Penny Feltham - Academia.edu (original) (raw)

Papers by Penny Feltham

Otolaryngology -- Head and Neck Surgery, 2013

ABSTRACT Objectives: 1) Highlight ear anomalies (external, middle, and inner ear) and types of he... more ABSTRACT Objectives: 1) Highlight ear anomalies (external, middle, and inner ear) and types of hearing loss in children with CHARGE syndrome (CS). 2) Use cases to discuss surgical options for treating hearing loss in CS children, including bone conduction implants and cochlear implantation.

The Hearing Journal, 2014

International journal of pediatric otorhinolaryngology, 2014

Percutaneous bone conduction hearing aids are an established treatment for selected children unab... more Percutaneous bone conduction hearing aids are an established treatment for selected children unable to use conventional hearing aids. Currently in children, loading the implant is delayed for 3-6 months following fixture placement, due to concerns regarding bone quality, bone thickness and subsequent implant stability. Traditionally, such concerns led to children undergoing 2-stage Baha(®) surgery, with a second operation to attach the abutment after 3-6 months. Bone conduction implant stability can be objectively measured using resonance-frequency analysis (RFA) to generate Implant Stability Quotients (ISQs). We aimed to assess implant stability in children undergoing 1-stage surgery using RFA measurements and investigate the possible implications for earlier loading following surgery. We report a case series of consecutive children undergoing Baha(®) at our tertiary paediatric hospital. The interval to implant loading remained 3-6 months for the duration of this study. RFA measure...

International Journal of Audiology, 2014

Objective: A study was conducted to determine whether modifications to input compression and inpu... more Objective: A study was conducted to determine whether modifications to input compression and input frequency response characteristics can improve music-listening satisfaction in cochlear implant users. Design: Experiment 1 compared three pre-processed versions of music and speech stimuli in a laboratory setting: original, compressed, and flattened frequency response. Music excerpts comprised three music genres (classical, country, and jazz), and a running speech excerpt was compared. Experiment 2 implemented a flattened input frequency response in the speech processor program. In a take-home trial, participants compared unaltered and flattened frequency responses. Study sample: Ten and twelve adult Nucleus Freedom cochlear implant users participated in Experiments 1 and 2, respectively. Results: Experiment 1 revealed a significant preference for music stimuli with a flattened frequency response compared to both original and compressed stimuli, whereas there was a significant preference for the original (rising) frequency response for speech stimuli. Experiment 2 revealed no significant mean preference for the flattened frequency response, with 9 of 11 subjects preferring the rising frequency response. Conclusions: Input compression did not alter music enjoyment. Comparison of the two experiments indicated that individual frequency response preferences may depend on the genre or familiarity, and particularly whether the music contained lyrics.

Otolaryngology -- Head and Neck Surgery, 2013

ABSTRACT Objectives: 1) Highlight ear anomalies (external, middle, and inner ear) and types of he... more ABSTRACT Objectives: 1) Highlight ear anomalies (external, middle, and inner ear) and types of hearing loss in children with CHARGE syndrome (CS). 2) Use cases to discuss surgical options for treating hearing loss in CS children, including bone conduction implants and cochlear implantation.

Journal of Speech, Language, and Hearing Research, 2004

Children have higher auditory backward masking (BM) thresholds than adults. One explanation for t... more Children have higher auditory backward masking (BM) thresholds than adults. One explanation for this is poor temporal resolution, resulting in difficulty separating brief or rapidly presented sounds. This implies that the auditory temporal window is broader in children than in adults. Alternatively, elevated BM thresholds in children may indicate poor processing efficiency. In this case, children would need a higher signal-to-masker ratio than adults to detect the presence of a signal. This would result in poor performance on a number of psychoacoustic tasks but would be particularly marked in BM due to the compressive nonlinearity of the basilar membrane. The objective of the present study was to examine the competing hypotheses of "temporal resolution" and "efficiency" by measuring BM as a…

Journal of Research in Reading, 2006

The Journal of Laryngology & Otology, 2010

Bone-anchored hearing aid implantations have been performed in Manchester for over 20 years. This... more Bone-anchored hearing aid implantations have been performed in Manchester for over 20 years. This study examined a range of variables that can occur during the implantation process, and the effect they may have on successful outcome. Retrospective study and literature review. Tertiary referral centre in central Manchester. Details of 602 bone-anchored hearing aid implantation procedures were retrieved from the departmental database. The overall complication rate was 23.9 per cent. The rate of revision surgery was 12.1 per cent. This study involved a significantly larger number of patients than any previously reported, similar study. Possible reasons for differences in outcomes, and recommendations for best practice, are discussed.

