Michael J. Cevette 1 David M. Barrs 2 Alpen Patel 3 Kelly P. Conroy 4 Sarah Sydlowski 5 Brie N. N... more Michael J. Cevette 1 David M. Barrs 2 Alpen Patel 3 Kelly P. Conroy 4 Sarah Sydlowski 5 Brie N. Noble 6 Gregory A. Nelson 7 Jan Stepanek 8 1 PhD, Department of Otolaryngology, Section of Audiology Mayo Clinic Scottsdale AC United States. E-mail: Cevette.michael@mayo.edu 2 MD, Department of Otolaryngology, Head and Neck Surgery Mayo Clinic Scottsdale United States. E-mail: barrs.david@mayo.edu 3 BS, College of Medicine Phoenix University of Arizona Phoenix AC United States. E-mail: alpen@email.arizona.edu 4 AuD, Department of Otolaryngology, Section of Audiology Mayo Clinic Scottsdale United States. E-mail: conroy.kelly@mayo.edu 5 AuD, Section of Audiology Cleveland Clinic Head and Neck Institute Cleveland United States. E-mail: sydlows@ccf.org 6 BS, Biostatistics Mayo Clinic Scottsdale United States. E-mail: noble.brie@mayo.edu 7 BS, Department of Otolaryngology, Section of Audiology Mayo Clinic Scottsdale United States. E-mail: Gregory.Nelson4@va.gov 8 MD, Division of Preventive, O...
The need exists for a device that can rapidly and accurately assess mild cognitive impairment (MC... more The need exists for a device that can rapidly and accurately assess mild cognitive impairment (MCI). Because the link between oculometrics and cognition is well‐documented, the Oculo‐Cognitive Addition Test (OCAT) was developed which tracks users’ eye movements as they complete a simple mental addition test.
In this paper, we focus on the application of oculometric patterns extracted from raw eye movemen... more In this paper, we focus on the application of oculometric patterns extracted from raw eye movements during a mental workload task to assess changes in cognitive performance in healthy youth athletes over the course of a typical sport season. Oculometric features pertaining to fixations and saccades were measured on 116 athletes in pre- and post-season testing. Participants were between 7 and 14 years of age at pre-season testing. Due to varied developmental rates, there were large interindividual performance differences during a mental workload task consisting of reading numbers. Based on different reading speeds, we classified three profiles (slow, moderate, and fast) and established their corresponding baselines for oculometric data. Within each profile, we describe changes in oculomotor function based on changes in cognitive performance during the season. To visualize these changes in multidimensional oculometric data, we also present a multidimensional visualization tool named DiViTo (diagnostic visualization tool). These experimental, computational informatics and visualization methodologies may serve to utilize oculometric information to detect changes in cognitive performance due to mild or severe cognitive impairment such as concussion/mild traumatic brain injury, as well as possibly other disorders such as attention deficit hyperactivity disorders, learning/reading disabilities, impairment of alertness, and neurocognitive function.
Labyrinthine concussion due to a postauricular gunshot wound has not been well reported. Retrospe... more Labyrinthine concussion due to a postauricular gunshot wound has not been well reported. Retrospective chart review. We describe an otherwise healthy 22-year-old male who received a gunshot wound to the left mastoid and subsequently reported hearing loss and rotational vertigo. Audiometric testing demonstrated significant inverted scoop shaped sensorineural hearing loss. Vestibular diagnostic testing indicated a significant uncompensated left peripheral vestibulopathy. Imaging demonstrated no structural changes to the middle ear or labyrinth, suggesting that the auditory and vestibular losses noted on diagnostic examination were likely due to labyrinthine concussion. Labyrinthine concussion may lead to reduced vestibular reflex pathway following gunshot wounds to the temporal bone. Clinical presentation is likely to vary significantly among cases.
Australian Journal of Human Communication Disorders, 1977
A rationale for measuring middle ear function in the speech clinic is given. Anatomical and physi... more A rationale for measuring middle ear function in the speech clinic is given. Anatomical and physiological descriptions of the norman middle ear and four pathological conditions are described in light of present measurement techniques. Emphasis is placed on these measurements as routine procedures for the known or suspected cases of otitis media seen by speech pathologists.
Australian Journal of Human Communication Disorders, 1978
A rationale is given for measuring acoustic reflexes in order to establish an estimation of cochl... more A rationale is given for measuring acoustic reflexes in order to establish an estimation of cochlear funtion. Anatomical and physiological descriptions of the normal middle ear are outlined. Particular attention is paid to changes of the acoustic transmitting properties of the middle ear due to middle ear muscle contractions to acoustic stimuli, and the predictive value of these measures in the assessment of sensorineural hearing impairment.
