Screen exposure has both negative and positive effects on the level of language skills a child acquires. The purpose of this review is to address current literature on the possible relationship between unsupervised screen exposure and language development in children and to provide recommendations to caregivers regarding screen exposure of children, taking into consideration the possible effects. A scoping review was conducted using the PubMed/MEDLINE (Medical Literature Analysis and Retrieval System Online) database. A total of 590 articles were retrieved and considered for inclusion. Twenty-one articles were finally included and reviewed with an emphasis on language, communication, and executive skills as well as cognitive development. The negative effects of screen exposure for children outweigh the positive effects. The largest number of studies demonstrate that unsupervised screen exposure may negatively impact a child's language usage and cognitive and executive skills, disrupt playtime, and affect the quality of sleep. On the other hand, supervised screen use is associated with improved language skills. More evidence is needed on unsupervised exposure in children to new types of screens. As technology could play a significant role in schools in the future, additional research is required to create educational media for schoolchildren with specific guidelines.

Screen exposure has both negative and positive effects on the level of language skills a child acquires. The purpose of this review is to address current literature on the possible relationship between unsupervised screen exposure and language development in children and to provide recommendations to caregivers regarding screen exposure of children, taking into consideration the possible effects. A scoping review was conducted using the PubMed/MEDLINE (Medical Literature Analysis and Retrieval System Online) database. A total of 590 articles were retrieved and considered for inclusion. Twenty-one articles were finally included and reviewed with an emphasis on language, communication, and executive skills as well as cognitive development. The negative effects of screen exposure for children outweigh the positive effects. The largest number of studies demonstrate that unsupervised screen exposure may negatively impact a child's language usage and cognitive and executive skills, disrupt playtime, and affect the quality of sleep. On the other hand, supervised screen use is associated with improved language skills. More evidence is needed on unsupervised exposure in children to new types of screens. As technology could play a significant role in schools in the future, additional research is required to create educational media for schoolchildren with specific guidelines.

Aims: The primary goal of the present study was to compare the pre-and post-stapedotomy elicita-tion and waveform characteristics of both air-and bone-conduction (AC-, BC-) cervical vestibular evoked myogenic potentials (cVEMPs) through an individualized approach. A possible association between audi-ological characteristics, such as AC-and BC-pure tone audiometry thresholds and air-bone gap and the production of cVEMPs before and after stapedotomy was also investigated. Material and methods: Twenty-five ears were subjected to full audiological evaluation as well as AC -and BC-cVEMPs pre-and post-stapedotomy. Four subgroups were studied; consistently present/absent, post-operatively disappeared and restored cVEMPs. Results: Post-stapedotomy changes in cVEMP elicitability did not reach significance for either AC-cVEMP (OR = 5.41, 95% CI 0.88-33.36, P = 0.06) or BC-cVEMP (OR = 2.40, 95% CI 0.42-13.60, P = 0.3). Normal or abnormal AC-cVEMPs were equally subject to post-operative changes (OR = 1.95, 95% CI 0.32-12.01, P = 0.5), as were BC-cVEMPs (OR = 3.75, 95% CI 0.66-21.25, P = 0.1). Neither the audiological character-istics nor the surgical outcome, in terms of ABG results, were relevant to the presence or absence of AC -and BC-cVEMPs before or after stapedotomy. Conclusions: The presumed changes brought to the sacculus by stapedotomy are minor and beyond the diagnostic abilities of either AC-cVEMPs or BC-cVEMPs, both in terms of cVEMPs elicitability and waveform characteristics. In individual cases, however, which may deserve further investigation, cVEMPs may reappear or disappear after stapedotomy probably following minor changes toward a lower or higher vestibular system resistance for pressure and sound transmission. & COPY; 2022 Elsevier Masson SAS. All rights reserved.

