International Conference and Expo on Audiology and Hearing Devices August 17-18, 2015 Birmingham, UK

Biography:

Max Stanley Chartrand serves on the advisory committees to the American Tinnitus Association, the Better Hearing Institute, Audiology Online, and is a professional member of the Society of Behavioral Medicine, on the Federal & State Advocacy Committee of the International Hearing Society, and the Advisory Committee for the Arizona Division of Hearing Aid Dispenser Licensing. He is also a professor of Behavioral Medicine and has served on numerous doctoral research committees relative to human health and the hearing sciences. In 1994, he was recipient of the Joel S. Wernick Excellence in Education Award, and has published and lectured extensively throughout the world over the past four decades. At age 3 he became severely hearing impaired and later profoundly deaf. He utilized hearing aid and assistive technology for many years until cochlear implant technology and assistive devices were advanced enough to accommodate his profound deafness. He believes that there has never been a time that communicative options and amplification technologies have been more accessible, more attractive, and more affordable than they are today. His findings are that the market has grown exponentially faster than the industry’s ability to accommodate it. Now, he says, is the most exciting and empowering time to be in the hearing health—the good that can be done is immeasurable and so vital to the well-being of so many hearing loss sufferers and their families.

Abstract:

ABSTRACT Hearing care professionals and hearing aid manufacturers still report untenable levels of remakes, returns for credit, and cases of failure to fit for a variety of reasons. Hearing aid discomfort, own-voice artifacts, and cost/benefit perceptions top the list of reported reasons.1,2, 3,4In the present study, the status of the keratin or corneum stratum in the external auditory canal (EAC) has been found to negatively or positively affect hearing aid adaptation.5,6 These include keratin’s role in preventing oversensitivity in EAC mechanoreceptors (hair follicles, Meissner corpuscles and Pacinian corpuscles) and their subsequent neuroreflexes (Arnold’s Branch, Trigeminal, and Lymphatic Reflex), which affect own-voice perception, insertion and removal, wearing comfort, and coupler adaptation.1,7,8 STUDY PROFILE The Problem • Challenges due to missing or disrupted EAC keratin present obstacles to successful adaptation to wearing hearing aids • Because this is difficult to address adequately at the patient care level, too many new hearing aid users complain of discomfort, own-voice artifacts, and fail to accept their hearing aids • This perpetuates the problem of an unsustainable number of remakes and returns for credit (RFC), too many cases of failure to fit and subsequent delay in obtaining hearing correction Research Question: “How might clinicians identify keratin status and provide counsel relative to effects of hypersensitivity of the EAC neuroreflexes during hearing aid fitting and adaptation process?” Study Design: Bivariate correlational, retrospective file study, 45-day timeline, utilizing best practice standards Participants: 98 new hearing aid users, aged 29-95, 62 males, 36 females, selected randomly from 435 files at a hearing health/occupational therapy practice in Southern Colorado Materials: Patient files, Participant Data Sheet, Rating Scale for Keratin Status & Hearing Aid Adaptation, HIPAA Informed Consent Form, Notice of Privacy Policy, In-house Shipping & Logging Records Ethical Considerations: Observation of all federal, state, and local laws governing dispensing of hearing aids; Participants previously signed Informed Consent forms, HIPAA forms; IRB Review (Northcentral University) Hypotheses: • Ho: Keratin status of the EAC has no positive relationship with successful adaptation to wearing hearing aids. • Ha: Keratin status of the EAC is closely associated with success in physically adapting to wearing hearing aids. Measures Ratings of EAC Keratin Status (Likert-type scale 1-3): • Level 1: Absent/peeled keratin • Level 2: Thin or granulated keratin • Level 3: Moderate, thick keratin (w/ spaced desquamation lines) Ratings for hearing aid adaptation success (Likert-type scale 1-5): • Level 1: Failure to Fit/Complete RFC • Level 2: Exchange or one-sided RFC • Level 3: Remake/problems adapting • Level 4: In-office modifications • Level 5: Adaptation without difficulty

Biography:

Mashudu Tshifularo is an academic Professor and HOD, ENT specialist medical doctor. He was appointed at the University of Pretoria Republic of South Africa (RSA), ENT department and Steve Biko Academic Hospital as a Professor and Chief Specialist. He is running Cochlear Implant Unit in Steve Biko Academic Hospital, for the disadvantaged community state funded unit. He is passionate about Innovation in the Audiology – Medical devices development.

Abstract:

Otosclerosis and genetics among South African Blacks. An epidermiological study and hearing devices. Presentation of PhD work and new concept in stapes surgery and stapes prosthesis. Innovate new stapes prosthesis.

Biography:

Max Stanley Chartrand serves on the advisory committees to the American Tinnitus Association, the Better Hearing Institute, Audiology Online, and is a professional member of the Society of Behavioral Medicine, on the Federal & State Advocacy Committee of the International Hearing Society, and the Advisory Committee for the Arizona Division of Hearing Aid Dispenser Licensing. He is also a professor of Behavioral Medicine and has served on numerous doctoral research committees relative to human health and the hearing sciences. In 1994, he was recipient of the Joel S. Wernick Excellence in Education Award, and has published and lectured extensively throughout the world over the past four decades. At age 3 he became severely hearing impaired and later profoundly deaf. He utilized hearing aid and assistive technology for many years until cochlear implant technology and assistive devices were advanced enough to accommodate his profound deafness. He believes that there has never been a time that communicative options and amplification technologies have been more accessible, more attractive, and more affordable than they are today. His findings are that the market has grown exponentially faster than the industry’s ability to accommodate it. Now, he says, is the most exciting and empowering time to be in the hearing health the good that can be done is immeasurable and so vital to the well-being of so many hearing loss sufferers and their families.

