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Hearing Disorders: HELP
Articles from Milan area
Based on 196 articles published since 2010
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These are the 196 published articles about Hearing Disorders that originated from Milan area during 2010-2020.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7 · 8
151 Article Intratympanic steroid treatment for sudden deafness: a meta-analysis of randomized controlled trials. 2012

Garavello, Werner / Galluzzi, Francesca / Gaini, Renato Maria / Zanetti, Diego. ·Otorhinolaryngology Department, DNTB, University of Milano-Bicocca, Monza, Italy. werner.garavello@unimib.it ·Otol Neurotol · Pubmed #22699982.

ABSTRACT: BACKGROUND: The efficacy of intratympanic steroid (ITS) treatment in sudden deafness (SD) remains controversial. To shed light on this issue, we performed a systematic review of randomized controlled trials to assess the overall efficacy of ITS therapy and to clarify whether it is more suitable as a first-line approach (primary treatment) or as a salvage treatment when traditional systemic agents have failed. METHODS: An electronic database search (MEDLINE and PubMed) was performed with the objective of identifying all studies published in the English language between January 1980 and November 2011 on the efficacy of ITS in the treatment of SD. All relevant articles were retrieved, and the related reference lists were reviewed systematically to identify other reports that could be included. Data were synthesized using the Mantel-Haenszel model. Results are expressed as odds ratio (OR) with 95% confidence interval (CI). RESULTS: A total of 11 randomized studies including 472 subjects allocated to ITS and 453 controls were selected. Intratympanic steroid regimens used and treatments administered to controls varied widely across studies. When considering together trials investigating ITS therapy as a primary (n = 4) or salvage (n = 7) treatment, the common OR for recovery was 1.7 (95% CI, 1.3-2.3). When considering them separately, the common ORs for recovery were 0.9 (95% CI, 0.7-1.6) for primary and 2.9 (95% CI, 1.9-4.5) for salvage therapy. CONCLUSION: Intratympanic steroid therapy seems to confer a certain degree of benefit as a salvage but not as a primary treatment of SD. However, further evidence is needed to clarify some yet uncertain aspects, such as the optimal protocol of therapy.

152 Article VTMR, a new speech audiometry test with verbal tasks and motor responses. 2012

Di Berardino, Federica / Forti, Stella / Cesarani, Antonio. ·Dipartimento di Scienze Chirurgiche Specialistiche, Università degli Studi di Milano, Milan, Italy. federica.diberardino@unimi.it ·Ann Otol Rhinol Laryngol · Pubmed #22606929.

ABSTRACT: OBJECTIVES: The aim of this study was to design a complementary speech audiometry test using verbal tasks and motor responses (VTMR) to assess the ability of a subject to understand and perform simple motor tasks with 3-dimensional objects, to describe its construction, and to show the preliminary results of a pilot study on the Italian version of the test. METHODS: The items used in the test setting included 1 base, 1 hammer, 1 wooden structure with 4 sticks, and 5 rings of different colors and 20 lists with 5 verbal tasks per list. The VTMR test and bisyllabic speech audiometry were evaluated in normal-hearing subjects with and without cognitive impairment and in subjects with sensorineural hearing loss. RESULTS: All normal-hearing subjects without cognitive impairment performed the VTMR tasks (100%) correctly at 35 dB sound pressure level. In subjects with sensorineural hearing loss, the percentage of correct answers was significantly higher for the VTMR test than for bisyllabic speech audiometry above 50 dB sound pressure level. This percentage was higher for the VTMR also in normal-hearing subjects with poor cognitive skills. CONCLUSIONS: The VTMR might make it easier to check patients' ability to understand verbal commands than does traditional speech audiometry, in particular in those patients with poor test-taking skills.

153 Article Audiological findings in Williams syndrome: a study of 69 patients. 2012

Barozzi, Stefania / Soi, Daniela / Comiotto, Elisabetta / Borghi, Anna / Gavioli, Chiara / Spreafico, Emanuela / Gagliardi, Chiara / Selicorni, Angelo / Forti, Stella / Ambrosetti, Umberto / Cesarani, Antonio / Brambilla, Daniele. ·Audiologic Unit, Department of Specialized Surgical Sciences, University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milano, Italy. stefania.barozzi@unimi.it ·Am J Med Genet A · Pubmed #22411878.

ABSTRACT: The aim of this study was to investigate, in a clinical setting, the auditory function of a group of individuals affected by Williams syndrome (WS). Sixty-nine patients with WS, aged 2-30, underwent comprehensive audiological testing including air/bone conduction behavioral audiometry, speech audiometry, tympanometry and measurement of the acoustic reflex, transient evoked otoacoustic emissions and brainstem auditory evoked responses. Hearing loss, defined by a pure-tone average above 15 dB HL, affected 22.6% of the patients studied with traditional audiometry and was mostly slight in severity. Hearing loss was conductive in 9.4% of patients, mainly children with otitis media with effusion, and sensorineural in 13.2% of patients. However, 30% of the ears studied had a hearing impairment in the high frequency range (high-frequency pure-tone audiometry above 15 dB HL), higher in participants above 15 years (46.15%) than in the younger ones (23.45%). Contralateral stapedial reflexes were present in all patients with A-type tympanograms. Transient otoacoustic emissions were absent in 44% of the ears of patients with normal hearing. Brainstem auditory evoked responses fell within normal ranges thus confirming the absence of retrocochlear dysfunction. Although hearing loss does not seem to be frequent, a cochlear fragility, especially in the high frequency range, related to outer hair cells is characteristic of WS. Therefore we strongly recommend monitoring patients affected by WS using annual audiometric tests and performing otoacoustic emissions in order to identify a subclinical cochlear dysfunction which might benefit from an audiological follow up before the possible onset of hearing loss.

