's speech development following CI. We found that regions of the brain that were unaffected by auditory deprivation, in particular the auditory association and cognitive brain regions, produced the highest accuracy, specificity, and sensitivity in patient classification and the most precise prediction results. These findings suggest that brain areas unaffected by auditory deprivation are critical to developing closer to typical speech outcomes. Moreover, the findings suggest that determination of the type of neural reorganization caused by auditory deprivation before implantation is valuable for predicting post-CI language outcomes for young children.

Central Auditory Maturation and Behavioral Outcome in Children with Auditory Neuropathy Spectrum Disorder who Use Cochlear Implants

PubMed Central

Cardon, Garrett; Sharma, Anu

2013-01-01

Objective We examined cortical auditory development and behavioral outcomes in children with ANSD fitted with cochlear implants (CI). Design Cortical maturation, measured by P1 cortical auditory evoked potential (CAEP) latency, was regressed against scores on the Infant Toddler Meaningful Auditory Integration Scale (IT-MAIS). Implantation age was also considered in relation to CAEP findings. Study Sample Cross-sectional and longitudinal samples of 24 and 11 children, respectively, with ANSD fitted with CIs. Result P1 CAEP responses were present in all children after implantation, though previous findings suggest that only 50-75% of ANSD children with hearing aids show CAEP responses. P1 CAEP latency was significantly correlated with participants' IT-MAIS scores. Furthermore, more children implanted before age two years showed normal P1 latencies, while those implanted later mainly showed delayed latencies. Longitudinal analysis revealed that most children showed normal or improved cortical maturation after implantation. Conclusion Cochlear implantation resulted in measureable cortical auditory development for all children with ANSD. Children fitted with CIs under age two years were more likely to show age-appropriate CAEP responses within 6 months after implantation, suggesting a possible sensitive period for cortical auditory development in ANSD. That CAEP responses were correlated with behavioral outcome highlights their clinical decision-making utility. PMID:23819618

Mobile phones: influence on auditory and vestibular systems.

PubMed

Balbani, Aracy Pereira Silveira; Montovani, Jair Cortez

2008-01-01

Telecommunications systems emit radiofrequency, which is an invisible electromagnetic radiation. Mobile phones operate with microwaves (450900 MHz in the analog service, and 1,82,2 GHz in the digital service) very close to the users ear. The skin, inner ear, cochlear nerve and the temporal lobe surface absorb the radiofrequency energy. literature review on the influence of cellular phones on hearing and balance. systematic review. We reviewed papers on the influence of mobile phones on auditory and vestibular systems from Lilacs and Medline databases, published from 2000 to 2005, and also materials available in the Internet. Studies concerning mobile phone radiation and risk of developing an acoustic neuroma have controversial results. Some authors did not see evidences of a higher risk of tumor development in mobile phone users, while others report that usage of analog cellular phones for ten or more years increase the risk of developing the tumor. Acute exposure to mobile phone microwaves do not influence the cochlear outer hair cells function in vivo and in vitro, the cochlear nerve electrical properties nor the vestibular system physiology in humans. Analog hearing aids are more susceptible to the electromagnetic interference caused by digital mobile phones. there is no evidence of cochleo-vestibular lesion caused by cellular phones.

Auditory Cortical Maturation in a Child with Cochlear Implant: Analysis of Electrophysiological and Behavioral Measures

PubMed Central

Silva, Liliane Aparecida Fagundes; Couto, Maria Inês Vieira; Tsuji, Robinson Koji; Bento, Ricardo Ferreira; de Carvalho, Ana Claudia Martinho; Matas, Carla Gentile

2015-01-01

The purpose of this study was to longitudinally assess the behavioral and electrophysiological hearing changes of a girl inserted in a CI program, who had bilateral profound sensorineural hearing loss and underwent surgery of cochlear implantation with electrode activation at 21 months of age. She was evaluated using the P1 component of Long Latency Auditory Evoked Potential (LLAEP); speech perception tests of the Glendonald Auditory Screening Procedure (GASP); Infant Toddler Meaningful Auditory Integration Scale (IT-MAIS); and Meaningful Use of Speech Scales (MUSS). The study was conducted prior to activation and after three, nine, and 18 months of cochlear implant activation. The results of the LLAEP were compared with data from a hearing child matched by gender and chronological age. The results of the LLAEP of the child with cochlear implant showed gradual decrease in latency of the P1 component after auditory stimulation (172 ms–134 ms). In the GASP, IT-MAIS, and MUSS, gradual development of listening skills and oral language was observed. The values of the LLAEP of the hearing child were expected for chronological age (132 ms–128 ms). The use of different clinical instruments allow a better understanding of the auditory habilitation and rehabilitation process via CI. PMID:26881163

A surgical approach appropriate for targeted cochlear gene therapy in the mouse.