Abstract:

Objective: To help attendees integrate concepts of cognitive health issues of hearing impaired older adults into hearing health practice, while educating the larger allied professional community on the need for correction of hearing impairment in older adults. Learning Outcomes: 1) Explore the interaction of symptoms of hearing loss and Alzheimer's disease in older adults. 2) Understand the difficulties that arise when undetected hearing loss causes misdiagnoses/over-diagnoses of Alzheimer's in older adults. 3) Gain the skills in taking case history, fitting and dispensing hearing instruments, and counseling the hearing impaired and family members in cases where AD is suspected. 4) Effectively communicate with the larger allied professional healthcare team of the need for evaluation and resolution of hearing loss before concluding mental health diagnoses.

Background: Alzheimer's disease is a degenerative syndrome of cognitive and psycho-[social behaviors that, in many cases, is often difficult to diagnose. There is rising concern within the hearing health community that undiagnosed, untreated hearing loss combined with normal aging factors are driving a sizable portion of the increase in Alzheimer's diagnoses among today's older adults. Despite the many studies already indicating a strong correlation between the behaviors of hearing loss and cognitive dysfunction, there appears to be no substantial movement within the mental health field to require the assessment and mitigation of auditory limitations before concluding mental health diagnosis in older adults. This course will explore not only the need for correction of hearing loss in older adults, but also that such correction can bring improvements in mental health status, including such functions as short-term memory, cognition, and personal well-being. It will also show how dispensing professionals may: 1) detect and discuss auditory/cognitive concerns during the case history and audiometric examination, 2) work optimally with such individuals in achieving best-aided condition within a comprehensive auditory rehabilitative plan, and 3) interact within the larger community health care team, including referral and educating local mental health professionals about hearing loss and its cognitive and effects upon older adults. An updated literature review will accompany handout material, as well as aids for the professional dispenser to utilize within a best practice standards framework.

Biography:

Peter L Nagy has received his MD degree from the University of Pecs, Hungary in 1989. He has obtained his PhD at Purdue University in Biochemistry under the mentorship of Dr Howard Zalkin and his Anatomic and Molecular Genetic Pathology training at Stanford University working on the MLL gene with Michael Cleary and Roger Kornberg. His research is on neurodegenerative disorders like ALS and young adult onset ataxias (AOA2). He built and oversees the clinical next-generation sequencing facility in the Laboratory of Personalized Genomic Medicine at Columbia University Medical Center.

Abstract:

Our Laboratory of Personalized Genomic Medicine (LPGM) at Columbia University Medical Center started to offer clinical whole exome sequencing (WES) in January 2013. We processed and issued reports on over 500 constitutional cases including approximately 70 cases involving hearing loss. Next-generation sequencing in the clinical practice allows for a critical review of the literature describing the pathogenicity of specific mutations or the disease relatedness of specific genes and also provides an important discovery tool for new disease genes and disease causing mutations. Because of the large volume and complex nature of the data obtained from large panels and whole exome sequencing testing, the management of the data in a transparent, yet powerful analytical framework is the key to a successful clinical operation. We have provided diagnosis for constitutional patients in about one third of the cases we analyzed. The full potential for discovery of new disease associated genes and disease causing mutations can only be realized if there is a tight collaborative effort between the clinicians performing the interpretation and structural biologists and analytical chemists and cell biologists who can help predict and verify the effects of variants identified.

Biography:

King Chung is an Associate Professor of Audiology at Northern Illinois University. She has been leading students onto humanitarian research and service trips every summer. Past destinations include Taiwan, Hong Kong, Brazil, China, and Cambodia. A researcher at heart, she publishes information on the hearing systems in the visited countries/regions and the hearing status of individuals tested during the trips to raise the awareness of the great demand for hearing services in different countries. The long term goal is to facilitate the provision of frequent and high quality hearing services to underserved and unserved populations around the world.

Abstract:

Transient noise reduction (TNR) algorithms implemented in hearing aids are not well-understood or studied. The purposes of this study were to examine the amount of noise reduction provided by 3 TNR algorithms and the spectra characteristics of speech at the hearing aid outputs. Eight different transient noises were recorded in real-life environments approximately 1 meter away from the sources. Three hearing aids were programmed to have 1) flat frequency responses with linear amplification, 2) flat frequency responses with 3:1 amplification, and 3) NAL prescription for people with mild to moderately-severe hearing loss, when they were worn on a manikin. Transient noises and HINT sentences were then presented at 0° azimuth of the manikin in a sound field. Hearing aid outputs were recorded in the TNR ON or OFF condition. The levels of the recorded transient noises were calculated and the spectral characteristics of the recordings were compared in the ON and OFF conditions. Results showed that one hearing aid consistently provided high levels of noise reduction for all 8 noises but it reduced the high frequency energy in most of the recordings. The second hearing aid was inconsistent in reducing the noises and it only reduced the high frequency energy in a few recordings. The third hearing aid provided negligible amount of noise reduction or high frequency reduction. No consistent effect of compression or frequency response was observed. These results highlight the need to design consistently effective TNR algorithms without affecting the spectral characteristics of the signal.

