The aim of this study was to determine the age, in months, of conditioning in for visual reinforcement audiometry (VRA) in hearing-impaired infants, including the effects of the hearing levels and motor development. The subjects were 20 hearing-impaired infants who were diagnosed as having hearing impairment immediately after newborn hearing screening and received hearing aids under 6 months of age. The estimated hearing loss in each infant ranged from moderate to profound in the better ear. VRA was carried out to assess the minimum response levels (MRLs) across frequencies using 3A insert earphones and a bone oscillator with warble-tone stimuli generated from an audiometer. The ages of shaping a conditioning were distributed from 6 to 11 months in 19 infants (95%), except for the one infant with Down's syndrome. The correlation coefficient between the VRA MRLs at 2000Hz and ABR thresholds were high (r = 0.87), furthermore the difference of both means was close to 0.5dB (1SD=±9.6dB). A significant relation was found between the months of shape of conditioning and the averages of the MRLs (r = 0.58), whereas retardation of motor development (holding up head, sitting and toddling by themselves) had no significant effect. The findings indicated that a the cross-check assessment with VRA after 1 year of age could contribute to early amplification and aural habilitation.
The first aim of the study was to verify whether the combined use of a hearing aid with a sound generator (SG) might be more effective than the use of a hearing aid alone in alleviating the annoying symptom of tinnitus. “Tinnitus annoyance” was measured by Tinnitus Handicap Inventory (THI) and evaluation of the numerical scores for loudness, annoyance, effects on daily life, severity and subjective grade index for improvement. The second aim of the study was to compare the reduction in the score on THI with the use of hearing aids with and without by evaluating the subjective grade index for improvement. A total of 54 patients with sensorineural hearing loss were enrolled in the study. To validate the subjective improvement in tinnitus, the patients were asked at the first consultation as to which was effective; use of a hearing aid (HA) with a SG or use of a HA without a SG. By this comparative method patients were divided into two groups “the group using a HA alone and the group using a HA with a SG”. Both groups showed significant improvement, as indicated by a reduction of the THI and numerical scores, and improvement on the subjective grading scale. The results of this study suggest that both the use of a HA alone and that of a HA with a SG provide significant benefits in terms of alleviating the symptom of tinnitus. A controlled large-scale trial is needed to obtain more definitive results regarding the effects of a HA alone and those of a HA combined with a SG. As for the evaluation of the severity of tinnitus by THI, comparing cases with a reduction in the score by 20 or more points and by less than 19, the THI score did not appear to be correlated with the subjective improvement grade. In most patients of both groups, the tinnitus was alleviated; in 64% (excellent and very good) with the use of the HA combined with a SG and in 86% with the use of a HA alone (statistically not significant). All of these subjects could engage in their daily life activities without any trouble.
This study was conducted to evaluate the diagnostic value of wideband absorbance (AB) tympanometry for middle-ear effusion (MEE) and other conductive disorders of the middle ear, as compared to conventional 226-Hz tympanometry. Ears with MEE showed a lower AB across a broad range of frequencies. The usefulness of AB for the detection of MEE in a clinical setting was assessed. AB was measured in a no MEE group of 58 ears and an MEE group of 30 ears. The AB values at frequencies of 1, 2 and 4kHz were compared with the 10th percentile of the AB values (lower limits of age-dependent normative range). When a cutoff of the lower AB of under 1 frequency (0-1) pass, over 2 frequencies (2-3) fail was used, the diagnostic sensitivity was 97%, and specificity was 76%. In one ear with ossicular discontinuity, the AB below 1kHz increased due to the reduced middle ear stiffness. The present study suggested that AB is useful to differentiate between ossicular fixation and ossicular discontinuity. The characteristics of AB in ears with hypermobile tympanic membrane, tympanic membrane perforation, and negative middle ear pressure were examined. Middle ear disorders might can be more accurately predicted by AB than by 226-Hz tympanometry. Nevertheless, AB is currently recommended only as an adjunct to tympanometry.
A web-based/postal questionnaire survey was carried out of 120 hearing-impaired teachers working at nationwide schools for deaf children and at regular schools for children with normal hearing, to investigate the current status of their work, and the psychosocial effects on their work. On the basis of the results of the survey, the direction of improvement in the working environments for these teachers was explored. In regard to the means of assuring information access by teachers needed for work, the survey revealed frequent use of the sign language in schools for the deaf, but less frequent use of the sign language at regular schools for children with normal hearing. The findings revealed that the teachers perceived the following as stressors: various restrictions imposed by the hearing impairment, communication with children during education, etc. Maintaining good interpersonal relationships (e.g., collaboration among teachers) was found to be effective as a problem-coping behavior. For the teachers working at regular schools for children with normal hearing, the coping behaviors were not related to stress reduction, and how to establish stress-resolving behaviors was identified. The level of job satisfaction was high in the hearing-impaired teachers on the whole, although it was low in areas related to career development, such as occupational skill development and promotion. These results indicate the necessity of enlightenment improving the general awareness on hearing impairment, more systematic support for information access by teachers, and establishment of human improved interpersonal relationships at school.
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