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OBJECTIVE: Cochlear implant (CI) users frequently complain about speech quality perception (SQP). In patients undergoing cochlear implantation for single-sided deafness, there is concern that poor SQP from the implanted ear will negatively impact binaural (CI + normal hearing [NH]) SQP. In this study, we investigate if binaural SQP is measurably different than unimplanted NH alone. STUDY DESIGN: Cross-sectional study. SETTING: Tertiary care center. METHODS: Fifteen unilateral CI users with NH in the contralateral ear completed the validated Columbia Speech Quality Instrument. This instrument consists of 9 audio clips rated across 14 specific speech qualities using a 10-point visual analog scale. SQP was assessed in 3 conditions: CI only, NH only, and CI + NH. RESULTS: Median speech quality scores were worse in the CI only condition compared to the NH only (50.0 vs 72.6, P = .0003) and binaural (50.0 vs 71.0, P = .007) conditions. Median speech quality scores were not significantly different between the NH only and binaural conditions (72.6 vs 71, P = .8). Compared to NH, CI speech quality sounded less clear, less natural, and more mechanical. CONCLUSION: Compared to NH, SQP is poorer with a CI alone. However, in contrast to expectation, there is no significant difference between NH and binaural SQP. This suggests poorer CI speech perception does not negatively impact binaural SQP in patients undergoing cochlear implantation for single-sided deafness.
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BACKGROUND: Sheep have been proposed as a large-animal model for studying cochlear implantation. However, prior sheep studies report that the facial nerve (FN) obscures the round window membrane (RWM), requiring FN sacrifice or a retrofacial opening to access the middle-ear cavity posterior to the FN for cochlear implantation. We investigated surgical access to the RWM in Hampshire sheep compared to Suffolk-Dorset sheep and the feasibility of Hampshire sheep for cochlear implantation via a facial recess approach. METHODS: Sixteen temporal bones from cadaveric sheep heads (ten Hampshire and six Suffolk-Dorset) were dissected to gain surgical access to the RWM via an extended facial recess approach. RWM visibility was graded using St. Thomas' Hospital (STH) classification. Cochlear implant (CI) electrode array insertion was performed in two Hampshire specimens. Micro-CT scans were obtained for each temporal bone, with confirmation of appropriate electrode array placement and segmentation of the inner ear structures. RESULTS: Visibility of the RWM on average was 83% in Hampshire specimens and 59% in Suffolk-Dorset specimens (p = 0.0262). Hampshire RWM visibility was Type I (100% visibility) for three specimens and Type IIa (> 50% visibility) for seven specimens. Suffolk-Dorset RWM visibility was Type IIa for four specimens and Type IIb (< 50% visibility) for two specimens. FN appeared to course more anterolaterally in Suffolk-Dorset specimens. Micro-CT confirmed appropriate CI electrode array placement in the scala tympani without apparent basilar membrane rupture. CONCLUSIONS: Hampshire sheep appear to be a suitable large-animal model for CI electrode insertion via an extended facial recess approach without sacrificing the FN. In this small sample, Hampshire specimens had improved RWM visibility compared to Suffolk-Dorset. Thus, Hampshire sheep may be superior to other breeds for ease of cochlear implantation, with FN and facial recess anatomy more similar to humans.
