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1.
Eur Arch Otorhinolaryngol ; 274(10): 3599-3604, 2017 Oct.
Article in English | MEDLINE | ID: mdl-28762045

ABSTRACT

The objective of the present study is to evaluate the effect of hybrid cochlear implantation (hCI) on quality of life (QoL), quality of hearing (QoH), and working performance in adult patients, and to compare the long-term results of patients with hCI to those of patients with conventional unilateral cochlear implantation (CI), bilateral CI, and single-sided deafness (SSD) with CI. Sound localization accuracy and speech-in-noise test were also compared between these groups. Eight patients with high-frequency sensorineural hearing loss of unknown etiology were selected in the study. Patients with hCI had better long-term speech perception in noise than uni- or bilateral CI patients, but the difference was not statistically significant. The sound localization accuracy was equal in the hCI, bilateral CI, and SSD patients. QoH was statistically significantly better in bilateral CI patients than in the others. In hCI patients, residual hearing was preserved in all patients after the surgery. During the 3.6-year follow-up, the mean hearing threshold at 125-500 Hz decreased on average by 15 dB HL in the implanted ear. QoL and working performance improved significantly in all CI patients. Hearing outcomes with hCI are comparable to the results of bilateral CI or CI with SSD, but hearing in noise and sound localization are statistically significantly better than with unilateral CI. Interestingly, the impact of CI on QoL, QoH, and working performance was similar in all groups.


Subject(s)
Cochlear Implantation , Cochlear Implants , Hearing Loss, Bilateral , Hearing Loss, Unilateral , Quality of Life , Adult , Cochlear Implantation/instrumentation , Cochlear Implantation/methods , Cochlear Implants/adverse effects , Cochlear Implants/standards , Female , Finland , Follow-Up Studies , Hearing Loss, Bilateral/diagnosis , Hearing Loss, Bilateral/physiopathology , Hearing Loss, Bilateral/surgery , Hearing Loss, Unilateral/diagnosis , Hearing Loss, Unilateral/physiopathology , Hearing Loss, Unilateral/surgery , Hearing Tests/methods , Humans , Male , Middle Aged , Outcome Assessment, Health Care , Sound Localization , Speech Perception , Work Performance
2.
Article in English | MEDLINE | ID: mdl-26418165

ABSTRACT

AIMS: To evaluate the effect of a cochlear implant (CI) on quality of life (QoL), quality of hearing (QoH), and working performance in patients with single-sided deafness (SSD). METHODS: Using specific questionnaires, we measured QoL, QoH, and working performance in 7 SSD patients scheduled for CI surgery of the affected ear. Sound localization and speech perception in noise were also assessed. All questionnaires and tests were performed before the CI surgery and at 6 and 12 months after CI activation. RESULTS: The QoL, QoH, sound localization, and speech perception in noise had improved statistically significantly after CI surgery. Communication with co-workers became easier, and the patients were less fatigued after the working day. CONCLUSIONS: CI clearly improves QoL, QoH, and working performance in patients with SSD.


Subject(s)
Cochlear Implants , Deafness/surgery , Hearing/physiology , Quality of Life , Sound Localization/physiology , Speech Perception/physiology , Adult , Deafness/physiopathology , Deafness/psychology , Female , Follow-Up Studies , Hearing Tests , Humans , Male , Middle Aged , Surveys and Questionnaires , Time Factors , Treatment Outcome
3.
Laryngoscope ; 127(4): 927-931, 2017 04.
Article in English | MEDLINE | ID: mdl-27328455

ABSTRACT

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


Subject(s)
Glucocorticoids/therapeutic use , Hearing Loss, Sensorineural/diagnosis , Hearing Loss, Sensorineural/psychology , Hearing Loss, Sudden/diagnosis , Hearing Loss, Sudden/psychology , Quality of Life , Adult , Age Factors , Aged , Analysis of Variance , Audiometry, Pure-Tone , Cross-Sectional Studies , Female , Follow-Up Studies , Hearing Loss, Sensorineural/drug therapy , Hearing Loss, Sudden/drug therapy , Humans , Male , Middle Aged , Monitoring, Physiologic/methods , Risk Factors , Severity of Illness Index , Statistics, Nonparametric , Time Factors , Treatment Outcome , Young Adult
4.
Acta Otolaryngol ; 135(5): 440-6, 2015 May.
Article in English | MEDLINE | ID: mdl-25677966

