The Role of Religiosity and Spirituality in Helping Polish Subjects Adapt to Their Tinnitus.

This study aims to assess whether religiosity and spirituality might be significant internal resources that help people with tinnitus to adapt to their condition. The study group comprised 256 Polish patients with tinnitus (123 women and 133 men) who answered the Tinnitus Handicap Inventory and Tinnitus Functional Index (both of which measure tinnitus annoyance) and the Self-Description Questionnaire (which measures: religious attitudes, ethical sensitivity, and harmony). Significant positive correlations between religious attitudes and tinnitus annoyance were found in subjects with tinnitus. The higher the religiosity, the higher tinnitus the annoyance, at least in the two TFI questionnaire dimensions: sense of control and quality of life (although these correlations were statistically significant only for men). Religiosity was found to be a positive predictor of tinnitus annoyance. Also, ethical sensitivity positively predicted tinnitus annoyance, whereas harmony was a negative predictor. We suggest that psychologists and audiologists should, in their diagnostic and therapeutic work with patients with tinnitus, pay attention to the religious and spiritual aspects of their patients' lives.

Effects of training and using an audio-tactile sensory substitution device on speech-in-noise understanding.

Understanding speech in background noise is challenging. Wearing face-masks, imposed by the COVID19-pandemics, makes it even harder. We developed a multi-sensory setup, including a sensory substitution device (SSD) that can deliver speech simultaneously through audition and as vibrations on the fingertips. The vibrations correspond to low frequencies extracted from the speech input. We trained two groups of non-native English speakers in understanding distorted speech in noise. After a short session (30-45 min) of repeating sentences, with or without concurrent matching vibrations, we showed comparable mean group improvement of 14-16 dB in Speech Reception Threshold (SRT) in two test conditions, i.e., when the participants were asked to repeat sentences only from hearing and also when matching vibrations on fingertips were present. This is a very strong effect, if one considers that a 10 dB difference corresponds to doubling of the perceived loudness. The number of sentence repetitions needed for both types of training to complete the task was comparable. Meanwhile, the mean group SNR for the audio-tactile training (14.7 ± 8.7) was significantly lower (harder) than for the auditory training (23.9 ± 11.8), which indicates a potential facilitating effect of the added vibrations. In addition, both before and after training most of the participants (70-80%) showed better performance (by mean 4-6 dB) in speech-in-noise understanding when the audio sentences were accompanied with matching vibrations. This is the same magnitude of multisensory benefit that we reported, with no training at all, in our previous study using the same experimental procedures. After training, performance in this test condition was also best in both groups (SRT ~ 2 dB). The least significant effect of both training types was found in the third test condition, i.e. when participants were repeating sentences accompanied with non-matching tactile vibrations and the performance in this condition was also poorest after training. The results indicate that both types of training may remove some level of difficulty in sound perception, which might enable a more proper use of speech inputs delivered via vibrotactile stimulation. We discuss the implications of these novel findings with respect to basic science. In particular, we show that even in adulthood, i.e. long after the classical "critical periods" of development have passed, a new pairing between a certain computation (here, speech processing) and an atypical sensory modality (here, touch) can be established and trained, and that this process can be rapid and intuitive. We further present possible applications of our training program and the SSD for auditory rehabilitation in patients with hearing (and sight) deficits, as well as healthy individuals in suboptimal acoustic situations.

A simple qualitative scale for diagnosis of laryngopharyngeal reflux: high correlations with pH measurements and disease severity. The usefulness of the Warsaw Scale in LPR diagnostics compared to other diagnostic tools.

PURPOSE: Diagnosis and monitoring of laryngopharyngeal reflux (LPR) is a constant challenge in otolaryngological practice, chiefly because there are no specific symptoms characteristic of the disease. In this paper, we present the validation of a simple, 6-level qualitative scale to gauge the clinical findings of LPR. It has been previously published in Polish as the Warsaw Scale. METHODS: In the study, we enrolled 100 patients with voice problems who had registered in our clinic, and we performed an extended battery of diagnostic tests for LPR, together with 24-h pH monitoring. RESULTS: The Warsaw Scale significantly outperformed other instruments in both predicting LPR status and correlating with pH measurements. Moreover, the rating provided by the scale showed a strong association with patient-reported symptoms. CONCLUSION: The data indicate that the Warsaw Scale could be used as an affordable, consistent, and effective diagnostic and monitoring tool for LPR.

