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Desempenho de idosos no teste da habilidade de atenção auditiva sustentada - THAAS / Performance test for elderly in the ability of hearing sustained attention - SAAATJosé, Maria Renata 13 November 2013 (has links)
A atenção é uma habilidade importante para o bloqueio de ruídos ambientais competitivos ao estímulo de interesse do sujeito, principalmente para os idosos, que podem apresentar maior dificuldade em consequência de perdas auditivas decorrentes do envelhecimento, tal como a presbiacusia. Assim, a pesquisa em questão, visa verificar o desempenho de idosos com e sem diagnóstico de perda auditiva leve em um teste comportamental da habilidade de atenção auditiva sustentada e, comparar os resultados obtidos nos grupos de idosos com um grupo de adultos com audição periférica normal, visando constatar a influência que esta habilidade de atenção sofre no processo de envelhecimento, assim como, em consequência da privação sensorial de uma perda auditiva de grau leve, utilizando como instrumento o Teste da Habilidade de Atenção Auditiva Sustentada THAAS (FENIMAN, 2004). O THAAS é um método utilizado para avaliar a atenção auditiva, por meio da avaliação da habilidade do sujeito de escutar estímulos auditivos durante um período de tempo prolongado e responder somente para o estímulo específico. As tarefas exigidas são a vigilância auditiva e atenção auditiva sustentada. O desempenho no teste é verificado pela pontuação total dos erros (somatória dos erros desatenção e impulsividade) e o decréscimo de vigilância. Fizeram parte deste estudo 60 idosos (com idade igual ou superior a 60 anos) e, 30 sujeitos adultos (faixa etária entre 18 a 30 anos), de ambos os gêneros. Os participantes da pesquisa foram divididos em três grupos: GI: constituído por 30 idosos com audição periférica normal bilateralmente; GII: por 30 idosos com diagnóstico de perda auditiva sensorioneural bilateral de grau leve; e, GIII: constituído por 30 adultos, com audição periférica normal bilateralmente. O processo de avaliação de todos os participantes constituiu-se da aplicação do Questionário de atenção, Audiometria Tonal Liminar, Logoaudiometria, Imitanciometria e do THAAS. Para análise estatística foram realizados os testes Kruskal-Wallis, Miller, Mann- Whitney e coeficiente de correlação de Spearman, considerando diferença estatisticamente significante quando p≤0,05. As médias obtidas para a pontuação total de erros foram: GI: 6.2 (desatenção 1.9 e impulsividade 4.3); GII: 9.2 (desatenção 3.6 e impulsividade 5.6); e, GIII: 2.5 (desatenção 1.7 e impulsividade 0.8). Em relação ao decréscimo de vigilância, as médias verificadas foram: 0.5, 0.8 e 0.4 para os grupos GI, GII e GIII, respectivamente. Houve correlação entre a variável idade e decréscimo de vigilância (p=0.04). Por meio deste estudo observou-se que os grupos de idosos (GI e GII) apresentaram piores escores na pontuação total de erros em relação ao grupo de adultos (GIII), com maior ocorrência de erros de impulsividade e desatenção quando comparados com o grupo dos adultos; a perda auditiva não foi um fator que influenciou no tipo de erro mais frequentemente observado no THAAS (desatenção ou impulsividade), no entanto, a perda auditiva influenciou negativamente no desempenho do teste, na qual idosos do GII obtiveram maior pontuação total de erros do que àqueles sem perda auditiva (GI); e, o aumento da idade foi um fator que influenciou a perda do foco atencional durante a realização de uma tarefa auditiva nos grupos estudados. / Attention is an important skill to block environmental noise competitive to the interest stimulus of the subject, mainly for the elderly, who may present a higher difficulty in consequence of hearing losses due to aging, such as presbycusis. Therefore, the research aims to verify the performance of the elderly with and without a diagnosis of mild hearing loss in a behavioral test of sustained auditory attention and compare the results obtained in elderly groups with a group of adults with normal hearing in order to find the influence that this attention skills suffer in the aging process, even as, a consequence of sensory deprivation of a mild hearing loss, using as instrument the Sustained Auditory Attention Ability Test - SAAAT (FENIMAN, 2004). The SAAAT is a method used to evaluate the auditory attention by evaluating the subjects ability to listen to