Day 1 :
- Audiology: Medicine and Instrumentation
- Auditory Disorders
Aga Khan University,Pakistan
Dr. Sheikh graduated from the Aga Khan University Medical College, Pakistan in 2008 with an honors in Otorhinolaryngology and Head & Neck Surgery as well as Emergency Medicine rotations. He subsequently taught Anatomy at Islamabad Medical and Dental College, Pakistan for two years before completing his internship in General Surgery at the Khan Research Laboratories Hospital, Pakistan in 2011. Currently, he is pursuing a post graduate residency training accredited by ACGMEi (Accreditation Council for Graduate Medical Education international) in Otorhinolaryngology and Head & Neck Surgery at Hamad Medical Corporation, Doha, Qatar where he has also developed a keen interest in both basic and clinical research.
OBJECTIVE: Ossicular discontinuity may result from chronic otitis media and usually detected intra-operatively. Our objective is to determine if preoperative audiogram could predict preoperatively the presence of ossicular discontinuity.
METHODS: A prospective cohort study was run on patients aged 12 to 75 operated for non-cholesteatomous chronic otitis media. Pre-operative audiogram was analyzed to measure frequency specific air-bone gap (ABG) cut-off values. Intraoperatively, ossicular chain integrity was carefully checked. Logistic regression analysis was done to have a predictive model.
RESULTS: 270 patients (306 ears) were included. Frequency specific ABG cut-off values can predict ossicular discontinuity, namely: high ABGs at 1000 Hz (>27.5dB) and 2000 Hz (>17.5dB) are the most reliable variables associated with ossicular discontinuity.
CONCLUSION: Preoperative audiograms can predict presence of ossicular discontinuity in chronic suppurative otitis media.
University Hospital Center Zagreb and Medical School Zagreb,Croatian
Jadranka Handžić graduated in 1984y. at Medical School University of Zagreb, took Master degree at 1987y. And PhD at 1989y. Since 1987y she spent her residential program of Otolaryngology than diploma at 1989 as specialist of Otolaryngology and 2003y as sub-specialist of Audiology. At 2000-2001 she spent academic year on Fulbright Scholarship at Cleft Palate-Craniofacial Centre and Dental School of Medicine, University of Pittsburgh and Children’s Hospital Pittsburgh U.S.A Department for Paediatric Otolaryngology, University of Pittsburgh, U.S.A at position as Adjunct Associate Professor of Oral Medicine and Pathology and at
2001-2002 as Visiting Assistant Professor at Department of Oral Medicine and Pathology, Cleft Palate-Craniofacial Centre, Dental School of Medicine, University of Pittsburgh, U.S.A.
2001-2002 she had Lester Hamburg- Research Fellowship in Department for Paediatric Otolaryngology Children's Hospital of Pittsburgh, Medical School University of Pittsburgh, U.S.A. From 2002 she was Assistant Professor of Otolaryngology, University Clinical Hospital Centre and Medical School “Zagreb” and from 2008 Professor of Otolaryngology and Audiology. She is author and co-author of 16 articles in Current Contents, lecturer of 30 presentations on International conferences, reviewer in Journal and Annals of Maxillofacial Surgery, Director of 7 post-graduate studies of Otolaryngology and Audiology, author and co-author of 4 books, author of 3 international projects.
Objectives. Otitis media with effusion is characterized with conductive hearing (CHL) loss which affects a child’s ability to recognize and memorize spoken language and develop auditory working memory. The aim of the study was to find out; if peripheral hearing deficit cause speech recognition disorders, possible difference in speech recognition while hear binaurally vs. monaurally for left and right ear respectively, possible gender and ear side dependence.
Method: Clinical randomized study included right-handed 48 girls and 95 boys (mean age of 6y) tested in age subgroups; 4-7, 8-12 years, with OME and CHL and no previous otologic surgeries. Tonal audiometry estimated medians of left and right ears (M) for 500Hz,1000Hz,2000Hz,4000Hz and average hearing level for speech frequencies (AHL) and speech audiometry score (SDS) measured threshold of speech recognition while hear binaurally in free sound field and through the left or right ear respectively by headphones. All of the children undergo speech and language screening tests.
Results: Tonal audiometry showed MAHL on left ears (24.3dB) girls higher than on right ears (21.9 dB) and also higher than on of left (20.6 dB) and right ears (20.5 dB) in boys. Boys show no difference in average of AHL between left vs. right ears. Girls showed higher (M) mean for 500Hz (26.7dB) and 2000Hz (mean, 20.5dB) on left (21.8dB) ears than on their right (20.5dB) ears and both ear sides in boys. Girls have speech recognition threshold (20.8dB) and score of 100% (46.2dB) recognition on higher level than boys (13.6dB and 36.8dB). The worst score for speech threshold and 100% of recognition reach test by headphones on left ears in girls.
