Music students: conventional hearing thresholds and at high frequencies.

PubMed

Lüders, Débora; Gonçalves, Cláudia Giglio de Oliveira; Lacerda, Adriana Bender de Moreira; Ribas, Ângela; Conto, Juliana de

2014-01-01

Research has shown that hearing loss in musicians may cause difficulty in timbre recognition and tuning of instruments. To analyze the hearing thresholds from 250 Hz to 16,000 Hz in a group of music students and compare them to a non-musician group in order to determine whether high-frequency audiometry is a useful tool in the early detection of hearing impairment. Study design was a retrospective observational cohort. Conventional and high-frequency audiometry was performed in 42 music students (Madsen Itera II audiometer and TDH39P headphones for conventional audiometry, and HDA 200 headphones for high-frequency audiometry). Of the 42 students, 38.1% were female students and 61.9% were male students, with a mean age of 26 years. At conventional audiometry, 92.85% had hearing thresholds within normal limits; but even within the normal limits, the worst results were observed in the left ear for all frequencies, except for 4000 Hz; compared to the non-musician group, the worst results occurred at 500 Hz in the left ear, and at 250 Hz, 6000 Hz, 9000 Hz, 10,000 Hz, and 11,200 Hz in both the ears. The periodic evaluation of high-frequency thresholds may be useful in the early detection of hearing loss in musicians. Copyright © 2014 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Evaluating Behavioural Observation Audiometry with Handicapped Children.

ERIC Educational Resources Information Center

Flexer, Carol; Gans, Donald P.

1982-01-01

Three observers evaluated the responses to sound with 21 mild to severely handicapped children (7 months to 10 years old) on Behavioural Observation Audiometry, an alternative to conditioning paradigms in audiometric assessment. Results showed that inter-observer agreement was high and that responsitivity was not affected by stimulus presentation…

The RetroX auditory implant for high-frequency hearing loss.

PubMed

Garin, P; Genard, F; Galle, C; Jamart, J

2004-07-01

The objective of this study was to analyze the subjective satisfaction and measure the hearing gain provided by the RetroX (Auric GmbH, Rheine, Germany), an auditory implant of the external ear. We conducted a retrospective case review. We conducted this study at a tertiary referral center at a university hospital. We studied 10 adults with high-frequency sensori-neural hearing loss (ski-slope audiogram). The RetroX consists of an electronic unit sited in the postaural sulcus connected to a titanium tube implanted under the auricle between the sulcus and the entrance of the external auditory canal. Implanting requires only minor surgery under local anesthesia. Main outcome measures were a satisfaction questionnaire, pure-tone audiometry in quiet, speech audiometry in quiet, speech audiometry in noise, and azimuth audiometry (hearing threshold in function of sound source location within the horizontal plane at ear level). : Subjectively, all 10 patients are satisfied or even extremely satisfied with the hearing improvement provided by the RetroX. They wear the implant daily, from morning to evening. We observe a statistically significant improvement of pure-tone thresholds at 1, 2, and 4 kHz. In quiet, the speech reception threshold improves by 9 dB. Speech audiometry in noise shows that intelligibility improves by 26% for a signal-to-noise ratio of -5 dB, by 18% for a signal-to-noise ratio of 0 dB, and by 13% for a signal-to-noise ratio of +5 dB. Localization audiometry indicates that the skull masks sound contralateral to the implanted ear. Of the 10 patients, one had acoustic feedback and one presented with a granulomatous reaction to the foreign body that necessitated removing the implant. The RetroX auditory implant is a semi-implantable hearing aid without occlusion of the external auditory canal. It provides a new therapeutic alternative for managing high-frequency hearing loss.

Measuring Sound-Processor Threshold Levels for Pediatric Cochlear Implant Recipients Using Conditioned Play Audiometry via Telepractice

ERIC Educational Resources Information Center

Goehring, Jenny L.; Hughes, Michelle L.

2017-01-01

Purpose: This study evaluated the use of telepractice for measuring cochlear implant (CI) behavioral threshold (T) levels in children using conditioned play audiometry (CPA). The goals were to determine whether (a) T levels measured via telepractice were not significantly different from those obtained in person, (b) response probability differed…

Otoacoustic emissions versus audiometry in monitoring hearing loss after long-term noise exposure - a systematic review.

PubMed

Helleman, Hiske W; Eising, Hilde; Limpens, Jacqueline; Dreschler, Wouter A

2018-03-15

Objectives The objective of this systematic review was to compare otoacoustic emissions (OAE) with audiometry in their effectiveness to monitor effects of long-term noise exposure on hearing. Methods We conducted a systematic search of MEDLINE, Embase and the non-MEDLINE subset of PubMed up to March 2016 to identify longitudinal studies on effects of noise exposure on hearing as determined by both audiometry and OAE. Results This review comprised 13 articles, with 30-350 subjects in the longitudinal analysis. A meta-analysis could not be performed because the studies were very heterogeneous in terms of measurement paradigms, follow-up time, age of included subjects, inclusion of data points, outcome parameters and method of analysis. Overall there seemed to be small changes in both audiometry and OAE over time. Individual shifts were detected by both methods but a congruent pattern could not be observed. Some studies found that initial abnormal or low-level emissions might predict future hearing loss but at the cost of low specificity due to a high number of false positives. Other studies could not find such predictive value. Conclusions The reported heterogeneity in the studies calls for more uniformity in including, reporting and analyzing longitudinal data for audiometry and OAE. For the overall results, both methods showed small changes from baseline towards a deterioration in hearing. OAE could not reliably detect threshold shifts at individual level. With respect to the predictive value of OAE, the evidence was not conclusive and studies were not in agreement. The reported predictors had low specificity.

A Comparison of Video versus Conventional Visual Reinforcement in 7- to 16-Month-Old Infants

ERIC Educational Resources Information Center

Lowery, Kristy J.; von Hapsburg, Deborah; Plyler, Erin L.; Johnstone, Patti

2009-01-01

Purpose: To compare response patterns to video visual reinforcement audiometry (VVRA) and conventional visual reinforcement audiometry (CVRA) in infants 7-16 months of age. Method: Fourteen normal-hearing infants aged 7-16 months (8 male, 6 female) participated. A repeated measures design was used. Each infant was tested with VVRA and CVRA over 2…

Sensorineural hearing loss among cerebellopontine-angle tumor patients examined with pure tone audiometry and brainstem-evoked response audiometry

NASA Astrophysics Data System (ADS)

Rinindra, A. M.; Zizlavsky, S.; Bashiruddin, J.; Aman, R. A.; Wulani, V.; Bardosono, S.

2017-08-01

Tumor in the cerebellopontine angle (CPA) accurs for approximately 5-10% of all intracranial tumors, where unilateral hearing loss and tinnitus are the most frequent symptoms. This study aimed to collect data on sensorineural hearing loss in CPA tumor patients in Dr. Cipto Mangunkusumo Hospital (CMH) using pure tone audiometry and brainstem-evoked response audiometry (BERA). It also aimed to obtaine data on CPA-tumor imaging through magnetic resonance imaging (MRI). This was a descriptive, analytic, and cross-sectional study. The subjects of this study were gathered using a total sampling method from secondary data between July 2012 and November 2016. From 104 patients, 30 matched the inclusion criteria. The CPA-tumor patients in the ENT CMH outpatient clinic were mostly female, middle-aged patients (41-60 years) whose clinical presentation was mostly tinnitus and severe, asymmetric sensorineural hearing loss in 10 subjects. From 30 subjects, 29 showed ipsilaterally impaired BERA results, and 17 subjects showed contralaterally impaired BERA results. There were 24 subjects who with large-sized tumors and 19 subjects who had intracanal tumors that had spread until they were extracanal in 19 subjects.

Contrast sensitivity test and conventional and high frequency audiometry: information beyond that required to prescribe lenses and headsets

NASA Astrophysics Data System (ADS)

Comastri, S. A.; Martin, G.; Simon, J. M.; Angarano, C.; Dominguez, S.; Luzzi, F.; Lanusse, M.; Ranieri, M. V.; Boccio, C. M.

2008-04-01

In Optometry and in Audiology, the routine tests to prescribe correction lenses and headsets are respectively the visual acuity test (the first chart with letters was developed by Snellen in 1862) and conventional pure tone audiometry (the first audiometer with electrical current was devised by Hartmann in 1878). At present there are psychophysical non invasive tests that, besides evaluating visual and auditory performance globally and even in cases catalogued as normal according to routine tests, supply early information regarding diseases such as diabetes, hypertension, renal failure, cardiovascular problems, etc. Concerning Optometry, one of these tests is the achromatic luminance contrast sensitivity test (introduced by Schade in 1956). Concerning Audiology, one of these tests is high frequency pure tone audiometry (introduced a few decades ago) which yields information relative to pathologies affecting the basal cochlea and complements data resulting from conventional audiometry. These utilities of the contrast sensitivity test and of pure tone audiometry derive from the facts that Fourier components constitute the basis to synthesize stimuli present at the entrance of the visual and auditory systems; that these systems responses depend on frequencies and that the patient's psychophysical state affects frequency processing. The frequency of interest in the former test is the effective spatial frequency (inverse of the angle subtended at the eye by a cycle of a sinusoidal grating and measured in cycles/degree) and, in the latter, the temporal frequency (measured in cycles/sec). Both tests have similar duration and consist in determining the patient's threshold (corresponding to the inverse multiplicative of the contrast or to the inverse additive of the sound intensity level) for each harmonic stimulus present at the system entrance (sinusoidal grating or pure tone sound). In this article the frequencies, standard normality curves and abnormal threshold shifts inherent to the contrast sensitivity test (which for simplicity could be termed "visionmetry") and to pure tone audiometry (also termed auditory sensitivity test) are analyzed with the purpose of contributing to divulge their ability to supply early information associated to pathologies not solely related to the visual and auditory systems respectively.

Smartphone threshold audiometry in underserved primary health-care contexts.

PubMed

Sandström, Josefin; Swanepoel, De Wet; Carel Myburgh, Hermanus; Laurent, Claude

2016-01-01

To validate a calibrated smartphone-based hearing test in a sound booth environment and in primary health-care clinics. A repeated-measure within-subject study design was employed whereby air-conduction hearing thresholds determined by smartphone-based audiometry was compared to conventional audiometry in a sound booth and a primary health-care clinic environment. A total of 94 subjects (mean age 41 years ± 17.6 SD and range 18-88; 64% female) were assessed of whom 64 were tested in the sound booth and 30 within primary health-care clinics without a booth. In the sound booth 63.4% of conventional and smartphone thresholds indicated normal hearing (≤15 dBHL). Conventional thresholds exceeding 15 dB HL corresponded to smartphone thresholds within ≤10 dB in 80.6% of cases with an average threshold difference of -1.6 dB ± 9.9 SD. In primary health-care clinics 13.7% of conventional and smartphone thresholds indicated normal hearing (≤15 dBHL). Conventional thresholds exceeding 15 dBHL corresponded to smartphone thresholds within ≤10 dB in 92.9% of cases with an average threshold difference of -1.0 dB ± 7.1 SD. Accurate air-conduction audiometry can be conducted in a sound booth and without a sound booth in an underserved community health-care clinic using a smartphone.

Speech-evoked Brainstem Auditory Responses and Auditory Processing Skills: A Correlation in Adults with Hearing Loss

PubMed Central

Sanguebuche, Taissane Rodrigues; Peixe, Bruna Pias; Bruno, Rúbia Soares; Biaggio, Eliara Pinto Vieira; Garcia, Michele Vargas

2018-01-01

Introduction  The auditory system consists of sensory structures and central connections. The evaluation of the auditory pathway at a central level can be performed through behavioral and electrophysiological tests, because they are complementary to each other and provide important information about comprehension. Objective  To correlate the findings of speech brainstem-evoked response audiometry with the behavioral tests Random Gap Detection Test and Masking Level Difference in adults with hearing loss. Methods  All patients were submitted to a basic audiological evaluation, to the aforementioned behavioral tests, and to an electrophysiological assessment, by means of click-evoked and speech-evoked brainstem response audiometry. Results  There were no statistically significant values among the electrophysiological test and the behavioral tests. However, there was a significant correlation between the V and A waves, as well as the D and F waves, of the speech-evoked brainstem response audiometry peaks. Such correlations are positive, indicating that the increase of a variable implies an increase in another and vice versa. Conclusion  It was possible to correlate the findings of the speech-evoked brainstem response audiometry with those of the behavioral tests Random Gap Detection and Masking Level Difference. However, there was no statistically significant correlation between them. This shows that the electrophysiological evaluation does not depend uniquely on the behavioral skills of temporal resolution and selective attention. PMID:29379574

Going wireless and booth-less for hearing testing in industry.

PubMed

Meinke, Deanna K; Norris, Jesse A; Flynn, Brendan P; Clavier, Odile H

2017-01-01

To assess the test-retest variability of hearing thresholds obtained with an innovative, mobile wireless automated hearing-test system (WAHTS) with enhanced sound attenuation to test industrial workers at a worksite as compared to standardised automated hearing thresholds obtained in a mobile trailer sound booth. A within-subject repeated-measures design was used to compare air-conducted threshold tests (500-8000 Hz) measured with the WAHTS in six workplace locations, and a third test using computer-controlled audiometry obtained in a mobile trailer sound booth. Ambient noise levels were measured in all test environments. Twenty workers served as listeners and 20 workers served as operators. On average, the WAHTS resulted in equivalent thresholds as the mobile trailer audiometry at 1000, 2000, 3000 and 8000 Hz and thresholds were within ±5 dB at 500, 4000 and 6000 Hz. Comparable performance may be obtained with the WAHTS in occupational audiometry and valid thresholds may be obtained in diverse test locations without the use of sound-attenuating enclosures.

Clinical Validity of hearScreen™ Smartphone Hearing Screening for School Children.

PubMed

Mahomed-Asmail, Faheema; Swanepoel, De Wet; Eikelboom, Robert H; Myburgh, Hermanus C; Hall, James

2016-01-01

The study aimed to determine the validity of a smartphone hearing screening technology (hearScreen™) compared with conventional screening audiometry in terms of (1) sensitivity and specificity, (2) referral rate, and (3) test time. One thousand and seventy school-age children in grades 1 to 3 (8 ± 1.1 average years) were recruited from five public schools. Children were screened twice, once using conventional audiometry and once with the smartphone hearing screening. Screening was conducted in a counterbalanced sequence, alternating initial screen between conventional or smartphone hearing screening. No statistically significant difference in performance between techniques was noted, with smartphone screening demonstrating equivalent sensitivity (75.0%) and specificity (98.5%) to conventional screening audiometry. While referral rates were lower with the smartphone screening (3.2 vs. 4.6%), it was not significantly different (p > 0.05). Smartphone screening (hearScreen™) was 12.3% faster than conventional screening. Smartphone hearing screening using the hearScreen™ application is accurate and time efficient.

Temporary threshold shift in military pilots measured using conventional and extended high-frequency audiometry after one flight.

PubMed

Kuronen, Pentti; Sorri, Martti J; Pääkkönen, Rauno; Muhli, Arto

2003-01-01

Noise of such a high level that it can result in hearing deterioration is an inherent characteristic of military flying. Susceptibility to hearing impairment was studied using 51 Finnish Air Force military personnel as subjects. The test persons flew missions on a British Aerospace Hawk 51 advanced jet trainer, Boeing F-18 Hornet, Mikoyan & Gurevich MiG-21bis and Saab 35 Draken interceptors, and a Valmet Redigo turboprop liaison aircraft. The duration of noise exposure was one flight mission, which varied from 30 to 60 min. Noise doses and levels were measured using a miniature microphone at the inlet of the ear canal, while a second microphone was located at the level of the subject's shoulder. Hearing thresholds were measured before each flight using conventional (0.125-8 kHz) and extended high-frequency (EHF) (8.20 kHz) audiometry. The measurements were repeated as soon as possible after the flight. The study showed that the pre-flight threshold levels of the subjects were good. Both conventional and EHF audiometry revealed statistically significant temporary threshold shifts (TTS) at several frequencies and with all aircraft types involved. The changes were, however, minor. The risk of noise-induced hearing impairment at the studied exposure levels is, in all probability, rather small. The role of extended high-frequency audiometry would be in research, and it might be performed for flying personnel upon entering service and every fifth year thereafter.

Hearing Tests Based on Biologically Calibrated Mobile Devices: Comparison With Pure-Tone Audiometry

PubMed Central

Grysiński, Tomasz; Kręcicki, Tomasz

2018-01-01

Background Hearing screening tests based on pure-tone audiometry may be conducted on mobile devices, provided that the devices are specially calibrated for the purpose. Calibration consists of determining the reference sound level and can be performed in relation to the hearing threshold of normal-hearing persons. In the case of devices provided by the manufacturer, together with bundled headphones, the reference sound level can be calculated once for all devices of the same model. Objective This study aimed to compare the hearing threshold measured by a mobile device that was calibrated using a model-specific, biologically determined reference sound level with the hearing threshold obtained in pure-tone audiometry. Methods Trial participants were recruited offline using face-to-face prompting from among Otolaryngology Clinic patients, who own Android-based mobile devices with bundled headphones. The hearing threshold was obtained on a mobile device by means of an open access app, Hearing Test, with incorporated model-specific reference sound levels. These reference sound levels were previously determined in uncontrolled conditions in relation to the hearing threshold of normal-hearing persons. An audiologist-assisted self-measurement was conducted by the participants in a sound booth, and it involved determining the lowest audible sound generated by the device within the frequency range of 250 Hz to 8 kHz. The results were compared with pure-tone audiometry. Results A total of 70 subjects, 34 men and 36 women, aged 18-71 years (mean 36, standard deviation [SD] 11) participated in the trial. The hearing threshold obtained on mobile devices was significantly different from the one determined by pure-tone audiometry with a mean difference of 2.6 dB (95% CI 2.0-3.1) and SD of 8.3 dB (95% CI 7.9-8.7). The number of differences not greater than 10 dB reached 89% (95% CI 88-91), whereas the mean absolute difference was obtained at 6.5 dB (95% CI 6.2-6.9). Sensitivity and specificity for a mobile-based screening method were calculated at 98% (95% CI 93-100.0) and 79% (95% CI 71-87), respectively. Conclusions The method of hearing self-test carried out on mobile devices with bundled headphones demonstrates high compatibility with pure-tone audiometry, which confirms its potential application in hearing monitoring, screening tests, or epidemiological examinations on a large scale. PMID:29321124

Hearing Tests Based on Biologically Calibrated Mobile Devices: Comparison With Pure-Tone Audiometry.

PubMed

Masalski, Marcin; Grysiński, Tomasz; Kręcicki, Tomasz

2018-01-10

Hearing screening tests based on pure-tone audiometry may be conducted on mobile devices, provided that the devices are specially calibrated for the purpose. Calibration consists of determining the reference sound level and can be performed in relation to the hearing threshold of normal-hearing persons. In the case of devices provided by the manufacturer, together with bundled headphones, the reference sound level can be calculated once for all devices of the same model. This study aimed to compare the hearing threshold measured by a mobile device that was calibrated using a model-specific, biologically determined reference sound level with the hearing threshold obtained in pure-tone audiometry. Trial participants were recruited offline using face-to-face prompting from among Otolaryngology Clinic patients, who own Android-based mobile devices with bundled headphones. The hearing threshold was obtained on a mobile device by means of an open access app, Hearing Test, with incorporated model-specific reference sound levels. These reference sound levels were previously determined in uncontrolled conditions in relation to the hearing threshold of normal-hearing persons. An audiologist-assisted self-measurement was conducted by the participants in a sound booth, and it involved determining the lowest audible sound generated by the device within the frequency range of 250 Hz to 8 kHz. The results were compared with pure-tone audiometry. A total of 70 subjects, 34 men and 36 women, aged 18-71 years (mean 36, standard deviation [SD] 11) participated in the trial. The hearing threshold obtained on mobile devices was significantly different from the one determined by pure-tone audiometry with a mean difference of 2.6 dB (95% CI 2.0-3.1) and SD of 8.3 dB (95% CI 7.9-8.7). The number of differences not greater than 10 dB reached 89% (95% CI 88-91), whereas the mean absolute difference was obtained at 6.5 dB (95% CI 6.2-6.9). Sensitivity and specificity for a mobile-based screening method were calculated at 98% (95% CI 93-100.0) and 79% (95% CI 71-87), respectively. The method of hearing self-test carried out on mobile devices with bundled headphones demonstrates high compatibility with pure-tone audiometry, which confirms its potential application in hearing monitoring, screening tests, or epidemiological examinations on a large scale. ©Marcin Masalski, Tomasz Grysiński, Tomasz Kręcicki. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 10.01.2018.

Diagnostic pure-tone audiometry in schools: mobile testing without a sound-treated environment.

PubMed

Swanepoel, De Wet; Maclennan-Smith, Felicity; Hall, James W

2013-01-01

To validate diagnostic pure-tone audiometry in schools without a sound-treated environment using an audiometer that incorporates insert earphones covered by circumaural earcups and real-time environmental noise monitoring. A within-subject repeated measures design was employed to compare air (250 to 8000 Hz) and bone (250 to 4000 Hz) conduction pure-tone thresholds measured in natural school environments with thresholds measured in a sound-treated booth. 149 children (54% female) with an average age of 6.9 yr (SD = 0.6; range = 5-8). Average difference between the booth and natural environment thresholds was 0.0 dB (SD = 3.6) for air conduction and 0.1 dB (SD = 3.1) for bone conduction. Average absolute difference between the booth and natural environment was 2.1 dB (SD = 2.9) for air conduction and 1.6 dB (SD = 2.7) for bone conduction. Almost all air- (96%) and bone-conduction (97%) threshold comparisons between the natural and booth test environments were within 0 to 5 dB. No statistically significant differences between thresholds recorded in the natural and booth environments for air- and bone-conduction audiometry were found (p > 0.01). Diagnostic air- and bone-conduction audiometry in schools, without a sound-treated room, is possible with sufficient earphone attenuation and real-time monitoring of environmental noise. Audiological diagnosis on-site for school screening may address concerns of false-positive referrals and poor follow-up compliance and allow for direct referral to audiological and/or medical intervention. American Academy of Audiology.

Screening protocols for the prevention of occupational noise-induced hearing loss: the role of conventional and extended high frequency audiometry may vary according to the years of employment.

PubMed

Riga, Maria; Korres, George; Balatsouras, Dimitrios; Korres, Stavros

2010-07-01

Although occupational noise-induced hearing loss (NIHL) has become a major problem in industrialized societies, there is a notable lack of effective screening protocols to ensure its early diagnosis. The aim of this study was to detect a potential role of extended high frequency (EHF) audiometry in industrial hearing screening protocols. The population consisted of 151 persons, working for 8 hours daily in a noisy environment (90-110 dBA). The changes of hearing thresholds in industrial workers were analyzed, not only with respect to their age, as has been presented by previous studies, but also with respect to the duration of their previous employment. During the first 10 years of employment, the frequencies 12500, 14000 and 16000Hz were the only ones significantly affected. For the second decade of employment, thresholds were significantly elevated only at 2000 and 4000Hz. After exceeding 20 years of employment, the affected frequencies were 250, 500 and 1000Hz. The effects of age on hearing acuity were significant at all frequencies for the first 2 groups. EHF audiometry seems able to identify the first signs of NIHL, much earlier than conventional audiometry, and therefore may need to be implemented in the screening examinations especially of workers with less than 1 decade of employment. Hearing screening protocols could become more efficient by adjusting their frequency ranges according to the frequencies "at risk", which correspond to the duration of the workers' previous employment.

Audiologic and subjective evaluation of Baha® Attract device.

PubMed

Pérez-Carbonell, Tomàs; Pla-Gil, Ignacio; Redondo-Martínez, Jaume; Morant-Ventura, Antonio; García-Callejo, Francisco Javier; Marco-Algarra, Jaime

We included 9 patients implanted with Baha ® Attract. All our patients were evaluated by free field tonal audiometry, free field verbal audiometry and free field verbal audiometry with background noise, all the tests were performed with and without the device. To evaluate the subjective component of the implantation, we used the Glasgow Benefit Inventory (GBI) and Abbreviated Profile of Hearing Aid Benefit (APHAB). The auditive assessment with the device showed average auditive thresholds of 35.8dB with improvements of 25.8dB over the previous situation. Speech reception thresholds were 37dB with Baha ® Attract, showing improvements of 23dB. Maximum discrimination thresholds showed an average gain of 60dB with the device. Baha ® Attract achieves auditive improvements in patients for whom it is correctly indicated, with a consequent positive subjective evaluation. This study shows the attenuation effect in transcutaneous transmission, that prevents the device achieving greater improvements. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

Outcome measures in stapes surgery: postoperative results are independent from preoperative parameters.

PubMed

Koopmann, Mario; Weiss, Daniel; Savvas, Eleftherios; Rudack, Claudia; Stenner, Markus

2015-09-01

The aim of this study was to compare audiometric results before and after stapes surgery and identify potential prognostic factors to appropriately select patients with otosclerosis who will most likely benefit from surgery. We enrolled 126 patients with otosclerosis (162 consecutive ears) in our study who underwent stapes surgery between 2007 and 2012 at our institution. Preoperative and postoperative data including pure-tone audiometry, speech audiometry, stapedial reflex audiometry and surgical data were analyzed. The average preoperative air-bone gap (ABG) was 28.9 ± 8.6 dB. Male patients and patients older than 45 years of age had greater preoperative ABGs in comparison to females and younger patients. Postoperative ABGs were 11.2 ± 7.4 dB. The average ABG gain was 17.7 ± 11.1 dB. Preoperative audiometric data, age, gender and type of surgery did not influence the postoperative results. Stapes surgery offers predictable results independent from disease progression or patient-related factors. While absolute values of hearing improvement are instrumental in reflecting audiometric results of a cohort, relative values better reflect individual's audiometric data resembling the patient's benefit.

Active middle ear implant after lateral petrosectomy and radiotherapy for ear cancer.

PubMed

Cristalli, Giovanni; Sprinzl, Georg M; Wolf-Magele, Astrid; Marchesi, Paolo; Mercante, Giuseppe; Spriano, Giuseppe

2014-04-01

Tumor of the temporal bone is a rare disease with a very poor prognosis. Surgery and postoperative radiotherapy are usually the recommended treatments for squamous cell carcinoma (SCC) of the external and middle ear, which may cause conductive hearing loss. The purpose of this study was to evaluate the audiologic results and compliance of active middle ear implant (AMEI) and establish the feasibility of the procedure in a patient treated for middle ear cancer. A 73-year-old patient treated with lateral petrosectomy, neck dissection, reconstruction/obliteration by pedicled pectoralis major myocutaneous flap, and postoperative full dose radiotherapy for external and middle ear SCC was selected for AMEI. Preoperative audiometric and speech audiometry tests were performed on both ears before and after the activation. Pure tone free field audiometry. Binaural free field speech audiogram. Aided pure tone free field audiometry AMEI results show an increase in air conduction. Speech audiogram showed better discrimination scores in AMEI-aided situations. No complications were observed. AMEI after surgery followed by radiotherapy for middle ear cancer is feasible. Acoustic results in obliterated ear are satisfactory.

[Health surveillance in a steel making industry with electric arc furnace: 15 years of experience].

PubMed

Corti, P

2012-01-01

This paper analyzes the results of health surveillance carried out in an electric steel mill for 15 years. We have analyzed the trend of audiometry, spirometry and main indicators of exposure to chemical risk: serum lead, urinary OH-pyrene, erythrocyte ZPP, and the results of risk assessment of stress work related. The analyses of the trend of audiometry, spirometry and biological monitoring shows an important improving in the working environment due to the progressive automation of production steps in the course of several years, consistent and correct use of DPI, information and training.

[Effects on hearing due to the occupational noise exposure of marble industry workers in the Federal District, Brazil].

PubMed

Harger, Marília Rabelo Holanda Camarano; Barbosa-Branco, Anadergh

2004-01-01

To evaluate the prevalence of hearing loss, its degree and type, among workers in the marble industry in the Brazilian Federal District (FD). Workers from eight marble industries in the FD were evaluated by means of a cross sectional epidemiological study. An audiometry screening test (air conduction) was performed. Workers with hearing loss were submitted to liminal tonal audiometry air & bone conduction and speech audiometry tests using an audiometer AD-28 (Interacoustics). All subjects studied were submitted to a visual inspection of the external acoustic meatus. One hundred and fifty two workers were examined; mean age was 32 years (SD = 8.6); average occupational noise exposure was of 8.3 years (SD = 6.8). Audiometries demonstrated that 48.0% (n = 73) had some type of hearing loss. Among the workers with hearing loss, 50.0% had results compatible with noise-induced hearing loss (NIHL); 41.0% with incipient noise induced hearing loss, 5.0% with sensorineural hearing loss (all except NIHL) and 4.0% with conductive and mixed hearing losses. Among workers with NIHL, 57.1% had bilateral involvement, 17.1% in the right ear and 25.7% in the left ear. Among those with incipient NIHL, 13.9% were bilateral, 19.4% were only in the right ear and 66.7% were only in the left ear. Abnormal audiograms were found in 48.0% of the sample. Among those with hearing loss, the predominant cause was NIHL, followed by those classified as having incipient noise induced hearing loss. Hearing loss usually started at 6 kHz, frequently in the left ear.

The value of ASSR threshold-based bilateral hearing aid fitting in children with difficult or unreliable behavioral audiometry.

PubMed

Vlastarakos, Petros V; Vasileiou, Alexandra; Nikolopoulos, Thomas P

2017-12-01

We conducted an analysis to assess the relative contribution of auditory brainstem response (ABR) testing and auditory steady-state response (ASSR) testing in providing appropriate hearing aid fitting in hearing-impaired children with difficult or unreliable behavioral audiometry. Of 150 infants and children who had been referred to us for hearing assessment as part of a neonatal hearing screening and cochlear implantation program, we identified 5 who exhibited significant discrepancies between click-ABR and ASSR testing results and difficult or unreliable behavioral audiometry. Hearing aid fitting in pediatric cochlear implant candidates for a trial period of 3 to 6 months is a common practice in many implant programs, but monitoring the progress of the amplified infants and providing appropriate hearing aid fitting can be challenging. If we accept the premise that we can assess the linguistic progress of amplified infants with an acceptable degree of certainty, the auditory behavior that we are monitoring presupposes appropriate bilateral hearing aid fitting. This may become very challenging in young children, or even in older children with difficult or unreliable behavioral audiometry results. This challenge can be addressed by using data from both ABR and ASSR testing. Fitting attempts that employ data from only ABR testing provide amplification that involves the range of spoken language but is not frequency-specific. Hearing aid fitting should also incorporate and take into account ASSR data because reliance on ABR testing alone might compromise the validity of the monitoring process. In conclusion, we believe that ASSR threshold-based bilateral hearing aid fitting is necessary to provide frequency-specific amplification of hearing and appropriate propulsion in the prelinguistic vocalizations of monitored infants.

Self-administered hearing loss screening using an interactive, tablet play audiometer with ear bud headphones.

PubMed

Yeung, Jeffrey C; Heley, Sophie; Beauregard, Yves; Champagne, Sandra; Bromwich, Matthew A

2015-08-01

The timely diagnosis and treatment of acquired hearing loss in the pediatric population has significant implications for a child's development. Audiological assessment in children, however, carries both technological and logistical challenges. Typically, specialized methods (such as play audiometry) are required to maintain the child's attention and can be resource intensive. These challenges were previously addressed by a novel, calibrated, interactive play audiometer for Apple(®) iOS(®) called "ShoeBOX Audiometry". This device has potential applications for deployment in environments where traditional clinical audiometry is either unavailable or impractical. The objective of this study was to assess the screening capability of the tablet audiometer in an uncontrolled environment using consumer ear-bud headphones. Consecutive patients presenting to the Audiology Clinic at the Children's Hospital of Eastern Ontario (ages 4 and older) were recruited. Participants' hearing was evaluted using the tablet audiometer calibrated to Apple(®) In-Ear headphones. The warble tone thresholds obtained were compared to gold standard measurements taken with a traditional clinical audiometer inside a soundbooth. 80 patients were enrolled. The majority of participants were capable of completing an audiologic assessment using the tablet computer. Due to ambient noise levels outside a soundbooth, thresholds obtained at 500Hz were not consistent with traditional audiometry. Excluding 500Hz threholds, the tablet audiometer demonstrated strong negative predictive value (89.7%) as well as strong sensitivity (91.2%) for hearing loss. Thresholds obtained in an uncontrolled setting are not reflective of diagnostic thresholds due to the uncalibrated nature of the headphones and variability of the setting without a booth. Nevertheless, the tablet audiometer proved to be both a valid and sensitive instrument for unsupervised screening of warble-tone thresholds in children. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Self-test web-based pure-tone audiometry: validity evaluation and measurement error analysis.

PubMed

Masalski, Marcin; Kręcicki, Tomasz

2013-04-12

Potential methods of application of self-administered Web-based pure-tone audiometry conducted at home on a PC with a sound card and ordinary headphones depend on the value of measurement error in such tests. The aim of this research was to determine the measurement error of the hearing threshold determined in the way described above and to identify and analyze factors influencing its value. The evaluation of the hearing threshold was made in three series: (1) tests on a clinical audiometer, (2) self-tests done on a specially calibrated computer under the supervision of an audiologist, and (3) self-tests conducted at home. The research was carried out on the group of 51 participants selected from patients of an audiology outpatient clinic. From the group of 51 patients examined in the first two series, the third series was self-administered at home by 37 subjects (73%). The average difference between the value of the hearing threshold determined in series 1 and in series 2 was -1.54dB with standard deviation of 7.88dB and a Pearson correlation coefficient of .90. Between the first and third series, these values were -1.35dB±10.66dB and .84, respectively. In series 3, the standard deviation was most influenced by the error connected with the procedure of hearing threshold identification (6.64dB), calibration error (6.19dB), and additionally at the frequency of 250Hz by frequency nonlinearity error (7.28dB). The obtained results confirm the possibility of applying Web-based pure-tone audiometry in screening tests. In the future, modifications of the method leading to the decrease in measurement error can broaden the scope of Web-based pure-tone audiometry application.

Pure-tone Audiometer

NASA Astrophysics Data System (ADS)

Kapul, A. A.; Zubova, E. I.; Torgaev, S. N.; Drobchik, V. V.

2017-08-01

The research focuses on a pure-tone audiometer designing. The relevance of the study is proved by high incidence of an auditory analyser in older people and children. At first, the article provides information about subjective and objective audiometry methods. Secondly, we offer block-diagram and basic-circuit arrangement of device. We decided to base on STM32F407VG microcontroller and use digital pot in the function of attenuator. Third, we implemented microcontroller and PC connection. C programming language is used for microcontroller’s program and PC’s interface. Fourthly, we created the pure-tone audiometer prototype. In the future, we will implement the objective method ASSR in addition to pure-tone audiometry.

Brain stem evoked response audiometry of former drug users.

PubMed

Weich, Tainara Milbradt; Tochetto, Tania Maria; Seligman, Lilian

2012-10-01

Illicit drugs are known for their deleterious effects upon the central nervous system and more specifically for how they adversely affect hearing. This study aims to analyze and compare the hearing complaints and the results of brainstem evoked response audiometry (BERA) of former drug user support group goers. This is a cross-sectional non-experimental descriptive quantitative study. The sample consisted of 17 subjects divided by their preferred drug of use. Ten individuals were placed in the marijuana group (G1) and seven in the crack/cocaine group (G2). The subjects were further divided based on how long they had been using drugs: 1 to 5 years, 6 to 10 years, and over 15 years. They were interviewed, and assessed by pure tone audiometry, acoustic impedance tests, and BERA. No statistically significant differences were found between G1 and G2 or time of drug use in absolute latencies and interpeak intervals. However, only five of the 17 individuals had BERA results with adequate results for their ages. Marijuana and crack/cocaine may cause diffuse disorders in the brainstem and compromise the transmission of auditory stimuli regardless of how long these substances are used for.

Development and evaluation of an audiology app for iPhone/iPad mobile devices.

PubMed

Larrosa, Francisco; Rama-Lopez, Julio; Benitez, Jesus; Morales, Jose M; Martinez, Asuncion; Alañon, Miguel A; Arancibia-Tagle, Diego; Batuecas-Caletrio, Angel; Martinez-Lopez, Marta; Perez-Fernandez, Nicolas; Gimeno, Carlos; Ispizua, Angel; Urrutikoetxea, Alberto; Rey-Martinez, Jorge

2015-01-01

The application described in this study appears to be accurate and valid, thus allowing calculation of a hearing handicap and assessment of the pure-tone air conduction threshold with iPhone/iPad devices. To develop and evaluate a newly developed professional, computer-based hearing handicap calculator and a manual hearing sensitivity assessment test for the iPhone and iPad (AudCal). Multi-center prospective non-randomized validation study. One hundred and ten consecutive adult participants underwent two hearing evaluations, a standard audiometry and a pure-tone air conduction test using AudCal with an iOS device. The hearing handicap calculation accuracy was evaluated comparing AudCal vs a web-based calculator. Hearing loss was found in 83 and 84 out of 220 standard audiometries and AudCal hearing tests (Cohen's Kappa = 0.89). The mean difference between AudCal and standard audiogram thresholds was -0.21 ± 6.38 dB HL. Excellent reliability and concordance between standard audiometry and the application's hearing loss assessment test were obtained (Cronbach's alpha = 0.96; intra-class correlation coefficient = 0.93). AudCal vs a web-based calculator were perfectly correlated (Pearson's r = 1).

Long-term hearing outcomes after recurrent acute otitis media during early childhood.

PubMed

Krakau, Mattias; Dagöö, Britta Rynnel; Hellström, Sten; Granath, Anna

2017-12-01

To survey long-term hearing outcomes and middle ear pathology in a 30-year follow-up in individuals with onset of recurrent acute otitis media (rAOM) before three years of age. 28 adults, aged 30.1-31.8 years, who originally - at the age of 12-32 months - participated in a study on rAOM between 1979 and 1983, were re-examined regarding self-reported ear problems, current tympanic membrane changes and audiology. Thirteen subjects had suffered from rAOM during early childhood and 15 subjects served as a control group. Recurrent acute otitis media subjects reported hearing problems comparable to those of the controls. Pure tone audiometry, at 125-8000 Hz, did not differ between groups. The rAOM group had a trend for impaired high-frequency (9000-14,000 Hz) threshold levels (9000-14,000 Hz); implying that their cochlear function seemed to have deteriorated. Adults, who suffered from recurrent acute otitis media as infants, did not show any clinically significant hearing loss for pure tone audiometry when compared to controls, but there was a trend for impaired results regarding extended high frequency audiometry (9-14 kHz). Children suffering from rAOM will be at low risk of developing hearing loss and severe middle ear disease.

Evaluation of Two Circumaural Earphones for Audiometry.

PubMed

Smull, Clae C; Madsen, Brandon; Margolis, Robert H

2018-05-08

The Sennheiser HDA 200 earphone, a standard circumaural earphone used in audiometry for many years, is out of production and is replaced by the RadioEar DD450. The Sennheiser HD 280 Pro earphone is a consumer product that has characteristics that may be suitable for audiometry and may be a low-cost alternative to the DD450. The DD450 and HD 280 Pro earphones were compared with the HDA 200 for use in audiometry. RadioEar DD450 and Sennheiser HD 280 Pro earphones were evaluated for reference equivalent threshold sound pressure levels (RETSPLs), ambient-noise attenuation, and occlusion effects. Audiometric thresholds measured on a group of normal-hearing adults were used to determine RETSPLs. Ambient-noise attenuation was determined by measuring the sound pressure in the ear canal produced by a broadband signal from a loudspeaker with and without occlusion by the earphone. Acoustic occlusion effects were determined by measuring the ear-canal sound pressure produced by a bone-conducted source with and without occlusion by the earphone. The results were compared with measurements obtained from the HDA 200 earphone. Audiometric thresholds obtained using the DD450 earphone did not differ from those obtained with the HDA 200 earphones, indicating that the HDA 200 RETSPLs provided in the audiometer standards (ANSI S3.6-2010; ISO 389-8-2004) are transferable to the DD450. New RETSPLs for the HD 280 Pro earphone were determined from the threshold measurements. Ambient-noise attenuation provided by the DD450 was equivalent to the attenuation provided by the HDA 200. The HD 280 Pro provided less ambient-noise attenuation than the other circumaural earphones, but more than the supra-aural earphones commonly used in audiometry. The DD450 produced an occlusion effect 5 dB larger than that of the HDA 200 at 0.25 and 0.5 kHz; both earphones produced negligible occlusion effects at higher frequencies. The HD 280 Pro produced larger occlusion effects in the low frequencies than the other two earphones, with negligible occlusion effects at 1.0 kHz and above. The HDA 200 RETSPLs are transferable to the DD450. Ambient-noise attenuation and occlusion effects are similar for these two earphones. RETSPLs for the HD 280 Pro are provided. The HD 280 Pro has less ambient-noise attenuation and larger occlusion effects than the DD450 but is a viable low-cost alternative.

[Study of the hearing of rock and roll musicians].

PubMed

Maia, Juliana Rollo Fernandes; Russo, Ieda Chaves Pacheco

2008-01-01

rock and roll has as one of its main characteristics the excessive sound pressure levels. Several studies have demonstrated that the sound levels of rock concerts can range from 100 to 115dB (A), with peak levels of 150dB (A). to study the hearing of rock and roll musicians, analyzing the results of the audiological evaluation and verifying the influence of time of exposure to amplified music. a questionnaire was answered by 23 rock and roll musicians (46 ears) who were also evaluated by means of pure tone audiometry, immitance audiometry and transient/distortion product evoked otoacoustic emissions (OAET and OAEPD). regarding the time of exposure to music, values close to the limit of acceptance (tending to be significants) were found in the frequencies of 0.5 and 6kHz, in the pure tone audiometry. A statistically significant difference was also found in the OAET test in the frequency of 2kHz and also in the frequencies of 0.75, 1, 4 and 6kHz in the OAEPD test. the results indicate that although hearing loss was not found in the studied population, alteration in the register of the OAE already exists, suggesting alteration of the cochlear function. Regarding time of exposure, the results indicate that musicians with more than 10 years of practice present statistically significant differences when compared to those with less time of exposure.

Congenital Stapes Ankylosis in Children: Surgical Findings and Results in 35 Cases.

PubMed

Vincent, Robert; Wegner, Inge; Kamalski, Digna M A; Bittermann, Arnold J N; Grolman, Wilko

2016-04-01

To evaluate surgical findings and hearing results in children undergoing middle ear surgery for congenital stapes ankylosis with or without other ossicular malformations (Teunissen and Cremers class I and class II malformations). A nonrandomized, nonblinded case series of prospectively collected data. A tertiary referral center. Twenty-eight consecutive pediatric patients who underwent 35 surgical procedures for congenital stapes ankylosis with or without other ossicular malformations and had available postoperative pure-tone audiometry. Primary stapedotomy with vein graft interposition and reconstruction with a Teflon piston, bucket handle prosthesis or total ossicular replacement prosthesis. Pre- and postoperative audiometric evaluation using four-frequency (0.5, 1, 2, and 4 kHz) audiometry. Air-conduction thresholds, bone-conduction thresholds, and air-bone gaps (ABGs) were measured. Postoperative audiometry was performed at 3, 6, 9, 12, 18, and 24 months after surgery and at a yearly interval thereafter. Overall, a postoperative ABG closure of 10 dB or less was achieved in 73% of class I cases and in 50% of class II cases. A postoperative ABG closure of 20 dB or less was achieved in 77% of class I cases and 67% of class II cases. Postoperative sensorineural hearing loss occurred in one class I case (4%) and none of the class II cases. Stapedotomy is a safe and feasible treatment option in children with congenital stapes ankylosis.

Audiological manifestations in mitochondrial encephalomyopathy lactic acidosis and stroke like episodes (MELAS) syndrome.

PubMed

Vandana, V P; Bindu, Parayil Sankaran; Sonam, Kothari; Govindaraj, Periyasamy; Taly, Arun B; Gayathri, Narayanappa; Chiplunkar, Shwetha; Govindaraju, Chikkanna; Arvinda, H R; Nagappa, Madhu; Sinha, Sanjib; Thangaraj, Kumarasamy

2016-09-01

Reports of audiological manifestations in specific subgroups of mitochondrial disorders are limited. This study aims to describe the audiological findings in patients with MELAS syndrome and m.3243A>G mutation. Audiological evaluation was carried out in eight patients with confirmed MELAS syndrome and m.3243A>G mutation. The evaluation included a complete neurological evaluation, pure tone audiometry (n=8), otoacoustic emissions (n=8) and brainstem evoked response audiometry (n=6), magnetic resonance imaging (n=8) and muscle biospy (n=6). Eight patients (Age range: 5-45 years; M:F-1:3) including six children and two adults underwent formal audiological evaluation. Five patients had hearing loss; of these two had "subclinical hearing loss", one had moderate and two had severe hearing loss. The abnormalities included abnormal audiometry (n=5), otoacoustic emission testing (n=7) and absent brainstem auditory evoked responses (n=1). The findings were suggestive of cochlear involvement in four and retrocochlear in one. This study shows that hearing loss of both cochlear and retrocochlear origin occurs in patients with MELAS and may be subclinical. Early referrals for audiological evaluation is warranted to recognize the subclinical hearing loss in these patients. The therapeutic implications include early interventions in the form of hearing aids, cochlear implants and cautioning the physicians for avoidance of aminoglycosides. Copyright © 2016 Elsevier B.V. All rights reserved.

Pure-tone audiometry outside a sound booth using earphone attentuation, integrated noise monitoring, and automation.

PubMed

Swanepoel, De Wet; Matthysen, Cornelia; Eikelboom, Robert H; Clark, Jackie L; Hall, James W

2015-01-01

Accessibility of audiometry is hindered by the cost of sound booths and shortage of hearing health personnel. This study investigated the validity of an automated mobile diagnostic audiometer with increased attenuation and real-time noise monitoring for clinical testing outside a sound booth. Attenuation characteristics and reference ambient noise levels for the computer-based audiometer (KUDUwave) was evaluated alongside the validity of environmental noise monitoring. Clinical validity was determined by comparing air- and bone-conduction thresholds obtained inside and outside the sound booth (23 subjects). Twenty-three normal-hearing subjects (age range, 20-75 years; average age 35.5) and a sub group of 11 subjects to establish test-retest reliability. Improved passive attenuation and valid environmental noise monitoring was demonstrated. Clinically, air-conduction thresholds inside and outside the sound booth, corresponded within 5 dB or less > 90% of instances (mean absolute difference 3.3 ± 3.2 SD). Bone conduction thresholds corresponded within 5 dB or less in 80% of comparisons between test environments, with a mean absolute difference of 4.6 dB (3.7 SD). Threshold differences were not statistically significant. Mean absolute test-retest differences outside the sound booth was similar to those in the booth. Diagnostic pure-tone audiometry outside a sound booth, using automated testing, improved passive attenuation, and real-time environmental noise monitoring demonstrated reliable hearing assessments.

Prevalence of tinnitus in workers exposed to noise and organophosphates

PubMed Central

Delecrode, Camila Ribas; de Freitas, Thais Domingues; Frizzo, Ana Claúdia Figueiredo; Cardoso, Ana Claúdia Vieira

2012-01-01

Summary Introduction: Research on the workplace has emphasized the effects of noise exposure on workers' hearing, but has not considered the effects of agrochemicals. Aim: To evaluate and correlate the hearing level and tinnitus of workers exposed simultaneously to noise and organophosphates in their workplace and to measure tinnitus distress on their quality of life. Method: A retrospective clinical study. We evaluated 82 organophosphate sprinklers from the São Paulo State Regional Superintendence who were active in the fight against dengue and who were exposed to noise and organophosphates. We performed pure tone audiometry and applied the translated THI (Tinnitus Handicap Inventory) questionnaire. Results: Of the sample, 28.05% reported current tinnitus or had presented tinnitus, and the workers with tinnitus had an increased incidence of abnormal audiometry. The average hearing threshold for the 4–8-kHz frequency range of the workers with current tinnitus was higher than that of the others, and was most affected at the 4-kHz frequency. The THI score ranged 0–84, with an average score of 13.1. Twelve (52.17%) workers had THI scores consistent with discrete handicap. Conclusion: There is an increased incidence of abnormal pure tone audiometry in workers with tinnitus, and its impact on the workers' quality of life was discrete. The correlation between average hearing threshold and tinnitus distress was weak. PMID:25991953

Auditory-steady-state response reliability in the audiological diagnosis after neonatal hearing screening.

PubMed

Núñez-Batalla, Faustino; Noriega-Iglesias, Sabel; Guntín-García, Maite; Carro-Fernández, Pilar; Llorente-Pendás, José Luis

2016-01-01

Conventional audiometry is the gold standard for quantifying and describing hearing loss. Alternative methods become necessary to assess subjects who are too young to respond reliably. Auditory evoked potentials constitute the most widely used method for determining hearing thresholds objectively; however, this stimulus is not frequency specific. The advent of the auditory steady-state response (ASSR) leads to more specific threshold determination. The current study describes and compares ASSR, auditory brainstem response (ABR) and conventional behavioural tone audiometry thresholds in a group of infants with various degrees of hearing loss. A comparison was made between ASSR, ABR and behavioural hearing thresholds in 35 infants detected in the neonatal hearing screening program. Mean difference scores (±SD) between ABR and high frequency ABR thresholds were 11.2 dB (±13) and 10.2 dB (±11). Pearson correlations between the ASSR and audiometry thresholds were 0.80 and 0.91 (500Hz); 0.84 and 0.82 (1000Hz); 0.85 and 0.84 (2000Hz); and 0.83 and 0.82 (4000Hz). The ASSR technique is a valuable extension of the clinical test battery for hearing-impaired children. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

Audiometry

MedlinePlus

... any cause. Common causes of hearing loss include: Acoustic trauma Chronic ear infections Diseases of the inner ... hearing. The following conditions may affect test results: Acoustic neuroma Acoustic trauma Age-related hearing loss Alport ...

One-year audiologic monitoring of individuals exposed to the 1995 Oklahoma City bombing.

PubMed

Van Campen, L E; Dennis, J M; Hanlin, R C; King, S B; Velderman, A M

1999-05-01

This longitudinal study evaluated subjective, behavioral, and objective auditory function in 83 explosion survivors. Subjects were evaluated quarterly for 1 year with conventional pure-tone and extended high-frequencies audiometry, otoscopic inspections, immittance and speech audiometry, and questionnaires. There was no obvious relationship between subject location and symptoms or test results. Tinnitus, distorted hearing, loudness sensitivity, and otalgia were common symptoms. On average, 76 percent of subjects had predominantly sensorineural hearing loss at one or more frequencies. Twenty-four percent of subjects required amplification. Extended high frequencies showed evidence of acoustic trauma even when conventional frequencies fell within the normal range. Males had significantly poorer responses than females across frequencies. Auditory status of the group was significantly compromised and unchanged at the end of 1-year postblast.

22q11.2 microduplication syndrome with congenital aural atresia: a family report.