auditory stimuli over a prolonged period, and respond only to the specific stimulus. The tasks required are the auditory vigilance and sustained auditory attention. The test performance is verified by the total error score (the result of a sum of inattention errors and impulsivity) and the vigilance decrement. Participated in the study 60 elderly (aged over 60) and 30 adult subjects (aged 18 to 30) of both genders. Research participants were divided into three groups: GI: consisted of 30 elderly with bilaterally normal hearing, GII: 30 elderly diagnosed with mild hearing loss, sensorineural and bilateral, GIII: consisting of 30 adults with bilaterally normal peripheral hearing. The assessment process of all participants consisted of applying Attention Questionnaire, pure tone audiometry, speech audiometry, immittance and SAAAT. Statistical analysis was performed through Kruskal-Wallis, Miller, Mann-Whitney and Spearman correlation coefficient tests. Results were considered statistically significant when P value was less than 0.05. The averages for the total error score were: GI: 6.2 (1.9 inattention and 4.3 impulsivity), GII: 9.2 (3.6 inattention and 5.6 impulsivity) and GIII: 2.5 (1.7 inattention and 0.8 impulsivity). In relation to vigilance decrement the average observed was 0.5, 0.8 and 0.4 for groups GI, GII and GIII, respectively. There was a correlation between the age variable and vigilance decrement (p=0.04). In this study it was observed that the elderly groups (GI and GII) presented the worst scores on the total error score in relation to the adult group (GIII), with higher incidence of impulsivity and inattention errors compared with the adult group; hearing loss was not a factor that influenced the type of error most frequently observed in SAAAT (inattention or impulsivity), however, hearing loss negatively affected the performance of the test, in which the elderly of GII scored higher than total error score than those without hearing loss (GI) and aging was a factor that influenced in the loss of attentional focus while performing in an auditory task in the groups studied.
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Accessibility of music experiences for individuals with age-related hearing lossWilhelm, Lindsey Anne 01 December 2016 (has links)
The overarching purpose of the study was to explore how music interventions, including spoken communication can be effectively facilitated with older adults with hearing loss. Specifically, aspects of the listener, auditory input, environmental factors, and non-auditory information that could be modified within the context of music therapy sessions to enhance music and speech perception were explored. A modified sequential exploratory mixed methods design (Qual->Quan+Quan) was used to address the research questions.
The first phase of the study consisted of a one-time large group interview with audiologists to elicit an open discussion related to three questions: (a) What do music therapists need to know about hearing loss and assistive listening devices to effectively design and implement music therapy interventions for older adults with hearing loss? (b) What environmental considerations and modifications can be used to enhance successful communication and music listening in individual and group settings? and, (c) Are there strategies for supporting effective hearing and listening by older adults that could be applied to the context of music therapy? Data were gathered through written responses from the interview participants as well as notes taken by the moderator and a non-participant observer. Thematic analysis revealed the general categories of “areas of therapist knowledge,” “maximizing individual interactions,” and “improving access to communication.” From the initial phase of the study, a conceptual framework was identified to guide the parallel second and third phases to specifically investigate two forms of music stimuli.
Phase II of the study included the creation of standardized recordings of 24 musical instruments to answer the question, How do musical instruments commonly used by music therapists with older adults interface with common configurations of hearing loss? The spectral analysis from each instrument was then applied to a series of audiograms to facilitate the comparison of each instrument’s spectral properties with common hearing loss profiles to determine potential audibility.
