Name: neuro-rehabilitation approach for sudden sensorineural hearing loss
Uploaded: 2016-01-25T17:00:00.000+00:00
Duration: 9 min 44 s
Description: Watch this Scientific Journal Video about Neuro-rehabilitation Approach for Sudden Sensorineural Hearing Loss at JoVE.com

We thank Yoshimasa Sekiya for demonstrating the protocol technique on film. This work was supported by the ''Japan Society for the Promotion of Science for Young Scientists (26861426)'' and by the "COI STREAM (Center of Innovation Science and Technology based Radical Innovation and Entrepreneurship Program)".

윤리 문 : 절차는 의료 학부의 윤리위원회, 뮌스터 대학, 오사카 대학 병원의 윤리위원회에 의해 오사카 Rosai 병원의 윤리위원회에 의해 승인되었습니다. 장비 1. 준비 <ol><li> 도 2에 도시 된 바와 같이 귀 몰드, 휴대용 음악 플레이어, 폐쇄 형 헤드폰, 등화, 및 헤드폰 증폭기를 얻었다. </li><li> 휴대용 음악 플레이어에 다른 음악의 유형 (팝, 락, 클래식 등)의 라이브러리를 준비합니다. <ol><li> 음악의 다른 유형의 CD를 얻습니다. </li><li> (예를 들어, 어도비 오디션 3.0 또는 이와 유사한 것) 사운드 편집 응용 프로그램을 사용하여 컴퓨터에 CD에서 음악을 전송합니다. <ol><li> 컴퓨터의 CD-ROM ​​드라이브에 오디오 CD를 넣습니다. CD에서 오디오를 추출&gt; 파일을 선택합니다. 선택한 드라이브가 지원하는 모든 추출 속도에서 최대 속도 옵션을 선택합니다. </li></ol></li><li> 일 확인음악으로 넓은 주파수 범위 (즉, 125-8,000 Hz의 또는 더 넓은) 사운드 편집 프로그램을 사용하여 커버 (예를 들어, 어도비 실기 3.0 또는 유사). <ol><li> 편집&gt; 전체 웨이브를 선택합니다 선택하여, 파형을 모두 선택합니다. 창&gt; 주파수 분석을 선택합니다. 주파수 분석 패널에서 수직 축선을 따라 도면의 가로축의 주파수 및 진폭. </li></ol></li><li> 연결 케이블을 통해 휴대용 음악 플레이어로 컴퓨터에서 음악 파일을 전송합니다. <ol><li> USB 케이블을 통해 휴대용 음악 플레이어와 컴퓨터를 연결한다. 192 kbps로의 비트 레이트 .MP3 파일과 같은 휴대용 뮤직 플레이어의 [MUSIC] 폴더에 음악 파일을 저장한다. </li></ol></li></ol></li></ol> 2. 참가자 <ol><li> 순음 audiome 의해, 개질 Hughson - 웨스트 레이크의 절차에 따라 24 5dB의 스텝 사이즈를 이용하여 양쪽 귀에 임계 수준 (공기 및 골전도)를 측정하는 청각터. <ol><li> 1,000 Hz의에 청력 측정기의 주파수 제어를 설정하고 이어폰을 테스트 할 그대로 귀를 설정합니다. </li><li> 50dB의 강도 레벨을 설정합니다. </li><li> 환자에게 1,000 Hz 톤을 제공하기 위해 1 초 동안 사운드 프리젠 테이션 버튼을 누릅니다. (버튼을 누르거나 손 모금을 통해, 예를 들어) 자신의 응답을 기다립니다. </li><li> 환자 톤에 대응하는 경우, 단계 2.1.3에서 설명 된 방식으로 10dB를 소프 톤을 제시한다. 환자가 응답하지 않는 경우, 2.1.6 단계로 이동합니다. </li><li> 환자까지 단계를 반복 2.1.4은 더 이상 응답 할 수 없습니다. </li><li> 5dB에게 큰 소리로 톤을 제시하고 환자의 응답을 기다립니다. </li><li> 단계를 반복 2.1.6 환자가 응답하지 않는 경우. </li><li> 환자가 반응하는 부드러운 강도 수준을합니다. </li><li> 단계를 반복 2.1.4-2.1.8 동일한 휘도 레벨이 두 개 또는 세 번까지 유의한다. 이것은 1000 Hz에서 설립 된 청각 임계 값입니다. </li><li> 시험 주파수 단계를 반복 2.1.2-2.1.92,000, 4,000 및 8,000 Hz에서. </li><li> 1000 Hz에서 대한 청각 임계 값을 다시 테스트 1,000 Hz에서 제 1 및 제 2 임계 값이 5dB에서 동의 확인. </li><li> 시험 주파수 500, 250, 125 Hz에서하는 단계를 2.1.2-2.1.9 반복합니다. </li><li> 영향을받는 귀를 설정하는 이어폰으로 테스트를 반복 2.1.2-2.1.12 단계를합니다. 좌우 청각 임계 값 사이의 차이가 동일하거나 더 낮은 주파수 (125, 250, 500 Hz) 단위로 25dB를 초과하거나 같거나 초과하는 경우에는 고원 방법 (25)을 이용하여 이어폰 통해 안된 귀에 적절한 협 마스킹 잡음을 제시 에서 1,000 Hz의 위 40dB. </li><li> 단계 2.1.1-2.1.13과 동일한 방법으로 노이즈를 마스킹 골전 청각 임계 값을 측정한다. 골전도 청력을 측정하는 대신 헤드폰의 골 전도 진동자를 사용합니다. 크로스 토크를 방지하기 위해 검증되지 않은 귀에 적절한 협 대역 잡음 마스킹 (25)을 적용한다. </li><li> 임계 레벨에 청각 플롯n 개의 청력 양식. SSHL 환자의 예시적인 청력도는 그림 3과 같다. </li></ol></li><li> CIST에 참여 조건을 확인. <ol><li> SSHL 발병 이후의 일 수를 자기보고에 기초하여 5 이하가 있는지 확인합니다. </li><li> 2.1 단계에서 얻어진 공기 실시 순음 청력을 기준으로 dB의 귀 사이의 청력 수준의 차이가 1,000, 500에 걸쳐 평균, 2,000 Hz의가 50 미만인지 확인합니다. 