PeerJ Preprints: Otorhinolaryngologyhttps://peerj.com/preprints/index.atom?journal=peerj&subject=6000Otorhinolaryngology articles published in PeerJ PreprintsVocal emotion recognition in school-age children: normative data for the EmoHI testhttps://peerj.com/preprints/279212019-08-282019-08-28Leanne NagelsEtienne GaudrainDebi VickersMarta Matos LopesPetra HendriksDeniz Başkent
Traditionally, emotion recognition research has primarily used pictures and videos while audio test materials have received less attention and are not always readily available. Particularly for testing vocal emotion recognition in hearing-impaired listeners, the audio quality of assessment materials may becrucial. Here, we present a vocal emotion recognition test with non-language specific pseudospeech productions of multiple speakers expressing three core emotions (happy, angry, and sad): the EmoHI test. Recorded with high sound quality, the test is suitable to use with populations of children and adults with normal or impaired hearing, and across different languages. In the present study, we obtained normative data for vocal emotion recognition development in normal-hearing school-age (4-12 years) children using the EmoHI test. In addition, we tested Dutch and English children to investigate cross-language effects. Our results show that children’s emotion recognition accuracy scores improved significantly with age from the youngest group tested on (mean accuracy 4-6 years: 48.9%), but children’s performance did not reach adult-like values (mean accuracy adults: 94.1%) even for the oldest age group tested (mean accuracy 10-12 years: 81.1%). Furthermore, the effect of age on children’s development did not differ across languages. The strong but slow development in children’s ability to recognize vocal emotions emphasizes the role of auditory experience in forming robust representations of vocal emotions. The wide range of age-related performances that are captured and the lack of significant differences across the tested languages affirm the usability and versatility of the EmoHI test.
Traditionally, emotion recognition research has primarily used pictures and videos while audio test materials have received less attention and are not always readily available. Particularly for testing vocal emotion recognition in hearing-impaired listeners, the audio quality of assessment materials may becrucial. Here, we present a vocal emotion recognition test with non-language specific pseudospeech productions of multiple speakers expressing three core emotions (happy, angry, and sad): the EmoHI test. Recorded with high sound quality, the test is suitable to use with populations of children and adults with normal or impaired hearing, and across different languages. In the present study, we obtained normative data for vocal emotion recognition development in normal-hearing school-age (4-12 years) children using the EmoHI test. In addition, we tested Dutch and English children to investigate cross-language effects. Our results show that children’s emotion recognition accuracy scores improved significantly with age from the youngest group tested on (mean accuracy 4-6 years: 48.9%), but children’s performance did not reach adult-like values (mean accuracy adults: 94.1%) even for the oldest age group tested (mean accuracy 10-12 years: 81.1%). Furthermore, the effect of age on children’s development did not differ across languages. The strong but slow development in children’s ability to recognize vocal emotions emphasizes the role of auditory experience in forming robust representations of vocal emotions. The wide range of age-related performances that are captured and the lack of significant differences across the tested languages affirm the usability and versatility of the EmoHI test.Objective detection of auditory steady-state responses based on mutual information: Receiver operating characteristics and validation across modulation rates and levelshttps://peerj.com/preprints/33992017-11-092017-11-09Gavin M BidelmanClaire McElwain
Auditory steady-state responses (ASSRs) are sustained potentials used to assess the physiological integrity of the auditory pathway and objectively estimate hearing thresholds. ASSRs are typically analyzed using statistical procedures in order to remove the subjective bias of human operators. Knowing when to terminate signal averaging in ASSR testing is also critical for making efficient clinical decisions and obtaining high-quality data in empirical research. Here, we investigated a new detection metric for ASSRs based on mutual information (MI) [Bidelman, G. M. (2014). Objective information-theoretic algorithm for detecting brainstem evoked responses to complex stimuli. J. Am. Acad. Audiol., 25(8), 711-722], previously bench tested using only a single suprathreshold stimulus. ASSRs were measured in n=10 normal hearing listeners to various stimuli varying in modulation rate (40, 80 Hz) and level (80 – 20 dB SPL). MI-based classifiers applied to ASSRs recordings showed that accuracy of ASSR detection ranged from ~75 - 99% and was better for 40 compared to 80 Hz responses and for higher compared to lower stimulus levels. Detailed receiver operating characteristics (ROC) were used to establish normative ranges for MI for reliable ASSR detection across levels and rates (MI=0.9-1.6). Relative to current statistics for ASSR identification (F-test), MI was found to be a more efficient metric for determining the stopping criterion for signal averaging. Our new results confirm that MI can be applied across a broad range of ASSR stimuli and might offer improvements to conventional objective techniques for ASSR detection.
