Biomedical subjects

H Hosford-Dunn

Publications and source records attributed to H Hosford-Dunn.

13 recordsLinked to original sources

PubMed2001

Clinical application of the SADL scale in private practice II: predictive validity of fitting variables. Satisfaction with Amplification in Daily Life.

Predictive validity of 44 independent variables and their interactions with Satisfaction with Amplification in Daily Life (SADL) scores was assessed. SADL scores were influenced by patient age, years of hearing aid experience, hours of use per day, perceived hearing difficulty, pure-tone average, hearing aid style, processor type, and manufacturer's invoice cost. The relative importance of these variables to SADL measures was complex and very small, but the variables and their squares and interactions improved r2 predictions of SADL Global and subscale scores in a separate stepwise multiple linear regression procedure by 12 to 33 percent compared to SADL norms alone. More research with additional variables is needed to develop a clinically useful model for predicting wearer satisfaction. Clinically, SADL scores yield subscale-specific patterns of satisfaction and dissatisfaction that help in intervention planning and serve as graphic "snapshots" of satisfaction status. A series of patient profiles are presented illustrating the potential usefulness of the SADL in predicting hearing aid satisfaction. With its good construct and psychometric properties, the SADL could serve as a gold standard for satisfaction outcomes and a basis for development of a predictive model of hearing aid fitting success.

Adult↗

PubMed1987

Infant hearing screening: program implementation and validation.

Congenital and early-onset hearing losses were discovered in 6.1% of 975 Intensive Care Nursery (ICN) graduates. The methods used were neonatal screening by Crib-O-Gram (COG) and high risk register, in combination with repeated behavioral hearing tests at 1 to 3 years. This 7-year longitudinal study had follow-up hearing evaluations for a remarkably high 84% of all subjects. Significant losses that interfered with speech and language development (1000 to 8000 Hz average loss greater than 45 dB HL bilaterally) were found in 4.3% of infants. COG in combination with subsequent behavioral hearing screening was a sensitive strategy for detecting significant hearing loss: only one child was missed with this combination. Alone, COG sensitivity to significant hearing losses was 79.3%, but would have been higher had a stricter passing criterion been adopted. Behavioral hearing screenings detected bilateral hearing losses of even mild (greater than 20 dB HL) degree. Sensitivity to significant hearing losses was 82.6% and would have been improved if test frequencies greater than 3000 Hz were included in the screen. Even if screening failure occurred at 1 year of age, the age of actual confirmation of hearing loss depended on severity of the loss and ear involvement. Significant hearing losses were confirmed earlier than less severe or unilateral losses. Although behavioral screenings could be done during the first year of life, continued follow-up was required to detect progressive hearing losses.

Acoustic Stimulation↗

PubMed1987

Four factors that accurately predict hearing loss in "high risk" neonates.

Two simple overall measures of health--length of stay in the Intensive Care Nursery (ICN) and gestational age--predict hearing loss in ICN graduates. Craniofacial anomalies, congenital perinatal infections, and meconium aspiration are strong predictors of hearing loss, especially in term infants. Findings are based on univariate and multivariate analyses of a number of variables that might be associated with permanent hearing loss. Study variables included all seven High Risk Register items and a number of other features of the ICN history. They were examined in 799 ICN graduates whose hearing had been monitored in their first few years of life. These babies composed 40% of the ICN population and were selected because they had one or more "high risk" factors in their neonatal history. Prevalence of hearing loss in this high risk sample was similar to that found in other ICN samples. Prevalence of hearing loss associated with individual Risk Register items was similar to other published findings for some items and not for others.

Birth Weight↗

PubMed1986

Solving audiometric masking dilemmas with an insert masker.

For some bilateral hearing losses, standard audiometric techniques cannot provide sufficient data for correct otologic diagnosis. These hearing losses are termed "masking dilemmas" because sound attenuation across the head is inadequate to prevent unwanted masking of the test cochlea. In most cases, the masking dilemma can be eliminated by presenting masking through an insert phone in the ear canal, rather than through a standard earphone and cushion. Insert earphones are not standard on most audiometers, but the minimal necessary equipment and alterations are inexpensive, readily available, and require little time to implement. Test time is not increased significantly. Some masking dilemmas will not be solved by the insert masker, but, when properly constructed and used, an insert masker will provide an accurate measurement of cochlear reserve not otherwise obtainable for most cases.