PubMed

Boudewyns, An; van den Ende, Jenneke; Boiy, Tine; Van de Heyning, Paul; Declau, Frank

2012-06-01

22q11.2 microduplication syndrome is characterized by a large phenotypic variability including facial dysmorphism, developmental delay, and hearing loss. We describe a family in whom 5 of 11 children were affected by a unilateral or bilateral congenital aural atresia. Four of these 5 carried a 22q11.2 microduplication and had typical dysmorphic features. Computed tomography with 3-D reconstructions allowed for a detailed examination of the middle ear structures and classification of the atresia type. Audiometry revealed a moderately severe conductive hearing loss in accordance with the clinical and computed tomography findings. Detailed examination of the ear is warranted in patients with a 22q11.2 microduplication. When outer ear abnormalities are encountered, an additional workup including audiometry and computed tomography with 3-D reconstructions is required.

Noise induced hearing loss in dance music disc jockeys and an examination of sound levels in nightclubs.

PubMed

Bray, Adam; Szymański, Marcin; Mills, Robert

2004-02-01

Noise exposure, hearing loss and associated otological symptoms have been studied in a group of 23 disc jockeys using a questionnaire and pure tone audiometry. The level of noise exposure in the venues where they work has also been studied using Ametek Mk-3 audio dosimeters. Three members of the study group showed clear evidence of noise-induced hearing loss on audiometry, 70 per cent reported temporary threshold shift after sessions and 74 per cent reported tinnitus. Sound levels of up to 108 dB(A) were recorded in the nightclubs. The average level for a typical session was 96 dB(A) which is above the level at which the provision of ear protection is mandatory for employers in industry. It can be concluded that DJs are at substantial risk of developing noise-induced hearing loss and noise exposure in nightclubs frequently exceeds safe levels.

Initial experience with the Sophono Alpha 1 osseointegrated implant.

PubMed

Escorihuela-García, Vicente; Llópez-Carratalá, Ignacio; Pitarch-Ribas, Ignacia; Latorre-Monteagudo, Emilia; Marco-Algarra, Jaime

2014-01-01

In the last several years, bone anchored hearing aids have proven to be useful in treating conductive and mixed unilateral or bilateral hearing loss, as well as for sensorineural unilateral hearing loss. The Sophono Alpha 1 model has the advantage of not requiring an abutment, with it being coupled by magnetism instead. We report the cases of 3 infants with congenital malformations of external and middle ear. Audiometry showed conductive hearing loss. All 3 patients were implanted with Alpha 1 model (Sophono). Patients evolved satisfactorily. After 30 days we applied the processor and the control audiometry showed a marked improvement of hearing thresholds, although without a complete closure of the gap. With minimal care, the skin over the implant remained in excellent condition, with a very satisfactory cosmetic outcome. Copyright © 2013 Elsevier España, S.L.U. y Sociedad Española de Otorrinolaringología y Patología Cérvico-Facial. All rights reserved.

Automated smartphone audiometry: Validation of a word recognition test app.

PubMed

Dewyer, Nicholas A; Jiradejvong, Patpong; Henderson Sabes, Jennifer; Limb, Charles J

2018-03-01

Develop and validate an automated smartphone word recognition test. Cross-sectional case-control diagnostic test comparison. An automated word recognition test was developed as an app for a smartphone with earphones. English-speaking adults with recent audiograms and various levels of hearing loss were recruited from an audiology clinic and were administered the smartphone word recognition test. Word recognition scores determined by the smartphone app and the gold standard speech audiometry test performed by an audiologist were compared. Test scores for 37 ears were analyzed. Word recognition scores determined by the smartphone app and audiologist testing were in agreement, with 86% of the data points within a clinically acceptable margin of error and a linear correlation value between test scores of 0.89. The WordRec automated smartphone app accurately determines word recognition scores. 3b. Laryngoscope, 128:707-712, 2018. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

Interaural attenuation for Sennheiser HDA 200 circumaural earphones.

PubMed

Brännström, K Jonas; Lantz, Johannes

2010-06-01

Interaural attenuation (IA) was evaluated for pure tones (frequency range 125 to 16000 Hz) using Sennheiser HDA 200 circumaural earphones and Telephonics TDH-39P earphones in nine unilaterally deaf subjects. Audiometry was conducted in 1-dB steps using the manual ascending technique in accordance with ISO 8253-1. For all subjects and for all tested frequencies, the lowest IA value for HDA 200 was 42 dB. The present IA values for TDH-39P earphones closely resemble previously reported data. The findings show that the HDA 200 earphones provide more IA than the TDH-39P, especially at lower frequencies (

Hearing status in patients with rheumatoid arthritis.

PubMed

Ahmadzadeh, A; Daraei, M; Jalessi, M; Peyvandi, A A; Amini, E; Ranjbar, L A; Daneshi, A

2017-10-01

Rheumatoid arthritis is thought to induce conductive hearing loss and/or sensorineural hearing loss. This study evaluated the function of the middle ear and cochlea, and the related factors. Pure tone audiometry, speech reception thresholds, speech discrimination scores, tympanometry, acoustic reflexes, and distortion product otoacoustic emissions were assessed in rheumatoid arthritis patients and healthy volunteers. Pure tone audiometry results revealed a higher bone conduction threshold in the rheumatoid arthritis group, but there was no significant difference when evaluated according to the sensorineural hearing loss definition. Distortion product otoacoustic emissions related prevalence of conductive or mixed hearing loss, tympanometry values, acoustic reflexes, and speech discrimination scores were not significantly different between the two groups. Sensorineural hearing loss was significantly more prevalent in patients who used azathioprine, cyclosporine and etanercept. Higher bone conduction thresholds in some frequencies were detected in rheumatoid arthritis patients that were not clinically significant. Sensorineural hearing loss is significantly more prevalent in refractory rheumatoid arthritis patients.

[Correlation of pure tone thresholds and hearing loss for numbers. Comparison of three calculation variations for plausibility checking in expertise].

PubMed

Braun, T; Dochtermann, S; Krause, E; Schmidt, M; Schorn, K; Hempel, J M

2011-09-01

The present study analyzes the best combination of frequencies for the calculation of mean hearing loss in pure tone threshold audiometry for correlation with hearing loss for numbers in speech audiometry, since the literature describes different calculation variations for plausibility checking in expertise. Three calculation variations, A (250, 500 and 1000 Hz), B (500 and 1000 Hz) and C (500, 1000 and 2000 Hz), were compared. Audiograms in 80 patients with normal hearing, 106 patients with hearing loss and 135 expertise patients were analyzed in a retrospective manner. Differences between mean pure tone audiometry thresholds and hearing loss for numbers were calculated and statistically compared separately for the right and the left ear in the three patient collectives. We found the calculation variation A to be the best combination of frequencies, since it yielded the smallest standard deviations while being statistically different to calculation variations B and C. The 1- and 2.58-fold standard deviation (representing 68.3% and 99.0% of all values) was ±4.6 and ±11.8 dB for calculation variation A in patients with hearing loss, respectively. For plausibility checking in expertise, the mean threshold from the frequencies 250, 500 and 1000 Hz should be compared to the hearing loss for numbers. The common recommendation reported by the literature to doubt plausibility when the difference of these values exceeds ±5 dB is too strict as shown by this study.

Auditory brainstem response as a diagnostic tool for patients suffering from schizophrenia, attention deficit hyperactivity disorder, and bipolar disorder: protocol.

PubMed

Wahlström, Viktor; Åhlander, Fredrik; Wynn, Rolf

2015-02-12

Psychiatric disorders, such as schizophrenia, attention deficit hyperactivity disorder (ADHD), and bipolar disorder, may sometimes be difficult to diagnose. There is a great need for a valid and reliable diagnostic tool to aid clinicians in arriving at the diagnoses in a timely and accurate manner. Prior studies have suggested that patients suffering from schizophrenia and ADHD may process certain sound stimuli in the brainstem in an unusual manner. When these patient groups have been examined with the electrophysiological method of brainstem audiometry, some studies have found illness-specific aberrations. Such aberrations may also exist for patients suffering from bipolar disorder. In this study, we will examine whether the method of brainstem audiometry can be used as a diagnostic tool for patients suffering from schizophrenia, ADHD, and bipolar disorder. The method includes three steps: (1) auditory stimulation with specific sound stimuli, (2) simultaneous measurement of brainstem activity, and (3) automated interpretation of the resulting brain stem audiograms with data-based signal analysis. We will compare three groups of 12 individuals with confirmed diagnoses of schizophrenia, ADHD, or bipolar disorder with 12 healthy subjects under blinded conditions for a total of 48 participants. The extent to which the method can be used to reach the correct diagnosis will be investigated. The project is now in a recruiting phase. When all patients and controls have been recruited and the measurements have been performed, the data will be analyzed according to a previously arranged algorithm. We expect the recruiting phase and measurements to be completed in early 2015, the analyses to be performed in mid-2015, and the results of the study to be published in early 2016. If the results support previous findings, this will lend strength to the idea that brainstem audiometry can offer objective diagnostic support for patients suffering from schizophrenia, ADHD, and bipolar disorder. A positive result from the study could imply that brainstem audiometry could become an important supportive tool for clinicians in their efforts to diagnose patients with these disorders in a timely and accurate manner. ClinicalTrials.gov NCT01629355; https://clinicaltrials.gov/ct2/show/NCT01629355 (Archived by WebCite at http://www.webcitation.org/6VBfTwx5H).

Preventing collapse of external auditory meatus during audiometry.

PubMed

Pearlman, R C

1975-11-01

Occlusion of the external auditory meatus resulting from earphone pressure can produce a pseudoconductive hearing loss. I describe a method for detecting ear canal collapse by otoscopy and I suggest a method of correcting the problem with a polyethylene tube prosthesis.

Observations on Hearing Levels of Preschool Cleft-Palate Children

ERIC Educational Resources Information Center

Harrison, Robert J.; Philips, Betty Jane

1971-01-01

Pure-tone audiometry performed monthly on nine preschool cleft palate children showed the incidence of hearing loss ranging from 25 to 71 percent from month to month, with all children experiencing a significant hearing loss at some time. (Author/KW)

Audiological Evaluation for Exaggerated Hearing Level.

ERIC Educational Resources Information Center

Engelberg, Marvin W.

Described are clinical techniques and procedures useful in evaluations for exaggerated hearing levels. Discussed are considerations of the audiologist, his equipment, and erroneous findings; patient cooperation, anticipated hearing handicaps, detection of exaggeration, and order of test presentation; voluntary aid conduction audiometry,…

49 CFR 227.5 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... this part. Exchange rate means the change in sound level, in decibels, which would require halving or... audiometric testing, showing the thresholds of hearing sensitivity measured at discrete frequencies, as well... discrete frequencies. Audiometry can also be referred to as audiometric testing. Baseline audiogram means...

Right Ear Advantage of Speech Audiometry in Single-sided Deafness.

PubMed

Wettstein, Vincent G; Probst, Rudolf

2018-04-01

Postlingual single-sided deafness (SSD) is defined as normal hearing in one ear and severely impaired hearing in the other ear. A right ear advantage and dominance of the left hemisphere are well established findings in individuals with normal hearing and speech processing. Therefore, it seems plausible that a right ear advantage would exist in patients with SSD. The audiometric database was searched to identify patients with SSD. Results from the German monosyllabic Freiburg word test and four-syllabic number test in quiet were evaluated. Results of right-sided SSD were compared with left-sided SSD. Statistical calculations were done with the Mann-Whitney U test. Four hundred and six patients with SSD were identified, 182 with right-sided and 224 with left-sided SSD. The two groups had similar pure-tone thresholds without significant differences. All test parameters of speech audiometry had better values for right ears (SSD left) when compared with left ears (SSD right). Statistically significant results (p < 0.05) were found for a weighted score (social index, 98.2 ± 4% right and 97.5 ± 4.7% left, p < 0.026), for word understanding at 60 dB SPL (95.2 ± 8.7% right and 93.9 ± 9.1% left, p < 0.035), and for the level at which 100% understanding was reached (61.5 ± 10.1 dB SPL right and 63.8 ± 11.1 dB SPL left, p < 0.022) on a performance-level function. A right ear advantage of speech audiometry was found in patients with SSD in this retrospective study of audiometric test results.

Auditory agnosia as a clinical symptom of childhood adrenoleukodystrophy.

PubMed

Furushima, Wakana; Kaga, Makiko; Nakamura, Masako; Gunji, Atsuko; Inagaki, Masumi

2015-08-01

To investigate detailed auditory features in patients with auditory impairment as the first clinical symptoms of childhood adrenoleukodystrophy (CSALD). Three patients who had hearing difficulty as the first clinical signs and/or symptoms of ALD. Precise examination of the clinical characteristics of hearing and auditory function was performed, including assessments of pure tone audiometry, verbal sound discrimination, otoacoustic emission (OAE), and auditory brainstem response (ABR), as well as an environmental sound discrimination test, a sound lateralization test, and a dichotic listening test (DLT). The auditory pathway was evaluated by MRI in each patient. Poor response to calling was detected in all patients. Two patients were not aware of their hearing difficulty, and had been diagnosed with normal hearing by otolaryngologists at first. Pure-tone audiometry disclosed normal hearing in all patients. All patients showed a normal wave V ABR threshold. Three patients showed obvious difficulty in discriminating verbal sounds, environmental sounds, and sound lateralization and strong left-ear suppression in a dichotic listening test. However, once they discriminated verbal sounds, they correctly understood the meaning. Two patients showed elongation of the I-V and III-V interwave intervals in ABR, but one showed no abnormality. MRIs of these three patients revealed signal changes in auditory radiation including in other subcortical areas. The hearing features of these subjects were diagnosed as auditory agnosia and not aphasia. It should be emphasized that when patients are suspected to have hearing impairment but have no abnormalities in pure tone audiometry and/or ABR, this should not be diagnosed immediately as psychogenic response or pathomimesis, but auditory agnosia must also be considered. Copyright © 2014 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

[Subclinical sensorineural hearing loss in female patients with rheumatoid arthritis].

PubMed

Treviño-González, José Luis; Villegas-González, Mario Jesús; Muñoz-Maldonado, Gerardo Enrique; Montero-Cantu, Carlos Alberto; Nava-Zavala, Arnulfo Hernán; Garza-Elizondo, Mario Alberto

2015-01-01

The rheumatoid arthritis is a clinical entity capable to cause hearing impairment that can be diagnosed promptly with high frequencies audiometry. To detect subclinical sensorineural hearing loss in patients with rheumatoid arthritis. Cross-sectional study on patients with rheumatoid arthritis performing high frequency audiometry 125Hz to 16,000Hz and tympanometry. The results were correlated with markers of disease activity and response to therapy. High frequency audiometry was performed in 117 female patients aged from 19 to 65 years. Sensorineural hearing loss was observed at a sensitivity of pure tones from 125 to 8,000 Hz in 43.59%, a tone threshold of 10,000 to 16,000Hz in 94.02% patients in the right ear and in 95.73% in the left ear. Hearing was normal in 8 (6.84%) patients. Hearing loss was observed in 109 (93.16%), and was asymmetric in 36 (30.77%), symmetric in 73 (62.37%), bilateral in 107 (91.45%), unilateral in 2 (1.71%), and no conduction and/or mixed hearing loss was encountered. Eight (6.83%) patients presented vertigo, 24 (20.51%) tinnitus. Tympanogram type A presented in 88.90% in the right ear and 91.46% in the left ear, with 5.98 to 10.25% type As. Stapedius reflex was present in 75.3 to 85.2%. Speech discrimination in the left ear was significantly different (p = 0.02)in the group older than 50 years. No association was found regarding markers of disease activity, but there was an association with the onset of rheumatoid arthritis disease. Patients with rheumatoid arthritis had a high prevalence of sensorineural hearing loss for high and very high frequencies. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

Characterization of Hearing Thresholds from 500 to 16,000 Hz in Dentists: A Comparative Study

PubMed Central

Gonçalves, Claudia Giglio de Oliveira; Santos, Luciana; Lobato, Diolen; Ribas, Angela; Lacerda, Adriana Bender Moreira; Marques, Jair

2014-01-01

Introduction High-level noise exposure in dentists' workplaces may cause damages to the auditory systems. High-frequency audiometry is an important tool in the investigation in the early diagnosis of hearing loss. Objectives To analyze the auditory thresholds at frequencies from 500 to 16,000 Hz of dentists in the city of Curitiba. Methods This historic cohort study retrospectively tested hearing thresholds from 500 to 16,000 Hz with a group of dentists from Curitiba, in the state of Paraná, Brazil. Eighty subjects participated in the study, separated into a dentist group and a control group, with the same age range and gender across groups but with no history of occupational exposure to high levels of sound pressure in the control group. Subjects were tested with conventional audiometry and high-frequency audiometry and answered a questionnaire about exposure to noise. Results Results showed that 81% of dentists did not receive any information regarding noise at university; 6 (15%) dentists had sensorineural hearing impairment; significant differences were observed between the groups only at frequencies of 500 Hz and 1,000, 6,000 and 8,000 Hz in the right ear. There was no significant difference between the groups after analysis of mean hearing thresholds of high frequencies with the average hearing thresholds in conventional frequencies; subjects who had been working as dentists for longer than 10 years had worse tonal hearing thresholds at high frequencies. Conclusions In this study, we observed that dentists are at risk for the development of sensorineural hearing loss especially after 10 years of service. PMID:25992172

A study of the high-frequency hearing thresholds of dentistry professionals

PubMed Central

Lopes, Andréa Cintra; de Melo, Ana Dolores Passarelli; Santos, Cibele Carmelo

2012-01-01

Summary Introduction: In the dentistry practice, dentists are exposed to harmful effects caused by several factors, such as the noise produced by their work instruments. In 1959, the American Dental Association recommended periodical hearing assessments and the use of ear protectors. Aquiring more information regarding dentists', dental nurses', and prosthodontists' hearing abilities is necessary to propose prevention measures and early treatment strategies. Objective: To investigate the auditory thresholds of dentists, dental nurses, and prosthodontists. Method: In this clinical and experimental study, 44 dentists (Group I; GI), 36 dental nurses (Group II; GII), and 28 prosthodontists (Group III; GIII) were included, , with a total of 108 professionals. The procedures that were performed included a specific interview, ear canal inspection, conventional and high-frequency threshold audiometry, a speech reception threshold test, and an acoustic impedance test. Results: In the 3 groups that were tested, the comparison between the mean hearing thresholds provided evidence of worsened hearing ability relative to the increase in frequency. For the tritonal mean at 500 to 2,000 Hz and 3,000 to 6,000 Hz, GIII presented the worst thresholds. For the mean of the high frequencies (9,000 and 16,000 Hz), GII presented the worst thresholds. Conclusion: The conventional hearing threshold evaluation did not demonstrate alterations in the 3 groups that were tested; however, the complementary tests such as high-frequency audiometry provided greater efficacy in the early detection of hearing problems, since this population's hearing loss impaired hearing ability at frequencies that are not tested by the conventional tests. Therefore, we emphasize the need of utilizing high-frequency threshold audiometry in the hearing assessment routine in combination with other audiological tests. PMID:25991940

Validated Smartphone-Based Apps for Ear and Hearing Assessments: A Review

PubMed Central

Pallawela, Danuk

2016-01-01

Background An estimated 360 million people have a disabling hearing impairment globally, the vast majority of whom live in low- and middle-income countries (LMICs). Early identification through screening is important to negate the negative effects of untreated hearing impairment. Substantial barriers exist in screening for hearing impairment in LMICs, such as the requirement for skilled hearing health care professionals and prohibitively expensive specialist equipment to measure hearing. These challenges may be overcome through utilization of increasingly available smartphone app technologies for ear and hearing assessments that are easy to use by unskilled professionals. Objective Our objective was to identify and compare available apps for ear and hearing assessments and consider the incorporation of such apps into hearing screening programs Methods In July 2015, the commercial app stores Google Play and Apple App Store were searched to identify apps for ear and hearing assessments. Thereafter, six databases (EMBASE, MEDLINE, Global Health, Web of Science, CINAHL, and mHealth Evidence) were searched to assess which of the apps identified in the commercial review had been validated against gold standard measures. A comparison was made between validated apps. Results App store search queries returned 30 apps that could be used for ear and hearing assessments, the majority of which are for performing audiometry. The literature search identified 11 eligible validity studies that examined 6 different apps. uHear, an app for self-administered audiometry, was validated in the highest number of peer reviewed studies against gold standard pure tone audiometry (n=5). However, the accuracy of uHear varied across these studies. Conclusions Very few of the available apps have been validated in peer-reviewed studies. Of the apps that have been validated, further independent research is required to fully understand their accuracy at detecting ear and hearing conditions. PMID:28582261

Amplitude changes in otoacoustic emissions after exposure to industrial noise.

PubMed

Baradarnfar, Mohammad Hossein; Karamifar, Kayvan; Mehrparvar, Amir Houshang; Mollasadeghi, Abolfazl; Gharavi, Marjan; Karimi, Ghasem; Vahidy, Mohammad Reza; Baradarnfar, Amin; Mostaghaci, Mehrdad

2012-01-01

Noise-induced hearing loss (NIHL) is a frequent problem in industrial settings, especially where a high noise level is present. It is permanent, and irreversible, but preventable. Routine audiometry (an objective and time consuming) test is used for NIHL screening. Otoacoustic emissions (OAEs) are recently proposed as a more sensitive test for early diagnosis of NIHL. In this study, we aimed to compare the results of pure tone audiometry (PTA) with OAE in the diagnosis of NIHL. In a cross-sectional study on 120 workers (in three groups: Not exposed to noise, exposed to noise without NIHL and exposed to noise with NIHL), we compared the results of PTA and OAE. OAE can detect some changes in the function of hearing system in subjects exposed to noise, and these changes are apparently prior to hearing loss, which is diagnosed by PTA. OAE is a more sensitive method for the early diagnosis of cochlear damage than PTA, and can be performed in industrial settings for NIHL screening.

The dissociation of video head impulse test (vHIT) and bithermal caloric test results provide topological localization of vestibular system impairment in patients with "definite" Ménière's disease.

PubMed

McCaslin, Devin L; Rivas, Alejandro; Jacobson, Gary P; Bennett, Marc L

2015-03-01

We report 3 patients with Ménière's disease and describe how the combination of audiometry, video head impulse testing, and caloric results may prove helpful in the diagnosis of Ménière's disease. Three patients with "definite" Ménière's disease were evaluated in a tertiary care medical center. Each patient underwent videonystagmography, horizontal canal video head impulse testing, and audiometry. All 3 patients demonstrated moderate, flat, sensorineural hearing losses; significant caloric asymmetries; and bilaterally normal video head impulse testing. This pattern of findings suggests differential preservation of high-frequency function (video head impulse testing) with impairment of low-frequency function (unilaterally abnormal caloric test results) in these patients. Ipsilesional abnormal caloric testing in the presence of normal video head impulse testing is a pattern of findings observed in a cohort of patients who have "definite" Ménière's disease.

[The Freiburg speech intelligibility test : A pillar of speech audiometry in German-speaking countries].

PubMed

Hoth, S

2016-08-01

The Freiburg speech intelligibility test according to DIN 45621 was introduced around 60 years ago. For decades, and still today, the Freiburg test has been a standard whose relevance extends far beyond pure audiometry. It is used primarily to determine the speech perception threshold (based on two-digit numbers) and the ability to discriminate speech at suprathreshold presentation levels (based on monosyllabic nouns). Moreover, it is a measure of the degree of disability, the requirement for and success of technical hearing aids (auxiliaries directives), and the compensation for disability and handicap (Königstein recommendation). In differential audiological diagnostics, the Freiburg test contributes to the distinction between low- and high-frequency hearing loss, as well as to identification of conductive, sensory, neural, and central disorders. Currently, the phonemic and perceptual balance of the monosyllabic test lists is subject to critical discussions. Obvious deficiencies exist for testing speech recognition in noise. In this respect, alternatives such as sentence or rhyme tests in closed-answer inventories are discussed.

[Value of the study of cochlear microphonic recordings in deep and severe deafness].

PubMed

Moatti, L; Busquet, D; Cotin, G

1983-01-01

A study was conducted to assess the contribution of cochlear microphonic potential recordings during electrophysiologic audiometry examinations. Amplitude of microphonic recordings were correlated with the degree of deafness, its etiology, and the prosthetic prognosis in 38 electrocochleographic examinations. Preliminary results are analyzed.

Speech Recognition Thresholds for Multilingual Populations.

ERIC Educational Resources Information Center

Ramkissoon, Ishara

2001-01-01

This article traces the development of speech audiometry in the United States and reports on the current status, focusing on the needs of a multilingual population in terms of measuring speech recognition threshold (SRT). It also discusses sociolinguistic considerations, alternative SRT stimuli for second language learners, and research on using…

Diagnosing Dyslexia: The Screening of Auditory Laterality.

ERIC Educational Resources Information Center

Johansen, Kjeld

A study investigated whether a correlation exists between the degree and nature of left-brain laterality and specific reading and spelling difficulties. Subjects, 50 normal readers and 50 reading disabled persons native to the island of Bornholm, had their auditory laterality screened using pure-tone audiometry and dichotic listening. Results…

Relations between Neurological Aberrations and Psychological Dysfunctions in Children with Serious Language Problems.

ERIC Educational Resources Information Center

Bo, Ola O.; And Others

1992-01-01

Relationships between neuropsychological aberrations and psychological dysfunction were studied for 20 Swedish children (average age around 10 years at first testing) with serious language problems through (1) electroencephalography; (2) brain stem response audiometry; (3) magnetic resonance imaging; and (4) brain electric activity mapping by…

A Classical Conditioning Procedure for the Hearing Assessment of Multiply Handicapped Persons.

ERIC Educational Resources Information Center

Lancioni, Giulio E.; And Others

1989-01-01

Hearing assessments of multiply handicapped children/adolescents were conducted using classical conditioning (with an air puff as unconditioned stimulus) and operant conditioning (with a modified visual reinforcement audiometry procedure or edible reinforcement). Findings indicate that classical conditioning was successful with 21 of the 23…

Reiter's syndrome and hearing loss: a possible association?

PubMed

Monsanto, Rafael C; Neto, Arlindo C L; Lorenzetti, Fábio T M

2014-12-01

Patient complained of hearing loss and tinnitus after the onset of Reiter's syndrome. Audiometry confirmed the hearing loss on the left ear; blood work showed increased erythrocyte sedimentation rate and C3 fraction of the complement. Genotyping for HLA-B27 was positive. Treatment with prednisolone did not improve the hearing levels.

Is There a Silent Hearing Loss among Children in Jordan?

ERIC Educational Resources Information Center

Alaqrabawi, Wala' S.; Alshawabka, Amneh Z.; Al-Addasi, Zainab M.

2016-01-01

This study measured the prevalence of hearing loss among school children in Jordan. A random sample of 1649 children (990 males and 659 females) was collected from randomly chosen 40 schools in Amman. Screening was conducted between November 2010 and October 2014. Otoscopic examination, tympanometry, and audiometry were used for screening. Based…

THE DEAF. PRENTICE-HALL FOUNDATIONS OF SPEECH PATHOLOGY SERIES.

ERIC Educational Resources Information Center

DI CARLO, LOUIS M.

DESIGNED FOR STUDENTS OF SPEECH PATHOLOGY AND AUDIOLOGY AND PRACTICING CLINICIANS, THIS BOOK PRESENTS AN HISTORICAL OVERVIEW OF ATTEMPTS TO TEACH THE DEAF FROM BEFORE THE 15TH CENTURY THROUGH THE 20TH CENTURY. A DISCUSSION OF DIAGNOSTIC PROCEDURES FOR AUDITORY DISORDERS IN CHILDREN INCLUDED INFORMAL TESTING, PLAY AUDIOMETRY, SPEECH TESTS,…

Q-Type Factor Analysis of Healthy Aged Men.

ERIC Educational Resources Information Center

Kleban, Morton H.

Q-type factor analysis was used to re-analyze baseline data collected in 1957, on 47 men aged 65-91. Q-type analysis is the use of factor methods to study persons rather than tests. Although 550 variables were originally studied involving psychiatry, medicine, cerebral metabolism and chemistry, personality, audiometry, dichotic and diotic memory,…

Diagnosis of Hearing Loss.

ERIC Educational Resources Information Center

World Federation of the Deaf, Rome (Italy).

Seven conference papers from the U.S.S.R., India, Poland, Czechoslovakia, and Yugoslavia consider the diagnosis of hearing loss. They are "Examination of Hearing of Children, Aged from 2 to 5, by Means of Playing Audiometry" by A. P. Kossacheva, "A Study of the Etiology and Pattern of Deafness in a School for the Deaf in Madras,…

Auditory effects of aircraft noise on people living near an airport.

PubMed

Chen, T J; Chen, S S; Hsieh, P Y; Chiang, H C

1997-01-01

Two groups of randomly chosen individuals who lived in two communities located different distances from the airport were studied. We monitored audiometry and brainstem auditory-evoked potentials to evaluate cochlear and retrocochlear functions in the individuals studied. The results of audiometry measurements indicated that hearing ability was reduced significantly in individuals who lived near the airport and who were exposed frequently to aircraft noise. Values of pure-tone average, high pure-tone average, and threshold at 4 kHz were all higher in individuals who lived near the airport, compared with those who lived farther away. With respect to brainstem auditory-evoked potentials, latencies between the two groups were not consistently different; however, the abnormality rate of such potentials was significantly higher in volunteers who lived near the airport, compared with less-exposed counterparts. In addition, a positive correlation was found between brainstem auditory-evoked potential latency and behavioral hearing threshold of high-frequency tone in exposed volunteers. We not only confirmed that damage to the peripheral cochlear organs occurred in individuals exposed frequently to aircraft noise, but we demonstrated involvement of the central auditory pathway.

The effect of mobile phone to audiologic system.

PubMed

Kerekhanjanarong, Virachai; Supiyaphun, Pakpoom; Naratricoon, Jantra; Laungpitackchumpon, Prinya

2005-09-01

Mobile phones have come into widespread use. There are a lot of possible adverse effect to health. Use of mobile phone generate potentially harmful radiofrequency electromagnetic field (EMF) particularly for the hearing aspect. 98 subjects underwent hearing evaluations at Department of Otolaryngology, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University. 31 males and 67females, mean age was 30.48 +/- 9.51 years old, all subjects were investigated the hearing level by audiometry, tympanometry, otoacoustic emission (OAE) and auditory brain stem evoked response (ABR). The average of using time were 32.54 +/- 27.64 months, 57 subjects usually used the right side and 41 the left side. Average time of use per day was 26.31 +/- 30.91 minutes (range from 3 to 180 mins). When the authors compared the audiogram, both pure tone and speech audiometry, between the dominant and nondominant side, it indicated that there is no significant different. When the authors focused on the 8 subjects that used the mobile phone more than 60 mins per day. It indicated that the hearing threshold of the dominant ears was worse than the nondominant ears.

Transiently-Evoked Otoacoustic Emissions (teoaes) in Monitoring Adult Cis-Platin Patients.

NASA Astrophysics Data System (ADS)

Ribera, John Everett

1995-01-01

There is evidence to suggest that otoacoustic emissions (OAEs) reflect the integrity of cochlear outer hair cell (OHC) function. Cis-platin (CDDP) is a potent ototoxic chemotherapeutic agent that tends to destroy or disable OHCs. Therefore, this study was designed to answer the following questions: (1) Can TEOAEs be used in monitoring for ototoxicity in adult VA oncology patients receiving CDDP treatment? (2) If so, how sensitive are TEOAEs in detecting significant changes when compared to Audiometry in a VA population? and (3) Which of several TEOAE measures is the most sensitive to changes in hearing due to CDDP ototoxicity in a VA population?. In Experiment I, VA Medical Center patients were recruited (control group) and tested using a conventional audiometer and the ILO88 Otoacoustic Analyzer on three separate days. Data from this experiment were used to develop change criteria in each of four TEOAE measures (Reproducibility, Compare, 1 kHz Band Analysis, and OAE Response) for Experiment II. Experiment II was of similar design with the exception that the subjects (experimental group) were patients enrolled from the oncology ward and were administered CDDP after the first and second test sessions. Data from both groups and all test measures revealed (1) that there was no ear effect in any of the test conditions, (2) there was a group (drug) effect, and (3) there was a frequency effect at 2 kHz. Audiometry detected changes in 56% of the experimental subjects, while the number of changes varied among the TEOAE measures studied. Compare agreed with Audiometry more often and performed better than any other TEOAE measure in detecting change. Based on these findings, incorporation of Compare into an audiometric test battery to monitor for ototoxicity in the VA population is feasible. There is evidence to suggest that as measurement techniques are refined TEOAE analysis will become a valid test for monitoring of adult CDDP patients.

A Multinomial Model for Identifying Significant Pure-Tone Threshold Shifts

ERIC Educational Resources Information Center

Schlauch, Robert S.; Carney, Edward

2007-01-01

Purpose: Significant threshold differences on retest for pure-tone audiometry are often evaluated by application of ad hoc rules, such as a shift in a pure-tone average or in 2 adjacent frequencies that exceeds a predefined amount. Rules that are so derived do not consider the probability of observing a particular audiogram. Methods: A general…

Reiter's syndrome and hearing loss: a possible association?

PubMed Central

Monsanto, Rafael C; Neto, Arlindo C L; Lorenzetti, Fábio T M

2014-01-01

Key Clinical Message Patient complained of hearing loss and tinnitus after the onset of Reiter's syndrome. Audiometry confirmed the hearing loss on the left ear; blood work showed increased erythrocyte sedimentation rate and C3 fraction of the complement. Genotyping for HLA-B27 was positive. Treatment with prednisolone did not improve the hearing levels. PMID:25548635

Pediatric Audiometry: The Relative Success of Toy and Video Reinforcers.

ERIC Educational Resources Information Center

Doggett, Sheryl; Gans, Donald P.; Stein, Ramona

2000-01-01

An operate conditional technique was used to determine the relative success of toys and video shows as reinforcers for testing the hearing of 28 younger (30-month-old) and 28 older (45-month old) children. Animated toys and video shows for children were equally effective as reinforcers for both age groups. (Contains references.) (Author/CR)

Evaluation of Monitoring Audiometry in the United States Air Force Hearing Conservation Program

DTIC Science & Technology

1993-01-01

the True Positive on the y-axis (MacMillian and Creelman , 1991). Issues to consider include the cost of the 40 hour noise-free audiogram vs. the benefit... Creelman , C.D. (1991). Detection theory: a user’s guide. New York: Capbridge University Press. Melnick, W. (1979). Hearing loss from noise exposure. In

[Erespal effectiveness in exudative otitis media].

PubMed

Levina, Iu V; Luchikhin, L A; Krasiuk, A A

2003-01-01

Standard conservative treatment of exudative otitis media (EOM) was performed in 82 patients, but 44 of them received adjuvant fenspiride (erespal) in a dose 80 mg per os 3 times a day for 10 days. Dynamic pure tone audiometry, tympanometry and subjective response demonstrated higher treatment efficiency in the erespal group. Therefore, it is recommended to include erespal in combined conventional therapy of EOM.

Risks to hearing from a rock concert.

PubMed Central

Yassi, A.; Pollock, N.; Tran, N.; Cheang, M.

1993-01-01

We measured noise exposure and temporary threshold shift (TTS) from a rock concert for 22 volunteers, using dosimetry, questionnaires, and audiometry. Most (81%) participants showed TTS of 10 dB or more 5 to 25 minutes after exposure; of these, 76% showed continued TTS at 40 to 60 minutes. Family physicians should counsel patients about the risks of recreational noise. PMID:8499785

Influence of compact disk recording protocols on reliability and comparability of speech audiometry outcomes: acoustic analysis.

PubMed

Di Berardino, F; Tognola, G; Paglialonga, A; Alpini, D; Grandori, F; Cesarani, A

2010-08-01

To assess whether different compact disk recording protocols, used to prepare speech test material, affect the reliability and comparability of speech audiometry testing. We conducted acoustic analysis of compact disks used in clinical practice, to determine whether speech material had been recorded using similar procedures. To assess the impact of different recording procedures on speech test outcomes, normal hearing subjects were tested using differently prepared compact disks, and their psychometric curves compared. Acoustic analysis revealed that speech material had been recorded using different protocols. The major difference was the gain between the levels at which the speech material and the calibration signal had been recorded. Although correct calibration of the audiometer was performed for each compact disk before testing, speech recognition thresholds and maximum intelligibility thresholds differed significantly between compact disks (p < 0.05), and were influenced by the gain between the recording level of the speech material and the calibration signal. To ensure the reliability and comparability of speech test outcomes obtained using different compact disks, it is recommended to check for possible differences in the recording gains used to prepare the compact disks, and then to compensate for any differences before testing.

Ototoxicity (cochleotoxicity) classifications: A review.

PubMed

Crundwell, Gemma; Gomersall, Phil; Baguley, David M

2016-01-01

Drug-mediated ototoxicity, specifically cochleotoxicity, is a concern for patients receiving medications for the treatment of serious illness. A number of classification schemes exist, most of which are based on pure-tone audiometry, in order to assist non-audiological/non-otological specialists in the identification and monitoring of iatrogenic hearing loss. This review identifies the primary classification systems used in cochleototoxicity monitoring. By bringing together classifications published in discipline-specific literature, the paper aims to increase awareness of their relative strengths and limitations in the assessment and monitoring of ototoxic hearing loss and to indicate how future classification systems may improve upon the status-quo. Literature review. PubMed identified 4878 articles containing the search term ototox*. A systematic search identified 13 key classification systems. Cochleotoxicity classification systems can be divided into those which focus on hearing change from a baseline audiogram and those that focus on the functional impact of the hearing loss. Common weaknesses of these grading scales included a lack of sensitivity to small adverse changes in hearing thresholds, a lack of high-frequency audiometry (>8 kHz), and lack of indication of which changes are likely to be clinically significant for communication and quality of life.

Reduced auditory efferent activity in childhood selective mutism.

PubMed

Bar-Haim, Yair; Henkin, Yael; Ari-Even-Roth, Daphne; Tetin-Schneider, Simona; Hildesheimer, Minka; Muchnik, Chava

2004-06-01

Selective mutism is a psychiatric disorder of childhood characterized by consistent inability to speak in specific situations despite the ability to speak normally in others. The objective of this study was to test whether reduced auditory efferent activity, which may have direct bearings on speaking behavior, is compromised in selectively mute children. Participants were 16 children with selective mutism and 16 normally developing control children matched for age and gender. All children were tested for pure-tone audiometry, speech reception thresholds, speech discrimination, middle-ear acoustic reflex thresholds and decay function, transient evoked otoacoustic emission, suppression of transient evoked otoacoustic emission, and auditory brainstem response. Compared with control children, selectively mute children displayed specific deficiencies in auditory efferent activity. These aberrations in efferent activity appear along with normal pure-tone and speech audiometry and normal brainstem transmission as indicated by auditory brainstem response latencies. The diminished auditory efferent activity detected in some children with SM may result in desensitization of their auditory pathways by self-vocalization and in reduced control of masking and distortion of incoming speech sounds. These children may gradually learn to restrict vocalization to the minimal amount possible in contexts that require complex auditory processing.

The effect of head protection on the hearing of rugby players.

PubMed

Kieran, S M; Dunne, J; Hughes, J P; Fenton, J E

2008-09-01

Professional rugby players utilise various methods of head protection to prevent against the development of a pinna haematoma. This study tests the hypothesis that these measures, whilst preventing injury, decrease the wearers' hearing threshold and therefore their performance. Eight patients had free field audiometry performed in a soundproof room, with warble tones. All patients were young men (mean 24.75 years (range 22-34)). No participant had ear symptomatology or a past history of ear surgery. Three separate audiological assessments were performed on each patient: normal free field audiometry in a sound field room, following application of adhesive tape and whilst wearing a scrum cap. All measurements were performed by a single audiological scientist. A significant clinical drop in hearing threshold was defined as an increase of 10 dB. No patient demonstrated a significant drop in hearing threshold following the application of either tape or a scrum cap, nor was there a significant difference in the mean (SD) warble tone average: air 7.03 (5.47); tape 7.19 (6.40); scrum cap 6.56 (5.58). Theoretical concerns that "ear taping" and scrum caps affect hearing of rugby players are unfounded and should not discourage their use.

Validity and reliability of in-situ air conduction thresholds measured through hearing aids coupled to closed and open instant-fit tips.

PubMed

O'Brien, Anna; Keidser, Gitte; Yeend, Ingrid; Hartley, Lisa; Dillon, Harvey

2010-12-01

Audiometric measurements through a hearing aid ('in-situ') may facilitate provision of hearing services where these are limited. This study investigated the validity and reliability of in-situ air conduction hearing thresholds measured with closed and open domes relative to thresholds measured with insert earphones, and explored sources of variability in the measures. Twenty-four adults with sensorineural hearing impairment attended two sessions in which thresholds and real-ear-to-dial-difference (REDD) values were measured. Without correction, significantly higher low-frequency thresholds in dB HL were measured in-situ than with insert earphones. Differences were due predominantly to differences in ear canal SPL, as measured with the REDD, which were attributed to leaking low-frequency energy. Test-retest data yielded higher variability with the closed dome coupling due to inconsistent seals achieved with this tip. For all three conditions, inter-participant variability in the REDD values was greater than intra-participant variability. Overall, in-situ audiometry is as valid and reliable as conventional audiometry provided appropriate REDD corrections are made and ambient sound in the test environment is controlled.

[Comparative studies of the quality of the esophageal voice following laryngectomy: the insufflation test and reverse speech audiometry].

PubMed

Böhme, G; Clasen, B

1989-09-01

We carried out a transnasal insufflation test according to Blom and Singer on 27 laryngectomy patients as well as a speech communications test with the help of reverse speech audiometry, i.e. the post laryngectomy telephone test according to Zenner and Pfrang. The combined evaluation of both tests provided basic information on the quality of the esophagus voice and functionability of the speech organs. Both tests can be carried out quickly and easily and allow a differentiated statement to be made on the application possibilities of a esophagus voice, electronic speech aids and voice prothesis. Three groups could be identified from our results: 1. Insufflation test and reverse speech test provided conformable good or very good results. The esophagus voice was well understood. 2. Complete failure in the insufflation and telephone tests calls for further examinations to exclude any spasm, stricture, divertical and scarred membrane stenosis as well as tumor relapse in the region of the pharyngo-esophageal segments. 3. Organic causes must be looked for in the area of the nozzle as well as cranial nerve failure and social-determined causes in the case of normal insufflation and considerably reduced speech communication in the telephone test.

The use of transient evoked otoacoustic emissions as a hearing screen following grommet insertion.

PubMed

Dale, O T; McCann, L J; Thio, D; Wells, S C; Drysdale, A J

2011-07-01

This study aimed to evaluate the sensitivity of transient evoked otoacoustic emission testing as a screening tool for hearing loss in children, after grommet insertion. A prospective study was conducted of 48 children (91 ears) aged three to 16 years who had undergone grommet insertion for glue ear. At post-operative review, pure tone audiometry was performed followed by transient evoked otoacoustic emission testing. Outcomes for both tests, in each ear, were compared. The pure tone audiometry threshold was ≤ 20 dB in 85 ears (93.4 per cent), 25 dB in two ears (2.2 per cent) and ≥ 30 dB in four ears (4.4 per cent). Transient evoked otoacoustic emissions were detected in 69 ears (75.8 per cent). The sensitivity of transient evoked otoacoustic emission testing for detecting hearing loss was 100 per cent for ≥ 30 dB loss but only 66.7 per cent for ≥ 25 dB loss. Transient evoked otoacoustic emission testing offers a sensitive means of detecting hearing loss of ≥ 30 dB following grommet insertion in children. However, the use of such testing as a screening tool may miss some cases of mild hearing loss.

The Repeatable Battery for the Assessment of Neuropsychological Status for Hearing Impaired Individuals (RBANS-H) before and after Cochlear Implantation: A Protocol for a Prospective, Longitudinal Cohort Study.

PubMed

Claes, Annes J; Mertens, Griet; Gilles, Annick; Hofkens-Van den Brandt, Anouk; Fransen, Erik; Van Rompaey, Vincent; Van de Heyning, Paul

2016-01-01

Background: Currently, an independent relationship between hearing loss and cognitive decline in older adults is suggested by large prospective studies. In general, cochlear implants improve hearing and the quality of life in severely to profoundly hearing impaired older persons. However, little is known about the effects of cochlear implantation on the cognitive evolution in this population. Aim of the study: The primary goal of this prospective, longitudinal cohort study is to explore the cognitive profile of severely to profoundly postlingually hearing impaired subjects before and after cochlear implantation. In addition, the current study aims to investigate the relationship between the cognitive function, audiometric performances, quality of life, and self-reliance in these patients. Methods: Twenty-five patients aged 55 or older, scheduled for cochlear implantation, will be enrolled in the study. They will be examined prior to implantation, at 6 and 12 months after implantation and annually thereafter. The test battery consists of (1) a cognitive examination, using the Repeatable Battery for the Assessment of Neuropsychological Status adapted for Hearing impaired persons (RBANS-H), (2) an audiological examination, including unaided and aided pure tone audiometry, speech audiometry in quiet and speech audiometry in noise, (3) the administration of four questionnaires evaluating quality of life and subjective hearing benefit and (4) a semi-structured interview about the self-reliance of the participant. Discussion: Up until now only one study has been conducted on this topic, focusing on the short-term effects of cochlear implantation on cognition in older adults. The present study is the first study to apply a comprehensive neuropsychological assessment adapted for severely to profoundly hearing impaired subjects in order to investigate the cognitive capabilities before and after cochlear implantation. Trial registration: The present protocol is retrospectively registered at Clinical Trials (ClinicalTrials.gov) on June 9th, 2016. The first participant was enrolled on June 22nd, 2015. The protocol identifier is NCT02794350.

The Repeatable Battery for the Assessment of Neuropsychological Status for Hearing Impaired Individuals (RBANS-H) before and after Cochlear Implantation: A Protocol for a Prospective, Longitudinal Cohort Study

PubMed Central

Claes, Annes J.; Mertens, Griet; Gilles, Annick; Hofkens-Van den Brandt, Anouk; Fransen, Erik; Van Rompaey, Vincent; Van de Heyning, Paul

2016-01-01

Background: Currently, an independent relationship between hearing loss and cognitive decline in older adults is suggested by large prospective studies. In general, cochlear implants improve hearing and the quality of life in severely to profoundly hearing impaired older persons. However, little is known about the effects of cochlear implantation on the cognitive evolution in this population. Aim of the study: The primary goal of this prospective, longitudinal cohort study is to explore the cognitive profile of severely to profoundly postlingually hearing impaired subjects before and after cochlear implantation. In addition, the current study aims to investigate the relationship between the cognitive function, audiometric performances, quality of life, and self-reliance in these patients. Methods: Twenty-five patients aged 55 or older, scheduled for cochlear implantation, will be enrolled in the study. They will be examined prior to implantation, at 6 and 12 months after implantation and annually thereafter. The test battery consists of (1) a cognitive examination, using the Repeatable Battery for the Assessment of Neuropsychological Status adapted for Hearing impaired persons (RBANS-H), (2) an audiological examination, including unaided and aided pure tone audiometry, speech audiometry in quiet and speech audiometry in noise, (3) the administration of four questionnaires evaluating quality of life and subjective hearing benefit and (4) a semi-structured interview about the self-reliance of the participant. Discussion: Up until now only one study has been conducted on this topic, focusing on the short-term effects of cochlear implantation on cognition in older adults. The present study is the first study to apply a comprehensive neuropsychological assessment adapted for severely to profoundly hearing impaired subjects in order to investigate the cognitive capabilities before and after cochlear implantation. Trial registration: The present protocol is retrospectively registered at Clinical Trials (ClinicalTrials.gov) on June 9th, 2016. The first participant was enrolled on June 22nd, 2015. The protocol identifier is NCT02794350. PMID:27895549

Association Between Childhood Hearing Disorders and Tinnitus in Adulthood.

PubMed

Aarhus, Lisa; Engdahl, Bo; Tambs, Kristian; Kvestad, Ellen; Hoffman, Howard J

2015-11-01

The association between childhood hearing disorders and adult tinnitus has not been examined in longitudinal cohort studies. To determine the association between different types of childhood hearing loss and tinnitus in adulthood and evaluate whether tinnitus risk is mediated by adult hearing loss. Population-based cohort study of 32 430 adults (aged 20-56 years) who underwent pure-tone audiometry and completed a tinnitus questionnaire in the Nord-Trøndelag Hearing Loss Study, which was a part of the Nord-Trøndelag Health Study 2 (HUNT2). The study was conducted from January 1, 2014, to April 1, 2015. Data analysis was performed from April 1, 2014, to April 1, 2015. As children, the same individuals had undergone screening audiometry in a longitudinal primary school hearing investigation, including ear, nose, and throat examinations when indicated. Pure-tone audiometry, questionnaires, and ear, nose, and throat examinations. Self-reported tinnitus (yes or no) in adulthood measured by questionnaires. Adults who had hearing loss at the time of the school investigation (n = 3026) reported more tinnitus, measured as odds ratio (95% CI), than did adults with normal childhood hearing (n = 29 404) (1.4 [1.3-1.6]). Childhood hearing disorders associated with tinnitus in adulthood included sensorineural hearing loss, chronic suppurative otitis media, and hearing loss associated with a history of recurrent acute otitis media (2.4 [1.9-3.0], 2.4 [1.5-3.9], and 1.6 [1.3-2.0], respectively). These estimates were adjusted for age, sex, and noise exposure in adulthood. After further analyses that included adjustment for adult hearing threshold, none of these childhood hearing disorders remained positively associated with tinnitus. Childhood hearing disorders associated with tinnitus in adulthood include sensorineural hearing loss, chronic suppurative otitis media, and hearing loss associated with a history of recurrent acute otitis media. After adjustment for the adult hearing threshold, none of the childhood hearing disorders was positively associated with tinnitus. Hence, it appears that these significant associations are mediated or transmitted through adult hearing loss.

In-flight speech intelligibility evaluation of a service member with sensorineural hearing loss: case report.

PubMed

Casto, Kristen L; Cho, Timothy H

2012-09-01

This case report describes the in-flight speech intelligibility evaluation of an aircraft crewmember with pure tone audiometric thresholds that exceed the U.S. Army's flight standards. Results of in-flight speech intelligibility testing highlight the inability to predict functional auditory abilities from pure tone audiometry and underscore the importance of conducting validated functional hearing evaluations to determine aviation fitness-for-duty.

Measuring Sound-Processor Threshold Levels for Pediatric Cochlear Implant Recipients Using Conditioned Play Audiometry via Telepractice

PubMed Central

Goehring, Jenny L.

2017-01-01

Purpose This study evaluated the use of telepractice for measuring cochlear implant (CI) behavioral threshold (T) levels in children using conditioned play audiometry (CPA). The goals were to determine whether (a) T levels measured via telepractice were not significantly different from those obtained in person, (b) response probability differed between remote and in-person conditions, and (c) the remote visit required more time than the in-person condition. Method An ABBA design (A, in-person; B, remote) was split across 2 visits. Nineteen children aged 2.6–7.1 years participated. T levels were measured using CPA for 3 electrodes per session. A “hit” rate was calculated to determine whether the likelihood of obtaining responses differed between conditions. Test time was compared across conditions. A questionnaire was administered to assess parent/caregiver attitudes about telepractice. Results Results indicated no significant difference in T levels between conditions. Hit rates were not significantly different between in-person and remote conditions (98% vs. 97%, respectively). Test time was similar between conditions. Questionnaire results revealed that 100% of caregivers would use telepractice for CI appointments either some or all of the time. Conclusion Telepractice is a viable option for routine pediatric programming appointments for children using CPA to set behavioral thresholds. PMID:28257529

Sequential analysis as a tool for detection of amikacin ototoxicity in the treatment of multidrug-resistant tuberculosis.