Auditory steady-state responses (ASSRs) are sustained potentials used to assess the physiological integrity of the auditory pathway and objectively estimate hearing thresholds. ASSRs are typically analyzed using statistical procedures in order to remove the subjective bias of human operators. Knowing when to terminate signal averaging in ASSR testing is also critical for making efficient clinical decisions and obtaining high-quality data in empirical research. Here, we investigated a new detection metric for ASSRs based on mutual information (MI) [Bidelman, G. M. (2014). Objective information-theoretic algorithm for detecting brainstem evoked responses to complex stimuli. J. Am. Acad. Audiol., 25(8), 711-722], previously bench tested using only a single suprathreshold stimulus. ASSRs were measured in n=10 normal hearing listeners to various stimuli varying in modulation rate (40, 80 Hz) and level (80 – 20 dB SPL). MI-based classifiers applied to ASSRs recordings showed that accuracy of ASSR detection ranged from ~75 - 99% and was better for 40 compared to 80 Hz responses and for higher compared to lower stimulus levels. Detailed receiver operating characteristics (ROC) were used to establish normative ranges for MI for reliable ASSR detection across levels and rates (MI=0.9-1.6). Relative to current statistics for ASSR identification (F-test), MI was found to be a more efficient metric for determining the stopping criterion for signal averaging. Our new results confirm that MI can be applied across a broad range of ASSR stimuli and might offer improvements to conventional objective techniques for ASSR detection.Cross-institutional evaluation of a mastoidectomy assessment instrumenthttps://peerj.com/preprints/29542017-10-022017-10-02Thomas KerwinBrad HittleDon StredneyPaul De BoeckGregory Wiet
Objective: The objective of this work is to obtain validity evidence for an evaluation instrument used to assess the performance level of a mastoidectomy. The instrument has been previously described and had been formulated by a multi-institutional consortium.
Design: Mastoidectomies were performed on a virtual temporal bone system and then rated by experts using a previously described 15 element task-based checklist. Based on the results, a second, similar checklist was created and a second round of rating was performed.
Setting: Twelve otolaryngological surgical training programs in the United States.
Participants: 65 mastoidectomy performances were evaluated coming from 37 individuals with a variety of temporal bone dissection experience, from medical students to attending physicians. Raters were attending surgeons from 12 different institutions.
Results: Intraclass correlation (ICC) scores varied greatly between items in the checklist with some being low and some being high. Percentage agreement scores were similar to previous rating instruments. There is strong evidence that a high score on the task-based checklist is necessary for a rater to consider a mastoidectomy to be performed at the level of an expert but a high score is not a sufficient condition.
Conclusions: Rewording of the instrument items to focus on safety does not result in increased reliability of the instrument. The strong result of the Necessary Condition Analysis suggests that going beyond simple correlation measures can give extra insight into grading results. Additionally, we suggest using a multiple point scale instead of a binary pass/fail question combined with descriptive mastery levels.