Polish version of the pediatric Voice Handicap Index (pVHI).

INTRODUCTION: The modern standard of voice diagnostics in both the adult and pediatric populations is based on perceptual, acoustic and videolaryngoscopic assessment, as well as self-assessment of voice quality. Currently, only two tools for assessing the voice in the pediatric population were translated into Polish: pVHI and its abbreviated version - cVHI (Children Voice Handicap Index). Thanks to the use of pVHI, the therapist and the patient, as well as his family and relatives, become aware of what functional zones are disturbed as a result of voice problems. AIM: The aim of the study was to analyze various methods of assessing children's voice, including the pVHI voice disability questionnaire in children with various voice disorders. In addition, the authors wanted to develop a classification of the degree of disability of children's voice expressed by the sum of points obtained in pVHI. MATERIAL AND METHOD: The study included a group of 89 children aged 5-12. Each child underwent a standard otolaryngological and phoniatric examination procedure with hearing assessment and fiberoscopic laryngeal evaluation. The voice of the dysphonic children was assessed with a spectrogram and the GRBAS scale. The children's guardians completed the Pediatric Voice Handicap Index (pVHI). RESULTS: Polish children without voice disorders obtained an average of 1.9 points as a total result of the pVHI questionnaire. The results of the questionnaire obtained from children with voice disorders were on average 24.7 (SD 13.9). Total and individual domain scores were significantly higher in children with dysphonia than in asymptomatic children. Children with voice disorders were rated an average of 1.95 (SD 0.6) degree of hoarseness in Yanagihara's scale, and obtained an average overall score of 4.8 on the GRBAS scale (SD 2). A common upward trend in all types of evaluation is evident, along with an increase in the handicap expressed in pVHI score. Statistical analysis showed significant dependence between the overall pVHI score and other voice rating indicators. The result correlated to a moderate degree with the sum of points obtained from GRBAS and the severity of hoarseness assessed subjectively (G) and objectively according to Yanagihara's scale. In addition, weak correlations of the functional part of the questionnaire with the presence of learning problems, and the emotional part with the presence of problems with socialization were noticed. Analyzing the results of the questionnaire depending on the GRBAS results and the Yanagihara scale, a better fit of the exponential trend line than the linear one was observed. The point of inflection of the exponential curve, and thus a significant deterioration in voice assessment indicators, was observed in children who obtained over 32 points, which is 33% of the maximum value that can be obtained from the questionnaire. CONCLUSIONS: A new voice assessment tool for the pediatric population has been developed that complements the diagnostic facilities of the otolaryngologist, phoniatrician and speech therapist. Adaptation of the Polish version of the Voice Handicap Index (pVHI) allows the introduction of a new diagnostic indicator into medical and speech therapy practice. The pVHI questionnaire result differentiates children with voice and speech disorders from healthy children. The analysis of children's voice using various methods allows the clinician to further characterize the disturbance of voice quality. It is possible to assess the scale of the severity and type of problem, as well as the spheres of life it concerns most. There is a correlation between the severity of voice disorders and the severity of voice disability expressed in the pVHI question.

Effect of yoga training on the tinnitus induced distress.

The study addressed the efficacy of 12 weeks of yoga training in treating 25 patients with chronic tinnitus. Ten of the patients underwent magnetic resonance imaging (MRI) before and after training. A control group comprised 13 people reporting chronic tinnitus. All participants were assessed with the Tinnitus Functional Index. After the 12-week yoga course, the areas considered to have benefited most were the sense of control of tinnitus, sleep, quality of life, and intrusiveness. The MRI studies indicated that connections in the white matter of the motor cortex appeared to be stronger as a result of training. Yoga training has good potential to improve the daily functioning of patients with chronic tinnitus and can be considered a promising supporting method for tinnitus treatment.

Radiologic measurement of cochlea and hearing preservation rate using slim straight electrode (CI422) and round window approach.