PubMed

Jero, J; Tseng, C J; Mhatre, A N; Lalwani, A K

2001-01-01

Therapeutic manipulations of the mammalian cochlea, including cochlear gene transfer, have been predominantly studied using the guinea pig as the experimental model. With the significant developments in mouse genomics and the availability of mutant strains of mice with well-characterized hearing loss, the mouse justifiably will be the preferred animal model for therapeutic manipulations. However, the potential advantages of the mouse model have not been fully realized due to the surgical difficulty of accessing its small cochlea. This study describes a ventral approach, instead of the routinely used postauricular approach in other rodents, for accessing the mouse middle and inner ear, and its application in cochlear gene transfer. This ventral approach enabled rapid and direct delivery of liposome-transgene complex to the mouse inner ear while avoiding blood loss, facial nerve morbidity, and mortality. Transgene expression at 3 days was detected in Reissner's membrane, spiral limbus, spiral ligament, and spiral ganglion cells, in a pattern similar to that previously described in the guinea pig. The successful access and delivery of material to the mouse cochlea and the replication of gene expression seen in the guinea pig demonstrated in this study should promote the use of the mouse in future studies investigating targeted cochlear therapy.

Development of micro-electromechanical system (MEMS) cochlear biomodel

NASA Astrophysics Data System (ADS)

Ngelayang, Thailis Bounya Anak; Latif, Rhonira

2015-05-01

Human cochlear is undeniably one of the most amazing organs in human body. The functional mechanism is very unique in terms of its ability to convert the sound waves in the form of mechanical vibrations into the electrical nerve impulses. It is known that the normal human auditory system can perceive the audible frequency range between 20 Hz to 20 kHz. Scientists have conducted several researches trying to build the artificial basilar membrane in the human cochlea (cochlear biomodel). Micro-electromechanical system (MEMS) is one of the potential inventions that have the ability to mimic the active behavior of the basilar membrane. In this paper, an array of MEMS bridge beams that are mechanically sensitive to the perceived audible frequency has been proposed. An array of bridge bridge beams with 0.5 µm thickness and length varying from 200 µm to 2000 µm have been designed operate within the audible frequency range. In the bridge beams design, aluminium (Al), copper (Cu), tantalum (Ta) and platinum (Pt) have considered as the material for the bridge beam structure. From the finite element (FE) and lumped element (LE) models of the MEMS bridge beams, platinum has been found to be the best material for the cochlear biomodel design, closely mimicking the basilar membrane.

Modeling the Electrode-Neuron Interface of Cochlear Implants: Effects of Neural Survival, Electrode Placement, and the Partial Tripolar Configuration

PubMed Central

Goldwyn, Joshua H.; Bierer, Steven M.; Bierer, Julie A.

2010-01-01

The partial tripolar electrode configuration is a relatively novel stimulation strategies that can generate more spatially focused electric fields than the commonly used monopolar configuration. Focused stimulation strategies should improve spectral resolution in cochlear implant users, but may also be more sensitive to local irregularities in the electrode-neuron interface. In this study, we develop a practical computer model of cochlear implant stimulation that can simulate neural activation in a simplified cochlear geometry and we relate the resulting patterns of neural activity to basic psychophysical measures. We examine how two types of local irregularities in the electrode-neuron interface, variations in spiral ganglion nerve density and electrode position within the scala tympani, affect the simulated neural activation patterns and how these patterns change with electrode configuration. The model shows that higher partial tripolar fractions activate more spatially restricted populations of neurons at all current levels and require higher current levels to excite a given number of neurons. We find that threshold levels are more sensitive at high partial tripolar fractions to both types of irregularities, but these effects are not independent. In particular, at close electrode-neuron distances, activation is typically more spatially localized which leads to a greater influence of neural dead regions. PMID:20580801

Cochlear implantation in patient with Dandy-walker syndrome

PubMed Central

de Oliveira, Adriana Kosma Pires; Hamerschmidt, Rogerio; Mocelin, Marcos; Rezende, Rodrigo K.