Phase III consisted of a single-group, repeated measures design to investigate sung sentence recognition and the potential benefit derived from the inclusion of non-auditory information to facilitate top-down processing. For the purposes of this study, the Sung Sentence Recognition Test was developed to measure sentence recognition under three presentation conditions: sung with guitar accompaniment (SU-G), sung with guitar accompaniment and contextual cues (SU-G+C), and sung with guitar accompaniment and visual cues (SU-G+V). A total of 24 bilateral hearing aid users between the ages of 60 and 79 participated in Phase III. Results indicated that the presence of non-auditory information, in the form of contextual or visual cues, was beneficial for all listeners with a greater degree of benefit derived from visual cues. In addition, Phase III affirmed that listener characteristics such as music training also play a role in determining success. Clinical implications in the form of general strategies as well as recommendations matched with the auditory perceptual requirements of specific music interventions are proposed integrating the results from each of the three phases in this study.
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Machine learning approaches for predicting genotype from phenotype and a novel clustering technique for subgenotype discovery: an application to inherited deafnessTaylor, Kyle Ross 01 July 2014 (has links)
This thesis describes a method, software tool, and web-based service called AudioGene, which can be used to predict genotype from phenotype in patients with inherited forms of hearing loss. To enhance the effectiveness of this prediction facility, a novel clustering technique was developed called Hierarchal Surface Clustering (HSC), which allows existing phenotype data to drive the discovery of new disease subtypes and their genotypes. The accuracy of AudioGene for predicting the top three candidate loci was 68% when using a multi-instance support vector machine, compared to 44% using a Majority classifier for Autosomal Dominant Non-syndromic Hearing loss (ADNSHL). The method was extended to predict the mutation type for patients with mutations in the Autosomal Recessive Non-syndromic Hearing Loss locus DFNB1, and had an accuracy of 83% compared to 50% for a Majority classifier. Along with HSC, a novel visualization technique was developed to plot the progression of the hearing loss with age in 3D as surfaces. Simulated datasets were used along with actual clinical data to evaluate the performance of HSC and compare it to other clustering techniques. When evaluating using the clinical data, HSC had the highest Adjusted Rand Index with a value of 0.459 compared to 0.187 for spectral clustering and 0.103 for K-means clustering.
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Proposta de um programa intensivo de habilitação auditiva para crianças e suas famílias durante a rotina de acompanhamento em um serviço de implante coclear / Proposal of intensive hearing habilitation program for children and families during the follow-up appointment at the cochlear implant referral serviceFernandes, Júlia Speranza Zabeu 27 March 2019 (has links)
INTRODUÇÃO: A Portaria nº 2.776 aponta a obrigatoriedade da terapia fonoaudiológica para crianças com deficiência auditiva usuárias de implante coclear para a construção da linguagem oral por meio da via auditiva. O acesso gratuito às terapias em suas cidades de origem é uma das principais dificuldades devido à falta de capacitação dos fonoaudiólogos; falta de informação das famílias e ausência de gestão integrada da rede. Frente ao compromisso do serviço de referência em oferecer assessoria técnica especializada à contrarreferência e às dificuldades de acompanhamento com procedimentos mais efetivos de terapia, faz-se necessário novas propostas. OBJETIVO: Propor programa intensivo de habilitação auditiva para crianças e famílias associado rotina de acompanhamento em serviço de referência de implante coclear. MÉTODOS: Estudo prospectivo longitudinal desenvolvido pelo Departamento de Fonoaudiologia (FOB-USP) e pela SIC-HRAC-USP. Participaram do estudo cinco crianças usuárias de implante coclear, máximo de 12 meses de idade auditiva, suas mães/avó, selecionadas aleatoriamente. Programa composto de três módulos presenciais, duas semanas sequenciais cada, três terapias individuais/dia, uma sessão de grupo diária. Utilizada a Abordagem Aurioral, com atendimento centrado na família; planejamento terapêutico individualizado, objetivos gerais relacionados a família, acompanhamento fonoaudiológico na cidade de origem e construção da linguagem oral pela via auditiva. Nos dois intervalos à distância entre os módulos foram disponibilizados materiais para continuidade pela família dos trabalhos iniciados. A avaliação das crianças ocorreu com protocolo padronizado quanto ao desenvolvimento auditivo e de linguagem oral, para avaliação da satisfação das famílias utilizou-se o Questionário de Procedimentos de Tratamento. RESULTADOS/DISCUSSÃO: Houve 100% de adesão das famílias. Houve necessidade de remodelação da estrutura do Programa quanto à diminuição do