How can we manage children with poor speech discrimination but with normal audiogram

We often come across children and young adults brought in for consultation for suspected hearing loss and having hearing difficulty in noisy backgrounds but who often have normal audiograms. Such patients are suspected to have auditory neuropathy. The term auditory...

The basis of auditory processing disorder: what can we learn from corticals?

Auditory processing disorder (APD) is a poorly understood, heterogenous and surprisingly common condition. It manifests as a perceptual difficulty in centrally processing auditory information. Diagnosis is usually based on a variety of behavioural tests involving verbal and non-verbal assessments. In...

Alcohol and hearing

Alcohol is a well-known central nervous system depressant. Individual reactions to alcohol might vary, but the connection between alcohol consumption and tolerance to loud noise or difficulties in communication in noisy environments are well-observed phenomena; for example, at evening parties....

Effect of stimulation levels on speech recognition and auditory threshold performance

When programming a Cochlear® device, two measurements are normally assessed. T levels relate to the quietest sound the CI user can hear i.e. thresholds, and C levels are comfortable levels which are tolerable for the CI user. If these levels...

Multiple surgeries for RRP – does a greater number of operations result in a worse voice outcome?

Recurrent respiratory papillomatosis (RRP) of the larynx remains a challenging condition to treat, with a number of affected patients requiring multiple operations to remove recurrent disease over the course of their lifetime. At the most severe end of the spectrum,...

Possible correlation of ABR changes with prognosis in sudden sensorineural hearing loss

A sensorineural hearing loss (SNHL) of 30dB or more affecting at least three frequencies and occurring over less than three days is classified as ‘sudden’ SNHL (SSNHL). Treatment is urgently undertaken with systemic and/or intra-tympanic steroids, and ijn some cases...

How to train adults with single-sided deafness and cochlear implants

Cochlear implantation (CI) in patients with single-sided deafness (SSD) has been carried out in Perth, Australia from 2008. It poses challenges to clinicians and patients who are trying to tune in the poorer ear while still having a normally hearing...

Death related to epistaxis

One of the commonest emergencies presenting in ENT is epistaxis. The presentation can be through accident and emergency or through ward referrals. In this national audit of epistaxis management involving 113 centres, it was noted that 33 of the 985...

Is there hope of hearing for postmeningitic patients deemed unsuitable for a cochlear implant?

Rehabilitation of patients with profound hearing loss deemed unsuitable for cochlear implants is challenging. An auditory brainstem implant (ABI) is a viable option for these patients. This paper evaluates auditory and speech perception outcome measures following ABI in 10 postmeningitic...

The paediatric dilemma of one ear in and one ear out of NICE criteria

The auditory implant team in Manchester have implanted a cohort of children where audiological thresholds meet the NICE guidance for cochlear implantation (CI) in one ear only, and the other falls into moderate, severe or sloping loss. These children are...

Hearing loss and QOL

This article evaluates the impact of hearing loss and its rehabilitation on the quality of life (QoL) of adults. The authors suggest that the currently used scale, Aphab, is long, complicated and does not take into account minor changes. The...

Milestones profile for children with cochlear implant

Over the last eight years, Nottingham auditory implant programme have developed and validated a profile of auditory milestones for use with children receiving bilateral cochlear implants under the age of two years. The structure of the Nottingham Auditory Milestones profile...

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