Objectives: Cochlear implant (CI) listeners experience diminished music perception and enjoyment from a variety of patient-related and implant-related factors. We investigate the hypothesis that patient-directed music re-engineering may enhance music enjoyment with CI. Study Design: Prospective cohort study. Setting: Academic cochlear implant center. Subjects and Methods: A multidisciplinary team of neurotologists, audiologists, and a sound/audio engineer collaborated with a web developer to create a music re-engineering application. Experienced adult CI listeners rated original excerpts from five major genres of music on enjoyment using a visual analog scale (VAS). Subjects were then allowed to re-engineer the original by adjusting treble frequencies, bass frequencies, percussion emphasis, and reverberation and again rated on enjoyment. Results: Total of 46 subjects, with a mean age of 57.6 years (SD ¼ 16; range, 18-90) participated in the study. Usermixed audio was rated higher across all measures of enjoyment than original recordings (mean difference þ0.92; p < 0.05, CI [0.22, 1.62]), an effect that was seen across all genres except for country music. Subjects preferred louder bass frequencies (mean difference þ7.1 dB; p < 0.01, CI [2.15, 24.3]) and more reverberation (mean difference þ6.6 ms; p < 0.01, CI [2.85, 10.7]). Re-engineered music increased enjoyment in 57%, and 79% reported an interest in being able to mix music of their own choosing. Conclusion: User-directed music re-engineering increases music enjoyment for CI listeners. The cochlear implantee preferred heightened bass, reverberation, and treble across musical genres. These findings support the implementation of patient-directed music re-engineering to enhance music enjoyment with technology that is readily available today.
An anterior glottic web is an abnormal fusion of the anterior aspect of the membranous vocal folds. Noncongenital glottic webs are usually iatrogenic from intubation or laryngeal surgery. We present six adult patients whose initial in‐office diagnoses were consistent with “idiopathic” benign anterior glottic webs as determined by three laryngologists (a.m.k., j.m.b., m.j.p.). Further evaluation revealed the diagnoses of laryngeal squamous cell carcinoma in all cases. The high risk of malignancy in cases of idiopathic anterior glottic web necessitates biopsy for tissue diagnosis of all such lesions.
Laryngoscope, 129:2118–2120, 2019
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