Effects of cognitive tasks on eye movements.

Eye movements are guided by vestibular and visual information. The vestibulo-ocular knowledge of the vestibule includes eye movements in the opposite direction of head movements. This study investigated the effect of auditory "what" and "where" tasks on the visual "where" to evaluate the effects of cognitive tasks on eye movements. All subjects underwent testing with videonystagmography (VNG). The VNG battery of saccade and tracking oculomotor tests were performed. The study design was planned in three stages: (1) without any cognitive tasks, eye movements were recorded with VNG, (2) participants were asked to tell "what" sound they heard during VNG recording, and (3) the subject was asked to tell from what direction, or "where," the sound had come from during VNG recording. Providing individuals with a cognitive task changed the test results negatively in all parameters. Giving cognitive tasks to individuals spoils all VNG parameters. The VNG oculomotor tests are affected by the dual tasks. Daily tasks such as sound object localization and recognition have a significant effect on scanning the visual environment in daily life such as during driving or walking in a crowded environment.

Safety and Complications of Sedation Anesthesia during Pediatric Auditory Brainstem Response Testing.

OBJECTIVE: The auditory brainstem response (ABR) test has been widely used in childhood. Although it is a painless procedure, sedation can be needed in pediatric patients. Thus, this study aimed to evaluate safety and complications of sedation anesthesia applied in pediatric patients during ABR testing. METHODS: Medical records of 75 children who underwent ABR testing between 2018 and 2020 were evaluated retrospectively in terms of applicability, safety, and complications of sedation anesthesia. RESULTS: The ages ranged from 3 to 9 (mean 6.2) years. Comorbidity was detected in 20% (n = 15); 3 had multiple comorbidities, and the most common comorbidity was Down syndrome (4%). The drugs used in sedation anesthesia were midazolam in 81.3% (n = 61), a combination of propofol and ketamine in 14.7% (n = 11), and only propofol in 4% (n = 3) of the patients. An additional drug use was needed in 44% (n = 33). The mean procedure time was 40 (range 30-55) min. The mean anesthesia duration was 45 (range 35-60) min. The mean recovery time was 10 (range 5-15) min. Complications related to anesthesia developed in 4 (5.33%) of the patients; respiratory distress, agitation, cough, and nausea-vomiting were seen in one of the patients, respectively. Complications like bradycardia and respiratory or cardiac arrest were not seen at all. CONCLUSIONS: The complication rate of sedation anesthesia performed during ABR testing of pediatric patients is quite low. It may be more beneficial to use combinations of sedation drugs instead of using a single sedation drug. Although sedation anesthesia appears to be safe in general, the potentially life-threatening complications of sedative agents should be remembered, especially in children who have comorbidities.

Individualized Treatment of Tinnitus during Sleep Using Combined Tinnitus Signal and Music.

INTRODUCTION: Tinnitus is a widely seen otological symptom that interferes with daily activities and causes discomfort. Tinnitus treatments can be classified into 4 main groups: pharmacological treatments, cognitive and behavioral therapy, psychological treatments, and combined treatment approaches made up of at least 2 of these 3 treatment methods. OBJECTIVE: The aim of this study was to assess whether it would be possible to develop an individualized treatment method of tinnitus by application of a combined tinnitus signal and music during sleep. METHODS: Forty-three ears of 30 patients who had subjective tinnitus were included. The patients were evaluated using Tinnitus Handicap Inventory, Visual Analogue Scale, and Beck Depression Inventory. The psychoacoustic parameters of tinnitus, such as tinnitus frequency and loudness, and minimal masking levels, were determined. The patients were asked to select musical melodies that they liked. The tinnitus frequency of each patient was taken as the central frequency according to ANSI 2004. All sound files were prepared as stereo channels, with 16-bit resolution and 44,100 Hz sampling rate. The root mean square power value of the music and the band noise's average root mean square power value were equalized with the "Amplification" command, and 70% of the music and 30% of wide/narrow-band noise were mixed as a stereo channel by the "Mix Paste" command. The patients were instructed to listen to that individualized music/narrow-band noise (tinnitus signal) for 2 h during sleep for a duration of 6 months. RESULTS: Tinnitus frequencies of the patients measured prior to treatment and at the second, fourth, and sixth months of follow-up were not significantly different. A statistically significant decrease was seen in tinnitus loudness, minimal masking levels, and residual inhibition during the follow-up. Tinnitus Handicap Inventory scores decreased significantly during follow-up, and the number of patients who complained of tinnitus decreased (p < 0.05). The Visual Analogue Scale scores significantly decreased during follow-up (p < 0.05). Beck Depression Inventory scores decreased significantly during follow-up (p < 0.05). CONCLUSION: Stimulation of the auditory and limbic systems during sleep by the tinnitus signal combined with individualized musical melodies seems an alternative, effective, and cheap method in the treatment of tinnitus.