2012-01-01

Summary Introduction: Dandy Walker Syndrome is a congenital abnormality in the central nervous system, characterized by a deficiency in the development of middle cerebelar structures, cystic dilatation of the posterior pit communicating with the fourth ventricle and upward shift of the transverse sinuses, tentorium and dyes. Among the clinical signs are occipital protuberances, a progressive increase of the skull, bowing before the fontanels, papilledema, ataxia, gait disturbances, nystagmus, and intellectual impairment. Objectives: To describe a case of female patient, 13 years old with a diagnosis of this syndrome and bilateral hearing loss underwent cochlear implant surgery under local anesthesia and sedation. Case Report: CGS, 13 years old female was referred to the Otolaryngological Department of Otolaryngology Institute of Parana with a diagnosis of “Dandy-Walker syndrome” for Otolaryngological evaluation for bilateral hearing loss with no response to the use of hearing aids. Final Comments: The field of cochlear implants is growing rapidly. We believe that the presence of Dandy-Walker syndrome cannot be considered a contraindication to the performance of cochlear implant surgery, and there were no surgical complications due to neurological disorders with very favorable results for the patient who exhibits excellent discrimination. It has less need for lip reading with improvement in speech quality. PMID:25991966

Determination of the position of nucleus cochlear implant electrodes in the inner ear.

PubMed

Skinner, M W; Ketten, D R; Vannier, M W; Gates, G A; Yoffie, R L; Kalender, W A

1994-09-01

Accurate determination of intracochlear electrode position in patients with cochlear implants could provide a basis for detecting migration of the implant and could aid in the selection of stimulation parameters for sound processor programming. New computer algorithms for submillimeter resolution and 3-D reconstruction from spiral computed tomographic (CT) scans now make it possible to accurately determine the position of implanted electrodes within the cochlear canal. The accuracy of these algorithms was tested using an electrode array placed in a phantom model. Measurements of electrode length and interelectrode distance from spiral CT scan reconstructions were in close agreement with those from stereo microscopy. Although apparent electrode width was increased on CT scans due to partial volume averaging, a correction factor was developed for measurements from conventional radiographs and an expanded CT absorption value scale added to detect the presence of platinum electrodes and wires. The length of the cochlear canal was calculated from preoperative spiral CT scans for one patient, and the length of insertion of the electrode array was calculated from her postoperative spiral CT scans. The cross-sectional position of electrodes in relation to the outer bony wall and modiolus was measured and plotted as a function of distance with the electrode width correction applied.

A novel mechanism of cochlear excitation during simultaneous stimulation and pressure relief through the round window

PubMed Central

Weddell, Thomas D.; Yarin, Yury M.; Drexl, Markus; Russell, Ian J.; Elliott, Stephen J.; Lukashkin, Andrei N.

2014-01-01

The round window (RW) membrane provides pressure relief when the cochlea is excited by sound. Here, we report measurements of cochlear function from guinea pigs when the cochlea was stimulated at acoustic frequencies by movements of a miniature magnet which partially occluded the RW. Maximum cochlear sensitivity, corresponding to subnanometre magnet displacements at neural thresholds, was observed for frequencies around 20 kHz, which is similar to that for acoustic stimulation. Neural response latencies to acoustic and RW stimulation were similar and taken to indicate that both means of stimulation resulted in the generation of conventional travelling waves along the cochlear partition. It was concluded that the relatively high impedance of the ossicles, as seen from the cochlea, enabled the region of the RW not occluded by the magnet, to act as a pressure shunt during RW stimulation. We propose that travelling waves, similar to those owing to acoustic far-field pressure changes, are driven by a jet-like, near-field component of a complex pressure field, which is generated by the magnetically vibrated RW. Outcomes of research described here are theoretical and practical design principles for the development of new types of hearing aids, which use near-field, RW excitation of the cochlea. PMID:24501274

Development of micro-electromechanical system (MEMS) cochlear biomodel

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

Ngelayang, Thailis Bounya Anak; Latif, Rhonira

Human cochlear is undeniably one of the most amazing organs in human body. The functional mechanism is very unique in terms of its ability to convert the sound waves in the form of mechanical vibrations into the electrical nerve impulses. It is known that the normal human auditory system can perceive the audible frequency range between 20 Hz to 20 kHz. Scientists have conducted several researches trying to build the artificial basilar membrane in the human cochlea (cochlear biomodel). Micro-electromechanical system (MEMS) is one of the potential inventions that have the ability to mimic the active behavior of the basilar membrane. Inmore » this paper, an array of MEMS bridge beams that are mechanically sensitive to the perceived audible frequency has been proposed. An array of bridge bridge beams with 0.5 µm thickness and length varying from 200 µm to 2000 µm have been designed operate within the audible frequency range. In the bridge beams design, aluminium (Al), copper (Cu), tantalum (Ta) and platinum (Pt) have considered as the material for the bridge beam structure. From the finite element (FE) and lumped element (LE) models of the MEMS bridge beams, platinum has been found to be the best material for the cochlear biomodel design, closely mimicking the basilar membrane.« less