The Journal of Laryngology & Otology, 2014

This study compared the performance of two new bone-anchored hearing aids with older bone-anchore... more This study compared the performance of two new bone-anchored hearing aids with older bone-anchored hearing aids that were not fully digital. Fourteen experienced bone-anchored hearing aid users participated in this cross-over study. Performance of their existing bone-anchored hearing aid was assessed using speech-in-noise testing and questionnaires. Participants were then fitted with either a Ponto Pro or a BP100 device. After four weeks of use with each new device, the same assessments were repeated. Speech-in-noise testing for the 50 per cent signal-to-noise ratio (the ratio at which 50 per cent of responses were correct) showed no significant differences between the Ponto Pro and the BP100 devices (p = 0.1) However, both devices showed significant improvement compared with the participants' previous bone-anchored hearing aid devices (p < 0.001). There were no significant differences between the two new devices in the questionnaire data. Both fully digital bone-anchored hearing aids demonstrated superior speech processing compared with the previous generation of devices. There were no substantial differences between the two digital devices in either objective or subjective tests.

International Congress Series, 2003

Cochlear Implants International, 2012

In October 2009, a multi-disciplinary group of UK clinicians met to review issues relating to bon... more In October 2009, a multi-disciplinary group of UK clinicians met to review issues relating to bone-anchored hearing-aid (BAHA) development. The aim was to help define a model for BAHA services and service development via a process of widespread consultation with UK BAHA professionals. A modified Delphi technique was used. Statements were proposed by the lead group and sent out for consultation. Those with ≥90% agreement were approved without further discussion. Statements with 50-89% agreement were discussed by the lead group to determine whether they should be included in the final document. Any statement with <50% agreement was removed without discussion. A second consultation was then made, and the process repeated. This led to a final set of consensus statements. The final consensus comprises 33 statements validated by the modified Delphi process. All of these statements achieved >75% agreement, with only six statements having <90% agreement. When these statements were presented to the UK BAHA Professionals group at their annual conference there was 89% agreement from the group for the consensus statements to be accepted. The levels of agreement for the final questionnaire show that the mandate for the consensus statements was exceptionally high. Implementation of the consensus is discussed, as are each of the key areas of the consensus, such as funding and minimum assessment standards.

Otolaryngology -- Head and Neck Surgery, 2013

ABSTRACT Objectives: 1) Highlight ear anomalies (external, middle, and inner ear) and types of he... more ABSTRACT Objectives: 1) Highlight ear anomalies (external, middle, and inner ear) and types of hearing loss in children with CHARGE syndrome (CS). 2) Use cases to discuss surgical options for treating hearing loss in CS children, including bone conduction implants and cochlear implantation.

The Hearing Journal, 2014

International journal of pediatric otorhinolaryngology, 2014

Percutaneous bone conduction hearing aids are an established treatment for selected children unab... more Percutaneous bone conduction hearing aids are an established treatment for selected children unable to use conventional hearing aids. Currently in children, loading the implant is delayed for 3-6 months following fixture placement, due to concerns regarding bone quality, bone thickness and subsequent implant stability. Traditionally, such concerns led to children undergoing 2-stage Baha(®) surgery, with a second operation to attach the abutment after 3-6 months. Bone conduction implant stability can be objectively measured using resonance-frequency analysis (RFA) to generate Implant Stability Quotients (ISQs). We aimed to assess implant stability in children undergoing 1-stage surgery using RFA measurements and investigate the possible implications for earlier loading following surgery. We report a case series of consecutive children undergoing Baha(®) at our tertiary paediatric hospital. The interval to implant loading remained 3-6 months for the duration of this study. RFA measure...

International Journal of Audiology, 2014

Objective: A study was conducted to determine whether modifications to input compression and inpu... more Objective: A study was conducted to determine whether modifications to input compression and input frequency response characteristics can improve music-listening satisfaction in cochlear implant users. Design: Experiment 1 compared three pre-processed versions of music and speech stimuli in a laboratory setting: original, compressed, and flattened frequency response. Music excerpts comprised three music genres (classical, country, and jazz), and a running speech excerpt was compared. Experiment 2 implemented a flattened input frequency response in the speech processor program. In a take-home trial, participants compared unaltered and flattened frequency responses. Study sample: Ten and twelve adult Nucleus Freedom cochlear implant users participated in Experiments 1 and 2, respectively. Results: Experiment 1 revealed a significant preference for music stimuli with a flattened frequency response compared to both original and compressed stimuli, whereas there was a significant preference for the original (rising) frequency response for speech stimuli. Experiment 2 revealed no significant mean preference for the flattened frequency response, with 9 of 11 subjects preferring the rising frequency response. Conclusions: Input compression did not alter music enjoyment. Comparison of the two experiments indicated that individual frequency response preferences may depend on the genre or familiarity, and particularly whether the music contained lyrics.

