• Journal of Audiology & Otology
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• 제25권1호
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• pp.43-48
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• 2021

Background and Objectives: Conflicting mechanisms have been reported about spontaneous reversal of positional nystagmus during head-roll maneuver in patients with benign paroxysmal positional vertigo (BPPV). The objective of this study is to review the reports about the characteristics and possible mechanisms of reversing positional nystagmus and to present seven new cases. Subjects and Methods: Seven cases (5 males, 2 females; 4 left-sided, 3 right-sided) were recruited among 732 patients with BPPV seen outpatient clinic between 2009 and 2019. Diagnosis of lateral canal canalolithiasis was confirmed when transient geotropic nystagmus was documented during head-roll test. Reversing positional nystagmus was analyzed in each case and clinical characteristics of the patients were documented. Results: The age of patients was ranging between 30 to 64 years (46.44±10.91). Duration of symptoms was short (21.34±19.74). Six of them had a story of head trauma. Initial latency was short. First, intense geotropic nystagmus was observed following provocative head-roll position on the affected side. There was short "silent phase". Then, a longer second-phase of reversed nystagmus was noted. Total duration of nystagmus was 78.40±6.82 seconds. Maximal slow phase velocity was 24.05±6.34 deg/sec. All patients were cured with barbeque maneuver. Conclusions: Ipsilateral reversing positional nystagmus during head-roll maneuver is due to lateral canal canalolithiasis. Mechanism is likely to be due to endolymphatic double flow. Bilateral cases may be due to simultaneous co-existence of canalolithiasis and cupulolithiasis. Longer recording of nystagmus is recommended not to miss the cases with spontaneous direction-changing positional nystagmus.

• Journal of Audiology & Otology
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• 제24권1호
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• pp.1-9
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• 2020

Auditory scene analysis is defined as a listener's ability to segregate a meaningful message from meaningless background noise in a listening environment. To gain better understanding of auditory perception in terms of message integration and segregation ability among concurrent signals, we aimed to systematically review the size of auditory scenes among individuals. A total of seven electronic databases were searched from 2000 to the present with related key terms. Using our inclusion criteria, 4,507 articles were classified according to four sequential steps-identification, screening, eligibility, included. Following study selection, the quality of four included articles was evaluated using the CAMARADES checklist. In general, studies concluded that the size of auditory scene increased as the number of sound sources increased; however, when the number of sources was five or higher, the listener's auditory scene analysis reached its maximum capability. Unfortunately, the score of study quality was not determined to be very high, and the number of articles used to calculate mean effect size and statistical significance was insufficient to draw significant conclusions. We suggest that study design and materials that consider realistic listening environments should be used in further studies to deep understand the nature of auditory scene analysis within various groups.

• Journal of Audiology & Otology
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• 제24권1호
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• pp.48-52
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• 2020

Lateralization for central auditory processing (CAP) with dichotic digits recognition (DDR) test is believed expression of hemispheric dominance. Multiple sclerosis (MS) is considered an inflammatory and autoimmune alteration of central nervous system (CNS). Hearing alterations in MS and their role in CAP has not been well studied. A patient with MS and new kind of alteration in lateralization of CAP with DDR test is presented. A 53 year of age female with MS of 16 years of evolution, nine of them remained asymptomatic. She has a persistent advantage of the right ear for DDR test; but other monaural tests showed predominance of the left afferent pathway. Brainstem auditory evoked potentials (BAEPs) and long latency auditory evoked potentials (LLAEPs) showed adequate right response with deficits in organization of left response in BAEP, and N2 wave. In the contrary direction of previous publication, we disclosed advantage for DDR test, BAEP, and LLAEP in the right ear. We observed no left ear suppression; with predominance of correct left percentages in monaural psychoacoustics tests. We must keep on searching to find pathophysiological meaning of predominant of right or left auditory laterality as a CAP disorder in patients with MS.