참고 :도 3에 도시 청력 경우, 청력 레벨 차이는 (40 + 40 + 45) / 3 - (5 + 5 + 0) / 3 = 38.3 dB. </li><li> 환자가 편안하게 자신의 영향을받는 귀 음악을들을 수 있는지 확인합니다. </li><li> 환자가 2 단계에서 얻은 순수한 톤 청력 1 세 이상의 인접 주파수에서 (자기보고 기준) 급성 일방적 인 청력 손실 적어도 30dB의 급성 일방적 인 감각 청력 손실의 특발성 상태에서 고통 있는지 확인.1. 예를 들어,도 3에 도시 한 청력의 경우에서와 오른쪽 귀 250 Hz에서 상기 청력 레벨은 적어도 30dB의 감각 신경성 난청을 나타낸다. </li><li> 환자가 자기보고 및 의료 기록을 바탕으로 SSHL의 어떤 병력이없는 것을 확인합니다. 또한 그들은 자기보고 및 의료 기록을 바탕으로 더 신경 또는 정신 합병증이없는 것을 확인합니다. </li><li> 차동 진단을 고려 및 메니 에르 병 (26), 두부 외상,자가 면역 내이 질환 8,9와 같은 다른 진단을받은 환자를 제외, Cogan은 증후군 27, 28, 유전 질환 29 ototoxic 약물 (30), retrocochlear 장애는 전정 신경초종 (31) 관련 청각 신경 병증 (32), 뇌졸중 (33). </li></ol></li></ol> 3. 시작 CIST 참고 : 입원은 P 권장합니다atients의 안전. 환자가 CIST 절차에 내재 듣고 인해 플러그 및 음악 환경 소리에서 밀봉되어 있기 때문에, 자신의 일상 생활에서 사고의 위험이 증가 할 것으로 예상된다. <ol><li> 이어 몰드를 사용하여 환자의 영향을받지 귀의 외부 운하를 연결합니다. 단단히 공백이 외이도 (外耳道)에 존재하지 않도록 외측 도관에 이어 몰드 팩. </li><li> 환자는 통증을 느끼거나 밀봉이 불완전한 경우, 즉시 귀 곰팡이를 제거하고 다시 삽입합니다. </li><li> 라이브러리에서 음악의 즐거운 유형을 선택하는 환자에게 문의하십시오. 주 : 후자가 충분히 넓은 주파수 대역 (Hz에서 125-8,000 또는 더 넓은)을 덮는 경우 그들은 또한 그들 자신의 음악을들을 수있다. </li><li> 폐쇄 형 헤드폰을 착용하는 환자에게 문의하십시오. 도 1에 나타낸 바와 같이 만 영향 귀에 선택된 음악을 제시한다. </li><li> 증가 또는 각각 FRE의 사운드 레벨을 감소시키는 등화기를 사용quency 게인 레벨이 각 주파수에서 귀 사이의 단차 청력의 절반 양에 동등 중임 &quot;반 이득 규칙&quot;에 따라. <ol><li> 예를 들어, 귀 사이의 청력 수준의 차이가 각각 X 125 X 250 X 500 X 1,000 X 2,000 X 4,000, 및 X 125 8000, 250 500, 1,000, 2,000, 4,000, 8,000 Hz의 경우, 1,000 Hz에서 이퀄라이저를 설정 &quot;X 2분의 1,000 - (X + 125 X 250 + X 500 + X 1,000 + X 2,000 + X 4,000 + X 8,000) / 14&quot;. 참고 :도 3에 도시 청력 경우에는, 125, 250, 500, 1,000, 2,000, 4,000, 및 Hz에서 8,000 -5, -3, 0, +2, +2, +5 설정 등화 및 0dB,​​ 각각. </li></ol></li><li> 음악이 N으로 소리 같은 것을 스스로 사운드 레벨과 이퀄라이저 설정의 미세 조정을 수행하기 위해 환자에게 문의ATURAL 가능한 한 편안하게. 뮤직 플레이어의 내부 등화 충분히 유효하지 않은 경우도 2에 도시 된 바와 같이, 하드웨어 이퀄라이저를 사용. </li><li> 그들은 십자가 청문회 (34)가 발생하지 않는 것을 확인하기 위해 영향을받는 귀 음악을 인식 여부를 환자에게 물어보십시오. 때문에 크로스 청문회에 연결 영향을받지 귀 음악을들을 환자를 제외합니다. </li></ol> 4. 절차 CIST 시작 후 <ol><li> 그들은 같은 CIST 프로토콜 외에도 스테로이드로 SSHL에 대한 표준 치료를받을 수있는 환자를 지시한다. </li><li> 환자 밀폐형 헤드폰 (도 1)를 사용하여 영향을받는 귀 하루 6 시간 동안 음악을들을 갖는다. 그들은 음악을 듣고 보내는 시간이 분할 될 수있는 환자를 지시한다. 또한, 환자가 소비 시간 동안 liste (책을 읽고 인터넷 서핑을 포함한) 다른 작업을 수행 할 수 있도록음악 닝. </li><li> 그들이 병원을 떠날 때까지 하루 종일 이어 몰드를 사용하는 환자를 지시합니다. </li><li> 동일한 방식으로 이틀 단계 2.1에서와 같이 영향 귀의 공기 전도 임계 레벨을 측정한다. 볼륨을 조정하고 단계 3.5 및 3.6에서 언급 한 바와 같이 설정 이퀄라이저. </li><li> 환자는 퇴원 그들이 외래로 돌아 가면, 단계 2.1에서와 동일한 방법으로 청각 임계 수준을 측정하는 경우. </li></ol> CIST 5. 나는 중지 <ol><li> 환자 (예 : 이명 또는 통증 등) 연결을 그대로 이어에 대한 불편 함을보고하면 귀 곰팡이를 제거합니다. </li><li> 단계 2.1에서와 동일한 방법으로 그대로 귀에 임계 레벨 청력 측정. </li><li> 청력 수준 (500)에 걸쳐 평균하면 1,000, 2,000 Hz의 단계 4.4에서 얻어진 및 / 또는 5.2 단계 2.1에서 얻어진에 비해보다 5dB 저하, CIST 절차를 중지합니다. 예를 들어, 청력의 경우에는도 3에 도시 </stroNG는&gt;, 청력 수준은 2,000 Hz의 영향을받는 귀 (40 + 40 + 45) / 3 = 41.7 dB로하고 그대로 귀 (5 + 0 + 5) / 3 = 3.3 dB이며, 500, 1000을 통해 평균. </li></ol>