SMAD4 Defect Causes Auditory Neuropathy Via Specialized Disruption of Cochlear Ribbon Synapses in Mice.

PubMed

Liu, Ke; Ji, Fei; Yang, Guan; Hou, Zhaohui; Sun, Jianhe; Wang, Xiaoyu; Guo, Weiwei; Sun, Wei; Yang, Weiyan; Yang, Xiao; Yang, Shiming

2016-10-01

More than 100 genes have been associated with deafness. However, SMAD4 is rarely considered a contributor to deafness in humans, except for its well-defined role in cell differentiation and regeneration. Here, we report that a SMAD4 defect in mice can cause auditory neuropathy, which was defined as a mysterious hearing and speech perception disorder in human for which the genetic background remains unclear. Our study showed that a SMAD4 defect induces failed formation of cochlear ribbon synapse during the earlier stage of auditory development in mice. Further investigation found that there are nearly normal morphology of outer hair cells (OHCs) and post-synapse spiral ganglion nerves (SGNs) in SMAD4 conditional knockout mice (cKO); however, a preserved distortion product of otoacoustic emission (DPOAE) and cochlear microphonic (CM) still can be evoked in cKO mice. Moreover, a partial restoration of hearing detected by electric auditory brainstem response (eABR) has been obtained in the cKO mice using electrode stimuli toward auditory nerves. Additionally, the ribbon synapses in retina are not affected by this SMAD4 defect. Thus, our findings suggest that this SMAD4 defect causes auditory neuropathy via specialized disruption of cochlear ribbon synapses.

Using Zebra-speech to study sequential and simultaneous speech segregation in a cochlear-implant simulation.

PubMed

Gaudrain, Etienne; Carlyon, Robert P

2013-01-01

Previous studies have suggested that cochlear implant users may have particular difficulties exploiting opportunities to glimpse clear segments of a target speech signal in the presence of a fluctuating masker. Although it has been proposed that this difficulty is associated with a deficit in linking the glimpsed segments across time, the details of this mechanism are yet to be explained. The present study introduces a method called Zebra-speech developed to investigate the relative contribution of simultaneous and sequential segregation mechanisms in concurrent speech perception, using a noise-band vocoder to simulate cochlear implants. One experiment showed that the saliency of the difference between the target and the masker is a key factor for Zebra-speech perception, as it is for sequential segregation. Furthermore, forward masking played little or no role, confirming that intelligibility was not limited by energetic masking but by across-time linkage abilities. In another experiment, a binaural cue was used to distinguish the target and the masker. It showed that the relative contribution of simultaneous and sequential segregation depended on the spectral resolution, with listeners relying more on sequential segregation when the spectral resolution was reduced. The potential of Zebra-speech as a segregation enhancement strategy for cochlear implants is discussed.

Using Zebra-speech to study sequential and simultaneous speech segregation in a cochlear-implant simulation

PubMed Central

Gaudrain, Etienne; Carlyon, Robert P.

2013-01-01

Previous studies have suggested that cochlear implant users may have particular difficulties exploiting opportunities to glimpse clear segments of a target speech signal in the presence of a fluctuating masker. Although it has been proposed that this difficulty is associated with a deficit in linking the glimpsed segments across time, the details of this mechanism are yet to be explained. The present study introduces a method called Zebra-speech developed to investigate the relative contribution of simultaneous and sequential segregation mechanisms in concurrent speech perception, using a noise-band vocoder to simulate cochlear implants. One experiment showed that the saliency of the difference between the target and the masker is a key factor for Zebra-speech perception, as it is for sequential segregation. Furthermore, forward masking played little or no role, confirming that intelligibility was not limited by energetic masking but by across-time linkage abilities. In another experiment, a binaural cue was used to distinguish target and masker. It showed that the relative contribution of simultaneous and sequential segregation depended on the spectral resolution, with listeners relying more on sequential segregation when the spectral resolution was reduced. The potential of Zebra-speech as a segregation enhancement strategy for cochlear implants is discussed. PMID:23297922

Relationships among Professionals' Knowledge, Experience, and Expectations Regarding Cochlear Implants

ERIC Educational Resources Information Center

Ben-Itzhak, D.; Most, T.; Weisel, A.

