Clinical Characteristics of Dizziness Associated with Acute Peripheral Facial Palsy

Song, Kudamo,Chang, Sehun,Lee, Jun,Shin, Sun Ae,Lee, Ho Yun The Korean Audiological Society and Korean Otologi 2018 Journal of Audiology & Otology Vol.22 No.3

<P><B>Background and Objectives</B></P><P>We aimed to assess the clinical significance of dizziness associated with acute peripheral facial palsy (APFP).</P><P><B>Subjects and Methods</B></P><P>Medical records of patients who visited an otorhinolaryngology clinic at a university hospital and were admitted for treatment of APFP between 2014 and 2016 were thoroughly reviewed.</P><P><B>Results</B></P><P>In total, 15.3% (n=15) of patients had dizziness. Continuous, rotatory dizziness without exacerbating factors was most common and frequently accompanied by nausea/vomiting. Dizziness disappeared within 1 week during the hospitalization period. Patients with Ramsay Hunt syndrome (31.0%) had dizziness more frequently than those with Bell’s palsy (8.7%). In addition, higher hearing thresholds and pain around the ear was reported more often in dizzy patients (<I>p</I><0.05). Logistic regression analysis revealed that the initial House-Brackmann grade of facial paralysis was solely associated with final recovery, but dizziness was not associated with prognosis.</P><P><B>Conclusions</B></P><P>Patients with APFP may have transient dizziness in the early stage, which may be more frequently accompanied by worse hearing thresholds and/or pain around the ear. However, these symptoms including dizziness seem to be unrelated to final prognosis.</P>

Recovery Phase Spontaneous Nystagmus, Its Existence and Clinical Implication

Lee, Min Young,Son, Hye Ran,Rah, Yoon Chan,Jung, Jae Yun,Suh, Myung-Whan The Korean Audiological Society and Korean Otologi 2019 Journal of Audiology & Otology Vol.23 No.1

<P><B>Background and Objectives</B></P><P>Determination of the lesion side based on the direction of the nystagmus could result in confusions to the clinicians due to mismatch between the vestibular function tests and also between vestibular and audiologic features. To minimize these mistakes, we elucidated the clinical manifestation and vestibular function test results in cases with recovery spontaneous nystagmus (rSN).</P><P><B>Subjects and Methods</B></P><P>Patients who visited ENT clinic of tertiary referral hospital for acute onset continuous vertigo from January 2008 to December 2011 were enrolled. In these patients, we assessed onset time of vertigo, time point of paralytic spontaneous nystagmus (SN) and time point of rSN. At each time point of SN, vestibular function tests and hearing function tests were performed.</P><P><B>Results</B></P><P>We confirmed the rSN among patients with unilateral vestibulopathy and demonstrated that high gain of the rotatory chair test (slow harmonic acceleration) and/or mismatch of the SN direction and contralateral caloric weakness could indicate the recovery state of patients and nystagmus observed in this stage is recovery phase nystagmus.</P><P><B>Conclusions</B></P><P>In acute vestibulopathy patients, recovery phase nystagmus was observed and on this stage of disease vestibular function tests shows several features that could predict recovery state.</P>

Pole-Zero Fitting for Transfer Function of Hearing-Aid Receiver: Evidence-Based Review

Han, Woojae,Kim, Noori The Korean Audiological Society and Korean Otologi 2018 Journal of Audiology & Otology Vol.22 No.3

<P>The hearing-aid transducer is ubiquitous in the hearing-aid industry. For example, the balanced armature receiver (BAR), first invented by A.G. Bell, has been used in all telephone earphones because it has the highest output and best frequency response. Nevertheless, previous electro-mechanical studies on these miniature speakers are quite primitive, given the price of the transducers. Thus, more detailed analysis is critically important for the field of hearing science. This review study was motivated by Hunt’s parameter calibration (1954), a widely used commercial hearing-aid receiver (ED series, manufactured by Knowles Electronics, Inc.). In the body of the study, the transfer function of the BAR system (i.e., pressure over voltage) was calculated from Hunt’s parameters, solely from the electrical terminals of the device. The computed transfer function was then further investigated by comparing to the pole-zero fitting method using the methods of Gustavsen and Semlyen (1999) and Prony (1975). Based on our short experiment, the better fitting result was achieved with Gustavsen and Semlyen’s method. By decomposing results of the transfer function fitting into all-pass and minimum-phase parts, the system was confirmed as a delay system. We conclude that the BAR system is linear, time-invariant, stable, and causal while providing an evidence-based understanding of the hearing-aid receiver system.</P>

Analysis of Output Levels of an MP3 Player: Effects of Earphone Type, Music Genre, and Listening Duration