<ol>
	<li>National Institute of Health. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> Sudden Deafness. 00-4757, (2000).</li><li>Byl, F. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Sudden+hearing+loss:+eight+years'+experience+and+suggested+prognostic+table.">Sudden hearing loss: eight years' experience and suggested prognostic table.</a> Laryngoscope. 94, 647-661 (1984).</li><li>Nosrati-Zarenoe, R., Arlinger, S., Hultcrantz, E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Idiopathic+sudden+sensorineural+hearing+loss:+results+drawn+from+the+Swedish+national+database.">Idiopathic sudden sensorineural hearing loss: results drawn from the Swedish national database.</a> Acta Oto-Laryngol. 127, 1168-1175 (2007).</li><li>Rasmussen, H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Sudden+deafness.">Sudden deafness.</a> Acta Otolaryngol. 37, 65-70 (1949).</li><li>Xenellis, J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Simultaneous+and+sequential+bilateral+sudden+sensorineural+hearing+loss:+Are+they+different+from+unilateral+sudden+sensorineural+hearing+loss?.">Simultaneous and sequential bilateral sudden sensorineural hearing loss: Are they different from unilateral sudden sensorineural hearing loss?.</a> ORL-J. Oto-Rhino-Laryngol. Relat. Spec. 69, 306-310 (2007).</li><li>Fukuda, S., Chida, E., Kuroda, T., Kashiwamura, M., Inuyama, Y. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=An+anti-mumps+IgM+antibody+level+in+the+serum+of+idiopathic+sudden+sensorineural+hearing+loss.">An anti-mumps IgM antibody level in the serum of idiopathic sudden sensorineural hearing loss.</a> Auris Nasus Larynx. 28, S3-S5 (2001).</li><li>Wackym, P. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Molecular+temporal+bone+pathology:+II.+Ramsay+Hunt+syndrome+(herpes+zoster+oticus).">Molecular temporal bone pathology: II. Ramsay Hunt syndrome (herpes zoster oticus).</a> Laryngoscope. 107, 1165-1175 (1997).</li><li>Mathews, J., Kumar, B. N. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Autoimmune+sensorineural+hearing+loss.">Autoimmune sensorineural hearing loss.</a> Clin Otolaryngol. 28, 479-488 (2003).</li><li>Mccabe, B. F. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Auto-Immune+Sensorineural+Hearing-Loss.">Auto-Immune Sensorineural Hearing-Loss.</a> Ann Oto Rhinol Laryn. 88, 585-589 (1979).</li><li>Wilson, W. R., Byl, F. M., Laird, N. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+efficacy+of+steroids+in+the+treatment+of+idiopathic+sudden+hearing+loss.+A+double-blind+clinical+study.">The efficacy of steroids in the treatment of idiopathic sudden hearing loss. A double-blind clinical study.</a> Arch Otolaryngol. 106, 772-776 (1980).</li><li>Cinamon, U., Bendet, E., Kronenberg, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Steroids,+carbogen+or+placebo+for+sudden+hearing+loss:+a+prospective+double-blind+study.">Steroids, carbogen or placebo for sudden hearing loss: a prospective double-blind study.</a> Eur Arch Otorhinolaryngol. 258, 477-480 (2001).</li><li>Conlin, A. E., Parnes, L. S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Treatment+of+sudden+sensorineural+hearing+loss+II.+A+meta-analysis.">Treatment of sudden sensorineural hearing loss II. A meta-analysis.</a> Arch Otolaryngol Head Neck Surg. 133, 582-586 (2007).</li><li>Conlin, A. E., Parnes, L. S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Treatment+of+sudden+sensorineural+hearing+loss+I.+A+systematic+review.">Treatment of sudden sensorineural hearing loss I. A systematic review.</a> Arch Otolaryngol Head Neck Surg. 133, 573-581 (2007).</li><li>Nosrati-Zarenoe, R., Hultcrantz, E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Corticosteroid+treatment+of+idiopathic+sudden+sensorineural+hearing+loss:+randomized+triple-blind+placebo-controlled+trial.">Corticosteroid treatment of idiopathic sudden sensorineural hearing loss: randomized triple-blind placebo-controlled trial.</a> Otol Neurotol. 33, 523-531 (2012).</li><li>Li, L. P. H., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Healthy-side+dominance+of+cortical+neuromagnetic+responses+in+sudden+hearing+loss.">Healthy-side dominance of cortical neuromagnetic responses in sudden hearing loss.</a> Ann. Neurol. 53, 810-815 (2003).</li><li>Morita, T., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+recovery+from+enhancement+of+activation+in+auditory+cortex+of+patients+with+idiopathic+sudden+sensorineural+hearing+loss.">A recovery from enhancement of activation in auditory cortex of patients with idiopathic sudden sensorineural hearing loss.</a> Neurosci Res. 58, 6-11 (2007).</li><li>Suzuki, M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Cortical+representation+of+hearing+restoration+in+patients+with+sudden+deafness.">Cortical representation of hearing restoration in patients with sudden deafness.</a> Neuroreport. 13, 1829-1832 (2002).</li><li>Li, L. P. H., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Neuromagnetic+Index+of+Hemispheric+Asymmetry+Prognosticating+the+Outcome+of+Sudden+Hearing+Loss.">Neuromagnetic Index of Hemispheric Asymmetry Prognosticating the Outcome of Sudden Hearing Loss.</a> PLoS ONE. 7, e335055 (2012).</li><li>Blanton, S., Wolf, S. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=An+application+of+upper-extremity+constraint-induced+movement+therapy+in+a+patient+with+subacute+stroke.">An application of upper-extremity constraint-induced movement therapy in a patient with subacute stroke.</a> Phys Ther. 79, 847-853 (1999).</li><li>Wolf, S. L., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Effect+of+constraint-induced+movement+therapy+on+upper+extremity+function+3+to+9+months+after+stroke+-+The+EXCITE+randomized+clinical+trial.">Effect of constraint-induced movement therapy on upper extremity function 3 to 9 months after stroke - The EXCITE randomized clinical trial.</a> JAMA. 296, 2095-2104 (2006).</li><li>Taub, E., Mark, V. W., Uswatte, G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Implications+of+CI+therapy+for+visual+deficit+training.">Implications of CI therapy for visual deficit training.</a> Front Integr Neurosci. 8, 78 (2014).</li><li>Scheffler, K., Bilecen, D., Schmid, N., Tschopp, K., Seelig, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Auditory+cortical+responses+in+hearing+subjects+and+unilateral+deaf+patients+as+detected+by+functional+magnetic+resonance+imaging.">Auditory cortical responses in hearing subjects and unilateral deaf patients as detected by functional magnetic resonance imaging.</a> Cereb Cortex. 8, 156-163 (1998).</li><li>Okamoto, H., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Constraint-induced+sound+therapy+for+sudden+sensorineural+hearing+loss--behavioral+and+neurophysiological+outcomes.">Constraint-induced sound therapy for sudden sensorineural hearing loss--behavioral and neurophysiological outcomes.</a> Sci Rep. 4, 3927 (2014).</li><li>Carhart, R., Jerger, J. F. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Preferred+Method+For+Clinical+Determination+Of+Pure-Tone+Thresholds.">Preferred Method For Clinical Determination Of Pure-Tone Thresholds.</a> J Speech Hear Disord. 24, 330-345 (1959).</li><li>Hood, J. D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+principles+and+practice+of+bone+conduction+audiometry:+A+review+of+the+present+position.">The principles and practice of bone conduction audiometry: A review of the present position.</a> Laryngoscope. 70, 1211-1228 (1960).</li><li>Hallpike, C. S., Cairns, H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Observations+on+the+Pathology+of+M&#233;ni&#232;re's+Syndrome.">Observations on the Pathology of M&#233;ni&#232;re's Syndrome.</a> J Laryngol Otol. 53, 625-655 (1938).</li><li>Lunardi, C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Autoantibodies+to+inner+ear+and+endothelial+antigens+in+Cogan's+syndrome.">Autoantibodies to inner ear and endothelial antigens in Cogan's syndrome.</a> Lancet. 360, 915-921 (2002).</li><li>Greco, A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Cogan's+syndrome:+An+autoimmune+inner+ear+disease.">Cogan's syndrome: An autoimmune inner ear disease.</a> Autoimmun Rev. 12, 396-400 (2013).</li><li>Janecke, A. R., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Progressive+hearing+loss,+and+recurrent+sudden+sensorineural+hearing+loss+associated+with+GJB2+mutations+-+phenotypic+spectrum+and+frequencies+of+GJB2+mutations+in+Austria.">Progressive hearing loss, and recurrent sudden sensorineural hearing loss associated with GJB2 mutations - phenotypic spectrum and frequencies of GJB2 mutations in Austria.</a> Hum Genet. 111, 145-153 (2002).</li><li>Guthrie, O. W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Aminoglycoside+induced+ototoxicity.">Aminoglycoside induced ototoxicity.</a> Toxicology. 249, 91-96 (2008).</li><li>Matthies, C., Samii, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Management+of+1000+vestibular+schwannomas+(acoustic+neuromas):+Clinical+presentation.">Management of 1000 vestibular schwannomas (acoustic neuromas): Clinical presentation.</a> Neurosurgery. 40, 1-9 (1997).</li><li>Starr, A., Picton, T. W., Sininger, Y., Hood, L. J., Berlin, C. I. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Auditory+neuropathy.">Auditory neuropathy.</a> Brain. 119, 741-753 (1996).</li><li>Shaia, F. T., Sheehy, J. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Sudden+Sensori-Neural+Hearing+Impairment+-+Report+of+1,220+Cases.">Sudden Sensori-Neural Hearing Impairment - Report of 1,220 Cases.</a> Laryngoscope. 86, 389-398 (1976).</li><li>Zwislocki, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Acoustic+Attenuation+between+the+Ears.">Acoustic Attenuation between the Ears.</a> J Acoust Soc Am. 25, 752-759 (1953).</li><li>H&#228;m&#228;l&#228;inen, M., Hari, R., Ilmoniemi, R. J., Knuutila, J., Lounasmaa, O. V. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Magnetoencephalography+theory,+instrumentation,+and+applications+to+noninvasive+studies+of+the+working+human+brain.">Magnetoencephalography theory, instrumentation, and applications to noninvasive studies of the working human brain.</a> Rev. Mod. Phys. 65, 413-497 (1993).</li><li>Nilsson, M., Soli, S. D., Sullivan, J. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Development+of+the+hearing+in+noise+test+for+the+measurement+of+speech+reception+thresholds+in+quiet+and+in+noise.">Development of the hearing in noise test for the measurement of speech reception thresholds in quiet and in noise.</a> J Acoust Soc Am. 95, 1085-1099 (1994).</li><li>Henry, J. A., Meikle, M. B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Psychoacoustic+measures+of+tinnitus.">Psychoacoustic measures of tinnitus.</a> J. Am. Acad. Audiol. 11, 138-155 (2000).</li></ol>

