RESUMO
Persistent otorrhoea is a common issue for both children and adults, which can be caused by leakage of cerebrospinal fluid from the lateral skull base. Bacterial superinfection of the chronically humid middle ear, arising from continuous cerebrospinal fluid leakage, may contribute to an atypical clinical presentation. That is, otogenous cerebrospinal fluid leakage may mimic serious otitis media with concomitant conductive hearing loss, leading to a serious diagnostic delay in some patients. On the basis of three cases with cerebrospinal fluid leakage, resulting in persistent otorrhoea, we underline the importance of its timely diagnosis and treatment.
Assuntos
Diagnóstico Tardio , Otite Média , Adulto , Vazamento de Líquido Cefalorraquidiano , Otorreia de Líquido Cefalorraquidiano/diagnóstico , Otorreia de Líquido Cefalorraquidiano/etiologia , Criança , HumanosRESUMO
Cochlear implants are largely unable to encode voice pitch information, which hampers the perception of some prosodic cues, such as intonation. This study investigated whether children with a cochlear implant in one ear were better able to detect differences in intonation when a hearing aid was added in the other ear ("bimodal fitting"). Fourteen children with normal hearing and 19 children with bimodal fitting participated in two experiments. The first experiment assessed the just noticeable difference in F0, by presenting listeners with a naturally produced bisyllabic utterance with an artificially manipulated pitch accent. The second experiment assessed the ability to distinguish between questions and affirmations in Dutch words, again by using artificial manipulation of F0. For the implanted group, performance significantly improved in each experiment when the hearing aid was added. However, even with a hearing aid, the implanted group required exaggerated F0 excursions to perceive a pitch accent and to identify a question. These exaggerated excursions are close to the maximum excursions typically used by Dutch speakers. Nevertheless, the results of this study showed that compared to the implant only condition, bimodal fitting improved the perception of intonation.
Assuntos
Implantes Cocleares , Correção de Deficiência Auditiva/psicologia , Sinais (Psicologia) , Auxiliares de Audição , Pessoas com Deficiência Auditiva/reabilitação , Percepção da Altura Sonora , Inteligibilidade da Fala , Percepção da Fala , Estimulação Acústica , Adolescente , Audiometria de Tons Puros , Audiometria da Fala , Limiar Auditivo , Estudos de Casos e Controles , Criança , Discriminação Psicológica , Feminino , Humanos , Idioma , Masculino , Emissões Otoacústicas Espontâneas , Pessoas com Deficiência Auditiva/psicologia , Reconhecimento Psicológico , Acústica da FalaRESUMO
The aims of the study were to investigate whether sound localization acuity improved when children with 1 cochlear implant use a hearing aid in the contralateral ear (bimodal fitting), and whether this enabled them to benefit from a binaural masking level difference. Four different noise bursts were used as stimuli for a minimal audible angle localization test. On average, localization acuity remained poor with the cochlear implant alone, but also with bimodal fitting. A significant benefit of bimodal fitting was only shown when the most complicated stimulus with roved amplitude and spectrum was presented (minimal audible angle of 151 degrees with bimodal fitting vs. 175 degrees with cochlear implant alone). No significant binaural masking level difference was found between the cochlear implant alone and the bimodal condition.