Biography:

Vural Fidan has recieved his MD and PhD in Hacettepe University. He is the Deputy Director of ENT department. He is an Otorhinolaryngologist at Yunus Emre Goverment Hospital. He has worked as a Visiting Scientist at Yale University ENT and Allegry departments. He has more than 20 SCI indexed articles. His Research interests are pulmonary hypertension, allergy, otology, rhinology and sleep medicine.

Abstract:

Tinnitus is generally resulted by expression of neural plasticity evoked by deprivation of auditory input. The hearing aids makes the patient less aware of the tinnitus and it helps communication in tinnitus patients. Hearing loss reduces stimulation from sounds. Hearing aids help enough activation of the auditory nervous system to reduce the tinnitus perception so they have an impact on tinnitus by restoring neural function. We studied on 25 patients to investigate the effect of hearing aids on tinnitus. 60% of patients said that their tinnitus were absent and 36% of them said that their tinnitus were decreased. Only 4% said that his tinnitus was not changed. As a result hearing aids should be used to both ears to take the best results.

Biography:

Madhup Chaurasia is a Senior Consultant ENT surgeon with United Lincolnshire Hospitals NHS Trust. He qualified from University of Jaipur, India and did his surgical training at University Hospitals NHS Trust Glasgow. He specialises in the field of Otology and Rhinology and his interests are focussed on Early Childhood Hearing Loss which has been the subject of his research and contributions to the development of the National Hearing Screening Programme. He also has a special interest in Noise Induced Hearing loss and regularly does many reports as expert witness, both for the claimants and defendants. In this presentation, he will focus on some of the complexities of the subject.

Abstract:

Abstract Damage to the inner ear as a result of noise exposure is a common occupational hazard and leads to numerous claims. The purpose of this presentation is to outline and discuss the criteria that confirm noise induced hearing loss in relation to the audiograms and the quantity of noise exposure, based on randomly selected cases from the authors’ reports. Characteristics of tinnitus related to hearing loss are described and the degree of disability associated with severity of tinnitus and hearing loss is discussed. Illustrations of borderline cases are presented and methods to reach conclusions are elaborated with examples of cases that are difficult to diagnose. The presentation includes a general guidance to make reports for noise induced hearing loss

Biography:

Somia Tawfik is a Professor of Audiology at Ain Shams University, Cairo, Egypt. She graduated from the Faculty of Medicine at Ain Shams University in 1978 and received her Master’s (1982) and Doctorate (1986) degrees at the same university. She has many publications in the area of Central auditory evaluation & development of Arabic material for central auditory testing in adults & children and shared in development of an Arabic computer-based material for remediation of children with central auditory processing disorders. She has good clinical experience in evaluating and remediating patients with different hearing disorders, especially children with auditory neuropathy. She had been the Director of the audiology unit, Ain Shams University for twelve years (1998-2010) and got two grants and organized many local and international conferences. Presently, she is a member of the International Association of Physicians in Audiology, the Egyptian Audio-Vestibular Medicine Association and the Egyptian Society of Oto-rhino-laryngology. She is reviewer of the Egyptian Journal of Ear, Nose and Throat and Allied Sciences and Journal of the American Academy of Audiology. Her present research focuses on new horizons in central auditory testing such as speech-evoked potentials in children with central auditory processing disorders and language disorders. She also shares in research on hearing aids, vestibular testing and rehabilitation of hearing-impaired children and central auditory testing in elderly.

Abstract:

Most of the training programs for cochlear implant recipients focus on the role of pitch and loudness for verbal communication. Unfortunately, the role of temporal aspects of auditory stimuli and the phonemic abilities in the training programs of CI children were not explored. This study was designed to explore the value of applying a computer-based training that was developed by audiology unit, Ain Shams University in Arabic language to improve temporal processing and phonemic awareness abilities. This program was applied on 33 CI children (Nucleus 24) with a minimum of one year of device use. Children received regular sessions twice /week for three months. Each session lasted for approximately 30 minutes. Results showed that 25 of 33 children could accomplish the training program. Children who completed training showed improvement in auditory skills as measured by Arabic version of MAIS questionnaire, Arabic speech perception tests and auditory fusion test that measured temporal processing. The neuroplastic changes following remediation was documented electophysiologically by increased amplitude of mismatch negativity test. On the other hand, they could not achieve significant change of Arabic language score. Such improvement was retained for a period of 6 months up two years after training was completed. It can be concluded that computer-based training of temporal and phonemic abilities are effective and promising for CI children.

Biography:

King Chung is an Associate Professor of Audiology at Northern Illinois University. She has been leading students onto humanitarian research and service trips every summer. Past destinations include Taiwan, Hong Kong, Brazil, China, and Cambodia. A researcher at heart, she publishes information on the hearing systems in the visited countries/regions and the hearing status of individuals tested during the trips to raise the awareness of the great demand for hearing services in different countries. The long term goal is to facilitate the provision of frequent and high quality hearing services to underserved and unserved populations around the world.

