The Annals of otology, rhinology & laryngology. Supplement最新文献

{"title":"Aberrant internal carotid artery in the middle ear.","authors":"Jochen P Windfuhr","doi":"10.1177/00034894041130s301","DOIUrl":"https://doi.org/10.1177/00034894041130s301","url":null,"abstract":"<p><p>This study was undertaken to evaluate the incidence, typical clinical signs, and proper management of patients with an aberrant internal carotid artery in the middle ear as presented in a case report and review of the relevant literature. A total of 86 cases were reviewed concerning gender, affected side, presenting symptoms, findings on clinical and radiologic examination, and further treatment. About two thirds of the patients (68.6%) were female. The right side was affected in 40 patients, and both sides were affected in 13 patients. Hearing loss (41 patients) and pulsatile tinnitus (26 patients) were the most common symptoms. Preponderances of affected side and gender seem to be reduced by the increasing number of reports. Bilateral findings are not unusual, indicating meticulous examination of both sides. Glomus tumors often mimic an aberrant internal carotid artery. If vascular malformations in the middle ear are suspected, high-resolution computed tomography or magnetic resonance angiography is required before any surgical intervention to exclude vascular malformations. Brisk bleeding, hemiparesis, aphasia, deafness, Horner's syndrome, and intractable vertigo may result if the lesion is injured unintentionally. Once the disorder is correctly diagnosed, yearly follow-up is advisable.</p>","PeriodicalId":76600,"journal":{"name":"The Annals of otology, rhinology & laryngology. Supplement","volume":"192 ","pages":"1-16"},"PeriodicalIF":0.0,"publicationDate":"2004-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/00034894041130s301","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24442515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Technology and the future of cochlear implants.","authors":"Ben M Clopton,&nbsp;Francis A Spelman","doi":"10.1177/00034894031120s906","DOIUrl":"https://doi.org/10.1177/00034894031120s906","url":null,"abstract":"Cochlear implants are one of the dramatic success stories of the bioengineering enterprise. Although these prostheses are used extensively, they still can be improved substantially. We suggest that high-density electrode designs will permit field shaping and field steering to an extent not presently possible with the arrays that are used today. Those opportunities will make it possible to make use of the phase information that is richly available to normal listeners. Although this information makes possible more precise location of sound sources in the auditory environment, and will likely improve the recognition of intelligent sound in noise, it will require the consumption of additional power in future cochlear prostheses. Those opportunities and trade-offs provide the designers of cochlear implants with exciting goals for the future.","PeriodicalId":76600,"journal":{"name":"The Annals of otology, rhinology & laryngology. Supplement","volume":"191 ","pages":"26-32"},"PeriodicalIF":0.0,"publicationDate":"2003-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/00034894031120s906","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24019105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing cochlear implant speech performance.","authors":"Margaret W Skinner","doi":"10.1177/00034894031120s903","DOIUrl":"https://doi.org/10.1177/00034894031120s903","url":null,"abstract":"<p><p>Results of studies performed in our laboratory suggest that cochlear implant recipients understand speech best if the following speech processor parameters are individually chosen for each person: minimum and maximum stimulation levels on each electrode in the speech processor program (MAP), stimulation rate, and speech coding strategy. If these and related parameters are chosen to make soft sounds (from approximately 100 to 6,000 Hz) audible at as close to 20 dB hearing level as possible and loud sounds not too loud, recipients have the opportunity to hear speech in everyday life situations that are of key importance to children who are learning language and to all recipients in terms of ease of communication.</p>","PeriodicalId":76600,"journal":{"name":"The Annals of otology, rhinology & laryngology. Supplement","volume":"191 ","pages":"4-13"},"PeriodicalIF":0.0,"publicationDate":"2003-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/00034894031120s903","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24019102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prosthetic stimulation of the auditory system with intraneural electrodes.","authors":"H Alexander Arts,&nbsp;Derek A Jones,&nbsp;David J Anderson","doi":"10.1177/00034894031120s905","DOIUrl":"https://doi.org/10.1177/00034894031120s905","url":null,"abstract":"<p><p>Prosthetic electrical stimulation of the auditory system is presently accomplished either via scala tympani electrode arrays or via cochlear nucleus surface electrode arrays. Many of the early cochlear implant studies, however, used electrode arrays placed within the auditory nerve itself--either within the modiolus or within the trunk of the nerve. For many reasons, such intraneural electrode arrays were abandoned in favor of intrascalar arrays. There remain, however, several theoretical and practical reasons why intraneural arrays might be advantageous, and recent developments in electrode technology solve many of the problems posed by early attempts at intraneural stimulation. In this article, we review the history and current status of intraneural auditory stimulation, and present some preliminary results of this mode of stimulation in an animal model.