PubMed

Vasconcelos, Karla Anacleto de; Frota, Silvana Maria Monte Coelho; Ruffino-Netto, Antonio; Kritski, Afrânio Lineu

2018-04-01

To investigate early detection of amikacin-induced ototoxicity in a population treated for multidrug-resistant tuberculosis (MDR-TB), by means of three different tests: pure-tone audiometry (PTA); high-frequency audiometry (HFA); and distortion-product otoacoustic emission (DPOAE) testing. This was a longitudinal prospective cohort study involving patients aged 18-69 years with a diagnosis of MDR-TB who had to receive amikacin for six months as part of their antituberculosis drug regimen for the first time. Hearing was assessed before treatment initiation and at two and six months after treatment initiation. Sequential statistics were used to analyze the results. We included 61 patients, but the final population consisted of 10 patients (7 men and 3 women) because of sequential analysis. Comparison of the test results obtained at two and six months after treatment initiation with those obtained at baseline revealed that HFA at two months and PTA at six months detected hearing threshold shifts consistent with ototoxicity. However, DPOAE testing did not detect such shifts. The statistical method used in this study makes it possible to conclude that, over the six-month period, amikacin-associated hearing threshold shifts were detected by HFA and PTA, and that DPOAE testing was not efficient in detecting such shifts.

Hearing impairment in children with congenital cytomegalovirus (CMV) infection based on distortion product otoacoustic emissions (DPOAE) and brain evoked response audiometry stimulus click (BERA Click) examinations

NASA Astrophysics Data System (ADS)

Airlangga, T. J.; Mangunatmadja, I.; Prihartono, J.; Zizlavsky, S.

2017-08-01

Congenital cytomegalovirus (congenital CMV) infection is a leading factor of nongenetic sensorineural hearing loss in children. Hearing loss caused by CMV infection does not have a pathognomonic configuration hence further research is needed. The development of knowledge on hearing loss caused by congenital CMV infection is progressing in many countries. Due to a lack of research in the context of Indonesia, this study assesses hearing impairment in children with congenital CMV infection in Indonesia, more specifically in the Cipto Mangunkusumo Hospital. Our objective was to profile hearing impairment in children 0-5 years of age with congenital CMV infection using Distortion Product Otoacoustic Emissions (DPOAE) and Brain Evoked Response Audiometry Stimulus Click (BERA Click) examinations. This cross-sectional study was conducted in the Cipto Mangunkusum Hospital from November, 2015 to May 2016 with 27 children 0-5 years of age with congenital CMV infection. Of individual ears studied, 58.0% exhibited sensorineural hearing loss. There was a significant relationship between developmental delay and incidence of sensorineural hearing loss. Subjects with a developmental delay were 6.57 times more likely (CI 95%; 1.88-22.87) to experience sensorineural hearing loss. Congenital CMV infection has an important role in causing sensorineural hearing loss in children.

[The criteria for the relationship between hearing impairment and professional occupation and the criteria for professional suitability in terms of hearing among the aeronautical personnel engaged in civilian aviation].

PubMed

Pankova, V B

This article describes the main clinical features associated with the development and manifestations of disturbed sound perception in the members of the aeronautical personnel engaged in the Russian civilian aviation. The main expert criteria for the relationship between the diseases of the organs of hearing (as exemplified by chronic sensorineural hearing impairment) and professional occupation have been developed based on the results of the clinical and diagnostic examination with the use of whispered and loud speech acumetry, tonal threshold audiometry, speech audiometry, impedancometry and evoked optoacoustic emission. Civilian aviation sectoral approaches to the evaluation of professional suitability in terms of hearing among the aeronautical personnel are considered in accordance with the criteria adopted by the International Civil Aviation Organization (ICAO), a specialized UN agency that sets the international standards for the civilian aviation and co-ordinates its development with the purpose of enhancing the safety and effectiveness of flights. The criteria are formulated for the solution of the expert problems arising from the relationship between the professional occupation and the diseases of the organs of hearing and for the evaluation of the professional suitability in terms of hearing among the aeronautical personnel engaged in civilian aviation.

Hearing thresholds, tinnitus, and headphone listening habits in nine-year-old children.

PubMed

Båsjö, Sara; Möller, Claes; Widén, Stephen; Jutengren, Göran; Kähäri, Kim

2016-10-01

Investigate hearing function and headphone listening habits in nine-year-old Swedish children. A cross-sectional study was conducted and included otoscopy, tympanometry, pure-tone audiometry, and spontaneous otoacoustic emissions (SOAE). A questionnaire was used to evaluate headphone listening habits, tinnitus, and hyperacusis. A total of 415 children aged nine years. The prevalence of a hearing threshold ≥20 dB HL at one or several frequencies was 53%, and the hearing thresholds at 6 and 8 kHz were higher than those at the low and mid frequencies. SOAEs were observed in 35% of the children, and the prevalence of tinnitus was 5.3%. No significant relationship between SOAE and tinnitus was found. Pure-tone audiometry showed poorer hearing thresholds in children with tinnitus and in children who regularly listened with headphones. The present study of hearing, listening habits, and tinnitus in nine-year old children is, to our knowledge, the largest study so far. The main findings were that hearing thresholds in the right ear were poorer in children who used headphones than in children not using them, which could be interpreted as headphone listening may have negative consequences to children's hearing. Children with tinnitus showed poorer hearing thresholds compared to children without tinnitus.

Hearing loss in children with otitis media with effusion: a systematic review.

PubMed

Cai, Ting; McPherson, Bradley

2017-02-01

Otitis media with effusion (OME) is the presence of non-purulent inflammation in the middle ear. Hearing impairment is frequently associated with OME. Pure tone audiometry and speech audiometry are two of the most primarily utilised auditory assessments and provide valuable behavioural and functional estimation on hearing loss. This paper was designed to review and analyse the effects of the presence of OME on children's listening abilities. A systematic and descriptive review. Twelve articles reporting frequency-specific pure tone thresholds and/or speech perception measures in children with OME were identified using PubMed, Ovid, Web of Science, ProQuest and Google Scholar search platforms. The hearing loss related to OME averages 18-35 dB HL. The air conduction configuration is roughly flat with a slight elevation at 2000 Hz and a nadir at 8000 Hz. Both speech-in-quiet and speech-in-noise perception have been found to be impaired. OME imposes a series of disadvantages on hearing sensitivity and speech perception in children. Further studies investigating the full range of frequency-specific pure tone thresholds, and that adopt standardised speech test materials are advocated to evaluate hearing related disabilities with greater comprehensiveness, comparability and enhanced consideration of their real life implications.

Modernising speech audiometry: using a smartphone application to test word recognition.

PubMed

van Zyl, Marianne; Swanepoel, De Wet; Myburgh, Hermanus C

2018-04-20

This study aimed to develop and assess a method to measure word recognition abilities using a smartphone application (App) connected to an audiometer. Word lists were recorded in South African English and Afrikaans. Analyses were conducted to determine the effect of hardware used for presentation (computer, compact-disc player, or smartphone) on the frequency content of recordings. An Android App was developed to enable presentation of recorded materials via a smartphone connected to the auxiliary input of the audiometer. Experiments were performed to test feasibility and validity of the developed App and recordings. Participants were 100 young adults (18-30 years) with pure tone thresholds ≤15 dB across the frequency spectrum (250-8000 Hz). Hardware used for presentation had no significant effect on the frequency content of recordings. Listening experiments indicated good inter-list reliability for recordings in both languages, with no significant differences between scores on different lists at each of the tested intensities. Performance-intensity functions had slopes of 4.05%/dB for English and 4.75%/dB for Afrikaans lists at the 50% point. The developed smartphone App constitutes a feasible and valid method for measuring word recognition scores, and can support standardisation and accessibility of recorded speech audiometry.

Pure-Tone Audiometry With Forward Pressure Level Calibration Leads to Clinically-Relevant Improvements in Test-Retest Reliability.

PubMed

Lapsley Miller, Judi A; Reed, Charlotte M; Robinson, Sarah R; Perez, Zachary D

2018-02-21

Clinical pure-tone audiometry is conducted using stimuli delivered through supra-aural headphones or insert earphones. The stimuli are calibrated in an acoustic (average ear) coupler. Deviations in individual-ear acoustics from the coupler acoustics affect test validity, and variations in probe insertion and headphone placement affect both test validity and test-retest reliability. Using an insert earphone designed for otoacoustic emission testing, which contains a microphone and loudspeaker, an individualized in-the-ear calibration can be calculated from the ear-canal sound pressure measured at the microphone. However, the total sound pressure level (SPL) measured at the microphone may be affected by standing-wave nulls at higher frequencies, producing errors in stimulus level of up to 20 dB. An alternative is to calibrate using the forward pressure level (FPL) component, which is derived from the total SPL using a wideband acoustic immittance measurement, and represents the pressure wave incident on the eardrum. The objective of this study is to establish test-retest reliability for FPL calibration of pure-tone audiometry stimuli, compared with in-the-ear and coupler sound pressure calibrations. The authors compared standard audiometry using a modern clinical audiometer with TDH-39P supra-aural headphones calibrated in a coupler to a prototype audiometer with an ER10C earphone calibrated three ways: (1) in-the-ear using the total SPL at the microphone, (2) in-the-ear using the FPL at the microphone, and (3) in a coupler (all three are derived from the same measurement). The test procedure was similar to that commonly used in hearing-conservation programs, using pulsed-tone test frequencies at 0.5, 1, 2, 3, 4, 6, and 8 kHz, and an automated modified Hughson-Westlake audiometric procedure. Fifteen adult human participants with normal to mildly-impaired hearing were selected, and one ear from each was tested. Participants completed 10 audiograms on each system, with test-order randomly varied and with headphones and earphones refitted by the tester between tests. Fourteen of 15 ears had standing-wave nulls present between 4 and 8 kHz. The mean intrasubject SD at 6 and 8 kHz was lowest for the FPL calibration, and was comparable with the low-frequency reliability across calibration methods. This decrease in variability translates to statistically-derived significant threshold shift criteria indicating that 15 dB shifts in hearing can be reliably detected at 6 and 8 kHz using FPL-calibrated ER10C earphones, compared with 20 to 25 dB shifts using standard TDH-39P headphones with a coupler calibration. These results indicate that reliability is better with insert earphones, especially with in-the-ear FPL calibration, compared with a standard clinical audiometer with supra-aural headphones. However, in-the-ear SPL calibration should not be used due to its sensitivity to standing waves. The improvement in reliability is clinically meaningful, potentially allowing hearing-conservation programs to more confidently determine significant threshold shifts at 6 kHz-a key frequency for the early detection of noise-induced hearing loss.

Air-conduction estimated from tympanometry (ACET) 1: relationship to measured hearing in OME.

PubMed

2009-01-01

In otitis media with effusion (OME), the accuracy of predicting air-conduction hearing-level (HLs) from tympanometry has generally been seen as too poor for use in clinical practice. Previous studies of the relationship have mostly concerned single ears, many using samples with predominantly mild cases of OM and weak statistical approaches. A better understanding of the interrelations between these tests might improve efficiency in testing and decision-making for individuals. Binaural average HL was adopted as the measure to be predicted most relevant to auditory disability. Multiple regression from modified Jerger tympanogram categories B, C2, C1 and A tympanogram types on 3085 children aged 3(1/4)-6(3/4) years gave formulae which we tested for replication, stability and generalization across distributions differing in severity. Age-adjusted formulae explained up to 49% of the variance in binaural HL (i.e. a multiple correlation of 0.70), and were robust across phase of disease. Best predictions were seen in a severe sample permitting exploitation of the strong conditioning effect by a B tympanogram in one ear upon the tympanometry/HL relationship in the other. This permits a trichotomous approximation (0, 1, or 2 B-tympanograms) to also perform well. We name the HL prediction formula "ACET" - Air Conduction Estimated from Tympanometry. We do not recommend replacing audiometry with tympanometry, particularly not at first assessment. However, where the diagnosis is, or likely from history to be, OME (even if fluid is absent on test day), the informativeness of further air-conduction audiometry on the same or later occasion may not always be worth the further effort or cost. It is therefore clinically useful to have a dB measure, from an evidence-based formula justifying a principled estimate. Non-clinical uses include imputation when research data are missing, and non-intensive applications where audiometry is impracticable, e.g. field clinics and large scale or longitudinal research. A companion paper shows how the part of the air-conduction HL variance that is not explicable by ACET, also offers a surrogate, but for bone-conduction HL (BC), where BC testing may be problematic, as in the very young. This surrogate can also define cases needing true BC testing.

[The influence of various acoustic stimuli upon the cumulative action potential (SAP) of the auditory nerves in guinea pigs (author's transl)].

PubMed

Hofmann, G; Kraak, W

1976-08-31

The impact of various acoustic stimuli upon the cumulative action potential of the auditory nerves in guinea pigs is investigated by means of the averaging method. It was found that the potential amplitude within the measuring range increases with the logarithm of the rising sonic pressure velocity. Unlike the evoked response audiometry (ERA), this potential seems unsuitable for furnishing information of the frequency-dependent threshold course.

Stapedotomy in osteogenesis imperfecta: a prospective study of 32 consecutive cases.

PubMed

Vincent, Robert; Wegner, Inge; Stegeman, Inge; Grolman, Wilko

2014-12-01

To prospectively evaluate hearing outcomes in patients with osteogenesis imperfecta undergoing primary stapes surgery and to isolate prognostic factors for success. A nonrandomized, open, prospective case series. A tertiary referral center. Twenty-five consecutive patients who underwent 32 primary stapedotomies for osteogenesis imperfecta with evidence of stapes fixation and available postoperative pure-tone audiometry. Primary stapedotomy with vein graft interposition and reconstruction with a regular Teflon piston or bucket handle-type piston. Preoperative and postoperative audiometric evaluation using conventional 4-frequency (0.5, 1, 2, and 4 kHz) audiometry. Air-conduction thresholds, bone-conduction thresholds, and air-bone gap were measured. The overall audiometric results as well as the results of audiometric evaluation at 3 months and at least 1 year after surgery were used. Overall, postoperative air-bone gap closure to within 10 dB was achieved in 88% of cases. Mean (standard deviation) gain in air-conduction threshold was 22 (9.4) dB for the entire case series, and mean (standard deviation) air-bone gap closure was 22 (9.0) dB. Backward multivariate logistic regression showed that a model with preoperative air-bone gap closure and intraoperatively established incus length accurately predicts success after primary stapes surgery. Stapes surgery is a feasible and safe treatment option in patients with osteogenesis imperfecta. Success is associated with preoperative air-bone gap and intraoperatively established incus length.

Impact of hearing impairment on spousal mental health: the Nord-Trøndelag Health Study

PubMed Central

Krog, Norun Hjertager; Tambs, Kristian

2010-01-01

Background: Previous studies indicate that hearing loss have negative emotional implications also on spouses of the hearing impaired persons. We sought to assess the relationship between hearing impairment and spousal mental health in the general population. Methods: Pure tone audiometry and questionnaires were administered to the adult population of Nord–Trøndelag County, Norway (1996–97). In the age group between 20 and 44 years, the number of cases with hearing impairment was very low; thus, this age group was excluded from analyses. In total, 8607 couples with women over 44 years and 9530 couples with men over 44 years were identified. Associations between measured and self-reported hearing impairment and spousal self-reported symptoms of anxiety and depression, and subjective well-being were estimated. Stratified by sex and adjusting for several covariates, mental health in spouses of persons with hearing impairment was compared with that of spouses of persons with normal hearing using the general linear model. Results: Audiometrically measured hearing was not significantly associated with spousal mental health. Moderate relations between self-reported hearing and spousal mental health were observed. Conclusion: Contrary to previous results based on self-reported hearing loss, our results based on audiometry did not indicate severe loss of mental health among spouses of persons with impaired hearing. PMID:19887520

Equivalence and test-retest reproducibility of conventional and extended-high-frequency audiometric thresholds obtained using pure-tone and narrow-band-noise stimuli.

PubMed

John, Andrew B; Kreisman, Brian M

2017-09-01

Extended high-frequency (EHF) audiometry is useful for evaluating ototoxic exposures and may relate to speech recognition, localisation and hearing aid benefit. There is a need to determine whether common clinical practice for EHF audiometry using tone and noise stimuli is reliable. We evaluated equivalence and compared test-retest (TRT) reproducibility for audiometric thresholds obtained using pure tones and narrowband noise (NBN) from 0.25 to 16 kHz. Thresholds and test-retest reproducibility for stimuli in the conventional (0.25-6 kHz) and EHF (8-16 kHz) frequency ranges were compared in a repeated-measures design. A total of 70 ears of adults with normal hearing. Thresholds obtained using NBN were significantly lower than thresholds obtained using pure tones from 0.5 to 16 kHz, but not 0.25 kHz. Good TRT reproducibility (within 2 dB) was observed for both stimuli at all frequencies. Responses at the lower limit of the presentation range for NBN centred at 14 and 16 kHz suggest unreliability for NBN as a threshold stimulus at these frequencies. Thresholds in the conventional and EHF ranges showed good test-retest reproducibility, but differed between stimulus types. Care should be taken when comparing pure-tone thresholds with NBN thresholds especially at these frequencies.

Sex-specific predictors of hearing-aid use in older persons: The age, gene/environment susceptibility - Reykjavik study

PubMed Central

Fisher, Diana E.; Li, Chuan-Ming; Hoffman, Howard J.; Chiu, May S.; Themann, Christa L.; Petersen, Hannes; Jonsson, Palmi V.; Jonsson, Helgi; Jonasson, Fridbert; Sverrisdottir, Johanna Eyrun; Launer, Lenore J.; Eiriksdottir, Gudny; Gudnason, Vilmundur; Cotch, Mary Frances

2015-01-01

Objective We estimate the prevalence of hearing-aid use in Iceland and identify sex-specific factors associated with use. Design Population-based cohort study. Study sample A total of 5172 age, gene/environment susceptibility - Reykjavik study (AGES-RS) participants, aged 67 to 96 years (mean age 76.5 years), who completed air-conduction and pure-tone audiometry. Results Hearing-aid use was reported by 23.0% of men and 15.9% of women in the cohort, although among participants with at least moderate hearing loss in the better ear (pure-tone average [PTA] of thresholds at 0.5, 1, 2, and 4 kHz ≥ 35 dB hearing level [HL]) it was 49.9% and did not differ by sex. Self-reported hearing loss was the strongest predictor of hearing-aid use in men [OR: 2.68 (95% CI: 1.77, 4.08)] and women [OR: 3.07 (95% CI: 1.94, 4.86)], followed by hearing loss severity based on audiometry. Having diabetes or osteoarthritis were significant positive predictors of use in men, whereas greater physical activity and unimpaired cognitive status were important in women. Conclusions Hearing-aid use was comparable in Icelandic men and women with moderate or greater hearing loss. Self-recognition of hearing loss was the factor most predictive of hearing-aid use; other influential factors differed for men and women. PMID:25816699

Audiovestibular impairments associated with intracranial hypotension.

PubMed

Choi, Jae-Hwan; Cho, Kee-Yong; Cha, Seung-Yi; Seo, Jae-Deuk; Kim, Min-Ji; Choi, Yu Ri; Kim, Sung-Hee; Kim, Ji-Soo; Choi, Kwang-Dong

2015-10-15

To investigate the patterns and mechanisms of audiovestibular impairments associated with intracranial hypotension. We had consecutively recruited 16 patients with intracranial hypotension at the Neurology Center of Pusan National University Hospital for two years. Spontaneous, gaze-evoked, and positional nystagmus were recorded using 3D video-oculography in all patients, and the majority of them also had pure tone audiometry and bithermal caloric tests. Of the 16 patients, five (31.3%) reported neuro-otological symptoms along with the orthostatic headache while laboratory evaluation demonstrated audiovestibular impairments in ten (62.5%). Oculographic analyses documented spontaneous and/or positional nystagmus in six patients (37.5%) including weak spontaneous vertical nystagmus with positional modulation (n=4) and pure positional nystagmus (n=2). One patient presented with recurrent spontaneous vertigo and tinnitus mimicking Meniere's disease, and showed unidirectional horizontal and torsional nystagmus with normal head impulse tests during the attacks. Bithermal caloric tests were normal in all nine patients tested. Audiometry showed unilateral (n=6) or bilateral (n=1) sensorineural hearing loss in seven (53.8%) of the 13 patients tested. Intracranial hypotension frequently induces audiovestibular impairments. In addition to endolymphatic hydrops and irritation of the vestibulocochlear nerve, compression or traction of the brainstem or cerebellum due to loss of CSF buoyancy may be considered as a mechanism of frequent spontaneous or positional vertical nystagmus in patients with intracranial hypotension. Copyright © 2015 Elsevier B.V. All rights reserved.

Occupational noise-induced hearing loss in Indian steel industry workers: an exploratory study.

PubMed

Singh, Lakhwinder Pal; Bhardwaj, Arvind; Deepak, Kishore Kumar

2013-04-01

The present study focused on exploring the current level of hearing protection and subsequently determined the prevalence of occupational noise-induced hearing loss among casting and forging industry workers. The casting and forging industry provides employment to a significant portion of the population. The level of hearing protection was assessed through questionnaire survey of 572 workers. Out of these workers, 165 and another control group of 57 participants were assessed by formal audiometry. Audiometric tests were conducted at frequencies of 1.0 KHz to 8.0 KHz.The occurrence of hearing loss was determined on the basis of a hearing threshold level with a low fence of 25 dB. Student's test and ANOVA were used to compare the various groups; a p value < .05 was considered statistically significant. More than 90% of the workers sampled showed significant hearing loss at medium and high frequencies. The analyses revealed a higher prevalence of significant hearing loss among the forging workers compared with the workers associated with the other activities. The workers of the Indian steel industry are highly exposed to occupational noise. The majority of workers are not protected from noise-induced hearing loss. There is a need to provide special ear protectors for workers engaged in forging. A complete hearing protection program, including training, audiometry, job rotation, and the use of hearing protection devices, needs to be introduced.

Otitis media in indonesian urban and rural school children.

PubMed

Anggraeni, Ratna; Hartanto, Widya W; Djelantik, Bulantrisna; Ghanie, Abla; Utama, Denny S; Setiawan, Eka P; Lukman, Erica; Hardiningsih, Chintriany; Asmuni, Suprihati; Budiarti, Rery; Rahardjo, Sutji Pratiwi; Djamin, Riskiana; Mulyani, Tri; Mutyara, Kuswandewi; Carosone-Link, Phyllis; Kartasasmita, Cissy B; Simões, Eric A F

2014-10-01

Although the epidemiology of otitis media is well-known in industrialized countries, the extent of otitis media in developing Asian countries, especially in south East Asia is not well studied. To define the burden of otitis media and its sequelae in children 6-15 years of age, we enrolled elementary and junior high school children in 6 areas in rural and urban Indonesia. Randomly selected schools and classrooms were selected. All children were administered a questionnaire and had ear examinations, pneumatic otoscopy and screening audiometry. Children with any abnormality on examination or with a relevant history underwent diagnostic audiometry and tympanometry, if indicated. Of the 7005 children studied, 116 had chronic suppurative otitis media (CSOM), 30 had acute otitis media and 26 had otitis media with effusion. 2.7% of rural children had CSOM compared with 0.7% of urban children (P < 0.0001). The rates per 1000 of CSOM in rural Bali and Bandung were significantly higher (75 and 25, respectively) than in the rest of Indonesia (P < 0.05). In rural Bali, the rate per 1000 children of inactive CSOM was 63 in 6- to 9-year-old children, compared with 37 in children aged 13-15 years. Concomitantly, the rates of tympanosclerosis were 7 and 26/1000, respectively, in these age groups. In Indonesia, the prevalence of CSOM is relatively high with most disease occurring in rural areas. The high rates in rural Bali with early progression to tympanosclerosis suggest a significant burden of potentially vaccine preventable illness.

Free Field Word recognition test in the presence of noise in normal hearing adults.

PubMed

Almeida, Gleide Viviani Maciel; Ribas, Angela; Calleros, Jorge

In ideal listening situations, subjects with normal hearing can easily understand speech, as can many subjects who have a hearing loss. To present the validation of the Word Recognition Test in a Free Field in the Presence of Noise in normal-hearing adults. Sample consisted of 100 healthy adults over 18 years of age with normal hearing. After pure tone audiometry, a speech recognition test was applied in free field condition with monosyllables and disyllables, with standardized material in three listening situations: optimal listening condition (no noise), with a signal to noise ratio of 0dB and a signal to noise ratio of -10dB. For these tests, an environment in calibrated free field was arranged where speech was presented to the subject being tested from two speakers located at 45°, and noise from a third speaker, located at 180°. All participants had speech audiometry results in the free field between 88% and 100% in the three listening situations. Word Recognition Test in Free Field in the Presence of Noise proved to be easy to be organized and applied. The results of the test validation suggest that individuals with normal hearing should get between 88% and 100% of the stimuli correct. The test can be an important tool in measuring noise interference on the speech perception abilities. Copyright © 2016 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Screening of dental staff nurses for noise induced hearing loss.

PubMed

Daud, M K M; Noh, N F M; Sidek, D S; Abd Rahman, N; Abd Rani, N; Zakaria, M N

2011-01-01

The effect of noise on employees of dental clinics is debatable. The purposes of this study were to determine the intensity and frequency components of dental instruments used by dental staff nurses and the prevalence of noise induced hearing loss. We performed a comparative, cross sectional study on a group of dental staff nurses. Participants underwent ear examination followed by pure tone audiometry. Pure tone audiometry was performed at least 48 hours after the participants were free from noise exposure. Noise induced hearing loss was defined as failed definitive threshold at a frequency of 4000 Hz greater than 20 dB. The intensity level, noise spectrum, and frequency of hand piece, saliva suction, and scaler were recorded during the dental procedure. A total of 65 dental staff nurses were included. The mean intensity of hand pieces, scalers, and saliva suctions were 88.7 (SD2.2), 87.1 (SD2.6), and 77.4 (SD6.3) dBA while their most prominent frequencies were 3880, 7997, and 3513 Hz, respectively. Three of the subjects had slightly more than 20 dB hearing loss at 4 kHz on audiogram; all were affected unilaterally. These three individuals worked as dental nurses for 11, 13, and 21 years, respectively. Therefore, the prevalence of noise induced hearing loss was 5.0% (95% CI: -1.0%, 10.0%). Dental staff nurses might have an increased risk of noise induced hearing loss, depending upon individual factors influencing susceptibility and duration of noise exposure.

Inner ear problems of Thai priest at Priest Hospital.

PubMed

Karnchanakas, Taweporn; Tantanavat, Are; Sinsakontavat, Jamjan

2008-01-01

The inner ear problems of Thai priest at Priest Hospital had never been reported previously, so Department of Ear Nose Throat try to correlate the metebotic disorder with inner ear problems. 1) To study the fasting blood sugar (FBS), total cholesterol (T. Chol), low density lipoprotein (LDL), and triglyceride (TG), the factors expected to involve in inner ear problems of priests at Priest Hospital. 2) To compare the FBS, T. Chol, HDL, LDL, and TG of priests with inner ear problems at Priest Hospital. 3) To find the percentage of abnormal from FBS, T. Chol, LDL, and TG. The study using 83 sampling of priests with inner ear problems and 107 priests as a controlled group. The research instruments used to collect data was the questionnaire which composed of general information, physical, ear-nose-throat and neurological examination, pure tone audiometry, brainstem evoke response audiometry (BERA) and the blood tests:FBS, T. Chol, TG, and LDL. The inner ear problems were composed of: 1) Dizziness 2) Hearing Loss 3) Tinnitus Aurium. The descriptive statistics were used to analyze the data from questionnaires and utilized frequency, percentage, standard deviation (S.D.) and t-test to achieve desired results. Priest at middle age and elderly with inner ear problems had greater FBS and TG than expected values of the control group. The middle age and elderly priests who had greater FBS and TG than expected values were sick with inner ear problems that causing dizziness, hearing loss and tinnitus aurium.

Titanium clip ball joint: a partial ossicular reconstruction prosthesis.

PubMed

Beutner, Dirk; Luers, Jan Christoffer; Bornitz, Matthias; Zahnert, Thomas; Huttenbrink, Karl-Bernd

2011-06-01

To describe a new titanium clip prosthesis for partial ossicular reconstruction with a micro ball joint in the headplate for compensation of tympanic membrane displacements. Laboratory experiments followed by 18 consecutive patients. A micro ball joint was implemented into a headplate of titanium middle ear prosthesis. First, the new prosthesis was tested in the laboratory in temporal bone experiments. Second, the new prosthesis was clinically installed in 18 patients. Results of laser Doppler vibrometry and force measurements in the laboratory experiments, analysis of a questionnaire, and preoperative and postoperative pure tone audiometry. The frictional resistance in the joint was measured to be 12 mN that should allow for adequate mobility under physiologic conditions. The effective sound transmission of the prosthesis was demonstrated by laser Doppler vibrometry. Intraoperatively, the installation of the prosthesis was always straightforward with headplate prosthesis shaft angles between 60 and 90 degrees. Postoperatively, pure tone audiometry revealed satisfying hearing results with a remaining average air-bone gap of 18.2 dB over the frequencies 500, 1,000, 2,000, and 3,000 Hz. No signs of prosthesis dislocation were discovered within the follow-up period of approximately 6 months. The experimental data show that the new modified prosthesis headplate fulfills the requirements necessary for sound transmission. The joint allows the plate to follow movements of the tympanic membrane. This characteristic in conjunction with the proven clip design ensure for optimal prosthesis placement and effectiveness.

Frequency of auditory involvement and of associated factors in patients with juvenile idiopathic arthritis.

PubMed

Céspedes Cruz, Adriana Ivonne; Méndez Núñez, Myriam; Solís Vallejo, Eunice; Zeferino Cruz, Maritza; Torres Jiménez, Alfonso Ragnar; Ocampo Sánchez, Verónica; Flores Meza, Beatriz; Quintana Ruiz, Norma

2017-09-08

Juvenile idiopathic arthritis (JIA) is a chronic autoimmune disease characterized by the presence of arthritis in children under 16 years of age for more than 6 weeks in the absence of any other known cause. The extra-articular manifestations, especially in the audiovestibular system, are related to the involvement of the joints of the ossicular chain as a result of the inflammatory process in the synovium. Previous clinical studies in pediatric patients have shown conductive or sensorineural hearing loss. The aim of this study was to assess the frequency of hearing impairment and of associated factors in patients with JIA. A prospective, analytical study was conducted from January 2013 to August 2014 in 62 patients with JIA aged between 5 and 15 years. The study was approved by the local ethics committee and parents signed their informed consent. All subjects underwent audiological examination involving otomicroscopy, audiometry, tympanometry, stapedius reflex and test for transient otoacoustic emissions (TOAE); rheumatologic evaluation included joint examination and the application of a measure of functional ability (disability) using the Childhood Health Assessment Questionnaire (CHAQ). Measures of central tendency and of dispersion were used (chi-square for associations and P<.05 for statistical significance). Sixty-two patients were included: 56 girls and 6 boys, mean age 11.9 years and mean disease duration of 3.4 years; 46% had rheumatoid factor (RF)- positive polyarticular JIA, 40% had RF-negative polyarticular JIA, 15% had disease of systemic onset and 3% had oligoarthritis. Active disease was found in 29 patients and 33 were in remission with medication. Of the total of 124 ears evaluated according to the Jerger classification for tympanometry, abnormal findings were observed in 78 that were type As and in 1 that was type Ad, whereas there were 45 type A ears. Hearing loss was disclosed by speech audiometry, rather than by pure tone audiometry. The TOAE were absent in 4% of those assessed and the stapedius reflex was absent in less than 10%. Factors that had a positive correlation with hearing impairment were RF-positive polyarticular JIA, disease duration, degree of disability and the erythrocyte sedimentation rate level (P<.000). The presence of an abnormal tympanogram suggested early involvement in the structure of the tympanic-ossicular complex; however, 3.4 years later, no hearing loss had been reported. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

[Pontine cavernous angioma (cavernoma) with initial ENT manifestations].

PubMed

Pino Rivero, V; González Palomino, A; Pantoja Hernández, C G; Trinidad Ruíz, G; Marqués Rebollo, L; Blasco Huelva, A

2006-01-01

We report the case of a 22 years old female who consulted us for facial parestesias, hearing loss in right ear and sudden tinnitus. Her audiometry showed an unilateral discreet sensorineural hipoacusia and the cranial IRM, a mass of 20 mm diameter in right pontine region and bulbus informed as cavernous angioma with signs of recent bleeding. The patient was sent to Neurosurgery but she refused the intervention. The risk of hemorrhage in the cavernomas is estimated at 0.25% to 1.6% per year and represents the main reason to advise a surgical treatment.

[Audiometry in the cellulose industry].

PubMed

Corrao, C R; Milano, L; Pedulla, P; Carlesi, G; Bacaloni, A; Monaco, E

1993-01-01

A noise level dosimetry and audiometric testing were conducted in a cellulose factory to determine the hazardous noise level and the prevalence of noise induced hearing loss among the exposed workers. The noise level was recorded up to 90 db (A) in several working areas. 18 workers, potentially exposed to noise injury, evidenced a significant hearing loss. While no evidence of noise injury was recorded in a control group of 100 subjects. This finding suggest a strict relationship between audiometric tests, the noise level recorded in the working place and the working seniority of exposed employers.

Identifying Early Onset of Hearing Loss in Young Adults With Diabetes Mellitus Type 2 Using High Frequency Audiometry.

PubMed

Vignesh, S S; Jaya, V; Moses, Anand; Muraleedharan, A

2015-09-01

Diabetes mellitus (DM) is a metabolic disorder caused by hyperglycemia which leads to dysfunction of various organs. Hearing acuity is equally hindered by this disorder. Among individuals with DM audiological characteristics of DM type 1 are of great concern in the literature. This study aims at establishing high frequency audiometry (HFA) as a useful tool in identifying early onset of hearing loss in individuals with DM type 2. 20 non-diabetic participants and 20 individuals with DM type 2 in the age range of 20-40 years were considered for the study. Subjects in both groups underwent otoscopic examination, PTA at 0.25, 0.5, 1, 2, 4 and 8 kHz and HFA at 9, 10, 11.2, 12.5, 14 and 16 kHz. Results revealed statistically significant difference in thresholds of both PTA and HFA at all frequencies across the group, but the mean threshold difference between the diabetic and non-diabetic group was marked in HFA than in PTA. In the diabetic subjects the thresholds of PTA was within 25 dBHL at all frequencies when compared to the thresholds of HFA. Individuals with DM type 2 showed bilateral symmetrical mild hearing loss in HFA and the hearing loss increased with ascending test frequencies from 9,000 to 16,000 Hz. Mild hearing loss in HFA is an indicator for early onset of hearing loss in DM type 2. Hence this present study emphasis the clinical utility of HFA in young adults with DM type 2.

Validation of the use of self-reported hearing loss and the Hearing Handicap Inventory for elderly among rural Indian elderly population.

PubMed

Deepthi, R; Kasthuri, Arvind

2012-01-01

Hearing loss is a potentially disabling problem among elderly leading to physical and social dysfunction. Though audiometric assessment of hearing loss is considered as gold standard, it is not feasible in community settings. Several questionnaires measuring hearing handicap have been developed. Knowledge regarding applicability of these questionnaires among rural elderly is limited, hence a study was planned to validate single question and Shortened Hearing Handicap Inventory for Elderly (HHIE-S) in detecting hearing loss against pure tone-audiometry among rural Indian elderly. A single question 'do you feel you have a hearing loss?' and the HHIE-S was administered to 175 elderly in two rural areas. Hearing ability was assessed using pure tone audiometry. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of both screening tools were compared with pure tone averages (PTAs) greater than 25, 40 and 55 dB hearing level (mild, moderate and severe hearing loss, respectively). The single question yielded low sensitivity (30.9%) and high specificity (93.9%) for mild hearing loss. Similarly HHIE-S yielded a sensitivity of 26.2% and specificity of 95.9%. Sensitivity with single question increased to 76.2% and specificity decreased to 83.1% with severe hearing loss. Sensitivity with HHIE-S also increased to 76.2% and specificity decreased to 87.7% with severe hearing loss. These hearing screening questionnaires will be useful in identifying more disabling hearing losses among rural elderly which helps in rehabilitation services planning. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Multidisciplinary assessment of patients with musical hallucinations, tinnitus and hearing loss.

PubMed

Rocha, Savya Cybelle Milhomem; Kii, Marcia Akemi; Pereira, Cristiana Borges; Borelli, Danilo Totarelli; Forlenza, Orestes; Sanchez, Tanit Ganz

2015-01-01

Although auditory hallucinations are considered a psychopathological phenomenon, musical hallucinations have been reported in individuals without psychosis but with auditory symptoms (tinnitus and/or hearing loss). Thus, a possible different cognitive functioning may be involved in musical hallucinations. The aim of the study was to characterize patients with tinnitus and musical hallucinations through a multidisciplinary assessment, allowing a better understanding of these concomitant phenomena. As this sample is rare to find, all consecutive patients with tinnitus, hearing loss and musical hallucinations were included over a 3-year period, excluding those unable to respond. All subjects underwent the following assessments: (1) otolaryngological and audiological assessment (physical examination and audiometry), (2) neurological assessment (cognition, electroencephalogram and imaging examination) and (3) psychiatric assessment (structured interview). A total of 16 patients were included (87.5% women; mean age 61.43 ± 15.99 years). The otolaryngological examination was normal in all cases, but audiometry revealed that the degree of hearing loss was severe to profound in 68.75% of participants. Neurological assessment showed electroencephalogram changes in only 17.6% of cases, while 25% presented with mild attention deficit and 43.75% had small foci of gliosis or ischemia on the imaging examination. Psychiatric assessment showed that 68.75% of cases had depression, 6.25% had anxiety disorder and 25% had no psychiatric conditions. Musical hallucinations were strongly associated with female elderly adults and with mood disorders. Thus, in contrast to common auditory hallucinations, patients with musical hallucinations associated with tinnitus and hearing loss should be offered a more multidisciplinary assessment. © 2015 S. Karger AG, Basel.

A study on the effect of prolonged mobile phone use on pure tone audiometry thresholds of medical students of Sikkim

PubMed Central

Das, S; Chakraborty, S; Mahanta, B

2017-01-01

Introduction: Mobile phones have become indispensable for daily activities, and people are exposed to them from an early age. There is, however, concern about the harmful effect of the electromagnetic radiation emitted from the mobile phones. Objective: The objective of the study was to study the effect of mobile phone on average pure tone audiometry (PTA) threshold of the person and to study the changes in the pure tone threshold at high frequencies such as 2 kHz, 4 kHz, and 8 kHz among the students with prolonged exposure to mobile phones. Methodology: A cross-sectional study was conducted among the medical students who have been using mobile phones for the past 5 years. The effect of mobile phones on the PTA threshold in the exposed ear and the nonexposed ear was assessed. Results: The study shows that there is a significant difference in average air conduction (AC) and bone conduction (BC) hearing threshold among the exposed and the nonexposed ears (P < 0.05). A significant rise of both AC and BC threshold at individual frequencies between the exposed and the nonexposed ear is also noted in this study. Conclusion: The study conducted shows changes in the hearing threshold of the exposed ear when compared with the nonexposed ear. There are however lot of unanswered questions which provide an interesting avenue for further research. Till concrete evidence is available the only feasible way to control its exposure is to limit the duration of usage of mobile phones. PMID:28272071

[Musical hallucinosis following infarction of the right middle cerebral artery].

PubMed

Augustin, J; Guegan-Massardier, E; Levillain, D; Lemarchand, M; Mihout, B; Hannequin, D

2001-03-01

A 44-year-old woman demonstrated a musical hallucinosis four months after a massive infarction in the territory of the right middle cerebral artery. This musical hallucinosis consisting of familiar tunes, was continuous and perceived by both ears. Magnetic Resonance Imaging, middle and late auditory evoked potentials suggested that right Heschl's gyrus and associative areas were imparied. Audiometry demonstrated a low right transmission deafness. The hallucinosis was persistent for seven months and stopped just after hemorrhage of the right ear. This case gives the opportunity to review the different mechanisms responsible for musical hallucinosis.

The Development of Performance-Based Auditory Aviation Classification Standards in the U.S. Navy,

DTIC Science & Technology

1987-12-01

Gerontology, Vol. 24(2), pp. 189-192, 1969. 10. Palva, A. and Jokinen, K., ’The Role of the Binaural Test in Filtered Speech Audiometry." Acta Oto...BEAD BEAT BEAN REEL HEEL EEL PAVE PALE PAY WIG RIG FIG GALE MALE TALE PAGE PANE PACE PIG BIG DIG PALE SALE BALE DID DIN DIP SAP SAG SAD SIN WIN...SEEN SEED SEEK CAME GAME SAME NEAT BEAT SEAT SEEM SEETHE SEEP PAD PASS PATH PARK MARK HARK SIP RIP TIP PACK PAN PAT DARK LARK BARK LIP HIP DIP LED

Evaluation of aural manifestations in temporo-mandibular joint dysfunction.

PubMed

Sobhy, O A; Koutb, A R; Abdel-Baki, F A; Ali, T M; El Raffa, I Z; Khater, A H

2004-08-01

Thirty patients with temporo-mandibular joint dysfunction were selected to investigate the changes in otoacoustic emissions before and after conservative treatment of their temporo-mandibular joints. Pure tone audiometry, transient-evoked otoacoustic emissions (TEOAE), distortion-product otoacoustic emissions (DPOAE) as well as a tinnitus questionnaire were administered to all patients before and after therapy. Therapy was conservative in the form of counselling, physiotherapy, anti-inflammatory agents, muscle relaxants, and occlusal splints. Results indicated insignificant changes in the TEOAEs, whereas there were significant increases in distortion product levels at most of the frequency bands. These results were paralleled to subjective improvement of tinnitus.

Computer-assisted CI fitting: Is the learning capacity of the intelligent agent FOX beneficial for speech understanding?

PubMed

Meeuws, Matthias; Pascoal, David; Bermejo, Iñigo; Artaso, Miguel; De Ceulaer, Geert; Govaerts, Paul J

2017-07-01

The software application FOX ('Fitting to Outcome eXpert') is an intelligent agent to assist in the programing of cochlear implant (CI) processors. The current version utilizes a mixture of deterministic and probabilistic logic which is able to improve over time through a learning effect. This study aimed at assessing whether this learning capacity yields measurable improvements in speech understanding. A retrospective study was performed on 25 consecutive CI recipients with a median CI use experience of 10 years who came for their annual CI follow-up fitting session. All subjects were assessed by means of speech audiometry with open set monosyllables at 40, 55, 70, and 85 dB SPL in quiet with their home MAP. Other psychoacoustic tests were executed depending on the audiologist's clinical judgment. The home MAP and the corresponding test results were entered into FOX. If FOX suggested to make MAP changes, they were implemented and another speech audiometry was performed with the new MAP. FOX suggested MAP changes in 21 subjects (84%). The within-subject comparison showed a significant median improvement of 10, 3, 1, and 7% at 40, 55, 70, and 85 dB SPL, respectively. All but two subjects showed an instantaneous improvement in their mean speech audiometric score. Persons with long-term CI use, who received a FOX-assisted CI fitting at least 6 months ago, display improved speech understanding after MAP modifications, as recommended by the current version of FOX. This can be explained only by intrinsic improvements in FOX's algorithms, as they have resulted from learning. This learning is an inherent feature of artificial intelligence and it may yield measurable benefit in speech understanding even in long-term CI recipients.

[The comparative analysis of clinical symptomatology before and after the operation of otosclerosis].

PubMed

Terzić, Negra; Zivić, Ljubica

2009-01-01

Otosclerosis is a progressive osteodystrophic disease of the osseous capsule of the labyrinth which leads to the fixation of the stapes and partial deafness. The progressive hearing loss followed by ear tingling--tinitus and vertigo is of great importance for this disease. The aim of the work was to determine the changes of clinical symptomatology before and after the operative treatment of otoscleoris. The study included 32 subjects between 25 and 60 years of age affected by otosclerosis who had undergone surgical treatment at the VMA (Military Medical Academy) Clinic, Department of Otolaryngology in Belgrade. Besides the clinical examination and detailed case history, audiometry and tympanometry examinations were performed. During the postoperative period the clinical symptomatology was evaluated and audiometry examinations were performed in order to determine the effect of the surgical intervention. Of the total number of 32 subjects, partial deafness was present in all of them before the operation, whereas tinitus, vertiginous disturbances and otalgia were found in a certain number of the subjects. During the postoperative period a partial recovery was found in a larger number of the subjects in relation to the total hearing recovery. During the postoperative period tinitus of lower intensity was found in a greater number of the subjects, whereas the number of those without tinitus was smaller. The problem of vertiginous disturbances as well as otalgia were not found during the postoperative period. By following the changes of the clinical symptomatology we came to the conclusion that surgical treatment of otosclerosis results in the reduction and disappearance of subjective disturbances, tinitus, vertigo and otalgia and leads to the partial or complete hearing recovery.

[Vestibulo-cochlear disturbances in the course of vaso-neural conflict of vestibule-cochlear nerve--diagnostic and therapeutic problems].

PubMed

Orendorz-Fraczkowska, Krystyna; Jaworska, Marzena; Gawron, Wojciech; Badowski, Roman; Nadolska, Beata

2007-01-01

Symptoms encompassing sensorineural hearing loss, tinnitus and vertigo occur in many diseases of various origin. The diagnostics in such cases is especially difficult and often requires interdisciplinary cooperation. Despite of that many cases remain unexplained. The two cases with above mentioned symptoms (52 year-old woman and 46 year-old man) with differentiated clinical course were presented. The woman for one year experienced left sided, extreme tinnitus with paroxysmal vertigo and dizziness. The man with sudden monolateral hearing loss and tinnitus that disappeared after corticosteroid therapy, complained about recurrence of fluctuating hearing loss and tinnitus accompanied by chronic instability. The diagnostics of hearing and balance organs was performed (pure tone audiometry, impedance audiometry, DPOAE, ABR, ENG) complemented with computed tomography and Nuclear Resonance. Female patient presented bilateral mild sensorineural hearing loss, more intensive on the left side, male patient right sided sensorineural hearing loss in the frequencies from 250 to 1500 Hz. The elongation of some peak values in ABR test (with bilaterally proper otoacoustic emissions) as well as partial canal paresis on the hearing loss side suggested primary diagnosis of neoplasmatic process. It was an indication to perform radiological diagnostics. The radiologic findings revealed the contact of vestibulo-cochlear nerve with the loop of cerebellar inferior anterior artery within the internal acoustic canal. The course of the disease and diagnostic tests do not provide characteristic data that let diagnose neuro-vascular conflict. One has to be aware of such possibility in patients with intensive vertigo and dizziness that do not improve after treatment when other causes do not justify the symptoms.

[Investigation of neural stem cell-derived donor contribution in the inner ear following blastocyst injection].

PubMed

Volkenstein, S; Brors, D; Hansen, S; Mlynski, R; Dinger, T C; Müller, A M; Dazert, S

2008-03-01

Utilising the enormous proliferation and multi-lineage differentiation potentials of somatic stem cells represents a possible therapeutical strategy for diseases of non-regenerative tissues like the inner ear. In the current study, the possibility of murine neural stem cells to contribute to the developing inner ear following blastocyst injection was investigated. Fetal brain-derived neural stem cells from the embryonic day 14 cortex of male mice were isolated and expanded for four weeks in neurobasal media supplemented with bFGF and EGF. Neural stem cells of male animals were harvested, injected into blastocysts and the blastocysts were transferred into pseudo-pregnant foster animals. Each blastocyst was injected with 5-15 microspheres growing from single cell suspension from neurospheres dissociated the day before. The resulting mice were investigated six months POST PARTUM for the presence of donor cells. Brainstem evoked response audiometry (BERA) was performed in six animals. To visualize donor cells Lac-Z staining was performed on sliced cochleas of two animals. In addition, the cochleas of four female animals were isolated and genomic DNA of the entire cochlea was analyzed for donor contribution by Y-chromosome-specific PCR. All animals had normal thresholds in brainstem evoked response audiometry. The male-specific PCR product indicating the presence of male donor cells were detected in the cochleas of three of the four female animals investigated. In two animals, male donor cells were detected unilateral, in one animal bilateral. The results suggest that descendants of neural stem cells are detectable in the inner ear after injection into blastocysts and possess the ability to integrate into the developing inner ear without obvious loss in hearing function.

Sex-Related Cochlear Impairment in Cigarette Smokers

PubMed Central

Lisowska, Grażyna; Jochem, Jerzy; Gierlotka, Agata; Misiołek, Maciej; Ścierski, Wojciech

2017-01-01

Background A number of studies have documented the influence of cigarette smoking on hearing. However, the association between sex and hearing impairment in smokers as measured by otoacoustic emissions (OAEs) has not been clearly established. The aim of this study was to analyze sex-specific effects of smoking on hearing via conventional and ultra-high-frequency pure tone audiometry (PTA), and OAEs, specifically spontaneous OAEs, click-evoked OAEs, and distortion-product OAEs. Material/Methods The study included 84 healthy volunteers aged 25–45 years (mean 34), among them 46 women (25 non-smokers and 21 smokers) and 38 men (16 non-smokers and 22 smokers). The protocol of the study included otoscopic examination, tympanometry, low-, moderate-, and ultra-high-frequency PTA, evaluation of spontaneous click-evoked (CEAOEs) and distortion-product otoacoustic emissions (DPOAEs), assessment of the DP-grams for 2f1-f2 (f1 from 977 to5 164 Hz), and input/output function at L2 primary tone level of 40–70 dB SPL. Results Smokers and non-smokers did not differ significantly in terms of their hearing thresholds assessed with tone audiometry. Male smokers presented with significantly lower levels of CEAOEs and DPOAEs than both male non-smokers and female smokers. Conclusions Smoking does not modulate a hearing threshold determined with PTA at low, moderate, and ultra-high frequencies, but causes a significant decrease in OAE levels. This effect was observed only in males, which implies that they are more susceptible to smoking-induced hearing impairment. Sex-specific differences in otoacoustic emissions level may reflect influences of genetic, hormonal, behavioral, and/or environmental factors. PMID:28110343

Correlation between CD64 and PCT levels in cerebrospinal fluid and degree of hearing impairment sequelae in neonates with purulent meningitis.