154 Article Electric field and current density distribution in an anatomical head model during transcranial direct current stimulation for tinnitus treatment. 2012

Parazzini, Marta / Fiocchi, Serena / Ravazzani, Paolo. ·National Research Council, Institute of Biomedical Engineering, ISIB-CNR, Milan, Italy. marta.parazzini@polimi.it ·Bioelectromagnetics · Pubmed #22298345.

ABSTRACT: Tinnitus is considered an auditory phantom percept. Recently, transcranial direct current stimulation (tDCS) has been proposed as a new approach for tinnitus treatment including, as potential targets of interest, either the temporal and temporoparietal cortex or prefrontal areas. This study investigates and compares the spatial distribution of the magnitude of the electric field and the current density in the brain tissues during tDCS of different brain targets. A numerical method was applied on a realistic human head model to calculate these field distributions in different brain structures, such as the cortex, white matter, cerebellum, hippocampus, medulla oblongata, pons, midbrain, thalamus, and hypothalamus. Moreover, the same distributions were evaluated along the auditory pathways. Results of this study show that tDCS of the left temporoparietal cortex resulted in a widespread diffuse distribution of the magnitude of the electric fields (and also of the current density) on an area of the cortex larger than the target brain region. On the contrary, tDCS of the dorsolateral prefrontal cortex resulted in a stimulation mainly concentrated on the target itself. Differences in the magnitude distribution were also found on the structures along the auditory pathways. A sensitivity analysis was also performed, varying the electrode position and the human head models. Accurate estimation of the field distribution during tDCS in different regions of the head could be valuable to better determine and predict efficacy of tDCS for tinnitus suppression.

155 Article Molecular and functional studies of 4 candidate loci in Pendred syndrome and nonsyndromic hearing loss. 2012

Cirello, Valentina / Bazzini, Claudia / Vezzoli, Valeria / Muzza, Marina / Rodighiero, Simona / Castorina, Pierangela / Maffini, Antonia / Bottà, Guido / Persani, Luca / Beck-Peccoz, Paolo / Meyer, Giuliano / Fugazzola, Laura. ·Dept. of Medical Sciences, Università degli Studi, Milan, Italy. ·Mol Cell Endocrinol · Pubmed #22285650.

ABSTRACT: Patients with PS or non-syndromic deafness were submitted to genetic/functional analyzes of SLC26A4, of its binding domain for FOXI1 (FOXI1-DBD), of the transcription activator FOXI1, and of the potassium channel KCNJ10. SLC26A4 was the most frequently mutated gene. An altered intracellular localization with immunocytochemistry, and a hampered maturation process were demonstrated for two novel SLC26A4 variants. Biochemical and immunocytochemical analyzes led to the development of a more sensitive fluorometric functional assay able to reveal the partial loss-of-function of SLC26A4 mutations. A novel missense variant was found in FOXI1 gene, though functional analysis showed no significant impairment in the transcriptional activation of SLC26A4. Finally, 3 patients were found to harbor a variant in KCNJ10, which was classified as polymorphism. The novelty of the study resides in the analysis of all the 4 candidate genetic loci linked to PS/non-syndromic deafness, and in the precise definition of the thyroid phenotype. PS was invariably associated with biallelic mutations of SLC26A4, whereas the genetic origin of non-syndromic deafness remained largely undetermined, since monoallelic SLC26A4 variants accounted for one fourth of the cases and FOXI1 and KCNJ10 were not involved in this series.

156 Article Myringoplasty in simple chronic otitis media: critical analysis of long-term results in a 1,000-adult patient series. 2012

Nardone, Massimiliano / Sommerville, Ryan / Bowman, James / Danesi, Giovanni. ·ENT Department and Microsurgery of Skull Base, Ospedali Riuniti, Bergamo, Italy. mnardone@ospedaliriuniti.bergamo.it ·Otol Neurotol · Pubmed #22143300.