</p>","PeriodicalId":76600,"journal":{"name":"The Annals of otology, rhinology & laryngology. Supplement","volume":"191 ","pages":"20-5"},"PeriodicalIF":0.0,"publicationDate":"2003-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/00034894031120s905","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24019104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Signal coding in cochlear implants: exploiting stochastic effects of electrical stimulation.","authors":"Jay T Rubinstein,&nbsp;Robert Hong","doi":"10.1177/00034894031120s904","DOIUrl":"https://doi.org/10.1177/00034894031120s904","url":null,"abstract":"<p><p>Speech perception in quiet with cochlear implants has increased substantially over the past 17 years. If current trends continue, average monosyllabic word scores will be nearly 80% by 2010. These improvements are due to enhancements in speech processing strategies, to the implantation of patients with more residual hearing and shorter durations of deafness, and to unknown causes. Despite these improvements, speech perception in noise and music perception are still poor in most implant patients. These deficits may be partly due to poor representation of temporal fine structure by current speech processing strategies. It may be possible to improve both this representation and the dynamic range of electrical stimulation through the exploitation of stochastic effects produced by high-rate (eg, 5-kilopulse-per-second) pulse trains. Both the loudness growth and the dynamic range of low-frequency sinusoids have been enhanced via this technique. A laboratory speech processor using this strategy is under development. Although the clinical programming for such an algorithm is likely to be complex, some guidelines for the psychophysical and electrophysiological techniques necessary can be described now.</p>","PeriodicalId":76600,"journal":{"name":"The Annals of otology, rhinology & laryngology. Supplement","volume":"191 ","pages":"14-9"},"PeriodicalIF":0.0,"publicationDate":"2003-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/00034894031120s904","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24019103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Voice and treatment outcome from phonosurgical management of early glottic cancer.","authors":"Steven M Zeitels,&nbsp;Robert E Hillman,&nbsp;Ramon A Franco,&nbsp;Glenn W Bunting","doi":"10.1177/0003489402111s1202","DOIUrl":"https://doi.org/10.1177/0003489402111s1202","url":null,"abstract":"<p><p>Phonosurgical management of early glottic cancer has evolved considerably, but objective vocal outcome data are sparse. A prospective clinical trial was done on 32 patients with unilateral cancer (T1a in 28 and T2a in 4) who underwent ultranarrow-margin resection; 15 had resection superficial to the vocal ligament, and 17 deep to it. The subepithelial infusion technique facilitated selection of these patients for the appropriate procedure. All are cancer-free without radiotherapy or open surgery. Involvement of the anterior commissure (22/32) or the vocal process (15/32) of the arytenoid cartilage did not influence local control. Nine of 17 patients had resection of paraglottic musculature, and all underwent medialization reconstruction by lipoinjection and/or Gore-Tex laryngoplasty. Eight of the 17 had resections deep to the vocal ligament, but without vocalis muscle, and 1 of the 8 underwent medialization. Posttreatment vocal function measures were obtained for all patients. A clear majority of the patients displayed normal values for average fundamental frequency (72%) during connected speech, and normal noise-to-harmonics ratio (75%) and average glottal airflow (91%) measures during sustained vowels. Smaller majorities of patients displayed normal values for average sound pressure level (SPL; 59%) during connected speech and for maximum ranges for fundamental frequency (56%) and SPL (59%). Fewer than half of the patients displayed normal values for sustained vowel measures of jitter (45%), shimmer (22%), and maximum phonation time (34%). Almost all patients had elevated subglottal pressures and reduced values for the ratio of SPL to subglottal pressure (vocal efficiency). There were significant improvements in a majority of patients for most vocal function measures after medialization reconstruction. Normal or near-normal conversation-level voices were achieved in most cases, regardless of the disease depth, by utilization of a spectrum of resection and reconstruction options. These favorable results are based on establishing aerodynamic glottal competency and preserving the layered microstructure of noncancerous glottal tissue.</p>","PeriodicalId":76600,"journal":{"name":"The Annals of otology, rhinology & laryngology. Supplement","volume":"190 ","pages":"3-20"},"PeriodicalIF":0.0,"publicationDate":"2002-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0003489402111s1202","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22169990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phonomicrosurgery in singers and performing artists: treatment outcomes, management theories, and future directions.","authors":"Steven M Zeitels,&nbsp;Robert E Hillman,&nbsp;Rosemary Desloge,&nbsp;Marcello Mauri,&nbsp;Patricia B Doyle","doi":"10.1177/0003489402111s1203","DOIUrl":"https://doi.org/10.1177/0003489402111s1203","url":null,"abstract":"<p><p>Phonomicrosurgery in performing artists has historically been approached with great trepidation, and vocal outcome data are sparse. The vocal liability of surgically disturbing the superficial lamina propria (SLP) and epithelium must be balanced with the inherent detrimental vocal effect of the lesion(s). A prospective investigation was performed on 185 performing artists who underwent phonomicrosurgical resection of 365 lesions: 201 nodules, 