The authors declare that they have no competing interests.

This article describes a behavioral treatment approach for SSHL. The CIST protocol merely requires the use of easily available devices. A comparison of the treatment effects of CIST + SCT with those of SCT alone revealed significantly better hearing improvements with the CIST + SCT treatment. No apparent side effects were associated with the CIST protocol. The cost of CIST is markedly lower than other newly suggested treatments (including a stellate ganglion block and hyperbaric oxygen therapy). The CIST protocol represents an effective, inexpensive, easy, and safe treatment for SSHL; however, several important points must be considered. One point is the prevention of acoustic trauma. Although the maximal volume settings of recent commercial portable music players are limited to remain below the harmful levels, the sound level needs to be observed when a large adjustment is made to the equalizer settings or when a headphone amplifier is used. The second point is 'cross hearing'. The purpose of the CIST procedure is to enable SSHL patients to actively use their affected ear for listening. When patients develop severe hearing loss, they may still hear sounds with the intact ear despite plugging. The third point is 'accidents'. In the case of traditional pharmacotherapy, the intact ear is not plugged, and thus SSHL patients can pick up environmental sounds via this intact ear. On the other hand, plugging and music listening inherent to the CIST protocol seal patients from environmental sounds, and thus the accident hazard is likely increased. Therefore, the CIST protocol should be conducted in a safe environment. 
Unlike pharmacotherapy, the CIST protocol has no limitations concerning medications, allergies, or other diseases such as diabetes, hypertension, and hyperlipidemia. However, the limitation of this protocol is that it is intended for patients who are able to listen to sounds with their affected ear. As such, the CIST protocol is not suited for SSHL patients with severe hearing loss. This protocol is applied to acute stage SSHL (days since SSHL onset &#8804; 5) because previous studies reported that a shorter time delay between the onset of SSHL and the start of treatment led to better hearing recovery2. It remains elusive whether there is a time restriction for starting the CIST protocol. Moreover, the optimum duration of the CIST protocol and the total music listening time require further investigation.
This protocol utilizes the corticosteroid therapy in addition to CIST. At present, corticosteroids are the most commonly used treatment for SSHL, and therefore it is ethically not feasible to stop this treatment. However, recent triple-blinded SSHL treatment studies14 revealed that the recovery of non-treated patients was similar to that of patients who had received corticosteroids. Even though one cannot exclude the possibility that the combination of CIST + SCT led to the results obtained, it appears reasonable to assume that CIST alone will be beneficial, especially for patients with diseases that are worsened by corticosteroids such as infections, diabetes, and glaucoma.
In this protocol, patients are hospitalized in order to avoid accidents. However, SSHL patients often cannot be hospitalized because of work, family, and financial reasons. The utilization of a hearing aid may allow these outpatients to perform the CIST protocol. SSHL patients who wear a hearing aid in their affected ear are 'functionally' exposed to an enriched acoustic environment, are not in danger to be exposed to harmful sound levels, and are able to detect warning sound signals. However, the daily monitoring of hearing threshold levels and appropriate adjustments to the hearing aid settings would be necessary since hearing capability of SSHL patients can improve rapidly. Generally, the CIST protocol will not disturb other treatment approaches and may actually manifest a synergic effect when used in combination with other SSHL treatment strategies.
In the present study, a limited number of SSHL patients underwent the CIST protocol, and the participants were not randomized to the different treatment conditions. Thus, a randomized controlled study including a larger number of patients should be executed in the future. Moreover, the effectiveness of the CIST protocol should be investigated in patients with different types of hearing loss. Further, in the present study, all participants who performed the CIST protocol also received the corticosteroid therapy. Therefore, it remains unresolved whether the CIST protocol alone can improve the hearing ability of SSHL patients. It would be valuable to perform a randomized controlled study in which SSHL patients, for whom corticosteroids may cause severe side effects (such asinfectious diseases or diabetes mellitus), would either merely receive the CIST protocol or merely a standard corticosteroid therapy. Notably, in our previous report23, the effects of the CIST protocol within the human auditory cortex were examined by means of magnetoencephalography35. The results showed that the CIST protocol could have prevented maladaptive cortical reorganization in the human primary and non-primary auditory cortices. Of course, it is difficult to conduct neuroimaging studies in practices and hospitals; however, speech test, hearing in noise test36, and tinnitus related examinations37 may contribute to reveal the functional plasticity in the central auditory system induced by the CIST protocol. Eventually, even though the CIST protocol is in a very early stage in development, and although further investigations are needed, the CIST protocol as an effective, inexpensive, and safe treatment option can complement the corticosteroid therapy, which may induce severe and potentially lethal side effects.

갑작스런 감각 신경성 난청 (SSHL), 또는 갑작스런 난청 1, 청각의 급속한 손실을 특징으로 특발성 조건이다. 여러 역학 연구 2,3는 산업화 된 국가에서 연간 십만명 당 5~30가지 경우의 SSHL 발생률을보고했다. SSHL의 원인과 SSHL의 기초가되는 메커니즘을 광범위하게 검토되고 있지만, SSHL에 대한 우리의 지식은 제한 남아있다. 특발성 SSHL의 많은 잠재적 인 원인 중 공통 가설 순환 장애 4, 바이러스 감염 5-7, 및자가 면역 질환 8,9 등이 있습니다. 코르티코 스테로이드 치료는 10이 가설에 기초하여 제안하고 가장 일반적인가 치료되었지만,이 표준 요법의 효과는 여전히 3,11-14을 논의 중이다. 따라서, 다른 관점에 의해 동기 혁신적인 SSHL 치료 전략이 강하게 요구되고있다. SSHL달팽이관에서뿐만 아니라 청각 피질뿐만 아니라 신경 활동에 영향을 미친다. 여러 뇌 영상 연구 15-17 SSHL이 발병 몇 일 이내에 인간의 청각 피질에서 대뇌 피질 가소성을 유도하는 것이 좋습니다. 또한, 청각의 반대쪽 반구 dominancy의 손실로 표시 피질 재구성의 정도는 필드에 부정적인 18 청력 손실 회복 속도와 상관 관계가 나타났다 유발. SSHL의 발병에 의한 대뇌 피질 가소성은 영향을받는 귀의 청력 기능에 대한 부적응으로 고려 될 수있다. 따라서 SSHL와 연관이 부적응 피질 재구성 예방 새로운 치료 전략을 나타낼 수있다. 이 문서 방지하거나 부적응 대뇌 피질의 조직 개편을 줄이기 위해 &#39;배운 비 사용&#39;대뇌 피질의 변화를 방지하는 신경 재활 방법을 제안한다. 예를 들어, 운동 기능 장애의 경우에, 비 사용을 알게인한 부작용이 처음으로 이동이 억제되는 현상을 limbis 어떤 활동 장애 결국 신경 활동 및 동작 (19, 20)의 대응 진압 결과 손상된 다리로 시도. 학습 미사용 모터 부전에 한정되는 것으로 보이지 않지만,도 21 감각 장애 관여 할 수있다. SSHL 환자들이 주로 사용하고 청취 그대로 귀에주의를 기울입니다. 이 청취 동작은, 동시에, 그대로 귀에 대응 신경 활성을 증가 영향 와우 청각 피질 신경 (22) 사이의 연결을 감소시키기 위해 나타난다. SSHL 환자 &#39;제약 유도 음향 치료 영향 귀를 통해 집중적으로 음악을들을 참가자 동기 (CIST) &#39;23을 수행하기위한 &quot;비 사용&quot;에 의해 유도 된 이러한 부적응 피질 변화를 방지하기 위하여, 유익한 것으로 보인다 과 영향을받는 귀에 청각주의해야 할 사항(그림 1). 종래의 약물에 비하여 CIST 기발한 SSHL위한 안전 쉽고, 저렴하고 효과적인 치료 방법이다.

