Effects of residual hearing on cochlear implant outcomes in children: A systematic-review

Publication date: September 2017
Source:International Journal of Pediatric Otorhinolaryngology, Volume 100
Author(s): Julia Santos Costa Chiossi, Miguel Angelo Hyppolito
Objectivesto investigate if preoperative residual hearing in prelingually deafened children can interfere on cochlear implant indication and outcomes. Methods: a systematic-review was conducted in five international databases up to November-2016, to locate articles that evaluated cochlear implantation in children with some degree of preoperative residual hearing. Outcomes were auditory, language and cognition performances after cochlear implant. The quality of the studies was assessed and classified according to the Oxford Levels of Evidence table - 2011. Risk of biases were also described. Results: From the 30 articles reviewed, two types of questions were identified: (a) what are the benefits of cochlear implantation in children with residual hearing? (b) is the preoperative residual hearing a predictor of cochlear implant outcome? Studies ranged from 04 to 188 subjects, evaluating populations between 1.8 and 10.3 years old. The definition of residual hearing varied between studies. The majority of articles (n = 22) evaluated speech perception as the outcome and 14 also assessed language and speech production. Conclusion: There is evidence that cochlear implant is beneficial to children with residual hearing. Preoperative residual hearing seems to be valuable to predict speech perception outcomes after cochlear implantation, even though the mechanism of how it happens is not clear. More extensive researches must be conducted in order to make recommendations and to set prognosis for cochlear implants based on children preoperative residual hearing.



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Hearing loss in children with growth hormone deficiency

Publication date: September 2017
Source:International Journal of Pediatric Otorhinolaryngology, Volume 100
Author(s): John S. Muus, Forest W. Weir, Kathryn L. Kreicher, Deborah A. Bowlby, Christopher M. Discolo, Ted A. Meyer
ObjectiveAlthough insulin-like growth factor 1 (IGF-1) has been shown to be important for inner-ear development in animal models, little is known about the otologic and audiologic findings of children with growth hormone deficiency (GHD). The goal of this study is to evaluate the prevalence, type, and severity of hearing impairment in children with GHD.MethodsAudiologic, otologic, and demographic data were recorded for children with a diagnosis of GHD in the AudGen database. Data for each patient were selected based on the first encounter with available complete audiometric data or the first encounter with a type of hearing loss documented. The patients were then stratified by type and severity of hearing loss, and otologic issues were documented. A separate cohort comprised of children with GHD without hearing loss was compared as a control.Results209 children with GHD met inclusion criteria. 173 (83%) of these patients had hearing loss. 79% of losses were bilateral and 21% were unilateral (309 total ears with hearing loss). 293 of the 309 ears with hearing loss had audiograms with ear-specific thresholds; 47 had conductive, 24 had sensorineural, 65 had mixed and 157 had undefined hearing loss with incomplete audiograms. Pure-tone averages (PTA) were higher among patients with mixed hearing loss compared to patients with all other loss types.ConclusionHearing loss is prevalent in children with GHD with a predisposition to be bilateral. These findings suggest the need for increased awareness and routine hearing screening for patients with GHD. Further studies may elucidate the etiology of the hearing impairment in children with GHD to better aid pediatricians, endocrinologists, otolaryngologists and audiologists when assessing and managing these children.



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A novel management of streptococcal pharyngotonsillar infections by laser-activated silver nanoparticles and methylene blue conjugate, in vitro study

Publication date: September 2017
Source:International Journal of Pediatric Otorhinolaryngology, Volume 100
Author(s): Ahmed Kassab, Ola Dabous, Mona Morsy
IntroductionSpecies of Streptococcus are classified based on their hemolytic properties into alpha and beta types. And, since antimicrobial drug resistance is an increasingly problematic issue, the efforts to develop modalities that would overcome this obstacle and avoid antibiotic side effects is an ongoing challenge.Methods and materials20 patients from both sexes were selected. The isolated organisms were identified according to standard laboratory methods. Bacterial Cultures were subjected to the low-level diode laser (660 nm), methylene blue (MB) as a photosensitizing agent and for silver nanoparticles.ResultsAll the experimental groups showed statistically lower values of CFU/ml than the positive control group. Conclusion: The photoactivated MB, silver nanoparticles conjugate showed the maximum inhibitory effect on Streptococci, which opens a gate to further investigation of such a promising protocol to establish a safe and efficient method of management for resistant cases of streptococcal tonsillar infections.