71 polyps, 66 varices and ectasias, 13 cysts, 8 keratotic lesions, 2 granulomas, 2 Reinke's edema, and 2 papillomas. Nearly all patients with SLP lesions reported improvement in their postsurgical vocal function. This subjective result was supported by objective acoustic and aerodynamic measures. All postsurgical objective vocal function measures fell within normal limits, including a few that displayed presurgical abnormalities. However, given the relative insensitivity of standard objective measures to assess higher-level vocal performance-related factors, it is even more noteworthy that 8 of 24 objective measures displayed statistically significant postsurgical improvements in vocal function. Such changes in objective measures mostly reflect overall enhancement in the efficiency of voice production. Phonomicrosurgical resection of vocal fold lesions in performing artists is enjoying an expanding role because of a variety of improvements in diagnostic assessment, surgical instrumentation and techniques, and specialized rehabilitation. Most of these lesions are the result of phonotrauma and arise within the SLP. Successful management depends on prudent patient selection and counseling, ultraprecise technique, and vigorqus vocal rehabilitation. Furthermore, an understanding of the vocal function and dysfunction of this high-performance population provides all otolaryngologists who manage laryngeal problems with valuable information that they can extrapolate for use in their practices.</p>","PeriodicalId":76600,"journal":{"name":"The Annals of otology, rhinology & laryngology. Supplement","volume":"190 ","pages":"21-40"},"PeriodicalIF":0.0,"publicationDate":"2002-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0003489402111s1203","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22169991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relative importance of rate and place: experiments using pitch scaling techniques with cochlear implants recipients.","authors":"R Fearn,&nbsp;J Wolfe","doi":"10.1177/0003489400109s1221","DOIUrl":"https://doi.org/10.1177/0003489400109s1221","url":null,"abstract":"<p><p>Pitch scaling was used to determine the dependence of perceived pitch on rate and place of stimulation in postlingually deafened adult subjects using cochlear implants. For stimulation rates below about 500 pulses per second (pps), perceived pitch is a strong function of both rate and place. In this range, perceived pitch increases logarithmically with stimulation rate, but decreases with distance from the round window. A 2-mm displacement into the cochlea has an effect similar to that of halving the stimulation rate. Place resolution in this context is comparable with the interelectrode spacing (0.75 mm). At rates approaching 1,000 pps, rate has little effect on perceived pitch. An average of bipolar quality judgments showed that periodic pulsatile stimulation is least pleasant when low frequencies are applied to the region closest to the window.</p>","PeriodicalId":76600,"journal":{"name":"The Annals of otology, rhinology & laryngology. Supplement","volume":"185 ","pages":"51-3"},"PeriodicalIF":0.0,"publicationDate":"2000-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0003489400109s1221","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21962337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early experience with the cochlear ESPrit ear-level speech processor in children.","authors":"C Totten,&nbsp;Y Cope,&nbsp;B McCormick","doi":"10.1177/0003489400109s1231","DOIUrl":"https://doi.org/10.1177/0003489400109s1231","url":null,"abstract":"<p><p>The ESPrit ear-level speech processor has recently become available in the United Kingdom for use with the Nucleus CI24M multichannel cochlear implant. We report on the use of this ear-level processor with 6 children, ages 8 to 15 years. In this study, all patients were initially fitted with the SPrint body-worn processor, this being a prerequisite for programming the ESPrit. Five of the children were fitted successfully with the ESPrit and are using their devices consistently. The results show that patient experience with the ESPrit has been favorable, although there have been some device and programming difficulties. Aided threshold measures show that the ESPrit processor performs at least as well as the SPrint processor, with a trend toward improved aided thresholds for the ESPrit processor compared with the SPrint processor. Further study of the functional benefit of both of these devices may confirm these potential gains. The ESPrit device currently has a disadvantage for children in that it does not support FM radio hearing aid use. Finally, caution is advised in the fitting of the ESPrit in very young children or inexperienced listeners, because of difficulties in monitoring device function.</p>","PeriodicalId":76600,"journal":{"name":"The Annals of otology, rhinology & laryngology. Supplement","volume":"185 ","pages":"73-5"},"PeriodicalIF":0.0,"publicationDate":"2000-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0003489400109s1231","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21962348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reliability of the nucleus CI22 and CI24M cochlear implants.","authors":"M Lehnhardt,&nbsp;E L von Wallenberg,&nbsp;J M Brinch","doi":"10.1177/0003489400109s1205","DOIUrl":"https://doi.org/10.1177/0003489400109s1205","url":null,"abstract":"","PeriodicalId":76600,"journal":{"name":"The Annals of otology, rhinology & laryngology. Supplement","volume":"185 ","pages":"14-6"},"PeriodicalIF":0.0,"publicationDate":"2000-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0003489400109s1205","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21962366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}