Objective: The objective of this work is to obtain validity evidence for an evaluation instrument used to assess the performance level of a mastoidectomy. The instrument has been previously described and had been formulated by a multi-institutional consortium.Design: Mastoidectomies were performed on a virtual temporal bone system and then rated by experts using a previously described 15 element task-based checklist. Based on the results, a second, similar checklist was created and a second round of rating was performed.Setting: Twelve otolaryngological surgical training programs in the United States.Participants: 65 mastoidectomy performances were evaluated coming from 37 individuals with a variety of temporal bone dissection experience, from medical students to attending physicians. Raters were attending surgeons from 12 different institutions.Results: Intraclass correlation (ICC) scores varied greatly between items in the checklist with some being low and some being high. Percentage agreement scores were similar to previous rating instruments. There is strong evidence that a high score on the task-based checklist is necessary for a rater to consider a mastoidectomy to be performed at the level of an expert but a high score is not a sufficient condition.Conclusions: Rewording of the instrument items to focus on safety does not result in increased reliability of the instrument. The strong result of the Necessary Condition Analysis suggests that going beyond simple correlation measures can give extra insight into grading results. Additionally, we suggest using a multiple point scale instead of a binary pass/fail question combined with descriptive mastery levels.Multi-institutional development of a mastoidectomy performance evaluation instrumenthttps://peerj.com/preprints/29312017-04-182017-04-18Thomas KerwinBrad HittleDon StredneyPaul De BoeckGregory Wiet
A method for rating surgical performance of a mastoidectomy procedure that is shown to apply universally across teaching institutions has not yet been devised. This work describes the development of a rating instrument created from a multi-institutional consortium. Using a participatory design and a modified Delphi approach, a multi-institutional group of expert otologists constructed a 15 element task-based checklist for evaluating mastoidectomy performance. This instrument was further refined into a 14 element checklist focusing on the concept of safety after using it to rate a large and varied population of performances. By using 14 experts from 12 different institutions and a literature review, individual metrics were identified, rated as to the level of importance and operationally defined to create a rating scale for mastoidectomy performance. Initial use of the rating scale showed modest rater agreement. The operational definitions of individual metrics were modified to emphasize “safe” as opposed to “proper” technique. A second rating instrument was developed based on this feedback. Using a consensus building approach with multiple rounds of communication between experts is a feasible way to construct a rating instrument for mastoidectomy. Expert opinion alone using a Delphi method provides face and content validity evidence, however, this is not sufficient to develop a universally acceptable rating instrument. A continued process of development and experimentation to demonstrate evidence for reliability and validity making use of a large population of raters and performances is necessary to achieve universal acceptance.
A method for rating surgical performance of a mastoidectomy procedure that is shown to apply universally across teaching institutions has not yet been devised. This work describes the development of a rating instrument created from a multi-institutional consortium. Using a participatory design and a modified Delphi approach, a multi-institutional group of expert otologists constructed a 15 element task-based checklist for evaluating mastoidectomy performance. This instrument was further refined into a 14 element checklist focusing on the concept of safety after using it to rate a large and varied population of performances. By using 14 experts from 12 different institutions and a literature review, individual metrics were identified, rated as to the level of importance and operationally defined to create a rating scale for mastoidectomy performance. Initial use of the rating scale showed modest rater agreement. The operational definitions of individual metrics were modified to emphasize “safe” as opposed to “proper” technique. A second rating instrument was developed based on this feedback. Using a consensus building approach with multiple rounds of communication between experts is a feasible way to construct a rating instrument for mastoidectomy. Expert opinion alone using a Delphi method provides face and content validity evidence, however, this is not sufficient to develop a universally acceptable rating instrument. A continued process of development and experimentation to demonstrate evidence for reliability and validity making use of a large population of raters and performances is necessary to achieve universal acceptance.Effects of early and late cheiloplasty on anterior part of maxillary dental arch development in infants with unilateral complete cleft lip and palatehttps://peerj.com/preprints/14022015-09-282015-09-28Silvia V Valentová-StrenáčikováRadovan Malina
Objectives. The objective of this study is to compare the impact of early and late reconstruction of complete unilateral cleft lip and palate on the growth and development of the front of the dentoalveolar arch. Methods. This study was carried out in the years 2012 - 2015 at the Clinic of Plastic, Reconstructive and Aesthetic Surgery in Banska Bystrica. Infants with unilateral complete cleft lip and palate were divided into 2 groups according to the timing of lip reconstruction. Group A consisted of infants with early lip reconstruction - realised in the first 14 days of life. Group B consisted of infants with later lip reconstruction - realised in the third month of age. Maxillary dental casts were obtained for each child in four periods – in the first 14 days of life, in the third month, in the sixth month and in the age of one year. These were followed by the identification, measurement and evaluation of anthropometric parameters. Results. Significant differences were occurred after the reconstruction of the lips in linear and angle measurements between infants in the A and B groups. Conclusion. The early surgical reconstruction of the lips in the first 14 days of life has a positive effect on the growth and development of the anterior segment of the dentoalveolar arch. Early lip reconstruction forms a continuous pressure on the frontal segment, resulting in the earlier remedy of anatomical properties and creates appropriate conditions for the best development of this area.