Objective: Normative otoacoustic emission (OAE) suppression values are currently lacking and the role of cochlear efferent innervation in tinnitus is controversial. The aim of this study was to investigate the association between tinnitus and medial olivocochlear bundle (MOCB) malfunction. Potential suppression amplitude cut-off criteria that could differentiate participants with tinnitus from those without were sought. Design: Mean suppression amplitudes of transient evoked OAEs and distortion product OAEs by contralateral white noise (50dBSL) were recorded. Six mean suppression amplitudes criteria were validated as possible cut-off points. Study sample: The population consisted of normal hearing (n=78) or presbycusic adults (n=19) with tinnitus or without (n=28 and 13, respectively) chronic tinnitus (in total, n=138 78 females/60males, aged 49 +/- 14 years). Results: Participants with mean suppression values lower than 0.5-1dBSPL seem to present a high probability to report tinnitus (specificity 88-97%). On the other hand, participants with mean suppression values larger than 2-2.5dBSPL seem to present a high probability of the absence of tinnitus (sensitivity 87-99%). Correlations were stronger among participants with bilateral presence or absence of tinnitus. Conclusions: This study seem to confirm an association between tinnitus and low suppression amplitudes (<1 dBSPL), which might evolve into an objective examination tool, supplementary to conventional audiological testing.

Objectives Myotonic dystrophy type 1 is associated with various oculomotor, vestibular, and auditory abnormalities. However, auditory system investigation has been mainly performed with the subjective method of pure-tone audiometry. In this study, a detailed vestibular and audiological evaluation was undertaken, including the objective and more sensitive method of transiently evoked otoacoustic emissions (TEOAEs). Materials and methods Twenty-four patients with genetically diagnosed myotonic dystrophy type 1 and 21 controls were studied. Audiological and vestibular investigations included pure-tone audiometry, tympanometry, auditory brainstem responses (ABRs), TEOAEs, and electronystagmography. Results Hearing impairment was evident in 15 (62.5%) patients and in nine of them (37.5%) ABR abnormalities were found. However, subclinical cochlear damage was found in all patients, as evidenced by absent emissions or lower otoacoustic emission amplitude. Vestibular hypesthesia was found in nine patients (37.5%), accompanied by spontaneous nystagmus in four of them (15.6%). Conclusions Auditory and vestibular abnormalities are quite common in patients with myotonic dystrophy type 1. However, it appears that subclinical cochlear damage is an ubiquitous finding of the disease.

OBJECTIVES:Over 5 years, 68,472 newborns were screened through a newly implemented universal newborn hearing screening program. In 15 cases, atresia of the external ear canal was found. The aim of this study was to estimate the hearing status of these newborns using transiently evoked otoacoustic emissions (TEOAEs) and auditory brainstem responses (ABRs). METHODS:TEOAEs were performed during the first days after birth in the normal ears of all newborns. Diagnostic ABR audiometry was performed in 10 newborns. RESULTS:Unilateral involvement occurred in all newborns studied. TEOAEs were present in all the contralateral ears. Normal ABRs were recorded from the healthy ear, whereas a conductive hearing loss, of approximately 50-60 dB, was found in the involved ear. In long-term follow-up, a satisfactory level of hearing, language, and speech development was found in 9 of the newborns; it was too early to come to definite conclusions in 4 newborns and 2 newborns were lost in follow-up. CONCLUSIONS:In this study, all newborns with aural atresia had normal function in the contralateral ear. Yet, a comprehensive assessment of hearing is essential as early intervention is necessary in the rare case of bilateral hearing impairment.

Background and Aim: Vestibular involvement in cases of idiopathic sudden hearing loss (ISHL) is common and is reported to be an important prognostic factor. The aim of this study was to evaluate the extent of inner ear lesion in ISHL and to correlate it with the severity of hearing loss and the degree of short-term recovery.

Background and Aim: Stapes surgery, the first-choice treatment for otosclerosis, restores the ossicular chain mobility. Otoacoustic emissions, particularly transient-evoked (TEOAEs) and distortion product (DPOAEs), are capable of noninvasively recording both conductive hearing and cochlear function.

Background and Aim: Occupational hearing loss is an issue with important socioeconomic and psychological extensions. Early diagnosis and application of effective preventive measures are currently limited by the lack of widely accepted screening protocols. This study was aimed at investigating the role of extended high-frequency audiometry in the early diagnosis of occupational hearing loss.

