Cases reported "Hearing Loss"

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1/15. Minimal, progressive, and fluctuating hearing losses in children. Characteristics, identification, and management.

    Referring to specific types of hearing loss as "minimal" or "mild" seems to imply that their effects are equally mild or negligible. A growing body of literature, however, supports the notion that such losses can have a significant impact on the communicative and educational development of young children. Although OME is considered a common childhood ailment, mounting evidence suggests that it is not always benign and may contribute to significant educational and communicative difficulties in some young children when accompanied by conductive hearing loss. Even very mild bilateral and unilateral SNHL seems to contribute to problems in the areas of social and emotional function, educational achievement, and communication in some children. Because these hearing losses are so mild, they may not be immediately recognized as the source of such difficulties. The purpose of this report is to heighten the general pediatrician's awareness of the significance of even very mild or minimal hearing losses in children. As the gatekeepers for children's health care, pediatricians are typically the primary recipients of parental expressions of concern and the initiators of evaluations or referrals to address such.
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keywords = communication
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2/15. Temporary and permanent signs of interhemispheric disconnection after traumatic brain injury.

    The corpus callosum is frequently damaged by closed head traumas, and the resulting deficits of interhemispheric communication may vary according to the specific position of the lesion within the corpus callosum. This paper describes a single case who suffered a severe traumatic brain injury resulting in a lesion of the posterior body of the corpus callosum. Among the classical symptoms of interhemispheric disconnection, left hand anomia, left upper limb ideomotor dyspraxia, left visual field dyslexia and dysnomia, and left ear suppression in a dichotic listening task were observed shortly after the injury but recovered completely or almost completely with the passage of time. The only symptom of interhemispheric disconnection which was found to persist more than 4 years after the injury was an abnormal prolongation of the crossed-uncrossed difference in a simple visuomotor reaction time task. This prolongation was comparable with that observed in subjects with complete callosal lesions or agenesis. The results suggest that the posterior body of the corpus callosum may be an obligatory interhemispheric communication channel for mediating fast visuo-motor responses. The transient nature of other symptoms of interhemispheric disconnection suggests a relatively wide dispersion of fibers with different functions through the callosal body, such that parts of them can survive a restricted lesion and allow functional recovery of hemispheric interactions. An assessment of the evolution in time of symptoms of interhemispheric disconnection following restricted callosal lesions may reveal fine and coarse features of the anatomo-functional topography of the corpus callosum.
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keywords = communication
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3/15. A new method of partial deafness treatment.

    BACKGROUND: There is a significant group of patients whose hearing impairment is characterized by normal or slightly elevated thresholds in the low frequency band with nearly total deafness in high frequency range. These patients remain beyond the scope of effective treatment by hearing aids. We name this kind of hearing loss 'partial deafness'. CASE REPORT: A new method of partial deafness treatment was applied in the case of a young woman. A partially-inserted cochlear implant was used to restore hearing at high frequencies, while preserving low-frequency acoustic hearing in the implanted ear. CONCLUSIONS: The results demonstrate a substantial improvement in speech discrimination and communication skills when electric stimulation on one side was combined with acoustic stimulation on both sides.
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keywords = communication
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4/15. Beginning to communicate after cochlear implantation: oral language development in a young child.

    This longitudinal case study examined the emergence of a wide range of oral language skills in a deaf child whose cochlear implant was activated at 20 months. The main purposes of this study were to determine "Hannah's" rate of spoken language development during her second to fourth year of implant experience and to estimate the efficiency of her progress by comparing her performance to that of typically developing children. Mother-child interactions were also examined to determine changes in Hannah's communication competence. Normal or above-normal rates of development were observed in the following areas: (a) decreased production of nonwords, (b) increased receptive vocabulary, (c) type-token ratio, (d) regular use of word combinations, and (e) comprehension of phrases. Below-normal rates of development were observed in the following areas: (a) speech intelligibility, (b) number of word types and tokens, and (c) mean length of utterance in morphemes. Analysis of parent-child interactions showed a large increase in responses to questions during the third year of implant use. Data from Hannah's first post-implantation year (D. J. Ertmer & J. A. Mellon, 2001) indicated that some early language milestones were attained quite rapidly (e.g., canonical vocalizations and emergence of first word combinations). In contrast, the current study revealed that progress had slowed for related, but more advanced skills (e.g., production of intelligible speech and consistent use of word combinations). These changes in rate of development suggest that any advantages for language learning due to Hannah's advanced maturity (or other unknown factors) decreased with time and increasing linguistic complexity.
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keywords = communication
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5/15. Perilymphatic fistula in cabin attendants: an incapacitating consequence of flying with common cold.