2005-01-01

The present study examined the relationships between teachers' and communication clinicians' self-reported knowledge on cochlear implants and their expectations of CIs. The authors also explored these professionals' views regarding the child's communication mode, educational setting, and social options following cochlear implantation. The…

Gain and frequency tuning within the mouse cochlear apex

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

Oghalai, John S.; Raphael, Patrick D.; Gao, Simon

Normal mammalian hearing requires cochlear outer hair cell active processes that amplify the traveling wave with high gain and sharp tuning, termed cochlear amplification. We have used optical coherence tomography to study cochlear amplification within the apical turn of the mouse cochlea. We measured not only classical basilar membrane vibratory tuning curves but also vibratory responses from the rest of the tissues that compose the organ of Corti. Basilar membrane tuning was sharp in live mice and broad in dead mice, whereas other regions of the organ of Corti demonstrated phase shifts consistent with additional filtering beyond that provided bymore » basilar membrane mechanics. We use these experimental data to support a conceptual framework of how cochlear amplification is tuned within the mouse cochlear apex. We will also study transgenic mice with targeted mutations that affect different biomechanical aspects of the organ of Corti in an effort to localize the underlying processes that produce this additional filtering.« less

Evidence of across-channel processing for spectral-ripple discrimination in cochlear implant listeners.

PubMed

Won, Jong Ho; Jones, Gary L; Drennan, Ward R; Jameyson, Elyse M; Rubinstein, Jay T

2011-10-01

Spectral-ripple discrimination has been used widely for psychoacoustical studies in normal-hearing, hearing-impaired, and cochlear implant listeners. The present study investigated the perceptual mechanism for spectral-ripple discrimination in cochlear implant listeners. The main goal of this study was to determine whether cochlear implant listeners use a local intensity cue or global spectral shape for spectral-ripple discrimination. The effect of electrode separation on spectral-ripple discrimination was also evaluated. Results showed that it is highly unlikely that cochlear implant listeners depend on a local intensity cue for spectral-ripple discrimination. A phenomenological model of spectral-ripple discrimination, as an "ideal observer," showed that a perceptual mechanism based on discrimination of a single intensity difference cannot account for performance of cochlear implant listeners. Spectral modulation depth and electrode separation were found to significantly affect spectral-ripple discrimination. The evidence supports the hypothesis that spectral-ripple discrimination involves integrating information from multiple channels. © 2011 Acoustical Society of America

Evidence of across-channel processing for spectral-ripple discrimination in cochlear implant listeners a

PubMed Central

Ho Won, Jong; Jones, Gary L.; Drennan, Ward R.; Jameyson, Elyse M.; Rubinstein, Jay T.

2011-01-01

Spectral-ripple discrimination has been used widely for psychoacoustical studies in normal-hearing, hearing-impaired, and cochlear implant listeners. The present study investigated the perceptual mechanism for spectral-ripple discrimination in cochlear implant listeners. The main goal of this study was to determine whether cochlear implant listeners use a local intensity cue or global spectral shape for spectral-ripple discrimination. The effect of electrode separation on spectral-ripple discrimination was also evaluated. Results showed that it is highly unlikely that cochlear implant listeners depend on a local intensity cue for spectral-ripple discrimination. A phenomenological model of spectral-ripple discrimination, as an “ideal observer,” showed that a perceptual mechanism based on discrimination of a single intensity difference cannot account for performance of cochlear implant listeners. Spectral modulation depth and electrode separation were found to significantly affect spectral-ripple discrimination. The evidence supports the hypothesis that spectral-ripple discrimination involves integrating information from multiple channels. PMID:21973363

Clinical presentations and outcomes of bile duct loss caused by drugs and herbal and dietary supplements.