<table><tbody><tr><td>Ear mold</td><td>RION Co.Ltd, Tokyo, Japan</td><td>EM-59</td><td></td></tr><tr><td>portable music player</td><td>Sony Corporation, Tokyo, Japan</td><td>NW-S775</td><td></td></tr><tr><td>headphone</td><td>SENNHEISER Electronic GmbH &amp;amp; Co. KG, Hannover, Germany</td><td>HD280pro</td><td></td></tr><tr><td>equalizer</td><td>Roland Corporation, Hamamatsu, Japan</td><td>GE-7</td><td></td></tr><tr><td>headphone amplifier</td><td>FiiO Electronics Technology Co. Ltd, Guangzhou, China</td><td>E11</td><td></td></tr><tr><td>sound editing application</td><td>Adobe Systems Inc., CA, USA</td><td>Audition 3.0</td><td></td></tr></tbody></table>

neuro-rehabilitation approach for sudden sensorineural hearing loss

갑작스런 감각 신경성 난청 (SSHL)는 급성 특발성 난청을 특징으로한다. 추정 발생률은 연간 십만명 당 5~30가지 경우입니다. SSHL의 원인과 현재 SSHL을 기본 메커니즘은 알 수없는 남아 있습니다. 이러한 달팽이관 순환 장애, 바이러스 감염,자가 면역 질환과 같은 여러 가설을 바탕으로, 약리학 치료 적 접근법 SSHL 환자의 치료에 적용되어왔다; 그러나, 표준 치료, 코르티코 스테로이드 요법의 효능은 논의 중에있다. 강렬한 사운드에 노출은 청각 시스템에 영구적 인 손상을 일으킬 것으로 나타났다; 그러나, 중간 수준의 노출은 청각 장애를 줄일 수 있습니다 소음 외상 후 음향 환경을 풍부. 여러 뇌 영상 연구는 최근 SSHL의 시작은 인간의 청각 피질에 부적응 대뇌 피질의 구조 조정을 유도 것을 제안하고, 급성 SSHL 단계에 부정적인 CORR에서 대뇌 피질의 구조 조정의 정도가청각 손실로부터 복구 속도 양양. 이 문서 SSHL, &quot;제약 조건에 의한 소리 치료 (CIST)&quot;에 대한 새로운 신경 재활 접근 방법의 개발을보고합니다. CIST 프로토콜의 목적은 예방 또는 농축 된 음향 환경을 이용하여 재구성 부적응 피질을 감소시키는 것이다. SSHL 환자의 손상 귀 운하는 적극적으로 영향을받는 귀를 사용하여 부적응 대뇌 피질의 조직 개편의 진행을 방지하기 위해 동기를 부여하기 위해 연결되어 있습니다. 영향을받는 귀는 입원 기간 동안 하루에 6 시간 동안 헤드폰을 통해 음악에 노출된다. CIST 프로토콜은 SSHL에 대한 안전하고 쉽게, 저렴하고 효과적인 치료가 될 것으로 보인다.

