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Biomedical subjects

Paul H Van de Heyning

Publications and source records attributed to Paul H Van de Heyning.

At least 19 recordsLinked to original sources
PubMed2007

The dizziness handicap inventory and its relationship with functional balance performance.

OBJECTIVE: The purpose of this study was to describe the relation between the Dizziness Handicap Inventory (DHI) and balance performance measures. STUDY DESIGN: Retrospective case series. SETTING: Outpatient balance clinic in a tertiary referral center. PATIENTS: Patients referred with dizziness or imbalance of vestibular and nonvestibular origin. OUTCOME MEASURES: DHI, Romberg with Jendrassik maneuver, standing on foam, tandem Romberg, single-leg stance, the timed up and go test, the Dynamic Gait Index (DGI), tandem gait, and the 10-m walking test. RESULTS: The mean age of participants (n = 214) was 53.9 years. The mean DHI total score was 35.1, ranging from 0 to 96. Spearman rank correlation coefficients (rS) between DHI and the static balance tests were fair and ranged between -0.42 (p < 0.01) for single-leg stance with eyes closed and -0.51 (p < 0.01) for single-leg stance with eyes open. Only the Romberg test with Jendrassik maneuver correlated weakly (rS = -0.25; p < 0.01) with the DHI. Correlations with the walking tests were moderate, the connection with the DGI being the strongest one (rS = -0.69; p < 0.01). Forty-two percent of the variance in DHI scores in our patients was accounted for by the DGI score (r = 0.417). CONCLUSION: Functional balance tests involving locomotion correlate better with DHI scores when compared with static balance measures. The DGI explains a large component of handicap in dizzy and unsteady patients, which advocates its use in these patients.

Adult↗
PubMed2006

The ASSR: clinical application in normal-hearing and hearing-impaired infants and adults, comparison with the click-evoked ABR and pure-tone audiometry.

The objective of this study was to investigate the clinical application of the ASSR (GSI Audera). It was completed in two parts: Study 1. Correlation between the ASSR-based threshold estimations and the conventional pure-tone thresholds in adults; and Study 2. Correlation between the average of the 2-4 kHz ASSR-based threshold estimations and c-ABR thresholds in children. The ASSRs were recorded in awake adults and sleeping infants with a range of hearing loss at CFs of 0.5 to 4 kHz and MFs between 46 and 95 Hz. The results show that in hearing-impaired adults (thresholds > 40 dBHL) good correlations can be observed between the behavioural thresholds and the ASSR-based threshold estimations. For the normal- to near-normal-hearing adults, a significant correspondence exists between the ASSR-based threshold estimations and FPTA. In children, strong correlations were found between the c-ABR and the 2-4 kHz ASSR-based threshold estimation average. These studies illustrate that the GSI Audera ASSR can accurately predict the behavioural audiogram in hearing-impaired subjects. In subjects with normal hearing the individual ASSR-based threshold estimations scatter too much. Instead the average of the ASSR-based threshold estimations corresponds well with the FPTA.

Adolescent↗
PubMed2006

Improving vestibular evoked myogenic potential reliability by using a blood pressure manometer.

OBJECTIVE/HYPOTHESIS: To improve the reliability of vestibular evoked myogenic potentials (VEMP), we propose a feedback method making use of a readily available blood pressure manometer with inflatable cuff to control the sternocleidomastoid muscle (SCM) contraction. STUDY DESIGN: Prospective study. MATERIALS AND METHODS: The feedback method for SCM contraction consisted of subjects pushing with their jaw against the hand-held inflated cuff to generate a specified cuff pressure. This pressure level was monitored by subject and investigator. First, we tested in a group of healthy subjects whether there was a learning or fatigue effect during four successive SCM contraction runs when making use of the feedback method. Then, we investigated the mean rectified voltage (MRV) values of the SCM. Next, we examined the hypothesis that the MRV values of the SCM contraction measured before and simultaneously with the VEMP test were equal when using this feedback method. Finally, we compared the VEMP amplitude variability in two circumstances: with and without the feedback method. RESULTS: There was no learning or fatigue effect, and the MRV values measured before the VEMP were not significantly different from those measured during the VEMP test. The VEMP amplitude variability was significantly lower when applying the feedback method than when no feedback method was used. CONCLUSION: This feedback method improves significantly the VEMP amplitude reliability.

Acoustic Stimulation↗
PubMed2005

Analysis and evaluation of a voice-training program in future professional voice users.