PubMed

Bonkovsky, Herbert L; Kleiner, David E; Gu, Jiezhun; Odin, Joseph A; Russo, Mark W; Navarro, Victor M; Fontana, Robert J; Ghabril, Marwan S; Barnhart, Huiman; Hoofnagle, Jay H

2017-04-01

Bile duct loss during the course of drug-induced liver injury is uncommon, but can be an indication of vanishing bile duct syndrome (VBDS). In this work, we assess the frequency, causes, clinical features, and outcomes of cases of drug-induced liver injury with histologically proven bile duct loss. All cases of drug-induced liver injury enrolled into a prospective database over a 10-year period that had undergone liver biopsies (n = 363) were scored for the presence of bile duct loss and assessed for clinical and laboratory features, causes, and outcomes. Twenty-six of the 363 patients (7%) with drug-, herbal-, or dietary-supplement-associated liver injury had bile duct loss on liver biopsy, which was moderate to severe (<50% of portal areas with bile ducts) in 14 and mild (50%-75%) in 12. The presenting clinical features of the 26 cases varied, but the most common clinical pattern was a severe cholestatic hepatitis. The implicated agents included amoxicillin/clavulanate (n = 3), temozolomide (n = 3), various herbal products (n = 3), azithromycin (n = 2), and 15 other medications or dietary supplements. Compared to those without, those with bile duct loss were more likely to develop chronic liver injury (94% vs. 47%), which was usually cholestatic and sometimes severe. Five patients died and 2 others underwent liver transplantation for progressive cholestasis despite treatment with corticosteroids and ursodiol. The most predictive factor of poor outcome was the degree of bile duct loss on liver biopsy. Bile duct loss during acute cholestatic hepatitis is an ominous early indicator of possible VBDS, for which at present there are no known means of prevention or therapy. (Hepatology 2017;65:1267-1277). © 2016 by the American Association for the Study of Liver Diseases.

Radiopaque biodegradable stent for duct-to-duct biliary reconstruction in pigs.

PubMed

Tanimoto, Yoshisato; Tashiro, Hirotaka; Mikuriya, Yoshihiro; Kuroda, Shintaro; Hashimoto, Masakazu; Kobayashi, Tsuyoshi; Taniura, Tokunori; Ohdan, Hideki

2016-06-01

Biliary stricture is a common cause of morbidity after liver transplantation. We previously developed a duct-to-duct biliary anastomosis technique using a biodegradable stent tube and confirmed the feasibility and safety of biliary stent use. However, the duration and mechanism of biliary stent absorption in the common bile duct remain unclear. Radiopaque biodegradable biliary stents were created using a copolymer of L-lactide and ε-caprolactone (70: 30) and coated with barium sulfate. Stents were surgically implanted in the common bile duct of 11 pigs. Liver function tests and computed tomography (CT) scans were performed postoperatively, and autopsies were conducted 6 months after biliary stent implantation. After the surgery, all 11 pigs had normal liver function and survived without any significant complications such as biliary leakage. A CT scan at 2 months post-procedure showed that the biliary stents were located in the hilum of the liver. The stents were not visible by CT scan at the 6-month follow-up examination. The surgical implantation of radiopaque biodegradable biliary stents in biliary surgery represents a new option for duct-to-duct biliary reconstruction. This technique appears to be feasible and safe and is not associated with any significant biliary complications. The advantage of coated biliary stent use is that it may be visualized using abdominal radiography such as CT.

Role of the Accessory Parotid Gland in the Etiology of Parotitis: Statistical Analysis of Sialographic Features

PubMed Central

Zhu, Wangyong; Hu, Fengchun; Liu, Xingguang; Guo, Songcan; Tao, Qian

2016-01-01

This retrospective study aimed to identify if the existence of the accessory parotid gland correlated with the etiology of parotitis. This may aid the development of better treatment strategies in the future. Sialographic features of cases with parotitis and healthy subjects were reviewed. The chi-square test was used to compare the incidence of accessory parotid gland between the groups. The Student’s t test was used to compare the length of Stensen’s duct, the length from the orifice to the confluence of the accessory duct, and the angle between the accessory duct and Stensen’s duct between the groups. The incidence of accessory parotid gland in patients with parotitis was 71.8% (28/39), which was significantly higher than that in healthy subjects (P = 0.005). Patients with parotitis had a longer Stensen’s duct than healthy subjects (P = 0.003). There was no significant difference in the length from the orifice to the confluence of the accessory duct or the angle between the accessory duct and Stensen’s duct (P = 0.136 and 0.511, respectively) between the groups. The accessory parotid gland might play a role in the pathogenesis of parotitis. The existence of an accessory parotid gland is likely to interfere with salivary flow. Computational fluid dynamics analysis of salivary flow in the ductal system would be useful in future etiologic studies on parotitis. PMID:26913509