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Implantación Coclear , Modelos Animales , Animales , Implantación Coclear/métodos , Ovinos , Hueso Temporal , Ventana Redonda/cirugía , Ventana Redonda/anatomía & histología , Implantes CoclearesRESUMEN
OBJECTIVE: In this study, we examine how impairments in vision, hearing, touch, and olfaction relate to depression in older adults, considering both individual and multisensory impairments (MSIs). STUDY DESIGN: Analysis of cross-sectional data from a longitudinal investigation involving black and white older adults aged 70 to 79 at enrollment. SETTING: We studied 1640 black and white participants in the Health ABC study using complete sensory evaluation data from years 3 to 5. METHODS: Our MSI assessment utilized data obtained for visual acuity, hearing perception, olfactory performance, and tactile function. We performed multivariable logistic regression analyses to examine the associations between the presence of individual and MSIs and depression which was defined as the presence of antidepressants prescribed for depression, or a Center for Epidemiological Studies Depression Scale score of greater than 10. RESULTS: We observed a possible dose-response relationship between the number of sensory impairments and depression. In adjusted models, when compared to no impairments, vision (odds ratio [OR] = 1.45, 95% confidence interval [CI]: 1.09-1.93) and hearing impairments (OR = 1.49, 95% CI: 1.11-1.99) were significantly associated with depression, whereas olfaction (OR = 1.11, 95% CI: 0.83-1.47) and tactile impairments (OR = 1.28, 95% CI: 0.96-1.70) were not. Participants with 3 sensory impairments had a higher rate of depression (OR = 2.05, 95% CI: 1.22-3.54) compared to those without impairments, and this risk increased further for those with 4 sensory impairments (OR = 2.95, 95% CI: 1.48-5.88). CONCLUSION: The findings suggest that individuals with MSI represent a high-risk population for depression, warranting close monitoring to screen for depression. The study emphasizes the importance of considering multiple sensory impairments in the context of mental health and supports the early identification and monitoring of depression in this population.
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Depresión , Humanos , Anciano , Masculino , Femenino , Estudios Transversales , Depresión/epidemiología , Trastornos de la Sensación/epidemiología , Trastornos de la Visión/epidemiología , Trastornos de la Visión/psicología , Estudios Longitudinales , Trastornos del Olfato/epidemiología , Trastornos del Olfato/psicologíaRESUMEN
OBJECTIVES: Social media plays an ever-growing part in modern life and is a frequent source of health information for patients. Singers are particularly likely to receive health information solely from fellow musicians and may experience barriers to seeking vocal healthcare. However, there have been no studies to date evaluating vocal health information on social media. Our study aimed to assess the quality, reliability, and accuracy of vocal health content on TikTok. STUDY DESIGN: Cross-sectional analysis. METHODS: Three searches were carried out on Tiktok, using the terms "vocal health," "vocal injury," and "voice tips." The top 50 videos in each category were cataloged for extraction of data and for analysis on three discrete scales. Two independent reviewers rated each video using the Global Quality Scale (GQS), modified DISCERN scale, and Accuracy in Digital-health Instrument (ANDI). RESULTS: After the removal of duplicates and unavailable content, 146 videos were analyzed. The mean (range) length was 59.8 seconds (5-239), and number of views per video was 886,265 (432-36,700,000). The vast majority of videos (94.5%) were created by non-clinicians; only two videos (1.37%) were posted by otolaryngologists. The mean (SD) GQS score was 2.34 (0.75) out of a maximum of five, the DISCERN score was 0.97 (0.56) out of five, and the ANDI score was 2.85 (0.87) out of four. Video length was positively correlated with GQS and DISCERN scores, but views, likes, and shares were either not associated or negatively associated with GQS, DISCERN, and ANDI. CONCLUSIONS: Most videos were of low quality and reliability and moderate accuracy. Measures of popularity were either uncorrelated or negatively correlated with quality, reliability, and accuracy, suggesting that TikTok users are more likely to engage with lower-quality content online. This implies a potential role for vocal health professionals to fill a crucial gap with reliable information on social media.
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Objectives: To analyze the association between neurocognitive performance and age-related hearing loss in the right and left ear, individually. Design: Subjects included 5277 participants (≥50 years) from the general Hispanic population who underwent audiometric testing in a US multicentered epidemiologic study. Linear regression was performed to assess the cross-sectional association between cognitive performance (Digit Symbol Substitution Test [DSST], Word Frequency Test, Spanish-English Verbal Learning Test [SEVLT] 3 Trials, SEVLT Recall, and Six-Item Screener) and hearing in each ear (4-frequency pure-tone average), adjusting for age, sex, education, cardiovascular disease, and hearing aid use. Results: Mean age was 58.4 ± 6.2 years; 3254 (61.7%) were women. Mean pure-tone averages were 20.2 ± 11.7 dB (right ear) and 20.2 ± 12.3 dB (left ear). Multivariable regression demonstrated significant associations between all cognitive tests and hearing loss in both ears. Conclusions: Worsening hearing loss in the right and left ear was associated with decreased performance across all tests. No laterality in the association was demonstrated.