OBJECTIVE:The aim of this study was to investigate the contribution of electronystagmography and magnetic resonance imaging to the aetiological diagnosis of vertigo and unsteadiness, in a population in which the history and clinical examination provide no conclusive diagnosis of the origin of the dysfunction (i.e. peripheral or central).PATIENTS AND METHODS:This retrospective study included 102 patients, who underwent full ENT clinical evaluation, history and neurotological assessment (including pure tone audiography, auditory brainstem response testing, electronystagmography and magnetic resonance imaging).RESULTS:Electronystagmography contributed to establishment of a diagnosis in 53/102 patients (52 per cent), whereas magnetic resonance imaging did the same in four of 102 patients (3.9 per cent).CONCLUSION:Electronystagmography remains the most useful examination for aetiological diagnosis of patients with vertigo and unsteadiness, since the actual number of patients with vertigo and unsteadiness of central origin is small (3.9 per cent), even in a population in which history and clinical examination may indicate an increased probability of central nervous system dysfunction.

The aim of this study was to determine clinical features that could predict the presence of tonsillar malignancy in children and adults. A retrospective review of the histopathologic reports of the children, who underwent tonsillectomy (753 cases) during the past 16 years (January 1991–December 2006) in a busy district general hospital, was undertaken. We compared the results to the pre-operative data of the patients, for risk factors of malignancy. Such proposed risk factors were tonsillar asymmetry, palpable firmness, visible lesions, neck adenopathy, history of malignancy, and systemic symptoms. The same data (history, risk factors and histopathologic results) were reviewed for an adult group (>16 years old, 1,027 cases) who underwent tonsillectomy during that period, and the results of the two groups were compared. In the pediatric group only one case was diagnosed as lymphoma (0.13%) and the rest as chronic inflammation (47%), reactive tonsil tissue (26%), lymphoid hyperplasia (19%) and actinomycosis (8%). In the lymphoma case, the diagnosis was suspected preoperatively by history and clinical manifestations. In the adult group, there were 21 cases of malignancy out of 1,027 cases (2.04%), again with one or more positive risk factors in the pre-surgery history. Based on our review, it is concluded that histopathology of tonsillectomy is not necessary in children unless there is clinical suspicion based on preoperative findings. A protocol based on proposed risk factors which may be predictive of possible malignancy can be used as a guide to intraoperative histology.

OBJECTIVES:The aim of this study was to evaluate hearing in a population of industrial workers exposed to occupational noise by using both conventional and extended high-frequency (EHF) audiometry, and to compare our results with the findings from a control group. METHODS:A total of 139 industry workers exposed to noise were examined over a period of two years and 32 healthy subjects were used as controls. Conventional audiometry in the frequency range 0.25-8 kHz and EHF audiometry in the frequency range 9-20 kHz were performed. RESULTS:Thresholds in the noise-exposed group were higher than in the control group for both standard and extended high frequencies, but variability was greater in EHF. Larger differences were found in the 4,000-18,000 Hz frequency region, and especially in the 12,500-18,000 frequency zone. A statistically significant correlation between the elevation of puretone thresholds and time of exposure was found across all frequencies (from 250 to 20,000 Hz), with the exception of 10,000 Hz. CONCLUSIONS:EHF audiometry is a useful adjunct to conventional audiometry in the audiological assessment of subjects exposed to occupational noise. This test performs well in the frequency range 12,500-18,000 Hz, but there is greater variability in the results compared with conventional audiometry.

OBJECTIVE:The aim of this study was to investigate the frequency of posterior semicircular canal benign paroxysmal positional vertigo in each ear, and to assess the association between the ear affected by benign paroxysmal positional vertigo and the head-lying side during sleep onset. Based on a previous study which used objective methods to prove the preference of the elderly for the right head-lying side during sleep, we hypothesised that a predominance of the same head-lying side in benign paroxysmal positional vertigo patients may affect the pathophysiology of otoconia displacement.STUDY DESIGN:We conducted a prospective study of out-patients with posterior semicircular canal benign paroxysmal positional vertigo, confirmed by a positive Dix-Hallpike test.METHODS:One hundred and forty-two patients with posterior semicircular canal benign paroxysmal positional vertigo were interviewed about their past medical history, focusing on factors predisposing to benign paroxysmal positional vertigo. All patients included in the study were able to define a predominant, favourite head-lying side, right or left, during sleep onset.RESULTS:The Dix-Hallpike test was found to be positive on the right side in 82 patients and positive on the left side in 54; six patients were found to be positive bilaterally. During sleep onset, 97 patients habitually laid their head on the right side and the remaining 45 laid their head on the left. The association between the affected ear and the head-lying side during sleep onset was statistically significant (p < 0.001).CONCLUSIONS:Our study found a predominance of right-sided benign paroxysmal positional vertigo, a subjective preference amongst patients for a right head-lying position during sleep onset, and an association between the ear affected by benign paroxysmal positional vertigo and the preferred head-lying side during sleep onset. The clinical and therapeutical implications of this observation are discussed.