Hearing preservation surgery constitutes a considerable branch of cochlear implantation surgery and is being steadily developed and perfected. The aim of the study was to verify if insertion of a cochlear implant electrode according to individually calculated linear insertion depth improves hearing preservation. We evaluated the relations between the size of a cochlea, insertion depth angle, linear insertion depth and hearing preservation rate (HP) according to Hearing Preservation Classification in a retrospective case review of 54 patients implanted with a slim straight electrode Nucleus CI422 in 2008-2011. Group HP was 0.75 at activation, 0.67 at 12 months (for 53 patients) and 0.60 at 24 months. In 53 cases, the mean insertion depth angle was 375° (SD 17°); mean calculated cochlear duct length 35.87 mm (SD 1.95); mean calculated linear insertion depth 23.14 mm (SD 1.68). There was no significantly relevant relation between HP values and angular insertion depth or insertion depth. Preoperative measurements of cochlea and specific parameters such as linear insertion depth have no effect on hearing preservation. Poor hearing preservation in some deep insertion cases cannot be explained entirely by the electrode position.

Electroglottography in the diagnosis of functional dysphonia.

INTRODUCTION: Electroglottography (EGG) is the most commonly used method of indirect visual examination of vocal fold vibration. AIM: The study was conducted with an aim of assessing EGG quasi open quotient (QOQEGG) in different functional dysphonias to develop a differential diagnosis. The second aim was to check the influence of articulation on QOQEGG values. MATERIAL AND METHODS: There were 20 people without voice problems, 20 patients with hypofunctional dysphonia and 20 patients with hyperfunctional dysphonia included in the study. Electroglottography was recorded during comfortable sustained phonation of [a], [e], [i], [o], [u]. RESULTS: There were no statistically significant differences in QOQEGG observed during phonation of different vowels in the control group and patients with hyperfunctional dysphonia. In patients with hypofunctional dysphonia, significantly higher values of QOQEGG were observed during [a] and [e]. Both in the control and in studied groups vowel [i] was vocalized significantly quieter. CONCLUSIONS: To conclude, EGG can be useful in differential diagnosis of functional dysphonia. QOQEGG is a parameter differentiating hypofunctional dysphonia from hyperfunctional dysphonia. Dissimilarities in articulation of different vowels in patients with various types of dysphonia influence values of QOQEGG. EGG study protocol in cases of functional dysphonia should include a comparison of [a], [e], [i] vowels.

Preservation of cochlear structures and hearing when using the Nucleus Slim Straight (CI422) electrode in children.

OBJECTIVE: In cochlear implantation, there are two crucial factors promoting hearing preservation: an atraumatic surgical approach and selection of an electrode that does not damage cochlear structures. This study aimed to evaluate hearing preservation in children implanted with the Nucleus Slim Straight (CI422) electrode. METHODS: Nineteen children aged 6-18 years, with partial deafness, were implanted using the 6-step Skarzynski procedure. Electrode insertion depth was 20-25 mm. Hearing status was assessed with pure tone audiometry before surgery, and at 1, 5, 9, 12 and 24 months after surgery. Electrode placement was confirmed with computed tomography. RESULTS: Mean hearing preservation in the study group at activation of the cochlear implant was 73 per cent (standard deviation = 37 per cent). After 24 months, it was 67 per cent (standard deviation = 45 per cent). On a categorical scale, hearing preservation was possible in 100 per cent of cases. CONCLUSION: Hearing preservation in children implanted with the Nucleus CI422 slim, straight electrode is possible even with 25 mm insertion depth, although the recommended insertion depth is 20 mm. A round window approach using a soft, straight electrode is most conducive to hearing preservation.

Idiopathic sudden sensorineural hearing loss: cardiovascular risk factors do not influence hearing threshold recovery.