Abstract:

Hearing services are often not available to children and adults in many countries, especially for those with disabilities or living in rural areas. A variety of populations in Brazil, Cambodia, China, Hong Kong, and Taiwan were tested using a combination of otoscopy, otoacoustic emissions, and tympanometry during annual humanitarian service trips. Those who failed or could not be tested using the testing protocol were then followed up with pure tone audiometry on-site. Populations tested include: 1) adults living in nursing homes, 2) children and adults with special needs, 3) children and adults with HIV+ or AIDS, 4) adults with recreational drug addiction, 5) children living in orphanages, and 6) children living in rural areas. The test results indicated most of these populations, except children living in an orphanage in Taiwan or adults with drug addiction, exhibited high incidences of excessive cerumen, middle-ear problems, and/or hearing loss. The rate of referral was as high as 50% in some populations. These results combined with the fact that many of the individual tested have never had their ears or hearing checked highlight the tremendous need for regular and quality hearing services for these underserved or unserved populations.

Biography:

Lindsey E Jorgensen completed her AuD and PhD at the University of Pittsburgh. She is an Assistant Professor at the University of South Dakota, a clinical audiologist and an audiology researcher. Her areas of interest include examining the impact of aging/dementia and traumatic brain injury on speech perception and how hearing aids or other assistive listening devices may improve the processing of speech.

Abstract:

Providing appropriate amplification to patients is more than just providing audibility. Many other factors must be taken into account when selecting options and fitting strategies. Most audiologists and clinicians understand the complexity the patient needs and perspective play into the selection of appropriate amplification. However, once the choices of style/manufacturer/etc. have been made, most audiologists use the same fitting strategy for every patient. The purpose of this presentation will be to discuss what other factors should be taken into account when fitting patients. Additionally, suggestions for changes which can/should be made in the hearing aid software to appropriate fit the young, aging and cognitively impaired patient. Current research findings will be discussed about fitting options for patients who are underperforming or who present with cognitive decline.

Biography:

Assoc. Prof. Ayşe Sanem SAHLI, PhD. She earned ‘Master of Science degree’ at Hacettepe University, Institute of Health Sciences, Department of Otorhinolaryngology, Educational Audiology Program in 2005 and ‘Doctorate degree’ in the same program in 2010 and she received “Assoc Prof” title in field of Audiology in 2012. Between 2008–2010, she has worked with Warren Estabrooks who is a Global Ambassador of the Alexander Graham Bell Association for the Deaf and Hard of Hearing and professional trainer and she has earned certificate of Auditory-Verbal Therapy and Trainers of trainers. In 2009, during four months, she has been Albert Ludwig University, Freiburg University Hospital, Department of Otolaryngology and Freiburg Cochlear Implant Center as a fellow and visiting researcher. She carried out studies on cochlear implantation, programing (fitting), auditory re/habilitation and music therapy in Hearing and Speech Training Center Turkish and German patients and performed doctorate thesis on multiple intelligences and learning preferences of Turkish children with cochlear implant in Germany. She has been carrying out music therapy programs of hearing and speech disorder with childrens and their parents still. She has been working in Cochlear Implant Assosication Supervisory Board since 2006 and Hacettepe Disability Research and Application Center, Education Unit actively since 2010. She has been in organizations of many Audiology meetings and congresses and educational meetings for parents, teachers and society in different regions of Turkey. Dr.Sahlı, has been working as ‘editorial consultant/ scientific reviewer’ in journals and she has many scientific articles in international and national journals. She has attended many international and national congress/symposium as speaker or listener and currently, she has been continuing her vocational and academic studies as staff in Hacettepe University Vocational School of Health Services Hearing and Speech Training Center since 2004. Workspace: : Hearing loss, delayed speech, educational assessment in children with hearing and speech disorders and cochlear implant, assessment of speech and language, educational follows, auditory re/habilitation, auditory-verbal therapy, music therapy, family counselling,

Abstract:

Cochlear implants have been designed primarily to enhance speech and language skills. Therefore, musical perception and appreciation can be challenging for many users with cochlear implant. Children and adults with cochlear implant have difficulty with accurately perceiving certain elements of music, such as pitch and timbre. Also, they often provide lower scores of musical sound quality when compared to normally hearing people. Musical skills depend on many factors in cochlear implant users. The age and duration of hearing loss and cochlear implant, number and condition of surviving auditory neurons, processing capabilities of the implant and sound processor and musical trainings after cochlear implant very important factors for musical perception. Music activities reinforcing the levels of auditory development can help children and adults with cochlear implant to develop their listening, auditory perception and communication.

Biography:

Somia Tawfik is a Professor of Audiology at Ain Shams University, Cairo, Egypt. She graduated from the Faculty of Medicine at Ain Shams University in 1978 and received her Master’s (1982) and Doctorate (1986) degrees at the same university. She has many publications in the area of Central auditory evaluation & development of Arabic material for central auditory testing in adults & children and shared in development of an Arabic computer-based material for remediation of children with central auditory processing disorders. She has good clinical experience in evaluating and remediating patients with different hearing disorders, especially children with auditory neuropathy. She had been the Director of the audiology unit, Ain Shams University for twelve years (1998-2010) and got two grants and organized many local and international conferences. Presently, she is a member of the International Association of Physicians in Audiology, the Egyptian Audio-Vestibular Medicine Association and the Egyptian Society of Oto-rhino-laryngology. She is reviewer of the Egyptian Journal of Ear, Nose and Throat and Allied Sciences and Journal of the American Academy of Audiology. Her present research focuses on new horizons in central auditory testing such as speech-evoked potentials in children with central auditory processing disorders and language disorders. She also shares in research on hearing aids, vestibular testing and rehabilitation of hearing-impaired children and central auditory testing in elderly.