ABSTRACT

CONCLUSIONS: This prospective study shows that working performance, quality of life (QoL), and quality of hearing (QoH) are better with two compared with a single cochlear implant (CI). The impact of the second CI on the patient's QoL is as significant as the impact of the first CI. OBJECTIVES: To evaluate the benefits of sequential bilateral cochlear implantation in working, QoL, and QoH. METHODS: We studied working performance, work-related stress, QoL, and QoH with specific questionnaires in 15 patients with unilateral CI scheduled for sequential CI of another ear. Sound localization performance and speech perception in noise were measured with specific tests. All questionnaires and tests were performed before the second CI surgery and 6 and 12 months after its activation. RESULTS: Bilateral CIs increased patients' working performance and their work-related stress and fatigue decreased. Communication with co-workers was easier and patients were more active in their working environment. Sequential bilateral cochlear implantation improved QoL, QoH, sound localization, and speech perception in noise statistically significantly.


Subject(s)
Auditory Threshold , Cochlear Implantation/methods , Hearing Loss, Bilateral/rehabilitation , Quality of Life , Adult , Female , Hearing Tests , Humans , Male , Middle Aged , Patient Satisfaction , Perceptual Masking , Rehabilitation, Vocational/methods , Reoperation , Speech Reception Threshold Test , Surveys and Questionnaires , Young Adult
5.
Int J Androl ; 26(3): 187-94, 2003 Jun.
Article in English | MEDLINE | ID: mdl-12755998

ABSTRACT

The activity of androgen receptor (AR) is modulated by a polymorphic CAG trinucleotide repeat in the AR gene. In the present study, we investigated hormonal changes among ageing men, and whether the number of AR CAG triplets is related to the appearance of these changes, as well as symptoms and diseases associated with ageing. A total of 213 41-70-year-old men donated blood for hormone analyses (LH, testosterone, oestradiol and SHBG) and answered questions concerning diseases and symptoms associated with ageing and/or androgen deficiency. Of these men, 172 donated blood for the measurement of the CAG repeat length of AR. The CAG repeat region of the AR gene was amplified by polymerase chain reaction (PCR) and the products were sized on polyacrylamide gels. The repeat number was analysed as a dichotomized variable divided according to cut-off limits of the lowest (< or =20 repeats) and the highest quartile (> or =23 repeats), and as a continuous variable. The proportion of men with serum LH in the uppermost quartile (>6.0 IU/L) with normal serum testosterone (>9.8 nmol/L, above the lowest 10%) increased significantly with age (p = 0.01). There were fewer men with this hormonal condition among those with CAG repeat number in the uppermost quartile (> or =23 repeats) (p = 0.03). These men also reported less decreased potency (p < 0.05). The repeat number was positively correlated with depression, as expressed by the wish to be dead (r = 0.45; p < 0.0001), depressed mood (r = 0.23; p = 0.003), anxiety (r = 0.15; p < 0.05), deterioration of general well-being (r = 0.22; p = 0.004), as well as decreased beard growth (r = 0.49; p < 0.0001). A hormonal condition where serum testosterone is normal but LH increased is a frequent finding in male ageing. Only certain types of age-related changes in ageing men were associated with the length of the AR gene CAG repeat, suggesting that this parameter may play a role in setting different thresholds for the array of androgen actions in the male.


Subject(s)
Aging/genetics , Climacteric/genetics , Receptors, Androgen/genetics , Trinucleotide Repeats , Adult , Aged , Aging/blood , Aging/physiology , Androgens/deficiency , Climacteric/blood , Climacteric/psychology , Humans , Luteinizing Hormone/blood , Male , Middle Aged , Pituitary Gland/physiology , Testis/physiology , Testosterone/blood
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