The effect of very low birth weight on otoacoustic emissions. Objectives: The aim of this study was to examine the effect of very low birth weight (VLBW) on the measurement of transiently evoked otoacoustic emissions (TEOAEs) in newborns.Methods: TEOAEs were recorded in all VLBW newborns (birth weight <1500 g) who were admitted in the Neonatal Intensive Care Unit of the Iaso Maternity Hospital, during a period of 1 year. Twenty-four VLBW newborns were included in the study. Their mean birth weight was 1283 g and they had mean gestational age 31.3 weeks. Forty full-term newborns with absence of any risk factor for hearing impairment were used as controls.Results: TEOAEs were present in 97.5% of controls, but only in 79.2% of the VLBW group. Statistically significant differences were found between VLBW newborns and controls in most TEOAE measures.Conclusions: Increased rate of initial 'fail' in hearing screening, in conjunction with statistically confirmed lower TEOAE measures in VLBW newborns, justifies special care and long term follow-up for this group of newborns.

Management of second branchial cleft abnormalities in adults. Objective: Branchial cleft anomalies are developmental disorders of the neck. Our aim is to report the diagnostic and treatment procedure followed in three cases of second branchial cleft abnormalities in adults.Methodology: A patient aged over 40 underwent surgical excision of a well-encapsulated cystic neck structure and two further patients of a branchial sinus and branchial fistula respectively. Prior to surgery the patients were assessed by means of imaging techniques, FNA cytology and cytometric DNA analysis.Results: Neutrophils, debris, mature squamous epithelial cells including degenerate forms and lymphoid cells were the key features in the cytological diagnosis. DNA analysis of the pre-operative cytological material in two cases revealed euploidy, thus indicating no malignancy. Histological examination of the lesions after excision established the diagnosis in all cases. No recurrences were reported.Conclusions: Although congenital lesions, the second branchial cleft abnormalities usually present in adulthood and have to be distinguished from benign and malignant lateral neck swellings. FNA cytology as well as DNA ploidy determination contributes to the establishment of the diagnosis of branchial cleft abnormalities and their differential diagnosis.

Aim: Vestibular evoked myogenic potentials (VEMP) are electric potentials that can be recorded after sound stimulation and are used as a parameter for the assessment of the otolith function. These potentials arise after stimulation of the saccule and they can be recorded with surface electrodes over each sternocleidomastoid muscle. The responses consist of one positive and one negative successive wave. Benign paroxysmal positional vertigo (BPPV) is believed to be caused by degenerative debris free-floating in the endolymph that during a head movement leaves the macula of the utricle and gravitates into one of the semicircular canals. The aim of this study was to record and analyze the VEMP in patients with BPPV and compare them with the results of their caloric responses.