Previous studies have suggested that risk factors for ischaemic vascular disease, such as cigarette smoking, hypertension and hyperlipidaemia, can also be considered risk factors for the development of idiopathic sudden sensorineural hearing loss (ISSNHL). In this study, we have evaluated the hypothesis that these factors can influence hearing threshold recovery in patients affected by ISSNHL. A total of 141 subjects who suffered an episode of ISSNHL were included. All subjects were assessed with tonal audiometry, auditory brainstem responses and MRI to exclude retrocochlear pathology. Hearing tests were conducted at ISSNHL onset (t = 0) and after 30 days. Patients were divided into three classes according to the presence/absence of one or more cardiovascular risk factors including: history of smoking, total serum cholesterol/triglycerides, history of hypertension and diabetes mellitus. Values of hearing threshold recovery were estimated and comparisons were conducted across the three risk factor classes. 75% of patients affected by ISSNHL showed a threshold recovery. However, the threshold recovery was found to be class-independent (average recovery value of 18 dB HL per classes) and also independent of age and gender. Even if cardiovascular risk factors have been found to be involved in the pathogenesis of ISSNHL, the present study suggests that these factors do not have any significant influence on the threshold recovery in ISSNHL.

Genetics of presbycusis and presbystasis.

Presbycusis and presbystasis represent relevant problems of aging, caused by the increase in life expectancy in developed countries. As such, it is advantageous to better understand the physiopathological mechanisms of these age-related inner ear diseases. The hypothesis that presbycusis and presbystasis have a genetic background was proposed some years ago. Several studies (in humans and animals) are available in the literature, and possible genes involved in the physiopathology of both diseases have been identified. The aim of this paper is to present an overview of the information available in the current medical literature on presbycusis and presbystasis.

Deep insertion - round window approach by using SRA electrode.

Hearing preservation surgery requires specially a traumatic technique. Having some preoperative anatomical data of the size of patient's cochlea surgeon can design his or her insertion depth. In the study we have evaluated a relation between hearing preservation rate and angular insertion depth estimated intraoperatively and postoperatively having measured insertion angle from radiological assessment and calculations given by Escude. There has not been no statistically significant difference between insertion depth angle, either estimated intraoperatively and measured and calculated post-operatively, and hearing preservation rate in the group. This analysis confirms a traumaticy of insertion in hearing preservation surgery.

Identifying congenital hearing impairment: preliminary results from a comparative study using objective and subjective audiometric protocols.

To compare objective and subjective protocols assessing hearing loss in young children and evaluate frequency-specific hearing impairment through a comparison between auditory steady state responses (ASSR), auditory brainstem responses (ABR), transient otoacoustic emissions and conditioned orientation reflex responses (COR). Thirty-five hearing-impaired children (20 male and 15 female), aged between 14 months and 4 years, participated in the study. Hearing threshold levels and peripheral auditory function were assessed by measurements of ABR, ASSR, otoacoustic emissions and COR. The analysis of the COR and ASSR variables showed significant correlations in the majority of tested frequencies. The data highlight a characteristic of the COR procedure, which is an underestimation of the hearing threshold in comparison to the ASSR estimate. The data show that the COR threshold assessment follows the pattern of the other two established electrophysiological methods (ABR, ASSR). The correlation analyses did not permit evaluation of the precision of these estimates. Considering that the ASSR variables show a better relationship with ABR (higher correlation values) than COR, it might be advantageous to utilize the ASSR to gain frequency-specific information.

Automatic removal of sonomotor waves from auditory brainstem responses.

We have developed a computerized technique for automatic detection and removal of sonomotor waves (SMWs) from auditory brainstem responses (ABRs). Our approach is based on adaptive decomposition using a redundant set of Gaussian and 1-cycle-limited Gabor functions. In order to find optimal parameters and evaluate the efficiency of the methods, simulated data were first used before applying it to clinical data. Results were good and confirmed by an expert with years of clinical experience in ABR evaluation.

Troublesome tinnitus in children: epidemiology, audiological profile, and preliminary results of treatment.

Introduction. Although tinnitus often has a significant impact on individual's life, there are still few reports relating to tinnitus in children. In our tinnitus clinic, children with distressing tinnitus constitute about 0,5% of all our patients. Objectives. The aim of this study was to analyse children with troublesome tinnitus as regards epidemiology, audiological profile, and preliminary effects of the therapy. Methods. A retrospective study was carried out involving the cases of 143 children consulted in our Tinnitus Clinic in 2009. The selected group with troublesome tinnitus was evaluated and classified for proper category of Tinnitus Retraining Therapy (TRT). Results. The study showed that 41.3% of the children suffered from bothersome tinnitus. In this group 44.1% of the patients demonstrated normal hearing. The success of the therapy after 6 months was estimated on 81.4% of significant improvement. Conclusions. It is recommended that a questionnaire include an inquiry about the presence of tinnitus during hearing screening tests.