프로토콜에 설명 된 기준과 일치하고 스물 두 SSHL 입원 환자는 표준 스테로이드 치료 (CIST + SCT 그룹) (23)에 추가로 CIST을받은 대상 그룹에 할당 된 CIST을받을 의향이 있었다. 대조군은 표준 스테로이드 요법 (SCT 그룹)를 수신 SSHL 입원 31로 구성되었다. 모든 참가자는 완전히 연구에 대한 정보를하고, 의료 학부의 윤리위원회, 뮌스터 대학, 오사카 대학 병원의 윤리위원회에 의해 오사카 Rosai 병원의 윤리위원회의 승인 절차에 따라 동의를 통보하여 작성했다. 본 연구는 헬싱키 선언에 따라 수행되었다. 두 그룹 (SCT 대 SCT + CIST)의 각 참가자는 SSHL의 발생과 초기 청력 사이에 비슷한 연령과 시간 지연이 있었다. (1 차 심사), (II) 병원 (2 차 심사에서 방전시 : 1 차 및 2 차 측정 사이의 시간 간격 63.45 ± 28.56 일 : 표준 편차 (SCT + CIST ± 평균 : (III) 몇 달 후 (3 차 시험에 다시 10.42 ± 3.18 일)과 : 9.41 ± 3.14 일, SCT (± 표준 편차 (SCT + CIST을 의미 , SCT : 84.64 ± 38.68 일)) 순음 청력 측정기를 사용하여. 도 4는 처리 전 (1 차 측정)에 도시 된 바와 같이, 큰 차이가 영향 귀에 측정 된 모든 주파수 그룹 간의 임계 청각 관찰되지 않는다 (125, 250, 500, 1,000, 2,000, 4,000, 8,000 Hz에서)했다 . 영향을받는 귀에 청각 치료 (2 차 및 3 차 시험)는, 모든 FREQU에서 개선 한 후SCT + CIST와 스코틀랜드 그룹 (그림 4) 모두에서 용지는. 모든 주파수에서 청력 역치 수준은 개별적으로 각각의 귀에 대해 평균 한과 귀 사이에 다음 청력 수준의 차이는 (그림 5)를 계산 하였다. 영향을받는 그대로 귀 사이의 청력 수준의 차이는 SSHL에 기인했다. 귀 사이의 계산 된 청력 수준의 차이는 1 차 시험 (그림 5)에서 치료 전 그룹 사이에 차이가 없었다. 그러나, 유의 한 차이가 퇴원에 두 그룹 사이에 관찰되었다 (:) P &lt;0.001 (페로 니는 보정 3 차 시험) (2 차 시험 P &lt;0.05 () 페로 니는 보정)과 몇 달 후에. 그대로 귀에 청력 수준에 대해서는, 평균 임계 값은 크게 세 가지 시험 중 하나의 주파수의에서 그룹간에 차이가 없었다. 이 결과 번째 플러깅 지적전자 외이도는 그대로 귀에 부정적인 효과가 나타나지 않았다. CIST을받은 22 참가자에서, 명백한 부작용은 관찰되지 않았다. <img alt="그림 1" src="/files/ftp_upload/53264/53264fig1.jpg" /> 그림 제약에 의한 소리 치료 (CIST)의 도식 그림은. 그대로 귀 운하는 영향을받는 귀의 사용 동기를 부여하기 위해 연결되어 있습니다. 음악 monaurally 밀폐형 헤드폰을 통해 영향을받는 귀에 제시되고; 그대로 귀에 해당하는 다른 채널 (.이 그림은 오카모토 등 (23)에서 채택되었다. : 로타 Lagemann의 호의를 그리기) 침묵을 유지한다. <img alt="그림 2" src="/files/ftp_upload/53264/53264fig2.jpg" /> 그림 2. 연결 및 장치 CIST에 사용할 수 있습니다. 휴대용 음악 플레이어, 이퀄라이저, 헤드폰 앰프, 그리고 폐쇄 형<html> 헤드폰은 순차적으로 연결되어있다. 이퀄라이저와 헤드폰 앰프는 휴대용 음악 플레이어의 디지털 이퀄라이저가 충분히 효과적이지 않을 경우에만 사용됩니다. <a href="https://www.jove.com/files/ftp_upload/53264/53264fig2large.jpg" target="_blank">이 그림의 더 큰 버전을 보려면 여기를 클릭하십시오.</a> <img alt="그림 3" src="/files/ftp_upload/53264/53264fig3.jpg" /> . 영향을받는 귀에; (한 옥타브 단계 125 ~ 8,000 Hz의 범위) 그림 3. SSHL 환자의 예시적인 청력이 그림은 청력 수준을 나타냅니다 (공기 전도 : 열린 원, 골전이 : 대괄호 왼쪽)과 그대로 귀 (공기 전도 : 십자가, 뼈 전도 : 오른쪽 대괄호) 치료 전 SSHL 환자의. <a href="https://www.jove.com/files/ftp_upload/53264/53264fig3large.jpg" target="_blank">이 그림의 더 큰 버전을 보려면 여기를 클릭하십시오.</a> 1 &quot;&gt; :&quot;유지 - together.within 페이지 = FO &quot;e_content <img alt="그림 4" src="/files/ftp_upload/53264/53264fig4.jpg" /> . 표준을 수용 할뿐만 아니라 제약에 의한 소리 치료를받은 참가자의 영향을받는 귀에; (한 옥타브 단계 (125) 8,000 Hz의 범위) 영향을받는 귀에서 평균 청력 수준의 그림 4. 시간의 과정이 그림은 평균 청력도를 보여줍니다 코르티코 스테로이드 치료 (CIST + SCT : 열린 사각형) 또는 전용 표준 스테로이드 치료를받은 사람들에서 (SCT : 채워진 사각형). 1 차, 2 차 및 3 차 청력 검사가 수행되었다 퇴원시 처리 전 (I), (II), 및 (iii) 몇 개월 후에 각각. 오차 막대는 95 % 신뢰 구간 (이 그림은 오카모토 등의 알에서 수정되었습니다. 23). 나타내는 <a href="https://www.jove.com/files/ftp_upload/53264/53264fig4large.jpg" target="_blank">이 그림의 더 큰 버전을 보려면 여기를 클릭하십시오</a>URE. <img alt="그림 5" src="/files/ftp_upload/53264/53264fig5.jpg" /> 그림 5. 귀 사이의 레벨 차이를 듣고 평균 (왼쪽 : 치료 전) 1에 영향을 그대로 귀 사이의 임계 값의 차이가 모든 측정 주파수에 걸쳐 평균 한 청각., 2 (센터 : 퇴원시), 3 차 (오른쪽 : 나중에 몇 개월) 순음 청력 검사. 열고 채워진 사각형 제약에 의한 소리 치료 + 표준 스테로이드 치료 그룹 (CIST + SCT) 각각 표준 코르티코 스테로이드 요법 단독 군 (SCT)를 나타낸다. 오차 막대는 95 % 신뢰 구간 (이 그림은 오카모토 등. (23)에서 수정 된)를 나타낸다. <a href="https://www.jove.com/files/ftp_upload/53264/53264fig5large.jpg" target="_blank">이 그림의 더 큰 버전을 보려면 여기를 클릭하십시오.</a>

Watch this Scientific Journal Video about Neuro-rehabilitation Approach for Sudden Sensorineural Hearing Loss at JoVE.com

Neuro-rehabilitation Approach for Sudden Sensorineural Hearing Loss

This article reports the development of a neuro-rehabilitation approach, "constraint-induced sound therapy (CIST)" for sudden sensorineural hearing loss. The aim of CIST is to prevent maladaptive cortical reorganization by using an enriched acoustic environment. CIST represents a safe, easy, inexpensive, and effective approach to treat sudden sensorineural hearing loss.

갑작스런 감각 신경성 감소를위한 신경 재활 접근

Sudden sensorineural hearing loss (SSHL) is characterized by acute, idiopathic hearing loss. The estimated incidence rate is 5-30 cases per 100,000 people ...

neuro-rehabilitation-approach-for-sudden-sensorineural-hearing-loss

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Behavior

19.1K 조회수.  National Institute for Physiological Sciences. This article reports the development of a neuro-rehabilitation approach, "constraint-induced sound therapy (CIST)" for sudden sensorineural hearing loss. The aim of CIST is to prevent maladaptive cortical reorganization by using an enriched acoustic environment. CIST represents a safe, easy, inexpensive, and effective approach to treat sudden sensorineural hearing loss.

비디오: Neuro-rehabilitation Approach for Sudden Sensorineural Hearing Loss

A Method to Study Adaptation to Left-Right Reversed Audition

An unusual sensory space is one of the effective tools to uncover the mechanism of adaptability of humans to a novel environment. Although most of the previous studies have used special spectacles with prisms to achieve unusual spaces in the visual domain, a methodology for studying the adaptation to unusual auditory spaces has yet to be fully established. This study proposes a new protocol to set-up, validate, and use a left-right reversed stereophonic system using only wearable devices, and to study the adaptation to left-right reversed audition with the help of neuroimaging. Although individual acoustic characteristics are not yet implemented, and slight spillover of unreversed sounds is relatively uncontrollable, the constructed apparatus shows high performance in a 360&#176; sound source localization coupled with hearing characteristics with little delay. Moreover, it looks like a mobile music player and enables a participant to focus on daily life without arousing curiosity or drawing attention of other individuals. Since the effects of adaptation were successfully detected at the perceptual, behavioral, and neural levels, it is concluded that this protocol provides a promising methodology for studying adaptation to left-right reversed audition, and is an effective tool for uncovering the adaptability of humans to a novel environments in the auditory domain.

The present study proposes a protocol to investigate the adaptation to left-right reversed audition achieved only by wearable devices, using neuroimaging, which can be an effective tool for uncovering the adaptability of humans to a novel environment in the auditory domain.

왼쪽 오른쪽에 적응을 연구 하는 방법 반대로 오디션

An unusual sensory space is one of the effective tools to uncover the mechanism of adaptability of humans to a novel environment. Although most of the ...

연구

행동분석학

Sound Source Localization Testing in Single-sided Deafness Following Bone Conduction Intervention

Single-sided deafness (SSD), where there is severe to profound hearing loss in one ear and normal hearing in the other, is a prevalent auditory condition that significantly impacts the quality of life for those affected. The ability to accurately localize sound sources is crucial for various everyday activities, including speech communication and environmental awareness. In recent years, bone conduction intervention has emerged as a promising solution for patients with SSD, offering a non-invasive alternative to traditional air conduction hearing aids. However, the effectiveness of bone conduction devices (BCDs), especially in terms of improving sound localization abilities, remains a topic of considerable interest.
Here, we present a protocol to assess the impact of bone conduction intervention on sound localization ability in patients with SSD. The protocol includes the experimental setup (a sound-treated room and a semicircular array of loudspeakers), stimuli, and data analysis methods. Participants indicate the perceived direction of noise bursts, and their responses are analyzed using root mean square error (RMSE) and bias. The results of sound localization testing before and after bone conduction intervention are reported and compared. Despite no significant differences, most patients (71%) had a localization bias clearly toward the intervention side after bone conduction intervention. The study concludes that bone conduction intervention can promptly enhance certain sound localization skills in patients with SSD, offering evidence to support the efficacy of BCDs as a treatment for SSD.

