Efficient Detection of Cortical Auditory Evoked Potentials in Adults Using Bootstrapped Methods

pa.ythelady61 shared this article with you from Inoreader Efficient Detection of Cortical Auditory Evoked Potentials in Adults Using Bootstrapped Methods Via Ear and Hearing - Published Ahead-of-Print Background: Statistical detection methods are useful tools for assisting clinicians with cortical auditory evoked potential (CAEP) detection, and can help improve the overall efficiency and reliability of the test. However, many of these detection methods rely on parametric distributions when evaluating test significance, and thus make various assumptions regarding the electroencephalogram (EEG) data. When these assumptions are violated, reduced test sensitivities and/or increased or decreased false-positive rates can be expected. As an alternative to the parametric approach, test significance can be evaluated using a bootstrap, which does not require some of the aforementioned assumptions. Bootstrapping also permits a large amount of freedom when choosing or designing the statistical test for response detection, as the distributions underlying the test statistic no longer need to be known prior to the test. Objectives: To improve the reliability and efficiency of CAEP-related applications by improving the specificity and sensitivity of objective CAEP detection methods. Design: The methods included in the assessment were Hotelling's T2 test, the Fmp, four modified q-sample statistics, and various template-based detection methods (calculated between the ensemble coherent average and some predefined template), including the correlation coefficient, covariance, and dynamic time-warping (DTW). The assessment was carried out using both simulations and a CAEP threshold series collected from 23 adults with normal hearing. Results: The most sensitive method was DTW, evaluated using the bootstrap, with maximum increases in test sensitivity (relative to the conventional Hotelling's T2 test) of up to 30%. An important factor underlying the performance of DTW is that the template adopted for the analysis correlates well with the subjects' CAEP. Conclusion: When subjects' CAEP morphology is approximately known before the test, then the DTW algorithm provides a highly sensitive method for CAEP detection. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and text of this article on the journal's Web site (www.ear-hearing.com). ACKNOWLEDGMENTS: The authors would also like to thank Jo Brooks and Sara Al-Hanbali for data collection. This article presents independent research funded by the Oticon Fonden and by the National Institute for Health Research (NIHR) under its Research for Patient Benefit (RfPB) Programme (Grant Reference Number PB-PG-0214-33009). K.J.M. was supported by the NIHR Manchester Biomedial Research Centre. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. M.A.C. and D.M.S. contributed toward algorithm design and data analysis, S.L.B., K.J.M., A.V., M.A.S., J.M.H., and L.B.S. contributed toward project conception and/or experiment design and/or data acquisition and interpretation. All authors contributed toward the drafting and critical revision of the manuscript. The authors declare no conflicts of interest to disclose. Received September 27, 2019; accepted August 12, 2020. Address for correspondence: Michael Alexander Chesnaye, Institute of Sound and Vibration Research, Faculty of Engineering and the Environment, University of Southampton, United Kingdom. E-mail: mac1r19@soton.ac.uk Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Internal Consistency and Convergent Validity of the Inventory of Hyperacusis Symptoms

