Perception of Deep Band Modulated Speech in the Presence of Noise by Elderly Individuals with Hearing Impairment

Background: Deep band modulation (DBM) is an envelope enhancement strategy that enhances temporal modulation and may provide a cue for speech understanding among individuals who suffer from temporal processing deficits. Objective: To investigate the effect of deep band modulation on phrase recognition scores at different signal-to-noise ratios (SNRs) among older adults having hearing loss classified as good and poor performers based on temporal resolution ability. Method: Phrase recognition score was obtained for unprocessed and DBM phrases at three SNRs (4, 5, and - 4 dB signal to noise ratio) in 25 (age range 60 to 82 years, mean age 71.48 years) older adults having bilateral mild to moderately severe sloping sensorineural hearing loss. In addition, the gap detection test was also administered to the study participants. Results: A significant better recognition score was obtained in DBM than the unprocessed phrase. The magnitude of improvement from DBM was not the same in all the participants. Thus, the participants were classified into good and poor performers based on their temporal processing ability. The mean unprocessed and DBM phrase recognition scores in each SNR were higher for good performers than the poor performers. The benefit of deep band modulation was evident for the good performers, especially at high SNR, which was moderately correlated with age and temporal processing ability. Conclusion: The benefit from DBM on recognition score for the good performers is predicted from the temporal resolution abilities and age. However, the benefit is minuscule for the poor performers in noise.

Otolaryngology Societies on Popular Social Media Platforms

Objective: The objective of this study is to investigate the use of social media, including Twitter, Facebook, Instagram, YouTube, and TikTok amongst otolaryngology societies. Study Design: Online assessment of social media pages and engagement amongst otolaryngology societies. Setting: Otolaryngology societies and their online engagement with the general community as well as those in the field of otolaryngology. Methods: A list of otolaryngology societies affiliated with Combined Otolaryngology Spring Meetings (COSM)and American Academy of Otolaryngology – Head and Neck Surgery (AAO-HNSF) were compiled. Two reviewers independently accessed popular social media platforms for societal accounts and their online engagement. Results: There is a wide range of social media participation amongst societies. The American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) has the highest numbers of followers on Twitter, Facebook, and Instagram. The highest follower count on Twitter and Facebook was followed by the American Otological Society (AOS). The American Laryngological Association had no social media accounts. On YouTube, The American Head and Neck Society (AHNS) had the highest amount of engagement. Conclusion: Social media usage and a robust online presence can provide patients a source of reliable healthcare information, educational opportunities to residents, and may be used for recruitment. Otolaryngology societies should consider improving their social media presence as a way to educate the public, patients, and future recruits.

Pathological Findings in Neck Dissections of Head and Neck Cancer, and their Associations with outcome

Importance: Consensus has not been reached regarding the prognostic value of various pathological factors, including extranodal extension (ENE), in patients with head and neck squamous cell carcinoma (HNSCC). Objective: To evaluate associations of pathological findings in neck dissection on survival rates of HNSCC Design: A retrospective study of patients with HNSCC treated during 2009-2017, either surgically (Surgery Group) or with radiotherapy or chemotherapy, followed by neck dissection (Organ Preservation Group). The respective mean follow-up periods were 50.1±44.1 and 43.3±27.4 months. Setting: A tertiary care university-affiliated medical Patients: 135 patients were selected consecutively. After excluding 36 with oropharyngeal cancer, nasopharyngeal carcinoma, or an unknown primary, the cohort comprised 72 patients in the Surgery Group and 27 in the Organ Preservation Exposure: Surgical treatment or the combination of radiotherapy/chemoradiotherapy and neck dissection. Main outcomes: Five-year overall survival and associations of demographic and nodal Characteristics with Results: The Surgery Group comprised 53/72 males, mean age 71.6±12.96 years. The Organ Preservation Group comprised 26/27 males, mean age 71.3±10.5 years. For the respective groups, the mean values of nodal yield were 30.54±13.09 and 18±9.33, and the mean numbers of pathological lymph nodes were 2.09±3.7 and 0.88 ± 1.8; ENE was detected in 39% and 22%, respectively. In the Surgery Group, the AJCC 8th edition guidelines upstaged 28/53 patients (53%) with nodal metastases. The 5-year overall survival rate was 44.7%: 31% vs 55% for patients with without ENE (p=0.037). In a multivariate Cox proportional-hazard model, age and the number of pathological nodes were associated with overall survival. In the Organ Preservation Group, the 5-year overall survival rate was 44%. In a multivariate Cox model, ENE and the number of pathological nodes were associated with overall survival. None of the patients with ENE in the last group survived at 5 years. Conclusion: Among patients with HNSCC, the number of positive nodes in neck dissection was associated with overall survival, both in those for whom surgery was first-line treatment and those who underwent surgery following chemoradiotherapy. However, ENE was associated with overall survival in the latter group only, with fatal outcome.