Australian Journal of Human Communication Disorders, 1977
Hearing conservation programs are often plagued with a lack of follow-through at the conclusion o... more Hearing conservation programs are often plagued with a lack of follow-through at the conclusion of identification audiometry. The procedures and results of the Lincoln Institute's hearing conservation program are reported. The results indicate some of the inherent problems associated with screening techniques. In addition, they help demonstrate the need for precautions in informing parents of such results. These precautions in parental counselling must not only be conservative in nature, but also ensure parental co-operation and understanding. These precautions chiefly stem from the lack of personal contact that is possible from mass screenings. Without personal contact, an indirect form of counselling results. This type of counselling must express tact and yet be persuasive enough to generate concern for the necessary confirmation of the hearing impairment.
This case study details the evaluation, explantation, and subsequent reimplantation of a cochlear... more This case study details the evaluation, explantation, and subsequent reimplantation of a cochlear implant (CI) recipient with an unusually deep electrode array insertion. Although the positive value of sufficiently deep insertion and the effect of insertion variability have been researched, there are few data available that illustrate the detrimental effects on speech recognition when deep insertion corrupts optimal use of the CI. This unique case report challenges the assumption that deeper insertion will result in improved speech understanding and demonstrates the importance of fully evaluating recipients' complaints and recognizing the impact of frequency-to-place mismatch.
Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology, 2011
Superficial siderosis of the central nervous system (SSCN) results after chronic subarachnoid hem... more Superficial siderosis of the central nervous system (SSCN) results after chronic subarachnoid hemorrhage. Consequent demyelination, particularly of the cochleovestibular nerve and cerebellum, causes auditory-vestibular dysfunction. Predominant symptoms include progressive sensorineural hearing loss, imbalance, and ataxia. Despite characteristic auditory-vestibular involvement, SSCN is not well known among the hearing health community. Clinical records of 49 patients diagnosed with SSCN were reviewed. Analysis included review of demographic, audiometric, and vestibular data of the largest sample to date and comparison to 31 audiovestibular case reports in the literature. Hearing loss and disordered balance were reported by 92% and 67% of patients, respectively. Results suggest variable but substantial auditory-vestibular involvement related to SSCN. Hearing loss is typically progressive, sloping, and asymmetric and exceeds hearing loss expected based on age or sex. Decreased word rec...
The last several decades have revealed clinical and experimental data regarding the importance of... more The last several decades have revealed clinical and experimental data regarding the importance of magnesium (Mg) in hearing. Increased susceptibility to noise damage, ototoxicity, and auditory hyperexcitability are linked to states of Mg deficiency. Evidence for these processes has come slowly and direct effects have remained elusive because plasma Mg levels do not always correlate with its deficiency. Despite the major progress in the understanding of cochlear mechanical and auditory nerve function, the neurochemical and pharmacologic role of Mg is not clear. The putative mechanism suggests that Mg deficiency may contribute to a metabolic cellular cascade of events. Mg deficiency leads to an increased permeability of the calcium channel in the hair cells with a consequent over influx of calcium, an increased release of glutamate via exocytosis, and over stimulation of NMDA receptors on the auditory nerve. This paper provides a current overview of relevant Mg metabolism and deficien...
Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 1989
Thirty-six weanling guinea pigs were fed either a low (600 ppm) or normal (3000 ppm) diet of magn... more Thirty-six weanling guinea pigs were fed either a low (600 ppm) or normal (3000 ppm) diet of magnesium for 8 weeks. One half of each diet group received intramuscular injections of magnesium-depleting drugs, furosemide and gentamicin. The other half were controls and received equal intramuscular injections of saline. Auditory brainstem responses were obtained from all animals before and after 8 weeks of treatment of diet and drugs to examine the effects of treatment upon hearing and auditory brainstem function. A three-way analysis of variance of dietary magnesium, by drug and by sex, showed no significant differences in auditory brainstem wave V thresholds, wave V latencies, or interpeak wave I-V latencies between the control and experimental groups. The low magnesium diet group, which received drugs, had significantly greater wave V auditory brainstem response amplitudes. Results can be explained on the basis of magnesium influencing the uptake of calcium into both the hair cells ...