We present a protocol to evaluate the impact of bone conduction intervention on sound localization ability in patients with single-sided deafness (SSD). This protocol can be applied to assess the efficacy of bone conduction devices in restoring sound localization abilities and improving the overall quality of life for individuals with SSD.

Sound Source Localization Testing in Single-sided Deafness Following Bone Conduction Intervention(골전도 중재술에 따른 편측성 난청에서의 음원 현지화 테스트)

Single-sided deafness (SSD), where there is severe to profound hearing loss in one ear and normal hearing in the other, is a prevalent auditory condition ...

The Mouse Round-window Approach for Ototoxic Agent Delivery: A Rapid and Reliable Technique for Inducing Cochlear Cell Degeneration

Investigators have utilized a wide array of animal models and investigative techniques to study the mammalian auditory system. Much of the basic research involving the cochlea and its associated neural pathways entails exposure of model cochleae to a variety of ototoxic agents. This allows investigators to study the effects of targeted damage to cochlear structures, and in some cases, the self-repair or regeneration of those structures. Various techniques exist for delivery of ototoxic agents to the cochlea. When selecting a particular technique, investigators must consider a number of factors, including the induction of inadvertent systemic toxicity, the amount of cochlear damage produced by the surgical procedure itself, the type of lesion desired, animal survivability, and reproducibility/reliability of results. Currently established techniques include parenteral injection, intra-peritoneal injection, trans-tympanic injection, endolymphatic sac injection, and cochleostomy with perilymphatic perfusion. Each of these methods has been successfully utilized and is well described in the literature; yet, each has various shortcomings. Here, we present a technique for topical application of ototoxic agents directly to the round window niche. This technique is non-invasive to inner ear structures, produces rapid onset of reliably targeted lesions, avoids systemic toxicity, and allows for an intra-animal control (the contra-lateral ear). Results stemming from this approach have helped deeper understanding of auditory pathophysiology, cochlear cell degeneration, and regenerative capacity in response to an acute injury. Future investigations may use this method to conduct interventional studies involving gene therapy and stem cell transplantation to combat hearing loss.

Various methods exist for introducing ototoxic agents to the cochleae of animal models. Presented is a surgical protocol for delivery of ototoxic agents to the round window niche. The procedure is reliable, creates targeted intra-cochlear lesions, and avoids mechanical damage to the microarchitecture. Examination of cochlear self-repair/regeneration is possible.

인공 와우 세포 변성을 유도하기위한 신속하고 신뢰할 수있는 기술 : Ototoxic 에이전트 배달을 위해 마우스 라운드 창 접근

Investigators have utilized a wide array of animal models and investigative techniques to study the mammalian auditory system. Much of the basic research ...

의학

Simple Surgical Induction of Conductive Hearing Loss with Verification Using Otoscope Visualization and Behavioral Clap Startle Response in Rat

Conductive hearing loss (CHL) is a prevalent hearing impairment in humans. The goal of the protocol is to describe a simple surgical procedure for inducing CHL in rodents. The protocol demonstrates CHL by tympanic membrane puncture. Verification of CHL surgery was by otoscope examination and behavioral assessment by clap startle response, both replicable and reliable, and are simple methods to demonstrate hearing loss has occurred. The simple CHL procedure is advantageous due to its reproducibility and flexibility to different pursuits in hearing loss research. The limitations of inducing CHL by a surgical approach are associated with the learning curve to perform the surgical procedure and confidence in audiological examination. Inducing a hearing impairment by CHL allows one to readily study the neural manifestations and behavioral outcomes of hearing loss.

Here, we present a protocol to establish a replicable conductive hearing loss induction via surgical tympanic membrane puncture and verification by otoscope visualization and behavioral assessment by clap startle.

쥐에 있는 이경 가시화 및 행동 박수 깜짝 반응을 사용하여 확인을 가진 전도성 청력 손실의 간단한 외과 유도

Conductive hearing loss (CHL) is a prevalent hearing impairment in humans. The goal of the protocol is to describe a simple surgical procedure for ...

신경과학

Structured Motor Rehabilitation After Selective Nerve Transfers

After severe nerve injuries, selective nerve transfers provide an opportunity to restore motor and sensory function. Functional recovery depends both on the successful re-innervation of the targets in the periphery and on the motor re-learning process entailing cortical plasticity. While there is an increasing number of methods to improve rehabilitation, their routine implementation in a clinical setting remains a challenge due to their complexity and long duration. Therefore, recommendations for rehabilitation strategies are presented with the aim of guiding medical doctors and therapists through the long-lasting rehabilitation process and providing step-by-step instructions for supporting motor re-learning.
Directly after nerve transfer surgery, no motor function is present, and therapy should focus on promoting activity in the sensory-motor cortex areas of the paralyzed body part. After about two to six months (depending on the severity and modality of injury, the distance of nerve regeneration and many other factors), the first motor activity can be detected via electromyography (EMG). Within this phase of rehabilitation, multimodal feedback is used to re-learn the motor function. This is especially critical after nerve transfers, as muscle activation patterns change due to the altered neural connection. Finally, muscle strength should be sufficient to overcome gravity/resistance of antagonistic muscles and joint stiffness, and more functional tasks can be implemented in rehabilitation.

Here, we present a protocol for the motor rehabilitation of patients with severe nerve injuries and selective nerve transfer surgery. It aims at restoring the motor function proposing several stages in patient education, early-stage therapy after surgery and interventions for rehabilitation after successful re-innervation of the nerve&#8217;s target.

선택적 신경 전달 후 구조화 된 모터 재활

After severe nerve injuries, selective nerve transfers provide an opportunity to restore motor and sensory function. Functional recovery depends both on ...

Assessment of Audio-Tactile Sensory Substitution Training in Participants with Profound Deafness Using the Event-Related Potential Technique

This paper examines the application of electroencephalogram-based methods to assess the effects of audio-tactile substitution training in young, profoundly deaf (PD) participants, with the aim of analyzing the neural mechanisms associated with vibrotactile complex sound discrimination. Electrical brain activity reflects dynamic neural changes, and the temporal precision of event-related potentials (ERPs) has proven to be key in studying time-locked processes while performing behavioral tasks that involve attention and working memory. 
The current protocol was designed to study electrophysiological activity in PD subjects while they performed a continuous performance task (CPT) using complex-sound stimuli, consisting of five different animal sounds delivered through a portable stimulator system worn on the right index finger. As a repeated-measures design, electroencephalogram (EEG) recordings in standard conditions were performed before and after a brief training program (five 1 h sessions over 15 days), followed by offline artifact correction and epoch averaging, to obtain individual and grand-mean waveforms. Behavioral results show a significant improvement in discrimination and a more robust P3-like centroparietal positive waveform for the target stimuli after training. In this protocol, ERPs contribute to the further understanding of learning-related neural changes in PD subjects associated with audio-tactile discrimination of complex sounds.

This protocol is designed to explore underlying learning-related electrophysiological changes in subjects with profound deafness after a short training period in audio-tactile sensory substitution by applying the event-related potential technique.