PubMed

Liu, Cui; Zhao, Dongchi

2017-12-01

This study investigated the possible correlation between the degree of hearing impairment caused by neonatal purulent meningitis and the levels of CD64 and PCT in cerebrospinal fluid of patients, and assessed the prognostic value of such levels. We recorded data from 156 cases of neonatal purulent meningitis retrospectively. All the patients received brainstem response audiometry, and cerebrospinal fluid samples were collected within the first day after admission through lumbar puncture. Flow cytometry was used to detect CD64 levels and enzyme-linked fluorescent assay was used to detect PCT levels. The children with hearing impairment were followed up for 1 year and brainstem response audiometry was performed again in them. We found that 43.59% of the children showed different degrees of hearing impairment, and 55% of them did not fully recover. The levels of PCT and CD64 in cerebrospinal fluid of children with hearing impairment were significantly higher than those of children with normal hearing (P<0.01). The levels of PCT and CD64 in mild, moderate and severe hearing impaired children increased gradually with higher degrees of impairment, and the differences between groups were significant (P<0.01). During the follow-up, it was found that the levels of PCT and CD64 in children correlated well with the degree of hearing recovery, and the differences between groups were significant (P<0.01). In our study, approximately 1/4 children with purulent meningitis showed long-term hearing impairment. Based on our analyses, the levels of CD64 and PCT in cerebrospinal fluid can be used to predict the degree and long-term prognosis of hearing impairment caused by purulent meningitis in children.

Auditory changes in acromegaly.

PubMed

Tabur, S; Korkmaz, H; Baysal, E; Hatipoglu, E; Aytac, I; Akarsu, E

2017-06-01

The aim of this study is to determine the changes involving auditory system in cases with acromegaly. Otological examinations of 41 cases with acromegaly (uncontrolled n = 22, controlled n = 19) were compared with those of age and gender-matched 24 healthy subjects. Whereas the cases with acromegaly underwent examination with pure tone audiometry (PTA), speech audiometry for speech discrimination (SD), tympanometry, stapedius reflex evaluation and otoacoustic emission tests, the control group did only have otological examination and PTA. Additionally, previously performed paranasal sinus-computed tomography of all cases with acromegaly and control subjects were obtained to measure the length of internal acoustic canal (IAC). PTA values were higher (p < 0.001 for right ears and p = 0.001 for left ears), and SD scores were (p = 0.002 for right ears and p = 0.002 for left ears) lower in acromegalic patients. IAC width in acromegaly group was narrower compared to that in control group (p = 0.03 for right ears and p = 0.02 for left ears). When only cases with acromegaly were taken into consideration, PTA values in left ears had positive correlation with growth hormone and insulin-like growth factor-1 levels (r = 0.4, p = 0.02 and r = 0.3, p = 0.03). Of all cases with acromegaly 13 (32%) had hearing loss in at least one ear, 7 (54%) had sensorineural type and 6 (46%) had conductive type hearing loss. Acromegaly may cause certain changes in the auditory system in cases with acromegaly. The changes in the auditory system may be multifactorial causing both conductive and sensorioneural defects.

Noise-induced hearing loss caused by gunshot in South Korean military service.

PubMed

Moon, In Seok

2007-04-01

Noise-induced hearing loss is a preventive disease and yet the effective treatment modality has not been established. Acute acoustic traumas caused by an exposure to gunshot noise are common in young South Korean males in military service. Considering the significant lack of awareness on this serious issue as well as the absence of proper protective gear, an in-depth analysis is desperately needed. All 3650 soldiers performed regular periodic gunfire exercise without any hearing protective measures. Seven patients with hearing impairment after periodic gunfire visited the aeromedical squadron; all were right-handed males. Six were tested with the K-2 rifle and one was tested with a K-5 revolver. History taking, physical examination, pure-tone audiometry, and impedance audiometry were conducted. In the next periodic gunfire exercise, all 3650 soldiers performed gunfire with unilateral hearing protection. The average outcome of postexposure air conduction thresholds was 6.5 dB in the right ear and 33.1 dB in the left ear. After medical treatment, hearing impairment was much improved; however, tinnitus was not diminished. In the next periodic gunfire exercise, the result of a supplement of unilateral earplug protection proved its effectiveness on acoustic trauma caused by gunfire noise. Asymmetry in hearing loss is related to the position of the head during gunfire. A unilateral hearing protection device was enough to protect hearing from gunfire noise. At the same time, it can effectively prevent a potential firearm accident that can be caused by trainees mishearing the instruction of a firearm instructor if both earplugs are worn. Thus, providing a unilateral earplug for protection against acoustic trauma must be taken into serious consideration.

The role of IGF-1 and the distribution of body fat in decreasing the number of prostate rebiopsies.

PubMed

Morán, E; Martínez, M; Budía, A; Broseta, E; Cámara, R; Boronat, F

2017-03-01

To assess the usefulness of IGF-1 and internal organ fat measured by bioelectrical impedance audiometry to avoid rebiopsies in patients with persistently high prostate-specific antigen (PSA) levels. A prospective study was conducted with 92 patients who underwent prostate rebiopsy due to high PSA levels with negative results in the rectal examination and a lack of preneoplastic lesions. The patients previously had their IGF-1 levels measured and had undergone an impedance audiometry test using the abdominal Fat Analyser AB-140 TANITA system. We calculated the receiver operating characteristic (ROC) curves for the PSA levels, %PSA, internal organ fat and IGF-1 and PSA density. Twenty-five patients were diagnosed with prostate cancer. These patients had significantly higher PSA, PSAd and IGF-1 values and a tendency towards higher internal organ fat levels and lower %PSA readings (p=.001, p=.003, p=.001, p=.24 and P=0.28, respectively). The ROC curve showed an area under the curve for IGF-1 and PSA of .82 and .81, respectively. Using the cutoff points for 95% sensitivity and using the 3 criteria as an indication of rebiopsy, 74% of the biopsies would have been spared, leaving undiagnosed only 1 patient with clinically significant cancer -Gleason score>7 (4+3)-. The positive and negative predictive values for the set of variables were higher than for each one separately (PPV: 66/NPV: 63). The cost of both determinations was 82 euros. Our results suggest that measuring IGF-1 could significantly decrease the number of unnecessary rebiopsies in an inexpensive and safe manner. Copyright © 2016 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

Benign paroxysmal vertigo of childhood: diagnostic value of vestibular test and high stimulus rate auditory brainstem response test.

PubMed

Zhang, Daogong; Fan, Zhaomin; Han, Yuechen; Wang, Mingming; Xu, Lei; Luo, Jianfen; Ai, Yu; Wang, Haibo

2012-01-01

To investigate the diagnostic value of vestibular test and high stimulus rate auditory brainstem response (ABR) test and the possible mechanism responsible for benign paroxysmal vertigo of childhood (BPVC). Data of 56 patients with BPVC in vertigo clinic of our hospital from May 2007 to September 2008 were retrospectively analyzed in this study. Patients with BPVC were tested with pure tone audiometry, high stimulus rate auditory brainstem response test (ABR), transcranial Doppler sonography (TCD), bithermal caloric test, and VEMP. The results of the hearing and vestibular function test were compared and analyzed. There were 56 patients with BPVC, including 32 men, 24 women, aged 3-12 years old, with an average of 6.5 years. Among 56 cases of BPVC patients, the results of pure tone audiometry were all normal. High stimulus rate ABR was abnormal in 66.1% (37/56) of cases. TCD showed 57.1% abnormality in 56 cases, including faster flow rate in 28 cases and slower flow rate in 4 cases. High stimulus rate ABR and TCD were both abnormal in 48.2% (27/56) of cases. Bithermal caloric test was abnormal in 14.3% (8/56) of cases. VEMP showed 32.1% abnormality, including amplitude abnormality in 16 cases and latency abnormality in 2 cases. The abnormal rate of VEMP was much higher than that of caloric test. Vascular mechanisms might be involved in the pathogenesis of BPVC and there is strong evidence for close relationship between BPVC and migraine. High stimulus rate ABR is helpful in the diagnosis of BPVC. The inferior vestibular pathway is much more impaired than the superior vestibular pathway in BPVC. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Risk Factors for Hearing Loss in Patients Treated With Intensity-Modulated Radiotherapy for Head-and-Neck Tumors

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zuur, Charlotte L.; Simis, Yvonne J.; Lamers, Emmy A.

2009-06-01

Purpose: Radiotherapy (RT) is a common treatment of head-and-neck carcinoma. The objective of this study was to perform a prospective multivariate assessment of the dose-effect relationship between intensity-modulated RT and hearing loss. Methods and Materials: Pure tone audiometry at 0.250-16 kHz was obtained before and after treatment in 101 patients (202 ears). All patients received full-course intensity-modulated RT (range, 56-70 Gy), with a median cochlear dose of 11.4 Gy (range, 0.2-69.7). Results: Audiometry was performed 1 week before and a median of 9 weeks (range, 1-112) after treatment. The mean hearing deterioration at pure tone average air-conduction 1-2-4 kHz wasmore » small (from 28.6 dB HL to 30.1 dB HL). However, individual patients showed clinically significant hearing loss, with 10-dB threshold shift incidences of 13% and 18% at pure tone averages air-conduction 1-2-4 kHz and 8-10-12.5 kHz, respectively. Post-treatment hearing capability was unfavorable in the case of greater inner ear radiation doses (p <0.0001), unfavorable baseline hearing capability (p <0.0001), green-eyed patients (p <0.0001), and older age (p <0.0001). Using multivariate analysis, a prediction of individual hearing capabiltity after treatment was made. Conclusion: RT-induced hearing loss in the mean population is modest. However, clinically significant hearing loss was observed in older patients with green eyes and unfavorable pretreatment hearing. In these patients, the intended radiation dose may be adjusted according to the proposed predictive model, aiming to decrease the risk of ototoxicity.« less

Short-term auditory effects of listening to an MP3 player.

PubMed

Keppler, Hannah; Dhooge, Ingeborg; Maes, Leen; D'haenens, Wendy; Bockstael, Annelies; Philips, Birgit; Swinnen, Freya; Vinck, Bart

2010-06-01

To determine the output levels of a commercially available MPEG layer-3 (MP3) player and to evaluate changes in hearing after 1 hour of listening to the MP3 player. First, A-weighted sound pressure levels (measured in decibels [dBA]) for 1 hour of pop-rock music on an MP3 player were measured on a head and torso simulator. Second, after participants listened to 1 hour of pop-rock music using an MP3 player, changes in hearing were evaluated with pure-tone audiometry, transient-evoked otoacoustic emissions, and distortion product otoacoustic emissions. Twenty-one participants were exposed to pop-rock music in 6 different sessions using 2 types of headphones at multiple preset gain settings of the MP3 player. Output levels of an MP3 player and temporary threshold and emission shifts after 1 hour of listening. The output levels at the full gain setting were 97.36 dBA and 102.56 dBA for the supra-aural headphones and stock earbuds, respectively. In the noise exposure group, significant changes in hearing thresholds and transient-evoked otoacoustic emission amplitudes were found between preexposure and postexposure measurements. However, this pattern was not seen for distortion product otoacoustic emission amplitudes. Significant differences in the incidence of significant threshold or emission shifts were observed between almost every session of the noise exposure group compared with the control group. Temporary changes in hearing sensitivity measured by audiometry and otoacoustic emissions indicate the potential harmful effects of listening to an MP3 player. Further research is needed to evaluate the long-term risk of cumulative noise exposure on the auditory system of adolescents and adults.

Role of ocular VEMP test in assessing the occurrence of vertigo in otosclerosis patients.

PubMed

Lin, Kuei-You; Young, Yi-Ho

2015-01-01

This study adopted an inner ear test battery comprising audiometry, caloric test, ocular vestibular-evoked myogenic potential (oVEMP) test and cervical VEMP (cVEMP) test to find the factors related to the occurrence of vertigo in patients with otosclerosis. Fifty otosclerosis patients comprising 27 patients with vertigo (Group A) and 23 patients without vertigo/dizziness (Group B) were enrolled. Each patient underwent otoscopy, image study, audiometry, caloric test, and oVEMP and cVEMP tests via bone vibration stimuli. The sequence of inner ear deficits in Group A was in the order from oVEMP test (84%), cVEMP test (51%), caloric test (38%) and mean bone-conducted (BC) hearing threshold (14%), exhibiting a significantly declining trend (p<0.001). The rate of inner ear dysfunction in Group B also declined significantly but in a different order - cVEMP test (55%), oVEMP test (52%), mean BC hearing threshold (33%), and caloric test (18%). Comparison between the two groups revealed a significant difference in the oVEMP test results (p<0.01), but not in the results of the BC hearing threshold, caloric test or cVEMP test (p>0.05). Further, no significant differences existed between the BC hearing threshold and vestibular function test results. Otosclerosis patients with vertigo have more frequent abnormalities of oVEMPs to impulsive stimulation than do those without, consistent with more frequent abnormalities of the utricle. Abnormalities of oVEMPs and cVEMPs are more frequent than for caloric testing and BC hearing thresholds. The relative frequency of abnormalities may reflect the degree of pathological involvement of the utricle, saccule, semicircular canals and cochlea in otosclerosis patients with vertigo. Copyright © 2014 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

[Treatment of Paget's disease with diphosphonate (disodium ethydronate)].

PubMed

Caniggia, A; Gennari, C; Guideri, R; Vattimo, A; Nardi, P

1976-01-07

16 patients suffering from Paget's disease were studied before, during and after 3 or 6 month treatment with disodium ethydronate (EHDP) per os. An appreciable improvement in pain symptomatology was noted and at times an evident improvement in audiometry; from the metabolic viewpoint there was a fall in serum alkaline phosphatase and urinary excretion of calcium and hydroxyproline. A study of radiocalcium kinetics demonstrated a reduction in the exchangeable calcium pool and the fractional turnover rate. Histological examination following needle biopsy of the iliac crest showed evident diminution in the active bone cell population (osteoclasts, osteoblasts) and, in certain cases, appearance of osteoid borders.

[Perceptive deafness and AIDS].

PubMed

Sancho, E M; Domínguez, L; Urpegui, A; Martínez, J; Jiménez, M; Bretos, S; Vallés, H

1997-06-01

We report a case of a 23 years old woman HIV positive for the past five years with a four year history of right perceptive hypoacusia evolution without tinitus, vertigo or any other otologic symptomatology. After reviewing her personal and family history and conducting imilar tonal audiometry, tympanometry bilateral, contralateral estapedial reflex, auditory evoked brain stem response and a bilateral nasal fiberendoscopy, we analyzed the evolution of her immunal deficiency and the treatments to which she has been submitted with the purpose of determining the risk factors that have coincided in this case to be able to establish some criteria to follow the auditive affect in HIV positive patients.

Audiological and electrophysiological evaluation of children with acquired immunodeficiency syndrome (AIDS).

PubMed

Matas, Carla Gentile; Leite, Renata Aparecida; Magliaro, Fernanda Cristina Leite; Gonçalves, Isabela Crivellaro

2006-08-01

We examined the peripheral auditory system and the auditory brainstem pathway of children with Acquired Immunodeficiency Syndrome (AIDS). One hundred and one children, 51 with AIDS diagnosis and 50 normal children were evaluated. Audiological assessment included immittance measures, pure tone and speech audiometry and auditory brainstem response (ABR). The children with AIDS more frequently had abnormal results than did their matched controls, presenting either peripheral or auditory brainstem impairment. We suggest that AIDS be considered a risk factor for peripheral and/or auditory brainstem disorders. Further research should be carried out to investigate the auditory effects of HIV infection along the auditory pathway.

[A case of transient auditory agnosia and schizophrenia].

PubMed

Kanzaki, Jin; Harada, Tatsuhiko; Kanzaki, Sho

2011-03-01

We report a case of transient functional auditory agnosia and schizophrenia and discuss their relationship. A 30-year-old woman with schizophrenia reporting bilateral hearing loss was found in history taking to be able to hear but could neither understand speech nor discriminate among environmental sounds. Audiometry clarified normal but low speech discrimination. Otoacoustic emission and auditory brainstem response were normal. Magnetic resonance imaging (MRI) elsewhere evidenced no abnormal findings. We assumed that taking care of her grandparents who had been discharged from the hospital had unduly stressed her, and her condition improved shortly after she stopped caring for them, returned home and started taking a minor tranquilizer.

System and algorithm for evaluation of human auditory analyzer state

NASA Astrophysics Data System (ADS)

Bachynskiy, Mykhaylo V.; Azarkhov, Oleksandr Yu.; Shtofel, Dmytro Kh.; Horbatiuk, Svitlana M.; Ławicki, Tomasz; Kalizhanova, Aliya; Smailova, Saule; Askarova, Nursanat

2017-08-01

The paper discusses questions of human auditory state evaluation with technical means. It considers the disadvantages of existing clinical audiometry methods and systems. It is proposed to use method for evaluating of auditory analyzer state by means of pulsometry to get the medical study more objective and efficient. It provides for use of two optoelectronic sensors located on the carotid artery and ear lobe, Using this method the biotechnical system for evaluation and stimulation of human auditory analyzer stare wad developed. Its hardware and software were substantiated. Different modes of simulation in the designed system were tested and the influence of the procedure on a patient was studied.

Observational Study of Prevalence of Long-term Raynaud-Like Phenomena and Neurological Side Effects in Testicular Cancer Survivors

PubMed Central

Oldenburg, Jan; Klepp, Olbjørn; Bremnes, Roy M.; Wist, Erik A.; Wentzel-Larsen, Tore; Hauge, Erik R.; Dahl, Olav; Fosså, Sophie D.

2009-01-01

Background Sensory neuropathy (paresthesias), tinnitus, hearing impairment, and Raynaud phenomena are side effects of cisplatin-based chemotherapy used to treat testicular cancer patients. We assessed the long-term occurrence of these side effects among testicular cancer survivors according to the treatment they received. Methods A total of 1814 men who were treated for unilateral testicular cancer in Norway during 1980–1994 were invited to participate in a national multicenter follow-up survey conducted during 1998–2002. The men were allocated to six groups according to the treatment they had received. Self-reported symptoms were assessed by a mailed questionnaire that included the Scale for Chemotherapy-Induced Neurotoxicity. A total of 1409 participants who responded to the questionnaire and/or underwent audiometry were assessable in this study. Respondents to the questionnaire (n = 1402) scored the relevant symptoms according to how troubled they were by each (not at all, a little, quite a bit, or very much). Hearing impairment was objectively assessed by audiometry at 4000 Hz in 755 men (seven of whom did not respond to the questionnaire). Group comparisons of symptom assessments were performed with χ2 or Kruskal–Wallis tests. Associations between relevant factors and self-reported symptoms or hearing impairment measured by audiometry were assessed using proportional odds ordinal logistic regression models and linear regression models, respectively. All statistical tests were two-sided. Results The median follow-up for the 1409 assessable men was 10.7 years (range = 4–21 years). All chemotherapy groups had statistically significantly higher odds for increasing severity of all assessed symptoms and inferior audiometric results compared with men who did not receive chemotherapy. Among chemotherapy-treated men, 39% (95% confidence interval [CI] = 35% to 43%) reported Raynaud-like phenomena (defined as white or cold hands or fingers [or feet or toes] on cold exposure), 29% (95% CI = 25% to 33%) reported paresthesias in the hands or feet, 21% (95% CI = 18% to 25%) reported hearing impairment, and 22% (95% CI = 19% to 26%) reported tinnitus as major symptoms troubling them quite a bit or very much. Hearing impairment (odds ratio [OR] = 5.3, 95% CI = 3.0 to 9.2) and tinnitus (OR = 7.1, 95% CI = 4.1 to 12.4) were particularly common in the dose-intensive chemotherapy group compared with the no chemotherapy group. Men who were treated with radiotherapy had higher odds of self-reported paresthesias in feet compared with those not treated with radiotherapy (OR = 1.5, 95% CI = 1.01 to 2.1, P = .04). Conclusion Long-term survivors of testicular cancer who were treated with cisplatin-based chemotherapy were more often troubled by dose-dependent neurological side effects and Raynaud-like phenomena compared with those who were not treated with chemotherapy. PMID:19940282

Retrocochlear impairments in systemic sclerosis: a case report study.

PubMed

Valente, Julia de Souza Pinto; Corona, Ana Paula

2017-12-07

To report three cases of patients with Systemic Sclerosis (SSc) and retrocochlear impairments. This is a case report of three individuals with SSc and retrocochlear impairments assisted at a rheumatology outpatient clinic. All individuals underwent Brainstem Auditory Evoked Potential (BAEP) and, when necessary, audiometry. All three individuals presented sensorineural hearing loss. Although no retrocochlear impairment was identified in the basic audiologic evaluation, the BAEP results were altered. Retrocochlear impairments were present in the individuals under study, both in the absolute latencies and interpeak interval, thereby demanding the attention of rheumatologists and speech-language pathologists to such changes during the monitoring of SSc patients. The results also show a need for epidemiological studies on the theme.

Aberrant sylvian vein: A newly described cause of pulsatile tinnitus.

PubMed

Liu, Zhaohui; Yu, Jingge; Zhao, Pengfei; Zhang, Hanjuan; Wang, Qian; Wang, Zhenchang

2017-10-01

We herein report a newly described cause of venous pulsatile tinnitus: protrusion of an aberrant sylvian vein into the tympanum. A 60-year-old woman presented with a 4-month history of objective persistent pulsatile tinnitus in the right ear with no other complaints. The pulsatile tinnitus diminished with rotation of the head to the right side or by compression of the right cervical vascular structures. The frequency and intensity of the tinnitus were 125 Hz and 20 dB HL, respectively. Audiometry and otoscopic examination findings were normal. Radiologic examination showed that the right sylvian vein protruded into the tympanum through the dehiscent anterior cortical plate of the tympanum.

Otitis Media with ANCA-associated Vasculitis: A New Concept and the Associated Criteria

PubMed Central

Kobari, Yusuke; Nagasawa, Tasuku

2017-01-01

A previously healthy 77-year-old Japanese man presented with a 2-week history of daily fevers peaking at 38°C, chills, hearing loss, and almost 10 kg of unintentional weight loss over 2 months. Pure tone audiometry showed mixed conductive-sensorineural hearing loss: right, 63.6 dB, left, 80.0 dB. Blood tests after admission showed a high myeloperoxidase-antineutrophil cytoplasmic antibody (MPO-ANCA) level (＞300 U/mL), so we suspected ANCA-related vasculitis. The Japanese Otorhinolaryngology Society has recently been advocating the concept of otitis media with ANCA-associated vasculitis (OMAAV). Our case met the criteria proposed, leading to our diagnosis. PMID:29021451

Otitis Media with ANCA-associated Vasculitis: A New Concept and the Associated Criteria.

PubMed

Kobari, Yusuke; Nagasawa, Tasuku

2017-12-15

A previously healthy 77-year-old Japanese man presented with a 2-week history of daily fevers peaking at 38°C, chills, hearing loss, and almost 10 kg of unintentional weight loss over 2 months. Pure tone audiometry showed mixed conductive-sensorineural hearing loss: right, 63.6 dB, left, 80.0 dB. Blood tests after admission showed a high myeloperoxidase-antineutrophil cytoplasmic antibody (MPO-ANCA) level (>300 U/mL), so we suspected ANCA-related vasculitis. The Japanese Otorhinolaryngology Society has recently been advocating the concept of otitis media with ANCA-associated vasculitis (OMAAV). Our case met the criteria proposed, leading to our diagnosis.

Correlations between self-assessed hearing handicap and standard audiometric tests in elderly persons.

PubMed

Pedersen, K; Rosenhall, U

1991-01-01

The relationship between self-assessed hearing handicap and audiometric measures using pure-tone and speech audiometry was studied in a group of elderly persons representative of an urban Swedish population. The study population consisted of two cohorts, one of which was followed longitudinally. Significant correlations between measured and self-assessed hearing were found. Speech discrimination scores showed lower correlations with the self-estimated hearing than pure-tone averages and speech reception threshold. Questions concerning conversation with one person and concerning difficulty in hearing the doorbell showed lower correlations with measured hearing than the other questions. The discrimination score test is an inadequate tool for measuring hearing handicap.

The Galker test of speech reception in noise; associations with background variables, middle ear status, hearing, and language in Danish preschool children.

PubMed

Lauritsen, Maj-Britt Glenn; Söderström, Margareta; Kreiner, Svend; Dørup, Jens; Lous, Jørgen

2016-01-01

We tested "the Galker test", a speech reception in noise test developed for primary care for Danish preschool children, to explore if the children's ability to hear and understand speech was associated with gender, age, middle ear status, and the level of background noise. The Galker test is a 35-item audio-visual, computerized word discrimination test in background noise. Included were 370 normally developed children attending day care center. The children were examined with the Galker test, tympanometry, audiometry, and the Reynell test of verbal comprehension. Parents and daycare teachers completed questionnaires on the children's ability to hear and understand speech. As most of the variables were not assessed using interval scales, non-parametric statistics (Goodman-Kruskal's gamma) were used for analyzing associations with the Galker test score. For comparisons, analysis of variance (ANOVA) was used. Interrelations were adjusted for using a non-parametric graphic model. In unadjusted analyses, the Galker test was associated with gender, age group, language development (Reynell revised scale), audiometry, and tympanometry. The Galker score was also associated with the parents' and day care teachers' reports on the children's vocabulary, sentence construction, and pronunciation. Type B tympanograms were associated with a mean hearing 5-6dB below that of than type A, C1, or C2. In the graphic analysis, Galker scores were closely and significantly related to Reynell test scores (Gamma (G)=0.35), the children's age group (G=0.33), and the day care teachers' assessment of the children's vocabulary (G=0.26). The Galker test of speech reception in noise appears promising as an easy and quick tool for evaluating preschool children's understanding of spoken words in noise, and it correlated well with the day care teachers' reports and less with the parents' reports. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

[Effects of electromagnetic fields emitted by cellular phone on auditory and vestibular labyrinth].

PubMed

Sievert, U; Eggert, S; Goltz, S; Pau, H W

2007-04-01

It is the subject of this study to investigate the biological effect of the HF radiation produced by the Global System for Mobile Communications-( GSM)-mobile phone on the inner ear with its sensors of the vestibular and auditive systems. Thermographic investigations made on various model materials and on the human temporal bone should show whether mobile phone does induce any increases of temperature which would lead to a relevant stimulus for the auditive and vestibular system or not. We carried out video-nystagmographic recordings of 13 subjects, brainstem electric response audiometry of 24 ears, and recordings of distorsion products of otoacoustic emissions of 20 ears. All tests were made with and without a mobile phone in use. The data was then analyzed for variation patterns in the functional parameters of the hearing and balance system that are subject to the (non)existence of electromagnetic radiation from the mobile phone. The thermographic investigations suggest that the mobile phone does not induce any increases of temperature which would lead to a relevant stimulus for the auditive and vestibular system. Video-nystagmographic recordings under field effect do not furnish any indication of vestibular reactions generated by field effects. Compared with the recording without field, the brainstem electric response audiometry under field effect did not reveal any changes of the parameters investigated, i. e. absolute latency of the peaks I, III, V and the interpeak latency between the peaks I and V. The distorsion products of otoacoustic emissions do not indicate, comparing the three measuring situations, i. e. before field effect, pulsed field and continuous field, any possible impacts of the HF field on the spectrum or levels of emissions for none of the probands. The investigations made show that the electromagnetic fields generated in using the mobile phone do not have an effect on the inner ear and auditive system to the colliculus inferior in the brainstem and on the vestibular receptors in the inner ear and the vestibular system.

An epidemiologic study of tinnitus in a population in Jiangsu Province, China.

PubMed

Xu, Xia; Bu, Xingkuan; Zhou, Ling; Xing, Guangqian; Liu, Cheng; Wang, Dengyuan

2011-10-01

Tinnitus is a common complaint and often of no clinical significance. There are a number of unresolved issues concerning the etiology, pathogenesis, and natural history of tinnitus. There are a few current population-based estimates of the prevalence of tinnitus done in representative large geographic areas, but there is little data from multi-area, large sample studies of tinnitus in China. To investigate the prevalence of tinnitus and related factors in a Chinese population. These data would be used to plan and evaluate health-care services. We carried out an epidemiologic study of tinnitus as part of an epidemiologic study of ear and hearing disorders that was undertaken in Jiangsu Province, China. A question about tinnitus history was included in a comprehensive questionnaire about hearing. All participants also had both pure tone audiometry and an otological examination. The sample consisted of 6333 people 10 yr of age or older, selected by the methods of probability proportional to size. All participants answered a questionnaire concerning their tinnitus and had pure tone audiometry testing and an ear examination. All data were entered using EPIDATD 3.0 software and analyzed by a chi-squared test and test for trends. The overall prevalence of tinnitus was 14.5%, and the standardized rates were 11.4% in the whole country and 12.4% in Jiangsu province. Its prevalence increased with age. The prevalence of tinnitus was 11.9 and 15.6% in urban and rural residents, respectively There was no significant difference in prevalence between men and women. Hearing impairment, history of middle ear infections, and noise exposure were the main risk factors for tinnitus. Tinnitus is a common problem in the population. With the aging of the population, the prevalence of tinnitus will increase. The prevention of tinnitus should focus on hearing impairment screening, otitis media treatment, and noise exposure reduction. Health services in rural areas should emphasize prevention more. American Academy of Audiology.

[Audiological characteristics of young children with otitis media with effusion].

PubMed

Wang, Qiu-ju; Shi, Wei; Lan, Lan; Wang, Da-yong; Zhang, Ya-mei

2008-12-01

To characterize the audiological features in the infants with otitis media with effusion (OME) and to investigate the utility of variety of objective audiometry methods in diagnosis and intervention on OME. Fifty six infants (40 males and 16 females) were investigated, who were referred to our clinic at the General Hospital of Chinese People's Liberation Army by the other hospitals from December 2004 to June 2007 when the infants were diagnosed or highly suspected of OME. The ages at the initial diagnosis ranged from 42 days to three years, with an average of five months. The infants, after receiving the conventional otolaryngological exams, were subjected to the tests of auditory brainstem response (ABR), otoacoustic emission (OAE), tympanometry (226 Hz and 1000 Hz) and behaviors audiometry. Among 56 affected infants, 87 ears were diagnosed with OME, of which 31 infants were affected bilateral and 25 with monaural. For the 49 infants who received hearing screening at birth, 36 infants were referred at the initial screening. For the 52 infants who received repeated screening, all subjects were referred. Six infants without receiving hearing screening came to clinic when their parents observed their kids' hearing impairment. Among the 52 cases (104 ears) who received tympanometry test, 20 subjects (28 ears) showed B or C type tympanometry curve. Thirty-nine cases (78 ears) were given tympanometry test at 1000 Hz, of which 38 cases (55 ears) showed abnormal hearing. Among 56 infants (112 ears) with ABR test, 49 subjects (74 ears) exhibited prolonged ABR type I curve. All 56 infants (112 ears) received OAE test, of which 55 subjects (81 ears) were referred. Four infants (8 ears) accepted the behavior test and all of them showed A-B Gap. The combined tympanometry test at both 226 Hz and 1000 Hz, ABR latency or threshold test, infant's behavior test and OAE, used jointly, enable characterizing better OME in infants, thus helping early diagnosis of this hearing disorder.

Evaluation of peripheral auditory pathways and brainstem in obstructive sleep apnea.

PubMed

Matsumura, Erika; Matas, Carla Gentile; Magliaro, Fernanda Cristina Leite; Pedreño, Raquel Meirelles; Lorenzi-Filho, Geraldo; Sanches, Seisse Gabriela Gandolfi; Carvallo, Renata Mota Mamede

2016-11-25

Obstructive sleep apnea causes changes in normal sleep architecture, fragmenting it chronically with intermittent hypoxia, leading to serious health consequences in the long term. It is believed that the occurrence of respiratory events during sleep, such as apnea and hypopnea, can impair the transmission of nerve impulses along the auditory pathway that are highly dependent on the supply of oxygen. However, this association is not well established in the literature. To compare the evaluation of peripheral auditory pathway and brainstem among individuals with and without obstructive sleep apnea. The sample consisted of 38 adult males, mean age of 35.8 (±7.2), divided into four groups matched for age and Body Mass Index. The groups were classified based on polysomnography in: control (n=10), mild obstructive sleep apnea (n=11) moderate obstructive sleep apnea (n=8) and severe obstructive sleep apnea (n=9). All study subjects denied a history of risk for hearing loss and underwent audiometry, tympanometry, acoustic reflex and Brainstem Auditory Evoked Response. Statistical analyses were performed using three-factor ANOVA, 2-factor ANOVA, chi-square test, and Fisher's exact test. The significance level for all tests was 5%. There was no difference between the groups for hearing thresholds, tympanometry and evaluated Brainstem Auditory Evoked Response parameters. An association was observed between the presence of obstructive sleep apnea and changes in absolute latency of wave V (p=0.03). There was an association between moderate obstructive sleep apnea and change of the latency of wave V (p=0.01). The presence of obstructive sleep apnea is associated with changes in nerve conduction of acoustic stimuli in the auditory pathway in the brainstem. The increase in obstructive sleep apnea severity does not promote worsening of responses assessed by audiometry, tympanometry and Brainstem Auditory Evoked Response. Copyright © 2016 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

The efficacy and safety of systemic injection of Ginkgo biloba extract, EGb761, in idiopathic sudden sensorineural hearing loss: a randomized placebo-controlled clinical trial.

PubMed

Koo, Ja-Won; Chang, Mun Young; Yun, Sung-Cheol; Kim, Tae Su; Kong, Soo-Keun; Chung, Jong Woo; Goh, Eui-Kyung

2016-09-01

Steroids are currently the most frequently accepted agents for idiopathic sudden sensorineural hearing loss (ISSNHL). However, the therapeutic effect of steroids is not always satisfactory. In this pilot study, we evaluated whether systemic treatment with Ginkgo biloba extract (EGb761) has an additive therapeutic effect in patients receiving a systemic steroid due to ISSNHL. A multicenter, randomized, double-blind clinical trial was performed. Fifty-six patients with ISSNHL were allocated to either EGb761 or placebo. In both groups, methylprednisolone was administered for 14 days. EGb761 was infused intravenously for 5 days in the EGb761 group, while the same amount of normal saline was infused in the placebo group. For the efficacy evaluation, pure-tone audiometry, speech audiometry, tinnitus handicap inventory (THI) and short form-36 health (SF-36) survey outcomes were obtained before administration and on days 3, 5, 14 and 28 of administration. Twenty-four patients in each group completed the study protocol. There was no difference in hearing loss between the two groups before treatment. At day 28, air conduction threshold values in the placebo and EGb761 groups were 34.63 ± 28.90 and 23.84 ± 25.42 dB, respectively (p = 0.082). Speech discrimination scores in the placebo and EGb761 groups were 69.17 ± 40.89 and 87.48 ± 28.65 %, respectively (p = 0.050). THI and SF-36 scores in the placebo and EGb761 groups were similar. Although a combination of steroid and EGb761 for initial treatment did not show better pure tone threshold, compared with steroid alone, speech discrimination was significantly improved in combination therapy. Further studies will be needed to know if addition of EGb761 actually improves the outcome of ISSNHL treatment.

Effects of serum zinc level on tinnitus.

PubMed

Berkiten, Güler; Kumral, Tolgar Lütfi; Yıldırım, Güven; Salturk, Ziya; Uyar, Yavuz; Atar, Yavuz

2015-01-01

The aim of this study was to assess zinc levels in tinnitus patients, and to evaluate the effects of zinc deficiency on tinnitus and hearing loss. One-hundred patients, who presented to an outpatient clinic with tinnitus between June 2009 and 2014, were included in the study. Patients were divided into three groups according to age: Group I (patients between 18 and 30years of age); Group II (patients between 31 and 60years of age); and Group III (patients between 61 and 78years of age). Following a complete ear, nose and throat examination, serum zinc levels were measured and the severity of tinnitus was quantified using the Tinnitus Severity Index Questionnaire (TSIQ). Patients were subsequently asked to provide a subjective judgment regarding the loudness of their tinnitus. The hearing status of patients was evaluated by audiometry and high-frequency audiometry. An average hearing sensitivity was calculated as the mean value of hearing thresholds between 250 and 20,000Hz. Serum zinc levels between 70 and 120μg/dl were considered normal. The severity and loudness of tinnitus, and the hearing thresholds of the normal zinc level and zinc-deficient groups, were compared. Twelve of 100 (12%) patients exhibited low zinc levels. The mean age of the zinc-deficient group was 65.41±12.77years. Serum zinc levels were significantly lower in group III (p<0.01). The severity and loudness of tinnitus were greater in zinc-deficient patients (p=0.011 and p=0.015, respectively). Moreover, the mean thresholds of air conduction were significantly higher in zinc-deficient patients (p=0.000). We observed that zinc levels decrease as age increases. In addition, there was a significant correlation between zinc level and the severity and loudness of tinnitus. Zinc deficiency was also associated with impairments in hearing thresholds. Copyright © 2015 Elsevier Inc. All rights reserved.

[Acute hearing loss and tinnitus caused by amplified recreational music].

PubMed

Metternich, F U; Brusis, T

1999-11-01

Hearing loss resulting from exposure to permanent or repeated amplified music in professional musicians and music consumers is described in literature. The risk of hearing loss does not exist only after prolonged exposure to music. Short-term exposure to very high sound levels, for example in concerts, can also cause hearing loss and tinnitus. The retrospective study includes 24 patients who required rheologic therapy between 1994 and 1997 due to a music related acoustic trauma. The type, intensity, and length of music exposure as well as the distance and the position to the source of noise were examined. The type of hearing damage and its development during rheological treatment was studied by pure-tone audiometry. In the majority of examined patients (67%) the hearing loss developed on the basis of one-time exposure at a rock concert or pop concert, followed by hearing loss from attending discotheques (17%) or parties (12%), and music exposure from personal cassette players (4%). The majority of patients showed a maximum hearing loss of 40-60 dB (A) in a frequency between 3 kHz and 4 kHz. Pure-tone audiometry in 58% of the patients exhibited a unilateral threshold in a frequency between 3 kHz and 4 kHz combined with ipsilateral tinnitus of the same frequency. Twenty-one percent of the patients showed a symmetric bilateral threshold and tinnitus between 3 kHz and 4 kHz. In 8% there was a unilateral tinnitus, and in 13% a bilateral tinnitus without any hearing loss. All patients improved their hearing loss during rheologic treatment. Improvement in the tinnitus was only achieved in 33% of the examined cases. The risk of permanent hearing loss resulting from short-term exposure to amplified music is low compared to the risk of continuous tinnitus. Given the lack of acceptance of personal ear protectors, the risk of acute hearing damage due to amplified music could be reduced by avoiding the immediate proximity to the speakers.

[Conversion of sound into auditory nerve action potentials].

PubMed

Encke, J; Kreh, J; Völk, F; Hemmert, W

2016-11-01

Outer hair cells play a major role in the hearing process: they amplify the motion of the basilar membrane up to a 1000-fold and at the same time sharpen the excitation patterns. These patterns are converted by inner hair cells into action potentials of the auditory nerve. Outer hair cells are delicate structures and easily damaged, e. g., by overexposure to noise. Hearing aids can amplify the amplitude of the excitation patterns, but they cannot restore their degraded frequency selectivity. Noise overexposure also leads to delayed degeneration of auditory nerve fibers, particularly those with low a spontaneous rate, which are important for the coding of sound in noise. However, this loss cannot be diagnosed by pure-tone audiometry.

Laser Doppler vibrometry: new ENT applications

NASA Astrophysics Data System (ADS)

Stasche, Norbert; Baermann, M.; Kempe, C.; Hoermann, Karl; Foth, Hans-Jochen

1996-12-01

Common audiometry often does not really allow a reliable and objective differential diagnosis of hearing disorders such as otosclerosis, adhesive otitis, ossicular interruption or tinnitus, even though several methods might be used complementarily. In recent years, some experimental studies on middle ear mechanics established laser Doppler vibrometry (LDV) as a useful method allowing objective measurement of human tympanic membrane displacement. The present study on LDV investigated the clinical use of this new method under physiological conditions. LDV proved to be a fast, reproducible, non-invasive and very sensitive instrument to characterize ear-drum vibrations in various middle ear dysfunctions, except in tinnitus patients. For future applications, improved optical characteristics of the vibrometer might result in a better differential diagnosis of subjective and objective tinnitus, otoacoustic emissions or Morbus Meniere.

A case of high noise sensitivity

NASA Astrophysics Data System (ADS)

Murata, M.; Sakamoto, H.

1995-10-01

A case of noise sensitivity with a five-year follow-up period is reported. The patient was a 34-year-old single man who was diagnosed as having psychosomatic disorder triggered by two stressful life events in rapid succession with secondary hypersensitivity to noise. Hypersensitivity to light and cold also developed later in the clinical course. The auditory threshold was within the normal range. The discomfort threshold as a measure of the noise sensitivity secondary to mental illness was measured repeatedly using test tone of audiometry. The discomfort threshold varied depending upon his mental status, ranging from 40-50 dB in the comparatively poorer mental state to 70-95 dB in the relatively good mental state. The features of noise sensitivity, including that secondary to mental illness, are discussed.

Assessment of cortical auditory evoked potentials in children with specific language impairment.

PubMed

Włodarczyk, Elżbieta; Szkiełkowska, Agata; Pilka, Adam; Skarżyński, Henryk

2018-02-28

The proper course of speech development heavily influences the cognitive and personal development of children. It is a condition for achieving preschool and school successes - it facilitates socializing and expressing feelings and needs. Impairment of language and its development in children represents a major diagnostic and therapeutic challenge for physicians and therapists. Early diagnosis of coexisting deficits and starting the therapy influence the therapeutic success. One of the basic diagnostic tests for children suffering from specific language impairment (SLI) is audiometry, thus far referred to as a hearing test. Auditory processing is just as important as a proper hearing threshold. Therefore, diagnosis of central auditory disorder may be a valuable supplementation of diagnosis of language impairment. Early diagnosis and implementation of appropriate treatment may contribute to an effective language therapy.

Decreased Speech-In-Noise Understanding in Young Adults with Tinnitus

PubMed Central

Gilles, Annick; Schlee, Winny; Rabau, Sarah; Wouters, Kristien; Fransen, Erik; Van de Heyning, Paul

2016-01-01

Objectives: Young people are often exposed to high music levels which make them more at risk to develop noise-induced symptoms such as hearing loss, hyperacusis, and tinnitus of which the latter is the symptom perceived the most by young adults. Although, subclinical neural damage was demonstrated in animal experiments, the human correlate remains under debate. Controversy exists on the underlying condition of young adults with normal hearing thresholds and noise-induced tinnitus (NIT) due to leisure noise. The present study aimed to assess differences in audiological characteristics between noise-exposed adolescents with and without NIT. Methods: A group of 87 young adults with a history of recreational noise exposure was investigated by use of the following tests: otoscopy, impedance measurements, pure-tone audiometry including high-frequencies, transient and distortion product otoacoustic emissions, speech-in-noise testing with continuous and modulated noise (amplitude-modulated by 15 Hz), auditory brainstem responses (ABR) and questionnaires.Nineteen students reported NIT due to recreational noise exposure, and their measures were compared to the non-tinnitus subjects. Results: No significant differences between tinnitus and non-tinnitus subjects could be found for hearing thresholds, otoacoustic emissions, and ABR results.Tinnitus subjects had significantly worse speech reception in noise compared to non-tinnitus subjects for sentences embedded in steady-state noise (mean speech reception threshold (SRT) scores, respectively −5.77 and −6.90 dB SNR; p = 0.025) as well as for sentences embedded in 15 Hz AM-noise (mean SRT scores, respectively −13.04 and −15.17 dB SNR; p = 0.013). In both groups speech reception was significantly improved during AM-15 Hz noise compared to the steady-state noise condition (p < 0.001). However, the modulation masking release was not affected by the presence of NIT. Conclusions: Young adults with and without NIT did not differ regarding audiometry, OAE, and ABR.However, tinnitus patients showed decreased speech-in-noise reception. The results are discussed in the light of previous findings suggestion NIT may occur in the absence of measurable peripheral damage as reflected in speech-in-noise deficits in tinnitus subjects. PMID:27445661

Effects of diabetes mellitus and systemic arterial hypertension on elderly patients' hearing.

PubMed

Rolim, Laurie Penha; Samelli, Alessandra Giannella; Moreira, Renata Rodrigues; Matas, Carla Gentile; Santos, Itamar de Souza; Bensenor, Isabela Martins; Lotufo, Paulo Andrade

2017-09-21

Chronic diseases can act as an accelerating factor in the auditory system degeneration. Studies on the association between presbycusis and diabetes mellitus and systemic arterial hypertension have shown controversial conclusions. To compare the initial audiometry (A1) with a subsequent audiometry (A2) performed after a 3 to 4-year interval in a population of elderly patients with diabetes mellitus and/or systemic arterial hypertension, to verify whether hearing loss in these groups is more accelerated when compared to controls without these clinical conditions. 100 elderly individuals participated in this study. For the auditory threshold assessment, a previous complete audiological evaluation (A1) and a new audiological evaluation (A2) performed 3-4 years after the first one was utilized. The participants were divided into four groups: 20 individuals in the diabetes mellitus group, 20 individuals in the systemic arterial hypertension group, 20 individuals in the diabetes mellitus/systemic arterial hypertension group and 40 individuals in the control group, matching them with each study group, according to age and gender. ANOVA and Kruskal-Wallis statistical tests were used, with a significance level set at 0.05. When comparing the mean annual increase in the auditory thresholds of the A1 with the A2 assessment, considering each study group and its respective control, it can be observed that there was no statistically significant difference for any of the frequencies for the diabetes mellitus group; for the systemic arterial hypertension group, significant differences were observed after 4kHz. For the diabetes mellitus and systemic arterial hypertension group, significant differences were observed at the frequencies of 500, 2kHz, 3kHz and 8kHz. It was observed that the systemic arterial hypertension group showed the greatest decrease in auditory thresholds in the studied segment when compared to the other groups, suggesting that among the three studied conditions, hypertension seems to have the greatest influence on hearing. Copyright © 2017 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Audiology Assistants: Results of a Multicenter Survey.

PubMed

Karzon, Roanne; Hunter, Lisa; Steuerwald, Wendy

2018-05-01

Although audiologists have been using support personnel for over 45 yr, controversy and variability continue with respect to the entry-level education, training methods, and scope of practice. As part of a larger clinical practices survey, this report focuses on use of audiology assistants (AAs) for pediatric settings and "life-span" facilities that had a significant population of pediatric patients. A questionnaire was sent to 116 facilities in geographically diverse locations. Of the 25 surveys returned, 22 had sufficient data to be included for analysis purposes. The majority of respondents assigned duties to AAs as follows: assisting with conditioned play audiometry and visual reinforcement audiometry, infection control, mail management, disposing of protected health information, ordering supplies, calling families, fielding family phone calls, and stocking supplies. In addition, of the nine pediatric facilities that used AAs and reported job duties, the majority assigned troubleshooting equipment and auditory brainstem response (ABR) screening. Two of the five life-span facilities that reported job duties assigned several duties not assigned by any of the pediatric facilities: pure-tone screening, earmold impressions, assisting with videonystagmography and ABR, and in-house hearing aid repairs. Of facilities that use AAs and reported staffing, the ratio of AAs to audiologists ranged from 0.03:1 to 1:0.37, with an average of 0.15 for life-span facilities and 0.17 for the pediatric facilities. Minimum educational levels required were reported as follows: high school (n = 8), college (n = 3), certificate (n = 1), and no requirement (n = 1). Within a small sample size of pediatric and life-span facilities, 14 of 22 centers used AAs to perform a variety of direct patient care, indirect patient care, and clerical duties. Based on the duties recommended within the American Speech-Language-Hearing Association guidelines and by many states, expanded employment of AAs, as well as expansion of assigned duties should be considered. Data are needed to determine the appropriate ratio of AAs to audiologists within different settings and to determine the impact of AAs for accessibility, productivity, and profitability. American Academy of Audiology.

Chronic inflammatory demyelinating polyneuropathy: evaluation of the vestibular system with cervical and ocular vestibular evoked myogenic potentials.

PubMed

Magliulo, Giuseppe; Iannella, Giannicola; Manno, Alessandra; Libonati, Laura; Onesti, Emanuela; Vestri, Annarita; Fegatelli, Danilo Alunni; Angeletti, Diletta; Pace, Annalisa; Gulotta, Giampiero; Gagliardi, Silvia; Inghilleri, Maurizio

2018-06-01

To investigate the possibility of vestibular damage in a group of patients suffering from chronic inflammatory demyelinating polyneuropathy (CIDP) using a diagnostic protocol including the caloric test, C-VEMPs and O-VEMPs. Twenty patients suffering from CIDP (mean age 58.5 years, range 33-80 years; 4 women and 16 men) were investigated. To assess any eventual audio-vestibular involvement, all patients of the study underwent pure tone audiometry, Fitzgerald-Hallpike caloric vestibular test, C-VEMPs and O-VEMPs. In 11 patients with CIDP values of both O-VEMPs and C-VEMPs were either absent or abnormal. An absent trace at O-VEMPs testing occurred in 36% of these pathological patients, whereas an increase of n10 latency and amplitude was present in the other 64% . A specific diagnostic protocol including the caloric test, C-VEMPS, O-VEMPS, could be useful when employed for identifying vestibular damage in CIDP patients.

Evaluation of cochlear involvement by transient evoked otoacoustic emission test in children with Crimean-Congo hemorrhagic fever.

PubMed

Uysal, İsmail Önder; Kaya, Ali; Güven, Ahmet Sami; Altuntaş, Emine Elif; Müderris, Suphi

2011-06-01

The aim of this study was to investigate cochlear involvement in child patients with Crimean-Congo hemorrhagic fever (CCHF) disease. Twenty-eight CCHF disease patients (56 ears) and 26 sex- and age-matched healthy control subjects (52 ears) were included in the study. Pure-tone audiometry at frequencies 0.25, 0.5, 1, 2, 4, and 6 kHz, immittance measures including tympanometry and acoustic reflex testing, and transient evoked otoacoustic emission (TEOAE) testing were performed in the patients and controls. The proportion with a result of 'fail' for the TEOAE test in the CCHF patients was not statistically significant from the control group (p>0.05). CCHF disease does not impair cochlear function in children. The clinical course of CCHF among children seems to be milder than in adults. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Tuberculous otitis media: a case presentation and review of the literature

PubMed Central

Aremu, S K; Alabi, B S

2010-01-01

A 42-year-old farmer being treated for pulmonary tuberculosis was referred to our clinic after developing otorrhoea and hearing loss in his right ear. Examination revealed a large subtotal perforation in the right ear in addition to a purulent discharge with right facial nerve palsy. Audiometry indicated a 35 dB conductive hearing loss at 0.5, 1 and 2 kHz with air–bone gaps of 12, 15 and 10 dB, respectively. A middle ear biopsy was performed under direct visualisation, with a middle ear lavage which was positive for allergic fungal sinusitis (AFS). The final diagnosis was tuberculous otitis media (TOM). Clinical symptoms and signs should be reviewed in every case of chronic otitis media keeping the possibility of tuberculosis in mind. Otorrhoea in a patient with known or suspected active pulmonary tuberculosis should be assumed to be TOM until proven otherwise. PMID:22798297

Tuberculous otitis media: a case presentation and review of the literature.

PubMed

Aremu, S K; Alabi, B S

2010-12-01

A 42-year-old farmer being treated for pulmonary tuberculosis was referred to our clinic after developing otorrhoea and hearing loss in his right ear. Examination revealed a large subtotal perforation in the right ear in addition to a purulent discharge with right facial nerve palsy. Audiometry indicated a 35 dB conductive hearing loss at 0.5, 1 and 2 kHz with air-bone gaps of 12, 15 and 10 dB, respectively. A middle ear biopsy was performed under direct visualisation, with a middle ear lavage which was positive for allergic fungal sinusitis (AFS). The final diagnosis was tuberculous otitis media (TOM). Clinical symptoms and signs should be reviewed in every case of chronic otitis media keeping the possibility of tuberculosis in mind. Otorrhoea in a patient with known or suspected active pulmonary tuberculosis should be assumed to be TOM until proven otherwise.