Objectives.The objective of this study is to compare the impact of early and late reconstruction of complete unilateral cleft lip and palate on the growth and development of the front of the dentoalveolar arch. Methods. This study was carried out in the years 2012 - 2015 at the Clinic of Plastic, Reconstructive and Aesthetic Surgery in Banska Bystrica. Infants with unilateral complete cleft lip and palate were divided into 2 groups according to the timing of lip reconstruction. Group A consisted of infants with early lip reconstruction - realised in the first 14 days of life. Group B consisted of infants with later lip reconstruction - realised in the third month of age. Maxillary dental casts were obtained for each child in four periods – in the first 14 days of life, in the third month, in the sixth month and in the age of one year. These were followed by the identification, measurement and evaluation of anthropometric parameters. Results. Significant differences were occurred after the reconstruction of the lips in linear and angle measurements between infants in the A and B groups. Conclusion. The early surgical reconstruction of the lips in the first 14 days of life has a positive effect on the growth and development of the anterior segment of the dentoalveolar arch. Early lip reconstruction forms a continuous pressure on the frontal segment, resulting in the earlier remedy of anatomical properties and creates appropriate conditions for the best development of this area.Human Hearing Losshttps://peerj.com/preprints/378v12014-05-012014-05-01Stacy Lee Ware
Hearing loss affects as much as 5% of the global human population and its negative consequences, often exacerbated by cultural bias or distributive injustice, include delayed cognitive and language development, learning deficits and poor academic performance, chronic unemployment and dependency, poverty, elevated risk of harm and poor health. This paper is based on a review of the academic literature as well as other credible published resources to identify the principal causes of hearing loss; its consequences for individuals, communities, and states; and potential interventions most appropriate for developing and low-resource countries where hearing loss is currently most prevalent and its burdens most egregious.
Hearing loss affects as much as 5% of the global human population and its negative consequences, often exacerbated by cultural bias or distributive injustice, include delayed cognitive and language development, learning deficits and poor academic performance, chronic unemployment and dependency, poverty, elevated risk of harm and poor health. This paper is based on a review of the academic literature as well as other credible published resources to identify the principal causes of hearing loss; its consequences for individuals, communities, and states; and potential interventions most appropriate for developing and low-resource countries where hearing loss is currently most prevalent and its burdens most egregious.Mutation analysis of the SLC26A4, FOXI1 and KCNJ10 genes in individuals with congenital hearing losshttps://peerj.com/preprints/275v12014-03-072014-03-07Lynn M PiqueMarie-Luise BrennanColin J DavidsonFrederick SchaeferJohn Greinwald Jr.Iris Schrijver
Pendred syndrome (PDS) and DFNB4 comprise a phenotypic spectrum of sensorineural hearing loss disorders that typically result from biallelic mutations of the SLC26A4 gene. Although PDS and DFNB4 are recessively inherited, sequencing of the coding regions and splice sites of SLC26A4 in individuals suspected to be affected with these conditions often fails to identify two mutations. We investigated the potential contribution of large SLC26A4 deletions and duplications to sensorineural hearing loss (SNHL) by screening 107 probands with one known SLC26A4 mutation by Multiplex Ligation-dependent Probe Amplification (MLPA). A heterozygous deletion, spanning exons 4-6, was detected in only one individual, accounting for approximately 1% of the missing mutations in our cohort. This low frequency is consistent with previously published MLPA results. We also examined the potential involvement of digenic inheritance in PDS/DFNB4 by sequencing the coding regions of FOXI1 and KCNJ10. Of the 29 probands who were sequenced, three carried nonsynonymous variants including one novel sequence change in FOXI1 and two polymorphisms in KCNJ10. We performed a review of prior studies and, in conjunction with our current data, conclude that the frequency of FOXI1 (1.4%) and KCNJ10 (3.6%) variants in PDS/DFNB4 individuals is low. Our results, in combination with previously published reports, indicate that large SLC26A4 deletions and duplications as well as mutations of FOXI1 and KCNJ10 play limited roles in the pathogenesis of SNHL and suggest that other genetic factors likely contribute to the phenotype.