사건 관련 잠재적 기술을 사용한 심도 난청이 있는 참가자의 청각 감각 대체 훈련 평가

This paper examines the application of electroencephalogram-based methods to assess the effects of audio-tactile substitution training in young, ...

Semi-Automated Analysis of Peak Amplitude and Latency for Auditory Brainstem Response Waveforms Using R

Many reports in the last 15 years have assessed changes in the auditory brainstem response (ABR) waveform after insults such as noise exposure. Common changes include reductions in the peak 1 amplitude and the relative latencies of the later peaks, as well as increased central gain, which is reflected by a relative increase in the amplitudes of the later peaks compared to the amplitude of peak 1. Many experimenters identify the peaks and troughs visually to assess their relative heights and latencies, which is a laborious process when the waveforms are collected in 5 dB increments throughout the hearing range for each frequency and condition. This paper describes free routines that may be executed in the open-source platform R with the RStudio interface to semi-automate the measurements of the peaks and troughs of auditory brainstem response (ABR) waveforms. The routines identify the amplitudes and latencies of peaks and troughs, display these on a generated waveform for inspection, collate and annotate the results into a spreadsheet for statistical analysis, and generate averaged waveforms for figures. In cases when the automated process misidentifies the ABR waveform, there is an additional tool to assist in correction. The goal is to reduce the time and effort needed to analyze the ABR waveform so that more researchers will include these analyses in the future.

This article describes the semi-automated measurement of the amplitudes and latencies of the first five peaks and troughs in the auditory brainstem response waveform. An additional routine compiles and annotates the data into a spreadsheet for experimenter analysis. These free computer routines are executed using the open-source statistical package R.

R을 이용한 청각 뇌간 반응 파형에 대한 피크 진폭 및 대기 시간의 반자동 분석

Many reports in the last 15 years have assessed changes in the auditory brainstem response (ABR) waveform after insults such as noise exposure. Common ...

Systematic Hearing Performance Evaluation Process for Adolescents with Cochlear Implantation at Early Ages

Cochlear implant (CI) provision is the most effective clinical treatment to restore hearing performance in individuals with profound sensorineural hearing loss (SNHL). It has been successful in providing improved speech perception outcomes, especially in quiet environments. However, speech perception performance within complex environments, lexical tone recognition, and music perception have been shown to only improve with newer fine structure coding strategies or related techniques. Therefore, the methods used to assess hearing performance in noisy environments, lexical tone recognition, and music perception are of vital importance. These assessments must reflect the postoperative outcomes and also provide guidance for the programming, rehabilitation, and application of new coding strategies. In this study, hearing performance in simple and complex situations was evaluated before and after upgrading to a fine structure strategy. The participants were a cohort of Mandarin-speaking adolescents, who were experienced CI users. The comprehensive clinical workflow involved assessments of speech in quiet conditions, speech in noisy conditions, lexical tone recognition, and music perception. This battery of tests is explained in detail, from the coding strategy to the test methods, including the test process, environment, device, material, and order. The details that require special attention are discussed, such as the position of the participants, the angle of the loudspeaker, the intensity of the sound, the noise type, the practice test, and the way of answering questions. Each test step, method, and material for speech, lexical tone, and music perception is presented in detail. Finally, the clinical results are discussed.

This paper describes a battery of tests used to clinically assess the hearing performance of adolescent, Mandarin-speaking, experienced cochlear implant users upgraded to a new fine structure coding strategy. The battery of tests include speech in quiet conditions, speech in noisy conditions, lexical tone, and music perception.

어린 나이에 인공와우를 이식한 청소년을 위한 체계적인 청력 성능 평가 과정

Cochlear implant (CI) provision is the most effective clinical treatment to restore hearing performance in individuals with profound sensorineural hearing ...

A State-of-the-Art Method for Preserving Residual Hearing During Cochlear Implant Surgery

The developments in surgical techniques and cochlear implant (CI) electrode design have expanded the indications for CI treatment. Currently, patients with high-frequency hearing loss may benefit from CIs when low-frequency residual hearing can be preserved, as this enables combined electric-acoustic stimulation (EAS). The possible benefits of EAS include, for example, improved sound quality, music perception, and speech intelligibility in noise.
The risks of inner ear trauma and a deterioration or even complete loss of residual hearing vary according to the surgical technique and the type of electrode array used. Short, lateral-wall electrodes with shallower angular insertion depths have demonstrated higher rates of hearing preservation than longer electrodes. The very slow insertion of the electrode array through the round window of the cochlea contributes to insertion atraumaticity and, thus, may lead to favorable hearing preservation results. However, residual hearing can be lost even after an atraumatic insertion. 
Electrocochleography (ECochG) can be used to monitor inner ear hair cell function during the insertion of the electrode. Several investigators have demonstrated that the ECochG responses during surgery may predict postoperative hearing preservation results. 
In a recent study, we correlated the patients' subjective hearing perception with simultaneously recorded intracochlear ECochG responses during the insertion. This is the first report evaluating the association between intraoperative ECochG responses and hearing perception in a subject undergoing cochlear implantation under local anesthesia without sedation. The combination of intraoperative ECochG responses with the patient's real-time feedback to sound stimuli has excellent sensitivity for the intraoperative monitoring of cochlear function. This paper presents a state-of-the-art method for the preservation of residual hearing during CI surgery. We describe this treatment procedure with the special consideration of performing the surgery under local anesthesia, which makes it feasible for monitoring the patient's hearing during the insertion of the electrode array.

The preservation of cochlear structures and possible residual hearing is one important factor to consider during cochlear implant surgery. Here, we present a state-of-the-art method for preserving residual hearing during cochlear implant surgery under local anesthesia.

The developments in surgical techniques and cochlear implant (CI) electrode design have expanded the indications for CI treatment. Currently, patients ...

<meta charset="utf8"></head><body>Hearing Preservation with Long Electrodes in Electric-Acoustic Stimulation(전기-음향 자극에서 긴 전극을 사용한 청력 보존)

Enhanced Cochlear Coverage and Hearing Preservation in High-Frequency Hearing Loss via Electric Acoustic Stimulation with Longer Electrode

Electric-acoustic stimulation (EAS) is a promising treatment to improve hearing ability in patients with high-frequency hearing loss (HL). In EAS surgeries, shorter electrodes have been preferred to avoid the presence of an electrode covering the residual hearing region. However, our earlier studies showed that EAS with longer electrodes (28 mm) could preserve acoustic hearing. Additionally, we reported that the hearing preservation (HP) scores were independent of the length of the inserted electrodes, consistent with the systematic review. As most EAS patients gradually lose residual hearing over time due to the natural course of HL, in these cases, providing broader cochlear coverage using longer electrodes was beneficial toward better place-pitch matching. In addition to preparing for the deterioration in&#160;hearing in&#160;the future, EAS with longer electrodes could offer various types of map strategies. Herein, we show the pre-, intra-, and post-procedures for EAS surgery. Appropriate preoperative evaluation, less invasive surgery, flexible lateral-wall electrodes, and steroid administration resulted in good HP following EAS with longer electrodes.

<meta charset="utf8"></head><body>저자 스포트라이트: 달팽이관 적용 범위 및 청력 보존을 위해 긴 전극으로 EAS 최적화

Electric acoustic stimulation (EAS) with longer electrodes can offer broader cochlear coverage and various types of maps in cases of high-frequency hearing loss. Combining less invasive surgery, flexible lateral-wall electrodes, and steroid administration permits deeper insertion with little or no surgical trauma, resulting in good preservation of hearing.

갑작스런 감각 신경성 감소를위한 신경 재활 접근

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