Effects of Craniosacral Osteopathy in Patients with Peripheral Vestibular Pathology.

INTRODUCTION: Vertigo appears as a result of a sudden neural activity imbalance of the vestibular system. The vertigo prevalence is higher in patients over 60 years of age compared to patients under 40 years of age. OBJECTIVES: The purpose of this study was to analyze the effect of craniosacral osteopathy on dizziness and balance in individuals who have peripheral vestibular pathology. METHODS: A total of 30 individuals, aged 24-50 years, participated in this study. Twenty-four of the participants were female (80%) and 6 were male (20%). The participants were separated into 2 groups, with 15 patients included in the cranial osteopathy treatment group (study group) and 15 patients included in the group that used dimenhydrinate (control group). The individuals were evaluated in terms of dizziness and balance. A visual analog scale was used to evaluate dizziness. Balance was evaluated using the Berg balance scale and the Activities-Specific Balance Confidence scale. The craniosacral treatment program was applied once per week for 6 sessions. All of the individuals included in this study were evaluated 3 times, i.e., prior to treatment, on the third week of treatment, and on the sixth week of treatment. RESULTS: Significant improvement was noted within each group in terms of dizziness and balance (p < 0.05). When the groups were compared with each other, it was observed that craniosacral osteopathy was more effective than dimenhydrinate treatment for dizziness and balance (p < 0.05). CONCLUSION: Craniosacral osteopathy is an effective treatment choice in individuals who have chronic peripheral vestibular pathology. In individuals who have resistant and chronic vestibular pathology, craniosacral osteopathy should be evaluated among the treatment choices.

Effects of Cochlear Implantation on Tinnitus and Depression.

INTRODUCTION: Tinnitus is prevalent in 66-88% of cochlear implant users. The reason for this high prevalence is that hearing impairment is the most common cause of tinnitus. OBJECTIVE: This study aims to determine the effect of cochlear implant and to compare the severity of tinnitus and depression in adult cochlear implant users with tinnitus. METHODS: Patients diagnosed with tinnitus filled out the Tinnitus Handicap Inventory and the Beck Depression Inventory during CI candidate evaluation. The audiological follow-up in the present study included only patients suffering from tinnitus before the cochlear implant surgery. This study included only patients who had tinnitus handicap inventory and Beck Depression Inventory clinical records pre- and postoperatively, including 23 adult cochlear implant users (13 males and 10 females) aged 18-76 years. RESULTS AND CONCLUSION: There was a statistically significant decrease in the severity of tinnitus and depression after cochlear implant. As the participants' tinnitus level and grade decreased, their depression levels also decreased. Depression levels decreased after the use of a cochlear implant compared to before cochlear implantation. Cochlear implantation is currently used only for hearing restoration. However, cochlear implantation may be used in rehabilitation for tinnitus in patients with severe hearing loss and in tinnitus patients. In addition cochlear implantation can be a depression rehabilitation method by reducing tinnitus.

Investigating the effects of subthalamic Nucleus-Deep brain stimulation on the voice quality.