Abstract:

A comprehensive program for remediation of auditory processing disorders was developed in Arabic language in order to suit Arabic-speaking children. Arabic computer-based auditory training program (CBAT) was developed by a multidisciplinary team of audiology, phoniatrics, acoustic engineering, and software programming. The program proved to be an efficient approach for remediation of auditory processing disorders. It offered several advantages including multi-sensory stimulation in an engaging format, generous feedback and reinforcement that facilitates intensive training with a highly interesting and attractive theme for children. Application of the program on children with auditory processing disorders particularly those with language and learning problems as well as on children with (C)APD combined with other perceptual disorders & neuro-psychiatric disorders showed promising outcome. Evaluation of the outcome showed beneficial improvement subjectively and objectively. Arabic CBAT program is a new horizon for management of auditory processing disorders.

Biography:

Allan T P Ho is an Associate Professor in the Department of Surgery, Faculty of Medicine at the University of Alberta. He is an Otologist, cochlear implant and lateral skull base Surgeon in the Division of Otolaryngology Head and Neck Surgery. He serves on several local, national and international scientific committees. He chairs the Canadian Otology subspecialty group of the Canadian Society of Otolaryngology. He is the Director of the Edmonton Ear Clinic. He graduated from the University of Newcastle-upon-Tyne, United Kingdom. He obtained fellowship training in otology, neurotology and skull base surgery in Halifax, Nova Scotia.

Abstract:

Objectives 1. To update the audience on the latest developments in hearing loss management with surgical implant technology 2. To discuss the evolution of bone conduction hearing devices 3. To explore the clinical rationale behind choice of surgical hearing implantable devices including active and passive middle ear implants and cochlear implantation. In the last 5 years the surgical implant world has seen an explosion of innovation for patients with mixed hearing loss, conductive hearing loss and single sided deafness. This includes percutaneous bone conduction devices (Cochlear BAHA, Oticon Ponto), transcutaneous bone conduction devices (Sophono, BAHA Attract), active transcutaneous bone conduction devices (MedEl Bonebridge, Oticon BCI) and also devices with their actuator coupled directly to the cochlea (MedEl Vibrant soundbridge, Codacs). The extensive choices of internal implantable devices and external processors make the rationale for the choice of treatment more complex and challenging. With regard to these new devices, safety, stability, complexity of surgery, risks of surgery and the economic considerations will be explored.

Biography:

Luciana Macedo de Resende is a Speech-Therapist and Audiologist. Graduation and Post Graduation Professor at Federal University of Minas Gerais (UFMG), Brasil, Doctor in Human Communication Disorders. She develops research with biomedical engineering research group at UFMG as well as part of the research group CTBG/UFMG (Congenital Toxoplasmosis Brazilian Group).

Abstract:

Aim: The present study aimed to describe the performance of patients referenced to auditory processing assessment and associate findings to age, gender, complaints and also correlate behavioral and electrophysiological findings.

Methods: Cross-sectional descriptive study. Patients referenced to the audiology service for auditory processing assessment were included in the study. All patients underwent tonal audiometry, tympanometry, acoustic reflexes, behavioral and electrophysiological measures. Selected behavioral procedures included dichotic tests, monaural low redundancy tests, temporal processing tests and binaural interactions tests. Auditory brainstem response (ABR), middle latency responses (MLR) and P300 were the electrophysiological measures. Chi square and Fisher’s exact test were used at statistical analysis to associate categorical variables, followed by Kappa’s to observe the degree of associations. T test and Mann-Whitney were also used. Variables distribution was assessed with Kolmogorov-Smirnov and a p-value of 5% was adopted.

Results: Patients’ main complaint was learning disability and behavioral results which indicated maximum disorders in auditory temporal processing aspects and dichotic listening. Correlation was observed between behavioral and electrophysiological measures, particularlyauditory closure and MLRs, temporal ordering and MLR and P300, dichotic listening and P300, binaural interaction and acoustic reflexes.

Discussion: Individuals with learning disabilities may present maturational delay in cortical structures related to auditory abilities assessed with behavioral and electrophysiological measures. Both measures are relevant in diagnosing auditory processing disorders and directing auditory intervention plans.

Conclusion: Most patients referred to auditory processing assessment presented some learning complaint. Difficulties in temporal processing and dichotic listening tasks were the most prevalent. Electrophysiological measures helped diagnosis become more precise with correlation in many auditory aspects.

Biography:

Mark Williams is a Chief Audiologist at the The Tinnitus Clinic Ltd. He is a senior clinician specialising in the provision of tinnitus and hyperacusis management options for adults. He has a specific interest in tinnitus psychoacoustic measurement along with researching the efficacy of neuromodualtion therapies for the treatment of subjective percepts. He has both led and contributed to a number of clinic based observational studies. He currently leads a multidisciplinary clinical team for The Tinnitus Clinic Ltd. He has previously led a team of audiologists for the NHS and have been a clinical tutor/examiner for MSc and BSc Audiology students at University College London (UCL). He originally studied at UCL and obtained an honors degree in Molecular Biology, a Masters Degree in Audiological Science and a Post Graduate Diploma in Audiology Clinical Competency. He is registered as a Hearing Aid Dispenser with the Health Professions Council (HPC) and as a Clinical Audiologist with the Registration Council for Clinical Physiologists (RCCP).