ABSTRACT: OBJECTIVES: Investigate the recurrence of chronic otitis media after primary and revision myringoplasty, compare long-term anatomic and audiologic results of underlay and overlay myringoplasty, and examine the prognostic factors. STUDY DESIGN: Retrospective study. PATIENTS: Approximately 1,040 adult patients with chronic simple otitis media undergoing a myringoplasty (overlay and underlay) by different surgeons at a single institution (ENT Department of Bergamo Ospedali Riuniti) between May 1999 and March 2009. METHODS: The cumulative recurrence rate of chronic otitis media during 10-year follow-up period was calculated using a Kaplan-Meier survival analysis. A multivariate analysis was used to evaluate different prognostic factors based on long-term outcome in myringoplasty. RESULTS: The overall 10-year graft success rate was 78% in 1,040 patients. The 10-year recurrence rate of chronic otitis media was 15% in overlay myringoplasty and 26% using the underlay technique (p < 0.05). In revision myringoplasty, the overlay technique showed a better success rate than underlay (p < 0.05). Significant recovery was observed in the air conduction thresholds and air-bone gaps in both groups with no statistical difference between techniques (p = 0.1). Multivariate analysis demonstrated that the underlay myringoplasty technique, a pathologic contralateral ear and an anterior or subtotal perforation, using a perichondrial graft or age of surgery younger than 40 years were statistically significant (p < 0.01) factors that negatively influenced the myringoplasty outcomes. CONCLUSION: More successful outcomes in primary and revision surgery for chronic otitis media occurred using overlay myringoplasty, although there were more minor postoperative complications. Both clinical and technical variables affected the success rate of myringoplasty.

157 Article ENT function in a 14-days guinness scuba dive. 2012

Revelli, L / D'Alatri, L / Scorpecci, A / D'Amore, A / De Corso, E / Lombardi, C P / Fetoni, A R. ·Endocrine Surgery Unit, Catholic University of Rome, Italy. lucarevelli@rm.unicatt.it ·Int J Sports Med · Pubmed #22095323.

ABSTRACT: Scuba diving is known to affect the rhino-pharyngo-tubaric district (RPT unit). The aim of the study was to document function modifications of the RPT unit in 6 Italian divers (3 men and 3 women) who lived for 14 days consecutively at a depth of 8-10 m, breathing air (21% oxygen) at a pressure ranging between 1.8 and 2 ATA. RPT and inner ear assessment were carried out before the dive (TIME 0) and 24 h (TIME 1) after resurfacing, in order to investigate diving-related RPT and inner ear alterations. Physical examination after resurfacing revealed: fungal external otitis, otoscopic findings consistent with middle ear barotraumas and rhinosinusitis. Rhino-manometry showed a remarkable increase in inspiratory nasal flow and a substantial decrease in nasal resistance. No epithelial cell disruption was retrieved comparing pre and post resurfacing samples. Post-diving tubaric dysfunction was found. Pure tone audiometry revealed a bilateral 40 dB HL hearing loss at 4 kHz in 1 diver. Relevant PTA functions did not seem to be affected by the experiment, no remarkable changes were found at the Sensory Organisation Test and at the Motor Control Test. The 14-day underwater period had a positive effect on nasal flows and resistances.

158 Article A novel mutation within the MIR96 gene causes non-syndromic inherited hearing loss in an Italian family by altering pre-miRNA processing. 2012

Soldà, Giulia / Robusto, Michela / Primignani, Paola / Castorina, Pierangela / Benzoni, Elena / Cesarani, Antonio / Ambrosetti, Umberto / Asselta, Rosanna / Duga, Stefano. ·Dipartimento di Biologia e Genetica per Scienze Mediche, Università degli Studi di Milano, Milan, Italy. giulia.solda@unimi.it ·Hum Mol Genet · Pubmed #22038834.

ABSTRACT: The miR-96, miR-182 and miR-183 microRNA (miRNA) family is essential for differentiation and function of the vertebrate inner ear. Recently, point mutations within the seed region of miR-96 were reported in two Spanish families with autosomal dominant non-syndromic sensorineural hearing loss (NSHL) and in a mouse model of NSHL. We screened 882 NSHL patients and 836 normal-hearing Italian controls and identified one putative novel mutation within the miR-96 gene in a family with autosomal dominant NSHL. Although located outside the mature miR-96 sequence, the detected variant replaces a highly conserved nucleotide within the companion miR-96*, and is predicted to reduce the stability of the pre-miRNA hairpin. To evaluate the effect of the detected mutation on miR-96/mir-96* biogenesis, we investigated the maturation of miR-96 by transient expression in mammalian cells, followed by real-time reverse-transcription polymerase chain reaction (PCR). We found that both miR-96 and miR-96* levels were significantly reduced in the mutant, whereas the precursor levels were unaffected. Moreover, miR-96 and miR-96* expression levels could be restored by a compensatory mutation that reconstitutes the secondary structure of the pre-miR-96 hairpin, demonstrating that the mutation hinders precursor processing, probably interfering with Dicer cleavage. Finally, even though the mature miR-96 sequence is not altered, we demonstrated that the identified mutation significantly impacts on miR-96 regulation of selected targets. In conclusion, we provide further evidence of the involvement of miR-96 mutations in human deafness and demonstrate that a quantitative defect of this miRNA may contribute to NSHL.

159 Article Hearing shapes our perception of time: temporal discrimination of tactile stimuli in deaf people. 2012

Bolognini, Nadia / Cecchetto, Carlo / Geraci, Carlo / Maravita, Angelo / Pascual-Leone, Alvaro / Papagno, Costanza. ·Department of Psychology, University of Milano-Bicocca, Piazza dellʼAteneoNuovo 1, Milan, Italy. costanza.papagno@unimib.it ·J Cogn Neurosci · Pubmed #21916563.