Music perception in electric acoustic stimulation users as assessed by the Mu.S.I.C. test.

AIMS: This study compared the music perception abilities of 13 electric acoustic stimulation (EAS) users with two control groups: unilateral cochlear implant (CI) users and normal-hearing (NH) listeners. METHODS: Groups were matched according to age and musical experience before hearing loss (HL) and tested using the Musical Sounds in Cochlear Implants (Mu.S.I.C.) test. RESULTS: No difference was found on rhythm perception, chord discrimination, dissonance rating, and emotion rating subtest performance between groups. Mean frequency discrimination scores were significantly better in EAS participants than in CI participants and not significantly worse than in NH participants. However, the EAS and CI groups scored similarly (significantly worse than NH participants) on both instrument detection and identification. Results for EAS participants were not significantly worse when the hearing aid component was removed. Frequency of listening to music before HL was negatively correlated with EAS participants' frequency discrimination scores, though singing and playing an instrument appeared to have no effect. EAS participants who indicated many reasons for listening to music and who listen to many genres after implantation scored higher on instrument detection and instrument identification. Better results on these two subtests were correlated with EAS participants' better postoperative auditory thresholds at 250 and 500 Hz. CONCLUSIONS: Though EAS participants performed better on music perception testing (though not timbre-based tasks) than CI participants, their scores did not reach the level of NH participants. This indicates that acoustic hearing in the low frequencies is helpful for music perception, though not the only important factor.

[Event-related potentials - an objective tool for assessment of the speech understanding process. II. Syntactic potentials (ELAN, P600)].

Investigations into electrophysiological potentials reflecting the process of grammatical analysis of the speech structure revealed a positive wave with the latency of 600 ms and maximum amplitude within the parietal region (P 600 wave). Presumably, this wave can reflect some consciously controlled processes of re-analysis and correction of grammatical and syntactic inconsistencies. It can be used for the diagnosis of speech disorders.

The size of selected human skull foramina in relation to skull capacity.

An anatomical study was undertaken in order to investigate whether the sizes of selected human skull foramina with significant venous compartments correlated significantly with skull capacity. A total of 100 macerated human skulls were examined to determine the diameter of the foramina and the skull capacity. Measurements of the surface area of the foramina were made using a computerised digital analysis system. Only the size of the hypoglossal canal and jugular foramen were found to correlate significantly with the capacity of the skull. This correlation, together with the considerable size of the hypoglossal canal, indicated its important role in the venous drainage of the brain. There was considerable centralisation of venous outflow from the brain, with 60% of the area of all venous foramina of the skull occupied by jugular foramina. Asymmetry between the right and left jugular foramina was identified, with an average ratio of 1.6 (ranging between 1 and 3.47). In the case of right-sided domination the correlation between the skull capacity and the size of both jugular foramina was negative (the larger the skull cavity, the less the asymmetry), while in the case of left-sided domination the correlation was positive. Perhaps the left-sided domination is less advantageous for the haemodynamics of blood outflow, as the left brachiocephalic vein is longer and is often compressed by the sternum and aortic arch.

Open-set speech perception in adult cochlear implant users with ossified cochleae.

This study describes open-set speech recognition in cochlear implant subjects with ossified cochleae and compares it to a control group with open cochleae. Twenty-one postlingually deafened adults with a Med-El Combi 40/40+GB split- electrode implant were matched to patients using a Med-El cochlear implant with a standard electrode. Speech recognition was assessed over an 18-month period. Split- electrode patients improved significantly over time, but their scores were significantly lower and increased significantly slower than those of controls. Of 14 patients with a duration of deafness less than 20 years, average sentence test scores were 50%, and average monosyllabic word test scores were 31%. This study provides evidence that cochlear implantation is beneficial to patients with ossified cochleae, but early implantation is advisable.