número das sessões e introdução de terapia em grupo para as crianças para diminuir cansaço e desmotivação das mães/avó. O uso dos materiais usados nos intervalos a distância auxiliou no aumento da motivação. Os atendimentos individuais e as sessões de grupo foram ricos quanto à troca de experiências. As atitudes facilitadoras e estratégias de estimulação nas vivências diárias foram incorporadas pelas mães/avó. Observou-se maior dificuldade para a mãe 5 em incorporar as estratégias terapêuticas, e maior dificuldade para mãe 3 em incorporar as técnicas terapêuticas. Nos intervalos a distância verificou-se baixa adesão ao site e e-mail e aumento da adesão ao aplicativo WhatsApp®. Notou-se dificuldades em conciliar a rotina com as brincadeiras de estimulação nos intervalos à distância. Houve superação das dificuldades, notou-se mudança no comportamento das mães/avó relacionado ao empoderamento frente ao conhecimento adquirido, que se refletiu na evolução das crianças, de modo que quanto maior a participação das mães melhor evolução apresentada pela criança. Em audição e linguagem verificouse evolução para todas as crianças, as crianças 1 e 2 apresentaram desempenho crescente de acordo com o esperado para idade auditiva; já as crianças 3, 4, e 5 ficaram aquém. Observou-se alta satisfação das famílias quanto ao Programa. CONCLUSÃO: Elaboração de um modelo de terapia intensiva viável e replicável para intervenção na habilitação auditiva de crianças, com adesão positiva das famílias e necessidade de proposta dinâmica em conformidade com a avaliação contínua dos participantes. / INTRODUCTION: The Ordinance No. 2.776 highlights the obligations of auditory therapy for children with hearing loss and cochlear implant to develop the verbal language by auditory pathways. Free access to children in their hometowns is one of the main difficulties which is due to lack of training of speech therapists, lack of information of families and absence of integrated management of the health network. To fulfill the referenced service intended to offer specialized technical advice and to counter referral and follow-up difficulties with more effective therapy procedures, new proposals are necessary. OBJECTIVE: Propose an intensive hearing habilitation program for children and families associate to the follow-up appointment at the cochlear implant referral service. METHODS: A prospective longitudinal study developed by the Department of Speech-Language Pathology and Audiology (FOBUSP) and SIC-HRAC-USP. Five children with a cochlear implant, who had the maximum of 12 months of hearing age, and their mothers/grandmothers were randomly assigned. The program consists of three face-to-face modules, two sequential weeks each and three individual therapies/day, and one daily group session. The program is making use of the Auditory-verbal Approach, with familycentered care: an individualized therapeutic plan, general family-related objectives, speech-language pathology done in the city of origin, and oral language construction by the auditory pathway. During the two intervals between the modules, materials were provided to the family for continuity of the activities. The assessment of the children was based on a standardized protocol for hearing and oral language development and, the \"Treatment Procedures Questionnaire\" was used to evaluate family satisfaction. RESULTS/DISCUSSION: There was 100% of the familys compliance. It was necessary to remodel the program to reduce fatigue and demotivation of mothers/grandmothers. To achieve that, the number of sessions was reduced and a therapy in group for children was introduced. The use of materials in the intervals helped to increase motivation. Individual and group sessions were rich in the exchange of experiences. The attitudes and strategies of stimulation in the daily experiences were incorporated by the mothers/grandmother. It was observed that mother #5 had greater difficulty incorporating the therapeutic strategies and mother #3 had a very difficult time incorporating the therapeutic techniques. During the intervals between modules, there was reduced use of the website and e-mail and increased use of the WhatsApp® application. Difficulties were observed in reconciling the daily routine with the stimulation of therapeutic games. Despite of difficulties, it was noticed that there was a change in the behavior of the mothers/grandmother related to the empowerment of the acquired knowledge. This was reflected in the evolution of the children, so that the greater the participation of the mothers, the better evolution was presented by the child. Hearing and language evolution was observed for all children. Children #1 and #2 presented increased performance according to what was expected for hearing age, while children #3, #4, and #5 less than expected. Families were highly satisfied with the program. CONCLUSION: Elaboration of a viable and replicable intensive care model for intervention in the auditory habilitation of children was achieved with positive compliance by the families. Furthermore, there is a need for a dynamic element as it relates to the continuous evaluation of the all participants.