ABSTRACT: Confronted with the loss of one type of sensory input, we compensate using information conveyed by other senses. However, losing one type of sensory information at specific developmental times may lead to deficits across all sensory modalities. We addressed the effect of auditory deprivation on the development of tactile abilities, taking into account changes occurring at the behavioral and cortical level. Congenitally deaf and hearing individuals performed two tactile tasks, the first requiring the discrimination of the temporal duration of touches and the second requiring the discrimination of their spatial length. Compared with hearing individuals, deaf individuals were impaired only in tactile temporal processing. To explore the neural substrate of this difference, we ran a TMS experiment. In deaf individuals, the auditory association cortex was involved in temporal and spatial tactile processing, with the same chronometry as the primary somatosensory cortex. In hearing participants, the involvement of auditory association cortex occurred at a later stage and selectively for temporal discrimination. The different chronometry in the recruitment of the auditory cortex in deaf individuals correlated with the tactile temporal impairment. Thus, early hearing experience seems to be crucial to develop an efficient temporal processing across modalities, suggesting that plasticity does not necessarily result in behavioral compensation.

160 Article Unbalanced oxidative status in idiopathic sudden sensorineural hearing loss. 2012

Capaccio, Pasquale / Pignataro, Lorenzo / Gaini, Lorenzo M / Sigismund, Paolo E / Novembrino, Cristina / De Giuseppe, Rachele / Uva, Valentina / Tripodi, Armando / Bamonti, Fabrizia. ·Dipartimento di Scienze Specialistiche e Chirurgiche, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122, Milan, Italy. ·Eur Arch Otorhinolaryngol · Pubmed #21706323.

ABSTRACT: An impaired cochlear perfusion seems to be an important etiopathogenetic event in idiopathic sudden sensorineural hearing loss (ISSNHL). Recently, oxidative stress has been proposed as risk factors of microvascular damage. This observational study aimed to evaluate the possible role of oxidative stress in ISSNHL. In thirty-nine ISSNHL patients and seventy healthy subjects serum reactive oxygen species concentrations (ROS) and total antioxidant capacity (TAC) were measured by spectrophotometric methods on F.R.E.E. analyzer (Diacron International, Italy). Moreover, a global oxidative stress index (Oxidative-INDEX), reflecting both oxidative and antioxidant counterparts, was also calculated. 25/39 patients showed oxidative stress due to ROS levels significantly higher than controls (348.2 ± 84.8 vs. 306.75 ± 46.7 UCarr; p = 0.001). The Oxidative-INDEX was significantly higher in patients than in controls (0.75 ± 2.4 vs. -0.0007 ± 1.28 AU, p = 0.03). As oxidative stress is a key determinant in endothelial dysfunction, our findings could suggest vascular impairment involvement in ISSNHL etiopathogenesis.

161 Article Overlay versus underlay myringoplasty: report of outcomes considering closure of perforation and hearing function. 2011

Sergi, B / Galli, J / De Corso, E / Parrilla, C / Paludetti, G. ·Clinic of Otorhinolaryngology, Università Cattolica, Rome, Italy. bruno.sergi@rm.unicatt.it ·Acta Otorhinolaryngol Ital · Pubmed #22323847.

ABSTRACT: In this series of patients, the underlay or overlay positioning of a graft achieves successful outcome for both repair of perforation and hearing function, with better hearing gain in the underlay group. In myringoplasty, the two most common techniques for positioning the graft relative to the remnant of both the tympanic membrane and the annulus are the "overlay" and the "underlay" techniques. 115 patients who underwent myringoplasty for tympanic membrane perforation secondary to chronic otitis media and/or trauma were included, and hearing function was evaluated. We prefer an overlay technique in subtotal perforations, in those involving the anterior and antero-inferior parts of the ear drum with respect to the handle of the malleus and in revision surgery. We reserve an underlay technique for smaller perforations and for those limited to the posterior part of the tympanic membrane. Of 115 cases, 63 underwent an overlay myringoplasty and 52 underlay myringoplasty. In the former group, five cases were anatomically unsuccessful, whereas in the second group there were three failures. The air bone gap improved significantly in both groups with a better hearing gain in the underlay group.

162 Article [Growth hormone deficiency associated with 22q11.2 deletion: a case report]. 2011

Bizzocchi, A / Genoni, G / Petri, A / Prodam, F / Negro, M / Bellone, S / Bona, G. ·Dipartimento di Scienze Mediche Clinica Pediatrica, Università del Piemonte Orientale, Novara, Italia. ·Minerva Pediatr · Pubmed #22075807.

ABSTRACT: The 22q11.2 microdeletion produces many syndromes, characterized by similar phenotypical features. The most known syndromes are: the DiGeorge syndrome, the velocardiofacial syndrome, the conotruncal anomaly face syndrome. The hallmark features are represented by cardiac anomalies, palate defects, immune and cognitive deficiencies, facial dysmorphisms. Less common disorders include: genito-urinary abnormalities, visual defects, autoimmune disorders and pituitary anomalies, being the last represented by growth hormone and/or insulin growth factor-I deficiency. We present the case of a 8 years old male admitted to our Division for failure to thrive. We found growth hormone deficiency and pituitary hypoplasia associated with some of the anomalies shown above, thus we suspected and confirmed the 22q11.2 deletion syndrome. In literature few cases of associated 22q11.2 deletion syndrome with growth hormone deficiency are described, while short stature between children with and children without cleft palate is reported to be more frequent in the first ones, suggesting that the 22q11.2 deletion syndrome remains undetected in many affected children and that the growth hormone deficiency prevalence in affected children has to be investigated. The wide phenotypical presentation of 22q11.2 deletion syndrome requires a multidisciplinary approach to the affected subject and, from the auxologic point of view, is good to monitoring the growing trend and, if short stature is present, check for the growth hormone deficiency.