Visual performance impairment after hypoxia is well recognized in military and civilian aviation.... more Visual performance impairment after hypoxia is well recognized in military and civilian aviation. The aims of this study were: 1) to assess oculometric features such as blink metrics, pupillary dynamics, fixations, and saccades as cognitive indicators of early signs of hypoxia; and 2) to analyze the impact of different hypoxic conditions ["hypoxic hypoxia" (HH) and "isocapnic hypoxia" (IH)] on specified oculometrics during mental workloads. Oculometric data were collected on 25 subjects under 3 conditions: normoxia, HH (8% O2 + balance N2), and IH (7% O2 + 5% CO2 + balance N2). The mental workload task consisted of reading aloud linear arrays of numbers after exposure to gas mixtures. Blink rates were significantly increased under hypoxic conditions (by +100.7% in HH and by +92.8% in IH compared to normoxia). A faster recovery of blink rate was observed in transitioning from IH (23.6% vs. 76.3%) to normoxia. The percentage change in pupil size fluctuation was increased under HH more than under IH (29% vs. 4.4%). Under HH average fixation time and target area size were significantly higher than under IH. Total saccadic times under hypoxic conditions were significantly increased compared with normoxia. These results suggest that oculometric changes are indicators of hypoxia, which can be monitored using compact, portable, noninvasive eye-tracking devices in a cockpit analogous environment to detect hypoxia-induced physiological changes in aircrew. Comparative results between HH and IH support the potential role of carbon dioxide in augmenting cerebral perfusion and hence improved tissue oxygen delivery.
Galvanic stimulation has long been used as a nonmechanical means of activating the vestibular app... more Galvanic stimulation has long been used as a nonmechanical means of activating the vestibular apparatus through direct action on the vestibular nerve endings. This stimulation has been reported to be safe, but no studies have examined the potential changes in the corresponding cochlear receptors. The aim of the present study was to evaluate the effect of galvanic vestibular stimulation (GVS) on distortion product otoacoustic emissions (DPOAEs). Fourteen subjects underwent DPOAEs during several conditions of GVS. The DPOAEs ranged from ∼ 1 kHz to ∼ 8 kHz at 65/55 dB for f1/f2 and with an f2/f1 ratio of 1.2. The subjects were evaluated at 10 stimulation conditions that ranged from -2.0 mA to +2.0 mA for each frequency. Statistical analysis showed no significant differences in DPOAE amplitudes for all conditions with and without GVS. Results also showed no significant differences between DPOAE amplitudes before and after GVS. Multivariate analysis found subject variability in DPOAE amplitude, which was not thought to be GVS related. Results indicated that GVS produced neither temporary nor permanent changes in DPOAEs.
Michael J. Cevette 1 David M. Barrs 2 Alpen Patel 3 Kelly P. Conroy 4 Sarah Sydlowski 5 Brie N. N... more Michael J. Cevette 1 David M. Barrs 2 Alpen Patel 3 Kelly P. Conroy 4 Sarah Sydlowski 5 Brie N. Noble 6 Gregory A. Nelson 7 Jan Stepanek 8 1 PhD, Department of Otolaryngology, Section of Audiology Mayo Clinic Scottsdale AC United States. E-mail: Cevette.michael@mayo.edu 2 MD, Department of Otolaryngology, Head and Neck Surgery Mayo Clinic Scottsdale United States. E-mail: barrs.david@mayo.edu 3 BS, College of Medicine Phoenix University of Arizona Phoenix AC United States. E-mail: alpen@email.arizona.edu 4 AuD, Department of Otolaryngology, Section of Audiology Mayo Clinic Scottsdale United States. E-mail: conroy.kelly@mayo.edu 5 AuD, Section of Audiology Cleveland Clinic Head and Neck Institute Cleveland United States. E-mail: sydlows@ccf.org 6 BS, Biostatistics Mayo Clinic Scottsdale United States. E-mail: noble.brie@mayo.edu 7 BS, Department of Otolaryngology, Section of Audiology Mayo Clinic Scottsdale United States. E-mail: Gregory.Nelson4@va.gov 8 MD, Division of Preventive, O...
The need exists for a device that can rapidly and accurately assess mild cognitive impairment (MC... more The need exists for a device that can rapidly and accurately assess mild cognitive impairment (MCI). Because the link between oculometrics and cognition is well‐documented, the Oculo‐Cognitive Addition Test (OCAT) was developed which tracks users’ eye movements as they complete a simple mental addition test.