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Hearing loss and task-based noise exposures among agricultural populationsHumann, Michael Jerome 01 May 2011 (has links)
Hazardous noise exposures and hearing loss have been documented among farmers and farm workers for many years. However, little is known about the noise exposures during specific agricultural work tasks and their effect on hearing loss. The objective of this dissertation was to assess the effects of specific agricultural tasks on hearing loss and their contribution to total noise exposures.
Three studies were conducted to accomplish this objective. The first study examined associations between hearing sensitivity among rural residents (nfarmer = 960, nnon-farmers = 608) and self-reported years of participation in 12 agricultural tasks. Logistic regression analysis was used to examine associations between agricultural activities and hearing loss >25dB. Linear regression analysis was used to examine associations between agricultural tasks and mean decibels of hearing loss. The results indicated farmers have greater hearing loss than non-farmers. However years of participation in specific agricultural tasks was poorly associated with hearing loss. This result suggests that self-reported years engaging in specific agricultural activities may be a poor surrogate for true noise exposure
In the second study noise exposures (personal dosimetry) and corresponding task data (direct observation) were collected on 18 grain farms, and mean noise exposures (dBA) were calculated for specific agricultural tasks. Noise exposures ranged from 78.6 dBA to 99.0 dBA across all tasks. The noise exposures for each task varied greatly (large standard deviation and maximum exposure) with most of the variability within the farms. Although specific tasks with intense noise exposures were identified, most comparisons of mean noise exposures from one task to another were not statistically different and intense exposures were present for nearly all tasks. Therefore, controlling noise only for those tasks with the greatest mean noise exposures may not completely eliminate hazardous exposures or the hearing loss risk.
For the third study, estimates of 8-hr time-weighted-average (TWA) noise exposures were calculated using time-at-task observations from one population of farmers and prior dosimeter measured mean task-based noise exposures from an independent population of farmers. Additionally, dosimeter measured daily noise exposures from the independent population of farmers were also analyzed to identify significant determinants of noise exposure. Simple linear regression analysis was used to compare estimated and actual dosimeter-measured 8-hr TWA noise exposures. The noise exposure determinants were identified by conducting multivariable linear mixed-effects regression analysis on the one-minute noise measurements from the dosimeter measured daily noise exposures. The results indicated the estimated and measured 8-hr TWA noise exposures varied considerably. Therefore, the estimates were not considered reliable. Furthermore, task, number of noise sources and work area were found to have a statistically significant association with noise exposure.
In summary, hearing loss and noise exposures among agricultural populations are complex and cannot be completely explained by examining agricultural tasks only. More detailed evaluations of tasks are needed to increase the understanding of hearing loss and noise exposure in this dynamic work environment.
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Relationship Between Sensorineural Hearing Loss and Vestibular and Balance Function in ChildrenCushing, Sharon Lynn 30 July 2008 (has links)
Similarities between the peripheral auditory and vestibular systems suggest that children with sensorineural hearing loss (SNHL) may demonstrate vestibular and balance impairments. This hypothesis was studied in 40 children with severe to profound SNHL and unilateral cochlear implants (CI). Vestibular function was assessed with caloric, rotational, and vestibular evoked myogenic potential (VEMP) testing; balance was assessed with standardized static and dynamic tests. Horizontal semicircular canal function was abnormal in 53% (17/32) with caloric, and 39% (14/36) with rotational stimulation. Saccular function was absent bilaterally in 5/26 (19%) and unilaterally in 5/26 (19%) with VEMP. Balance abilities were significantly poorer (μ=12.9±5(SD)) than normal hearing controls (μ=17±5(SD); p=0.0006) and correlated best with horizontal canal function from rotational stimulation (p=0.004;R2=0.24). SNHL from meningitis was associated with worse balance function than other etiologies. Vestibular and balance dysfunction occurred in >1/3 of children with SNHL and CI, and is highly dependent on etiology.