163 Article [NHIL epidemiology in Italy. 20 years from DLgs 277/91: review and expectations]. 2011

Calcinoni, Orietta / Pecorari, Giancarlo / Giordano, Carlo. ·ENT. INAIL*CPDR, Corso di Porta Nuova 19, 20121 Milan, Italy. o.calcinoni@inail.it ·G Ital Med Lav Ergon · Pubmed #22073683.

ABSTRACT: Digs 277/91 and following related laws brought up a large number of NHILs, but also planned surveillance more and more effective in preventing hearing loss. In these two decades we also saw an inversion in percentages between working populations. The Authors analize these two factors, better and wider prevention and changing in work populations, related to resulting reduction of NHIL's cases. Besides, the Authors compare different insurance scales adopted to evaluate hearing damage in this period, bringing out similarities. INAIL's path achieved another last goal since 2007 in planning the new protocol about hearing aids, aiming to more effective compensation of the recognized hearing loss, looking more at "Biological value" of the person than at former "working capability".

164 Article Hearing preservation surgery in acoustic neuroma. Slow progress and new strategies. 2011

Mazzoni, A / Biroli, F / Foresti, C / Signorelli, A / Sortino, C / Zanoletti, E. ·Otolaryngology Unit, Department of Neurosurgery and Neurological Sciences, Ospedali Riuniti, Bergamo, Italy. antonio.mazzoni@libero.it ·Acta Otorhinolaryngol Ital · Pubmed #22064847.

ABSTRACT: Quality and rate of preserved hearing are crucial to make hearing preservation surgery a viable treatment. A long-term experience with hearing preservation surgery, with tumour size and hearing as admission criteria, was evaluated to assess which size and hearing allowed a high rate of success. The hearing outcome in relation to size of tumour and pre-operative hearing was retrospectively reviewed in a consecutive series of 115 cases of sporadic acoustic neuroma which were operated on with hearing preservation surgery. Inclusion criteria were hearing with ≤ 30 dB pure tone average and ≥ 70% Speech Discrimination Score. The size was ≤ 15 mm in the first series of 51 cases, and ≤ 10 mm in the second series of 64 cases. Pre-operative and post-operative pure tone average were measured at 0.5 to 4.0 KHz, and speech discrimination score at ≤ 40 dB above perception. Post-operative hearing within 30 dB pure tone average and 70% speech discrimination score was considered socially useful hearing and successful outcome. The change to 40 dB pure tone average and 60% speech discrimination score from a pre-operative 30 pure tone average/70% speech discrimination score was considered an acceptable outcome. Patients with a tumour of ≤ 10 mm size in the cerebello-pontine-angle and hearing within 20 dB pure tone average/80% speech discrimination score had a success rate of 76%. Patients with hearing between the 20 dB pure tone average/80% speech discrimination score and 30 dB pure tone average/ 70% speech discrimination score had a success rate of 41%, which increased to 53% if the limit to success was set at 40 dB pure tone average/60% speech discrimination score. Patients with a tumour larger than 10 mm or hearing worse than 30 dB pure tone average/70% speech discrimination score had a poor preservation rate. In conclusion, hearing preservation surgery on a ≤ 10 mm acoustic neuroma with good hearing had a high rate of success and appeared to be a realistic treatment option which could be integrated with observation and radiotherapy in updated guidelines of treatment.

165 Article Post-processing analysis of transient-evoked otoacoustic emissions to detect 4 kHz-notch hearing impairment--a pilot study. 2011

Zimatore, Giovanna / Fetoni, Anna Rita / Paludetti, Gaetano / Cavagnaro, Marta / Podda, Maria Vittoria / Troiani, Diana. ·Institute of Otolaryngology, Catholic University School of Medicine, Rome, Italy. ·Med Sci Monit · Pubmed #21629197.

ABSTRACT: BACKGROUND: To identify a parameter to distinguish normal hearing from hearing impairment in the early stages. The parameter was obtained from transient-evoked otoacoustic emissions (TEOAEs), overcoming the limitations of the usually adopted waveform descriptive parameters which may fail in standard clinical screenings. MATERIAL/METHODS: Audiometric examinations and TEOAE analysis were conducted on 15 normal ears and on 14 hearing-impaired ears that exhibited an audiometric notch around 4 kHz. TEOAE signals were analyzed through a multivariate technique to filter out the individual variability and to highlight the dynamic structure of the signals. The new parameter (named radius 2-dimension--RAD2D) was defined and evaluated for simulated TEOAE signals modeling a different amount of hearing impairment. RESULTS: Audiometric examinations indicated 14 ears as impaired-hearing (IH), while the TEOAE ILO92 whole reproducibility parameter (WWR) indicated as IH 7 signals out of 14 (50%). The proposed new parameter indicated as IH 9 signals out of 14 (64%), reducing the number of false negative cases of WWR. CONCLUSIONS: In this preliminary study there is evidence that the new parameter RAD2D defines the topology and the quantification of the damage in the inner ear. The proposed protocol can be useful in hearing screenings to identify hearing impairments much earlier than conventional pure tone audiometry and TEOAE pass/fail test.

