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Santa Maria P.L.,Stanford University | Gluth M.B.,University of Chicago | Gluth M.B.,University of Western Australia | Yuan Y.,Stanford University | And 3 more authors.
Otology and Neurotology | Year: 2014

Objective: To examine the results of hearing preservation in cochlear implantation surgery to identify surgical technical factors, electrode array design factors, and steroid usage, which predicts greater low-frequency hearing preservation.Data sources: A thorough search of Medline and Pubmed of English studies from January 1, 1995, to January 1, 2013, was performed using the key words "electric and acoustic hearing" or "hybrid cochlear implant" or "EAS cochlear implant" or "partial deafness cochlear implant" or "bimodal hearing cochlear implant" or "hearing preservation cochlear implant.".Study selection: The meta-analysis was conducted according to the PRISMA statement. Only articles in English were included. Studies were included if hearing preservation was the primary end point. A final number of 24 studies met the inclusion criteria.Data extraction: Patient populations were analyzed as intention to treat. Data were extracted from raw audiograms where possible. Data were excluded if not all explanatory variables were present or if variable values were ambiguous.Data synthesis: The weighted least-squares regression method was used to determine the predictive power of each explanatory variable across all studies.Conclusion: In this meta-analysis, the following are associated with better hearing preservation: cochleostomy over the round window approach, posterior tympanotomy over the suprameatal approach, a slow electrode array insertion technique over insertion of less than 30 seconds, a soft tissue cochleostomy seal over a fibrin glue only seal and the use of postoperative systemic steroids. Longer electrode arrays, topical steroid use, and lubricant use for electrode array insertion did not give an advantage. Copyright © 2014 Otology & Neurotology, Inc.

Marano R.J.,Ear science Institute Australia | Marano R.J.,University of Western Australia | Ben-Jonathan N.,University of Cincinnati
Molecular Endocrinology | Year: 2014

Prolactin (PRL) is an important hormone with many diverse functions. Although it is predominantly produced by lactrotrophs of the pituitary there are a number of other organs, cells, and tissues in which PRL is expressed and secreted. The impact of this extrapituitary PRL (ePRL) on localized metabolism and cellular functions is gaining widespread attention. In 1996, a comprehensive review on ePRL was published. However, since this time, there have been a number of advancements in ePRL research. This includes a greater understanding of the components of the control elements located within the superdistal promoter of the ePRL gene. Furthermore, several new sites of ePRL have been discovered, each under unique control by a range of transcription factors and elements. The functional role of ePRL at each of the expression sites also varies widely leading to gender and site bias. This review aims to provide an update to the research conducted on ePRL since the 1996 review. The focus is on new data concerning the sites of ePRL expression, its regulation, and its function within the organs in which it is expressed. © 2014 by the Endocrine Society.

Brennan-Jones C.G.,Ear science Institute Australia
The Cochrane database of systematic reviews | Year: 2014

Congenital or early-acquired hearing impairment poses a major barrier to the development of spoken language and communication. Early detection and effective (re)habilitative interventions are essential for parents and families who wish their children to achieve age-appropriate spoken language. Auditory-verbal therapy (AVT) is a (re)habilitative approach aimed at children with hearing impairments. AVT comprises intensive early intervention therapy sessions with a focus on audition, technological management and involvement of the child's caregivers in therapy sessions; it is typically the only therapy approach used to specifically promote avoidance or exclusion of non-auditory facial communication. The primary goal of AVT is to achieve age-appropriate spoken language and for this to be used as the primary or sole method of communication. AVT programmes are expanding throughout the world; however, little evidence can be found on the effectiveness of the intervention. To assess the effectiveness of auditory-verbal therapy (AVT) in developing receptive and expressive spoken language in children who are hearing impaired. CENTRAL, MEDLINE, EMBASE, PsycINFO, CINAHL, speechBITE and eight other databases were searched in March 2013. We also searched two trials registers and three theses repositories, checked reference lists and contacted study authors to identify additional studies. The review considered prospective randomised controlled trials (RCTs) and quasi-randomised studies of children (birth to 18 years) with a significant (≥ 40 dBHL) permanent (congenital or early-acquired) hearing impairment, undergoing a programme of auditory-verbal therapy, administered by a certified auditory-verbal therapist for a period of at least six months. Comparison groups considered for inclusion were waiting list and treatment as usual controls. Two review authors independently assessed titles and abstracts identified from the searches and obtained full-text versions of all potentially relevant articles. Articles were independently assessed by two review authors for design and risk of bias. In addition to outcome data, a range of variables related to participant groups and outcomes were documented. Of 2233 titles and abstracts searched, only 13 abstracts appeared to meet inclusion criteria. All 13 full-text articles were excluded following independent evaluation by two review authors (CGBJ and JW), as they did not meet the inclusion criteria related to the research design. Thus, no studies are included in this review. This review confirms the lack of well-controlled studies addressing the use of AVT as an intervention for promoting spoken language development in children with permanent hearing impairments. Whilst lack of evidence does not necessarily imply lack of effect, it is at present not possible for conclusions to be drawn as to the effectiveness of this intervention in treating children with permanent hearing impairments.

Eikelboom R.H.,Ear science Institute Australia | Eikelboom R.H.,University of Western Australia
Studies in Health Technology and Informatics | Year: 2012

The history of telemedicine is at times presented to commence in the 20th century. Events in Central Australia in 1874 show that the history goes further back, when the newly constructed telegraph played an important telemedicine role not only in enabling care for a wounded person, but also in uniting a dying man with his wife 2000 kilometres away. Innovation with the tools at hand has proven to be effective to bridge the tyranny of distance in the delivery of health care. © 2012 The authors and IOS Press.

Swanepoel D.W.,University of Pretoria | Swanepoel D.W.,University of Western Australia | Swanepoel D.W.,Ear science Institute Australia | Johl L.,University of Pretoria | Pienaar D.,University of Pretoria
International Journal of Pediatric Otorhinolaryngology | Year: 2013

Objective: To describe the nature of hearing loss and associated risk profile in a South African population of infants and children diagnosed at a pediatric referral clinic. Methods: A retrospective review of patient files for a pediatric auditory evoked potential clinic in Pretoria was conducted (January 2007-December 2011). Collected data included demographical information, risk factors from case history questionnaire, diagnosis (type and degree of hearing loss), documented age of caregiver suspicion and age of first diagnosis. Results: Hearing loss was present in 73% (73/100) of cases evaluated. Permanent hearing losses (SNHL, ANSD and mixed) constituted 76% of losses. Unilateral hearing losses constituted 8% of SNHL and 20% of conductive hearing loss. ANSD was diagnosed in 21.4% and SNHL in 78.6% of permanent non-conductive hearing loss cases. The most prevalent SNHL risk was family history of hearing loss and for ANSD it was admittance to the NICU for more than 5 days. The majority of the sample was diagnosed with a permanent bilateral SNHL and ANSD after 36 months of age (47%) despite 40% already suspected of having a hearing loss before 12 months of age. Conclusions: A high prevalence of ANSD was found with preventable risk factors often indicated. Age of diagnosis was significantly delayed, evidencing the lack of early hearing detection services in South Africa. The majority of children were diagnosed at ages precluding optimal benefits from early detection and subsequent intervention. © 2012 Elsevier Ireland Ltd.

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