Audiol. Res., Volume 5, Issue 1 (January 2015) – 7 articles

We lately reported the cases of patients complaining positional vertigo whose nystagmic pattern was that of a peripheral torsional vertical positional down beating nystagmus originating from a lithiasis of the non-ampullary arm of the posterior semicircular canal (PSC). We considered this particular pathological picture the apogeotropic variant of PSC benign paroxysmal positional vertigo (BPPV). Since the description of the pilot cases we observed more than 150 patients showing the same clinical sign and course of symptoms. In this paper we describe, in detail, both nystagmus of apogeotropic PSC BPPV (A-PSC BPPV) and symptoms reported by patients trying to give a reasonable explanation for these clinical features. Moreover we developed two specific physical therapies directed to cure A-PSC BPPV. Preliminary results of these techniques are related. Full article

The present study attempted to study perception of time-compressed speech and the effect of compression ratio for phonemically balanced (PB) word lists in Kannada and monosyllables. The test was administered on 30 normal hearing individuals at compression ratios of 40%, 50%, 60%, 70% and 80% for PB words in Kannada and monosyllables. The results of the study showed that the speech identification scores for time-compressed speech reduced with increase in compression ratio. The scores were better for monosyllables compared to PB words especially at higher compression ratios. The study provides speech identification scores at different compression ratio for PB words and monosyllables in individuals with normal hearing. The results of the study also showed that the scores did not vary across gender for all the compression ratios for both the stimuli. The same test material needs to be compared the clinical population with central auditory processing disorder for clinical validation of the present results. Full article

The aim of the study was to assess the effect of short-term musical training on speech perception in noise. In the present study speech perception in noise was measured pre- and post- short-term musical training. The musical training involved auditory perceptual training for raga identification of two Carnatic ragas. The training was given for eight sessions. A total of 18 normal hearing adults in the age range of 18-25 years participated in the study wherein group 1 consisted of ten individuals who underwent musical training and group 2 consisted of eight individuals who did not undergo any training. Results revealed that post training, speech perception in noise improved significantly in group 1, whereas group 2 did not show any changes in speech perception scores. Thus, short-term musical training shows an enhancement of speech perception in the presence of noise. However, generalization and long-term maintenance of these benefits needs to be evaluated. Full article

Enlarged vestibular aqueduct (EVA) is one of the commonly identified congenital temporal bone abnormalities associated with sensorineural hearing loss. Hearing loss may be unilateral or bilateral, and typically presents at birth or in early childhood. Vestibular symptoms have been reported in up to 50% of affected individuals, and may be delayed in onset until adulthood. The details of nystagmus in patients with EVA have not been previously reported. The objectives were to describe the clinical history, vestibular test findings and nystagmus seen in a case series of patients with enlarged vestibular aqueduct anomaly. Chart review, included computed tomography temporal bones, infrared nystagmography with positional and positioning testing, caloric testing, rotary chair and vibration testing. Clinical history and nystagmus varied among the five patients in this series. All patients were initially presumed to have benign paroxysmal positional vertigo, but repositioning treatments were not effective, prompting referral, further testing and evaluation. In three patients with longstanding vestibular complaints, positional nystagmus was consistently present. One patient had distinct recurrent severe episodes of positional nystagmus. Nystagmus was unidirectional and horizontal. In one case horizontal nystagmus was consistently reproducible with seated head turn to the affected side, and reached 48 d/s. Nystagmus associated with enlarged vestibular aqueduct is often positional, and can be confused with benign paroxysmal positional vertigo. Unexplained vestibular symptoms in patients with unilateral or bilateral sensorineural hearing loss should prompt diagnostic consideration of EVA. Full article

The purpose of this study was to revisit the two-channel, simultaneous click-evoked extratympanic electrocochleography and auditory brainstem response (ECoG/ABR) recording technique for clinical use in normal hearing participants. Recording the compound action potential (AP) of the ECoG simultaneously with ABR may be useful when Wave I of the ABR is small or diminished in patients with sensorineural or retrocochlear disorder and minimizes overall test time. In contrast to some previous studies that used the extratympanic electrode both as non-inverting electrode for the ECoG and inverting electrode for ABR, this study maintained separate recording channel montages unique to conventional click-evoked ECoG and ABR recordings. That is, the ABR was recorded using a vertical channel (Cz to ipsilateral earlobe), while the ECoG with custom extratympanic electrode was recorded using a horizontal channel (tympanic membrane to contralateral earlobe). The extratympanic electrode is easy to fabricate inhouse, or can be purchased commercially. Maintaining the conventional ABR montage permits continued use of traditional normative data. Broadband clicks at a fixed level of 85 dB nHL were presented with alternating polarity at stimulus rates of 9.3, 11.3, and 15.3/s. Different stimulation rates were explored to identify the most efficient rate without sacrificing time or waveform morphology. Results revealed larger ECoG AP than ABR Wave I, as expected, and no significant difference across stimulation rate and no interaction effect. Extratympanic electrode placement takes little additional clinic time and may improve the neurodiagnostic utility of the ABR. Full article

Tympanic membrane perforation is a common problem leading to hearing loss. Despite the autoregenerative activity of the eardrum, chronic perforations require surgery using different materials, from autologous tissue - fascia, cartilage, fat or perichondrium - to paper patch. However, both, surgical procedures (myringoplasty or tympanoplasty) and the materials employed, have a number of limitations. Therefore, the advances in this field are incorporating the principles of tissue engineering, which includes the use of scaffolds, biomolecules and cells. This discipline allows the development of new biocompatible materials that reproduce the structure and mechanical properties of the native tympanic membrane, while it seeks to implement new therapeutic approaches that can be performed in an outpatient setting. Moreover, the creation of an artificial tympanic membrane commercially available would reduce the duration of the surgery and costs. The present review analyzes the current treatment of tympanic perforations and examines the techniques of tissue engineering, either to develop bioartificial constructs, or for tympanic regeneration by using different scaffold materials, bioactive molecules and cells. Finally, it considers the aspects regarding the design of scaffolds, release of biomolecules and use of cells that must be taken into account in the tissue engineering of the eardrum. The possibility of developing new biomaterials, as well as constructs commercially available, makes tissue engineering a discipline with great potential, capable of overcoming the drawbacks of current surgical procedures. Full article

Generation of the auditory steady state responses (ASSR) is commonly explained by the linear combination of random background noise activity and the stationary response. Based on this model, the decrease of amplitude that occurs over the sequential averaging of epochs of the raw data has been exclusively linked to the cancelation of noise. Nevertheless, this behavior might also reflect the non-stationary response of the ASSR generators. We tested this hypothesis by characterizing the ASSR time course in rats with different auditory maturational stages. ASSR were evoked by 8-kHz tones of different supra-threshold intensities, modulated in amplitude at 115 Hz. Results show that the ASSR amplitude habituated to the sustained stimulation and that dishabituation occurred when deviant stimuli were presented. ASSR habituation increased as animals became adults, suggesting that the ability to filter acoustic stimuli with no-relevant temporal information increased with age. Results are discussed in terms of the current model of the ASSR generation and analysis procedures. They might have implications for audiometric tests designed to assess hearing in subjects who cannot provide reliable results in the psychophysical trials. Full article