Abstract:

Objective: To describe the quantitative treatment outcomes of patients undergoing acoustic coordinated reset (CR) neuromodulation at a single independent audiology practice over a 22- to 26-week period as part of an open label, non-randomized, non-controlled observational study.

Methods: Sixty-six patients with subjective tonal tinnitus were treated with acoustic CR neuromodulation with a retrospective review of patient records being performed in order to identify changes of visual analog scale (VAS, n = 66) and in the score of the tinnitus handicap questionnaire (THQ, n = 51). Patients had their tinnitus severity recorded prior to the initiation of therapy using the tinnitus handicap inventory in order to categorize patients into slight up to catastrophic impact categories. THQ and VAS for tinnitus loudness/annoyance were obtained at the patient’s initial visit, at 10–14 and 22–26 weeks.

Results: Visual analogue scale scores were significantly improved, demonstrating a 25.8% mean reduction in tinnitus loudness and a 32% mean reduction in tinnitus annoyance with a clinically significant reduction in percept loudness and annoyance being recorded in 59.1 and 72.7% of the patient group. THQ scores were significantly improved by 19.4% after 22–26 weeks of therapy compared to baseline.

Conclusion: Acoustic CR neuromodulation therapy appears to be a practical and promising treatment for subjective tonal tinnitus.

Biography:

K Ramdoo is working as an Ear, Nose and Throat Research Registrar in North West London Hospital Trust. Having completed his core surgical training in London, he has pursued his interest in research and is currently undertaking an MD at UCL alongside his clinical duties. His particular area of interest is screening for hearing loss and detection at an early stage and well as product development to enable this. He has written a number of research papers on the topic and presented both nationally and internationally.

Abstract:

Objective: The ageing population has led to increasing numbers (approximately 330,000) of older people residing in care homes across England; estimates suggest 75% of them could have a hearing loss. This study aims to illustrate the current prevalence of undiagnosed hearing loss in a typical elderly care home and evaluate the feasibility of opportunistic screening of hearing loss in the community.

Method: Subjects over the age of 65 years were recruited from three Nursing homes. A validated subjective bed-side hearing screen (whisper test) was performed to identify individuals with hearing impairment. Subjects who failed or self-reported hearing difficulties were offered gold standard audiological assessment, pure tone audiometry.

Results: Hearing screening was performed on 56 patients, 20 (36%) of those self-reported hearing loss, 22 (39%) failed the screening whisper test. All (n=42) were referred for audiological assessment, of whom 5 declined and 11 were unable to engage in audiometric assessment. 62% had aidable hearing loss and were referred for hearing aids. This identified a screen: aid ratio of 2:1.

Conclusion: This pilot highlights a high incidence of undiagnosed hearing loss in elderly patient residents in a typical Care home. The results suggest consideration should be given for a screening program to help address this unmet need as part of a portable toolkit utilizing our Audiology team in the community. The team involved is currently developing this patented toolkit.

Biography:

Sudhira Ratnayake, MBBS, MRCSEd, DO-HNS (RCS Eng), MSc, is a Consultant Audiovestibular Physician at The Royal Wolverhampton NHS Trust and is the Team Leader for the local Newborn Hearing Screening Programme. He completed specialist medical training in Audiovestibular Medicine in London, UK, and has a Masters degree in Audiovestibular Medicine from University College London. His research interests are in the causes of hearing and balance disorders. His MSc thesis on aetiology of unilateral deafness in newborns has been cited in UK national guidelines. He has been involved in teaching junior doctors, medical students and Audiology students for over 10 years.

Abstract:

Deafness is the commonest congenital sensory impairment in humans. About 1-2 babies per 1000 births have severe to profound deafness and the prevalence rises with age. Causes of permanent deafness are varied. Approximately 50% is genetic in origin and the rest are environmental reasons. Of the genetic reasons, about 15% is syndromic and 85% is non-syndromic. Non-syndromic causes can be autosomal dominant, autosomal recessive, x-linked or mitochondrial mutations. Most of the syndromes can cause disorders in other body systems. e.g. vision and vestibular disorders in Usher Type 1, renal disease in Alport Syndrome. There are numerous environmental causes. Congenital cytomegalovirus (CMV) is the commonest congenital infection and can present with late-onset or progressive deafness. Symptomatic congenital CMV, if diagnosed early, can be treated with anti-viral medication to prevent the progression. Infections such as measles, mumps and rubella are becoming rare due to immunization. Meningitis needs urgent auditory and vestibular assessments to establish amplification and cochlear implantation. Ototoxic and vestibulotoxic medication can cause sudden or progressive auditory and balance difficulties. Head injuries can cause sudden deafness. There are several reasons why it is important to establish the cause of deafness. It can be the initial presentation of a much wider health problem. The aetiology can indicate the prognosis of deafness to help plan future care. Parents and young people may wish for genetic counseling. Cochlear implant outcomes may relate with the aetiology of deafness as some causes have associated learning and neurological disabilities. Aetiology is also important for epidemiological studies.