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Intracranial complications of CSOM in pediatric patients: A persisting problem in developing countries

Publication date: September 2017
Source:International Journal of Pediatric Otorhinolaryngology, Volume 100
Author(s): Avani Jain, Nikhil Arora, Ravi Meher, J.C. Passey, Ramanuj Bansal
BackgroundIntracranial complications (ICC) of chronic suppurative otitis media (CSOM) occur even in the antibiotic area. These complications are commonly seen in pediatric patients due to poor hygiene and low immunity. They are more prevalent in developing countries due to illiteracy, low socioeconomic status and lack of access to health care facilities.ObjectiveTo study the incidence, clinical profile, treatment and outcome of pediatric patients presenting with intracranial complications of chronic suppurative otitis media.MethodsA retrospective analysis of intracranial complications of CSOM in pediatric patients was conducted over a period of 15 years at a tertiary level institute. Data regarding age, sex, clinical presentation, laboratory and radiological investigations, management, duration of hospitalization, and outcomes were recorded.ResultsThere were 142 patients, in the pediatric age group, diagnosed as having intracranial complications due to chronic otitis media during the study period. There was a decline in the incidence of ICC of CSOM. The most frequent intracranial complication seen was brain abscess (58.5%). All patients were administered intravenous antibiotics for 4–6 weeks and underwent canal wall down mastoidectomy. Neurosurgical intervention was considered in the required patients. The case fatality rate in our study was 2.8% (4 patients).ConclusionOtogenic intracranial complications can be fatal if not managed appropriately and timely. Broad spectrum intravenous antibiotics are usually required for 4–6 weeks with or without neurosurgical intervention and mastoid exploration. A high index of suspicion is required in all patients presenting with danger symptoms.



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Comparison of Different Hearing Aid Prescriptions for Children.

Objectives: To assess whether there are significant differences between speech scores for different hearing aid prescription methods, specifically DSL i/o, DSL V, and NAL-NL1, using age-appropriate closed- and open-set speech tests with young children, designed to avoid floor and ceiling effects. Design: Participants were 44 children with moderate or severe bilateral hearing loss, 8 aged 2 to 3 years, 15 aged 4 to 5 years, and 21 aged 6 to 9 years. Children wore bilateral hearing aids fitted with each prescription method in turn in a balanced double-blind design. The speech tests used with each child (and for some tests the levels) were chosen so as to avoid floor and ceiling effects. For the closed-set tests, the level used was selected for each child based on their hearing loss. The tests used were: (1) The closed-set Consonant Confusion Test of word identification; (2) The closed-set Chear Auditory Perception Test (CAPT) of word identification. This has separate sections assessing discrimination of consonants and vowels and detection of consonants; (3) The open-set Cambridge Auditory Word Lists for testing word identification at levels of 50 and 65 dBA, utilizing 10 consonant-vowel-consonant real words that are likely to be familiar to children aged 3 years or older; (4) The open-set Common Phrases Test to measure the speech reception threshold in quiet; (5) Measurement of the levels required for identification of the Ling 5 sounds, using a recording of the sounds made at the University of Western Ontario. Results: Scores for the Consonant Confusion Test and CAPT consonant discrimination and consonant detection were lower for the NAL-NL1 prescription than for the DSL prescriptions. Scores for the CAPT vowel-in-noise discrimination test were higher for DSL V than for either of the other prescriptions. Scores for the Cambridge Auditory Word Lists did not differ across prescriptions for the level of 65 dBA, but were lower for the NAL-NL1 prescription than for either of the DSL prescriptions for the level of 50 dBA. The speech reception threshold measured using the Common Phrases Test and the levels required for identification of the Ling 5 sounds were higher (worse) for the NAL-NL1 prescription than for the DSL prescriptions. Conclusions: The higher gains prescribed by the DSL i/o and DSL V prescription methods relative to NAL-NL1 led to significantly better detection and discrimination of low-level speech sounds. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