Hearing loss in the Royal Norwegian Navy: A longitudinal study

PubMed Central

Irgens-Hansen, Kaja; Baste, Valborg; Bråtveit, Magne; Lind, Ola; Koefoed, Vilhelm F.; Moen, Bente E

2016-01-01

The aims of this longitudinal study were to investigate a significant threshold shift (STS) among personnel working on board the Royal Norwegian Navy's (RNoN) vessels between 2012 and 2014 and to identify possible determinants of STS. Hearing thresholds were measured by pure tone audiometry in two consecutive examinations (n = 226). STS was defined as an average change in hearing thresholds ≥ + 10 dB at 2,000 Hz, 3,000 Hz, and 4,000 Hz in either ear. Determinants of STS were assessed through a questionnaire. The incidence of STS was 23.0%. Significant determinants of STS were the number of episodes of temporary threshold shifts (TTS) in the Navy, exposure to continuous loud noise during work on board, and the number of gun shots (in the Navy, hunting, and sports). This study indicated a significant association between noise exposure on board Navy vessels and development of STS. PMID:27157689

Hearing loss in the Royal Norwegian Navy: A longitudinal study.

PubMed

Irgens-Hansen, Kaja; Baste, Valborg; Bråtveit, Magne; Lind, Ola; Koefoed, Vilhelm F; Moen, Bente E

2016-01-01

The aims of this longitudinal study were to investigate a significant threshold shift (STS) among personnel working on board the Royal Norwegian Navy's (RNoN) vessels between 2012 and 2014 and to identify possible determinants of STS. Hearing thresholds were measured by pure tone audiometry in two consecutive examinations (n = 226). STS was defined as an average change in hearing thresholds ≥ + 10 dB at 2,000 Hz, 3,000 Hz, and 4,000 Hz in either ear. Determinants of STS were assessed through a questionnaire. The incidence of STS was 23.0%. Significant determinants of STS were the number of episodes of temporary threshold shifts (TTS) in the Navy, exposure to continuous loud noise during work on board, and the number of gun shots (in the Navy, hunting, and sports). This study indicated a significant association between noise exposure on board Navy vessels and development of STS.

Hearing impairment and mental state in the elderly living at home.

PubMed Central

Herbst, K G; Humphrey, C

1980-01-01

Altogether 153 (60%) out of a sample of 253 people aged 70 years and over living in their own homes were found to have impaired hearing when tested by pure-tone audiometry. This is almost twice the prevalence found in all other studies, in which deafness was assessed clinically or by self-reporting. The prevalence of deafness increased with age. Evidence of organic brain syndrome (dementia), as determined by questionnaire, was present in 39 (16%) out of 245 respondents, and of depression in 82 (35%). Dementia and depression were both age related. An apparent association between deafness and dementia was shown to be due to age alone. A significant relation between deafness and depression was independent of age and socioeconomic state. The use of audiometric techniques of assessment established that an association exists between deafness and depression that is not simply a function of differential reporting reflecting the emotional state of the respondent. PMID:7427503

Hearing loss among older construction workers: Updated analyses.

PubMed

Dement, John; Welch, Laura S; Ringen, Knut; Cranford, Kim; Quinn, Patricia

2018-04-01

A prior study of this construction worker population found significant noise-associated hearing loss. This follow-up study included a much larger study population and consideration of additional risk factors. Data included audiometry, clinical chemistry, personal history, and work history. Qualitative exposure metrics for noise and solvents were developed. Analyses compared construction workers to an internal reference group with lower exposures and an external worker population with low noise exposure. Among participants (n = 19 127) an overall prevalence of hearing loss of 58% was observed, with significantly increased prevalence across all construction trades. Construction workers had significantly increased risk of hearing loss compared to reference populations, with increasing risk by work duration. Noise exposure, solvent exposure, hypertension, and smoking were significant risk factors in multivariate models. Results support a causal relationship between construction trades work and hearing loss. Prevention should focus on reducing exposure to noise, solvents, and cigarette smoke. © 2018 Wiley Periodicals, Inc.

A Case of Generalized Auditory Agnosia with Unilateral Subcortical Brain Lesion

PubMed Central

Suh, Hyee; Kim, Soo Yeon; Kim, Sook Hee; Chang, Jae Hyeok; Shin, Yong Beom; Ko, Hyun-Yoon

2012-01-01

The mechanisms and functional anatomy underlying the early stages of speech perception are still not well understood. Auditory agnosia is a deficit of auditory object processing defined as a disability to recognize spoken languages and/or nonverbal environmental sounds and music despite adequate hearing while spontaneous speech, reading and writing are preserved. Usually, either the bilateral or unilateral temporal lobe, especially the transverse gyral lesions, are responsible for auditory agnosia. Subcortical lesions without cortical damage rarely causes auditory agnosia. We present a 73-year-old right-handed male with generalized auditory agnosia caused by a unilateral subcortical lesion. He was not able to repeat or dictate but to perform fluent and comprehensible speech. He could understand and read written words and phrases. His auditory brainstem evoked potential and audiometry were intact. This case suggested that the subcortical lesion involving unilateral acoustic radiation could cause generalized auditory agnosia. PMID:23342322

The effect of guessing on the speech reception thresholds of children.

PubMed

Moodley, A

1990-01-01

Speech audiometry is an essential part of the assessment of hearing impaired children and it is now widely used throughout the United Kingdom. Although instructions are universally agreed upon as an important aspect in the administration of any form of audiometric testing, there has been little, if any, research towards evaluating the influence which instructions that are given to a listener have on the Speech Reception Threshold obtained. This study attempts to evaluate what effect guessing has on the Speech Reception Threshold of children. A sample of 30 secondary school pupils between 16 and 18 years of age with normal hearing was used in the study. It is argued that the type of instruction normally used for Speech Reception Threshold in audiometric testing may not provide a sufficient amount of control for guessing and the implications of this, using data obtained in the study, are examined.

Diagnostic approach to patients with tinnitus.

PubMed

Yew, Kenneth S

2014-01-15

Tinnitus, a common symptom encountered in family medicine, is defined as the perception of noise in the absence of an acoustic stimulus outside of the body. Because tinnitus is a symptom and not a disease, its underlying cause must be determined to best help patients. Although tinnitus is often idiopathic, sensorineural hearing loss is the most common identified cause. It can also be caused by other otologic, vascular, neoplastic, neurologic, pharmacologic, dental, and psychological factors. More serious causes, such as Meniere disease or vestibular schwannoma, can be excluded during the evaluation. History and physical examination of the head, eyes, ears, nose, throat, neck, and neurologic system guide subsequent evaluation. Almost all patients with tinnitus should undergo audiometry with tympanometry, and some patients require neuroimaging or assessment of vestibular function with electronystagmography. Supportive counseling should begin during the initial evaluation to help patients cope with tinnitus. Counseling may also improve the chances of successful subsequent treatment.

[Management of sudden neurosensory hearing loss in a Primary Care Centre].

PubMed

Muñoz-Proto, F; Carnevale, C; Bejarano-Panadés, N; Ferrán-de la Cierva, L; Mas-Mercant, S; Sarría-Echegaray, P

2014-04-01

Sudden hearing loss is a rapid loss of neurosensory hearing that may occur within hours or days in an apparently healthy patient. Its origins are variable and multifactorial. Most patients do not recover hearing if not treated, and some even develop cophosis (deafness) in the affected ear. It is an otological emergency, as early therapeutic management offers a better hearing prognosis. As there is limited knowledge on this condition, it may be underdiagnosed in Primary Health Care Centers. It should be suspected in patients with abrupt hearing loss or tinnitus. Sophisticated instruments are not required for its diagnosis, just a detailed history, basic otoscopy, and proper interpretation of the hearing test. In this way, an accurate diagnosis is achieved in most cases, which is confirmed by audiometry. Copyright © 2012 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

Vestibular-evoked myogenic potential in response to bone-conducted sound in patients with otosclerosis

PubMed Central

Seo, Toru; Fujimori, Kiyoko; Mishiro, Yasuo; Sakagami, Masafumi

2012-01-01

Conclusion: Saccular dysfunction is a major cause of balance problems in patients with otosclerosis. Vestibular-evoked myogenic potential in response to bone-conducted sound (BC-VEMP) testing is useful for diagnosis of these patients. Objectives: The purpose of this study was to elucidate the origin of balance problems in patients with otosclerosis using BC-VEMP. Methods: Subjects comprised 25 patients with unoperated otosclerosis (9 men and 16 women). They were divided into two groups depending on type of balance problems. Results of cochleo-vestibular functions including pure-tone audiometry, caloric testing, and BC-VEMP testing were compared between the two groups. Results: Ten patients had complained of dizziness and/or vertigo (disequilibrium group), and the other 15 patients had not (Non-disequilibrium group). Nine patients showed abnormal results on BC-VEMP testing in the disequilibrium group, while one patient had abnormal results in the non-disequilibrium group (p < 0.001). PMID:22830649

[Neurotological long-term follow-up in Minamata disease in Niigata, Japan].

PubMed

Mizukoshi, Kanemasa; Watanabe, Yukio; Shojaku, Hideo; Aso, Shin; Asai, Masatsugu; Inukai, Kenya; Takahashi, Sugata

2002-03-01

To determine the long-term influence of organic mercurial intoxication on audiological and equilibrium findings, we followed up 36 patients neurotologically during 1980-1987 and 1991-2000 at Kido Hospital in Niigata. Typical findings were as follows: 1. In pure-tone audiometry, 24 of 72 ears (33%) showed slight hearing deterioration and 3 (4%) showed improvement. 2. Spontaneous nystagmus had disappeared in 5 patients (14%), but appeared in new 13 patients (36%). Positional nystagmus did not improve in any patient, and deteriorated in 11 (31%). 3. In optokinetic nystagmus (OKN) tests, especially in vertical OKN test showing significant deterioration (44%). 4. The caloric nystagmus test showed marked deterioration (47%). Body-equilibrium testing showed slight deterioration in 11 patients (31%) and improvement in 5 (14%). Neurotological findings thus varied widely among patients and we were concluded that these differences were caused both by duration of methyl mercury contamination and by aging factors in patients.

Auditory steady state response in sound field.

PubMed

Hernández-Pérez, H; Torres-Fortuny, A

2013-02-01

Physiological and behavioral responses were compared in normal-hearing subjects via analyses of the auditory steady-state response (ASSR) and conventional audiometry under sound field conditions. The auditory stimuli, presented through a loudspeaker, consisted of four carrier tones (500, 1000, 2000, and 4000 Hz), presented singly for behavioral testing but combined (multiple frequency technique), to estimate thresholds using the ASSR. Twenty normal-hearing adults were examined. The average differences between the physiological and behavioral thresholds were between 17 and 22 dB HL. The Spearman rank correlation between ASSR and behavioral thresholds was significant for all frequencies (p < 0.05). Significant differences were found in the ASSR amplitude among frequencies, and strong correlations between the ASSR amplitude and the stimulus level (p < 0.05). The ASSR in sound field testing was found to yield hearing threshold estimates deemed to be reasonably well correlated with behaviorally assessed thresholds.

Hearing impairment, disability and handicap in elderly people living in residential care and in the community.

PubMed

Stumer, J; Hickson, L; Worrall, L

1996-02-01

This study aimed to compare the prevalence of hearing impairment, disability and handicap in the elderly living in residential care with those living in the community, and to examine the relationship between impairment, disability and handicap in both groups. Fifty community-based and 129 residential subjects were assessed using pure-tone audiometry as a measure of impairment, and a self-assessment questionnaire as a measure of disability and handicap. Community-based subjects were also assessed using a test of speech discrimination as an objective measure of disability. Results indicated 95% of residential subjects and 70% of community-based subjects were hearing-impaired, while 27% of residential subjects and 42% of community-based subjects demonstrated significant disability/handicap. Significant correlations were obtained between impairment, disability and handicap in both subject groups. The implications of the findings for the aural rehabilitation of the elderly are discussed.

Communication interface and graphic module for audiometry equipment.

PubMed

Gutiérrez Martinez, Josefina; Barraza López, Fernando; Guadarrama Lara, Alberto; Núñez Gaona, Marco Antonio; Delgado Esquerra, Ruth; Gutiérrez Farfán, Ileana

2009-01-01

The National Rehabilitation Institute (INR) in Mexico City purchased 12 Madsen Orbiter 922 audiometers in 2006. While this audiometer is excellent for diagnosing the degree and type of hearing loss, it has presented problems in transfering, saving and printing the results of special tests and logoaudiometry from audiometer to workstation with the NOAH-3 system. The data are lost when the audiometer is turned off or a new patient is captured. There is no database storing and, shortly after the results have been printed on the thermal paper, the audiograms are erased. This problem was addressed by designing and implementing the InterAudio (AAMS) communication and graphical interface. The limitations and scope of the Automatic Audiometric Measurement System were analyzed, then a search of technical information was performed that included the resources for designing, developing and implementing the transfer interface, the user's graphical module requirements, and the tools for printing and saving the study.

Database for vertigo.

PubMed

Kentala, E; Pyykkö, I; Auramo, Y; Juhola, M

1995-03-01

An interactive database has been developed to assist the diagnostic procedure for vertigo and to store the data. The database offers a possibility to split and reunite the collected information when needed. It contains detailed information about a patient's history, symptoms, and findings in otoneurologic, audiologic, and imaging tests. The symptoms are classified into sets of questions on vertigo (including postural instability), hearing loss and tinnitus, and provoking factors. Confounding disorders are screened. The otoneurologic tests involve saccades, smooth pursuit, posturography, and a caloric test. In addition, findings from specific antibody tests, clinical neurotologic tests, magnetic resonance imaging, brain stem audiometry, and electrocochleography are included. The input information can be applied to workups for vertigo in an expert system called ONE. The database assists its user in that the input of information is easy. If not only can be used for diagnostic purposes but is also beneficial for research, and in combination with the expert system, it provides a tutorial guide for medical students.

Auditory function at 14 years of age of very-low-birthweight.

PubMed

Davis, N M; Doyle, L W; Ford, G W; Keir, E; Michael, J; Rickards, A L; Kelly, E A; Callanan, C

2001-03-01

The aim of the study was to determine audiological function at 14 years of age of very-low-birthweight (VLBW < or = 1500 g) children compared with a cohort of normal birthweight (NBW > 2499 g) children. Participants were consecutive surviving preterm children of birthweight < 1000 g born between 1977 and 1982 (n=86) and of birthweight 1000 to 1500 g born between 1980 and 1982 (n=124) and randomly selected NBW children born between 1981 and 1982 (n=60). Audiometric tests included pure tone audiometry, tympanometry, stapedius muscle reflexes, and measures of central auditory processing. Psychometric tests included measures of IQ, academic achievement, and behaviour. There were no significant differences in rates of hearing impairment, abnormal tympanograms, figure-ground problems, or digit recall between VLBW children and NBW control children. VLBW children had higher rates of some central auditory processing problems, which in turn were associated with poorer intellectual, academic, and behavioural progress.

Reflex Modification Audiometry Reveals Dual Roles for Olivocochlear Neurotransmission

PubMed Central

Allen, Paul D.; Luebke, Anne E.

2017-01-01

Approximately 15% of American adults report some degree of difficulty hearing in a noisy environment or have auditory filtering difficulties. There are objective clinical tests of auditory filtering, yet few tests exist for mouse models that do not rely on extensive training. We have used reflex modification audiometry (RMA) and developed exclusion criteria for the mouse model. This RMA based test makes use of the acoustic startle response (ASR) and the ability of prepulses to inhibit the ASR [i.e., prepulse inhibition (PPI)] to assess the mouse's ability to detect prepulse signals presented in quiet or embedded in masking noise. We have studied PPI behavior across four inbred mouse strains with normal cochlear function and developed pre-testing exclusion criteria and test/retest reliability measures. Moreover, because both the medial (MOC) and the lateral (LOC) olivocochlear efferent feedback systems have been proposed to improve auditory behavior performance, especially in noisy backgrounds, we have examined PPI abilities in mice (with their littermate controls) either lacking the MOC receptor subunit α9 nicotinic acetylcholine receptor [α9 nAChR (–/–)] or expressing an overactive receptor [Ld'T mutation in α9 nAChR KI], or lacking an LOC efferent neuropeptide, alpha calcitonin gene-related peptide [αCGRP (–/–)] only in the CNS. Because CGRP receptor formation has been shown to mature from juvenile to adult ages, we also studied if this maturation would be reflected in PPI behavioral responses in juvenile and adult (+/+) controls and in adult αCGRP (–/–) animals. We show that 50% PPI response thresholds (sound level with 50% correct responses) in quiet are decreased in the (–/–) α9 nAChR animals, and 50% PPI responses are increased for mice with an overactive receptor (α9 nAChR KI) and are increased in adult mice lacking αCGRP (–/–). However, in background noise, only mice lacking αCGRP exhibited increased 50% PPI response thresholds, as there were no significant differences between α9 nAChR adult mouse lines and their littermate controls. These findings suggest that MOC and LOC olivocochlear neurotransmission work in tandem to improve behavioral responses to sound. These experiments further pave the way for rapid behavioral hearing assessments in other mouse models. PMID:29213229

Hearing handicap in patients with chronic kidney disease: a study of the different classifications of the degree of hearing loss.

PubMed

Costa, Klinger Vagner Teixeira da; Ferreira, Sonia Maria Soares; Menezes, Pedro de Lemos

The association between hearing loss and chronic kidney disease and hemodialysis has been well documented. However, the classification used for the degree of loss may underestimate the actual diagnosis due to specific characteristics related to the most affected auditory frequencies. Furthermore, correlations of hearing loss and hemodialysis time with hearing handicap remain unknown in this population. To compare the results of Lloyd's and Kaplan's and The Bureau Internacional d'Audiophonologie classifications in chronic kidney disease patients, and to correlate the averages calculated by their formulas with hemodialysis time and the hearing handicap. This is an analytical, observational and cross-sectional study with 80 patients on hemodialysis. Tympanometry, speech audiometry, pure tone audiometry and interview of patients with hearing loss through Hearing Handicap Inventory for Adults. Cases were classified according to the degree of loss. The correlations of tone averages with hemodialysis time and the total scores of Hearing Handicap Inventory for Adults and its domains were verified. 86 ears (53.75%) had hearing loss in at least one of the tonal averages in 48 patients who responded to Hearing Handicap Inventory for Adults. The Bureau Internacional d'Audiophonologie classification identified a greater number of cases (n=52) with some degree of disability compared to Lloyd and Kaplan (n=16). In the group with hemodialysis time of at least 2 years, there was weak but statistically significant correlation of The Bureau Internacional d'Audiophonologie classification average with hemodialysis time (r=0.363). There were moderate correlations of average The Bureau Internacional d'Audiophonologie classification (r=0.510) and tritone 2 (r=0.470) with the total scores of Hearing Handicap Inventory for Adults and with its social domain. The Bureau Internacional d'Audiophonologie classification seems to be more appropriate than Lloyd's and Kaplan's for use in this population; its average showed correlations with hearing loss in patients with hemodialysis time≥2 years and it exhibited moderate levels of correlation with the total score of Hearing Handicap Inventory for Adults and its social domain (r=0.557 and r=0.512). Copyright © 2016 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Hearing preservation in the resection of vestibular schwannomas: patterns of hearing preservation and patient-assessed hearing function.

PubMed

Wind, Joshua J; Leonetti, John P; Raffin, Michael J M; Pisansky, Marc T; Herr, Brian; Triemstra, Justin D; Anderson, Douglas E

2011-05-01

No extant literature documents the analysis of patient perceptions of hearing as a corollary to objective audiometric measures in patients with vestibular schwannoma (VS), or acoustic neuroma. Therefore, using objective audiometric data and patient perceptions of hearing function as outlined on a questionnaire, the authors evaluated the hearing of patients who underwent VS resection. This investigation involved a retrospective review of 176 patients who had undergone VS resections in which hearing preservation was a goal. Both pre- and postoperative audiometry, expressed as a speech discrimination score (SDS) and pure tone threshold average (PTA), were performed, and the results were analyzed. Intraoperative auditory brainstem responses were also recorded. Eighty-seven of the patients (49.4%) completed a postoperative questionnaire designed to assess hearing function in a variety of social and auditory situations. Multiple linear regression analyses were completed to compare available audiometric results with questionnaire responses for each patient. One hundred forty-two patients (80.7%) had PTA and SDS audiometric data pertaining to the surgically treated ear; 94 of these patients (66.2%) had measurable postoperative hearing, as defined by a PTA < 120 dB or SD > 0%. Eighty-seven patients (49.4%) completed the retrospective questionnaire, and 74 of them had complete audiometric data and thus were included in a comparative analysis. Questionnaire data showed major postoperative subjective hearing decrements, even among patients with the same pre- and postoperative objective audiometric hearing status. Moreover, the subscore reflecting hearing while exposed to background noise, or the "cocktail party effect," characterized the most significant patient-perceived hearing deficit following VS resection. The authors' analysis of a patient-perceived hearing questionnaire showed that hearing during exposure to background noise, or the cocktail party effect, represents a significant postoperative hearing deficit and that patient perception of this deficit has a strong relation with audiometric data. Furthermore, questionnaire responses revealed a significant disparity between subjective hearing function and standard audiometrics such that even with similar levels of audiometric data, subjective measures of hearing, especially the cocktail party effect, decreased postoperatively. The authors posit that the incorporation of patient-perceived hearing function evaluation along with standard audiometry is an illustrative means of identifying subjective hearing deficits after VS resection and may ultimately aid in specific and subsequent treatment for these patients.

The relationship between distortion product otoacoustic emissions and extended high-frequency audiometry in tinnitus patients. Part 1: normally hearing patients with unilateral tinnitus.

PubMed

Fabijańska, Anna; Smurzyński, Jacek; Hatzopoulos, Stavros; Kochanek, Krzysztof; Bartnik, Grażyna; Raj-Koziak, Danuta; Mazzoli, Manuela; Skarżyński, Piotr H; Jędrzejczak, Wieslaw W; Szkiełkowska, Agata; Skarżyński, Henryk

2012-12-01

The aim of this study was to evaluate distortion product otoacoustic emissions (DPOAEs) and extended high-frequency (EHF) thresholds in a control group and in patients with normal hearing sensitivity in the conventional frequency range and reporting unilateral tinnitus. Seventy patients were enrolled in the study: 47 patients with tinnitus in the left ear (Group 1) and 23 patients with tinnitus in the right ear (Group 2). The control group included 60 otologically normal subjects with no history of pathological tinnitus. Pure-tone thresholds were measured at all standard frequencies from 0.25 to 8 kHz, and at 10, 12.5, 14, and 16 kHz. The DPOAEs were measured in the frequency range from approximately 0.5 to 9 kHz using the primary tones presented at 65/55 dB SPL. The left ears of patients in Group 1 had higher median hearing thresholds than those in the control subjects at all 4 EHFs, and lower mean DPOAE levels than those in the controls for almost all primary frequencies, but significantly lower only in the 2-kHz region. Median hearing thresholds in the right ears of patients in Group 2 were higher than those in the right ears of the control subjects in the EHF range at 12.5, 14, and 16 kHz. The mean DPOAE levels in the right ears were lower in patients from Group 2 than those in the controls for the majority of primary frequencies, but only reached statistical significance in the 8-kHz region. Hearing thresholds in tinnitus ears with normal hearing sensitivity in the conventional range were higher in the EHF region than those in non-tinnitus control subjects, implying that cochlear damage in the basal region may result in the perception of tinnitus. In general, DPOAE levels in tinnitus ears were lower than those in ears of non-tinnitus subjects, suggesting that subclinical cochlear impairment in limited areas, which can be revealed by DPOAEs but not by conventional audiometry, may exist in tinnitus ears. For patients with tinnitus, DPOAE measures combined with behavioral EHF hearing thresholds may provide additional clinical information about the status of the peripheral hearing.

Hearing improvement with softband and implanted bone-anchored hearing devices and modified implantation surgery in patients with bilateral microtia-atresia.

PubMed

Wang, Yibei; Fan, Xinmiao; Wang, Pu; Fan, Yue; Chen, Xiaowei

2018-01-01

To evaluate auditory development and hearing improvement in patients with bilateral microtia-atresia using softband and implanted bone-anchored hearing devices and to modify the implantation surgery. The subjects were divided into two groups: the softband group (40 infants, 3 months to 2 years old, Ponto softband) and the implanted group (6 patients, 6-28 years old, Ponto). The Infant-Toddler Meaning Auditory Integration Scale was used conducted to evaluate auditory development at baseline and after 3, 6, 12, and 24 months, and visual reinforcement audiometry was used to assess the auditory threshold in the softband group. In the implanted group, bone-anchored hearing devices were implanted combined with the auricular reconstruction surgery, and high-resolution CT was used to assess the deformity preoperatively. Auditory threshold and speech discrimination scores of the patients with implants were measured under the unaided, softband, and implanted conditions. Total Infant-Toddler Meaning Auditory Integration Scale scores in the softband group improved significantly and approached normal levels. The average visual reinforcement audiometry values under the unaided and softband conditions were 76.75 ± 6.05 dB HL and 32.25 ± 6.20 dB HL (P < 0.01), respectively. In the implanted group, the auditory thresholds under the unaided, softband, and implanted conditions were 59.17 ± 3.76 dB HL, 32.5 ± 2.74 dB HL, and 17.5 ± 5.24 dB HL (P < 0.01), respectively. The respective speech discrimination scores were 23.33 ± 14.72%, 77.17 ± 6.46%, and 96.50 ± 2.66% (P < 0.01). Using softband bone-anchored hearing devices is effective for auditory development and hearing improvement in infants with bilateral microtia-atresia. Wearing softband bone-anchored hearing devices before auricle reconstruction and combining bone-anchored hearing device implantation with auricular reconstruction surgery may bethe optimal clinical choice for these patients, and results in more significant hearing improvement and minimal surgical and anesthetic injury. Copyright © 2017 Elsevier B.V. All rights reserved.

A test protocol for assessing the hearing status of students with special needs.

PubMed

Chen, Hsiao-Chuan; Wang, Nan-Mai; Chiu, Wen-Chen; Liu, Shu-Yu; Chang, Yi-Ping; Lin, Pei-Yu; Chung, King

2014-10-01

Individuals with disabilities are often reported to have a high prevalence of undetected hearing disorders/loss, but there is no standardized hearing test protocol for this population. The purposes of this study were (1) to examine the hearing status of students with special needs in Taiwan, and (2) to investigate the use of an on-site hearing test protocol that would adequately detect hearing problems in this population and reduce unnecessary referrals for off-site follow-up services. A total of 238 students enrolled in two schools for special education and one habilitation center participated in the study. Most students had intellectual disabilities and some also had additional syndromes or disorders. A hearing screening protocol including otoscopy, tympanometry, and distortion product otoacoustic emissions was administered to examine students' outer, middle, and inner ear functions, respectively. Pure tone tests were then administered as an on-site follow-up for those who failed or could not be tested using the screening protocol. Only 32.4% of students passed. When administered alone, the referral rate of otoscopy, tympanometry, and otoacoustic emissions were 38.7%, 46.0%, and 48.5%, respectively. The integration of these subtests revealed 52.1% of students needed follow-up services, 11.8% could not be tested, 2.5% had documented hearing loss, and 1.3% needed to be monitored because of negative middle ear pressure. The inclusion of pure tone audiometry increased the passing rate by 9.9% and provided information on hearing sensitivity for an additional 8.6% of students. Hearing assessments and regular hearing screening should be provided as an integral part of health care services for individuals with special needs because of high occurrences of excessive cerumen, middle ear dysfunction, and sensorineural hearing loss. The training of care-givers and teachers of students with special needs is encouraged so that they can help identify hearing problems and reduce the negative impact of hearing disorders and hearing loss. The screening protocol needs to include subtests that examine the status of different parts of their auditory system. The addition of pure tone audiometry as an on-site follow-up tool reduced the rate of off-site referrals and provided more information on hearing sensitivity. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Familial auditory neuropathy.

PubMed

Wang, Qiuju; Gu, Rui; Han, Dongyi; Yang, Weiyan

2003-09-01

Auditory neuropathy is a sensorineural hearing disorder characterized by absent or abnormal auditory brainstem responses and normal cochlear outer hair cell function as measured by otoacoustic emission recordings. Many risk factors are thought to be involved in its etiology and pathophysiology. Four Chinese pedigrees with familial auditory neuropathy were presented to demonstrate involvement of genetic factors in the etiology of auditory neuropathy. Probands of the above-mentioned pedigrees, who had been diagnosed with auditory neuropathy, were evaluated and followed in the Department of Otolaryngology-Head and Neck Surgery, China People Liberation Army General Hospital (Beijing, China). Their family members were studied, and the pedigree maps established. History of illness, physical examination, pure-tone audiometry, acoustic reflex, auditory brainstem responses, and transient evoked and distortion-product otoacoustic emissions were obtained from members of these families. Some subjects received vestibular caloric testing, computed tomography scan of the temporal bone, and electrocardiography to exclude other possible neuropathic disorders. In most affected patients, hearing loss of various degrees and speech discrimination difficulties started at 10 to 16 years of age. Their audiological evaluation showed absence of acoustic reflex and auditory brainstem responses. As expected in auditory neuropathy, these patients exhibited near-normal cochlear outer hair cell function as shown in distortion product otoacoustic emission recordings. Pure-tone audiometry revealed hearing loss ranging from mild to profound in these patients. Different inheritance patterns were observed in the four families. In Pedigree I, 7 male patients were identified among 43 family members, exhibiting an X-linked recessive pattern. Affected brothers were found in Pedigrees II and III, whereas in pedigree IV, two sisters were affected. All the patients were otherwise normal without evidence of peripheral neuropathy at the time of writing. Patients with characteristics of nonsyndromic hereditary auditory neuropathy were identified in one large and three smaller Chinese families. Pedigree analysis suggested an X-linked, recessive hereditary pattern in one pedigree and autosomal recessive inheritances in the other three pedigrees. The phenotypes in the study were typical of auditory neuropathy; they were transmitted in different inheritance patterns, indicating clinical and genetic heterogeneity of this disorder. The observed inheritance and clinical audiological findings are different from those previously described for nonsyndromic low-frequency sensorineural hearing loss. This information should facilitate future molecular linkage analyses and positional cloning for the relative genes contributing to auditory neuropathy.

Longitudinal Development of Distortion Product Otoacoustic Emissions in Infants With Normal Hearing.

PubMed

Hunter, Lisa L; Blankenship, Chelsea M; Keefe, Douglas H; Feeney, M Patrick; Brown, David K; McCune, Annie; Fitzpatrick, Denis F; Lin, Li

2018-01-23

The purpose of this study was to describe normal characteristics of distortion product otoacoustic emission (DPOAE) signal and noise level in a group of newborns and infants with normal hearing followed longitudinally from birth to 15 months of age. This is a prospective, longitudinal study of 231 infants who passed newborn hearing screening and were verified to have normal hearing. Infants were enrolled from a well-baby nursery and two neonatal intensive care units (NICUs) in Cincinnati, OH. Normal hearing was confirmed with threshold auditory brainstem response and visual reinforcement audiometry. DPOAEs were measured in up to four study visits over the first year after birth. Stimulus frequencies f1 and f2 were used with f2/f1 = 1.22, and the DPOAE was recorded at frequency 2f1-f2. A longitudinal repeated-measure linear mixed model design was used to study changes in DPOAE level and noise level as related to age, middle ear transfer, race, and NICU history. Significant changes in the DPOAE and noise levels occurred from birth to 12 months of age. DPOAE levels were the highest at 1 month of age. The largest decrease in DPOAE level occurred between 1 and 5 months of age in the mid to high frequencies (2 to 8 kHz) with minimal changes occurring between 6, 9, and 12 months of age. The decrease in DPOAE level was significantly related to a decrease in wideband absorbance at the same f2 frequencies. DPOAE noise level increased only slightly with age over the first year with the highest noise levels in the 12-month-old age range. Minor, nonsystematic effects for NICU history, race, and gestational age at birth were found, thus these results were generalizable to commonly seen clinical populations. DPOAE levels were related to wideband middle ear absorbance changes in this large sample of infants confirmed to have normal hearing at auditory brainstem response and visual reinforcement audiometry testing. This normative database can be used to evaluate clinical results from birth to 1 year of age. The distributions of DPOAE level and signal to noise ratio data reported herein across frequency and age in normal-hearing infants who were healthy or had NICU histories may be helpful to detect the presence of hearing loss in infants.

Audiometric Characteristics of a Dutch DFNA10 Family With Mid-Frequency Hearing Impairment.

PubMed

van Beelen, Eline; Oonk, Anne M M; Leijendeckers, Joop M; Hoefsloot, Elisabeth H; Pennings, Ronald J E; Feenstra, Ilse; Dieker, Hendrik-Jan; Huygen, Patrick L M; Snik, Ad F M; Kremer, Hannie; Kunst, Henricus P M

2016-01-01

Mutations in EYA4 can cause nonsyndromic autosomal dominant sensorineural hearing impairment (DFNA10) or a syndromic variant with hearing impairment and dilated cardiomyopathy. A mutation in EYA4 was found in a Dutch family, causing DFNA10. This study is focused on characterizing the hearing impairment in this family. Whole exome sequencing was performed in the proband. In addition, peripheral blood samples were collected from 23 family members, and segregation analyses were performed. All participants underwent otorhinolaryngological examinations and pure-tone audiometry, and 12 participants underwent speech audiometry. In addition, an extended set of audiometric measurements was performed in five family members to evaluate the functional status of the cochlea. Vestibular testing was performed in three family members. Two individuals underwent echocardiography to evaluate the nonsyndromic phenotype. The authors present a Dutch family with a truncating mutation in EYA4 causing a mid-frequency hearing impairment. This mutation (c.464del) leads to a frameshift and a premature stop codon (p.Pro155fsX). This mutation is the most N-terminal mutation in EYA4 found to date. In addition, a missense mutation, predicted to be deleterious, was found in EYA4 in two family members. Echocardiography in two family members revealed no signs of dilated cardiomyopathy. Results of caloric and velocity step tests in three family members showed no abnormalities. Hearing impairment was found to be symmetric and progressive, beginning as a mid-frequency hearing impairment in childhood and developing into a high-frequency, moderate hearing impairment later in life. Furthermore, an extended set of audiometric measurements was performed in five family members. The results were comparable to those obtained in patients with other sensory types of hearing impairments, such as patients with Usher syndrome type IIA and presbyacusis, and not to those obtained in patients with (cochlear) conductive types of hearing impairment, such as DFNA8/12 and DFNA13. The mid-frequency hearing impairment in the present family was found to be symmetric and progressive, with a predominantly childhood onset. The results of psychophysical measurements revealed similarities to other conditions involving a sensory type of hearing impairment, such as Usher syndrome type IIA and presbyacusis. The study results suggest that EYA4 is expressed in the sensory cells of the cochlea. This phenotypic description will facilitate counseling for hearing impairment in DFNA10 patients.

Brain stem audiometry may supply markers for diagnostic and therapeutic control in psychiatry.

PubMed

Nielzén, Sören; Holmberg, Jens; Sköld, Mia; Nehlstedt, Sara

2016-10-06

The purpose of the present study is to try an alternative way of analyzing the ABR (Auditory Brainstem Response). The stimuli were complex sounds (c-ABR) as used in earlier studies. It was further aimed at corroborating earlier findings that this method can discriminate several neuropsychiatric states. Forty healthy control subjects, 26 subjects with the diagnosis schizophrenia (Sz) and 33 with ADHD (Attention deficit hyperactivity disorder) were recruited for the study. The ABRs were recorded. The analysis was based on calculation of areas of significantly group different time spans in the waves. Both latency and amplitude were thereby influential. The spans of differences were quantified for each subject in relation to the total area of the curve which made comparisons balanced. The results showed highly significant differences between the study groups. The results are important for future work on identifying markers for neuropsychiatric clinical use. To reach that goal calls for more extensive studies than this preliminary one. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Hearing improvement in a patient with variant Muckle‐Wells syndrome in response to interleukin 1 receptor antagonism

PubMed Central

Rynne, M; Maclean, C; Bybee, A; McDermott, M F; Emery, P

2006-01-01

Background Muckle‐Wells syndrome (MWS), familial cold autoinflammatory syndrome, and neonatal onset multisystem inflammatory disease, also called chronic, infantile, neurological, cutaneous, and articular syndrome, are three hereditary autoinflammatory syndromes caused by mutations affecting the CIAS1/NALP3 gene on chromosome 1q44. The proinflammatory cytokine, interleukin 1β, is believed to have a fundamental role in their pathogenesis. Case report The case is described of a 59 year old white woman who presented with increasingly severe MWS‐type features over a 15 year period. The response to interleukin 1β inhibition with anakinra was dramatic, including a reduction in intracranial pressure with associated auditory improvement, as demonstrated by serial audiometry. Conclusions The confirmed improvement in hearing after initiation of interleukin 1 receptor antagonism corroborates previous reports that specific blockade of this single cytokine reverses most of the symptoms of this group of CIAS1/NALP3 related autoinflammatory conditions, including the sensorineural deafness, which has not been previously reported. PMID:16531551

[Clinical features of a Chinese pedigree with Waardenburg syndrome type 2].

PubMed

Yang, Shu-zhi; Yuan, Hui-jun; Bai, Lin-na; Cao, Ju-yang; Xu, Ye; Shen, Wei-dong; Ji, Fei; Yang, Wei-yan

2005-10-12

To investigate detailed clinical features of a Chinese pedigree with Waardenburg syndrome type 2. Members of this pedigree were interviewed to identify personal or family medical histories of hearing loss, the use of aminoglycosides, and other clinical abnormalities by filling questionnaire. The audiological and other clinical evaluations of the proband and other members of this family were conducted, including pure-tone audiometry, immittance and auditory brain-stem response and ophthalmological, dermatologic, hair, temporal bone CT examinations. This family is categorized as Waardenburg syndrome type 2 according to its clinical features. It's an autosomal dominant disorder with incomplete penetrance. The clinical features varied greatly among family members and characterized by sensorineural hearing loss, heterochromia irides, freckle on the face and premature gray hair. Hearing loss can be unilateral or bilateral, congenital or late onset in this family. This Chinese family has some unique clinical features comparing with the international diagnostic criteria for Waardenburg syndrome. This study may provide some evidences to amend the diagnostic criteria for Waardenburg syndrome in Chinese population.

Cochlear hearing loss in patients with Laron syndrome.

PubMed

Attias, Joseph; Zarchi, Omer; Nageris, Ben I; Laron, Zvi

2012-02-01

The aim of this prospective clinical study was to test auditory function in patients with Laron syndrome, either untreated or treated with insulin-like growth factor I (IGF-I). The study group consisted of 11 patients with Laron syndrome: 5 untreated adults, 5 children and young adults treated with replacement IGF-I starting at bone age <2 years, and 1 adolescent who started replacement therapy at bone age 4.6 years. The auditory evaluation included pure tone and speech audiometry, tympanometry and acoustic reflexes, otoacoustic emissions, loudness dynamics, auditory brain stem responses and a hyperacusis questionnaire. All untreated patients and the patient who started treatment late had various degrees of sensorineural hearing loss and auditory hypersensitivity; acoustic middle ear reflexes were absent in most of them. All treated children had normal hearing and no auditory hypersensitivity; most had recordable middle ear acoustic reflexes. In conclusion, auditory defects seem to be associated with Laron syndrome and may be prevented by starting treatment with IGF-I at an early developmental age.

Otoacoustic Emissions before and after Listening to Music on a Personal Player

PubMed Central

Trzaskowski, Bartosz; Jędrzejczak, W. Wiktor; Piłka, Edyta; Cieślicka, Magdalena; Skarżyński, Henryk

2014-01-01

Background The problem of the potential impact of personal music players on the auditory system remains an open question. The purpose of the present study was to investigate, by means of otoacoustic emissions (OAEs), whether listening to music on a personal player affected auditory function. Material/Methods A group of 20 normally hearing adults was exposed to music played on a personal player. Transient evoked OAEs (TEOAEs) and distortion product OAEs (DPOAEs), as well as pure tone audiometry (PTA) thresholds, were tested at 3 stages: before, immediately after, and the next day following 30 min of exposure to music at 86.6 dBA. Results We found no statistically significant changes in OAE parameters or PTA thresholds due to listening to the music. Conclusions These results suggest that exposure to music at levels similar to those used in our study does not disturb cochlear function in a way that can be detected by means of PTA, TEOAE, or DPOAE tests. PMID:25116920

Safety of the HyperSound® Audio System in Subjects with Normal Hearing.

PubMed

Mehta, Ritvik P; Mattson, Sara L; Kappus, Brian A; Seitzman, Robin L

2015-06-11

The objective of the study was to assess the safety of the HyperSound® Audio System (HSS), a novel audio system using ultrasound technology, in normal hearing subjects under normal use conditions; we considered pre-exposure and post-exposure test design. We investigated primary and secondary outcome measures: i) temporary threshold shift (TTS), defined as >10 dB shift in pure tone air conduction thresholds and/or a decrement in distortion product otoacoustic emissions (DPOAEs) >10 dB at two or more frequencies; ii) presence of new-onset otologic symptoms after exposure. Twenty adult subjects with normal hearing underwent a pre-exposure assessment (pure tone air conduction audiometry, tympanometry, DPOAEs and otologic symptoms questionnaire) followed by exposure to a 2-h movie with sound delivered through the HSS emitter followed by a post-exposure assessment. No TTS or new-onset otological symptoms were identified. HSS demonstrates excellent safety in normal hearing subjects under normal use conditions.

Safety of the HyperSound® Audio System in Subjects with Normal Hearing

PubMed Central

Mattson, Sara L.; Kappus, Brian A.; Seitzman, Robin L.

2015-01-01

The objective of the study was to assess the safety of the HyperSound® Audio System (HSS), a novel audio system using ultrasound technology, in normal hearing subjects under normal use conditions; we considered pre-exposure and post-exposure test design. We investigated primary and secondary outcome measures: i) temporary threshold shift (TTS), defined as >10 dB shift in pure tone air conduction thresholds and/or a decrement in distortion product otoacoustic emissions (DPOAEs) >10 dB at two or more frequencies; ii) presence of new-onset otologic symptoms after exposure. Twenty adult subjects with normal hearing underwent a pre-exposure assessment (pure tone air conduction audiometry, tympanometry, DPOAEs and otologic symptoms questionnaire) followed by exposure to a 2-h movie with sound delivered through the HSS emitter followed by a post-exposure assessment. No TTS or new-onset otological symptoms were identified. HSS demonstrates excellent safety in normal hearing subjects under normal use conditions. PMID:26779330

Noise-induced hearing loss and associated factors among vector control workers in a Malaysian state.

PubMed

Masilamani, Retneswari; Rasib, Abdul; Darus, Azlan; Ting, Anselm Su

2014-11-01

This study aims to determine the prevalence and associated factors of noise-induced hearing loss (NIHL) among vector control workers in the state of Negeri Sembilan, Malaysia. This was an analytical cross-sectional study conducted on 181 vector control workers who were working in district health offices in a state in Malaysia. Data were collected using a self-administered questionnaire and audiometry. Prevalence of NIHL was 26% among this group of workers. NIHL was significantly associated with the age-group of 40 years and older, length of service of 10 or more years, current occupational noise exposure, listening to loud music, history of firearms use, and history of mumps/measles infection. Following logistic regression, age of more than 40 years and noise exposure in current occupation were associated with NIHL with an odds ratio of 3.45 (95% confidence interval = 1.68-7.07) and 6.87 (95% confidence interval = 1.54-30.69), respectively, among this group of vector control workers. © 2012 APJPH.

[Tuberculous Otitis media - a rare differential diagnosis in Germany].

PubMed

Teschner, M; Kramer, S; Donnerstag, F; Länger, F; Lenarz, Th; Schwab, B

2008-07-01

A 28-year-old female patient with a migrant background presented for surgery with a suspected cholesteatoma in the left ear. The patient reported having had an aural discharge for several months; otoscopic examination revealed a runny ear, and discrete granulation tissue was seen. Pure-tone audiometry showed conduction hearing loss of 30-40 dB across all frequencies in the left ear; high-resolution computed tomography of the temporal bone revealed that the mastoid and tympanic cavity were completely obscured. The intraoperative finding showed a caseous space-occupying mass that completely filled the tympanic cavity. The suspected diagnosis of tuberculosis was corroborated by pathohistological, microbiological and molecular biological tests. Tuberculostatic therapy was initiated at a different location. Although tuberculosis of the middle ear is a rare condition in Germany, it should nevertheless be considered when making a differential diagnosis, especially in high-risk patients where cholesteatoma is suspected on clinical and radiological evidence or in patients with a chronic middle ear process.

Effects of acoustic impulses on hearing

NASA Astrophysics Data System (ADS)

Fleischer, Gerald; Müller, Reinhard; Heppelmann, Guido; Bache, Thomas

2002-05-01

It is well known that acoustic impulses are especially dangerous to the ear. In order to understand the damaging mechanisms involved, cases of acute acoustic trauma in man were systematically collected and documented for many years. When possible, the damaging impulses were recreated and measured, to correlate the impulses with the auditory damage they caused. Detailed pure-tone audiometry up to 16 kHz was used to determine the effects on hearing. Together with epidemiological studies on various occupations, three different damaging mechanisms can be discerned. Relatively long and massive impulses (some explosions, some airbags) often lead to damage at low frequencies, from about 0.5 to 1.5 kHz. The typical notch at about 4 to 6 kHz typically is the result of strong peaks, lasting several milliseconds, or longer. There is another notch at 12 to 14 kHz, characteristic of very short, needle-like impulses that are caused by many hand weapons, toy pistols, and firecrackers. Probable mechanisms are discussed.

Delayed Immunomodulatory Effect of Cow Milk-Free Diet in Ménière's Disease.

PubMed

Di Berardino, Federica; Zanetti, Diego

2018-02-01

Since 1930, dietary modification has been proposed as adjunct treatment in Ménière's disease (MD) with different and controversial results. We report the case of a 42-year-old female suffering from definite MD and intermittent seasonal allergic rhino-conjunctivitis because it highlights the importance of evaluating the different combinations of defined causative elements in an atopic patient with MD. An immunological and audiological evaluation was performed, including pure-tone, speech, and immittance audiometry; glycerol dehydration test; bithermal caloric testing; video head impulse test; cervical vestibular evoked myogenic potentials; static posturography; and Dizziness Handicap Inventory questionnaire. A milk-free diet was crucial to relief from MD symptoms and a cow's milk challenge test was able to evoke them but vestibukar symptoms persist. The effect of dietary modification was evident only after specific immunotherapies against other allergens. This highlights the importance of evaluating different combinations of defined causative elements in the allergic treatment of MD.

Auditory system dysfunction in Alzheimer disease and its prodromal states: A review.

PubMed

Swords, Gabriel M; Nguyen, Lydia T; Mudar, Raksha A; Llano, Daniel A

2018-07-01

Recent findings suggest that both peripheral and central auditory system dysfunction occur in the prodromal stages of Alzheimer Disease (AD), and therefore may represent early indicators of the disease. In addition, loss of auditory function itself leads to communication difficulties, social isolation and poor quality of life for both patients with AD and their caregivers. Developing a greater understanding of auditory dysfunction in early AD may shed light on the mechanisms of disease progression and carry diagnostic and therapeutic importance. Herein, we review the literature on hearing abilities in AD and its prodromal stages investigated through methods such as pure-tone audiometry, dichotic listening tasks, and evoked response potentials. We propose that screening for peripheral and central auditory dysfunction in at-risk populations is a low-cost and effective means to identify early AD pathology and provides an entry point for therapeutic interventions that enhance the quality of life of AD patients. Copyright © 2018 Elsevier B.V. All rights reserved.

Clinical features and radiological evaluation of otic capsule sparing temporal bone fractures.

PubMed

Song, S W; Jun, B C; Kim, H

2017-03-01

To evaluate the clinical and radiological aspects of otic capsule sparing temporal bone fractures. Using medical records, 188 temporal bones of 173 patients with otic capsule sparing temporal bone fractures were evaluated. Otoscopic findings and symptoms, facial paralysis, and hearing loss were assessed. Using regional analysis, 7 fractures were classified as type I, 85 as type II, 169 as type III and 114 as type IV. Fourteen of the 17 facial paralysis cases improved to House-Brackmann grade II or lower at an average of 57.6 days after the initial evaluation. Thirty-one patients underwent initial and follow-up pure tone audiometry examinations. The air-bone gap closed significantly from 27.2 dB at an average of 21.8 days post-trauma to 19.6 dB at an average of 79.9 days post-trauma, without the need for surgical intervention. Initial conservative treatment for facial paralysis or conductive hearing loss is possible in otic capsule sparing fracture cases after careful evaluation of the patient.

Effect of atorvastatin on progression of sensorineural hearing loss and tinnitus in the elderly: results of a prospective, randomized, double-blind clinical trial.

PubMed

Olzowy, Bernhard; Canis, Martin; Hempel, John-Martin; Mazurek, Birgit; Suckfüll, Markus

2007-06-01

To test whether the 3-hydroxy-3-methylglutaryl- coenzyme A reductase inhibitor atorvastatin can slow down the progression of presbycusis. Fifty patients 60- to 75-years-old with presbycusis and moderately elevated serum cholesterol. In a double-blind design, patients were randomly assigned to treatment with either atorvastatin (40 mg/d orally) or placebo. Pure-tone audiometry and tinnitus evaluation at enrolment and after 7 and 13 months. Development of hearing thresholds after 7 and 13 months showed no significant differences between the groups. Tinnitus score continuously improved in the atorvastatin group (34.8 at 7 and 27.6 at 13 mo), whereas it slightly deteriorated in the placebo group (24.8 at 7 and 26.8 at 13 mo). The effect on tinnitus was a tendency without statistic significance (p = 0.0833). Atorvastatin had no effect on the development of hearing thresholds, but resulted in a trend toward a relief of tinnitus.

Oral steroids alone or followed by intranasal steroids versus watchful waiting in the management of otitis media with effusion.

PubMed

Hussein, A; Fathy, H; Amin, S M; Elsisy, N

2017-10-01

To evaluate the effects of oral steroids alone or followed by intranasal steroids versus watchful waiting on the resolution of otitis media with effusion in children aged 2-11 years. A total of 290 children with bilateral otitis media with effusion were assigned to 3 groups: group A was treated with oral steroids followed by intranasal steroids, group B was treated with oral steroids alone and group C was managed with watchful waiting. Patients were evaluated with audiometry and tympanometry. The complete resolution rates of otitis media with effusion were higher in groups A and B than in group C at six weeks. There were no significant differences in otitis media with effusion resolution rates between the groups at three, six and nine months. Oral steroids lead only to a quick resolution of otitis media with effusion, with no long-term benefits. There was no benefit of using intranasal steroids in the management of otitis media with effusion.

Musical anhedonia: selective loss of emotional experience in listening to music.