In this paper, we focus on the application of oculometric patterns extracted from raw eye movemen... more In this paper, we focus on the application of oculometric patterns extracted from raw eye movements during a mental workload task to assess changes in cognitive performance in healthy youth athletes over the course of a typical sport season. Oculometric features pertaining to fixations and saccades were measured on 116 athletes in pre- and post-season testing. Participants were between 7 and 14 years of age at pre-season testing. Due to varied developmental rates, there were large interindividual performance differences during a mental workload task consisting of reading numbers. Based on different reading speeds, we classified three profiles (slow, moderate, and fast) and established their corresponding baselines for oculometric data. Within each profile, we describe changes in oculomotor function based on changes in cognitive performance during the season. To visualize these changes in multidimensional oculometric data, we also present a multidimensional visualization tool named DiViTo (diagnostic visualization tool). These experimental, computational informatics and visualization methodologies may serve to utilize oculometric information to detect changes in cognitive performance due to mild or severe cognitive impairment such as concussion/mild traumatic brain injury, as well as possibly other disorders such as attention deficit hyperactivity disorders, learning/reading disabilities, impairment of alertness, and neurocognitive function.
Labyrinthine concussion due to a postauricular gunshot wound has not been well reported. Retrospe... more Labyrinthine concussion due to a postauricular gunshot wound has not been well reported. Retrospective chart review. We describe an otherwise healthy 22-year-old male who received a gunshot wound to the left mastoid and subsequently reported hearing loss and rotational vertigo. Audiometric testing demonstrated significant inverted scoop shaped sensorineural hearing loss. Vestibular diagnostic testing indicated a significant uncompensated left peripheral vestibulopathy. Imaging demonstrated no structural changes to the middle ear or labyrinth, suggesting that the auditory and vestibular losses noted on diagnostic examination were likely due to labyrinthine concussion. Labyrinthine concussion may lead to reduced vestibular reflex pathway following gunshot wounds to the temporal bone. Clinical presentation is likely to vary significantly among cases.
Australian Journal of Human Communication Disorders, 1977
A rationale for measuring middle ear function in the speech clinic is given. Anatomical and physi... more A rationale for measuring middle ear function in the speech clinic is given. Anatomical and physiological descriptions of the norman middle ear and four pathological conditions are described in light of present measurement techniques. Emphasis is placed on these measurements as routine procedures for the known or suspected cases of otitis media seen by speech pathologists.
Australian Journal of Human Communication Disorders, 1978
A rationale is given for measuring acoustic reflexes in order to establish an estimation of cochl... more A rationale is given for measuring acoustic reflexes in order to establish an estimation of cochlear funtion. Anatomical and physiological descriptions of the normal middle ear are outlined. Particular attention is paid to changes of the acoustic transmitting properties of the middle ear due to middle ear muscle contractions to acoustic stimuli, and the predictive value of these measures in the assessment of sensorineural hearing impairment.
Australian Journal of Human Communication Disorders, 1977
Hearing conservation programs are often plagued with a lack of follow-through at the conclusion o... more Hearing conservation programs are often plagued with a lack of follow-through at the conclusion of identification audiometry. The procedures and results of the Lincoln Institute's hearing conservation program are reported. The results indicate some of the inherent problems associated with screening techniques. In addition, they help demonstrate the need for precautions in informing parents of such results. These precautions in parental counselling must not only be conservative in nature, but also ensure parental co-operation and understanding. These precautions chiefly stem from the lack of personal contact that is possible from mass screenings. Without personal contact, an indirect form of counselling results. This type of counselling must express tact and yet be persuasive enough to generate concern for the necessary confirmation of the hearing impairment.
This case study details the evaluation, explantation, and subsequent reimplantation of a cochlear... more This case study details the evaluation, explantation, and subsequent reimplantation of a cochlear implant (CI) recipient with an unusually deep electrode array insertion. Although the positive value of sufficiently deep insertion and the effect of insertion variability have been researched, there are few data available that illustrate the detrimental effects on speech recognition when deep insertion corrupts optimal use of the CI. This unique case report challenges the assumption that deeper insertion will result in improved speech understanding and demonstrates the importance of fully evaluating recipients' complaints and recognizing the impact of frequency-to-place mismatch.
Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology, 2011
Superficial siderosis of the central nervous system (SSCN) results after chronic subarachnoid hem... more Superficial siderosis of the central nervous system (SSCN) results after chronic subarachnoid hemorrhage. Consequent demyelination, particularly of the cochleovestibular nerve and cerebellum, causes auditory-vestibular dysfunction. Predominant symptoms include progressive sensorineural hearing loss, imbalance, and ataxia. Despite characteristic auditory-vestibular involvement, SSCN is not well known among the hearing health community. Clinical records of 49 patients diagnosed with SSCN were reviewed. Analysis included review of demographic, audiometric, and vestibular data of the largest sample to date and comparison to 31 audiovestibular case reports in the literature. Hearing loss and disordered balance were reported by 92% and 67% of patients, respectively. Results suggest variable but substantial auditory-vestibular involvement related to SSCN. Hearing loss is typically progressive, sloping, and asymmetric and exceeds hearing loss expected based on age or sex. Decreased word rec...