The goal of this study is to analyze and evaluate the effectiveness of a voice-training program. Twenty-three professional voice users received voice training for 2 years and vocal hygiene education for 1 year. The voice-training program consisted of lectures, technical workshops, and vocal coaching. The European Laryngological Society (ELS) protocol, including the Dysphonia Severity Index (DSI) and the Voice Handicap Index (VHI), was applied before and after, respectively, 9 and 18 months of voice training. A questionnaire on daily habits was presented at study onset and after 18 months. The DSI improvement is more significant after 9 months (P=0.005) than it is after 18 months (P=0.2). On the other hand, the perceptual evaluation remained unchanged after 9 months, whereas it improved significantly after 18 months. The results of the daily habit questionnaire are disturbing: the prevalence of smoking, vocal abuse, stress, and late meals were not influenced by the lectures and remained high. This study emphasizes the need for a well-organized voice-training program that is most effective after 9 months. Regarding the low effectiveness of the vocal hygiene program, the concept needs revision.

Adult↗
PubMed2005

Surgical treatment of Meniere's disease.

PURPOSE OF REVIEW: This review comprises new insights from and discusses the impact of recent medical publications on the surgical treatment of Meniere's disease. RECENT FINDINGS: Refining surgical indications through recognition of clinical conditions with similar symptoms and through a more precise estimation of the degree of disability will improve the process of decision making for surgery. Further high-level evidence-based medical data supporting the effectiveness of intratympanic gentamycin has become available. Physiopathological progress, based on animal experiments, towards surgically applied intracochlear drug delivery is addressed. SUMMARY: Studies using level 1 or 2 evidence-based medicine must be conducted to enable better decision making, such as in the application of intratympanic gentamycin or micropressure Meniett therapy at an earlier stage of Meniere's disease. If the results of such studies are conclusive for surgery, this will lead to a shorter duration of discomfort for patients before being offered the possibility of surgery.

Animals↗
PubMed2005

Quality-of-life benefit from cochlear implantation in the elderly.

OBJECTIVE: To compare the audiologic results of geriatric patients receiving cochlear implants with younger age groups and to evaluate the quality of life after cochlear implantation in the geriatric population by means of validated quality-of-life questionnaires. STUDY DESIGN: Cross-sectional study involving 89 postlingually deafened cochlear implant subjects. SETTING: Tertiary referral center. PATIENTS: A total of 89 postlingually deafened patients were included in the study, among which were 25 patients who were aged 70 years or older. INTERVENTIONS: All patients received a cochlear implant. Subjects were implanted with either the Laura, Nucleus 24, or Med-el Combi 40+ cochlear implant systems implementing the SPEAK, ACE, CIS, or CIS+ coding strategies. MEAN OUTCOME MEASURES: Speech recognition was determined by means of phonetically balanced monosyllabic word lists. The Hearing Handicap Inventory for Adults, the Glasgow Benefit Inventory, and the scale for the prediction of hearing disability in sensorineural hearing loss were used to quantify the quality of life. RESULTS: Mean audiologic performance for the three groups increased significantly after implantation (p < 0.001). Postoperative audiologic performance of the geriatric population led to useful hearing, but these scores were significantly lower than for the younger age groups (p = 0.002). However, the quality-of-life outcomes for the geriatric group were similar to those of the younger age groups (p = 0.411 for the Hearing Handicap Inventory for Adults; p = 0.886 for the Glasgow Benefit Inventory). CONCLUSION: The results of this study prove that cochlear implantation in the elderly provides improvements in quality of life and speech understanding, similar to those for younger adult cochlear implant recipients.

Adolescent↗
PubMed2005

An international otology database.

There are many reports in the literature on the outcome of ear surgery. However, it is difficult to make comparisons from these reports because of a lack of uniformity in the way in which outcomes are reported. At the same time, the general public expects doctors to provide them with information regarding the benefits and risks of surgery. Many ear surgeons will not be able to provide this information because few have an up-to-date database. A group of otologists in Europe has attempted to establish a common otology database. The aim is to create a framework whereby surgeons in Europe can contribute to a common ear database using a web-based system. The proposed methodology involves two levels of data entry. Level 1 is a minimal database where the main outcomes are included. Level 2 is a comprehensive database where detailed information on pathologies, risk factors, and surgical procedures is also recorded. As both databases share the same core data, clinicians using database 1 can still compare their outcomes with those using database 2. Clinicians will be able to input and retrieve ear data onto or from the web-based database. There has already been an international consensus on the content of the common ear database. The website address is www.ear-audit.net. The international project has now been in operation for more than 6 months, and Ear UK has already given its endorsement. The founder members include 27 otologists from 12 European countries. The cumulative outcome from this group of surgeons will be used as the benchmark for the purpose of comparative audit. These benchmark sites will be subjected to regular external validation. The web-based system is interactive and gives instant feedback to individual surgeons who wish to compare their results to the benchmark. Therefore, it can be a good learning tool for trainees or less experienced surgeons. The common data entry system also provides an opportunity for clinicians to collaborate in clinical research.