• Journal of Audiology & Otology
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• 제25권1호
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• pp.1-7
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• 2021

The scope of teleaudiology has been noted with telehealth due to Coronavirus disease (COVID-19) recently. As the notion has been around us for more than 20 years ever since 1999, it is necessary to perceive the knowledge accurately and prepare for the successful implementation of it. Therefore, the literature review including screening and diagnostic audiometry, cochlear implants and hearing aids, and aural rehabilitation, telecommunications technology regarding several fields of teleaudiology, and considerations for practicing were identified. Although overall internet-based audiological services showed benefits in terms of outcome and accessibility, uncertainties of cost-effectiveness, the optimal level of support, and a need for further studies of many aspects for teleaudiology has arisen. In the view of technology, the store-and-forward (asynchronous/hybrid) and a real-time (synchronous) methods were introduced with one applied and nine registered patents recorded from 2004 to 2020 for the invention of teleaudiology in the United States. Also, 10 checklists were suggested for planning teleaudiology practice from prior experience in hosting the teleaudiology program. Conclusively, it is hoped that this review sheds light on recognizing and improving the existing teleaudiology services and helps overcome the challenges faced in the era of pandemic and untact world to come.

• Journal of Audiology & Otology
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• 제25권1호
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• pp.49-54
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• 2021

Type II mucopolysaccharidosis (MPS II) commonly known as Hunter syndrome, is a rare X-linked lysosomal storage disorder caused by iduronate-2-sulfatase deficiency, which in turn causes otorhinolaryngological manifestations, including sensorineural hearing loss (SNHL). Previously, the median survival age of patients with MPS was approximately 13.4 years. However, in the era of enzyme replacement therapy and other multidisciplinary care modalities, the life expectancy has increased. Herein, we report a rare case of an adolescent with MPS II who underwent SNHL treatment with cochlear implantation (CI). Based on unexpected findings of mastoid emissary veins and overgrowth of the vessels around the temporal bone, CI was performed using the transmeatal approach instead of the conventional transmastoid method, to avoid damage to the vessels. The average hearing threshold after CI was 35 dB and no surgical complications were encountered. Adolescent MPS II may present vessel abnormalities, which can reduce the success rate of surgery. In patients with MPS II with SNHL, CI should be performed under careful monitoring of vessel overgrowth. Moreover, with regard to feasibility of CI in adolescent patients with MPS II with SNHL, surgical techniques such as the transmeatal approach should be selected based on adequate assessment of the case.

• Journal of Audiology & Otology
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• 제25권1호
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• pp.36-42
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• 2021

Background and Objectives: Globally, the human immunodeficiency virus (HIV) is responsible for one of the most serious pandemics to date. The vulnerability of the vestibular system in individuals with HIV has been confirmed, and central vestibular impairments have been frequently reported. However, there are disagreements on the impact of HIV on peripheral vestibular function. Thus, the current study aimed to determine the prevalence of peripheral vestibular impairment, specifically related to the semi-circular canals (SCCs), in HIV-positive individuals receiving antiretroviral (ARV) treatment. Subjects and Methods: A total of 92 adults between the ages of 18 and 50 years (divided into two groups) participated in the study. The first group comprised HIV-positive individuals receiving ARV treatment (n₁=60), and the second group comprised HIV-negative participants (n₂=32). The video head impulse test was used to conduct the head impulse paradigm (HIMP). Results: Bilateral normal HIMP results were obtained in 95% of the HIV-positive participants and all HIV-negative participants. The gain of the left posterior SCCs was significantly lower in the HIV-positive group, while the gains of all other canals between the two groups were comparable. Conclusions: The prevalence of peripheral vestibular impairment in the HIV-positive group was not significantly different from that of the HIV-negative group. The reduced prevalence in the current study may be attributed to participant characteristics, the test battery employed, and the central compensation of the vestibular dysfunctions at the later stages of infection.

• Journal of Audiology & Otology
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• 제23권1호
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• pp.49-52
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• 2019

Background and Objectives: Considering important role of vitamin D in many physiological processes including vestibular system in the ear, aim of present study is to evaluate saccule function via cervical vestibular evoked myogenic potential (cVEMP), in patients with vitamin D deficiency. Subjects and Methods: After routine audiological tests, cVEMP were recorded in 15 patients with vitamin D deficiency and 16 normal subjects. The short tone burst (95 dB nHL, 500 Hz) was presented to ears. cVEMP was recorded with surface electromyography over the contracted ipsilateral sternocleidomastoid muscle. Results: Mean of p13, n13, interpeak latencies and amplitude ratios were measured in both groups. Statistical analysis did not show differences between two groups. Conclusions: Maybe serum 25-hydroxyvitamin D concentration was not low enough to have effect on saccule in the patients in present study or saccule have had low susceptibility to effects of vitamin D deficiency. For better judgment about effect of vitamin D deficiency on saccular function planning studies with high sample size is recommended.