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Relationship Between Sensorineural Hearing Loss and Vestibular and Balance Function in ChildrenCushing, Sharon Lynn 30 July 2008 (has links)
Similarities between the peripheral auditory and vestibular systems suggest that children with sensorineural hearing loss (SNHL) may demonstrate vestibular and balance impairments. This hypothesis was studied in 40 children with severe to profound SNHL and unilateral cochlear implants (CI). Vestibular function was assessed with caloric, rotational, and vestibular evoked myogenic potential (VEMP) testing; balance was assessed with standardized static and dynamic tests. Horizontal semicircular canal function was abnormal in 53% (17/32) with caloric, and 39% (14/36) with rotational stimulation. Saccular function was absent bilaterally in 5/26 (19%) and unilaterally in 5/26 (19%) with VEMP. Balance abilities were significantly poorer (μ=12.9±5(SD)) than normal hearing controls (μ=17±5(SD); p=0.0006) and correlated best with horizontal canal function from rotational stimulation (p=0.004;R2=0.24). SNHL from meningitis was associated with worse balance function than other etiologies. Vestibular and balance dysfunction occurred in >1/3 of children with SNHL and CI, and is highly dependent on etiology.
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Word Reading Strategy Development of Deaf and Hard-of-Hearing PreschoolersBurke, Victoria 20 December 2012 (has links)
WORD READING STRATEGY DEVELOPMENT OF DEAF AND HARD-OF-HEARING PRESCHOOLERS
by
Victoria Burke
Siegler’s (1996) overlapping waves model of strategy development applied to reading posits that children use multiple strategies to read words from the earliest stage of reading development, that these strategies coexist over a long period of time, and that experience results in gradual change in the strategies children use and the effectiveness with which they are executed. Phonological recoding is one of the most effective early developing reading strategies and is predictive of future reading success for hearing children (Ehri, 2005; Juel & Mindencupp, 2000; Share & Gur, 1999). However, less is known regarding the extent to which young children who are deaf and hard of hearing (DHH) develop and use phonological strategies to read words. Due to technological advances such as cochlear implants and digital hearing aids, many DHH children have sufficient functional hearing to be able to perceive and represent spoken language. For these children, beginning reading strategies may resemble those of hearing children (Geers, Tobey, Moog, & Brenner, 2008; Lederberg, Schick, & Spencer, in press). The purpose of this study was to describe changes in the word reading strategies of 15 DHH preschoolers with functional hearing. These children received explicit instruction in alphabetic knowledge, phonological awareness, and early reading strategies in a year-long intervention. Instruction was videotaped and children’s overt behavior while independently reading words was coded for reading strategy and accuracy. The preschoolers used multiple reading strategies at all times including two phonological recoding strategies (segmenting phonemes only, segmenting and blending phonemes) and retrieval. Gradual change was observed in strategy choice, execution, and accuracy. Children’s use of segmenting only decreased while segmenting and blending phonemes increased between the beginning and middle of the year. Retrieval use increased between the middle and end of the year. Execution of phonological strategies gradually improved over the year. These results suggest young DHH children who have functional hearing develop and use strategies in a manner similar to hearing children and benefit from explicit instruction in the alphabetic principle.