Databases, Factual↗
PubMed2005

Quantification of pharyngeal patency in patients with sleep-disordered breathing.

Many techniques are available for the assessment of pharyngeal characteristics in sleep-disordered breathing (SDB). However, most of the reported techniques are invasive to some extent and/or hard to perform during sleep studies. The focus of this concept paper is on the forced oscillation technique (FOT) to quantify pharyngeal patency in patients with SDB. In a pilot study, the potential of FOT for non-invasive and continuous assessment of pharyngeal patency during different types of respiratory events was studied in 8 patients with an established diagnosis of a sleep apnea-hypopnea syndrome. During polysomnography, FOT was applied using a 5-Hz pressure oscillation signal. The respiratory impedance was determined and considered as a marker for pharyngeal patency. The results demonstrate that FOT allows detection of the complete pharyngeal occlusion during obstructive sleep apnea. In addition, we found that central sleep apnea can be associated with pharyngeal closure. We also demonstrated that during the flow-limited breath preceding obstructive apnea, almost complete upper airway closure can occur during either the expiratory or the inspiratory phase. FOT is a suitable method to assess pharyngeal patency continuously and non-invasively during sleep. Furthermore, this technique has the potential to contribute substantially to our knowledge of upper airway physiology in SDB.

Body Mass Index↗
PubMed2004

Suppression of the E-effect during the subjective visual vertical test.

The subjective visual vertical was measured in 38 healthy subjects. The head was alternately roll-tilted to the right and to the left, and the start position of the light bar was alternately set clockwise and counterclockwise. When the head is tilted less than 60-70 degrees a deviation of the subjective visual vertical in the opposite direction to the head tilt is expected. This phenomenon has been reported in various studies as the E-effect. The present study demonstrates however that the E-effect is suppressed if the start position of the light bar is presented relatively parallel to the length axis of the tilted head.

Adolescent↗
PubMed2004

Pilot study of a novel mandibular advancement device for the control of snoring.

OBJECTIVE: Mandibular advancement devices (MADs) have been introduced as a conservative, non-invasive treatment for socially disturbing snoring and mild obstructive sleep apnea (OSA). A prospective, non-randomized pilot study was conducted to investigate the efficacy, feasibility, side-effects and compliance of Somnoguard, an immediately intraorally adaptable MAD made from thermoplastic material. MATERIAL AND METHODS: Twenty consecutive heavy snorers with a respiratory disturbance index of <20 events/h were prospectively selected. Prior to the adaptation of the appliance, ambulatory polygraphy was carried out without a MAD. After a 1-month habituation period, a polygraphic evaluation was carried out with the device. Treatment success was defined as a reduction in the apnea-hypopnea index (AHI) of at least 50%. RESULTS: The results indicated a success rate of 65%. The AHI decreased from 8.4 +/- 2.9 events/h at baseline to 3.9 +/- 1.8 events/h with the device (p = 0.001). At 1-month follow-up, significant reductions in the snoring index (p < 0.001) and the Epworth Sleepiness Scale (ESS) score (p = 0.036) were noted. At 6-month follow-up, similar results were achieved, with significant drops in the snoring index (p = 0.025) and ESS score (p = 0.033). CONCLUSION: We conclude that immediate intraoral adaptation of a low-cost fabricated "one-size-only" MAD is a feasible and well-tolerated treatment for snoring and mild OSA. Further research is needed to evaluate this thermoplastic appliance as a strategy to "screen" the efficacy of MAD treatment in the individual patient with a less expensive appliance before constructing a more expensive custom-made MAD.

Adult↗
PubMed2003

Bilateral cochlear implantation in children.

AIMS: to determine the benefit of bilateral cochlear implantation in a child on speech and language development. METHOD: This child got her first implant, a Nucleus 24-system, on the right side at the age of 2.5 years. The left side was implanted at the age of 4.4 years with a Nucleus 24Contour-system. On the right side she's now wearing an Esprit 24-speechprocessor (SPR). On the left side she has a Sprint-SPR. M. goes to a mainstream school and receives Speech and Language therapy in a Speech and Hearing Rehab Centre. The etiology of her deafness was hyperbilirubinemia. Auditory capacity and speech recognition tests were performed for both ears separately and together. RESULTS: Aided thresholds give a PTA of 28 dBA with the first implant, 22 dBA with the second implant and with both implants we get a PTA of 23 dBA. Results for speech identification and recognition demonstrated an increased performance when both implants are used together. Speech and language development was equivalent to the mean of age 4.5. At the time of testing M. was 4.8 years. At this time the speech and language development show no delays with normal hearing children. CONCLUSIONS: bilateral cochlear implantation in children may have additional value for their speech and language development. Also, implantation may be considered when auditory neuropathy is likely.