166 Article Open ear hearing aids in tinnitus therapy: An efficacy comparison with sound generators. 2011

Parazzini, Marta / Del Bo, Luca / Jastreboff, Margaret / Tognola, Gabriella / Ravazzani, Paolo. ·Consiglio Nazionale delle Ricerche, Istituto di Ingegneria Biomedica, Piazza Leonardo da Vinci 32, Milan, Italy. marta.parazzini@polimi.it ·Int J Audiol · Pubmed #21595527.

ABSTRACT: OBJECTIVE: This study aimed to compare the effectiveness of tinnitus retraining therapy (TRT) with sound generators or with open ear hearing aids in the rehabilitation of tinnitus for a group of subjects who, according to Jastreboff categories, can be treated with both approaches to sound therapy (borderline of Category 1 and 2). DESIGN: This study was a prospective data collection with a parallel-group design which entailed that each subject was randomly assigned to one of the two treatments group: half of the subjects were fitted binaurally with sound generators, and the other half with open ear hearing aids. Both groups received the same educational counselling sessions. STUDY SAMPLE: Ninety-one subjects passed the screening criteria and were enrolled into the study. Structured interviews, with a variety of measures evaluated through the use of visual-analog scales and the tinnitus handicap inventory self-administered questionnaire, were performed before the therapy and at 3, 6, and 12 months during the therapy. RESULTS: Data showed a highly significant improvement in both tinnitus treatments starting from the first three months and up to one year of therapy, with a progressive and statistically significant decrease in the disability every three months. CONCLUSIONS: TRT was equally effective with sound generator or open ear hearing aids: they gave basically identical, statistically indistinguishable results.

167 Article Neurofeedback for subjective tinnitus patients. 2011

Crocetti, Andrea / Forti, Stella / Del Bo, Luca. ·Fondazione Ascolta e Vivi, Via Foppa 15, Milan, Italy. ·Auris Nasus Larynx · Pubmed #21592701.

ABSTRACT: OBJECTIVE: Previous studies report that enhanced power in the delta range (1.5-4Hz) and reduced power in the alpha frequency band (8-12Hz) were most pronounced in the temporal regions. These studies referred to the 8-12Hz activity as tau activity, and they created a new neurofeedback protocol to treat tinnitus using a temporally generated tau rhythm (8-12Hz) and slow waves in the delta range (3-4Hz) for feedback. This study aims to repeat this protocol and to evaluate its effect on tinnitus. METHODS: Fifteen normal-hearing patients with tinnitus were treated with the neurofeedback protocol. The Tinnitus Handicap Inventory and Visual Analogue Scales were administered before and after treatment and at 1, 3 and 6 months post-treatment. RESULTS: After therapy, all questionnaires scores were significant improved, and the improvements persisted throughout the followup period. Moreover, an increasing trend in the tau/delta ratio was observed; specifically, the trend was more stable respect of the pre-recording measure. However, only in some subjects may the signal alone be enough to develop the correct behaviors. CONCLUSION: Further studies are necessary to characterize the tinnitus subjects who recovered from and adapted to this psychophysical condition and, therefore, responded to neurofeedback therapy.

168 Article Cytomegalovirus DNA retrieval in the inner ear fluids of a congenitally deaf child one month after primary infection: a case report. 2011

Di Nardo, Walter / Cattani, Paola / Scorpecci, Alessandro / Giannantonio, Sara / D'Onghia, Sara / Fadda, Giovanni / Paludetti, Gaetano. ·Department of Otorhinolaryngology, Catholic University of Sacred Heart, Rome, Italy. ·Laryngoscope · Pubmed #21305557.

ABSTRACT: In the present article we report cytomegalovirus (CMV) DNA localization in the inner ear of a 15-month-old deaf boy 1 month after a virologically documented primary infection. CMV DNA retrieval was possible thanks to polymerase chain reaction analysis of the perilymph collected at cochlear implant surgery. To the authors' knowledge this is the first demonstration of CMV persistence in the cochlea of an immunocompetent subject after an acquired infection.

169 Article Cobalt, chromium and molybdenum ions kinetics in the human body: data gained from a total hip replacement with massive third body wear of the head and neuropathy by cobalt intoxication. 2011

Pazzaglia, U E / Apostoli, P / Congiu, T / Catalani, S / Marchese, M / Zarattini, G. ·Orthopaedic Clinic, University of Brescia, Italy. ·Arch Orthop Trauma Surg · Pubmed #21298277.