PubMed

Satoh, Masayuki; Nakase, Taizen; Nagata, Ken; Tomimoto, Hidekazu

2011-10-01

Recent case studies have suggested that emotion perception and emotional experience of music have independent cognitive processing. We report a patient who showed selective impairment of emotional experience only in listening to music, that is musical anhednia. A 71-year-old right-handed man developed an infarction in the right parietal lobe. He found himself unable to experience emotion in listening to music, even to which he had listened pleasantly before the illness. In neuropsychological assessments, his intellectual, memory, and constructional abilities were normal. Speech audiometry and recognition of environmental sounds were within normal limits. Neuromusicological assessments revealed no abnormality in the perception of elementary components of music, expression and emotion perception of music. Brain MRI identified the infarct lesion in the right inferior parietal lobule. These findings suggest that emotional experience of music could be selectively impaired without any disturbance of other musical, neuropsychological abilities. The right parietal lobe might participate in emotional experience in listening to music.

Long-lasting uveitis remission and hearing loss recovery after rituximab in Vogt-Koyanagi-Harada disease.

PubMed

Caso, Francesco; Rigante, Donato; Vitale, Antonio; Costa, Luisa; Bascherini, Vittoria; Latronico, Eugenia; Franceschini, Rossella; Cantarini, Luca

2015-10-01

Vogt-Koyanagi-Harada disease (VKHD) is a multisystemic disorder characterized by granulomatous panuveitis variably combined with T cell-mediated neurologic and cutaneous manifestations. Early and aggressive treatment with systemic corticosteroids is the mainstay of treatment for VKHD. Additional use of immunosuppressants, intravenous immunoglobulins, and tumor necrosis factor-alpha inhibitors can help the most severely affected patients and work as corticosteroid-sparing agents. We report the case of a young woman with relapsing and multiresistant VKHD who demonstrated a stable remission of both uveitis and high-frequency hearing loss following rituximab intravenous administration (1 g. twice, 2 weeks apart, and 6 months later). A complete clinical response was observed 1 month since the first infusion, and no ocular relapses were recorded during the following year; in addition, audiometry showed a high-frequency hearing recovery in the right ear. Further observational studies are required to define the role of CD20 inhibition in the management of VKHD.

Evaluation of cochlear involvement by distortion product otoacoustic emission in Behçet's disease.

PubMed

Dagli, Muharrem; Eryilmaz, Adil; Tanrikulu, Salih; Aydin, Acar; Gonul, Muzeyyen; Gul, Ulker; Gocer, Celil

2008-09-01

The aim of this study was to investigate cochlear involvement in patients with Behçet's disease. Twenty-six Behçet's disease patients (52 ears) and 24 sex and age-matched healthy control subjects (48 ears) were included in the study. Pure-tone audiometry at frequencies 250, 500, 1000, 2000, 4000, 6000 Hz, immittance measures including tympanometry and acoustic reflex testing and DPOAE (distortion product otoacoustic emission) testing were performed in the patients and controls. A sensorineural hearing loss was found in eight patients (30.7%) as it was bilateral in five and unilateral in three patients. Although no typical audiometric configuration was found, one patient had a flat type audiogram, and the others had a high frequency hearing loss. The DPOAE responses of the patients and controls were significantly different in all frequencies (p<0.05). These results indicate that cochlea is affected by damage of outer hair cells in Behçet's disease.

Assessment of central auditory processing in a group of workers exposed to solvents.

PubMed

Fuente, Adrian; McPherson, Bradley; Muñoz, Verónica; Pablo Espina, Juan

2006-12-01

Despite having normal hearing thresholds and speech recognition thresholds, results for central auditory tests were abnormal in a group of workers exposed to solvents. Workers exposed to solvents may have difficulties in everyday listening situations that are not related to a decrement in hearing thresholds. A central auditory processing disorder may underlie these difficulties. To study central auditory processing abilities in a group of workers occupationally exposed to a mix of organic solvents. Ten workers exposed to a mix of organic solvents and 10 matched non-exposed workers were studied. The test battery comprised pure-tone audiometry, tympanometry, acoustic reflex measurement, acoustic reflex decay, dichotic digit, pitch pattern sequence, masking level difference, filtered speech, random gap detection and hearing-in-noise tests. All the workers presented normal hearing thresholds and no signs of middle ear abnormalities. Workers exposed to solvents had lower results in comparison with the control group and previously reported normative data, in the majority of the tests.

Prevalence of noise-induced hearing loss among woodworkers in Nepal: a pilot study

PubMed Central

Robinson, Tim; Whittaker, Joshua; Acharya, Aanand; Singh, Devesh; Smith, Michael

2015-01-01

Background: The woodworking industry represents an important cause of occupational noise-induced hearing loss (NIHL), a significant yet underappreciated problem in many developing countries. Objectives: To describe the prevalence of occupational NIHL among woodworkers in Nepal and measure noise levels at workplaces. Methods: We conducted a cross-sectional study with 124 woodworkers (88 carpenters, 36 sawyers), recruited through convenience sampling from 26 workplaces. Pure-tone audiometry between the frequencies 0·5 and 8 kHz ascertained participants’ hearing status, and noise readings were taken at selected workplaces. Results: In all, 31% of carpenters and 44% of sawyers met criteria for NIHL, with 7 and 17% meeting World Health Organization (WHO) criteria for hearing impairment (HI), respectively. Noise levels at various workplaces ranged from 71·2 to 93·9 dBA. Conclusions: Woodworkers in Nepal are at risk of occupational NIHL. As the industry develops, this problem will likely become more extensive, highlighting the need for workplace interventions and additional research. PMID:25335826

Atypical incus necrosis: a case report and literature review.

PubMed

Choudhury, N; Kumar, G; Krishnan, M; Gatland, D J

2008-10-01

We report an atypical case of ossicular necrosis affecting the incus, in the absence of any history of chronic serous otitis media. We also discuss the current theories of incus necrosis. A male patient presented with a history of right unilateral hearing loss and tinnitus. Audiometry confirmed right conductive deafness; tympanometry was normal bilaterally. He underwent a right exploratory tympanotomy, which revealed atypical erosion of the proximal long process of the incus. Middle-ear examination was otherwise normal, with a mobile stapes footplate. The redundant long process of the incus was excised and a partial ossicular replacement prosthesis was inserted, resulting in improved hearing. Ossicular pathologies most commonly affect the incus. The commonest defect is an absent lenticular and distal long process of the incus, which is most commonly associated with chronic otitis media. This is the first reported case of ossicular necrosis, particularly of the proximal long process of the incus, in the absence of chronic middle-ear pathology.

Hearing Tests on Mobile Devices: Evaluation of the Reference Sound Level by Means of Biological Calibration.

PubMed

Masalski, Marcin; Kipiński, Lech; Grysiński, Tomasz; Kręcicki, Tomasz

2016-05-30

Hearing tests carried out in home setting by means of mobile devices require previous calibration of the reference sound level. Mobile devices with bundled headphones create a possibility of applying the predefined level for a particular model as an alternative to calibrating each device separately. The objective of this study was to determine the reference sound level for sets composed of a mobile device and bundled headphones. Reference sound levels for Android-based mobile devices were determined using an open access mobile phone app by means of biological calibration, that is, in relation to the normal-hearing threshold. The examinations were conducted in 2 groups: an uncontrolled and a controlled one. In the uncontrolled group, the fully automated self-measurements were carried out in home conditions by 18- to 35-year-old subjects, without prior hearing problems, recruited online. Calibration was conducted as a preliminary step in preparation for further examination. In the controlled group, audiologist-assisted examinations were performed in a sound booth, on normal-hearing subjects verified through pure-tone audiometry, recruited offline from among the workers and patients of the clinic. In both the groups, the reference sound levels were determined on a subject's mobile device using the Bekesy audiometry. The reference sound levels were compared between the groups. Intramodel and intermodel analyses were carried out as well. In the uncontrolled group, 8988 calibrations were conducted on 8620 different devices representing 2040 models. In the controlled group, 158 calibrations (test and retest) were conducted on 79 devices representing 50 models. Result analysis was performed for 10 most frequently used models in both the groups. The difference in reference sound levels between uncontrolled and controlled groups was 1.50 dB (SD 4.42). The mean SD of the reference sound level determined for devices within the same model was 4.03 dB (95% CI 3.93-4.11). Statistically significant differences were found across models. Reference sound levels determined in the uncontrolled group are comparable to the values obtained in the controlled group. This validates the use of biological calibration in the uncontrolled group for determining the predefined reference sound level for new devices. Moreover, due to a relatively small deviation of the reference sound level for devices of the same model, it is feasible to conduct hearing screening on devices calibrated with the predefined reference sound level.

Hearing and Otoacoustic Emissions Outcome of Stapedotomy: Does the Prosthesis Diameter Matter?

PubMed

Faranesh, Nabil; Magamseh, Ebrahim; Zaaroura, Suliman; Zeidan, Reem; Shupak, Avi

2017-08-01

To compare the hearing and otoacoustic emissions (OAE) outcome of stapedotomy employing 0.4 and 0.6 mm diameter prostheses. In total, 18 patients with otosclerosis participated in a prospective, double-armed, randomized cohort study. All the patients underwent small fenestra drill stapedotomy employing the Causse fluroplastic large loop piston prostheses. The patients were randomly assigned to groups of 0.4 mm (n=9) and 0.6 mm (n=9) diameter prostheses. The results of pure tone air and bone audiometries, speech audiometry, and OAE conducted 12 months post operatively were compared within and between the groups. The within-group analysis showed significant post-stapedotomy improvements in the average air conduction pure tone thresholds in both groups (52.9±9.6 vs. 25.6±5.2 dB HL; p<0.0001 and 54.6±10.4 vs. 22.2±8.2 dB HL; p<0.0001 for the 0.4 and 0.6 mm groups, respectively) and average air-bone gap (ABG; 37.1±8.5 vs. 8.1±3.9 dB HL; p<0.0001 and 38.3±7.5 vs. 9.9±4.5 dB HL; p<0.0001 in the 0.4 and 0.6 mm groups, respectively). No significant differences were found between the groups in these outcome measures, as well as in the rate of ABG closure within 10 dB HL and the word recognition scores. Favorable outcome in the post-stapedotomy bone conduction (BC) was found for the 0.6 mm prosthesis group, reflecting superior cancellation of the Carhart phenomenon for the 500-3000 Hz pure tone thresholds average (-1.7±3.7 vs. 3.9±6.2 dB HL for the 0.4 and 0.6 mm groups, respectively; p<0.04) and 1000, 2000, and 4000 Hz average (-2.6±4.33 vs. 3.9±7.8 dB HL for the 0.4 and 0.6 mm groups, respectively; p<0.05). Small signal-to-noise ratio (SNR) values of the transient-evoked OAE (TEOAE) and distortion product OAE (DPOAE) were found at baseline and follow-up evaluation with no consistent changes post stapedotomy. Similar post-stapedotomy hearing results were found for the 0.4 and 0.6 mm prostheses with small but statistically significant advantage in BC gain and the overclosure parameter for the 0.6 mm prosthesis. OAE testing was not found to be of clinical value in the evaluation of stapedotomy hearing outcome.

Efficacy of Distortion Product Oto-Acoustic Emission (OAE)/Auditory Brainstem Evoked Response (ABR) Protocols in Universal Neonatal Hearing Screening and Detecting Hearing Loss in Children <2 Years of Age.

PubMed

Mishra, Girish; Sharma, Yojana; Mehta, Kanishk; Patel, Gunjan

2013-04-01

Deafness is commonest curable childhood handicap. Most remedies and programmes don't address this issue at childhood level leading to detrimental impact on development of newborns. Aims and objectives are (A) screen all newborns for deafness and detect prevalence of deafness in children less than 2 years of age. and (B) assess efficacy of multi-staged OAE/ABR protocol for hearing screening. Non-randomized, prospective study from August 2008 to August 2011. All infants underwent a series of oto-acoustic emission (OAE) and final confirmatory auditory brainstem evoked response (ABR) audiometry. Finally, out of 1,101 children, 1,069 children passed the test while 12 children had impaired hearing after final testing, confirmed by ABR. Positive predictive value of OAE after multiple test increased to 100 %. OAE-ABR test series is effective in screening neonates and multiple tests reduce economic burden. High risk screening will miss nearly 50 % deaf children, thus universal screening is indispensable in picking early deafness.

The association of indicators of fetal growth with visual acuity and hearing among conscripts.

PubMed

Olsen, J; Sørensen, H T; Steffensen, F H; Sabroe, S; Gillman, M W; Fischer, P; Rothman, K J

2001-03-01

Impaired fetal growth is associated with increased susceptibility to several chronic diseases. We studied the association between birth weight, indicators of disproportional fetal growth, and impaired visual acuity and hearing in 4,300 conscripts from a well-defined region in Denmark from August 1, 1993, to July 31, 1994. From the standard health examination for conscripts, we obtained data on sight based on the Snellen's chart and data on hearing acuity based on audiometry. By means of record linkage, we obtained data on outcomes for the conscripts at birth from the Medical Birth Registry. From this registry, we have data on birth weight, gestational age, and birth length that were recorded from existing computerized registers based on the records of midwives. A birth weight of less than 3,000 gm and a body mass index at birth of less than 3.4 were associated with reduced visual acuity and impaired hearing. The results could be due to fetal brain programming or due to confounding, by early birth trauma or other factors.

The relationships between cognitive function and hearing loss among the elderly.

PubMed

Huh, MyungJin

2018-01-01

[Purpose] Research related to dementia has gained momentum in South Korea and studies have found that the auditory sense affects dementia. This study aims to examine the relationship between the decline in hearing function and the overall cognitive function among the elderly. [Subjects and Methods] Eighty-two older adults aged 65-90 years (mean age: 79.3, SD: 5.2) participated. The Korean Mini-Mental State Examination was used to assess cognitive function. Further, to assess the hearing function, pure-tone audiometry was performed prior to the cognitive function test. We used a paired t-test and Pearson's correlation test for the analysis. [Results] Generally, the higher the frequency band, the more hearing loss was identified among the elderly. In addition, the difference in hearing between both ears was significant; particularly, hearing loss in the right ear was significantly higher than that in the left. Cognitive function was not related to age, however, the correlation between cognitive function and hearing loss in the right ear was statistically significant. [Conclusion] Hearing loss influences cognitive function among the elderly.

Prevalence of tinnitus complaints and probable association with hearing loss, diabetes mellitus and hypertension in elderly.

PubMed

Gibrin, Paula Carolina Dias; Melo, Juliana Jandre; Marchiori, Luciana Lozza de Moraes

2013-01-01

To assess the prevalence of tinnitus and possible association with hearing loss, diabetes mellitus and hypertension in elderly. Cross-sectional study with individuals older than 60 years who underwent audiological evaluation (pure tone audiometry and history) and answered a comorbidity questionnaire. We evaluated 519 subjects of both genders with a median age of 69 years. Individuals who did not participate in the audiometric test were excluded, then totaling 498 subjects. We applied the appropriate statistical tests to analyze the tinnitus and associated factors. The prevalence of 42.77% of tinnitus was found, being 58.68% bilateral tinnitus and 41.31% unilateral tinnitus. There was a difference between tinnitus and hearing loss, but there was no difference between tinnitus and hypertension and between tinnitus and diabetes mellitus alone. The prevalence of tinnitus is significant in the elderly. There are differences between tinnitus and hearing loss, with association between the side affected by tinnitus and the side of hearing loss. Only the association of comorbidity of diabetes mellitus and hypertension is an independent risk factor for tinnitus.

Tinnitus pitch and minimum masking levels in different etiologies.

PubMed

Zagólski, Olaf; Stręk, Paweł

2014-07-01

We sought to determine whether the results of audiological tests and tinnitus characteristics, particularly tinnitus pitch and minimum masking level (MML), depend on tinnitus etiology, and what other etiology-specific tinnitus characteristics there are. The patients answered questions concerning tinnitus laterality, duration, character, aggravation, alleviation, previous treatment, and circumstances of onset. The results of tympanometry, pure-tone audiometry, distortion-product otoacoustic emissions, tinnitus likeness spectrum, MML, and uncomfortable loudness level were evaluated. Patients with several tinnitus etiological factors were excluded. The remaining participants were divided into groups according to medical history: acute acoustic trauma: 67 ears; chronic acoustic trauma: 82; prolonged use of oral estrogen and progesterone contraceptives: 46; Ménière's disease: 25; congenital hearing loss: 19; sensorineural sudden deafness: 40; dull head trauma: 19; viral labyrinthitis: 53; stroke: 6; presbycusis: 152. Data of 509 ears were analysed. Tinnitus pitch was highest in patients with acute acoustic trauma and lowest in patients receiving estrogen and progesterone. MML was lowest after acute acoustic trauma and in congenital hearing loss, and highest after a stroke and in the case of presbytinnitus. Tinnitus pitch and MML are etiology dependent.

Increased mean platelet volume in patients with idiopathic subjective tinnitus.

PubMed

Sarıkaya, Yasin; Bayraktar, Cem; Karataş, Mehmet; Doğan, Sedat; Olt, Serdar; Kaskalan, Emin; Türkbeyler, İbrahim Halil

2016-11-01

Tinnitus is the perception of sound with no external stimulus and idiopathic subjective tinnitus is the most common type in adults. Mean platelet volume (MPV) alterations were shown in some inflammatory diseases and were evaluated as a clinically useful marker. Our aim was to investigate MPV alterations in idiopathic subjective tinnitus patients. A total of 101 patients and 54 age- and sex-matched healthy control subjects were enrolled in the study. Patients included in the study had complaints of tinnitus for at least 3 months. All patients underwent detailed otolaryngologic examination, blood sampling, pure tone audiometry, magnetic resonance imaging of ear, and vertebrobasilar artery Doppler ultrasonography to make the differential diagnosis of tinnitus. Blood sampling consisted of renal-liver-thyroid function tests, lipid profile, and complete blood count. All tests and examinations except the imaging modalities were also performed for the control group. There were no differences in age and sex distribution of groups. Mean platelet volume values were significantly increased in tinnitus patients when compared with controls (p = 0.001). We think that MPV can be qualified as a useful marker in tinnitus patients.

Comparison of Audiological Findings in Patients with Vestibular Migraine and Migraine

PubMed Central

Kırkım, Günay; Mutlu, Başak; Tanriverdizade, Tural; Keskinoğlu, Pembe; Güneri, Enis Alpin; Akdal, Gülden

2017-01-01

Objective The aim of this study was to investigate and compare the auditory findings in vestibular migraine (VM) and migraine patients without a history of vertigo. Methods This study was conducted on 44 patients diagnosed with definite VM and 31 patients diagnosed with migraine who were followed and treated between January 2011 and February 2015. Also, 52 healthy subjects were included in this study as a control group. All participants underwent a detailed otorhinolaryngological examination followed by audiological evaluation, including pure tone audiometry, speech reception threshold, speech recognition score, and acoustic immitancemetry. Results In the VM group, there were 16 patients (36.4%) with tinnitus, while in the other groups we did not observe any patients with tinnitus. The rate of tinnitus in the VM group was significantly higher in comparison to other groups (p<0.05). None of the groups had any patients with permanent or fluctuating sensorineural hearing loss. Conclusion We conclude that patients with VM should be closely and longitudinally followed up for the early detection of other otological symptoms and possible occurrence of sensorineural hearing loss in the long term. PMID:29515927

Aging of the ear, exposed and not exposed to noise

NASA Astrophysics Data System (ADS)

Fleischer, Gerald; Müller, Reinhard; Heppelmann, Guido; Bache, Thomas; Gao, Xia; Wang, Feng; Huang, Weiguo

2002-05-01

Hearing in two special groups was compared, using pure-tone audiometry up to 16 kHz. One group consisted of commercial airline pilots in Germany, the other of people living in remote parts of the People's Republic of China, without electricity, cars or, other technical equipment. The age of the 502 pilots (99% male) ranged from 22 to 65 years, while that of the 644 Chinese (61% male) ranged from 6 to 82 years. In both groups participants with diseases of the ear and with acute acoustic trauma were excluded. Analysis showed that the threshold of hearing in young adults is identical in Germany and in China. It is evident that the effect of aging is reduced in pilots, as compared to people living without technical or industrial noise. Older pilots clearly hear better than people not subjected to technical noise, most prominently at higher frequencies. Together with other observations, it can be concluded that continuous wideband noise reduces the aging of the ear. Long-term exposure to such noise-within limits-appears to be good for the ear.

Oral use of Streptococcus salivarius K12 in children with secretory otitis media: preliminary results of a pilot, uncontrolled study

PubMed Central

Di Pierro, Francesco; Di Pasquale, Daniele; Di Cicco, Maurizio

2015-01-01

Secretory otitis media (SOM) remains a common disease among children. Although its cause is not yet perfectly established, the pathology, often a sequel of acute otitis media (AOM), is mainly characterized by persistent fluid in the middle ear cavity. Twenty-two children with a diagnosis of SOM were treated daily for 90 days with an oral formulation containing the oral probiotic Streptococcus salivarius K12 (Bactoblis®). After treatment, the children were evaluated for AOM episodes and subjected to tone audiometry, tympanometry, endonasal endoscopy, otoscopy, and tonsillar examination. Subject compliance and probiotic tolerability and side effects have also been evaluated. Our results indicate a good safety profile, a substantial reduction of AOM episodes, and a positive outcome from the treatment for all of the clinical outcomes tested. We conclude that strain K12 may have a role in reducing the occurrence and/or severity of SOM in children. From our perspective, this study constitutes a starting point toward the organization of a more extensive placebo-controlled study aimed at critically appraising our preliminary observations. PMID:26396541

Estrogen and hearing from a clinical point of view; characteristics of auditory function in women with Turner syndrome.

PubMed

Hederstierna, Christina; Hultcrantz, Malou; Rosenhall, Ulf

2009-06-01

Turner syndrome is a chromosomal aberration affecting 1:2000 newborn girls, in which all or part of one X chromosome is absent. This leads to ovarial dysgenesis and little or no endogenous estrogen production. These women have, among many other syndromal features, a high occurrence of ear and hearing problems, and neurocognitive dysfunctions, including reduced visual-spatial abilities; it is assumed that estrogen deficiency is at least partially responsible for these problems. In this, study 30 Turner women aged 40-67, with mild to moderate hearing loss, performed a battery of hearing tests aimed at localizing the lesion causing the sensorineural hearing impairment and assessing central auditory function, primarily sound localization. The results of TEOAE, ABR and speech recognition scores in noise were all indicative of cochlear dysfunction as the cause of the sensorineural impairment. Phase audiometry, a test for sound localization, showed mild disturbances in the Turner women compared to the reference group, suggesting that auditory-spatial dysfunction is another facet of the recognized neurocognitive phenotype in Turner women.

Deficits in working memory, reading comprehension and arithmetic skills in children with mouth breathing syndrome: analytical cross-sectional study.

PubMed

Kuroishi, Rita Cristina Sadako; Garcia, Ricardo Basso; Valera, Fabiana Cardoso Pereira; Anselmo-Lima, Wilma Terezinha; Fukuda, Marisa Tomoe Hebihara

2015-01-01

Mouth breathing syndrome is very common among school-age children, and it is possibly related to learning difficulties and low academic achievement. In this study, we investigated working memory, reading comprehension and arithmetic skills in children with nasal and mouth breathing. Analytical cross-sectional study with control group conducted in a public university hospital. 42 children (mean age = 8.7 years) who had been identified as mouth breathers were compared with a control group (mean age = 8.4 years) matched for age and schooling. All the participants underwent a clinical interview, tone audiometry, otorhinolaryngological evaluation and cognitive assessment of phonological working memory (numbers and pseudowords), reading comprehension and arithmetic skills. Children with mouth breathing had poorer performance than controls, regarding reading comprehension (P = 0.006), arithmetic (P = 0.025) and working memory for pseudowords (P = 0.002), but not for numbers (P = 0.76). Children with mouth breathing have low academic achievement and poorer phonological working memory than controls. Teachers and healthcare professionals should be aware of the association of mouth breathing with children's physical and cognitive health.

The suffering of tinnitus in childhood and adolescence.

PubMed

Holgers, Kajsa-Mia; Juul, Jolanta

2006-05-01

Investigate the profile of young patients complaining of tinnitus and study the prevalence and the severity of tinnitus in schoolchildren. Ninety-five consecutive patients (55 boys), 8-20 years old, seeking help for tinnitus at our clinic were studied using audiometry, structural interviews, Tinnitus Severity Questionnaire (TSQ) and Hospital Anxiety and Depression Scale (HAD), together with Visual Analog Scales (VAS) on tinnitus loudness and annoyance. The onset of tinnitus was twice as often sudden than gradual. In 54% of the children, tinnitus had started after noise exposure, most commonly listening to music. Correlations were found between the pure-tone average (PTA) of 3, 4, and 6 kHz and TSQ scores; between TSQ and HAD subscales; and between TSQ and VAS. According to the Hospital Anxiety Depression Scale, 32% and 14.5%, respectively, were above the cut level for clinical anxiety and depressive disorders. The girls showed more signs of anxiety disorders than the boys. The majority of the help seekers had been exposed to noise, mostly music. Predisposing factors for tinnitus severity are high-frequency hearing loss and anxiety and depressive disorders.

Evaluation of hearing deficit in patients with oral submucous fibrosis.

PubMed

Devi, Parvathi; Singh, Ipsa; Setru, Ravindra; Tyagi, Kuber; Singh, Dharamveer; Thiyam, Bellona

2015-06-01

Oral submucous fibrosis (OSMF) is a well recognized premalignant condition predominantly affecting the oral cavity, but sometimes extending to the pharynx, esophagus or even the larynx. OSMF may lead to stiffness of the oral cavity, resulting in trismus and inability to eat, difficulty with speech or swallowing, pain in the throat and ears, and a relative loss of auditory acuity. To evaluate the hearing deficit in patients with OSMF, we examined a study group comprising 40 patients, and also 10 age- and sex-matched healthy subjects as controls. All of the subjects were evaluated for hearing loss by pure tone audiometry. The OSMF group showed a significant degree of hearing loss relative to the control group. OSMF in advanced stages was significantly associated with mild conductive hearing loss (P < 0.01). The present study revealed a significant association between OSMF and hearing deficit. Involvement of the palatal muscles with OSMF may decrease the patency of the Eustachian tube, leading to conductive hearing loss. Therefore, all patients with OSMF should be evaluated for hearing deficit and advised about appropriate treatment.

Hearing loss in the shaken baby syndrome.

PubMed

Alzahrani, Musaed; Ratelle, Justine; Cavel, Oren; Laberge-Malo, Marie; Saliba, Issam

2014-05-01

To evaluate hearing in children diagnosed with shaken baby syndrome. A retrospective study conducted in a pediatric tertiary care center between 2006 and 2012. Children diagnosed with shaken baby syndrome were included for hearing evaluation by conventional audiometry, distortion product otoacoustic emissions and auditory brainstem responses. Twenty-eight children were included (22 boys and 6 girls). The mean age of children at presentation was 8 months (range 1-26 months) and the mean delay before audiometric evaluation was 30 months (range 1-87 months). One child was diagnosed as having a moderate sensorineural hearing loss. The tympanic membrane mobility was normal (type A) for both ears in 22 children, one child had a reduced tympanic mobility in one ear, two children had a negative pressure, one child had a functional trans-tympanic tube and test was not performed in 2 patients. This is the first study reporting hearing loss as a possible result of shaken baby syndrome. However, further studies with larger number of children would be preferable. We recommend hearing evaluation for these children to rule out hearing loss. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

[Usefulness of fenspiride in the treatment of acute otitis media in children].

PubMed

Zielnik-Jurkiewicz, Beata; Jurkiewicz, Dariusz

2005-06-01

Acute otitis media is very general disease and concerns every child practically. The shortening the time of treatment as well as quick decrease of symptoms, and mainly the pain have large meaning in treatment of this disease. Combined treatment of fenspiride and typical treatment of otitis media permits as our investigations show on quicker and observed at children's larger number decrease of symptoms in children with acute otitis media. The aim of the study was to observe effectiveness of combined treatment with antibiotic and fenspiride in children with acute otitis media. The study comprised 40 children (mean age 8.2 years). The diagnosis of acute otitis media based on medical history data, otolaryngological examination and audiometry (tone and impedance). Children with GERD, hypersensitivity to amoxicillin and fenspiride as well as hypertrophy of adenoid were excluded from the study. Children were divided in two equal groups randomly. All children received amoxicillin in dose 80 mg/kg/day in three partite doses (Amotaks, Polfa Tarchomin Poland) as well as oxymethazolin 0.05% nasal drops 3 x day 1-2 drops (0.05% Nasivin, Merck Germany). In children from second group fenspiride was applied in dose 2 ml/kg/day in three divided doses (Eurespal, Servier Francja) additionally. Treatment was provided by 10 days. During the treatment parents made record of recession in 10 point scale, estimating following parameters: the pain of ear, bother, raised the temperature of body, loss of appetite, vomiting, diarrhea, otorrhea and crying. After end of treatment control otolaryngological and audiological examinations were performed. In studied children symptoms were similar, and the pain of ear was in both groups main suffering. Vomiting and diarrhea the most seldom were observed. In children with acute otitis media treated additionally with fenspiride statistically significant (p<0.01) quicker recession of clinical symptoms was observed. Statistically significant (p<0.01) reduction was observed of such symptoms as the pain of ear, bother, raised of body temperature as well as crying in children treated additionally with fenspiride in comparison to children treated only with antibiotic. Earlier return of hearing and state of middle ear was observed in children from group II than in children from group I (p<0.01). We observed also statistically significant (p<0.01) improvement of hearing estimated in tonal audiometry and impedance in this group. The undesirable symptoms during the treatment were not mentioned. Our study show that combined treatment with fenspiride and antibiotic in the treatment of acute otitis media in children causes quicker reduction of symptoms as well as improvement in audiological parameters (tone and impedance).

A faceoff with hazardous noise: Noise exposure and hearing threshold shifts of indoor hockey officials.

PubMed

Adams, Karin L; Brazile, William J

2017-02-01

Noise exposure and hearing thresholds of indoor hockey officials of the Western States Hockey League were measured to assess the impact of hockey game noise on hearing sensitivity. Twenty-nine hockey officials who officiated the league in an arena in southeastern Wyoming in October, November, and December 2014 participated in the study. Personal noise dosimetry was conducted to determine if officials were exposed to an equivalent sound pressure level greater than 85 dBA. Hearing thresholds were measured before and after hockey games to determine if a 10 dB or greater temporary threshold shift in hearing occurred. Pure-tone audiometry was conducted in both ears at 500, 1000, 2000, 3000, 4000, 6000, and 8000 Hz. All noise exposures were greater than 85 dBA, with a mean personal noise exposure level of 93 dBA (SD = 2.2), providing 17.7% (SD = 6.3) of the officials' daily noise dose according to the OSHA criteria. Hearing threshold shifts of 10 dB or greater were observed in 86.2% (25/29) of officials, with 36% (9/25) of those threshold shifts equaling 15 dB or greater. The largest proportion of hearing threshold shifts occurred at 4000 Hz, comprising 35.7% of right ear shifts and 31.8% of left ear shifts. The threshold shifts between the pre- and post-game audiometry were statistically significant in the left ear at 500 (p=.019), 2000 (p=.0009), 3000 (p<.0001) and 4000 Hz (p=.0002), and in the right ear at 2000 (p=.0001), 3000 (p=.0001) and 4000 Hz (p<.0001), based on Wilcoxon-ranked sum analysis. Although not statistically significant at alpha = 0.05, logistic regression indicated that with each increase of one dB of equivalent sound pressure measured from personal noise dosimetry, the odds of a ≥ 10 dB TTS were increased in the left ear at 500 (OR=1.33, 95% CI 0.73-2.45), 3000 (OR=1.02, 95% CI 0.68-1.51), 4000 (OR=1.26, 95% CI 0.93-1.71) and 8000 Hz (OR=1.22, 95% CI 0.76-1.94) and in the right ear at 6000 (OR=1.03, 95% CI 0.14-7.84) and 8000 Hz (OR=1.29, 95% CI 0.12-13.83). These findings suggest that indoor hockey officials are exposed to hazardous levels of noise, experience temporary hearing loss after officiating games, and a hearing conservation program is warranted. Further temporary threshold shift research has the potential to identify officials of other sporting events that are at an increased risk of noise-induced hearing loss.

Auditory dysfunction associated with solvent exposure

PubMed Central

2013-01-01

Background A number of studies have demonstrated that solvents may induce auditory dysfunction. However, there is still little knowledge regarding the main signs and symptoms of solvent-induced hearing loss (SIHL). The aim of this research was to investigate the association between solvent exposure and adverse effects on peripheral and central auditory functioning with a comprehensive audiological test battery. Methods Seventy-two solvent-exposed workers and 72 non-exposed workers were selected to participate in the study. The test battery comprised pure-tone audiometry (PTA), transient evoked otoacoustic emissions (TEOAE), Random Gap Detection (RGD) and Hearing-in-Noise test (HINT). Results Solvent-exposed subjects presented with poorer mean test results than non-exposed subjects. A bivariate and multivariate linear regression model analysis was performed. One model for each auditory outcome (PTA, TEOAE, RGD and HINT) was independently constructed. For all of the models solvent exposure was significantly associated with the auditory outcome. Age also appeared significantly associated with some auditory outcomes. Conclusions This study provides further evidence of the possible adverse effect of solvents on the peripheral and central auditory functioning. A discussion of these effects and the utility of selected hearing tests to assess SIHL is addressed. PMID:23324255

Pop-rock musicians: assessment of their satisfaction provided by hearing protectors.

PubMed

Santoni, Cristiane Bolzachini; Fiorini, Ana Claudia

2010-01-01

Pop-rock musicians are at risk of developing hearing loss and other symptoms related to amplified music. The aim of the present study was to assess the satisfaction provided by the use of hearing protection in pop-rock musicians. Contemporary cohort study. A study of 23 male pop-rock musicians, aged between 25 to 45 years. After audiological evaluation (pure tone audiometry, middle ear analysis, TEOAE and DPOAE) hearing protective devices were provided to be used for three months. After that musicians answered a satisfaction assessment questionnaire. The prevalence of hearing loss was of 21.7%. The most common complaints about the hearing protectors were: autophonia, pressure in the ears, interference in high frequencies perception and full time use of the hearing protector during concerts. There was a positive correlation between a reduction in tinnitus after the use of the HPD with the following complaints: tinnitus after beginning the career (p= 0.044), discomfort with the sound intensity in the work place (p= 0.009) and intolerance to loud sound (p= 0.029). There was a high prevalence of hearing loss and a positive tendency towards the use of the ear protector device among the sample population.

Assessment of hearing and hearing disorders in rock/jazz musicians.

PubMed

Kähärit, Kim; Zachau, Gunilla; Eklöf, Mats; Sandsjö, Leif; Möller, Claes

2003-07-01

The aim of this study was to assess hearing and hearing disorders among rock/jazz musicians. One hundred and thirty-nine (43 women and 96 men) musicians participated. The results are based on pure-tone audiometry and questionnaire responses. According to our definition of hearing loss, tinnitus, hyperacusis, distortion and/or diplacusis as hearing disorders, we found disorders in 74%, of the rock/jazz musicians studied. Hearing loss, tinnitus and hyperacusis were most common, and the latter two were found significantly more frequently than in different reference populations. The women showed bilateral, significantly better hearing thresholds at 3-6 kHz than the men. Hyperacusis, and the combination of both hyperacusis and tinnitus, were found to be significantly more frequent among women than among men. Hearing loss and tinnitus were significantly more common among men than among women. It is important to evaluate all kinds of hearing problems (other than hearing loss) in musicians, since they represent an occupational group especially dependent on optimal, functional hearing. On the basis of our results, we suggest that hearing problems such as tinnitus, hyperacusis, distortion and/or diplacusis should, in addition to hearing loss, be defined as hearing disorders.

Diagnostic value of three-dimensional magnetic resonance imaging of inner ear after intratympanic gadolinium injection, and clinical application of magnetic resonance imaging scoring system in patients with delayed endolymphatic hydrops.

PubMed

Gu, X; Fang, Z-M; Liu, Y; Lin, S-L; Han, B; Zhang, R; Chen, X

2014-01-01

Three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging of the inner ear after intratympanic injection of gadolinium, together with magnetic resonance imaging scoring of the perilymphatic space, were used to investigate the positive identification rate of hydrops and determine the technique's diagnostic value for delayed endolymphatic hydrops. Twenty-five patients with delayed endolymphatic hydrops underwent pure tone audiometry, bithermal caloric testing, vestibular-evoked myogenic potential testing and three-dimensional magnetic resonance imaging of the inner ear after bilateral intratympanic injection of gadolinium. The perilymphatic space of the scanned images was analysed to investigate the positive identification rate of endolymphatic hydrops. According to the magnetic resonance imaging scoring of the perilymphatic space and the diagnostic standard, 84 per cent of the patients examined had endolymphatic hydrops. In comparison, the positive identification rates for vestibular-evoked myogenic potential and bithermal caloric testing were 52 per cent and 72 per cent respectively. Three-dimensional magnetic resonance imaging after intratympanic injection of gadolinium is valuable in the diagnosis of delayed endolymphatic hydrops and its classification. The perilymphatic space scoring system improved the diagnostic accuracy of magnetic resonance imaging.

Gadolinium-enhanced inner ear magnetic resonance imaging for evaluation of delayed endolymphatic hydrops, including a bilateral case.

PubMed

Fukushima, Munehisa; Oya, Ryohei; Akazawa, Hitoshi; Tsuruta, Yukinori; Inohara, Hidenori

2016-01-01

The data suggests that gadolinium-enhanced inner ear MR imaging is useful for diagnosis of delayed endolymphatic hydrops (DEH) because it is independent of inner ear function, and the size of the affected endolymphatic space is clearly enlarged. This study was performed to semi-quantitatively evaluate the endolymphatic space in patients with all types of DEH using gadolinium-enhanced inner ear magnetic resonance (MR) imaging. Seven patients (age range = 21-77 years; five female, two male) with ipsilateral DEH (n = 5), contralateral DEH (n = 1), and bilateral DEH (n = 1). All patients underwent 3T MR imaging 4 h after intravenous injection of gadolinium. Software was used to determine the size of the endolymphatic space. Pure tone audiometry and caloric testing using an electronystagmogram were carried out. One side of the endolymphatic space was dominantly extended in patients with ipsilateral DEH, and both sides of the space were extended in patients with contralateral and bilateral DEH. In patients with ipsilateral DEH, the volume ratio of endolymph to vestibule was 2.5-4.3-times that in the unaffected ear. The volume ratio of endolymph to vestibule was nearly equal in patients with contralateral and bilateral DEH.

The Role of Trace Elements in Tinnitus.

PubMed

Yaşar, Mehmet; Şahin, Mehmet İlhan; Karakükçü, Çiğdem; Güneri, Erhan; Doğan, Murat; Sağıt, Mustafa

2017-03-01

In this study, we aimed to investigate the role of three trace elements, namely, zinc, copper, and lead, in tinnitus by analyzing the serum level of copper and lead and both the serum and tissue level of zinc. Eighty patients, who applied to outpatient otolaryngology clinic with the complaints of having tinnitus, and 28 healthy volunteers were included. High-frequency audiometry was performed, and participants who had hearing loss according to the pure tone average were excluded; tinnitus frequency and loudness were determined and tinnitus reaction questionnaire scores were obtained from the patients. Of all the participants, serum zinc, copper, and lead values were measured; moreover, zinc levels were examined in hair samples. The levels of trace elements were compared between tinnitus and control groups. The level of copper was found to be significantly lower in the tinnitus group (p = 0.02), but there was no significant difference between the groups in terms of the levels of zinc, neither in serum nor in hair, and lead in serum (p > 0.05). The lack of trace elements, especially that of "zinc," have been doubted for the etiopathogenesis of tinnitus in the literature; however, we only found copper levels to be low in patients having tinnitus.

Chronic suppurative otitis media in children of Luanda, Angola.

PubMed

Taipale, Anni; Pelkonen, Tuula; Taipale, Marko; Bernardino, Luis; Peltola, Heikki; Pitkäranta, Anne

2011-08-01

Evaluation of clinical characteristics, bacteriology and hearing in paediatric patients with and without chronic suppurative otitis media (CSOM) in Luanda, Angola. Interview, clinical examination, ear-discharge culture, open air pure-tone audiometry and brainstem auditory-evoked potentials of 23 outpatients with CSOM and 23 controls in a paediatric hospital. Of the CSOM vs. control children, 35% vs. 26% had running water, 70% vs. 70% electricity, 64% vs. 0% HIV (p<0.0001) and 36% vs. 0% tuberculosis in history (p=0.002). Ten (43%) children had bilateral CSOM. The major ear-discharge pathogens were Proteus spp. (44%) and Pseudomonas (22%). Hearing impairment of >25 dB was present in 52% of CSOM-affected ears and bilateral hearing loss in 7 (30%) CSOM children vs. zero control child (p=0.009). Only one hearing-impaired child's family had previously detected the handicap. CSOM occurred in children with high co-morbidity. Persistent otorrhoea was usually caused by Proteus spp. or Pseudomonas, and often suggestive of either HIV or hearing impairment. In the developing countries, prompt diagnosis and treatment of CSOM would enhance the children's linguistic and academic development. © 2011 The Author(s)/Acta Paediatrica © 2011 Foundation Acta Paediatrica.

Are thiazides effective on hypertensive vertigo? A preliminary study.

PubMed

Eryaman, Esra; Gökcan, Gökçen; Parmaksız, Ergün; Acar, Nurhan Ozdemir; Ozlüoğlu, Levent Naci

2012-01-01

In this study, we aimed to investigate whether the symptoms of vertigo related to hypertension resulted from endolymphatic hydrops and the efficacy of the thiazides in the treatment. A total of 24 vertigo patients without peripheric or central vestibular pathologies or hyperlipidemia were included. The study group comprised 15 patients with hypertension, including nine with regulated non-insulin-dependent diabetes mellitus (DM). The control group comprised nine patients without hypertension or DM. The patients in the study group received hydrochlorothiazide treatment. The European Evaluation of Vertigo Scale (EEVS) and Vertigo Handicap Questionnaire (VHQ), puretone audiometry, tympanometry, electronystagmography (ENG) for nystagmus tests, oculomotor tests, and caloric test were carried out initially and at three weeks for both groups. The results of the study group were compared to those of the control group. There was a statistically significant decrease in the scores of EEVS and VHQ at three weeks in the study group, compared to the baseline scores (for both groups p≤0.01). Our study results showed that thiazides alleviated vertigo symptoms in hypertensive patients, as measured by qualitative methods (i.e. EEVS, VHQ), but not with quantitative measurements (i.e. ENG).

Hearing Handicap and Speech Recognition Correlate With Self-Reported Listening Effort and Fatigue.

PubMed

Alhanbali, Sara; Dawes, Piers; Lloyd, Simon; Munro, Kevin J

To investigate the correlations between hearing handicap, speech recognition, listening effort, and fatigue. Eighty-four adults with hearing loss (65 to 85 years) completed three self-report questionnaires: the Fatigue Assessment Scale, the Effort Assessment Scale, and the Hearing Handicap Inventory for Elderly. Audiometric assessment included pure-tone audiometry and speech recognition in noise. There was a significant positive correlation between handicap and fatigue (r = 0.39, p < 0.05) and handicap and effort (r = 0.73, p < 0.05). There were significant (but lower) correlations between speech recognition and fatigue (r = 0.22, p < 0.05) or effort (r = 0.32, p< 0.05). There was no significant correlation between hearing level and fatigue or effort. Hearing handicap and speech recognition both correlate with self-reported listening effort and fatigue, which is consistent with a model of listening effort and fatigue where perceived difficulty is related to sustained effort and fatigue for unrewarding tasks over which the listener has low control. A clinical implication is that encouraging clients to recognize and focus on the pleasure and positive experiences of listening may result in greater satisfaction and benefit from hearing aid use.

Hearing conservation practices in eight noisy industries

NASA Astrophysics Data System (ADS)

Daniell, William E.; Swan, Susan S.; Camp, Janice; Cohen, Martin; McDaniel, Mary M.; Stebbins, John; Leo, Robert

2005-04-01

This study evaluated noise exposures and hearing conservation practices at 76 companies in eight industries with high rates of workers' compensation claims for hearing loss. Nearly all companies had exposures that required a hearing conservation program, and more than half had exposures that required consideration of noise controls. The use of noise measurements and consideration of controls was low in all industries. The completeness of hearing conservation programs was strongly associated with the extent of exposure in an industry, although practices varied widely within industries. Most companies had substantial deficiencies. More than one-third did not conduct annual training, and training had shortcomings at many others. One-third had not conducted audiometry. Hearing protection was commonly underused. Reported use was highest at companies with relatively complete programs, and in industries where exposure was most prevalent and least intermittent. Many employees had difficulty estimating how often, and presumably when, their exposure was excessive. There is a need for new strategies to promote and maintain hearing conservation efforts in noisy industries. The industries with greatest margin for improvement are not the noisiest industries but those where exposure is moderate or intermittent. [Work supported by the National Institute for Occupational Safety and Health.

Central auditory processing disorder (CAPD) in children with specific language impairment (SLI). Central auditory tests.

PubMed

Dlouha, Olga; Novak, Alexej; Vokral, Jan

2007-06-01

The aim of this project is to use central auditory tests for diagnosis of central auditory processing disorder (CAPD) in children with specific language impairment (SLI), in order to confirm relationship between speech-language impairment and central auditory processing. We attempted to establish special dichotic binaural tests in Czech language modified for younger children. Tests are based on behavioral audiometry using dichotic listening (different auditory stimuli that presented to each ear simultaneously). The experimental tasks consisted of three auditory measures (test 1-3)-dichotic listening of two-syllable words presented like binaural interaction tests. Children with SLI are unable to create simple sentences from two words that are heard separately but simultaneously. Results in our group of 90 pre-school children (6-7 years old) confirmed integration deficit and problems with quality of short-term memory. Average rate of success of children with specific language impairment was 56% in test 1, 64% in test 2 and 63% in test 3. Results of control group: 92% in test 1, 93% in test 2 and 92% in test 3 (p<0.001). Our results indicate the relationship between disorders of speech-language perception and central auditory processing disorders.

Auditory brainstem response screening for hearing loss in high risk neonates.

PubMed

Watson, D R; McClelland, R J; Adams, D A

1996-07-01

The present paper reports the findings of a 7 year study evaluating the use of the auditory brainstem response (ABR) as the basis of a hearing screening procedure in a group of newborns at increased risk of hearing impairment. A Special Care Baby Unit (SCBU) population of 417 infants with diverse clinical backgrounds and treatment histories was tested for hearing impairment at birth using ABR audiometry. Some 332 passed the original screen at 30 dBnHL test level in both ears. Of the failure group, 18 did not survive and 32 had some degree of hearing impairment confirmed, nine of which were sensorineural in origin. An increased incidence of persistent middle ear disease was also noted in the failure group. A detailed operational analysis demonstrates that provided appropriate pass/fail criteria are adopted, the ABR technique offers excellent sensitivity and specificity for the detection of significant hearing loss in the test population. Furthermore, the study establishes that implementation of an ABR-based screening programme could reduce the average age at detection of permanent hearing loss by 7 months. A cost assessment shows that the introduction of such a targetted screening procedure could be done at a reasonable outlay.

[Effect of the middle ear status on the recording of vestibular evoked myogenic potential--VEMP].

PubMed

Kurzyna, Agnieszka; Hassmann-Poznańska, Elzbieta; Topolska, Małgorzata Maria

2005-01-01

The aim of this study was to assess the effect of the middle ear status on the recording of air- and bone-conducted vestibular evoked myogenic potential. Forty eight children were included in the study, ranging in age from 4 to 10 years. All of the children underwent otoscopy, pure tone audiometry, tympanometry and air- and bone-conducted VEMP in response to click. There were 3 groups according to the condition of the middle ear: group I--52 ears (type A and C1 tympanogram, pure tone average < or = 20 dB), group II--23 ears (type C2 and B tympanogram, pure tone average < or = 20 dB), group III--21 (type B tympanogram, pure tone average > 20 dB). The threshold, presence of correct waveform morphology of the response and latency was evaluated. The condition of the middle ear has no significant effect on the recording of VEMP and mean level of the response threshold with bone stimulation, based on the performed studies. However, with air stimulation it has effect on the recording of VEMP, increase of the mean threshold response and shortening of latency p13 and n23.

Consensus Statement of the Indian Academy of Pediatrics on Newborn Hearing Screening.

PubMed

Paul, Abraham; Prasad, Chhaya; Kamath, S S; Dalwai, Samir; C Nair, M K; Pagarkar, Waheeda

2017-08-15

Hearing impairment is one of the most critical sensory impairments with significant social and psychological consequences. Evidence-based, standardized national guidelines are needed for professionals to screen for hearing impairment during the neonatal period. The meeting on formulation of national consensus guidelines on developmental disorders was organized by Indian Academy of Pediatrics in Mumbai, on 18th and 19th December, 2015. The invited experts included Pediatricians, Developmental Pediatricians, Pediatric Neurologists and Clinical Psychologists. The participants framed guidelines after extensive discussions. To provide guidelines on newborn hearing screening in India. The first screening should be conducted before the neonate's discharge from the hospital - if it 'fails', then it should be repeated after four weeks, or at first immunization visit. If it 'fails' again, then Auditory Brainstem Response (ABR) audiometry should be conducted. All babies admitted to intensive care unit should be screened via ABR. All babies with abnormal ABR should undergo detailed evaluation, hearing aid fitting and auditory rehabilitation, before six months of age. The goal is to screen newborn babies before one month of age, diagnose hearing loss before three months of age and start intervention before six months of age.

[Hearing capacity and speech production in 417 children with facial cleft abnormalities].

PubMed

Schönweiler, R; Schönweiler, B; Schmelzeisen, R

1994-11-01

Children with cleft palates often suffer from chronic conductive hearing losses, delayed language acquisition and speech disorders. This study presents results of speech and language outcomes in relation to hearing function and types of palatal malformations found. 417 children with cleft palates were examined during followup evaluations that extended over several years. Disorders were studied as they affected the ears, nose and throat, audiometry and speech and language pathology. Children with isolated cleft lips were excluded. Among the total group, 8% had normal speech and language development while 92% had speech or language disorders. 80% of these latter children had hearing problems that predominantly consisted of fluctuating conductive hearing losses caused by otitis media with effusion. 5% had sensorineural hearing losses. Fifty-eight children (14%) with rhinolalia aperta were not improved by speech therapy and required velopharyngoplasties, using a cranial-based pharyngeal flap. Language skills did not depend on the type of cleft palate presents but on the frequency and amount of hearing loss found. Otomicroscopy and audiometric follow-ups with insertions of ventilation tubes were considered to be most important for language development in those children with repeated middle ear infections. Speech or language therapy was necessary in 49% of the children.

Incidence of tinnitus in mp3 player users.