Biography:

Abstract:

Introduction: Intratympanic medication might alter cochlear NO-production resulting in damage or protection, respectively. In this study, the quantitative distribution patterns of gentamicin and doxycycline were determined after intratympanic application in the guinea pig animal model.

Materials & Methods: Gentamicin or doxycycline were injected into both middle ears of male animals (n = 24 and n = 3, respectively). The cochleae were removed 1, 2 and 7 days after gentamicin injection or 1, 6 and 24 h after doxycycline application, transferred into fixative and embedded in paraffin. The cellular staining reactions by specific antibodies against gentamicin and doxycycline were quantified computer-assisted on sections for seven different cochlear regions.

Results: Gentamicin was identified in all experimental groups in numerous regions of the cochlea but with quantitative cell-specific differences. An intense accumulation was observed within the spiral ligament, organ of Corti, nerve fibers, interdental cells and fibrocytes in the limbus-area. A low gentamicin accumulation was seen in spiral ganglion cells and no accumulation in the striavascularis. Statistic analysis revealed fixed effects of cell type and an interaction between treatment and cell type, but no effects of cochlea turn and of treatment. Analysis over time identified a reduction of gentamicin within the spiral ligament and nerve fibers. Doxycycline was preferentially located in the striavascularis and in hair cells.

Conclusion: In respect to the route of infiltration, a contribution of the vessel systems is discussed. The identified accumulation of gentamicin in those cochlea regions which are responsible for potassium recycling might result in a local NO-increase leading finally to cochlear damage. The specific accumulation of doxycycline in the striavascularis and hair cells might prevent an NO up-regulation in stress situations in these areas. Knowledge of cell specific accumulation of different pharmaceutical products offers a promising approach for human medication.

Biography:

Abstract:

Background: Dyslexia has been used to refer to the specific learning problem of reading. The temporal auditory processing deficit theory suggests that one causal deficit of dyslexia is an impaired ability to process sounds.

Objectives: To study auditory temporal processing in children with dyslexia using two electrophysiological tests.

Subjects & Methods: 80 children were participated in this study. They were divided into control group formed of 30 children and study group formed of 50 children. All participants had normal hearing sensitivity, normal middle ear function with average intelligent. All children were examined using speech auditory brainstem response and cortical auditory evoked potentials with /da/ speech stimulus at intensity 90 dBnHL.

Results: It showed that there was significant statistical difference between control and study group in both electrophysiological tests. Prolonged latency and reduced amplitude were recorded in children with dyslexia in S-ABR as well as in cortical auditory evoked potentials.

Conclusions: Children with dyslexia have deficit in auditory temporal processing and encoding of auditory information. Electrophysiological tests are sensitive in cases of dyslexia, so they were considered good diagnostic tests in such cases.

Biography:

Shalaby A, MD is a Professor of Audiology at Ain Shams University. He/She is a Member of International Auditory Physician Association (IAPA). He/She is a Member of Egyptian Otorhino-laryngology Society, and a Member of Egyptian Audio-Vestibular Medical Society. He/She is a Certified Trainer of KAMPS method of Auditory Integration Training (AIT), and a Reviewer of EJENTAS Journal. He/She is specialized in diagnosis & management of hearing & balance disorders. His/Her main domains are evaluation & management of children with learning disabilities, central auditory processing disorders (CAPD), attention deficit hyperactive disorder (ADHD), Autistic spectrum disorder.

Abstract:

This study included 2 groups: a study group of 60 children with mild to moderate sensorineural hearing loss (SNHL); and a control group of 30 normal hearing children. The children's age ranged from 6-12 years.

Objective & Methods: To study temporal auditory processing abilities in SNHL children using behavioural [Auditory fusion test (AFT); Duration pattern test (DPT); Pitch pattern sequence test (PPST); time compressed sentence test (TCST)] and electrophysiological measure [Mismatch negativity (MMN)]. And to study whether there is a correlation, if any, between results of behavioural tests and MMN in assessment of temporal auditory processing.

Results: The SNHL subgroups showed statistically significant lower scores in AFT, TCST, DPT and PPST as well as longer MMN latency than their controls. Age had significant effecton temporal auditory processing tests results and on MMN parameters but gender and aetiology of SNHL had no effect. There was no statistically significant correlation between results of behavioural tests and MMN in normal as well as SNHL children.

Conclusion: Sensorineural hearing loss affects temporal auditory processing abilities reflected on both behavioural & electrophysiological test results. Age showed maturational effect on behavioural tests in all subjects, but this effect was not reflected on the MMN results of the controls, despite of the significant effect of SNHL on MMN parameters. There was no correlation between behavioural & electrophysiological test results.

Biography:

Dr. Khabti Almuhanna.MD is KSU fellowship, Consultant Otorhinolaryngology, subspecialty Otology and Cochlear Implant at Prince Sultan Military Medical City, Riyadh KSA.