ABSTRACT: INTRODUCTION: A patient with a total hip replacement developed optic, acoustic and peripheral neuropathy from metal ions intoxication, due to the wear products released from the prosthesis. Subsequently the kinetics of the metal ions was studied. MATERIALS AND METHODS: Massive wear and acute intoxication allowed a study of the metal ions kinetics and of EDTA treatment. RESULTS: Plasma and other organic fluids were saturated by each of the metal ions released from the exposed surface according to the solubility of each ion; a larger fraction of Co ions was bound within red cells, while the plasmatic fraction appeared more movable. In a patient with a prosthesis subjected to wear, the ions released are from the prosthetic and from the debris surface (spread in the body). The latter is a function of the number and size of particles. DISCUSSION: Revision of the prosthesis from the point of view of the metal ions kinetics corresponded to a reduction of the releasing surface because of debris washed out by irrigation and tissue excision; however, the metal particles spread by lymphatic circulation continued to release ions even though the source of wear had been removed. Early diagnosis of high metal wear can be ascertained with mass spectrometry and after revision high levels of metal ions can only be reduced with repeated chelating treatment. It is preferable not to revise fractured ceramic components with a polyethylene-metal articulation.

170 Article Therapeutic window for ferulic acid protection against noise-induced hearing loss in the guinea pig. 2011

Fetoni, Anna Rita / Eramo, Sara / Troiani, Diana / Paludetti, Gaetano. ·Institutes of Otolaryngology, School of Medicine, Catholic University, Rome, Italy. afetoni@rm.unicatt.it ·Acta Otolaryngol · Pubmed #21198344.

ABSTRACT: CONCLUSION: Our results are in agreement with the general idea that natural antioxidants achieve their best cytoprotective capacity if given before and soon after the stressor. OBJECTIVE: We focused on ferulic acid (FA, 4-hydroxy 3-methoxycinnamic acid), a phenolic compound that is known to exhibit antioxidant properties. Our study was designed to evaluate the effectiveness of FA for different schedules of treatment to establish the 'therapeutic window' for FA protection. METHODS: Guinea pigs were exposed to acoustic trauma (6 kHz at 120 dB for 60 min) and received a total dose of 600 mg/kg of FA. Group I, noise control; group II, noise + FA (150 mg/kg) for 4 days starting 24 h post exposure; group III, noise + FA (60 mg/kg) 1 h before and 9 days post exposure; group IV, noise + FA (60 mg/kg) given 3 days before and 7 days post exposure; group V, noise + FA (150 mg/kg) 1 h before and 3 days post noise exposure. Auditory brainstem response (ABR) test and immunohistochemical and morphological studies were performed. RESULTS: Group V had significantly decreased noise-induced hearing loss at day 21 from noise exposure. The improvement of auditory function by FA was paralleled by a significant reduction in oxidative stress marker. The other schedules of drug administration showed a minor degree of protection.

171 Article GJB2 and MTRNR1 contributions in children with hearing impairment from Northern Cameroon. 2011

Trotta, Luca / Iacona, Elisabetta / Primignani, Paola / Castorina, Pierangela / Radaelli, Chiara / Del Bo, Luca / Coviello, Domenico / Ambrosetti, Umberto. ·Laboratory of Medical Genetics, Molecular Genetic Sector, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. ·Int J Audiol · Pubmed #21114417.

ABSTRACT: OBJECTIVE: the aim of this work was to evaluate the possible different impacts of genetic and environmental factors in childhood deafness in northern Cameroon. GJB2 mutations are responsible for more than half of all cases of prelingual nonsyndromic recessive deafness in Caucasians, representing the most important deafness-causing factor in the industrialized world. Other genes such as MTRNR1 are also involved. In sub-Saharan Africa, environmental factors seem to dominate genetic contributions, but few studies on the etiology of deafness in Africa are available for comparison. DESIGN: prospective cross sectional study. STUDY SAMPLE: we performed a molecular screen of the GJB2 and MTRNR1 genes in 70 deaf children and 67 unaffected controls in Maroua (Cameroon) and a literature analysis focused on deafness epidemiology in developing countries. RESULTS: no GJB2 mutations emerged, and only a single MTRNR1 variant that may be pathogenic was found. CONCLUSION: environmental factors turn out to be more relevant than genetic factor in the Maroua population.

172 Article Mitochondrial dementia: a sporadic case of progressive cognitive and behavioral decline with hearing loss due to the rare m.3291T>C MELAS mutation. 2011

Salsano, Ettore / Giovagnoli, Anna Rita / Morandi, Lucia / Maccagnano, Carmelo / Lamantea, Eleonora / Marchesi, Chiara / Zeviani, Massimo / Pareyson, Davide. ·IRCCS Foundation, C. Besta Neurological Institute, Via Celoria 11, 20133 Milano, Italy. ettore.salsano@istituto-besta.it ·J Neurol Sci · Pubmed #20943236.