PubMed

Figueiredo, Ricardo Rodrigues; Azevedo, Andreia Aparecida de; Oliveira, Patrícia Mello de; Amorim, Sandro Pereira Vasconcellos; Rios, Artur Guedes; Baptista, Vanderlei

2011-06-01

Exposure to loud noise is one of the main causes of tinnitus. To analyze the incidence of tinnitus in mp3 player users and non-users. One hundred subjects aged from 15 to 30 years were enrolled, 54 of them were regular mp3 player users and 46 were not. Patients with continuous tinnitus for at least 6 months completed the Tinnitus Handicap Inventory (THI) and were tested with high frequency audiometry and transient-evoked otoacoustic emissions (TAOE). A cross-sectional cohort study. The incidence of tinnitus in non-users was about 8 %; in mp3 player users it was about 28 %, a statistically significant difference. Hearing thresholds at 8 kHz were significantly higher in tinnitus patients that used mp3 portable players.TAOE were reduced at 2 kHz in the users group. No statistically significant difference was found in the THI scores between the two groups. Tinnitus was more frequent in teenagers and young adults who regularly listen to mp3 music in players. Moreover, the incidence of tinnitus among mp3 player users was associated with higher hearing thresholds at 8 kHz and lower TOAE at 2 kHz.

Smartphone-Based Hearing Screening in Noisy Environments

PubMed Central

Na, Youngmin; Joo, Hyo Sung; Yang, Hyejin; Kang, Soojin; Hong, Sung Hwa; Woo, Jihwan

2014-01-01

It is important and recommended to detect hearing loss as soon as possible. If it is found early, proper treatment may help improve hearing and reduce the negative consequences of hearing loss. In this study, we developed smartphone-based hearing screening methods that can ubiquitously test hearing. However, environmental noise generally results in the loss of ear sensitivity, which causes a hearing threshold shift (HTS). To overcome this limitation in the hearing screening location, we developed a correction algorithm to reduce the HTS effect. A built-in microphone and headphone were calibrated to provide the standard units of measure. The HTSs in the presence of either white or babble noise were systematically investigated to determine the mean HTS as a function of noise level. When the hearing screening application runs, the smartphone automatically measures the environmental noise and provides the HTS value to correct the hearing threshold. A comparison to pure tone audiometry shows that this hearing screening method in the presence of noise could closely estimate the hearing threshold. We expect that the proposed ubiquitous hearing test method could be used as a simple hearing screening tool and could alert the user if they suffer from hearing loss. PMID:24926692

Immune-Mediated Inner Ear Disease: Diagnostic and therapeutic approaches.

PubMed

Penêda, José Ferreira; Lima, Nuno Barros; Monteiro, Francisco; Silva, Joana Vilela; Gama, Rita; Condé, Artur

2018-03-07

Immune Mediated Inner Ear Disease (IMIED) is a rare form of sensorineural bilateral hearing loss, usually progressing in weeks to months and responsive to immunosuppressive treatment. Despite recent advances, there is no consensus on diagnosis and optimal treatment. A review of articles on IMIED from the last 10 years was conducted using PubMed ® database. IMIED is a rare disease, mostly affecting middle aged women. It may be a primary ear disease or secondary to autoimmune systemic disease. A dual immune response (both cellular and humoral) seems to be involved. Cochlin may be the inner ear protein targeted in this disease. Distinction from other (core common) forms of neurosensory hearing loss is a challenge. Physical examination is mandatory for exclusion of other causes of hearing loss; audiometry identifies characteristic hearing curves. Laboratory and imaging studies are controversial since no diagnostic marker is available. Despite recent research, IMIED diagnosis remains exclusive. Steroids are the mainstay treatment; other therapies need further investigation. For refractory cases, cochlear implantation is an option and with good relative outcome. Copyright © 2018 Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. Publicado por Elsevier España, S.L.U. All rights reserved.

Total leisure noise exposure and its association with hearing loss among adolescents.

PubMed

Dehnert, Knut; Raab, Ulla; Perez-Alvarez, Carmelo; Steffens, Thomas; Bolte, Gabriele; Fromme, Hermann; Twardella, Dorothee

2015-01-01

To investigate total leisure noise exposure among adolescents and to assess its association with hearing. Based on self-reported time spent on 19 leisure activities and associated mean sound pressure levels reported in the literature, total leisure noise exposure was evaluated and compared to noise at work limits (> 85 dB(A) = hazardous) in a cross-sectional survey. Tympanometry and pure-tone audiometry was performed in sound isolated rooms. The study sample consists of 2143 pupils attending grade nine in any school in a German city 2009-2011 (mean age: 15.4 years; range: 13-19 years). Audiometric data were available for 1837 (85.8%) pupils (53.9% girls). 41.9% of the 2143 adolescents who had provided self-reported data on leisure activities associated with noise exposure were estimated to be hazardously exposed to leisure time noise. The interaction of gender with total leisure time noise exposure was not significant. No association between leisure time noise exposure and audiometric notches could be detected. While hearing loss seems seldom in this age group, a high proportion of adolescents aged 15-16 years are exposed to noise levels during leisure time bearing long-term risks of hearing loss.

Audiological findings in Noonan syndrome.

PubMed

Tokgoz-Yilmaz, Suna; Turkyilmaz, Meral Didem; Cengiz, Filiz Basak; Sjöstrand, Alev Pektas; Kose, Serdal Kenan; Tekin, Mustafa

2016-10-01

The aim of this study was to evaluate audiologic properties of patients with Noonan syndrome and compare these findings with those of unaffected peers. The study included 17 children with Noonan syndrome and 20 typically developing children without Noonan syndrome. Pure tone and speech audiometry, immitancemetric measurement, otoacoustic emissions measurement and auditory brainstem response tests were applied to all (n = 37) children. Hearing thresholds of children with Noonan syndrome were higher (poorer) than those observed unaffected peers, while the hearing sensitivity of the both groups were normal limits (p = 0.013 for right, p = 0.031 for left ear). Transient evoked otoacoustic emissions amplitudes of the children with Noonan syndrome were lower than the children without Noonan syndrome (p = 0.005 for right, p = 0.002 for left ear). Middle ear pressures and auditory brainstem response values were within normal limits and there was no difference between the two groups (p > 0.05). General benefit of the present study is to characterize the audiologic findings of children with Noonan syndrome, which is beneficial in clinics evaluating children with Noonan syndrome. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

The audiological health of horn players.

PubMed

Wilson, Wayne J; O'Brien, Ian; Bradley, Andrew P

2013-01-01

Among orchestral musicians, horn players are one of the most at-risk groups for noise-induced hearing loss (NIHL). To investigate this group further, pure tone audiometry and a 14-item questionnaire were used to assess the hearing health, as well as attitudes and practices regarding hearing conservation, among 142 French horn players attending an international horn conference in Brisbane, Australia. Of this study's French horn players, 11.1% to 22.2%, and 17.7% to 32.9% of those aged ≤40 years, showed some form of hearing loss (corrected for age and gender) typical of NIHL, using conservative versus lenient criteria, respectively. Stepwise multiple regression analyses showed no obvious predictor of hearing loss in this study's participants. Of the 18% of participants who reported using hearing protection, 81% used this protection "sometimes" and 50% used generic, foam, or other inferior forms of protection. Continued efforts to better manage the hearing health of horn players is warranted particularly as any hearing loss will affect a horn player's ability to perform and therefore his or her livelihood. Managing the hearing health of horn players will be challenging, however, with no simple predictor of NIHL loss being identified in this study's sample.

Brainstem auditory-evoked potentials as an objective tool for evaluating hearing dysfunction in traumatic brain injury.

PubMed

Lew, Henry L; Lee, Eun Ha; Miyoshi, Yasushi; Chang, Douglas G; Date, Elaine S; Jerger, James F

2004-03-01

Because of the violent nature of traumatic brain injury, traumatic brain injury patients are susceptible to various types of trauma involving the auditory system. We report a case of a 55-yr-old man who presented with communication problems after traumatic brain injury. Initial results from behavioral audiometry and Weber/Rinne tests were not reliable because of poor cooperation. He was transferred to our service for inpatient rehabilitation, where review of the initial head computed tomographic scan showed only left temporal bone fracture. Brainstem auditory-evoked potential was then performed to evaluate his hearing function. The results showed bilateral absence of auditory-evoked responses, which strongly suggested bilateral deafness. This finding led to a follow-up computed tomographic scan, with focus on bilateral temporal bones. A subtle transverse fracture of the right temporal bone was then detected, in addition to the left temporal bone fracture previously identified. Like children with hearing impairment, traumatic brain injury patients may not be able to verbalize their auditory deficits in a timely manner. If hearing loss is suspected in a patient who is unable to participate in traditional behavioral audiometric testing, brainstem auditory-evoked potential may be an option for evaluating hearing dysfunction.

Sudden sensorineural hearing loss with positional vertigo: Initial findings of positional nystagmus and hearing outcomes.

PubMed

Kim, Chang-Hee; Shin, Jung Eun; Yang, Young Soo; Im, Donghyuk

2016-10-01

To investigate the initial findings of positional nystagmus in patients with sudden sensorineural hearing loss (SSNHL) and positional vertigo, and to compare hearing improvement among patients with different types of positional nystagmus. The characteristics of positional nystagmus upon initial examination were analysed, and the initial mean pure-tone audiometry (PTA) threshold was compared with that at three months after treatment. Forty-four SSNHL patients with concomitant positional vertigo were included. Positional nystagmus was classified into five subgroups; persistent geotropic direction-changing positional nystagmus (DCPN) in head-roll test (HRT) and negative Dix-Hallpike test (DHT), persistent apogeotropic DCPN in HRT and negative DHT, positive DHT and negative HRT, persistent geotropic DCPN in HRT and positive DHT, and persistent apogeotropic DCPN in HRT and positive DHT. PTA threshold improvement was significantly greater in SSNHL patients with negative DHT than with positive DHT (p = 0.027). When geotropic DCPN was elicited by HRT, the nystagmus was persistent, which suggests that alteration of specific gravity of the endolymph, rather than the lateral canal canalolithiasis, may be a cause of this characteristic positional nystagmus. Positive DTH may be a prognostic factor for worse hearing recovery among patients with SSNHL and positional vertigo.

Delayed auditory pathway maturation and prematurity.

PubMed

Koenighofer, Martin; Parzefall, Thomas; Ramsebner, Reinhard; Lucas, Trevor; Frei, Klemens

2015-06-01

Hearing loss is the most common sensory disorder in developed countries and leads to a severe reduction in quality of life. In this uncontrolled case series, we evaluated the auditory development in patients suffering from congenital nonsyndromic hearing impairment related to preterm birth. Six patients delivered preterm (25th-35th gestational weeks) suffering from mild to profound congenital nonsyndromic hearing impairment, descending from healthy, nonconsanguineous parents and were evaluated by otoacoustic emissions, tympanometry, brainstem-evoked response audiometry, and genetic testing. All patients were treated with hearing aids, and one patient required cochlear implantation. One preterm infant (32nd gestational week) initially presented with a 70 dB hearing loss, accompanied by negative otoacoustic emissions and normal tympanometric findings. The patient was treated with hearing aids and displayed a gradual improvement in bilateral hearing that completely normalized by 14 months of age accompanied by the development of otoacoustic emission responses. Conclusions We present here for the first time a fully documented preterm patient with delayed auditory pathway maturation and normalization of hearing within 14 months of birth. Although rare, postpartum development of the auditory system should, therefore, be considered in the initial stages for treating preterm hearing impaired patients.

Ear-Canal Reflectance, Umbo Velocity and Tympanometry in Normal Hearing Adults

PubMed Central

Rosowski, John J; Nakajima, Hideko H.; Hamade, Mohamad A.; Mafoud, Lorice; Merchant, Gabrielle R.; Halpin, Christopher F.; Merchant, Saumil N.

2011-01-01

Objective This study compares measurements of ear-canal reflectance (ECR) to other objective measurements of middle-ear function including, audiometry, umbo velocity (VU), and tympanometry in a population of strictly defined normal hearing ears. Design Data were prospectively gathered from 58 ears of 29 normal hearing subjects, 16 female and 13 male, aged 22–64 years. Subjects met all of the following criteria to be considered as having normal hearing. (1) No history of significant middle-ear disease. (2) No history of otologic surgery. (3) Normal tympanic membrane (TM) on otoscopy. (4) Pure-tone audiometric thresholds of 20 dB HL or better for 0.25 – 8 kHz. (5) Air-bone gaps no greater than 15 dB at 0.25 kHz and 10 dB for 0.5 – 4 kHz. (6) Normal, type-A peaked tympanograms. (7) All subjects had two “normal” ears (as defined by these criteria). Measurements included pure-tone audiometry for 0.25 – 8 kHz, standard 226 Hz tympanometry, Ear canal reflectance(ECR) for 0.2 – 6 kHz at 60 dB SPL using the Mimosa Acoustics HearID system, and Umbo Velocity (VU ) for 0.3 – 6 kHz at 70–90 dB SPL using the HLV-1000 laser Doppler vibrometer (Polytec Inc). Results Mean power reflectance (|ECR|2) was near 1.0 at 0.2– 0.3 kHz, decreased to a broad minimum of 0.3 to 0.4 between 1 and 4 kHz, and then sharply increased to almost 0.8 by 6 kHz. The mean pressure reflectance phase angle (∠ECR) plotted on a linear frequency scale showed a group delay of approximately 0.1 ms for 0.2 – 6 kHz. Small significant differences were observed in |ECR|2 at the lowest frequencies between right and left ears, and between males and females at 4 kHz. |ECR|2 decreased with age, but reached significance only at 1 kHz. Our ECR measurements were generally similar to previous published reports. Highly significant negative correlations were found between |ECR|2 and VU for frequencies below 1 kHz. Significant correlations were also found between the tympanometrically determined peak total compliance and |ECR|2 and The results suggest that middle-ear compliance VU at frequencies below 1 kHz. contributes significantly to the measured power reflectance and umbo velocity at frequencies below 1 kHz, but not at higher frequencies. Conclusions This study has established a database of objective measurements of middle ear function (ear-canal reflectance, umbo velocity, tympanometry) in a population of strictly defined normal hearing ears. The data will promote our understanding of normal middle ear function, and will serve as a control for comparison to similar measurements made in pathological ears. PMID:21857517

Spoken Word Recognition Errors in Speech Audiometry: A Measure of Hearing Performance?

PubMed Central

Coene, Martine; van der Lee, Anneke; Govaerts, Paul J.

2015-01-01

This report provides a detailed analysis of incorrect responses from an open-set spoken word-repetition task which is part of a Dutch speech audiometric test battery. Single-consonant confusions were analyzed from 230 normal hearing participants in terms of the probability of choice of a particular response on the basis of acoustic-phonetic, lexical, and frequency variables. The results indicate that consonant confusions are better predicted by lexical knowledge than by acoustic properties of the stimulus word. A detailed analysis of the transmission of phonetic features indicates that “voicing” is best preserved whereas “manner of articulation” yields most perception errors. As consonant confusion matrices are often used to determine the degree and type of a patient's hearing impairment, to predict a patient's gain in hearing performance with hearing devices and to optimize the device settings in view of maximum output, the observed findings are highly relevant for the audiological practice. Based on our findings, speech audiometric outcomes provide a combined auditory-linguistic profile of the patient. The use of confusion matrices might therefore not be the method best suited to measure hearing performance. Ideally, they should be complemented by other listening task types that are known to have less linguistic bias, such as phonemic discrimination. PMID:26557717

Current audiological diagnostics

PubMed Central

Hoth, Sebastian; Baljić, Izet

2017-01-01

Today’s audiological functional diagnostics is based on a variety of hearing tests, whose large number takes account of the variety of malfunctions of a complex sensory organ system and the necessity to examine it in a differentiated manner and at any age of life. The objective is to identify nature and origin of the hearing loss and to quantify its extent as far as necessary to dispose of the information needed to initiate the adequate medical (conservative or operational) treatment or the provision with technical hearing aids or prostheses. Moreover, audiometry provides the basis for the assessment of impairment and handicap as well as for the calculation of the degree of disability. In the present overview, the current state of the method inventory available for practical use is described, starting from basic diagnostics over to complex special techniques. The presentation is systematically grouped in subjective procedures, based on psychoacoustic exploration, and objective methods, based on physical measurements: preliminary hearing tests, pure tone threshold, suprathreshold processing of sound intensity, directional hearing, speech understanding in quiet and in noise, dichotic hearing, tympanogram, acoustic reflex, otoacoustic emissions and auditory evoked potentials. Apart from a few still existing gaps, this method inventory covers the whole spectrum of all clinically relevant functional deficits of the auditory system. PMID:29279727

Hearing, Auditory Processing, and Language Skills of Male Youth Offenders and Remandees in Youth Justice Residences in New Zealand.

PubMed

Lount, Sarah A; Purdy, Suzanne C; Hand, Linda

2017-01-01

International evidence suggests youth offenders have greater difficulties with oral language than their nonoffending peers. This study examined the hearing, auditory processing, and language skills of male youth offenders and remandees (YORs) in New Zealand. Thirty-three male YORs, aged 14-17 years, were recruited from 2 youth justice residences, plus 39 similarly aged male students from local schools for comparison. Testing comprised tympanometry, self-reported hearing, pure-tone audiometry, 4 auditory processing tests, 2 standardized language tests, and a nonverbal intelligence test. Twenty-one (64%) of the YORs were identified as language impaired (LI), compared with 4 (10%) of the controls. Performance on all language measures was significantly worse in the YOR group, as were their hearing thresholds. Nine (27%) of the YOR group versus 7 (18%) of the control group fulfilled criteria for auditory processing disorder. Only 1 YOR versus 5 controls had an auditory processing disorder without LI. Language was an area of significant difficulty for YORs. Difficulties with auditory processing were more likely to be accompanied by LI in this group, compared with the controls. Provision of speech-language therapy services and awareness of auditory and language difficulties should be addressed in youth justice systems.

Presbycusis among older Chinese people in Taipei, Taiwan: a community-based study.

PubMed

Chang, Hsin-Pin; Chou, Pesus

2007-12-01

The purpose of this study was to estimate the prevalence and severity of presbycusis in older Chinese people in Taipei, Taiwan. Pure-tone audiometry and a questionnaire were administered to a randomly-recruited cohort of people > 65 years old (n=1221) from a community in Taipei. The study cohort showed pure-tone thresholds worsening, especially at frequencies >2 kHz, with increasing age. The mean pure-tone average at speech frequencies (0.5, 1, and 2 kHz) of the better ear of subjects stratified by five-year age groups ranged from 34.9 dB hearing level (HL) to 46.4 dB HL. The pure-tone average at speech frequency in women was slightly higher than that in men in all age groups. The prevalence of presbycusis (M3 > or = 55 dBHL) was 1.6% (65-69 years), 3.2% (70-74 years), 7.5% (75-79 years), and 14.9% (> or =80 years). Persistent tinnitus was present in 13.9% of subjects, and 18.8% of subjects had a history of vertigo. Of subjects with a clinically evident hearing impairment (M3 > or = 55 dB HL), 18.4% used hearing aids. These data provide estimates of the prevalence and severity of presbycusis in community-dwelling older persons in Taiwan.

[Assessment of the efficiency of the auditory training in children with dyslalia and auditory processing disorders].

PubMed

Włodarczyk, Elżbieta; Szkiełkowska, Agata; Skarżyński, Henryk; Piłka, Adam

2011-01-01

To assess effectiveness of the auditory training in children with dyslalia and central auditory processing disorders. Material consisted of 50 children aged 7-9-years-old. Children with articulation disorders stayed under long-term speech therapy care in the Auditory and Phoniatrics Clinic. All children were examined by a laryngologist and a phoniatrician. Assessment included tonal and impedance audiometry and speech therapists' and psychologist's consultations. Additionally, a set of electrophysiological examinations was performed - registration of N2, P2, N2, P2, P300 waves and psychoacoustic test of central auditory functions: FPT - frequency pattern test. Next children took part in the regular auditory training and attended speech therapy. Speech assessment followed treatment and therapy, again psychoacoustic tests were performed and P300 cortical potentials were recorded. After that statistical analyses were performed. Analyses revealed that application of auditory training in patients with dyslalia and other central auditory disorders is very efficient. Auditory training may be a very efficient therapy supporting speech therapy in children suffering from dyslalia coexisting with articulation and central auditory disorders and in children with educational problems of audiogenic origin. Copyright © 2011 Polish Otolaryngology Society. Published by Elsevier Urban & Partner (Poland). All rights reserved.

The influence of music and stress on musicians' hearing

NASA Astrophysics Data System (ADS)

Kähäri, Kim; Zachau, Gunilla; Eklöf, Mats; Möller, Claes

2004-10-01

Hearing and hearing disorders among classical and rock/jazz musicians was investigated. Pure tone audiometry was done in 140 classical and 139 rock/jazz musicians. The rock/jazz musicians answered a questionnaire concerning hearing disorders and psychosocial exposure. All results were compared to age appropriate reference materials. Hearing thresholds showed a notch configuration in both classical and rock/jazz musicians indicating the inclusion of high sound levels but an overall well-preserved hearing thresholds. Female musicians had significantly better hearing thresholds in the high-frequency area than males. Rock/jazz musicians showed slight worse hearing thresholds as compared to classical musicians. When assessing hearing disorders, a large number of rock/jazz musicians suffered from different hearing disorders (74%). Hearing loss, tinnitus and hyperacusis were the most common disorders and were significantly more frequent in comparison with different reference populations. Among classical musicians, no extended negative progress of the pure tone hearing threshold values was found in spite of the continued 16 years of musical noise exposure. In rock/jazz musicians, there was no relationships between psychosocial factors at work and hearing disorders. The rock/jazz musicians reported low stress and high degree of energy. On the average, the rock/jazz musicians reported higher control, lower stress and higher energy than a reference material of white-collar workers.

Audiological and electrophysiological assessment of professional pop/rock musicians.

PubMed

Samelli, Alessandra G; Matas, Carla G; Carvallo, Renata M M; Gomes, Raquel F; de Beija, Carolina S; Magliaro, Fernanda C L; Rabelo, Camila M

2012-01-01

In the present study, we evaluated peripheral and central auditory pathways in professional musicians (with and without hearing loss) compared to non-musicians. The goal was to verify if music exposure could affect auditory pathways as a whole. This is a prospective study that compared the results obtained between three groups (musicians with and without hearing loss and non-musicians). Thirty-two male individuals participated and they were assessed by: Immittance measurements, pure-tone air conduction thresholds at all frequencies from 0.25 to 20 kHz, Transient Evoked Otoacoustic Emissions, Auditory Brainstem Response (ABR), and Cognitive Potential. The musicians showed worse hearing thresholds in both conventional and high frequency audiometry when compared to the non-musicians; the mean amplitude of Transient Evoked Otoacoustic Emissions was smaller in the musicians group, but the mean latencies of Auditory Brainstem Response and Cognitive Potential were diminished in the musicians when compared to the non-musicians. Our findings suggest that the population of musicians is at risk for developing music-induced hearing loss. However, the electrophysiological evaluation showed that latency waves of ABR and P300 were diminished in musicians, which may suggest that the auditory training to which these musicians are exposed acts as a facilitator of the acoustic signal transmission to the cortex.

Football match spectator sound exposure and effect on hearing: a pretest-post-test study.

PubMed

Swanepoel, De Wet; Hall, James W

2010-03-30

To determine (i) noise exposure levels of spectators at a FIFA 2010 designated training stadium during a premier soccer league match; and (ii) changes in auditory functioning after the match. This was a one-group pretest-post-test design of football spectators attending a premier soccer league match at a designated FIFA 2010 training stadium in Gauteng, South Africa. Individual spectator noise exposure for the duration of the football match and post-match changes in hearing thresholds were measured with pure-tone audiometry, and cochlear functioning was measured with distortion product oto-acoustic emissions (DPOAEs). The average sound exposure level during the match was 100.5 LAeq (dBA), with peak intensities averaging 140.4 dB(C). A significant (p=0.005) deterioration of post-match hearing thresholds was evident at 2 000 Hz, and post-match DPOAE amplitudes were significantly reduced at 1,266, 3,163 and 5,063 Hz (p=0.011, 0.019, 0.013, respectively). Exposure levels exceeded limits of permissible average and peak sound levels. Significant changes in post-match hearing thresholds and cochlear responsiveness highlight the possible risk for noise-induced hearing loss. Public awareness and personal hearing protection should be prioritized as preventive measures.

Brainstem evoked response audiometry: an investigatory tool in detecting hepatic encephalopathy in decompensated chronic liver disease.

PubMed

Kabali, Balasubramanian; Velayutham, Gowri; Kapali, Suresh Chander

2014-01-01

It is estimated that globally there is a marked increase in liver disease with reports of rising morbidity and mortality, particularly in younger age groups. Brainstem auditory evoked potential (BAEP) was recorded in 60 decompensated chronic liver disease (DCLD) subjects who fulfilled the selection criteria and compared to 60 age and gender matched healthy subjects with normal liver functions. DCLD subjects were divided into two inter groups based on presence or absence of hepatic encephalopathy (HE). Group 1 comprises of 30 subjects of grade- I HE and Group 2 included 30 subjects without hepatic encephalopathy (NHE). Absolute and interpeak wave latencies were measured. Results were analysed by student independent t- test using SPSS software 11 version. Statistical significance was tested using P value. From the present study it can be concluded that the central nervous system is involved in liver cirrhosis evidenced by an abnormal BAEP latencies parameters. This shows that there may be progressive demyelination occurring along with axonal loss or dysfunction in liver cirrhosis HE. This study suggests that periodic evaluation of cirrhotic individuals to such test will help in monitoring the progress of encephalopathy. The prime goal of this study is early diagnosis and initiation of treatment before the onset of coma can reduce the fatality rate.

Petrous bone fractures violating otic capsule.

PubMed

Magliulo, Giuseppe; Ciniglio Appiani, Mario; Iannella, Giannicola; Artico, Marco

2012-12-01

This study presents our experience with a series of patients suffering from petrous bone fractures violating the otic capsule who underwent subtotal petrosectomy combined with eustachian tube, middle ear, and mastoid obliteration, with the goal of preventing cerebrospinal fluid (CSF) leak and meningitis. This study enrolled 26 patients between 1997 and 2011. The clinical symptoms, otoscopy, and preoperative and postoperative audiometry and facial function, as well as CSF leak or meningitis, were evaluated in each patient. The entire group underwent a subtotal petrosectomy using the technique described in detail by Fisch. In addition, each patient was interviewed using a questionnaire to evaluate the impact on quality of life. Intraoperatively, we found significant CSF leaks in 14 patients (42.5%). No patient reported other episodes of CSF leak or meningitis after the surgery. The patients' responses of facial nerve function were slightly worse than the House-Brackmann evaluation (50% versus 42.3%; p < 0.05). The vast majority (88.5%) of the patients experienced no social impact. Our findings suggest the importance of not underestimating the risk for CSF leak in the petrous bone fractures violating the otic capsule. Preoperative counseling regarding the various troublesome complications must adequately motivate candidates to undergo surgery by pointing out the positive impact of the proposed treatment.

Effects of Smoking on Eustachian Tube and Hearing.

PubMed

Pezzoli, Matteo; Lofaro, Denise; Oliva, Alessandro; Orione, Monica; Cupi, Daniela; Albera, Andrea; Bongioannini, Guido; Albera, Roberto

2017-12-01

The purpose of this study was to evaluate the effect of tobacco use on the Eustachian tube and inner ear function. Case-control study. Thirty-one nonsmoking volunteers and 34 smoking subjects recruited in an University Hospital, submitted to an audiological evaluation including pure tone audiometry, basal tympanogram, stapedial reflexes analysis, and nine-step eustachian tube (ET) function test. Pure Tone Average (PTA) threshold at all frequencies tested was 12.5 dB in smokers and 3.7 in nonsmoking subjects. Nine smokers (27%) presented some degree of hearing loss versus none in the nonsmoker group. Linear regression analysis showed a higher degree of sensorineural hearing loss with age in smokers. Among the smokers, 20 subjects (59%) presented an impaired tubal function for the nine-step inflation/deflation tympanometric test, while only 6 (19%) subjects in the group of nonsmokers showed a tubal dysfunction. Tobacco use may reduce the ability to hear, mainly causing a sensorineural hearing loss for higher frequencies. We also found the presence of a high number of smokers suffering from tubal dysfunction. This has an important clinical relevance, not only because smoking increases the incidence of middle ear diseases, but also because tubal dysfunction may cause nonspecific symptoms characterised by ear fullness and difficulties in middle ear equalisation.

High-frequency profile in adolescents and its relationship with the use of personal stereo devices.

PubMed

Silvestre, Renata Almeida Araújo; Ribas, Ângela; Hammerschmidt, Rogério; de Lacerda, Adriana Bender Moreira

2016-01-01

To analyze and correlate the audiometric findings of high frequencies (9-16 kHz) in adolescents with their hearing habits and attitudes, in order to prevent noise-induced hearing loss. This was a descriptive cross-sectional study, which included 125 adolescents in a sample of normal-hearing students, at a state school. The subjects performed high-frequency audiometry testing and answered a self-administered questionnaire addressing information on sound habits concerning the use of personal stereo devices. The sample was divided according to the exposure characteristics (time, duration, intensity, etc.) and the results were compared with the observed thresholds, through the difference in proportions test, chi-squared, Student's t-test, and ANOVA, all at a significance level of 0.05. Average high-frequency thresholds were registered below 15 dB HL and no significant correlation was found between high frequency audiometric findings and the degree of exposure. The prevalence of harmful sound habits due to the use of personal stereo devices is high in the adolescent population, but there was no correlation between exposure to high sound pressure levels through personal stereos and the high-frequency thresholds in this population. Copyright © 2016 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

Transient evoked otoacoustic emissions in rock musicians.

PubMed

Høydal, Erik Harry; Lein Størmer, Carl Christian; Laukli, Einar; Stenklev, Niels Christian

2017-09-01

Our focus in this study was the assessment of transient evoked otoacoustic emissions (TEOAEs) in a large group of rock musicians. A further objective was to analyse tinnitus among rock musicians as related to TEOAEs. The study was a cross-sectional survey of rock musicians selected at random. A control group was included at random for comparison. We recruited 111 musicians and a control group of 40 non-musicians. Testing was conducted by using clinical examination, pure tone audiometry, TEOAEs and a questionnaire. TEOAE SNR in the half-octave frequency band centred on 4 kHz was significantly lower bilaterally in musicians than controls. This effect was strongly predicted by age and pure-tone hearing threshold levels in the 3-6 kHz range. Bilateral hearing thresholds were significantly higher at 6 kHz in musicians. Twenty percent of the musicians had permanent tinnitus. There was no association between the TEOAE parameters and permanent tinnitus. Our results suggest an incipient hearing loss at 6 kHz in rock musicians. Loss of TEOAE SNR in the 4 kHz half-octave frequency band was observed, but it was related to higher mean 3-6 kHz hearing thresholds and age. A large proportion of rock musicians have permanent tinnitus.

Spinal analgesia and auditory functions: a comparison of two sizes of Quincke needle.

PubMed

Malhotra, S K; Iyer, B A; Gupta, A K; Raghunathan, M; Nakra, D

2007-01-01

Spinal anaesthesia may produce complications ranging from minor problems such as pain on injection, backache and urinary retention to more serious consequences such as post-dural puncture headache (PDPH), neurological complications like meningitis, cranial and peripheral nerve palsies and even cardiac arrest. Impaired auditory function is a relatively lesser-recognized complication of spinal analgesia. The objective of this study was to investigate the effects of spinal analgesia on vestibular dysfunction, using different sizes of the same type of spinal needle. The study included 30 ASA I patients who had received spinal analgesia for lower abdominal surgery. Pure tone audiometry was performed before surgery and on postoperative day 2. In addition, any patient with hearing impairment of >15 dB was scheduled to undergo electrocochleography. Hearing levels were measured from 250 Hz to 8 kHz. In group 1 (n=15), a 26gauge Quincke needle was used. In group 2 (n=15), a 23-gauge Quincke needle was used. Comparison of hearing thresholds showed a significant reduction in the hearing level (P<0.05) in 2 patients in group 2 but none in group 1. The use of a 23-gauge Quincke needle is associated with a greater reduction in the mean hearing level compared to a 26-gauge needle of the same type.

Notched-noise embedded frequency specific chirps for objective audiometry using auditory brainstem responses

PubMed Central

Corona-Strauss, Farah I.; Schick, Bernhard; Delb, Wolfgang; Strauss, Daniel J.

2012-01-01

It has been shown recently that chirp-evoked auditory brainstem responses (ABRs) show better performance than click stimulations, especially at low intensity levels. In this paper we present the development, test, and evaluation of a series of notched-noise embedded frequency specific chirps. ABRs were collected in healthy young control subjects using the developed stimuli. Results of the analysis of the corresponding ABRs using a time-scale phase synchronization stability (PSS) measure are also reported. The resultant wave V amplitude and latency measures showed a similar behavior as for values reported in literature. The PSS of frequency specific chirp-evoked ABRs reflected the presence of the wave V for all stimulation intensities. The scales that resulted in higher PSS are in line with previous findings, where ABRs evoked by broadband chirps were analyzed, and which stated that low frequency channels are better for the recognition and analysis of chirp-evoked ABRs. We conclude that the development and test of the series of notched-noise embedded frequency specific chirps allowed the assessment of frequency specific ABRs, showing an identifiable wave V for different intensity levels. Future work may include the development of a faster automatic recognition scheme for these frequency specific ABRs. PMID:26557336

[Acoustic trauma generated by exposure to gun powder].

PubMed

Arch-Tirado, Emilio; Garnica-Escamilla, Marco Antonio; Delgado-Hernández, Alhelí; Campos-Muñoz, Teodora; Rodríguez-Rodríguez, Lourdes; Verduzco-Mendoza, Antonio

2014-01-01

Noise-induced hearing loss has increased due to factors such as industrialization. It is estimated that one third of the world's population suffers from some degree of hearing loss caused by exposure to high-intensity noise. Exposure to noise can cause disease of various ear structures, especially destruction of outer hair cells, causing varying degrees of hearing lossObjective: To describe the audiological findings in a group of subjects who were exposed to a source of fireworks explosion in the state of Tlaxcala Mexico. We carried out an audiometric study in eight patients admitted to CENIAQ-INR who were exposed to a firecracker explosion. In each subject, airway with conventional pure tone audiometry from 125 to 8000 Hz was assessed using a clinical audiometer (model 622, Minimate, Madsen) Clinical case: Hearing loss at all frequencies was found in all eight patients, from mild to severe in both ears. Audiogram showed decreases from 4000 Hz, diagnosing third-degree acoustic trauma in all patients. The main symptom was reported by patients with tinnitus. Other scenarios in which patients report the presence of tinnitus are acoustic trauma due to use of audio players in symphony orchestra musicians and detonating military firearms. Audiometric assessment is recommended after an explosive accident as an accurate method to determine if there is any hearing impairment.

Sinuclean Nebules treatment in children suffering from otitis media with effusion.

PubMed

Varricchio, A; De Lucia, A; Varricchio, A M; Della Volpe, A; Mansi, N; Pastore, V; Ciprandi, G

2017-03-01

Otitis media with effusion (OME) is an ear disorder defined by the presence of fluid in the middle ear without signs or symptoms of acute infection. The current randomized, double-blind, controlled study aimed to evaluate whether Sinuclean Nebules treatment, administered by nasal douche (Rinowash), could induce ear healing better than isotonic saline in children with OME. The study was randomized, double-blind, and controlled. Group A (30 children) was treated with Sinuclean Nebules 45 and Group B (31 children) was treated with isotonic saline; both compounds were administered by nasal nebulization with Rinowash nasal douche twice/day in the morning and in the evening for 10 days, followed by a one-week suspension, and after by a second course as the first. Tympanogram and audiometry were performed at baseline and after treatment. Considering the global evaluation of the treatment: in Group A, 28 (93.3%) patients had complete resolution and 2 (6.7%) had partial resolution; in Group B, all patients had failure of treatment. There was a significant difference between groups (p < 0.0001). The current randomized-controlled study demonstrated that Sinuclean Nebules was effective and in the treatment of children with OME. Copyright © 2017 Elsevier B.V. All rights reserved.

Killer whale (Orcinus orca) hearing: auditory brainstem response and behavioral audiograms.

PubMed

Szymanski, M D; Bain, D E; Kiehl, K; Pennington, S; Wong, S; Henry, K R

1999-08-01

Killer whale (Orcinus orca) audiograms were measured using behavioral responses and auditory evoked potentials (AEPs) from two trained adult females. The mean auditory brainstem response (ABR) audiogram to tones between 1 and 100 kHz was 12 dB (re 1 mu Pa) less sensitive than behavioral audiograms from the same individuals (+/- 8 dB). The ABR and behavioral audiogram curves had shapes that were generally consistent and had the best threshold agreement (5 dB) in the most sensitive range 18-42 kHz, and the least (22 dB) at higher frequencies 60-100 kHz. The most sensitive frequency in the mean Orcinus audiogram was 20 kHz (36 dB), a frequency lower than many other odontocetes, but one that matches peak spectral energy reported for wild killer whale echolocation clicks. A previously reported audiogram of a male Orcinus had greatest sensitivity in this range (15 kHz, approximately 35 dB). Both whales reliably responded to 100-kHz tones (95 dB), and one whale to a 120-kHz tone, a variation from an earlier reported high-frequency limit of 32 kHz for a male Orcinus. Despite smaller amplitude ABRs than smaller delphinids, the results demonstrated that ABR audiometry can provide a useful suprathreshold estimate of hearing range in toothed whales.

Evaluation of psychoacoustic tests and P300 event-related potentials in elderly patients with hyperhomocysteinemia.

PubMed

Díaz-Leines, Sergio; Peñaloza-López, Yolanda R; Serrano-Miranda, Tirzo A; Flores-Ávalos, Blanca; Vidal-Ixta, Martha T; Jiménez-Herrera, Blanca

2013-01-01

Hyperhomocysteinemia as a risk factor for hearing impairment, neuronal damage and cognitive impairment in elderly patients is controversial and is limited by the small number of studies. The aim of this work was determine if elderly patients detected with hyperhomocysteinemia have an increased risk of developing abnormalities in the central auditory processes as compared with a group of patients with appropriate homocysteine levels, and to define the behaviour of psychoacoustic tests and long latency potentials (P300) in these patients. This was a cross-sectional, comparative and analytical study. We formed a group of patients with hyperhomocysteinemia and a control group with normal levels of homocysteine. All patients underwent audiometry, tympanometry and a selection of psychoacoustic tests (dichotic digits, low-pass filtered words, speech in noise and masking level difference), auditory evoked brainstem potentials and P300. Patients with hyperhomocysteinemia had higher values in the test of masking level difference than did the control group (P=.049) and more protracted latency in P300 (P=.000). Hyperhomocysteinemia is a factor that alters the central auditory functions. Alterations in psychoacoustic tests and disturbances in electrophysiological tests suggest that the central portion of the auditory pathway is affected in patients with hyperhomocysteinemia. Copyright © 2012 Elsevier España, S.L. All rights reserved.

Auditory evoked functions in ground crew working in high noise environment of Mumbai airport.

PubMed

Thakur, L; Anand, J P; Banerjee, P K

2004-10-01

The continuous exposure to the relatively high level of noise in the surroundings of an airport is likely to affect the central pathway of the auditory system as well as the cognitive functions of the people working in that environment. The Brainstem Auditory Evoked Responses (BAER), Mid Latency Response (MLR) and P300 response of the ground crew employees working in Mumbai airport were studied to evaluate the effects of continuous exposure to high level of noise of the surroundings of the airport on these responses. BAER, P300 and MLR were recorded by using a Nicolet Compact-4 (USA) instrument. Audiometry was also monitored with the help of GSI-16 Audiometer. There was a significant increase in the peak III latency of the BAER in the subjects exposed to noise compared to controls with no change in their P300 values. The exposed group showed hearing loss at different frequencies. The exposure to the high level of noise caused a considerable decline in the auditory conduction upto the level of the brainstem with no significant change in conduction in the midbrain, subcortical areas, auditory cortex and associated areas. There was also no significant change in cognitive function as measured by P300 response.

Upper Nasopharyngeal Corridor for Transnasal Endoscopic Drainage of Petroclival Cholesterol Granulomas: Alternative Access in Conchal Sphenoid Patients.

PubMed

Turan, Nefize; Baum, Griffin R; Holland, Christopher M; Ahmad, Faiz U; Henriquez, Oswaldo A; Pradilla, Gustavo

2016-03-01

Background Cholesterol granulomas arising at the petrous apex can be treated via traditional open surgical, endoscopic, and endoscopic-assisted approaches. Endoscopic approaches require access to the sphenoid sinus, which is technically challenging in patients with conchal sphenoidal anatomy. Clinical Presentation A 55-year-old woman presented with intermittent headaches and tinnitus. Formal audiometry demonstrated moderately severe bilateral hearing loss. CT of the temporal bones and sella revealed a well-demarcated expansile lytic mass. MRI of the face, orbit, and neck showed a right petrous apex mass measuring 22 × 18 × 19 mm that was hyperintense on T1- and T2-weighted images without enhancement, consistent with a cholesterol granuloma. The patient had a conchal sphenoidal anatomy. Operative Technique Herein, we present an illustrative case of a low-lying petroclival cholesterol granuloma in a patient with conchal sphenoidal anatomy to describe an alternative high nasopharyngeal corridor for endoscopic transnasal transclival access. Postoperative Course Postoperatively, the patient's symptoms recovered and no complications occurred. Follow-up imaging demonstrated a patent drainage tract without evidence of recurrence. Conclusion In patients with a conchal sphenoid sinus, endoscopic transnasal transclival access can be gained using a high nasopharyngeal approach. This corridor facilitates safe access to these lesions and others in this location.

Absence of both auditory evoked potentials and auditory percepts dependent on timing cues.

PubMed

Starr, A; McPherson, D; Patterson, J; Don, M; Luxford, W; Shannon, R; Sininger, Y; Tonakawa, L; Waring, M

1991-06-01

An 11-yr-old girl had an absence of sensory components of auditory evoked potentials (brainstem, middle and long-latency) to click and tone burst stimuli that she could clearly hear. Psychoacoustic tests revealed a marked impairment of those auditory perceptions dependent on temporal cues, that is, lateralization of binaural clicks, change of binaural masked threshold with changes in signal phase, binaural beats, detection of paired monaural clicks, monaural detection of a silent gap in a sound, and monaural threshold elevation for short duration tones. In contrast, auditory functions reflecting intensity or frequency discriminations (difference limens) were only minimally impaired. Pure tone audiometry showed a moderate (50 dB) bilateral hearing loss with a disproportionate severe loss of word intelligibility. Those auditory evoked potentials that were preserved included (1) cochlear microphonics reflecting hair cell activity; (2) cortical sustained potentials reflecting processing of slowly changing signals; and (3) long-latency cognitive components (P300, processing negativity) reflecting endogenous auditory cognitive processes. Both the evoked potential and perceptual deficits are attributed to changes in temporal encoding of acoustic signals perhaps occurring at the synapse between hair cell and eighth nerve dendrites. The results from this patient are discussed in relation to previously published cases with absent auditory evoked potentials and preserved hearing.

Otological diagnoses and probable age-related auditory neuropathy in "younger" and "older" elderly persons.

PubMed

Rosenhall, Ulf; Hederstierna, Christina; Idrizbegovic, Esma

2011-09-01

Audiological data from a population based epidemiological investigation were studied on elderly persons. Specific diagnoses of otological and audiological disorders, which can result in hearing loss, were searched for. A retrospective register study. Three age cohorts, 474 70- and 75-year olds ("younger"), and 252 85-year olds ("older"), were studied. Clinical pure tone and speech audiometry was used. Data from medical files were included. Conductive hearing loss was diagnosed in 6.1% of the "younger" elderly persons, and in 10.3% of the "older" ones. Specific diagnoses (chronic otitis media and otosclerosis) were established in about half of the cases. Sensorineural hearing loss, other than age-related hearing loss and noise induced hearing loss, was diagnosed in 3.4 % and 5.2% respectively. Severely impaired speech recognition, possibly reflecting age-related auditory neuropathy, was found in 0.4% in the "younger" group, and in 10% in the "older" group. Bilateral functional deafness was present in 3.2% of the 85-year-old persons, but was not present in the 70-75-year group. The incidence of probable age-related auditory neuropathy increases considerably from 70-75 to 85 years. There are marked differences between "younger" and "older" elderly persons regarding hearing loss that severely affects oral communication.

[Association between cerumen impaction, cognitive function and hearing in Japanese elderly].

PubMed

Sugiura, Saiko; Uchida, Yasue; Nakashima, Tsutomu; Nishita, Yukiko; Tange, Chikako; Ando, Fujiko; Shimokata, Hiroshi

2012-01-01

In this study we aimed to evaluate the frequency of cerumen impaction in Japanese elderly and clarify the associations between cerumen, cognitive function, and hearing impairment. The subjects enrolleded in this study were participants in the National Institute for Longevity Sciences, Longitudinal Study of Aging (NILS-LSA). The data of 792 community-dwelling participants aged 60 to 88 years old were collected. All had taken the Mini-Mental State Examination (MMSE) and had undergone pure tone audiometry (PTA) assessment and video recording of an otoscopic examination. We then analyzed associations between the incidence of the cerumen impaction of better-hearing ear, hearing level and MMSE scores using a general linear model. Cerumen impaction of the better-hearing ear was observed in 10.7% of all participants. In participants with an MMSE score of less than 24, the frequency of cerumen impaction was 23.3%. Cerumen was significant associated with poorer hearing after adjustment for sex and age (p=0.0001). Cerumen impaction also showed a significant association with a low MMSE score after adjustment for sex, age, hearing level and education (p=0.02). The frequency of cerumen impaction in Japanese elderly was estimated to be approximately 10%. The existence of cerumen impaction was associated with poorer hearing level and lower MMSE score.

Health impacts of garage workers: A preliminary study

DOE Office of Scientific and Technical Information (OSTI.GOV)

Muttamara, S.; Alwis, K.U.

1994-05-01

This research study was carried out in two automobile repair garages situated in the Bangkok metropolitan area, employing 47 and 12 workers respectively. Air sampling, biological monitoring (blood, urine), noise monitoring, and audiometry of workers were done to assess the occupational environment and its impact on the workers. The occupational hygiene survey was carried out to observe the working conditions of both garages. It was found that conditions at both sites have a strong negative impact on the health of workers. The lead in air of Garage 1 was 0.20 mg/m[sup 3] which is the same as the threshold limitmore » value (TLV) for lead in air for a working environment. The level of lead in blood of four workers of each garage was above the exposed level. According to the occupational hygiene survey carried out at both garages, 79% of workers of Garage 1 and 70% of workers of Gage 2 suffered from redness of the eyes (eye pain, gritty feeling), and 5% and 2% of workers of Garage 1 and Garage 2 respectively, complained about breathing difficulties. Control measures should be taken to minimize pollution due to dust, fumes, and noise which would reduce the health impacts and lead to a healthier workforce.« less

Longitudinal analysis of hearing loss in a case of hemosiderosis of the central nervous system.

PubMed

Weekamp, H H; Huygen, P L M; Merx, J L; Kremer, H P H; Cremers, Cor W R J; Longridge, Neil S

2003-09-01

To describe cochleovestibular aspects of superficial hemosiderosis of the central nervous system. Superficial hemosiderosis of the central nervous system is a rare disease in which cochleovestibular impairment, cerebellar ataxia, and myelopathy are the most frequent signs. Chronic recurrent subarachnoidal hemorrhage with bleeding into the cerebrospinal fluid is the cause of deposition of hemosiderin in leptomeningeal and subpial tissue, cranial nerves, and spinal cord. Removing the cause of bleeding can prevent irreversible damage to these structures. Because this is the only effective treatment, an early diagnosis is crucial. Retrospective case review. Tertiary referral center. A 72-year-old woman with superficial hemosiderosis of the central nervous system that developed when she was age 39. Neurologic and imaging diagnostic examinations and longitudinal evaluation of cochleovestibular features were performed. Neurosurgery was not performed. Progressive bilateral sensorineural hearing loss and severe vestibular hyporeflexia developed within 15 years, which can be attributed to lesions in the cochleovestibular system. Additional pathology of the central nervous system developed later. The patient demonstrated cochlear and vestibular findings that are typical of this pathologic condition. It is the first documented case with extensive serial audiometry used to precisely outline the degree of hearing deterioration during the course of the disease.

Experiences of the use of FOX, an intelligent agent, for programming cochlear implant sound processors in new users.

PubMed

Vaerenberg, Bart; Govaerts, Paul J; de Ceulaer, Geert; Daemers, Kristin; Schauwers, Karen

2011-01-01

This report describes the application of the software tool "Fitting to Outcomes eXpert" (FOX) in programming the cochlear implant (CI) processor in new users. FOX is an intelligent agent to assist in the programming of CI processors. The concept of FOX is to modify maps on the basis of specific outcome measures, achieved using heuristic logic and based on a set of deterministic "rules". A prospective study was conducted on eight consecutive CI-users with a follow-up of three months. Eight adult subjects with postlingual deafness were implanted with the Advanced Bionics HiRes90k device. The implants were programmed using FOX, running a set of rules known as Eargroup's EG0910 advice, which features a set of "automaps". The protocol employed for the initial 3 months is presented, with description of the map modifications generated by FOX and the corresponding psychoacoustic test results. The 3 month median results show 25 dBHL as PTA, 77% (55 dBSPL) and 71% (70 dBSPL) phoneme score at speech audiometry and loudness scaling in or near to the normal zone at different frequencies. It is concluded that this approach is feasible to start up CI fitting and yields good outcome.

Association between sleep disorders, hyperacusis and tinnitus: evaluation with tinnitus questionnaires.

PubMed

Fioretti, Alessandra B; Fusetti, Marco; Eibenstein, Alberto

2013-01-01

Patients with tinnitus are heterogeneous and several factors influence the impact of this symptom on the quality of life. The aim of the study is to evaluate the relationship between age, gender, sleep disorders, hyperacusis and tinnitus annoyance and to demonstrate the utility of tinnitus questionnaires as screening tools for sleep disorders and hyperacusis in patients with tinnitus. 37 consecutive patients (18 males and 19 females) with subjective tinnitus lasting over 3 months were evaluated with a complete interview, otological examination, pure tone audiometry, Italian version of tinnitus sample case history (TSCH) and tinnitus handicap inventory (THI). Statistical analysis was performed with the Wilcoxon's rank sum test, the Spearman's rho non-parametric correlation and the logistic regression analysis. THI grades were slight (16%), mild (32%), moderate (30%), severe (19%) and catastrophic (3%). Based on the answers to TSCH 20 patients reported sleep disorders (54%) and 20 patients reported hyperacusis (54%). 11 patients (30%) reported sleep disorders and hyperacusis. No significant correlation was found between the severity of tinnitus and patients' age and gender. Significant correlation was found between sleep disorders (P = 0.0009) and tinnitus annoyance and between hyperacusis (P = 0.03) and tinnitus annoyance. TSCH and THI may be considered as screening tools in the clinical practice to evidence sleep disorders and hyperacusis in patients with tinnitus.

International survey of cochlear implant candidacy.