pa.ythelady61 shared this article with you from Inoreader Internal Consistency and Convergent Validity of the Inventory of Hyperacusis Symptoms Via Ear and Hearing - Published Ahead-of-Print Objectives: The aim was to assess the internal consistency and convergent and discriminant validity of a new questionnaire for hyperacusis, the Inventory of Hyperacusis Symptoms (IHS; Greenberg & Carlos 2018), using a clinical population. Design: This was a retrospective study. Data were gathered from the records of 100 consecutive patients who sought help for tinnitus and/or hyperacusis from an audiology clinic in the United Kingdom. The average age of the patients was 55 years (SD = 13 years). Audiological measures were the pure-tone average threshold (PTA) and uncomfortable loudness levels (ULL). Questionnaires administered were: IHS, Tinnitus Handicap Inventory (THI), Hyperacusis Questionnaire (HQ), Insomnia Severity Index, Generalized Anxiety Disorder, and Patient Health Questionnaire-9. Results: Cronbach's alpha for the 25-item IHS questionnaire was 0.96. Neither the total IHS score nor scores for any of its five subscales were correlated with the PTA of the better or worse ear. This supports the discriminant validity of the IHS, as hyperacusis is thought to be independent of the PTA. There were moderately strong correlations between IHS total scores and scores for the HQ, Tinnitus Handicap Inventory, Generalized Anxiety Disorder, and Patient Health Questionnaire-9, with r = 0.58, 0.58, 0.61, 0.54, respectively. Thus, although IHS scores may reflect hyperacusis itself, they may also reflect the coexistence of tinnitus, anxiety, and depression. The total score on the IHS was significantly different between patients with and without hyperacusis (as diagnosed based on ULLs or HQ scores). Using the HQ score as a reference, the area under the receiver operating characteristic for the IHS was 0.80 (95% confidence interval = 0.71 to 0.89) and the cutoff point of the IHS with high est overall accuracy was 56/100. The corresponding sensitivity and specificity were 74% and 82%. Conclusions: The IHS has good internal consistency and reasonably high convergent validity, as indicated by the relationship of IHS scores to HQ scores and ULLs, but IHS scores may also partly reflect the co-occurrence of tinnitus, anxiety, and depression. We propose an IHS cutoff score of 56 instead of 69 for diagnosing hyperacusis. ACKNOWLEDGMENTS: We thank the members of the THTSC at RSCH (Viveka Owen, Jemma Hatton, Jennifer Whiffin, Jenni Stevens, and Judith Ballinger) for their help in data collection. The authors have no conflicts of interest to disclose. Received October 20, 2019; accepted October 3, 2020 Address for correspondence: Hashir Aazh, Tinnitus & Hyperacusis Therapy Specialist Clinic, Audiology Department, Royal Surrey NHS Foundation Trust, Egerton Road, Guildford, GU2 7XX, United Kingdom. E-mail: info@hashirtinnitusclinic.com Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Advances in cutaneous allergy

pa.ythelady61 shared this article with you from Inoreader Advances in cutaneous allergy Via Annals of Allergy, Asthma & Immunology Atopic dermatitis (AD) has now been well documented to be associated with an important impact on quality of life and is a major driver of not only systemic comorbidities including other allergic diseases (such as asthma and food allergy) but also cardiovascular and autoimmune diseases.1 Sleep disturbance and adverse effects on mental health are common in patients with AD. A major contributor for these events is the skin and resultant systemic immune activation associated with AD.2 Recent studies support the importance of skin barrier dysfunction in driving cutaneous allergy. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Frequency of awake bruxism behavior in orthodontic patients: randomized clinical trial

pa.ythelady61 shared this article with you from Inoreader Frequency of awake bruxism behavior in orthodontic patients: randomized clinical trial Via Journal of Oral Rehabilitation Abstract Introduction The influence of aligners on the activity of the masticatory muscles is still controversial, especially regarding the behavior associated with awake bruxism (AB). Objective To compare the frequency of AB behaviors between patients treated with aligners and fixed appliances. Methods The sample comprised 38 Class I patients (mean age 22.08 years), divided by simple randomization into two groups: OA group; orthodontic aligners (n 19) and FA group; fixed appliance (n 19). The frequency of AB was investigated by the ecological momentary assessment using an online device (mentimeter), during 7 following days at different timepoints, before and after appliance placement and in the 2nd, 3rd, 4th and 6th months of orthodontic treatment. These variables were also evaluated: level of anxiety by the State‐Trait Anxiety Inventory, stress by the Perceived Stress Scale, catastrophizing related to pain and degree of hypervigilance by the Pain Vigilance and Awareness Questionnaire, and the presence of facial pain evaluated by the DC/TMD. Results There was no difference between groups in the frequency of AB behaviors, with mean of 53.5% for group OA and 51.3% for FA. The most frequent behavior was slightly touching the teeth, and in FA group there was a significant reduction in this behavior soon after appliance placement. The groups did not differ concerning the degree of anxiety, stress, catastrophizing, hypervigilance and facial pain. Conclusion The orthodontic treatment performed with aligners or fixed appliances did not influence the frequency of AB during the 6 months of treatment. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Recurrent aspiration pneumonia precipitated by obstructive sleep apnea