ABSTRACT: We report the case of a 23-year-old Italian female harboring the rare m.3291T>C mutation in the MT-TL1 gene, that encodes the mitochondrial transfer RNA for leucine 1 (UUA/G). MT-TL1 mutations usually cause the MELAS (mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes) syndrome. Our patient, however, suffered from a non-syndromic mitochondrial disorder (MID), clinically characterized by progressive cognitive and behavioral decline, and hearing loss; brain MRI disclosed diffuse supratentorial and infratentorial atrophy; EKG revealed a Wolff-Parkinson-White syndrome; combined neuroleptic and antidepressant treatment markedly improved her behavioral symptoms. This case expands the clinical spectrum of non-syndromic MIDs, and further confirms that no obvious genotype-phenotype correlation exists for the m.3291T>C DNA mutation; indeed, this mutation has been previously reported in a Japanese child, who suffered from MELAS, and in an Italian child, who presented an apparently isolated mild myopathy. Moreover, it supports the hypothesis that at least in MT-TL1-related MIDs, dementia may be caused by a progressive neurodegenerative process, rather than by injury accumulation due to stroke-like episodes. Finally, our case suggests that common neuroleptic and antidepressant drugs may be clinically efficacious in the management of psychiatric symptoms associated with MIDs.

173 Article Absence of primary hypothyroidism and goiter in Slc26a4 (-/-) mice fed on a low iodine diet. 2011

Calebiro, D / Porazzi, P / Bonomi, M / Lisi, S / Grindati, A / De Nittis, D / Fugazzola, L / Marinò, M / Bottà, G / Persani, L. ·Department of Medical Sciences, University of Milan, Milan, Italy. ·J Endocrinol Invest · Pubmed #20834201.

ABSTRACT: BACKGROUND: Mutations in the SLC26A4 gene, coding for the anion transporter pendrin, are responsible for Pendred syndrome, characterized by congenital sensorineural deafness and dyshormonogenic goiter. The physiological role of pendrin in the thyroid is still unclear and the lack of a thyroid phenotype in some patients with SLC26A4 mutations and in Slc26a4 (-/-) mice indicate the existence of environmental or individual modifiers able to compensate for pendrin inactivation in the thyroid. Since pendrin can transport iodide in vitro, variations in iodide supply have been claimed to account for the thyroid phenotype associated with pendrin defects. AIM: The Slc26a4 (-/-) mouse model was used to test the hypothesis that iodide supply may influence the penetrance and expressivity of SLC26A4 mutations. MATERIALS AND METHODS: Slc26a4 (-/-) and (+/+) mice were fed up to 6 months on a standard or low iodine diet and were evaluated for thyroid structural abnormalities or biochemical hypothyroidism. RESULTS: A 27-fold iodide restriction induced similar modifications in thyroid histology, but no differences in thyroid size, T4 or TSH levels were observed between between Slc26a4 (-/-) and (+/+) mice, either in standard conditions and during iodine restriction. CONCLUSIONS: Iodide restriction is not able to induce a thyroid phenotype in Slc26a4 (-/-) mice. These experimental data, together with those coming from a review of familial Pendred cases leaving in regions either with low or sufficient iodide supply, support the idea that the expression of thyroid phenotype in Pendred syndrome is more powerfully influenced by individual factors than by dietary iodide.

174 Article Looking for an explanation for the low sign span. Is order involved? 2011

Gozzi, Marta / Geraci, Carlo / Cecchetto, Carlo / Perugini, Marco / Papagno, Costanza. ·Dipartimento di Psicologia, Università di Milano-Bicocca, Piazza dell'Ateneo Nuovo 1, Milan, Italy. ·J Deaf Stud Deaf Educ · Pubmed #20679138.

ABSTRACT: Although signed and speech-based languages have a similar internal organization of verbal short-term memory, sign span is lower than word span. We investigated whether this is due to the fact that signs are not suited for serial recall, as proposed by Bavelier, Newport, Hall, Supalla, and Boutla (2008. Ordered short-term memory differs in signers and speakers: Implications for models of short-term memory. Cognition, 107, 433-459). We administered a serial recall task with stimuli in Italian Sign Language to 12 deaf people, and we compared their performance with that of twelve age-, gender-, and education-matched hearing participants who performed the task in Italian. The results do not offer evidence for the hypothesis that serial order per se is a detrimental factor for deaf participants. An alternative explanation for the lower sign span based on signs being phonologically heavier than words is considered.

175 Article Improving melody recognition in cochlear implant recipients through individualized frequency map fitting. 2011

Di Nardo, Walter / Scorpecci, Alessandro / Giannantonio, Sara / Cianfrone, Francesca / Paludetti, Gaetano. ·Institute of Otorhinolaryngology, Catholic University of the Sacred Heart, A. Gemelli University Hospital, Largo Gemelli, 8, 00168, Rome, Italy. ·Eur Arch Otorhinolaryngol · Pubmed #20635091.

ABSTRACT: Recent research has shown that music perception remains very difficult for most cochlear implant (CI) users, who generally report being unsatisfied with the quality of music listening through the CI. In particular, the appreciation of the spectral features of music, which include pitch, melody and timbre, is widely known to be poorer than its rhythmic patterns. One of the possible causes for this may be the misalignment between the conventional frequency band allocation to the electrodes of the array (frequency-place function) and the distribution of pitch percepts generated by electrode stimulation along the array (electrode-pitch function). In this paper the authors investigate whether mismatch correction through individualized fitting of the processor's frequency maps can improve music understanding in ten Nucleus™ cochlear implant users, by comparing scores obtained with experimental and old map; both maps were tested before, immediately after and 1 month after the fitting through a music test battery designed for the purpose of the study.

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