Introduction: Deep brain stimulation (DBS) is a standard surgical treatment method which is generally applied to subthalamic nucleus in Parkinson's patients in cases where medical treatment is insufficient in treating the motor symptoms. It is known that Subthalamic Nucleus Deep Brain Stimulation (STN-DBS) treats many motor symptoms. However, the results of studies on speech and voice vary. The aim of the study is analysing the effect of STN-DBS on the characteristics of voice.Materials/methods: A total of 12 patients, (8 male-4 female) with an age average of 58.8 ± 9.6, who have been applied DBS surgery on STN included in the study. The voice recordings of the patients have been done prior to surgery and 6 months after the surgery. The evaluation of voice has been carried out through the instrumental method. The patients' voice recordings of the /a,e,i/ vowels have been done. The obtained recordings were evaluated by the Praat programme and the effects on jhitter, shimmer, fundamental frequency (F0) and noise harmonic rate (NHR) were analysed.Results: Numerical values of F0 of all female participants have been decreased for all of the vowels postoperatively. In the females; jhitter and fraction parameters were found to be significantly different (0.056 and 0.017, perspectively) for the vowel /e/. In addition, p values in the shimmer for vowels /e,i/ were thought to be clinically significant (.087, .079 and .076) respectively. All these changes in second measurements were found to indicate worsening vocal quality after the DBS in females. In males, there is not any significant difference observed between two measures in any of the parameters of any vowels.Conclusions: Acoustic voice quality deteriorated after STN-DBS predominantly for females however this deterioration was not prominent audio-perceptually. This finding commented as a result of the fact that that voice quality deviance of the participants was not severe.

Assessment of inflammatory markers in otosclerosis patients.

INTRODUCTION: Otosclerosis is an idiopathic disease characterized by new bone formation in foci of the human otic capsule. It is more common in Caucasian populations; affecting females twice as often as males. Its etiopathogenesis has not yet been fully elucidated. OBJECTIVE: The aim of this study was to investigate the relationship between otosclerosis and white blood cell and thrombocyte counts, mean platelet volume, neutrophil lymphocyte ratio, and the platelet lymphocyte ratio. METHODS: This retrospective case-control study was conducted in the outpatient clinic Mustafa Kemal University, in the department of otolaryngology, between 2015 and 2018. A total of 30 patients with an established diagnosis of otosclerosis were compared to a control group of 30 healthy subjects, matched for age, gender and body mass index. The white blood cell, thrombocyte, mean platelet volume, neutrophil lymphocyte ratio and platelet lymphocyte ratio values were calculated for all participants. RESULTS: There was no statistically significant difference between the groups with respect to age, gender, or body mass index, or for the mean neutrophil lymphocyte ratio, platelet lymphocyte ratio, white blood cell, or thrombocyte values (p>0.05). A statistically significant difference was determined between the groups for the mean platelet volume values. The mean platelet volume values were lower in the otosclerotic patients (p=0.047). CONCLUSION: These results show that neutrophil lymphocyte ratio, platelet lymphocyte ratio, white blood cell and thrombocytes should not be used to predict otosclerosis, but suggest that mean platelet volume may be a negative predictive marker.

Evaluation of the quality of life in adults with cochlear implants: As good as the healthy adults?

PURPOSE: The aim of this study was to compare the quality of life (QoL) of adult CI users with the QoL of adults in the healthy and normal-hearing population. MATERIALS AND METHODS: 31 patients with CIs were included in the CI group, and 31 normal-hearing subjects were included in the control group. The QoL was evaluated using the World Health Organization Quality of Life-BREF (WHOQOL-BREF) for all subjects. RESULTS: A comparison of the QoL of the CI group to that of the control group found that the QoL of healthy adults was better than that of the CI users. The results obtained for the subdomains of physical health, psychological health, and social relations showed statistically significant differences between the two groups (p < 0.05). There were no statistically significant differences between the groups in the subdomains of environment and general health (p > 0.05). CONCLUSIONS: The effect of a hearing disability on daily life continues after the CI. As expected, adults with CIs still face challenges in their daily lives due to the hearing impairment.

Evaluation of Hearing and Balance Functions of Patients with Sickle Cell Anemia.

