Cochlear implantation in a 16-month-old with Chudley-McCullough Syndrome.

OBJECTIVE: The purpose of this report is to describe a case of bilateral cochlear implantation (CI) in a pediatric patient with Chudley-McCullough Syndrome (CMS). By reviewing the literature, we hope to describe common clinical presentations to aid in early diagnosis and management of pediatric patients with CMS. METHODS: Case report with literature review. RESULTS: We present a case of a 16-month-old female with CMS who presented to clinic after a failed newborn hearing screen and was found to have bilateral sensorineural hearing loss. After a failed trial of hearing amplification, the patient underwent successful bilateral CI. The patient had no surgical complications, and her follow up visit showed satisfactory speech and language development. CONCLUSION: This case validates that cochlear implantation in pediatric patients who present with CMS is both safe and efficacious. It also demonstrates the importance of early detection and treatment of sensorineural hearing loss in CMS to prevent speech and language delay.

Relationship between dietary quality, tinnitus and hearing level: data from the national health and nutrition examination survey, 1999-2002.

OBJECTIVE: To examine the relationship between the healthy eating index (HEI), a measure of dietary quality based on United States Department of Agriculture recommendations and report of tinnitus. DESIGN: This cross-sectional analysis was based on HEI data and report of tinnitus. STUDY SAMPLE: Data for adults between 20 and 69 years of age were drawn from the National Health and Nutrition Examination Survey (NHANES), 1999-2002. The NHANES is a programme of studies, to assess the health and nutritional status of adults and children in the United States. Two thousand one hundred and seventy-six participants were included in the analytic sample. RESULTS: Of the sample, 21.1% reported tinnitus within the past year and 11.7% reported persistent tinnitus, defined as tinnitus experienced at least monthly or greater. Controlling for age, sex, race/ethnicity, diabetes, noise exposure and smoking status, we found that with healthier diet (poorer vs. better HEI) there was decreased odds of reported persistent tinnitus [odds ratio (OR); 0.67; 95% confidence interval (CI) 0.45-0.98; p = 0.03]. CONCLUSIONS: The current findings support a possible relationship between healthier diet quality and reported persistent tinnitus.

Patient Complexity Charge Matrix for Audiology Services: A New Perspective on Unbundling.

Traditional approaches to unbundling hearing aid services often take existing bundled charges and then separate the charges across all potential services associated with dispensing the devices. However, this method results in every patient being charged the same amount even though the complexity of the service varies across patients. We describe a model of charging for hearing aid services that takes into account three elements associated with patient services (i.e., assessing hearing status, audiologic decision making and interpretation, and counseling and treatment options) and two levels of complexity (straightforward and complex). Using this approach, there is negligible long-term financial impact on a practice however patients will perceive a lower overall cost for amplification. Additionally, this approach provides a payment structure more representative of the professional value of each visit.