Browsing by Author "Chamseddin, Bahir"
Now showing 1 - 2 of 2
- Results Per Page
- Sort Options
Item Auditory Navigation in Bilateral Hearing Aid Users(2017-01-17) Chamseddin, Bahir; Shayman, Corey; Lee, Rebecca; Hullar, TimothyINTRODUCTION: Falling is a serious and common problem in the United States and is responsible for the most injuries, fatal and nonfatal, for Americans. Recent data implicates a link between those suffering from hearing loss and increased incidence of falls. Possible reasons include a coexisting reduction in cognitive capacity, reduced vestibular sense, and loss of auditory perception leading to decreased spatial awareness; however, none have been investigated during a walking balance test. This study investigates the ability of hearing aids to reduce veering, a walk that increases risk of falls, in the bilateral hearing aid population. METHODS: Healthy subjects (n=11) with no reported vestibular or auditory pathology and experienced bilateral hearing aid users (n=6) were blindfolded and instructed to walk 8m towards a speaker that emitted broadband white noise. Variables integrated a loud speaker, headphones, and no sound or bilaterally aided, unilaterally aided, and unaided in the healthy and pathologic populations, respectively. Recordings were taken for displacement from the speaker at the end of the runway and distance reached when subjects deviated within 1m from the intended walking path. Users also were instructed to walk normally or heel-to-toe. RESULTS: Using ANOVA analysis, healthy subjects significantly improved navigation during sound trials throughout both walking conditions (P= 0.005 for both tests). Bilateral hearing aid populations benefited from sound during narrow-based walking conditions (P= 0.06), yet during standard walking conditions the final displacement observed between aided and unaided trials were no different (P=0.85). Participants did not report a subjective improvement in balance with maximal sound cues. DISCUSSION: This study suggests that bilateral hearing aid population who do not have excellent familiarity with walking deprived of vision do not benefit from hearing aids to reduce veering during transient low-light conditions, such as getting up at night to use the restroom. The results also suggest differences in localization between normal walking and tandem walking which may have been attributed to sensory compensation, gait velocity, and attention required to keep balance. The reduction in veering with hearing aids in some cases may offer a public-health benefit through avoiding falls in this population. CONCLUSION: Auditory spatial awareness is responsible for the reduction in veering associated with imbalance. This study suggest that bilateral hearing aid population may benefit from hearing aids to walk during conditions in the absence of vision. Additionally, sound beacons can be used to benefit populations outside the blind.Item Obstructive Sleep Apnea in Children with Down Syndrome: Demographic and Clinical Factors(2018-01-23) Chamseddin, Bahir; Johnson, Romaine F.; Mitchell, RonINTRODUCTION: OSA is a disease characterized by obstruction of the airway during sleep leading to periodic reductions in airflow, hypoxemia, and hypercapnia and is the most common reason for this demographic to visit an otolaryngologist. Current research of factors predicting OSA in this population are non-linear, scarce, and inconclusive. Objective: The primary objective of this study was to use relatively large patient population to describe the demographic, clinical and polysomnographic characteristics of children with Down Syndrome (DS) suspected of having obstructive sleep apnea (OSA). The secondary objective was to identify demographic and clinical factors that predict severe OSA in children with DS. METHODS: A retrospective case-control study of children with DS who received PSG over 5 years was performed. Criteria for inclusion were age 2-18, negative history of adenotonsillectomy, data available on ethnicity, BMI z-score, medical comorbidities, clinical data including tonsil size and polysomnographic data. Severe OSA is defined by Apnea Hypoxia Index (AHI)>10 using polysomnography, the gold standard test for diagnosing OSA. RESULTS: Of a total of 106 children, 90% were diagnosed with OSA (AHI>1) and 44% were diagnosed with severe OSA (AHI?10). Obese compared to non-obese children had a significantly higher prevalence of severe OSA (56% versus 35%).The mean SaO2 nadir was significantly lower in obese compared to non-obese children (80 versus 85%). In children older than 12 years, the obese compared to non-obese children had a significantly higher mean AHI of 23 compared to 5.6. Tonsillar hypertrophy (grade III/IV) was not a predictive for OSA. Presence of other medical comorbidities including allergies, asthma, congenital heart disease, and hypothyroidism were not significant in predicting OSA. A multivariable logistic regression model predicting the likelihood of severe OSA in children with DS showed increasing weight (OR: 1.1, 95% CI 1.0-1.1, p=.015) was important in prediction of Severe OSA. Age (OR: .87, 95% CI: .6-1.3, p=.560) did not predict the risk of having severe OSA. CONCLUSIONS: In conclusion, a cohort of 106 children with Down Syndrome prior to corrective OSA surgery showed that weight was the primary risk factor of increasing AHI on PSG. Our study did not find an independent association between age and OSA severity in children with DS with older children, without obesity, showing no increased likelihood of severe OSA. This suggests that a major effort should be directed at avoiding obesity as children with DS as they reach adolescence.