Clinical OtolaryngologyVolume 31, Issue 5 p. 464-465 Semont's manoeuvre in BPPV: a forgotten technique P.D. Karkos, P.D. Karkos Department of Otolaryngology, Royal Liverpool University Hospital, Liverpool, UK, LiverpoolSearch for more papers by this authorS.C. Leong, S.C. Leong St George's Hospital and Medical School, London, UKSearch for more papers by this authorS.M. Papouliakos, S.M. Papouliakos Hippokration Hospital, University Hospital Athens, Athens, Greece, E-mail: [email protected]Search for more papers by this authorS.G. Korres, S.G. Korres Hippokration Hospital, University Hospital Athens, Athens, Greece, E-mail: [email protected]Search for more papers by this authorJ.F. Thong, J.F. Thong St George's Hospital and Medical School, London, UKSearch for more papers by this author P.D. Karkos, P.D. Karkos Department of Otolaryngology, Royal Liverpool University Hospital, Liverpool, UK, LiverpoolSearch for more papers by this authorS.C. Leong, S.C. Leong St George's Hospital and Medical School, London, UKSearch for more papers by this authorS.M. Papouliakos, S.M. Papouliakos Hippokration Hospital, University Hospital Athens, Athens, Greece, E-mail: [email protected]Search for more papers by this authorS.G. Korres, S.G. Korres Hippokration Hospital, University Hospital Athens, Athens, Greece, E-mail: [email protected]Search for more papers by this authorJ.F. Thong, J.F. Thong St George's Hospital and Medical School, London, UKSearch for more papers by this author First published: 02 October 2006 https://doi.org/10.1111/j.1749-4486.2006.01272.xCitations: 2Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL No abstract is available for this article. References 1 Dix M.R. & Hallpike C.S. (1952) The pathology, symptomatology and diagnosis of certain common disorders of the vestibular system. Ann. Otol. Rhinol. Laryngol. 61, 987– 1016 2 Lempert T., Wolsley C., Davies R. et al. (1997) Three hundred sixty-degree rotation of the posterior semicircular canal for treatment of benign positional vertigo: a placebo-controlled trial. Neurology 49, 729– 733 3 Epley J.M. (1992) The canalith repositioning manoeuvre for treatment of benign paroxysmal positional vertigo. Otolaryngol. Head Neck Surg. 107, 399– 404 4 Korres S.G. & Balatsouras D.G. (2004) Diagnostic, pathophysiologic and therapeutic aspects of benign paroxysmal positional vertigo. Otolaryngol. Head Neck Surg. 131, 438– 444 5 Semont A., Freyss E. & Vitte P. (1988) Curing the BPPV with a liberating maneuver. Adv. Otorhinolaryngol. 4, 290– 293 Citing Literature Volume31, Issue5October 2006Pages 464-465 ReferencesRelatedInformation

Objective: Transiently evoked (TEOAEs) and distortion-product otoacoustic emissions at the 2f1-f2 frequency (DPOAEs) are being used as a clinical toot for diagnosis of peripheral auditory pathology. Because both tests are fast and non-invasive, they may be an excellent method for hearing screening in infants and children. The purpose of this study was to compare the TEOAE and DPOAE measures obtained in a group of healthy children.Methods: Sixty-six school-aged children with normal hearing were included in the study. Subjects with recent otologic disease or abnormal tympanograms were excluded. TEOAEs and DPOAEs were performed using a DID Echoport ILO 292 Otodynamics analyzer connected to a portable personal computer. Correlation between TEOAE amplitudes and DPOAE levels was estimated.Results: Correlation between TEOAE amplitudes and DPOAE levels was highly significant across all measured frequencies. Correlation was more significant at the middle frequencies than at the tow and high frequencies.Conclusions: Although frequency specific information maybe obtained by both tests, most reliable results were obtained at the middle frequencies. TEOAE values were more prominent at low frequencies, whereas DPOAEs were more effective at high frequencies. Both methods are reliable, objective, fast and useful tests of the cochlear status and should be included in the standard audiological diagnostic work-up of children. (c) 2005 Elsevier Ireland Ltd. All rights reserved.

Objective: Following a tong period of pilot study, laso maternity hospital established a universal newborn hearing screening program based on transiently evoked otoacoustic emissions (TEOAEs). The aim of this study is to present the improvement of outcome measures of this program, comparing the results of two groups of newborns screened successively.Methods: We analyzed data from two groups of full-term newborns screened at our setting. The first group included all newborns born and screened during the initial 3 years of application of the program and the second group included all newborns born and screened during the next 2 years. TEOAEs were performed during the first days after birth. All newborns who failed the initial test underwent repeat testing with TEOAEs before hospital discharge. Newborns with absence of otoacoustic emissions were referred to follow-up test after 1 month. Results were compared between the two groups.Results: The first group included 22,195 newborns-examined during 3 years and the second group included 25,032 newborns-examined during 2 years, due to reduction of the rate of newborns who missed screening. Refer rate was 3.1% for the first group and 2.1% for the second group. "Missed to follow-up" rate was reduced from 72.2% in the first group to 58.2% in the second group.Conclusions: The rate of newborns who did not undergo screening and the rate of "missed to follow-up" newborns were reduced in time, due to various modifications of the protocol. Universal newborn hearing screening may be, thus, a feasible and cost effective method of identifying congenital hearing loss. (c) 2005 Elsevier Ireland Ltd. All rights reserved.