The last several decades have revealed clinical and experimental data regarding the importance of... more The last several decades have revealed clinical and experimental data regarding the importance of magnesium (Mg) in hearing. Increased susceptibility to noise damage, ototoxicity, and auditory hyperexcitability are linked to states of Mg deficiency. Evidence for these processes has come slowly and direct effects have remained elusive because plasma Mg levels do not always correlate with its deficiency. Despite the major progress in the understanding of cochlear mechanical and auditory nerve function, the neurochemical and pharmacologic role of Mg is not clear. The putative mechanism suggests that Mg deficiency may contribute to a metabolic cellular cascade of events. Mg deficiency leads to an increased permeability of the calcium channel in the hair cells with a consequent over influx of calcium, an increased release of glutamate via exocytosis, and over stimulation of NMDA receptors on the auditory nerve. This paper provides a current overview of relevant Mg metabolism and deficien...
Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 1989
Thirty-six weanling guinea pigs were fed either a low (600 ppm) or normal (3000 ppm) diet of magn... more Thirty-six weanling guinea pigs were fed either a low (600 ppm) or normal (3000 ppm) diet of magnesium for 8 weeks. One half of each diet group received intramuscular injections of magnesium-depleting drugs, furosemide and gentamicin. The other half were controls and received equal intramuscular injections of saline. Auditory brainstem responses were obtained from all animals before and after 8 weeks of treatment of diet and drugs to examine the effects of treatment upon hearing and auditory brainstem function. A three-way analysis of variance of dietary magnesium, by drug and by sex, showed no significant differences in auditory brainstem wave V thresholds, wave V latencies, or interpeak wave I-V latencies between the control and experimental groups. The low magnesium diet group, which received drugs, had significantly greater wave V auditory brainstem response amplitudes. Results can be explained on the basis of magnesium influencing the uptake of calcium into both the hair cells ...
Visual performance impairment after hypoxia is well recognized in military and civilian aviation.... more Visual performance impairment after hypoxia is well recognized in military and civilian aviation. The aims of this study were: 1) to assess oculometric features such as blink metrics, pupillary dynamics, fixations, and saccades as cognitive indicators of early signs of hypoxia; and 2) to analyze the impact of different hypoxic conditions ["hypoxic hypoxia" (HH) and "isocapnic hypoxia" (IH)] on specified oculometrics during mental workloads. Oculometric data were collected on 25 subjects under 3 conditions: normoxia, HH (8% O2 + balance N2), and IH (7% O2 + 5% CO2 + balance N2). The mental workload task consisted of reading aloud linear arrays of numbers after exposure to gas mixtures. Blink rates were significantly increased under hypoxic conditions (by +100.7% in HH and by +92.8% in IH compared to normoxia). A faster recovery of blink rate was observed in transitioning from IH (23.6% vs. 76.3%) to normoxia. The percentage change in pupil size fluctuation was increased under HH more than under IH (29% vs. 4.4%). Under HH average fixation time and target area size were significantly higher than under IH. Total saccadic times under hypoxic conditions were significantly increased compared with normoxia. These results suggest that oculometric changes are indicators of hypoxia, which can be monitored using compact, portable, noninvasive eye-tracking devices in a cockpit analogous environment to detect hypoxia-induced physiological changes in aircrew. Comparative results between HH and IH support the potential role of carbon dioxide in augmenting cerebral perfusion and hence improved tissue oxygen delivery.
Galvanic stimulation has long been used as a nonmechanical means of activating the vestibular app... more Galvanic stimulation has long been used as a nonmechanical means of activating the vestibular apparatus through direct action on the vestibular nerve endings. This stimulation has been reported to be safe, but no studies have examined the potential changes in the corresponding cochlear receptors. The aim of the present study was to evaluate the effect of galvanic vestibular stimulation (GVS) on distortion product otoacoustic emissions (DPOAEs). Fourteen subjects underwent DPOAEs during several conditions of GVS. The DPOAEs ranged from ∼ 1 kHz to ∼ 8 kHz at 65/55 dB for f1/f2 and with an f2/f1 ratio of 1.2. The subjects were evaluated at 10 stimulation conditions that ranged from -2.0 mA to +2.0 mA for each frequency. Statistical analysis showed no significant differences in DPOAE amplitudes for all conditions with and without GVS. Results also showed no significant differences between DPOAE amplitudes before and after GVS. Multivariate analysis found subject variability in DPOAE amplitude, which was not thought to be GVS related. Results indicated that GVS produced neither temporary nor permanent changes in DPOAEs.
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Papers by Michael Cevette