The Bonebridge in Adults with Mixed and Conductive Hearing Loss: Audiological and Quality of Life Outcomes.

BACKGROUND: Considering that hearing loss has a significant impact on social functioning, everyday activity and a person's emotional state, one of the most important goals of hearing rehabilitation with bone conduction devices is improvement in a patient's quality of life. OBJECTIVES: To measure self-assessed quality of life in patients implanted with the Bonebridge, a bone conduction device. METHOD: Prospective, observational, longitudinal study with one treatment group. Twenty-one patients with mixed or conductive hearing loss were included, and each individual served as its own control. The Abbreviated Profile of Hearing Aid Benefit (APHAB) was used to measure patient-reported quality of life before intervention and at 3 and 6 months after activation of the device. At the same time frames, pure-tone audiometry and speech understanding in quiet and in noise were tested. RESULTS: Hearing-specific quality of life increased significantly after intervention and remained stable up to 6 months. Both word recognition in quiet and speech reception threshold in noise were significantly better after 6 months compared to before surgery. Outcomes of aided speech understanding were independent of initial bone conduction thresholds and equally high (word recognition score >75%) across the device's indication range. CONCLUSIONS: The Bonebridge provides not only significant audiological benefit in both speech understanding in quiet and in noise, but also increases self-perceived quality of life in patients suffering from mixed and conductive hearing loss. Together with a very low rate and minor nature of adverse events, it is the state-of-the-art solution for hearing rehabilitation in patients with mixed or conductive hearing loss up to a bone conduction threshold of 45 dB HL.

Preservation of Hearing Following Cochlear Implantation Using Different Steroid Therapy Regimens: A Prospective Clinical Study.

BACKGROUND A prospective clinical study was conducted to assess different regimens of steroid therapy and preservation of hearing following cochlear implantation. MATERIAL AND METHODS Study participants were ≥18 years-of-age, with a cochlear duct length ≥27.1 mm measured by computed tomography (CT), with hearing sound levels in the range of 10-120 decibels (dB) and sound frequencies of 125-250 hertz (Hz); sound levels of 35-120 dB and frequencies of 500-1,000 Hz; sound levels of 75-120 dB and frequencies of 2,000-8,000 Hz. Study exclusion criteria included diseases with contraindications for steroid therapy or medications that increased the effects of steroids. Patients had cochlear implantation and were divided into three treatment groups: intravenous (IV) steroid therapy (standard steroid therapy): combined oral and IV steroid therapy (prolonged steroid therapy); and a control group (cochlear implantation without steroid therapy). Hearing preservation was established by pure tone audiometry based on the pre-operative and postoperative average hearing thresholds according to the formula developed by the HEARRING Network. RESULTS There were 36 patients included in the study. In all cases, the cochlear implant electrode was inserted via the round window approach with a straight electrode length of 28 mm. Patients with combined oral and IV steroid therapy (prolonged steroid therapy) had better results when compared with patients with intravenous (IV) steroid therapy (standard steroid therapy) and the control group. CONCLUSIONS Prolonged steroid therapy using combined oral and IV steroids stabilized hearing thresholds and preserved hearing in adult patients following cochlear implantation.

A Comparative Study of a Novel Adhesive Bone Conduction Device and Conventional Treatment Options for Conductive Hearing Loss.

OBJECTIVE: To compare the audiological performance with the novel adhesive bone conduction hearing device (ADHEAR) to that with a passive bone conduction (BC) implant and to that with a bone conduction device (BCD) on a softband. STUDY DESIGN: Prospective study in an acute setting, single-subject repeated measure in three situations: unaided, with conventional BCDs (passive implant or on softband), and with the ADHEAR. SETTING: Tertiary referral center. PATIENTS: Ten subjects with conductive hearing loss were evaluated with the ADHEAR. Five of these were users of a passive BC implant (Baha Attract with Baha4); five received a BCD (Baha4) on a softband for test purposes. INTERVENTION: Use of non-invasive adhesive bone conduction system for the treatment of conductive hearing loss. MAIN OUTCOME MEASURES: Air and bone conduction thresholds, sound field thresholds, word recognition scores in quiet, and speech recognition thresholds in quiet and noise were assessed. RESULTS: Users of the passive BC implant received comparable hearing benefit with the ADHEAR. The mean aided thresholds in sound field measurements and speech understanding in quiet and noise were similar, when subjects were evaluated either with the ADHEAR or the passive BC implant. The audiological outcomes for the non-implanted group were also comparable between the ADHEAR and the BCD on softband. CONCLUSIONS: Based on our initial data, the ADHEAR seems to be a suitable alternative for patients who need a hearing solution for conductive hearing loss but for medical reasons cannot or do not want to undergo surgery for a passive BC implant.

CAG and CTG repeat polymorphism in exons of human genes shows distinct features at the expandable loci.

Although the trinucleotide repeats are present in the exons of numerous human genes, the allele distribution is not well known, and the factors responsible for their intergenic and intragenic variability are not well understood. We have analyzed the length and sequence variation within the most commonly occurring CAG and CTG repeats in a large number of human genes selected to contain the longest reported repeat tracts. Our study revealed that in genes other than those implicated in the Triplet Repeat Expansion Diseases (TREDs), the very long and highly polymorphic repeats are rather infrequent. The length of pure repeat tract in the most frequent allele was found to correlate well with the rate of the repeat length polymorphism, and CAA triplets were shown to be the most frequent CAG repeat interruptions. As both the CAG and CAA triplets code for glutamine, our results may suggest that the selective pressure disfavors the long uninterrupted CAG repeats in genes and transcripts but not the long normal polyglutamine tracts in proteins. This may indicate that hairpin structures formed in ssDNA and RNA by long pure CAG repeats would be selected against as they may impede normal cellular processes.

Otoacoustic Emissions in Smoking and Nonsmoking Young Adults.

OBJECTIVES: The present study investigates the usefulness of transiently evoked otoacoustic emissions (TEOAEs) and distortion product OAEs (DPOAEs) in detecting small changes in the hearing of young smoking adults. METHODS: Otoacoustic emissions were acquired from the ears of 48 young adults (age, 20 to 27 years). The dataset was divided into two groups, smoking (24 persons/48 ears) and nonsmoking (24 persons/48 ears). The level of smoking was relatively small in comparison to previous studies, an average of 3.8 years and 8.7 cigarettes per day. In each ear three OAE measurements were made: TEOAEs, DPOAEs, and spontaneous OAEs (SOAEs). Pure tone audiometry and tympanometry were also conducted. Audiometric thresholds did not differ significantly between the datasets. Half-octave-band values of OAE signal to noise ratios and response levels were used to assess statistical differences. RESULTS: Averaged data initially revealed that differences between the two study groups occurred only for TEOAEs at 1 kHz. However when the datasets were divided into ears with and without SOAEs more differences became apparent, both for TEOAEs and DPOAEs. In ears that exhibited SOAEs, both smokers and nonsmokers, there were no statistically significant differences between evoked OAEs; however in all ears without SOAEs, evoked OAEs were higher in the ears of nonsmokers, by as much as 5 dB. These differences were most prominent in the 1-2 kHz range. CONCLUSION: A general decrease in OAE levels was found in the group of smokers. However, in ears which exhibited SOAEs, there was no difference between the evoked OAEs of smokers and nonsmokers. We conclude that smoking had not yet measurably affected the ears of those with acute hearing (i.e., those who exhibit SOAEs). However, in ears without SOAEs, smokers exhibited smaller evoked OAE amplitudes than nonsmokers, even though their audiometric thresholds were within the norm.