Shim, Hyunyong,Lee, Seungwan,Koo, Miseung,Kim, Jinsook The Korean Audiological Society and Korean Otologi 2018 Journal of Audiology & Otology Vol.22 No.3

<P><B>Background and Objectives</B></P><P>To prevent noise induced hearing losses caused by listening to music with personal listening devices for young adults, this study was aimed to measure output levels of an MP3 and to identify preferred listening levels (PLLs) depending on earphone types, music genres, and listening durations.</P><P><B>Subjects and Methods</B></P><P>Twenty-two normal hearing young adults (mean=18.82, standard deviation=0.57) participated. Each participant was asked to select his or her most PLLs when listened to Korean ballade or dance music with an earbud or an over-the-ear earphone for 30 or 60 minutes. One side of earphone was connected to the participant’s better ear and the other side was connected to a sound level meter via a 2 or 6 cc-couplers. Depending on earphone types, music genres, and listening durations, loudness A-weighted equivalent (LAeq) and loudness maximum time-weighted with A-frequency sound levels in dBA were measured.</P><P><B>Results</B></P><P>Neither main nor interaction effects of the PLLs among the three factors were significant. Overall output levels of earbuds were about 10-12 dBA greater than those of over-the-ear earphones. The PLLs were 1.73 dBA greater for earbuds than over-the-ear earphones. The average PLL for ballad was higher than for dance music. The PLLs at LAeq for both music genres were the greatest at 0.5 kHz followed by 1, 0.25, 2, 4, 0.125, 8 kHz in the order.</P><P><B>Conclusions</B></P><P>The PLLs were not different significantly when listening to Korean ballad or dance music as functions of earphone types, music genres, and listening durations. However, over-the-ear earphones seemed to be more suitable to prevent noise induce hearing loss when listening to music, showing lower PLLs, possibly due to isolation from the background noise by covering ears.</P>

Comparison of Single-Task versus Dual-Task for Listening Effort

Kwak, Chanbeom,Han, Woojae The Korean Audiological Society and Korean Otologi 2018 Journal of Audiology & Otology Vol.22 No.2

<P><B>Background and Objectives</B></P><P>Depending on the kind of task and/or material, listeners sometimes need to pay attention to understand communication. The present study aimed to estimate a listener’s amount of effort needed to understand communication by using recognition score and response time as a function of signal-to-noise ratio (SNR) and to confirm his/ her task dependency for listening effort.</P><P><B>Subjects and Methods</B></P><P>Forty-eight young adults with normal hearing participated in the study. As stimuli, Korean Speech Perception in Noise test without a question tag and three consecutive digits were used for sentence recognition (or single-task) and arithmetic (or dual-task), respectively. Both tasks were measured in quiet and under four SNR (i.e., 0, -4, -8, -12 dB) conditions. Their outcomes were analyzed and compared in terms of percent correct and response time.</P><P><B>Results</B></P><P>Sentence recognition scores and arithmetic scores decreased as the level of noise increased. Response time for sentence recognition decreased as noise increased, whereas the response time for arithmetic increased as noise increased. In addition, there was a negative correlation between error percent and response time in the sentence recognition. Conversely, a positive correlation between error percent and response time appeared in the arithmetic test.</P><P><B>Conclusions</B></P><P>Listening effort showed a different pattern based on the kind of task, single vs. dual, while the dual-task required greater effort from the listener.</P>

Update on Bone-Conduction Auditory Brainstem Responses: A Review

Seo, Young Joon,Kwak, Chanbeom,Kim, Saea,Park, Yoon Ah,Park, Kyoung Ho,Han, Woojae The Korean Audiological Society and Korean Otologi 2018 Journal of Audiology & Otology Vol.22 No.2

<P>Auditory brainstem responses (ABR) have been used as a powerful and the most common objective tool to evaluate hearing sensitivity and to diagnose the types of hearing loss and neurological disorders, through the auditory peripheral pathway to a central level of the brainstem, since 1971. Although bone-conduction (BC) ABR could be an alternative to air-conduction (AC) ABR, as the former overcomes some limitations of the latter, the majority of clinicians rarely utilize it due to a lack of knowledge and no routine test administration. This review presents the weaknesses of AC ABR that apply to all clinical population, and discusses the development of BC ABR. The optimal placements of bone oscillators to obtain favorable clinical outcomes in infants, children, and adults, and the appropriate stimuli for BC ABR are examined. While providing absolute thresholds and latencies of BC ABR based on previous studies compared to AC ABR, this review includes clinical data of infants and young children with both normal hearing in terms of maturation, and with pathology such as congenital external auditory canal atresia. We recommend the future clinical application of BC ABR for candidacy as well as for patients with BC hearing implants.</P>