Child, Preschool↗
PubMed2003

Effects of age, sex, and disorder on voice range profile characteristics of 230 children.

In this study, the effect of age, sex, and disorder on the vocal performance of 230 children 6 to 11 years of age was investigated by means of the voice range profile (VRP). Ninety-four control children and 136 children with disorders were studied. The VRPs were quantitatively described by frequency and intensity characteristics, as well as by morphological characteristics. Significant differences between healthy children and children with disorders were found. Age has a different effect in girls than in boys regarding vocal performance. Most of the characteristics for the healthy girls change gradually over the period from 6 to 11 years. For the healthy boys, however, two age groups can be identified: one below and one above 8 years of age. It is hypothesized that the androgen dehydroepiandrosterone (DHEA) and its sulfate may play a role in this phenomenon.

Age Distribution↗
PubMed2003

The interutricular distance determined from external landmarks.

Knowledge of the exact distance between the utricles is important in new vestibular tests, such as the unilateral centrifugation (UC) test for the unilateral examination of the utricles. During this test, subjects are rotated at constant velocity and simultaneously laterally displaced along an interaural axis so that one labyrinth becomes aligned with the axis of rotation. When the axis of rotation crosses precisely through one labyrinth, only the opposite labyrinth is stimulated. To achieve this setup, precise knowledge of the interutricular distance is needed. The purpose of this study is to investigate the correlation between the interutricular distance (IUD), measured on T2-weighted magnetic resonance images, and specific external measures of head dimensions such as distance nasion-inion, intermastoid distance (IMD), distances between the temporomandibular joints and between the lateral margins of the orbits. Data have been collected in a series of 50 subjects (25 men and 25 women). On MR images we found a mean IUD of 7.22 cm (SD = 0.42 cm). There was a strong correlation between the IUD measured on MR images and the intermastoid distance. A linear combination of the IMD, nasion-inion distance and height of the subjects could predict the IUD very satisfactory (R = 0.85, adjusted R2=0.723). We also determined a measure of eccentricity of the vestibular labyrinths. The 95% prediction interval for the asymmetry appeared to be less than 4.3%.

Adolescent↗
PubMed2003

Utricular sensitivity and preponderance assessed by the unilateral centrifugation test.

Utricular sensitivity and preponderance of the right or left utricle can be assessed by means of the unilateral centrifugation test. In this test, subjects are rotated about an earth vertical axis at a velocity of 400 degrees per second. During the ongoing rotation, the subject is gradually translated 4 cm first to the right, and then to the left, along an interaural axis, to a position at which one utricle becomes aligned with the axis of rotation, and at this point is subjected only to gravitational forces. At this eccentric position, the contralateral utricle is exposed to the combination of gravity and a centrifugal acceleration of 0.4g, corresponding to an apparent roll-tilt of 21.7 degrees. This stimulus induces ocular counterrolling (OCR), which is measured on-line using three-dimensional video-oculography (VOG). We observed that ocular counterrolling appears as a linear function of the gravito-inertial acceleration tilt of the head centre (GIA(HC)) during the lateral translation. We present a theoretical model for this linear relationship that contains two parameters: 1) the slope of the linear regression is a measure for the utricular sensitivity and 2) the intercept of the linear regression is a measure of the preponderance of the right or left utricle. The strength of the model is supported by data obtained from 28 healthy subjects and 14 patients with unilateral vestibular deafferentiation (UVD) due to acoustic neuroma surgery.

Acceleration↗
PubMed2002

Normative voice range profiles of untrained boys and girls.

Normative voice range profiles (VRPs) are calculated for a group of untrained boys and girls between 6 and 11 years based on 35 and 39 recordings, respectively. All individuals had healthy voices. These normative VRPs contain 95% prediction intervals (PI) for both frequency and intensity. They are based on a series of mathematical transformations of the original individual VRPs in order to maintain in the normative VRPs the typical oval VRP shape including the dip between modal and falsetto register. The presented normative VRPs are directly applicable in the clinical practice of otolaryngologists and speech-language pathologists.

Child↗