• Journal of Audiology & Otology
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• 제23권4호
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• pp.181-186
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• 2019

Background and Objectives: This study compared the perception of mono-syllabic and bisyllabic words in Tamil by young normal hearing adults in the presence of multi-talker speech babble at two signal-to-noise ratios (SNRs). Further for this comparison, a speech perception in noise test was constructed using existing mono-syllabic and bi-syllabic word lists in Tamil. Subjects and Methods: A total of 30 participants with normal hearing in the age range of 18 to 25 years participated in the study. Speech-in-noise test in Tamil (SPIN-T) constructed using mono-syllabic and bi-syllabic words in Tamil was used as stimuli. The stimuli were presented in the background of multi-talker speech babble at two SNRs (0 dB and +10 dB SNR). Results: The effect of noise on SPIN-T varied with SNR. All the participants performed better at +10 dB SNR, the higher of the two SNRs considered. Additionally, at +10 dB SNR performance did not vary significantly for neither mono-syllabic or bi-syllabic words. However, a significant difference existed at 0 dB SNR. Conclusions: The current study indicated that higher SNR leads to better performance. In addition, bi-syllabic words were identified with minimal errors compared to mono-syllabic words. Spectral cues were the most affected in the presence of noise leading to more of place of articulation errors for both mono-syllabic and bi-syllabic words.

• Journal of Audiology & Otology
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• 제23권4호
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• pp.187-192
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• 2019

Background and Objectives: Clear speech is an effective communication strategy used in difficult listening situations that draws on techniques such as accurate articulation, a slow speech rate, and the inclusion of pauses. Although too slow speech and improperly amplified spectral information can deteriorate overall speech intelligibility, certain amplitude of increments of the mid-frequency bands (1 to 3 dB) and around 50% slower speech rates of clear speech, when compared to those in conversational speech, were reported as factors that can improve speech intelligibility positively. The purpose of this study was to identify whether amplitude increments of mid-frequency areas and slower speech rates were evident in Korean clear speech as they were in English clear speech. Subjects and Methods: To compare the acoustic characteristics of the two methods of speech production, the voices of 60 participants were recorded during conversational speech and then again during clear speech using a standardized sentence material. Results: The speech rate and longterm average speech spectrum (LTASS) were analyzed and compared. Speech rates for clear speech were slower than those for conversational speech. Increased amplitudes in the mid-frequency bands were evident for the LTASS of clear speech. Conclusions:The observed differences in the acoustic characteristics between the two types of speech production suggest that Korean clear speech can be an effective communication strategy to improve speech intelligibility.

• Journal of Audiology & Otology
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• 제23권1호
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• pp.1-7
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• 2019

Self-reported difficulties in speech-in-noise (SiN) recognition are common among tinnitus patients. Whereas hearing impairment that usually co-occurs with tinnitus can explain such difficulties, recent studies suggest that tinnitus patients with normal hearing sensitivity still show decreased SiN understanding, indicating that SiN difficulties cannot be solely attributed to changes in hearing sensitivity. In fact, cognitive control, which refers to a variety of top-down processes that human beings use to complete their daily tasks, has been shown to be critical for SiN recognition, as well as the key to understand cognitive inefficiencies caused by tinnitus. In this article, we review studies investigating the association between tinnitus and cognitive control using behavioral and brain imaging assessments, as well as those examining the effect of tinnitus on SiN recognition. In addition, three factors that can affect cognitive control in tinnitus patients, including hearing sensitivity, age, and severity of tinnitus, are discussed to elucidate the association among tinnitus, cognitive control, and SiN recognition. Although a possible central or cognitive involvement has always been postulated in the observed SiN impairments in tinnitus patients, there is as yet no direct evidence to underpin this assumption, as few studies have addressed both SiN performance and cognitive control in one tinnitus cohort. Future studies should aim at incorporating SiN tests with various subjective and objective methods that evaluate cognitive performance to better understand the relationship between SiN difficulties and cognitive control in tinnitus patients.