pa.ythelady61 shared this article with you from Inoreader Recurrent aspiration pneumonia precipitated by obstructive sleep apnea Via Auris Nasus Larynx The clearance of the pharynx by deglutition and the respiratory phase patterns associated with deglutition are important in protecting airways and lungs against aspiration. The deglutition and respiratory phase patterns during sleep in patients (without swallowing disorders while awake) with obstructive sleep apnea (OSA) precipitating recurrent intractable aspiration pneumonia were investigated. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The use of grafts in frontal sinus drill-outs

pa.ythelady61 shared this article with you from Inoreader The use of grafts in frontal sinus drill-outs Via Current Opinion in Otolaryngology & Head and Neck Surgery - Published Ahead-of-Print Purpose of review A significant complication of the frontal sinus drill-out procedure is restenosis of the frontal neo-ostium. To improve postoperative healing in this region, various mucosal grafts and pedicled flaps have been designed to reconstruct the mucosal lining of the frontal neo-ostium. We provide an overview of the types of grafts described for reconstruction and discuss the latest evidence on their efficacy. Recent findings Frontal neo-ostium mucosal reconstruction may be performed using free, pedicled, or a combination of grafts. There are several case series that report good outcomes and low revision rates following the use of grafts in frontal sinus drill-outs, and one randomized controlled study demonstrating increased ostial patency. However, the use of grafts did not alter the rate of revision surgery and only one study reported an improvement in Sino-Nasal Outcome Test-22 scores after one year. Summary Studies have suggested that frontal sinus drill-out grafts result in favorable restenosis and graft success rates. However, larger randomized control trials will be required to determine whether frontal sinus drill-out grafts contribute to a tangible clinical benefit for patients. Correspondence to Richard Douglas, FRACP, FRACS, MD, Department of Surgery, The University of Auckland, Auckland, New Zealand. Tel: +64 9 9239820; e-mail: richard.douglas@auckland.ac.nz Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Treatment of persistent/recurrent nodal disease in nasopharyngeal cancer

pa.ythelady61 shared this article with you from Inoreader Treatment of persistent/recurrent nodal disease in nasopharyngeal cancer Via Current Opinion in Otolaryngology & Head and Neck Surgery - Published Ahead-of-Print Purpose of review Persistent or recurrent disease in the neck lymphatics is an unusual pattern of failure in nasopharyngeal carcinoma (NPC) after definitive radiotherapy or chemoradiotherapy. The purpose of this review is to critically synthesize the current knowledge regarding salvage treatment of this unique form of failure in NPC. Recent findings Surgery in the form of radical neck dissection has been established as the standard salvage treatment with 5-year regional control of 60--86%. Recent shift in paradigm has resulted in the use of modified or selective neck dissection as salvage surgery in some centers. Risk factors for poor survival outcome include recurrent nodal disease, number of involved lymph nodes, extracapsular extension, high lymph node ratio, and positive resection margin. There are no well controlled studies on the role of additional radiotherapy or chemotherapy to improve local control or survival after salvage neck dissection in this group of patients with regional failure. Summary There is limited literature regarding the extent of surgical dissection in treating nodal persistent or recurrent disease. Prospective studies are also needed to determine whether adjuvant therapy improves treatment outcomes. Correspondence to Wai-Tong Ng, Department of Clinical Oncology, The University of Hong Kong, Queen Mary Hospital, 102 Pokfulam Road, Pokfulam, Hong Kong SAR, China. Tel: +852 2255 4352; fax: +852 2872 6426; e-mail: ngwt1@hku.hk Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The role of endoscopic medial maxillectomy in sinus disease