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Sandblasting in New Zealand: Noise Exposure and Attenuation Provided by Safety EquipmentBlackmore, Sara Frances Elsie January 2009 (has links)
Noise Induced Hearing Loss (NIHL) is a sensorineural hearing loss resulting from excessive noise exposure (von Geirke, 1975). In New Zealand the Department of Labour stipulates that employees must not be exposed to more than an eight-hour equivalent continuous A-weighted sound pressure level (LAeq,8h) of 85 dB(A) or a peak sound pressure level (Lpeak) of 140 dB(A). Sandblasting is a process, whereby an abrasive is mixed with air at high pressures and exposes the operators to excessive noise (Blair, 1975). The protective equipment currently worn is a closed respirator system consisting of a helmet and cape, overseas research indicates noise levels inside the helmet are above the allowable levels (Blair, 1975; Environmental Medicine Unit, 1998; Irving, 1995; Patel and Irvings, 1999; Price and Whitaker, 1986 and Sussel 1992). There is disagreement in the literature as to the contribution of the noise created by the respirator system to the total noise exposure (Blair, 1975; Environmental Medicine Unit report, 1998; Irving, 1995 and Price and Whitaker, 1986). In some blasting sites additional hearing protection such as foam insert earplugs and/or earmuffs are worn in conjunction with the helmet. No research could be found investigating the resulting attenuation these combinations provide. It is well reported in the literature that the combined attenuation is more complex than the simple sum of the two components attenuation (Abel & Armstrong, 1991; Abel & Odell, 2006; Behar, 1990; Berger, 1983; Damongeot, Lataye & Kusy, 1989). The aims of the current study were to investigate noise levels during blasting inside booths and the operators’ helmets at two sites in New Zealand. The attenuation provided by the helmet alone and in combination with earmuffs was investigated in the laboratory. The contribution of the respirator airflow to the total noise exposure was also investigated. Finally the measured combined attenuation was compared to that calculated using three methods from the literature. Findings indicate that noise levels in blasting booths and inside operators’ helmets are above allowable levels. Laboratory findings indicate that the use of earmuffs in conjunction with the helmet increases the attenuation provided, therefore decreasing the risk of NIHL and that noise from the respirator airflow does not contribute to the total noise inside the helmet. The combined attenuation calculated from two methods in the literature was inaccurate while one was close. The findings, recommendations, limitations of the study and areas for further research are discussed.
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Ototoxicity in patients receiving concurrent cisplatin and cranial irradiation therapy for the treatment of head and neck cancers: an audiometric follow-upAlchin, Katrine Felice January 2010 (has links)
Cisplatin is a potent chemotherapeutic agent that is commonly used to treat a wide variety of tumours. Although highly effective, its administration is complicated by its ototoxic effect, a well known side effect that occurs in a significant number of patients. The hearing loss observed is typically irreversible, progressive, bilateral, high-frequency sensorineural hearing loss associated with tinnitus. At present there is no approved method for protecting or remedying against deterioration of hearing status, therefore, the detection and appropriate management of cisplatin-induced ototoxicity is reliant on effective audiological monitoring. The present study aimed to investigate the prevalence of ototoxicity in head and neck oncology patients who received cisplatin in combination with cranial irradiation. In addition, the study also aimed to examine the current state of audiological monitoring for this population at Christchurch Hospital.
Post-treatment diagnostic audiological assessments were performed for 23 participants. The post-treatment assessment battery included case history, standard pure-tone audiometry (0.25 – 8 kHz), extended high-frequency audiometry (9 – 16 kHz), speech audiometry, tympanometry, acoustic reflexes and distortion product otoacoustic emissions. Prior to the assessments, a search of the Christchurch Audiology and Ear, Nose and Throat (ENT) Department oncology audiogram files was undertaken to match any previous audiograms to participating individuals.
The results showed that pre-treatment assessment had been performed for 16 of the 23 participants. Of those 16, 15 participants experienced a significant cochleotoxic change in their hearing thresholds according to the ASHA criteria. One participant only received one dose of cisplatin due to deteriorating hearing, while one other participant elected to stop cisplatin treatment after the first dose due to a significant increase in tinnitus severity.
Ototoxicity resulting from cisplatin chemotherapy constitutes a significant clinical problem that may have serious vocational, educational, and social consequences. Findings from this study highlight the importance of effective audiological monitoring for the timely detection and appropriate management of cisplatin-induced ototoxicity.
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