Otolaryngology -- Head and Neck Surgery, 2013

ABSTRACT Objectives: 1) Highlight ear anomalies (external, middle, and inner ear) and types of he... more ABSTRACT Objectives: 1) Highlight ear anomalies (external, middle, and inner ear) and types of hearing loss in children with CHARGE syndrome (CS). 2) Use cases to discuss surgical options for treating hearing loss in CS children, including bone conduction implants and cochlear implantation.

Journal of Speech, Language, and Hearing Research, 2004

Children have higher auditory backward masking (BM) thresholds than adults. One explanation for t... more Children have higher auditory backward masking (BM) thresholds than adults. One explanation for this is poor temporal resolution, resulting in difficulty separating brief or rapidly presented sounds. This implies that the auditory temporal window is broader in children than in adults. Alternatively, elevated BM thresholds in children may indicate poor processing efficiency. In this case, children would need a higher signal-to-masker ratio than adults to detect the presence of a signal. This would result in poor performance on a number of psychoacoustic tasks but would be particularly marked in BM due to the compressive nonlinearity of the basilar membrane. The objective of the present study was to examine the competing hypotheses of "temporal resolution" and "efficiency" by measuring BM as a…

Journal of Research in Reading, 2006

The Journal of Laryngology & Otology, 2010

Bone-anchored hearing aid implantations have been performed in Manchester for over 20 years. This... more Bone-anchored hearing aid implantations have been performed in Manchester for over 20 years. This study examined a range of variables that can occur during the implantation process, and the effect they may have on successful outcome. Retrospective study and literature review. Tertiary referral centre in central Manchester. Details of 602 bone-anchored hearing aid implantation procedures were retrieved from the departmental database. The overall complication rate was 23.9 per cent. The rate of revision surgery was 12.1 per cent. This study involved a significantly larger number of patients than any previously reported, similar study. Possible reasons for differences in outcomes, and recommendations for best practice, are discussed.

The Journal of Laryngology & Otology, 2014

This study compared the performance of two new bone-anchored hearing aids with older bone-anchore... more This study compared the performance of two new bone-anchored hearing aids with older bone-anchored hearing aids that were not fully digital. Fourteen experienced bone-anchored hearing aid users participated in this cross-over study. Performance of their existing bone-anchored hearing aid was assessed using speech-in-noise testing and questionnaires. Participants were then fitted with either a Ponto Pro or a BP100 device. After four weeks of use with each new device, the same assessments were repeated. Speech-in-noise testing for the 50 per cent signal-to-noise ratio (the ratio at which 50 per cent of responses were correct) showed no significant differences between the Ponto Pro and the BP100 devices (p = 0.1) However, both devices showed significant improvement compared with the participants' previous bone-anchored hearing aid devices (p < 0.001). There were no significant differences between the two new devices in the questionnaire data. Both fully digital bone-anchored hearing aids demonstrated superior speech processing compared with the previous generation of devices. There were no substantial differences between the two digital devices in either objective or subjective tests.

International Congress Series, 2003

Cochlear Implants International, 2012

In October 2009, a multi-disciplinary group of UK clinicians met to review issues relating to bon... more In October 2009, a multi-disciplinary group of UK clinicians met to review issues relating to bone-anchored hearing-aid (BAHA) development. The aim was to help define a model for BAHA services and service development via a process of widespread consultation with UK BAHA professionals. A modified Delphi technique was used. Statements were proposed by the lead group and sent out for consultation. Those with ≥90% agreement were approved without further discussion. Statements with 50-89% agreement were discussed by the lead group to determine whether they should be included in the final document. Any statement with <50% agreement was removed without discussion. A second consultation was then made, and the process repeated. This led to a final set of consensus statements. The final consensus comprises 33 statements validated by the modified Delphi process. All of these statements achieved >75% agreement, with only six statements having <90% agreement. When these statements were presented to the UK BAHA Professionals group at their annual conference there was 89% agreement from the group for the consensus statements to be accepted. The levels of agreement for the final questionnaire show that the mandate for the consensus statements was exceptionally high. Implementation of the consensus is discussed, as are each of the key areas of the consensus, such as funding and minimum assessment standards.