Conclusions: More severe CHL for restrictive frequencies particularly for 4000Hz caused more speech recognition disturbances in girls than boys and starts at earlier age. Boys have higher frequency of OME but smaller rate of disorders of speech discrimination at preschool age and less severe CHL and SDS damage than girls. Girls CHL showed left side lateralization of peripheral hearing loss for higher frequencies which correlate with lateralization of central auditory processing.
- Diagnostics in Audiology
UNIVERSITY COLLEGE LONDON HOSPITALS,UK
She is an ENT and Allergist working at the world-renowned specialist ENT hospital in central London. She is also an Educational Supervisor for Foundation doctors in the NHS and is an undergraduates Examiner at University College London Medical School. She has spearheaded research into Rhinitis/Rhinosinusitis and has led international teams in collaborative projects. She is in-charge of the Womens section of Medical Organisation in her local community where she leads volunteer doctors in public health and mass gathering medical care incentives, she is also Student Support Lead helping those interested in medicine and supporting the training of current medical students.
Background: Rhinitis is a prevalent condition both in primary care and in specialist centres. It has been shown to significantly impact on quality of life. Treatment is often best managed on combined therapies. Dymista© nasal spray is filling a niche for an ‘all in one’ treatment of allergic rhinitis.
Results: Dymista has been shown to improve all domains of the patient experience of rhinitis and rhinosinusitis with positive feedback by both patients and prescribing physicians.
Conclusion: Dymista is effective at improving patient symptomatology and improves quality of life. These positive results have opened up further avenues for research to explore its efficiency and place as mode of treatment.
- Hearing: Biology and Physiology
University Clinical Hospital Centre "Zagreb" and Medical School,Hrvatska
Jasenka Broz Frajtag is a Professor of speech pathologist in University Clinical Hospital Centre, Zagreb, Department of Otorhinolaryngology Center for Audiology and Vestibulology in Croatia. Currently she is studying in Medical school Public Health. Work rehabilitation with children and adults who have hearing problems, wear hearing aid/s or cochlear implants and also having problems in speech and language. She has many publications and has delivered talks in international conferences.
Introduction: Otitis media with effusion is desease in the middle ear with no sign of inflamation and common cause of hearing loss worldwide and most common health problem in pre-school and school age. Conductive hearing loss adversely may affect acustic binaural, sound localization, speech perception in noise, impear early language acquisition, behaviour and vertigo. The aim of the study is to exame whether otitis media with effusion and association hearing loss are related to the language development, academic achievement and behavior.
Method: Participants were thirty-nine- average olds distributed among groups according to gender and age group. The diagnostic process included tonal audiometry, tympanometry and speech audiometry ( discrimination of speech) which were performed repetitively every 7 days during the 6 weeks.
Results: Bilateral conductive hearing loss and tympanograms of B type were present in all tested children. At the age up to 7 years equal number of female and male have speech disorders (mostly articulation) and lack of concentration to the sound in general, speech and events around. At the age of 8 years or higher were much more male than female dominated cognition disorders, behavior problems, learning disabilities and problems with social adaptation. Children in general have more readiness skills in literacy (verbal problems) and math, and lower scoring in recognizing of incomplete words at school age from 8 to older ages. Male children have more learning and behavior disabilities at school age than females. Psychological problems become directly or indirectly in all cases hearing damage included children with speech language pathology. Problems with attention, hard learn, weakly concentration, untidy handwriting, missed some important information and reduced productivity in school activities.
Conclusion: Our results suggested that such structural pathoanathomical changes have more hearing loss impact on left side ears. At least in conductive hearing loss this children have disorders in hearing, verbal expressing, problems in speech, behavior (hiperactivity).
The goal is to intervene before the child is six month. Early rehabilitation for that children is much better and quality in earlier age than afterward.
- Pediatric Audiology
Nanyang Technological University,Singapore
Dr. Hua Zhang, has got three the National Natural Science funds, a central health research project, and the Beijing Natural Science Found. The main research directions are clinical audiology and otology, especially in evaluation of cochlear implant and hearing aid, development of speech audiometry, hearing diagnosis research. He has engaged in clinical otology and audiology for more than 30 years.
At present, more than 90 % of cochlear implant (CI) recipients are children in China. Nowadays the implanting age is getting younger and younger. However, whether a infant less than twelve-month should be implanted immediately after diagnosis of hearing loss or not?
The most used auditory assessment questionnaires for hearing impaired infants in China are categories of auditory performance (CAP) and Infant-Toddler meaningful auditory integration scale (IT-MAIS). The former had no age distinction and no significance in short term. Some studies have indicated that the reliability of IT-MAIS is inexact. Is there any other questionnaire that can make up for the shortages?