pa.ythelady61 shared this article with you from Inoreader The role of endoscopic medial maxillectomy in sinus disease Via Current Opinion in Otolaryngology & Head and Neck Surgery - Published Ahead-of-Print Purpose of review The endoscopic medial maxillectomy (EMM) has remained a relevant procedure for certain sinus diseases and at the same time reemerged as a salvage technique or even as a primary procedure for other diseases. Several mucosal-sparing techniques have also been described and the outcome of the surgeries is available for review. Recent findings Modifications of the EMM technique in the last two decades, aimed at mucosal preservation of the inferior turbinate, nasolacrimal duct, and medial maxillary wall have been successful in addressing a multitude of diseases. There are also evidences to support adjunct procedures/methods to improve access, healing, and to address associated dysfunction such as impaired mucociliary clearance. Tailored approaches have shown favourable outcomes with a low rate of adverse effects. Summary The EMM is appropriate for selected indications, in particular lesions causing medial wall destruction or extensive tumour involving the anterior wall or the prelacrimal recess. As for other maxillary sinus diseases including those identified to a limited site, a modified EMM is a reasonable consideration. The choice is appropriate provided instrument access, visualization, the ability for complete resection, postoperative care, and the requirement for surveillance is not compromised. A tailored approach with or without adjunct procedures is recommended. Correspondence to Narayanan Prepageran, Department of Otorhinolaryngology – Head and Neck Surgery, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia. Tel: +60379492062; e-mail: prepageran@yahoo.com Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Tracheal Squamous Metaplasia in Children with Endotracheal Intubation or Tracheostomy

pa.ythelady61 shared this article with you from Inoreader Tracheal Squamous Metaplasia in Children with Endotracheal Intubation or Tracheostomy Via International Journal of Pediatric Otorhinolaryngology Publication date: Available online 6 December 2020 Source: International Journal of Pediatric Otorhinolaryngology Author(s): Hanaa Knaneh-Monem, Beth Osterbauer, Christian Hochstim View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Recurrent aspiration pneumonia precipitated by obstructive sleep apnea

pa.ythelady61 shared this article with you from Inoreader Recurrent aspiration pneumonia precipitated by obstructive sleep apnea Via Auris Nasus Larynx Publication date: Available online 6 December 2020 Source: Auris Nasus Larynx Author(s): Kiminori Sato, Shun-ichi Chitose, Kiminobu Sato, Fumihiko Sato, Takeharu Ono, Hirohito Umeno View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Differences in bone conduction ocular vestibular evoked myogenic potentials to 500 Hz narrow band chirp stimulus and 500 Hz tone burst

pa.ythelady61 shared this article with you from Inoreader Differences in bone conduction ocular vestibular evoked myogenic potentials to 500 Hz narrow band chirp stimulus and 500 Hz tone burst Via Auris Nasus Larynx This study aims to investigate the differences of N1 latency, P1 latency and N1P1 amplitude in response to bone conducted 500 Hz tone burst and narrowband CE chirp stimulus in ocular vestibular evoked myogenic potentials (oVEMPs). View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Limitations of non-echo planar diffusion weighted magnetic resonance imaging (non-EPI MRI) in cholesteatoma surveillance after ossicular chain reconstruction. A prospective study

pa.ythelady61 shared this article with you from Inoreader Limitations of non-echo planar diffusion weighted magnetic resonance imaging (non-EPI MRI) in cholesteatoma surveillance after ossicular chain reconstruction. A prospective study Via Auris Nasus Larynx Non-echo planar diffusion weighted magnetic resonance imaging is a reliable surveillance tool of residual cholesteatoma nowadays. It is not known whether the material of the ossicular chain prosthesis modifies the sensitivity and specificity of MRI in these cases. The aim of the study was to compare the sensitivity, specificity and a localization-specific accuracy of non-EPI DW MRI sequences for residual cholesteatoma in the following 3 subgroups: patients with titanium ossicular prosthesis (group T), with autologous cortical bone columella (group A) or without any reconstruction (group WR) of hearing bones. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.