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Reversal learning in C58 mice: Modeling higher order repetitive behavior

Publication date: 14 August 2017
Source:Behavioural Brain Research, Volume 332
Author(s): Cristina M. Whitehouse, Lisa S. Curry-Pochy, Robin Shafer, Joseph Rudy, Mark H. Lewis
Restricted, repetitive behaviors are diagnostic for autism and prevalent in other neurodevelopmental disorders. These behaviors cluster as repetitive sensory-motor behaviors and behaviors reflecting resistance to change. The C58 mouse strain is a promising model for these behaviors as it emits high rates of aberrant repetitive sensory-motor behaviors. The purpose of the present study was to extend characterization of the C58 model to resistance to change. This was done by comparing C58 to C57BL/6 mice on a reversal learning task under either a 100% or 80%/20% probabilistic reinforcement schedule. In addition, the effect of environmental enrichment on performance of this task was assessed as this rearing condition markedly reduces repetitive sensory-motor behavior in C58 mice. Little difference was observed between C58 and control mice under a 100% schedule of reinforcement. The 80%/20% probabilistic schedule of reinforcement generated substantial strain differences, however. Importantly, no strain difference was observed in acquisition, but C58 mice were markedly impaired in their ability to reverse their pattern of responding from the previously high density reinforcement side. Environmental enrichment did not impact acquisition under the probabilistic reinforcement schedule, but enriched C58 mice performed significantly better than standard housed C58 mice in reversal learning. Thus, C58 mice exhibit behaviors that reflect both repetitive sensory motor behaviors as well as behavior that reflects resistance to change. Moreover, both clusters of repetitive behavior were attenuated by environmental enrichment. Such findings, along with the reported social deficits in C58 mice, increase the translational value of this mouse model to autism.



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Environmental enrichment attenuates behavioral abnormalities in valproic acid-exposed autism model mice

Publication date: 30 August 2017
Source:Behavioural Brain Research, Volume 333
Author(s): Hiroshi Yamaguchi, Yuta Hara, Yukio Ago, Erika Takano, Shigeru Hasebe, Takanobu Nakazawa, Hitoshi Hashimoto, Toshio Matsuda, Kazuhiro Takuma
We recently demonstrated that prenatal exposure to valproic acid (VPA) at embryonic day 12.5 causes autism spectrum disorder (ASD)-like phenotypes such as hypolocomotion, anxiety-like behavior, social deficits and cognitive impairment in mice and that it decreases dendritic spine density in the hippocampal CA1 region. Previous studies show that some abnormal behaviors are improved by environmental enrichment in ASD rodent models, but it is not known whether environmental enrichment improves cognitive impairment. In the present study, we examined the effects of early environmental enrichment on behavioral abnormalities and neuromorphological changes in prenatal VPA-treated mice. We also examined the role of dendritic spine formation and synaptic protein expression in the hippocampus. Mice were housed for 4 weeks from 4 weeks of age under either a standard or enriched environment. Enriched housing was found to increase hippocampal brain-derived neurotrophic factor mRNA levels in both control and VPA-exposed mice. Furthermore, in VPA-treated mice, the environmental enrichment improved anxiety-like behavior, social deficits and cognitive impairment, but not hypolocomotion. Prenatal VPA treatment caused loss of dendritic spines in the hippocampal CA1 region and decreases in mRNA levels of postsynaptic density protein-95 and SH3 and multiple ankyrin repeat domains 2 in the hippocampus. These hippocampal changes were improved by the enriched housing. These findings suggest that the environmental enrichment improved most ASD-like behaviors including cognitive impairment in the VPA-treated mice by enhancing dendritic spine function.



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