Objective: To observe the auditory development of infants with CI between the ages of 8~24 months in the first year. The effect of implant age and intervention periods were analyzed.
Method: Based on different implant ages, 41 infants with CI were divided into group A (≤12months), group B (13-18 months), group C (19-24months), using LittlEARS Auditory Questionnaire to assess and analyze auditory development before switch-on and 3 months,6 months,9 months and 12 months after switch-on.
Results: Auditory ability was no significant difference among three groups at the same period. Significant differences were obtained among different switch-on stages.
Conclusion: Auditory abilities of infants after switch-on in the first year were significantly increased. Auditory abilities of infants before age of 24 months with CI were no difference at the same period in the first year. It is suggested that infants implanted before age of 24 months could wear hearing aids. This could establish hearing experience for children to increase the probability of hearing response and the parents’ confidence on rehabilitation. At the same time, the experience establishes a link between parents and therapists..
University of Iowa,USA
Stephen Newton completed his MD at Howard University where he graduated with honors. He then completed his residency in Otolaryngology at the University of Iowa and also performed a two year research postdoctoral fellowship looking at microRNAs and their role in hearing loss. Later, he did a clinical fellowship in Pediatric Otolaryngology at Boston Children’s Hospital. Currently Stephen is a Pediatric Otolaryngologist with Children’s Hospital of Colorado and an assistant professor in the Department of Otlaryngology at the University of Colorado. He heads the cochlear implant program at Children’s Hospital of Colorado’s extension in Colorado Springs.
The most common cause for conductive hearing loss in children is a middle ear effusion. However, there can be other causes, both congenital and acquired, that may require intervention beyond observation or pressure equalization tubes. Further evaluation is often required to define these types of hearing loss but an auditory history and audiogram may be the first clue. Congenital abnormalities of the ossicles and middle ear space may be suggested based on the level of hearing loss and tympanogram. These may be amenable to surgical procedure that may obviate the need for hearing aids. On the other hand, acquired and congenital cholesteatomas, can present in a multitude of ways and if not identified can lead to destruction of the ossicles and the potential for permanent hearing loss. Lastly, previous surgical intervention may alter the appearance of audiometric testing. The goal of the talk is to review the various types of conductive hearing loss in children and how they might present to the audiologist and on an audiogram.
Helwan University School of Medicine, Cairo, Egypt
Professor Dr. Hossam Abdelghaffar has completed his MD degree in Audiology at the age of 30 years from Cairo University School of Medicine . He was director of Audilogy Unit at Dr. Soliman Fakeeh Hospital in Kingdom of Saudia Arabia from 2003-2005 .Now he is holding the position of professor of Audilogy and Head of OtoRhinoLaryngology department at School of Medicine Helwan University ,Cairo ,Egypt He has published more than 15 papers in reputed journals and he is reviewer of the Egyptian Journal of Ear, Nose, Throat and Allied Sciences . He has supervised more than 20 Master and Doctorate degree thesis . He is a member of the International Association of Physicians in Audiology (IAPA)
To study the incidence of congenital hearing impairment in the Saudi population and to evaluate the need of establishing a Saudi universal neonatal hearing screening program based on transient evoked otoacoustic emission. A total of 11986 well non-high-risk neonates were screened by transient evoked otoacoustic emission over period of 8 years from September 1996 to February 2004. The universal hearing screening was consequently done in a daily base before discharge from nursery. Those who failed the initial screening were followed up diagnostically until hearing loss was confirmed or excluded. From the total number of 11,986 neonates (41.4% male and 58.6% females) examined in this study 10943 (91.3%) neonates passed the first screening step while 1043(8.7%) neonates failed. From the 1043 neonates examined in the second screening step in the 5th day of life, 300 (29%) neonates failed. At the age of 5 months, all the 300 infants that failed the second screening step underwent a comprehensive audiological assessment to confirm the existence of hearing loss. The 278 infants that passed the assessment were considered as normal; while 22 failed and were confirmed to have congenital hearing loss. Of these 22 infants, 2 had unilateral sensorineural hearing loss, and the remaining 20 had bilateral sensorineural hearing loss. The incidence of sensorineural hearing loss was estimated to be 0.18% while the incidence of bilateral sensorineural hearing loss was 0.17%. No significant difference between males and females was found. The average age at confirmation of congenital hearing loss was 5.5 months. The incidence of congenital hearing loss in the western region of Saudi Arabia is relatively high compared with international figures. Hearing screening for all neonates using transient evoked otoacoustic emission should be part of the standard medical care in Saudi Arabia
- Hearing Loss and Prevention