INTRODUCTION: Sickle cell anemia is a disease characterized by a wide vaso-occlusive incident from micro-vascular incident to muscularactivity. The cochlear function can also get affected by this vaso-occlusion. OBJECTIVE: It is aimed at determining what kind of effects sickle cell anemia has on hearing and balance system. METHODS: This study has been conducted on 46 patients with sickle cell anemia and 45 healthy individuals. For all participants, their pure tone hearing thresholds and videonystagmography (VNG) findings have been determined in 17 frequencies between 125-16.000 Hz. RESULTS: All hearing thresholds between 125 and 16,000 Hz, pure tone averages of patients with sickle cell anemia have been found statistically significant to be higher than the corresponding values in the control group(p < 0.05). The normal hearing rate of patients with sickle cell anemia has been determined to be 71.1% conductive hearing loss (CHL) to be 4.4%, sensorineural hearing loss (SNHL) to be 22.2%, and mixed type hearing loss to be 2.2% in right ear; the normal hearing rate has been determined to be 71.1%, CHL to be 2.2%, SNHL to be 22.2%, and mixed type hearing loss to be 4.4% in left ear. Statistically significant difference has not been found between head shake, spontaneous nystagmus, optokinetic, tracking test batteries, static and dynamic positional tests used in VNG, saccade accuracy and saccade peak velocity, which are saccadic test findings of 2 groups. However, saccadic latency, which is a saccadic test finding, has been determined to be longer in patients with sickle cell anemia in comparison to the control group. CONCLUSION: While sickle cell anemia causes hearing deficits, it does not have any effect on the central or peripheral vestibular system.

Investigating the effect of STN-DBS stimulation and different frequency settings on the acoustic-articulatory features of vowels.

INTRODUCTION: Parkinson's disease (PD) is the second most frequent progressive neuro-degenerative disorder. In addition to motor symptoms, nonmotor symptoms and voice and speech disorders can also develop in 90% of PD patients. The aim of our study was to investigate the effects of DBS and different DBS frequencies on speech acoustics of vowels in PD patients. METHODS: The study included 16 patients who underwent STN-DBS surgery due to PD. The voice recordings for the vowels including [a], [e], [i], and [o] were performed at frequencies including 230, 130, 90, and 60 Hz and off-stimulation. The voice recordings were gathered and evaluated by the Praat software, and the effects on the first (F1), second (F2), and third formant (F3) frequencies were analyzed. RESULTS: A significant difference was found for the F1 value of the vowel [a] at 130 Hz compared to off-stimulation. However, no significant difference was found between the three formant frequencies with regard to the stimulation frequencies and off-stimulation. In addition, though not statistically significant, stimulation at 60 and 230 Hz led to several differences in the formant frequencies of other three vowels. CONCLUSION: Our results indicated that STN-DBS stimulation at 130 Hz had a significant positive effect on articulation of [a] compared to off-stimulation. Although there is not any statistical significant stimulation at 60 and 230 Hz may also have an effect on the articulation of [e], [i], and [o] but this effect needs to be investigated in future studies with higher numbers of participants.

Nasality evaluation of Turkish phonemes in vowel-consonant combinations.

OBJECTIVES: The purpose of this study is to find average nasalance values of Turkish syllables with the nasometer. METHODS: This study is done at Hacettepe University Department of Otolaryngology Audiology and Speech Pathology Unit with 50 participating children. RESULTS: The normative nasalance values of Turkish phonemes are determined. It is found that nasalance scores of syllables that is combined with/i/phoneme is statistically have higher nasalance scores than/a/and/e/phonemes (p<0.05). There is no difference find statistically between age and nasalance value (p>0.05). Statistical difference between age and nasalance score is found in "iki, se, ese, isi, aç, eç, çi, içi, iç, al, yi, iy, iyi, yiy, ana, ne" syllables (p<0.05). These phonemes have positive relation with the age. There is no statistical difference between sex and nasalance scores (p<0.05). Statistical difference is only found in "tat- te- li- lil- aya" syllables (p<0.05). On these phonemes it is found that girls have higher nasalance score than boys. CONCLUSION: As a result, it is thought that gathered nasalance values of Turkish phonemes will be useful for resonance disorder diagnosis and follow ups on treatment.