Acoustic Impedance Tests↗

PubMed1986

Delayed onset hearing loss in a two-year old.

This paper describes a delayed onset sensorineural hearing loss in a baby known to have normal hearing until at least 13 months. A mild high-frequency loss was discovered quite by accident at 25 months. The bilaterally symmetrical loss progressed over the next 6 months to no measurable high-frequency hearing and a 70 dB threshold at 500 Hz. To our knowledge this is the youngest completely documented case of what has been called hereditary delayed onset hearing loss. However, in this instance, and perhaps unsuspected in others, this child had bilateral oval and round window fistulas whose repair may have not only arrested the progression of her loss, but even improved her residual hearing sensitivity.

Audiometry↗

PubMed1986

Prevalence of sensorineural hearing loss in premature and sick term infants with perinatally acquired cytomegalovirus infection.

Audiologic follow-up was obtained on 40 premature or sick term infants with perinatally acquired cytomegalovirus (CMV) infection and on 40 prospectively matched control subjects. Final evaluation was postponed until 3 years of age to assess any long-term hearing sequelae of perinatal CMV infection in this population, and to obtain reasonably complete audiometric results. One experimental subject had a bilateral sensorineural hearing loss above 4000 Hz. Four control subjects had sensorineural hearing losses, three requiring binaural hearing aids. The prevalence of confirmed hearing loss requiring amplification (3.75%) in this study group was consistent with that observed in all graduates of the Intensive Care Nursery who were considered at risk for hearing loss in the same time period (4.2%). These data suggest that perinatally acquired CMV infection is not associated with significant sensorineural hearing loss in premature or full term infants through age 3.

Cytomegalovirus Infections↗

PubMed1986

Clinical evaluation of a new nonelectronic all-in-the-ear hearing device for mild hearing loss.

A new, nonelectronic hearing aid was studied in 112 patients with mild sloping sensorineural hearing loss. The device, worn all in the ear and made of clear plastic, produced a mean functional gain of 9.6 dB at 1500 Hz, 12.4 dB at 1750 Hz, and 9.1 dB at 2000 Hz, with lesser gains at adjacent frequencies between 1000 and 2500 Hz. Speech discrimination in quiet and in noise was improved. Patient acceptance of the device (in a group of 884 patients) was 76%. The device appears to be useful in the treatment of mild hearing loss.

Adolescent↗

PubMed1985

Sequelae of acquired cytomegalovirus infection in premature and sick term infants.

To assess the risk of long-term sequelae after acquired cytomegalovirus (CMV) infection in premature and sick term infants, 55 CMV infected patients were matched prospectively with 55 control patients and these matched pairs were evaluated at 3 years of age. Sensorineural hearing losses were present in four of 43 CMV infected patients (all mild-moderate) and in two of 43 controls (one severe). The incidence of neurologic sequelae was not increased in CMV infected patients with birth weight greater than 2000 gm. Among patients with birth weight less than 2001 gm, moderately abnormal EEGs were found in four (17%) of 23 CMV infected patients and in one (4%) of 23 controls, and severe handicaps occurred in four (14%) of 29 CMV infected patients and in two (7%) of 29 controls. Severe handicaps in premature infants were significantly (P less than 0.05) associated with early onset of CMV excretion (less than 8 weeks of age) and severe cardiopulmonary disease. Among the premature infants who were documented early excretors, three of 13 had severe neuromuscular impairment, four of 13 had severe handicaps (DQ less than 70, severe neuromuscular impairment, or profound loss of vision or hearing), and an additional four had DQs of 70 to 79. Among their matched control subjects, none of 13 had severe neuromuscular impairment, two of 13 had severe handicaps, and an additional two had DQs between 70 and 79. None of the premature infants who were documented late excretors (greater than or equal to 8 weeks of age) had any neurologic sequelae. The risk of neurologic sequelae and handicap may be increased in premature infants with onset of CMV excretion in the first 2 months of life.

Cytomegalovirus Infections↗

PubMed1985

Word recognition performance with modified CID W-22 word lists.