Abstract:

Otosclerosis has been derived from a Greek word meaning ear hardening. Clinical judgment was the only way to diagnosis this disease. Confirmation of the diagnosis preoperatively is needed in order to explain to the patient the procedure and the outcome. Multiple–frequency tympanometry (MFT) is a non–invasive, quick, and inexpensive method for examining the middle-ear function that found to be with value in differentiating otosclerotic from normal middle ears that caused re-searchers to evaluate its sensitivity to detecting otosclerosis. Resonant frequency had been found to be higher in otosclerotic middle ears than normal. We conducted multiple – frequency tympanometry measurements in three groups. First group otosclerotic ears (25 subjects) before stapes surgery, second group normal ears control group (24 subjects) and the third group the FMT was conducted after stapes surgery (10 subjects). Mean middle-ear resonant frequency for the otosclerotic group was found to be 1190 Hz and mean middle – ear resonant frequency of the control group was 934.6 Hz (p<0.001) and post-operative group where as 800Hz. The present findings confirm the advantage of the resonant frequency tympanometry in detecting middle – ear status and mechanics in patients with otosclerosis. As a conclusion, multiple–frequency tympanometry is sensitive in detecting the otosclerosis and we recommend it to be part of diagnostic toll before stapes surgery. However, further studies are necessary in order to brace this proposal.

Biography:

Zheng-min Xu has completed his PhD from Ghent University and Postdoctoral studies from same University, in Belgium. He is the directors of Shanghai Pediatric Hearing Center and ENT Department, Children`s Hospital of Fudan University, in Shanghai. He has published more than 40 papers in reputed journals and has been serving as an Editorial Board Member of China ENT journals etc.

Abstract:

The Chirp-Stimulus generates an optimized synchronous excitation of neurons in all regions of the basilar membrane. The stimulus structure allows modification to excite predefined regions in the cochlear. However, the chirp-ABRs have been investigated in few studies involving young children with varying degrees of hearing loss. Only some researchers reported that in this study a variety of tools were used to analyze the synchronicity of ABRs evoked by chirp- and click-stimuli at 40 dB HL in 32 normal hearing subjects aged 18 to 55 years. In our recent study, we investigate the relationship chirp-ABR and behavioral visual reinforcement audiometric (VRA) hearing thresholds in a group of infants with varying degrees of sensorineural hearing loss. In particular, we examine how accurately the prediction formulae (which were based on Chirp-ABR/VRA threshold correlation data) estimated hearing threshold in order to find out if it is possible to be used as the clinical application with regard to diagnostic audiology in young children. This study demonstrates the effective implementation of chirp-ABR predicted frequency-specific thresholds, especially of low- middle-frequency. The use of a chirp-ABR testing could be higher sensitivity and accuracy than that of auditory steady-state evoked response (ASSR) for measuring frequency-specific thresholds in young children.

Biography:

Assoc. Prof. Ayşe Sanem SAHLI, PhD. She earned ‘Master of Science degree’ at Hacettepe University, Institute of Health Sciences, Department of Otorhinolaryngology, Educational Audiology Program in 2005 and ‘Doctorate degree’ in the same program in 2010 and she received “Assoc Prof” title in field of Audiology in 2012. Between 2008–2010, she has worked with Warren Estabrooks who is a Global Ambassador of the Alexander Graham Bell Association for the Deaf and Hard of Hearing and professional trainer and she has earned certificate of Auditory-Verbal Therapy and Trainers of trainers. In 2009, during four months, she has been Albert Ludwig University, Freiburg University Hospital, Department of Otolaryngology and Freiburg Cochlear Implant Center as a fellow and visiting researcher. She carried out studies on cochlear implantation, programing (fitting), auditory re/habilitation and music therapy in Hearing and Speech Training Center Turkish and German patients and performed doctorate thesis on multiple intelligences and learning preferences of Turkish children with cochlear implant in Germany. She has been carrying out music therapy programs of hearing and speech disorder with childrens and their parents still. She has been working in Cochlear Implant Assosication Supervisory Board since 2006 and Hacettepe Disability Research and Application Center, Education Unit actively since 2010. She has been in organizations of many Audiology meetings and congresses and educational meetings for parents, teachers and society in different regions of Turkey. Dr.Sahlı, has been working as ‘editorial consultant/ scientific reviewer’ in journals and she has many scientific articles in international and national journals. She has attended many international and national congress/symposium as speaker or listener and currently, she has been continuing her vocational and academic studies as staff in Hacettepe University Vocational School of Health Services Hearing and Speech Training Center since 2004. Workspace: : Hearing loss, delayed speech, educational assessment in children with hearing and speech disorders and cochlear implant, assessment of speech and language, educational follows, auditory re/habilitation, auditory-verbal therapy, music therapy, family counselling.

Abstract:

Congenital hearing loss is a important public health problem. 1-3 infants are born with congenital bilateral sensor ineural hearing loss in Turkey. Several factors including degree, type and configuration of hearing loss, interact to determine the impact of hearing loss on auditory perception, speech, language and communication skills. National Newborn Hearing Screening Program (NNHSP) are very important for early hearing detection and early intervention services. Newborn Hearing Screening Program has begun firstly in 2003 in Turkey. For a effective new born hearing screening program, all new borns should have access to hearing screeening before 1 month of age, confirm the presence of hearing loss before 3 months of age and receive intervention services before 6 months of age. Early intervention services include hearing technologies (hearing aid, cochlear implant) and auditory verbaltherapy (auditory habilitation). Early intervention programs should be family centered and all infants should be assessed and monitored for auditory, language and speech development.