Pendred syndrome (PDS) and DFNB4 comprise a phenotypic spectrum of sensorineural hearing loss disorders that typically result from biallelic mutations of the SLC26A4 gene. Although PDS and DFNB4 are recessively inherited, sequencing of the coding regions and splice sites of SLC26A4 in individuals suspected to be affected with these conditions often fails to identify two mutations. We investigated the potential contribution of large SLC26A4 deletions and duplications to sensorineural hearing loss (SNHL) by screening 107 probands with one known SLC26A4 mutation by Multiplex Ligation-dependent Probe Amplification (MLPA). A heterozygous deletion, spanning exons 4-6, was detected in only one individual, accounting for approximately 1% of the missing mutations in our cohort. This low frequency is consistent with previously published MLPA results. We also examined the potential involvement of digenic inheritance in PDS/DFNB4 by sequencing the coding regions of FOXI1 and KCNJ10. Of the 29 probands who were sequenced, three carried nonsynonymous variants including one novel sequence change in FOXI1 and two polymorphisms in KCNJ10. We performed a review of prior studies and, in conjunction with our current data, conclude that the frequency of FOXI1 (1.4%) and KCNJ10 (3.6%) variants in PDS/DFNB4 individuals is low. Our results, in combination with previously published reports, indicate that large SLC26A4 deletions and duplications as well as mutations of FOXI1 and KCNJ10 play limited roles in the pathogenesis of SNHL and suggest that other genetic factors likely contribute to the phenotype.Successful perioperative airway management in a patient with angiomatous macroglossia for laser ablation under general anesthesiahttps://peerj.com/preprints/99v12013-11-142013-11-14Kiichi Hirota
Macroglossia is defined as an abnormal enlargement of the tongue that predominantly affects pediatric patients and is not frequent in adult patients. Hypothyroidism and hyperpituitarism may cause macroglossia in adults. In addition, infiltration of the tongue by abnormal tissues, including angiomatous and lymphatic malformations and amyloidosis, is a major cause of macroglossia, particularly in adults. Here we describe the case of a 63-year-old male patient with massive macroglossia due to tongue hemangioma who underwent laser ablation under general anesthesia. Elaborate preanesthetic anatomical and functional airway evaluation facilitated successful airway management in this patient, even in the presence of massive macroglossia.
Macroglossia is defined as an abnormal enlargement of the tongue that predominantly affects pediatric patients and is not frequent in adult patients. Hypothyroidism and hyperpituitarism may cause macroglossia in adults. In addition, infiltration of the tongue by abnormal tissues, including angiomatous and lymphatic malformations and amyloidosis, is a major cause of macroglossia, particularly in adults. Here we describe the case of a 63-year-old male patient with massive macroglossia due to tongue hemangioma who underwent laser ablation under general anesthesia. Elaborate preanesthetic anatomical and functional airway evaluation facilitated successful airway management in this patient, even in the presence of massive macroglossia.