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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.
To demonstrate that Blu-tack is equally effective at attenuating sound as over-the-counter ear plugs.
Methods:
Nineteen healthy volunteers had their hearing thresholds assessed before and after the insertion of over-the-counter ear plugs. The results were compared with hearing thresholds following the insertion of Blu-tack. Thresholds were tested at: 0.5, 1, 2, 3, 4, 6 and 8 kHz. The differences were compared, and p values of less than 0.02 were regarded as significant. Using a visual analogue scale, volunteers were asked to assess the comfort and ease of insertion of the ear plugs and Blu-tack, and their peace of mind whilst using the ear plugs and Blu-tack.
Results:
Blu-tack was less effective at attenuating sound at low frequencies, but was as effective as over-the-counter ear plugs at attenuating sound above 3 kHz. Blu-tack was significantly more comfortable to wear (p = 0.006). There was no difference in terms of ease of insertion and peace of mind.
Conclusion:
Blu-tack can be regarded as a comfortable alternative to over-the-counter ear plugs for the attenuation of everyday sound.
To report clinical data from six centres in the US, Western Europe and Asia which have used phase-shift sound wave cancellation for treatment of predominant tone tinnitus, from the first treatment in 2000 to 2009.
Method:
Clinical data were obtained from New York City, London, Erie (Pennsylvania, USA), Antwerp, Grottamare (Italy) and Kuala Lumpur, and summarised.
Results:
A total of 493 patients were treated. A reduction in tinnitus volume (defined as ≥6 dB) was seen in 49–72 per cent of patients.
Otolaryngology is one of the surgical specialities employing high-powered instruments and this study was designed in order to establish whether sound levels at work conform to HSE guidelines. No study to date has measured intra-operative noise levels in ENT operation theatres. A prospective observational study was therefore performed. Sound levels were measured during the use of bone drills for mastoid surgery and microdebriders for endoscopic sinus surgery. A SLM/IS Acos Class I sound level meter calibrated to BS 1259 was employed. A spectrum analysis of drill-generated noise was measured using a calibrated B and K precision sound level meter. Sound levels emitted varied as follows: Large burrs- 72.4 dB (A), medium size; 71.2 dB (A), small sized burrs- 68.8 dB (A) (all values for cutting burrs) and 60.8 dB (A) for diamond burs. With microdebriders, the average sound level was 60.1 dBA. Spectrum analysis revealed that the maximum intensity was at 3.15 kHz, followed by 4 kHz, while the least sound was produced at 40 kHz and 31.5 kHz. Essentially sound produced by drills was between 1.6 kHz and 6.3 kHz. Powered instruments used in ENT surgery are safe and pose no occupational hazard.
Tinnitus retraining therapy has been heralded as a major advance in the alleviation of tinnitus perception. A cornerstone of this technique is to use white noise produced by a white noise generator (WNG) over a period of several months in order to assist the patient to habituate to their tinnitus. There are three factors which influence the frequency spectrum of the perceived noise such that the perception of white noise from a WNG is unlikely. These factors are the actual spectrum of the emitted noise, the ear canal resonance of the patient and the hearing sensitivity of the patient.
Advocates of tinnitus retraining therapy state that white noise is the optimal stimulation to assist habituation of tinnitus. This paper demonstrates that this optimal situation is unlikely to be achieved and that this may account for the long periods needed for patients to achieve benefit from the technique. The development of devices that allow for the above factors to be countered is suggested.
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