Abbreviated CID W-22 lists were administered to large groups of normal and hearing-impaired listeners to test the hypothesis, that fewer, judiciously chosen items can be used to test word recognition without compromising test accuracy. Data were analyzed by comparing each subject's performance on half- and 10-word lists to full-list scores. Sensitivity and specificity for various sublists and for several pass/fail criteria were calculated. Results show that fewer than the traditional 50 items can be used in word recognition test procedures if the words are sufficiently difficult and strict passing criteria are employed. We recommend terminating testing after 10 words if no errors occur and after 25 words if there are no more than four errors. Otherwise, a full 50-item list should be administered.

Hearing Disorders↗

PubMed1985

Auditory Brainstem Response audiometry. Applications in central disorders.

ABR is the most sensitive and specific test in the audiology battery for detecting disorders that affect the brainstem. When combined with central speech audiometry, ABR can detect most intra- and extra-axial tumors, demyelinating lesions, and polyneuropathies that affect brainstem auditory structures. Alone, it is a promising tool for monitoring neural maturation, tumor growth, coma, and neurologic or vascular therapies. The test can be severely compromised by peripheral hearing loss and knowledge of the audiogram is a prerequisite for any central testing application of ABR. Six cases of intra- or extra-axial brainstem pathology are described here. ABR results were abnormal in all but one case, based on response latency measurements. In two cases, ABR was the only audiologic test that detected the abnormality. In general, ABR was sensitive to and conventional tests were insensitive to central lesions involving the eighth nerve. ABR abnormalities were not in themselves sufficient to define the precise site of the lesion, nor could they determine the kind of lesion present. However, they were indicative of the level and extent of direct involvement by the disease process or of the pressure and distortion effects of the lesion on the brainstem. In one case where ABR failed to detect the lesion, central speech testing was abnormal. The potential usefulness of ABR to monitor brainstem status is emphasized. A case is described where ABR provided valuable information on the effects of an experimental embolic therapy for AVM. Special precautions are described for monitoring ABR in neonates. ABR is an important screening test for the detection of brainstem disorders, especially those that cannot be detected radiographically. Its greatest use, however, may prove to be as inexpensive and noninvasive monitor of brainstem status in patients with confirmed or suspected brainstem disorders.

Adolescent↗

PubMed1981

Binaural interactions in the short-latency evoked potentials of neonates.

Short-latency evoked potentials to monaural and binaural clicks were recorded from scalp electrodes on healthy full-term neonates and on normally hearing adults. Binaural interaction (BI) was measured by summing the average monaural responses obtained from each ear (L+R) and subtracting the binaural response (B) from the monaural sum (BI=L+R-B). Consistent BI was apparent following stimulation with moderate level clicks in all cooperative infants. As in the adult, BI occurred during waves IV, V and VI, where there were systematic amplitude differences between the L+R and B waveforms. Peak latencies of the waves were not significantly affected. However, peak latencies were longer in neonates than in adults, reflecting maturational changes in the response. Similarly, peak latencies in the BI waveforms were also prolonged for the neonates. These results indicate that: (1) BI is present at or soon after birth; (2) the gross response properties of BI are similar in infants and adults; (3) BI occurs during specific waves in the response, independent of age, and (4) the assessment of BI may prove useful in estimating the functional integrity of brain stem structures in infants.

Audiometry, Evoked Response↗

PubMedDate not supplied

Auditory brain stem response testing in infants with collapsed ear canals.

Auditory brain stem response (ABR) testing can provide valuable information about hearing in neonates. However, it is subject to a number of interpretive errors, not all of which have yet been resolved. Collapsing ear canals are one of these, as this report documents. We hypothesize that the quite common incidence of canal collapse in this age group, along with other transient conductive defects, may help to explain the 1:10 and 1:20 incidences of significantly abnormal ABRs in neonatal screening.

Brain Stem↗

PubMedDate not supplied

Clinical application of the satisfaction with amplification in daily life scale in private practice I: statistical, content, and factorial validity.

Statistical, content, and factorial validity of the Satisfaction with Amplification in Daily Life (SADL) scale was assessed. SADL subscales closely correspond to four satisfaction domains. Subjective benefit is a key component of satisfaction, but other nonauditory factors contribute to wearer satisfaction, notably telephone use and appearance. Results confirm the SADLs psychometric properties and verify its use to validate hearing aid fitting satisfaction in private practice settings for a general patient population at 1-year postfitting. Interim SADL norms may be refined as more SADL data are obtained for different patient populations, hearing aid types, and fitting environments.

Aged↗