    A perilymphatic fistula (PLF) is an abnormal communication between the inner ear and the middle ear that leaks perilymph. PLF is considered rare, but is known to occur during childbirth, straining, weightlifting, head trauma, and diving with middle ear equalizing problems. It has also, anecdotally, been described in connection with flying. The symptoms are uncharacteristic vertigo and, in some cases, hearing impairment and tinnitus. This study describes four cases of PLF during a period of 6 mo in a major Scandinavian airline company employing approximately 3000 cabin attendants (CAs). None of the cases were diagnosed at the primary health care level. All were referred to the aviation Medical Center for investigation. The PLF diagnosis was based on the case history, Platform pressure Test (a fistula test), and other vestibular tests. Only one CA has been able to return to flying duties. The article emphasizes the risk of flying with poor middle ear equalization and the necessity of reminding crews and airline companies to "never fly with a common cold".
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keywords = communication
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6/15. Quantifying and responding to patient needs and expectations.

    Comprehensive audiometric testing serves as the cornerstone of adult hearing aid fittings for many clinicians. The data will serve to define the degree, configuration, and site of lesion of the hearing loss. The data will be used in prescriptive formula to preset the hearing aid and may be entered into probe microphone or hearing aid test box equipment to provide verification targets. Clinicians are comfortable obtaining audiometric data, have an accepted way of obtaining these data, and are comfortable discussing these data with patients and other professionals. The patient, however, is not a walking audiogram and may bring all sorts of interesting nuances to the process. Just as part of the clinician's comfort with using audiometric data comes from the standard process of obtaining and reporting these data, the clinician who chooses to go beyond the audiogram in terms of data collection with a patient must have a means for gathering and quantifying additional information. The following case describes a method of obtaining and quantifying the patient's listening and communication needs. The case illustrates the use of these measures in recommending appropriate communication and safety solutions.
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ranking = 2
keywords = communication
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7/15. When hearing aids go bad: an FM success story.

    Both clinical and research findings support the effectiveness of frequency-modulated (FM) technology among individuals who continue to encounter significant communication problems despite the use of conventional hearing instruments. The use rate of FM devices throughout the nation, however, remains disappointingly low. The authors present a case of a longtime hearing aid user whose hearing aids provided decreasing benefit as his hearing impairment increased to the extent that cochlear implantation was considered. Through the establishment of patient-specific treatment goals, the provision of appropriate FM technology as verified through real-ear measurements, and careful and deliberate counseling and follow-up, this patient was able to realize significant communication benefits as reported through several self-assessment measures. The cost-benefit implications of FM technology versus cochlear implantation are discussed.
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ranking = 2
keywords = communication
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8/15. A review of current approaches to aural rehabilitation.

    Degree of hearing impairment is not directly related to hearing handicap or disability. Since the 1940s measures of peripheral auditory function have been the basis of hearing aid selection even though they provide no direct information on psychosocial, vocational, or educational handicap or disability or on rehabilitation needs. rehabilitation beyond provision of the hearing aid has been limited and demands new approaches. The evolution of aural rehabilitation is based on the notion of its being an ongoing process, of communication as a behaviour which relies on the integration of many types of information, and of the individual as a total person with multi-faceted hearing needs.
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keywords = communication
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9/15. The cochlear prosthesis. Bringing the world of sound to the deaf.

    The complexity of coding in the auditory nerve makes it unlikely that a prosthesis for deaf persons can exactly duplicate the normal function of the ear. With recent advances, however, cochlear prostheses can perform some of the frequency-analysis functions of the normal ear. Cochlear prostheses are effective aids to lipreading and allow recognition of some sounds without visual cues, thus enhancing the profoundly deaf person's communication skills substantially.
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keywords = communication
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10/15. diagnosis and cure of venous hum tinnitus.

    Sounds arising from abnormalities of or abnormal communications between blood vessels in the neck or cranial cavity may result in objective tinnitus. It is audible to patient and examiner alike. Contrary to the usual subjective tinnitus of non-vascular origin, it is low pitched and pulsatile in character. That tinnitus which arises from and within the internal jugular vein is particularly important, as it may be loud enough to interfere with sleep, and result in some loss of hearing. diagnosis is important as it can be cured by simple ligation of the internal jugular vein. Such a case is reported.
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keywords = communication
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