PubMed

Vickers, D; De Raeve, L; Graham, J

2016-04-01

The goal of this work was to determine international differences in candidacy based on audiometric and speech perception measures, and to evaluate the information in light of the funding structure and access to implants within different countries. An online questionnaire was circulated to professionals in 25 countries. There were 28 respondents, representing the candidacy practice in 17 countries. Results showed differences in the funding model between countries. Unilateral implants for both adults and children and bilateral implants for children were covered by national funding in approximately 60% of countries (30% used medical insurance, and 10% self-funding). Fewer countries provided bilateral implants routinely for adults: national funding was available in only 22% (37% used medical insurance and 41% self-funding). Main evolving candidacy areas are asymmetric losses, auditory neuropathy spectrum disorders and electro-acoustic stimulation. For countries using speech-based adult candidacy assessments, the majority (40%) used word tests, 24% used sentence tests, and 36% used a mixture of both. For countries using audiometry for candidacy (70-80% of countries), the majority used levels of 75-85 dB HL at frequencies above 1 kHz. The United Kingdom and Belgium had the most conservative audiometric criteria, and countries such as Australia, Germany, and Italy were the most lenient. Countries with a purely self-funding model had greater flexibility in candidacy requirements.

[The hearing function and vegetative reactions in airport technicians using individual hearing protectors].

PubMed

Chistov, S D; Soldatov, S K; Zinkin, V N; Poliakov, N M

2013-01-01

The objective of the present study was to evaluate the hearing function in the airport technical personnel and estimate the effectiveness of multicomponent anti-noise hearing protectors used by the specialists engaged in the aircraft maintenance. The tonal threshold audiometry was carried out before and after a shiftwork. The extra-aural effect of noise was assessed from the characteristics of cardiac rhythm variability. The study included two groups of subjects: in one of them (n=8) they used ordinary flight headsets (control) in the other the protection was ensured with the help of multi-insert hearing protectors (n=16). The initial hearing thresholds were found to be increased up to 70 and 60 dB at the frequencies of 4 and 8 kHz respectively. The regression analysis revealed the relationship between these parameters and the duration of aerodrome work experience. Temporary threshold shifts were observed only in the control group. An increase in the tone of the sympathetic nervous system was observed in the control subjects but was absent in the study group. It is concluded that the multi-component hearing protectors employed in the present study are highly efficacious anti-noise devices. The mechanisms of noise-induced hearing loss are discussed.

Vestibular evoked myogenic potentials in patients with BPPV.

PubMed

Korres, Stavros; Gkoritsa, Eleni; Giannakakou-Razelou, Dimitra; Yiotakis, Ioannis; Riga, Maria; Nikolpoulos, Thomas P

2011-01-01

The probable cause of Benign Paroxysmal Positional Vertigo (BPPV) is a degeneration of the oto lithic organs (utricle and saccule). The aim of the study is to find possible alterations in Vestibular Evoked Myogenic Potentials (VEMP) recordings in BPPV patients, because the saccule is part of the VEMP pathway. 27 BPPV patients (24 unilateral and 3 bilateral) aged 20 to 70 years and 30 healthy age matched controls. BPPV was diagnosed by the upbeating geotropic nystagmus found in the supine position with the head overextended towards one side. The subjects were investigated with pure tone audiometry, bi-thermal caloric test with electronystagmographic (ENG) recording, and VEMP recording. P1 latency and N1 latency did not present any statistical difference between control ears and affected ears of the BPPV population. The percentage of abnormal VEMP in the BPPV population was statistically higher than in the control ears (p < 0.005). No significant relationship could be shown between the occurrence of Canal Paresis and abnormal VEMP. No relationship was found between the side (right or left ear) where BPPV appeared clinically and the side where abnormal VEMP was registered. BPPV is a clinical entity associated with increased occurrence of abnormal VEMP recordings, possibly due to degeneration of the saccular macula, which is part of the neural VEMP pathway.

Vestibular evoked myogenic potential according to middle ear condition in chronic otitis media with tympanic membrane perforation.

PubMed

Lee, Jun Seok; Lee, Sun Kyu; Shin, Il Ho; Yeo, Seung Geun; Park, Moon Suh; Byun, Jae Yong

2014-01-01

Vestibular evoked myogenic potential (VEMP) function results can vary between individuals with different middle ear conditions. Therefore, by analyzing VEMP results after paper patching, we can predict the condition of the middle ear in chronic otitis media (COM) patients. VEMP responses decrease with impairment of sound transmission, such as in conductive hearing loss (CHL). COM with tympanic membrane (TM) perforation is a common disorder that causes various degrees of CHL. The aim of this study was to evaluate and clarify the VEMP responses in patients with COM with different middle ear pathology. This study included 50 patients with unilateral COM with TM perforation. Initial pure-tone audiometry (PTA) and VEMP responses were recorded. After paper patching, PTA and VEMP were re-performed. Each VEMP response was compared with those of the healthy controls. Moreover, VEMP responses between pre- and post-paper patching were compared. There was a positive correlation between normalizing of VEMP parameters, such as p13 and VEMP asymmetry ratio (VAR), and reduction of air-bone gap in patients with COM after paper patching. The VEMP response in patients with COM with intact ossicle and clean mucosa was more normalized compared with those in patients with COM with different middle ear conditions.

Factors related to mental health and hearing in community-dwelling elderly

PubMed Central

Nabeshima, Sumiyo; Yamada, Kiyomi

2018-01-01

ABSTRACT The purpose of this study was to clarify the factors related to mental health and hearing in community-dwelling elderly. Elderly participants in a project to prevent long-term care need were given a self-administered questionnaire and tested by pure-tone audiometry. One hundred fifty were taken as subjects. Forty-one of these subjects (27.3%) were found to have poor mental health. The results of multiple logistic regression analysis with mental health level as the dependent variable indicated that subjects 65–74 years old who did not think their own hearing was bad had better mental health than those who did think their hearing was bad (odds ratio 10.800). Among subjects 75 years and older, those who had not been certified as needing long-term care had better mental health than those who had been certified (odds ratio 3.937). When planning mental health support for community-dwelling elderly in the future, it will be necessary to consider differences in background due to age group. The present results suggest that appropriate support for awareness of hearing and acceptance of decreased hearing ability in people in early old age (65–74 years old) may help to prevent declining mental health in later old age.

Finite element analysis of auditory characteristics in patients with middle ear diseases.

PubMed

Tu, Bo; Li, Xiaoping; Nie, Zhenhua; Shi, Changzheng; Li, Hengguo

2017-07-01

This study validates that a finite element model of the human ossicular chain and tympanic membrane can be used as an effective surgical assessment tool in clinics. The present study was performed to investigate the application of a finite element model of ossicular chain and tympanic membrane for fabrication of individualized artificial ossicles. Twenty patients (20 ears) who underwent surgery for middle ear disease (n = 20) and 10 healthy controls (10 ears) were enrolled in the hospital. Computed tomography (CT) and pure tone audiometry were performed before and after surgery. A finite element model was developed using CT scans, and correlation analysis was conducted between stapes displacement and surgical methods. An audiometric test was also performed for 14 patients before and after surgery. Stapes displacement in the healthy group (average = 3.31 × 10 -5  mm) was significantly greater than that in the impaired group (average = 1.41 × 10 -6 mm) prior to surgery. After surgery, the average displacement in the impaired group was 2.55 × 10 -6 mm, which represented a significant improvement. For the patients who underwent the audiometric test, 10 improved hearing after surgery, and stapes displacement increased in nine of these 10 patients.

INF- α and ototoxicity.

PubMed

Sharifian, Mohammad Reza; Kamandi, Shima; Sima, Hamid Reza; Zaringhalam, Mohammad Ali; Bakhshaee, Mehdi

2013-01-01

INF- α is a common drug for the treatment of hepatitis B and C. Although a variety of related complications are discussed, possible ototoxic effects of this mediation are not well described. In a before-after control study, 24 patients who received INF- α for the treatment of hepatitis B and C and 30 normal controls were included. Subjective and objective ototoxicity evaluations via questionnaire, high frequency audiometry, and measuring transiently evoked otoacoustic emissions (TEOAEs) were performed one week before and one month after the prescription of the drug. Results. Subjective hearing complaint, tinnitus, and vertigo were seen in just 3 cases, which was not statistically significant (P = 0.083). In the frequency range of 4000 to 8000 Hz before (9.38 ± 1.0 and 10.7 ± 1.2, resp.) and after (17.9 ± 2.6 and 17.6 ± 2.6, resp.) one month of treatment, a significant difference (P = 0.083) was detected. Progressive decreases in amplitude of the OAE during TEOAE measurement in 1, 2, and 4 frequencies among 41.66%, 18.75 %, and 43.75% were observed, respectively. The hearing loss was seen more among older and male cases significantly. Conclusion. The results showed ototoxicity of INF- α that may encourage planning hearing monitoring in patients receiving this drug.

Analysing use of the Chinese HHIE-S for hearing screening of elderly in a northeastern industrial area of China.

PubMed

Wang, Yue; Mo, Lingyan; Li, Yagang; Zheng, Zhongwei; Qi, Yu

2017-04-01

The aim of the present study was to investigate the use of Chinese version of HHIE-S as a hearing screening tool for the elderly in an industrial area in northeast China. Prevalence, sensitivity and specificity of Chinese version of HHIE-S were calculated. Factors that had impact on HHIE-S were analysed. Five hundred and seventy Mandarin speaking participants, aged from 50 to 85 years were included. They were tested with pure tone audiometry and Chinese version of HHIE-S. The prevalence of hearing handicap was 55.3%. The sensitivity and specificity of HHIE-S were 84.5% and 58.3% respectively when the pass/fail criteria were set at PTA 0.5-4kHz >40 dBHL. In general, HHIE-S total and subscale scores were significantly associated with severity of hearing impairment. After stratified by severity of hearing impairment, both the prevalence of reported handicap and the scores of HHIE-S were not significantly associated with age. Male participants had significantly higher HHIE-S scores than female participants did. The Chinese version of HHIE-S contributes useful information to identifying hearing handicap and addressing the rehabilitative needs in the elderly in an industrial city in Mainland China.

Auditory evoked potentials in children and adolescents with Down syndrome.

PubMed

Gregory, Letícia; Rosa, Rafael F M; Zen, Paulo R G; Sleifer, Pricila

2018-01-01

Down syndrome, or trisomy 21, is the most common genetic alteration in humans. The syndrome presents with several features, including hearing loss and changes in the central nervous system, which may affect language development in children and lead to school difficulties. The present study aimed to investigate group differences in the central auditory system by long-latency auditory evoked potentials and cognitive potential. An assessment of 23 children and adolescents with Down syndrome was performed, and a control group composed of 43 children and adolescents without genetic and/or neurological changes was used for comparison. All children underwent evaluation with pure tone and vocal audiometry, acoustic immitance measures, long-latency auditory evoked potentials, and cognitive potential. Longer latencies of the waves were found in the Down syndrome group than the control group, without significant differences in amplitude, suggesting that individuals with Down syndrome have difficulty in discrimination and auditory memory. It is, therefore, important to stimulate and monitor these children in order to enable adequate development and improve their life quality. We also emphasize the importance of the application of auditory evoked potentials in clinical practice, in order to contribute to the early diagnosis of hearing alterations and the development of more research in this area. © 2017 Wiley Periodicals, Inc.

Examination of Insert Ear Interaural Attenuation (IA)Values in Audiological Evaluations.

PubMed

Gumus, Nebi M; Gumus, Merve; Unsal, Selim; Yuksel, Mustafa; Gunduz, Mehmet

2016-12-01

The purpose of this study was to evaluate Interaural Attenuation (IA) in frequency base in the insert earphones that are used in audiological assessments. Thirty healthy subjects between 18-65 years of age (14 female and 16 male) participated in our study. Otoscopic examination was performed on all participants. Audiological evaluations were performed using the Interacoustics AC40 clinical audiometer and ER-3A insert earphones. IA value was calculated by subtracting good ear bone conduction hearing thresholds of the worst airway hearing threshold. In our measuring for 0.125-8.0 kHz frequency were performed in our audiometry device separately for each frequency. IA amount in the results we found in 1000 Hz and below frequencies about 75-110 dB range avarage is 89±5dB, in above 1000 Hz frequencies in 50-95 dB range and avarage it is changed to 69±5dB. According to the obtained findings the quantity of melting in the transition between the ears are increasing with the insert earphones. The insert earphone should be beside supraaural earphone that is routinely used in clinics. Difficult masking applications due to the increase in the value of IA can be easily done with insert earphones.

Differential Diagnosis of Speech Sound Disorder (Phonological Disorder): Audiological Assessment beyond the Pure-tone Audiogram.

PubMed

Iliadou, Vasiliki Vivian; Chermak, Gail D; Bamiou, Doris-Eva

2015-04-01

According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, diagnosis of speech sound disorder (SSD) requires a determination that it is not the result of other congenital or acquired conditions, including hearing loss or neurological conditions that may present with similar symptomatology. To examine peripheral and central auditory function for the purpose of determining whether a peripheral or central auditory disorder was an underlying factor or contributed to the child's SSD. Central auditory processing disorder clinic pediatric case reports. Three clinical cases are reviewed of children with diagnosed SSD who were referred for audiological evaluation by their speech-language pathologists as a result of slower than expected progress in therapy. Audiological testing revealed auditory deficits involving peripheral auditory function or the central auditory nervous system. These cases demonstrate the importance of increasing awareness among professionals of the need to fully evaluate the auditory system to identify auditory deficits that could contribute to a patient's speech sound (phonological) disorder. Audiological assessment in cases of suspected SSD should not be limited to pure-tone audiometry given its limitations in revealing the full range of peripheral and central auditory deficits, deficits which can compromise treatment of SSD. American Academy of Audiology.

Relationship between CT densitometry with a slice thickness of 0.5 mm and audiometry in otosclerosis.

PubMed

Kawase, Setsuko; Naganawa, Shinji; Sone, Michihiko; Ikeda, Mitsuru; Ishigaki, Takeo

2006-06-01

The appropriate cutoff Hounsfield unit (HU) value for the diagnosis of otosclerosis was determined and the correlation between the bone conduction threshold and the findings of computed tomography (CT) densitometry investigated. CT images, 0.5-mm thick, were evaluated in 24 ears with otosclerosis and 19 control ears. Eight regions of interest were set around the otic capsule. The mean HU values in the area anterior to the oval window (A-OW) and anterior to the internal auditory canal (A-IAC) were significantly lower in otosclerosis than in controls. Based on receiver operating characteristic (ROC) analysis, the cutoff HU value in A-OW was determined to be 2,187.3 HU. The mean HU value in retrofenestral otosclerosis was significantly lower in the area A-OW, A-IAC and around the cochlea than in controls. Based on ROC analysis, the cutoff HU value in the latter was determined to be 2,045 HU. A statistically significant correlation was found between the density of the area A-OW and the hearing level at 500 and 1,000 Hz, and between the density of the area around the cochlea and the hearing level at most frequencies. These results suggest the semi-automated diagnosis of otosclerosis may be possible.

Radiotherapy-induced hearing loss in patients with laryngeal and hypopharyngeal carcinomas.

PubMed

Gudelj, Goran; Trotić, Robert; Herceg, Tonko; Parazajder, Domagoj; Vagić, Davor; Geber, Goran

2014-09-01

The purpose of this study was to investigate a hypothesized correlation of development of a sensorineural hearing loss and radiotherapy in patients with laryngeal and hypopharyngeal carcinoma. This prospective study included a total of 50 patients, which after strict exclusion critera (audiologic problems before RT primary tumors of the auditory system, spread of the primary tumor to any part of the auditory system) resulted in 23 analyzed patients, ranging between 50 and 76 years of age, with a mean age of 60. Audiometry measuring frequency-specific thresholds was performed in three time points: one month before radiotherapy, one and six months after radiotherapy. A significant statistical difference in hearing tresholds after radiotherapy was found in 6 out of 23 patients. An obvious tendency towards hearing loss without statistical significance at 250 and 4000 Hz was found for a whole tested population (p < or = 0.3 with Bonferroni correction). Observed tendency towards hearing loss after radiotherapy of laryngeal carcinoma was related to side of the tumor and less severe when chemotherapy was not added as adjuvant therapy. These results should help to decrease a rate of hearing loss by careful planing of ear protection, by using observed frequencies as relevant markers of hearing loss and by reconsidering adjuvant chemoterapy during radiotherapy of laryngeal carcinoma.

A neonate with reduced cytomegalovirus DNA copy number and marked improvement of hearing in the treatment of congenital cytomegalovirus infection.

PubMed

Hayakawa, Jun; Kawakami, Yasuhiko; Takeda, Sachiyo; Ozawa, Hiroshi; Fukazawa, Ryuji; Takase, Masato; Fukunaga, Yoshitaka

2012-01-01

Congenital cytomegalovirus (CMV) infection can cause severe permanent disabilities. A mother who is seronegative before conception but acquires infection during pregnancy is a risk factor for congenital infection. We describe a neonate in whom congenital CMV infection was diagnosed at birth and confirmed with DNA quantitation by means of the polymerase chain reaction, was accompanied by cerebral ventriculomegaly and severe hearing loss, and was treated with ganciclovir/valganciclovir for 6 weeks. Initially, cerebral ventriculomegaly and calcification were also found with computed tomography, and severe hearing loss was detected with auditory brainstem response testing. After treatment, CMV DNA decreased in copy number and became undetectable. No marked side effects occurred after treatment. Surprisingly, 1 year after treatment, neurological and motor development was equivalent to that in a healthy infant. Audiometry indicated that auditory ability would improve with rehabilitation, speech and language therapy, and cochlear implantation. Single-photon emission computed tomography showed marked improvement 6 months after treatment. This case provides compelling evidence that a reliable diagnosis of congenital CMV infections coupled with a prompt and appropriate treatment program can prevent permanent disability. It is, therefore, important to establish a more effective strategy for the management of congenital CMV infection.

Inner ear involvement in Behçet's disease.

PubMed

Süslü, Ahmet Emre; Polat, Mualla; Köybaşi, Serap; Biçer, Yusuf Ozgür; Funda, Yasemin Ongun; Parlak, Ali Haydar

2010-06-01

To assess cochlear involvement and hearing loss in patients with Behçet's disease (BD). Forty-two patients with BD and 24 sex and age matched healthy subjects were included in the study. pure-tone audiometry including high frequencies (250-16000Hz) and DPOAE were performed to all participants. Results of the audiological evaluation were compared and correlation between the audiologic status and clinical manifestations of the BD were investigated. Bilateral sensorineural hearing loss was detected in 27 (64.3%) patients. Hearing thresholds were found to be higher in patients with BD at all of the frequencies except at 500Hz when compared to control group (p<0.05). The difference in the hearing levels tend to increase in high frequencies. Compared with control group, distortion products and SNR of the BD patients were lower in all of the tested frequencies (p<0.05) which indicates weaker outer hair cell motility. There was no correlation between the clinical manifestations and the audiological parameters. Even having hearing levels within normal limits in speech frequencies, increased hearing thresholds in high frequencies and decreased signal-noise ratios (SNR) in distortion product otoacoustic emission (DPOAE) indicate a cochlear involvement in patients with BD. Copyright (c) 2009 Elsevier Ireland Ltd. All rights reserved.

Genetic modification of ALAD and VDR on lead-induced impairment of hearing in children.

PubMed

Pawlas, Natalia; Broberg, Karin; Olewińska, Elżbieta; Kozłowska, Agnieszka; Skerfving, Staffan; Pawlas, Krystyna

2015-05-01

Polymorphisms in the δ-aminolevulinic acid dehydratase (ALAD) and the vitamin D receptor (VDR) genes may modify lead metabolism and neurotoxicity. Two cohorts of children were examined for hearing [pure-tone audiometry (PTA), brain stem auditory evoked potentials (BAEP)], acoustic otoemission (transient emission evoked by a click) and blood-lead concentrations (B-Pb). The children were genotyped for polymorphisms in ALAD and VDR. The median B-Pbs were 55 and 36μg/L in the two cohorts (merged cohort 45μg/L). B-Pb was significantly associated with impaired hearing when tested with PTA (correlation coefficient rS=0.12; P<0.01), BAEP (rS=0.18; P<0.001) and otoemission (rS=-0.24; P<0.001). VDR significantly modified the lead-induced effects on PTA. Carriers of the VDR alleles BsmI B, VDR TaqI t and VDR FokI F showed greater toxic effects on PTA, compared to BsmI bb, VDR TaqI TT and VDR FokI ff carriers. No significant interaction was found for ALAD. Lead impairs hearing functions in the route from the cochlea to the brain stem at low-level exposure, and polymorphisms in VDR significantly modify these effects. Copyright © 2015 Elsevier B.V. All rights reserved.

Validity of the Hum Test, a Simple and Reliable Alternative to the Weber Test.

PubMed

Ahmed, Omar H; Gallant, Sara C; Ruiz, Ryan; Wang, Binhuan; Shapiro, William H; Voigt, Erich P

2018-06-01

To compare the diagnostic performance of the Hum Test against the Weber Test using pure tone audiometry (PTA) as the "gold standard" comparator. 29 participants with normal hearing of ages 18 to 35 without any history of hearing abnormalities or otologic conditions were enrolled. Subjects underwent three tests (Hum Test, Weber Test, and PTA) across two conditions: with an ear plug in one ear (side randomized) and without ear plugs. When examining the ability of the Hum Test to detect simulated conductive hearing loss (CHL), the test had a sensitivity of 89.7% and specificity of 100% with high pitched humming and 93.1% and 100%, respectively, with low pitched humming. The Weber Test had a sensitivity and specificity of 96.6% and 100%, respectively. McNemar's test demonstrated agreement between the Hum Test, performed with either high pitched ( P = .32) or low pitched ( P = .56) humming, and the Weber Test. Receiver operating characteristic (ROC) curves for the Hum Test (both high and low pitched) and Weber test were compared and demonstrated no statistically significant difference. The Hum Test is comparable to the Weber Test with regards to its sensitivity, specificity, and diagnostic accuracy in assessing new onset unilateral CHL in previously normal hearing subjects.

Effects of sleep bruxism related tinnitus on quality of life.

PubMed

Saltürk, Ziya; Özçelik, Erdinç; Kumral, Tolgar Lütfi; Çakır, Ozan; Kasımoğlu, Şeref; Atar, Yavuz; Yıldırım, Güven; Berkiten, Güler; Göker, Ayşe Enise; Uyar, Yavuz

2015-01-01

This study aims to analyze the subjective and objective characteristics of tinnitus in sleep bruxism patients. The study included 57 patients (12 males; 45 females; mean age 33.89±12.50 years; range 19 to 55 years) with sleep bruxism and tinnitus (sleep bruxism group) and 24 patients (6 males, 18 females; mean age 43.75±16.19 years; range 21 to 58 years) only with tinnitus (control group). Sleep bruxism was diagnosed by the diagnostic criteria of American Academy of Sleep Medicine. Patients were performed pure tone audiometry to detect hearing thresholds at standard and high frequencies. Tinnitus frequency and loudness were assessed. Subjective aspects of tinnitus were identified by tinnitus handicap inventory. The statistical analysis revealed that the sleep bruxism group had significantly lower hearing thresholds except 1000 Hz and 2000 Hz. Tinnitus frequency was between 3000 Hz and 18000 Hz in sleep bruxism group while it was between 6000 and 16000 Hz in control group with no statistically significant difference (p=0.362). Sleep bruxism group had significantly lower tinnitus loudness and tinnitus handicap inventory scores in comparison to control group (p=0.024 and p=0.000, respectively). Tinnitus caused by sleep bruxism and temporomandibular joint issues has higher frequency and lower loudness compared to patients with only tinnitus.

Pseudoexfoliation Syndrome and Sensorineural Hearing Loss

PubMed Central

Zojaji, Ramin; Alesheykh, Ali; Sedaghat, Mohammad Reza; Navia, Kiamarz; Mazloom Farsi Baf, Morteza; Khaki, Masoud; Raouf, Aliasghar

2011-01-01

Introduction: Pseudoexfoliation syndrome (PXS) occurs due to the deposition of extracellular fibrillar materials on the anterior chamber of the eye. This syndrome has been considered to be part of a systemic disease with the potential involvement of the inner ear called sensoroneural hearing loss (SNHL). In this study, we aimed on evaluating SNHL within PXS patients in Iran to compare them with other international reports. Materials and Methods: In total, 33 patients with PXS and 33 age and sex matched controls were enrolled prospectively in a case-control study. Both groups underwent complete ophthalmologic and otorhinolaryngologic examinations and pure tone audiometry (PTA) testing. Six frequencies (0.25, 0.5, 1, 2, 3, 4 and 6 KHz) were evaluated for PTA in the same ethnic group in order to select the case and control individuals. Data were analyzed using t-test and chi-square test. Results: Forty-nine out of 66 ears (75.2%) in the PXS group and 27 ears (40.9%) in the control group had SNHL (P<0.001). No significant difference was found between the existence of exfoliative glaucoma (EXG) and SNHL in the PXS patients (P=0.768). Conclusion: Our results indicate a significant association between PXS and SNHL and may support the systemic nature of this disease. PMID:24303375

Long term outcome of neonatal meningitis

PubMed Central

Stevens, J; Eames, M; Kent, A; Halket, S; Holt, D; Harvey, D

2003-01-01

Objectives: To quantify long term impairment after neonatal meningitis. Design: Longitudinal case-control study over 9–10 years. Subjects and methods: A total of 111 children who had suffered neonatal meningitis were seen and compared with 113 matched controls from their birth hospital and 49 controls from general practices. Assessments included the WISC IIIUK , movement assessment battery for children (mABC), audiometry, vision testing, and social and medical data. Statistical analysis was by multiple regression, analysis of variance, and χ2 tests. Results: Some 10.8% of cases had a severe and 9% a moderate overall outcome compared with 0% and 1.8% for the hospital controls. The mean intelligence quotient (IQ) of the cases (88.8) was significantly less than that of the hospital controls (99.4) or the GP controls (99.6) . The mABC score was significantly worse for the cases (7.08) than the hospital (5) or GP (4) controls. Some 3.6% of cases had sensorineural hearing loss, 2.7% had persisting hydrocephalus; no controls did. Some 5.4% of cases and 1.7% of hospital controls had treatment for seizures. Conclusions: Severe neurodisability and milder motor and psychometric impairment result from neonatal meningitis. Both clinical follow up and comprehensive developmental assessment are needed after this disease. PMID:12719389

Audiometric profile of civilian pilots according to noise exposure

PubMed Central

Falcão, Taiana Pacheco; Luiz, Ronir Raggio; Schütz, Gabriel Eduardo; Mello, Márcia Gomide da Silva; Câmara, Volney de Magalhães

2014-01-01

OBJECTIVE To evaluate the audiometric profile of civilian pilots according to the noise exposure level. METHODS This observational cross-sectional study evaluated 3,130 male civilian pilots aged between 17 and 59 years. These pilots were subjected to audiometric examinations for obtaining or revalidating the functional capacity certificate in 2011. The degree of hearing loss was classified as normal, suspected noise-induced hearing loss, and no suspected hearing loss with other associated complications. Pure-tone air-conduction audiometry was performed using supra-aural headphones and acoustic stimulus of the pure-tone type, containing tone thresholds of frequencies between 250 Hz and 6,000 Hz. The independent variables were professional categories, length of service, hours of flight, and right or left ear. The dependent variable was pilots with suspected noise-induced hearing loss. The noise exposure level was considered low/medium or high, and the latter involved periods > 5,000 flight hours and > 10 years of flight service. RESULTS A total of 29.3% pilots had suspected noise-induced hearing loss, which was bilateral in 12.8% and predominant in the left ear (23.7%). The number of pilots with suspected hearing loss increased as the noise exposure level increased. CONCLUSIONS Hearing loss in civilian pilots may be associated with noise exposure during the period of service and hours of flight. PMID:25372170

Some observations on the nature of the audiometric 4000 hz notch: data from 3430 veterans.

PubMed

Wilson, Richard H

2011-01-01

Pure-tone, air-conduction audiograms notched at 4000 Hz have long been considered the signature configuration for noise-induced hearing loss even though there is an extensive literature that does not mesh with this simple explanation. There are many reports of notched audiograms from individuals with no history of noise exposure and, conversely, reports of audiograms with no notches from individuals with a history of noise exposure. Recent reports increasingly suggest that unilateral 4000 Hz notches are common. The prevalence of notched audiograms at 4000 Hz is dependent on the definition of the notch and the population under study. To examine the prevalence and characteristics of audiograms that are notched at 4000 Hz. Retrospective, descriptive. The participants were 3430 veterans evaluated in the Audiology Clinic at the VA Medical Center, Mountain Home, Tennessee. The mean age was 62.3 yr. Data Collection and Analyses: The data were collected in the course of a 60 min, routine audiological evaluation. In addition to pure-tone audiometry, a history, otoscopy, speech audiometry in quiet and in noise, and aural-acoustic immittance measures were included in the clinic protocol but were not evaluated in this report. A notch was defined when the 4000 Hz threshold minus the 2000 Hz threshold and the 4000 Hz threshold minus the 8000 Hz threshold both were ≥10 dB. Overall the mean LE (left ear) thresholds at 2000, 3000, and 4000 Hz were at hearing levels 2-3 dB higher than the hearing levels for the corresponding mean RE (right ear) thresholds; the differences were significant. A notched audiogram was observed in 40.6% of the participants in at least one ear with 15.4% having bilateral notches, 28.8% LE notches, and 27.1% RE notches. Unilateral 4000 Hz notches were almost twice as prevalent as bilateral 4000 Hz notches. Viewed as a function of age, notched audiograms were most common (∼35% of the participants) in the 40 and 50 yr groups with a diminishing prevalence in the 60-80 yr groups. The mean notch depth at 4000 Hz was consistently 20-26 dB across the seven age groups. In comparison to the thresholds of the audiograms that were not notched, the thresholds of the audiograms with 4000 Hz notches (1) at 250-2000 Hz were at hearing levels 2-3 dB lower, (2) at 3000 and 4000 Hz were at hearing levels 8-17 dB higher, and (3) at 8000 Hz were at hearing levels 3-4 dB lower; the threshold differences were significant at all frequencies for both ears. The data suggest that unilateral, 4000 Hz notched audiograms are as common or more common than bilateral notched audiograms and that unilateral notched audiograms are equally common for the LE and RE. The prevalence and characteristics of 4000 Hz notched audiograms in this veteran sample are similar to those observed in the population as a whole. American Academy of Audiology.

Discrepancy between self-assessed hearing status and measured audiometric evaluation

PubMed Central

Kim, So Young; Kim, Hyung-Jong; Kim, Min-Su; Park, Bumjung; Kim, Jin-Hwan

2017-01-01

Objective The purpose of this study was to examine the difference between self-reported hearing status and hearing impairment assessed using conventional audiometry. The associated factors were examined when a concordance between self-reported hearing and audiometric measures was lacking. Methods In total, 19,642 individuals ≥20 years of age who participated in the Korea National Health and Nutrition Examination Surveys conducted from 2009 through 2012 were enrolled. Pure-tone hearing threshold audiometry (PTA) was measured and classified into three levels: <25 dB (normal hearing); ≥25 dB <40 dB (mild hearing impairment); and ≥40 dB (moderate-to-severe hearing impairment). The self-reported hearing loss was categorized into 3 categories. The participants were categorized into three groups: the concordance (matched between self-reported hearing loss and audiometric PTA), overestimation (higher self-reported hearing loss compared to audiometric PTA), and underestimation groups (lower self-reported hearing loss compared to audiometric PTA). The associations of age, sex, education level, stress level, anxiety/depression, tympanic membrane (TM) status, hearing aid use, and tinnitus with the discrepancy between the hearing self-reported hearing loss and audiometric pure tone threshold results were analyzed using multinomial logistic regression analysis with complex sampling. Results Overall, 80.1%, 7.1%, and 12.8% of the participants were assigned to the concordance, overestimation, and underestimation groups, respectively. Older age (adjusted odds ratios [AORs] = 1.28 [95% confidence interval = 1.19–1.37] and 2.80 [2.62–2.99] for the overestimation and the underestimation groups, respectively), abnormal TM (2.17 [1.46–3.23] and 1.59 [1.17–2.15]), and tinnitus (2.44 [2.10–2.83] and 1.61 [1.38–1.87]) were positively correlated with both the overestimation and underestimation groups. Compared with specialized workers, service workers, manual workers, and the unemployed were more likely to be in the overestimation group (1.48 [1.11–1.98], 1.39 [1.04–1.86], and 1.50 [1.18–1.90], respectively), and service workers were more likely to be in the underestimation group (AOR = 1.42 [1.01–1.99]). Higher education level (0.77 [0.59–1.01] and 0.43 [0.33–0.57]) and hearing aid use (0.36 [0.17–0.77] and 0.23 [0.13–0.43]) were negatively associated with being in the underestimation group (0.43 [0.37–0.50]). Compared with males, females were less likely to be assigned to the underestimation group (0.43 [0.37–0.50]). Stress (1.98 [1.32–2.98]) and anxiety/depression (1.30 [1.06–1.59]) were associated with overestimation group. Conclusion Older age, lower education level, occupation, abnormal TM, non-hearing aid use, and tinnitus were related to both overestimation and underestimation groups. Male gender was related to underestimation, and stress and anxiety/depression were correlated with overestimation group. An understanding of these factors associated with the self-reported hearing loss will be instrumental to identifying and managing hearing-impaired individuals. PMID:28792529

Discrepancy between self-assessed hearing status and measured audiometric evaluation.

PubMed

Kim, So Young; Kim, Hyung-Jong; Kim, Min-Su; Park, Bumjung; Kim, Jin-Hwan; Choi, Hyo Geun

2017-01-01

The purpose of this study was to examine the difference between self-reported hearing status and hearing impairment assessed using conventional audiometry. The associated factors were examined when a concordance between self-reported hearing and audiometric measures was lacking. In total, 19,642 individuals ≥20 years of age who participated in the Korea National Health and Nutrition Examination Surveys conducted from 2009 through 2012 were enrolled. Pure-tone hearing threshold audiometry (PTA) was measured and classified into three levels: <25 dB (normal hearing); ≥25 dB <40 dB (mild hearing impairment); and ≥40 dB (moderate-to-severe hearing impairment). The self-reported hearing loss was categorized into 3 categories. The participants were categorized into three groups: the concordance (matched between self-reported hearing loss and audiometric PTA), overestimation (higher self-reported hearing loss compared to audiometric PTA), and underestimation groups (lower self-reported hearing loss compared to audiometric PTA). The associations of age, sex, education level, stress level, anxiety/depression, tympanic membrane (TM) status, hearing aid use, and tinnitus with the discrepancy between the hearing self-reported hearing loss and audiometric pure tone threshold results were analyzed using multinomial logistic regression analysis with complex sampling. Overall, 80.1%, 7.1%, and 12.8% of the participants were assigned to the concordance, overestimation, and underestimation groups, respectively. Older age (adjusted odds ratios [AORs] = 1.28 [95% confidence interval = 1.19-1.37] and 2.80 [2.62-2.99] for the overestimation and the underestimation groups, respectively), abnormal TM (2.17 [1.46-3.23] and 1.59 [1.17-2.15]), and tinnitus (2.44 [2.10-2.83] and 1.61 [1.38-1.87]) were positively correlated with both the overestimation and underestimation groups. Compared with specialized workers, service workers, manual workers, and the unemployed were more likely to be in the overestimation group (1.48 [1.11-1.98], 1.39 [1.04-1.86], and 1.50 [1.18-1.90], respectively), and service workers were more likely to be in the underestimation group (AOR = 1.42 [1.01-1.99]). Higher education level (0.77 [0.59-1.01] and 0.43 [0.33-0.57]) and hearing aid use (0.36 [0.17-0.77] and 0.23 [0.13-0.43]) were negatively associated with being in the underestimation group (0.43 [0.37-0.50]). Compared with males, females were less likely to be assigned to the underestimation group (0.43 [0.37-0.50]). Stress (1.98 [1.32-2.98]) and anxiety/depression (1.30 [1.06-1.59]) were associated with overestimation group. Older age, lower education level, occupation, abnormal TM, non-hearing aid use, and tinnitus were related to both overestimation and underestimation groups. Male gender was related to underestimation, and stress and anxiety/depression were correlated with overestimation group. An understanding of these factors associated with the self-reported hearing loss will be instrumental to identifying and managing hearing-impaired individuals.

The impact of hearing loss on language performance in older adults with different stages of cognitive function

PubMed Central

Lodeiro-Fernández, Leire; Lorenzo-López, Laura; Maseda, Ana; Núñez-Naveira, Laura; Rodríguez-Villamil, José Luis; Millán-Calenti, José Carlos

2015-01-01

Purpose The possible relationship between audiometric hearing thresholds and cognitive performance on language tests was analyzed in a cross-sectional cohort of older adults aged ≥65 years (N=98) with different degrees of cognitive impairment. Materials and methods Participants were distributed into two groups according to Reisberg’s Global Deterioration Scale (GDS): a normal/predementia group (GDS scores 1–3) and a moderate/moderately severe dementia group (GDS scores 4 and 5). Hearing loss (pure-tone audiometry) and receptive and production-based language function (Verbal Fluency Test, Boston Naming Test, and Token Test) were assessed. Results Results showed that the dementia group achieved significantly lower scores than the predementia group in all language tests. A moderate negative correlation between hearing loss and verbal comprehension (r=−0.298; P<0.003) was observed in the predementia group (r=−0.363; P<0.007). However, no significant relationship between hearing loss and verbal fluency and naming scores was observed, regardless of cognitive impairment. Conclusion In the predementia group, reduced hearing level partially explains comprehension performance but not language production. In the dementia group, hearing loss cannot be considered as an explanatory factor of poor receptive and production-based language performance. These results are suggestive of cognitive rather than simply auditory problems to explain the language impairment in the elderly. PMID:25914528

Predicting hearing thresholds and occupational hearing loss with multiple-frequency auditory steady-state responses.

PubMed

Hsu, Ruey-Fen; Ho, Chi-Kung; Lu, Sheng-Nan; Chen, Shun-Sheng

2010-10-01

An objective investigation is needed to verify the existence and severity of hearing impairments resulting from work-related, noise-induced hearing loss in arbitration of medicolegal aspects. We investigated the accuracy of multiple-frequency auditory steady-state responses (Mf-ASSRs) between subjects with sensorineural hearing loss (SNHL) with and without occupational noise exposure. Cross-sectional study. Tertiary referral medical centre. Pure-tone audiometry and Mf-ASSRs were recorded in 88 subjects (34 patients had occupational noise-induced hearing loss [NIHL], 36 patients had SNHL without noise exposure, and 18 volunteers were normal controls). Inter- and intragroup comparisons were made. A predicting equation was derived using multiple linear regression analysis. ASSRs and pure-tone thresholds (PTTs) showed a strong correlation for all subjects (r = .77 ≈ .94). The relationship is demonstrated by the equationThe differences between the ASSR and PTT were significantly higher for the NIHL group than for the subjects with non-noise-induced SNHL (p < .001). Mf-ASSR is a promising tool for objectively evaluating hearing thresholds. Predictive value may be lower in subjects with occupational hearing loss. Regardless of carrier frequencies, the severity of hearing loss affects the steady-state response. Moreover, the ASSR may assist in detecting noise-induced injury of the auditory pathway. A multiple linear regression equation to accurately predict thresholds was shown that takes into consideration all effect factors.

[The health condition of forest workers exposed to noise and vibration produced by chain saws].

PubMed

Malinowska-Borowska, Jolanta; Socholik, Violetta; Harazin, Barbara

2012-01-01

Lumberjacks' working conditions are difficult due to the presence of numerous occupational hazards. Physical factors that pose a health risk are noise and vibration produced by chain saws. Excessive exposure of lumberjacks to noise and vibration can lead to the development of hand-arm vibration syndrome and hearing loss. The aim of the work was to analyze the health condition of forestry workers exposed to occupational physical hazards. A preliminary, questionnaire-based assessment of health status was conducted in 22 chain saw operators. In a group of 15 forestry workers audiometry, vibrotactile perception thresholds and cold provocation test were performed. X-ray diagnostic imaging of upper limbs was also done. At the same time noise and vibration produced by chain saws used in forestry was measured. Vascular or neurological disorders were found in nearly half of tested workers with seniority from 2 to 20 years; 40% of the surveyed was diagnosed with hearing impairment. An 8-hour energy equivalent vibration level measured on chain saws was 4.6 m/s2. An 8-hour equivalent sound pressure level was 99.1 dB(A). The threshold limit values for noise and vibration are exceeded at woodcutters' posts. There are changes in lumberjacks' health resulting from exposure to harmful physical agents. Preventive actions are urgently needed to be addressed, especially to people employed in single-handed forestry companies.

Roles of an anti-tuberculosis medication and surgery in patients with tuberculous otitis media.

PubMed

Kwon, Minsu; Choi, Seung Hyo; Chung, Jong Woo

2010-06-01

The standard treatment for tuberculous otitis media (TOM) without complications consists of anti-tuberculosis (anti-TB) medication, with which we experienced good treatment outcomes. However, surgery is required for recovery of anatomy and hearing function. To determine the clinical characteristics of TOM that might optimize diagnosis and to evaluate the differences in clinical courses between patients treated with and without surgery. We analyzed 14 patients (16 ears) who had been diagnosed and treated for TOM. Radiologic findings, laboratory data, and audiometry results were also evaluated. Patients were divided into a chemotherapy group and a surgery group according to treatment modality. Temporal bone CT (TBCT) showed total occupation of the tympanic cavity by soft tissue and little evidence of ossicular erosion. In the chemotherapy group, dry ears were obtained in all but one patient (14 ears) after treatment. Normalized tympanic membrane (TM) was found in 50% in the chemotherapy group and in 75% in the surgery group. The air-bone gap (ABG) changed from 40.3 +/- 2.5 dB to 47.0 +/- 19.2 dB in the chemotherapy group and from 35.2 +/- 7.6 dB to 30.2 +/- 11.4 dB in the surgery group. After treatment, ABG improved by > 10 dB in one ear in the chemotherapy group and in four ears in the surgery group.

Congenital cholesteatoma of the infratemporal fossa with congenital aural atresia and mastoiditis: a case report.

PubMed

Abdel-Aziz, Mosaad

2012-06-25

Congenital cholesteatoma may be expected in abnormally developed ear, it may cause bony erosion of the middle ear cleft and extend to the infratemporal fossa. We present the first case of congenital cholesteatoma of the infratemporal fossa in a patient with congenital aural atresia that has been complicated with acute mastoiditis. A sixteen year old Egyptian male patient presented with congenital cholesteatoma of the infratemporal fossa with congenital aural atresia complicated with acute mastoiditis. Two weeks earlier, the patient suffered pain necessitating hospital admission, magnetic resonance imaging revealed a soft tissue mass in the right infratemporal fossa. On presentation to our institute, Computerized tomography was done as a routine, it proved the diagnosis of mastoiditis, pure tone audiometry showed an air-bone gap of 60 dB. Cortical mastoidectomy was done for treatment of mastoiditis, removal of congenital cholesteatoma was carried out with reconstruction of external auditory canal. Follow-up of the patient for 2 years and 3 months showed a patent, infection free external auditory canal with an air-bone gap has been reduced to 35db. One year after the operation; MRI was done and it showed no residual or recurrent cholesteatoma. Congenital cholesteatoma of the infratemporal fossa in cases of congenital aural atresia can be managed safely even if it was associated with mastoiditis. It is an original case report of interest to the speciality of otolaryngology.

Effects of prematurity on language acquisition and auditory maturation: a systematic review.

PubMed

Rechia, Inaê Costa; Oliveira, Luciéle Dias; Crestani, Anelise Henrich; Biaggio, Eliara Pinto Vieira; Souza, Ana Paula Ramos de

2016-01-01

To verify which damages prematurity causes to hearing and language. We used the decriptors language/linguagem, hearing/audição, prematurity/prematuridade in databases LILACS, MEDLINE, Cochrane Library and Scielo. randomized controlled trials, non-randomized intervention studies and descriptive studies (cross-sectional, cohort, case-control projects). The articles were assessed independently by two authors according to the selection criteria. Twenty-six studies were selected, of which seven were published in Brazil and 19 in international literature. Nineteen studies comparing full-term and preterm infants. Two of the studies made comparisons between premature infants small for gestational age and appropriate for gestational age. In four studies, the sample consisted of children with extreme prematurity, while other studies have been conducted in children with severe and moderate prematurity. To assess hearing, these studies used otoacoustic emissions, brainstem evoked potentials, tympanometry, auditory steady-state response and visual reinforcement audiometry. For language assessment, most of the articles used the Bayley Scale of Infant and Toddler Development. Most studies reviewed observed that prematurity is directly or indirectly related to the acquisition of auditory and language abilities early in life. Thus, it could be seen that prematurity, as well as aspects related to it (gestational age, low weight at birth and complications at birth), affect maturation of the central auditory pathway and may cause negative effects on language acquisition.

[Intratympanic injection therapy for therapy refractory acute hearing loss: A safe option for secondary treatment].

PubMed

Mühlmeier, G; Maier, S; Maier, M; Maier, H

2015-10-01

High-dose corticosteroids are currently recommended for idiopathic sudden sensorineural hearing loss (ISSNHL) treatment. Intratympanic injections (ITI) are of growing importance, especially in cases of therapy resistance. The selection of patients for this procedure in SSNHL has not been adequately examined so far. A total of 77 patients with ISSNHL after ineffective systemic pretreatment underwent intratympanic administration of dexamethasone and hyaluronic acid. Improvement after treatment was determined by pure tone audiometry for both ears before and of the treated ear after ITI. In this study 34 female and 43 male patients with mean age of 57 years showed a pre-ITI hearing loss of 35 dB in the lower frequencies and 69 dB in the higher frequencies. The mean hearing gain was 10 dB and the response rate was 62%. Absolute hearing gain revealed significant improvements at 500 Hz, 1 kHz and 2 kHz. Under inclusion of contralateral thresholds there were hardly any differences up to 4 kHz. In a detailed analysis of responders moderate improvements could be observed even in higher frequencies. Overall, no relevant adverse events occurred. Treatment of ISSNHL resistant to systemic regimens by ITI of steroids provides an option that offers additional prospects of auditory improvement for affected patients. The presented results indicate that these modalities are also valid for patients with pancochlear ISSNHL.

[The Russian-language version of the matrix test (RUMatrix) in free field in patients after cochlear implantation in the long term].

PubMed

Goykhburg, M V; Bakhshinyan, V V; Petrova, I P; Wazybok, A; Kollmeier, B; Tavartkiladze, G A

The deterioration of speech intelligibility in the patients using cochlear implantation (CI) systems is especially well apparent in the noisy environment. It explains why phrasal speech tests, such as a Matrix sentence test, have become increasingly more popular in the speech audiometry during rehabilitation after CI. The Matrix test allows to estimate speech perception by the patients in a real life situation. The objective of this study was to assess the effectiveness of audiological rehabilitation of CI patients using the Russian-language version of the matrix test (RUMatrix) in free field in the noisy environment. 33 patients aged from 5 to 40 years with a more than 3 year experience of using cochlear implants inserted at the National Research Center for Audiology and Hearing Rehabilitation were included in our study. Five of these patients were implanted bilaterally. The results of our study showed a statistically significant improvement of speech intelligibility in the noisy environment after the speech processor adjustment; dynamics of the signal-to-noise ratio changes was -1.7 dB (p<0.001). The RUMatrix test is a highly efficient method for the estimation of speech intelligibility in the patients undergoing clinical investigations in the noisy environment. The high degree of comparability of the RUMatrix test with the Matrix tests in other languages makes possible its application in international multicenter studies.

HEARING IMPAIRMENT AND HYPERTENSION AMONG LONG DISTANCE BUS DRIVERS

PubMed Central

Abdelmoneim, Ismail

2003-01-01

Objectives: To investigate the prevalence of possible hearing impairment and hypertension in long distance bus drivers compared to the city bus drivers in Abha city. Methods: This was a cross-sectional study involving 62 long distance bus drivers and 46 city bus drivers from October 2001 to March 2002. A specially-designed questionnaire was administered to the drivers to explore some of their socioeconomic backgrounds. A pure tone air conduction audiometry and blood pressure measurements were performed. Results: Long distance bus drivers’ workload is significantly higher than that of city drivers (total weekly hours 64.0±14.3 compared to 46.7±5.5). Hearing impairment was significantly more among long distance drivers in the frequencies of 250, 500, 1000 and 2000 Hz especially in the left ear even after age corrections. The prevalence of mild hearing loss and hypertension were also higher among the long distance drivers (19.4% vs 4.5% and 38.7% vs 13% respectively). Conclusion and recommendations: This study showed more hearing affection and a higher prevalence of hypertension among long distance bus drivers than their counterparts operating in the city. Their hearing acuity should be tested before they start work and regularly afterwards. The stresses and strains of the job should be further studied and relieved; and regular health checks including blood pressure monitoring are to be instituted. PMID:23012034

Hearing handicap predicts the development of depressive symptoms after 3 years in older community-dwelling Japanese.

PubMed

Saito, Hideyuki; Nishiwaki, Yuji; Michikawa, Takehiro; Kikuchi, Yuriko; Mizutari, Kunio; Takebayashi, Toru; Ogawa, Kaoru

2010-01-01

To examine the association between hearing handicap and depressive symptoms in older community-dwelling Japanese. Community-based cohort study. Kurabuchi Town, Gunma Prefecture, Japan. Five hundred eighty residents (261 men, 319 women) aged 65 and older without depressive symptoms. In a baseline examination performed in 2005/06, participants answered the 10-item screening version of the Hearing Handicap Inventory for Elderly (HHIE-S). They were divided into two groups according to their scores: a group with no hearing handicap (HHIE-S scores of < or =8) and a hearing handicap group (HHIE-S scores of > or =10). The Geriatric Depression Scale was used to identify depressive symptoms in face-to-face home visit interviews conducted in 2008, and the association between hearing handicap and depressive symptoms was assessed using logistic regression. The incidence of depressive symptoms was 19.6% in the group with a hearing handicap and 8.0% in the group without a hearing handicap. When compared with the subjects without hearing handicap, subjects with a hearing handicap had a multiadjusted odds ratio of depressive symptoms of 2.45 (95% confidence interval=1.26-4.77). The association remained significant even when hearing impairment measured with pure-tone audiometry was added to the multiadjusted model. A hearing handicap can predict future depressive symptoms in older community-dwelling people.

Hearing loss in the royal Norwegian Navy: a cross-sectional study.

PubMed

Irgens-Hansen, Kaja; Sunde, Erlend; Bråtveit, Magne; Baste, Valborg; Oftedal, Gunnhild; Koefoed, Vilhelm; Lind, Ola; Moen, Bente Elisabeth

2015-07-01

Prior studies have indicated a high prevalence of noise-induced hearing loss (NIHL) among Navy personnel; however, it is not clear whether this is caused by work on board. The present study aimed to assess the prevalence of hearing loss among Navy personnel in the Royal Norwegian Navy (RNoN), and to investigate whether there is an association between work on board RNoN vessels and occurrence of hearing loss. Navy personnel currently working on board RNoN vessels were recruited to complete a questionnaire on noise exposure and health followed by pure tone audiometry. Hearing loss was defined as hearing threshold levels ≥25 dB in either ear at the frequencies 3,000, 4,000 or 6,000 Hz. Hearing thresholds were adjusted for age and gender using ISO 7029. The prevalence of hearing loss among Navy personnel was 31.4 %. The work exposure variables: years of work in the Navy, years on vessel(s) in the Navy and years of sailing in the Navy were associated with reduced hearing after adjusting for age, gender and otitis as an adult. Among the work exposure variables, years of sailing in the Navy was the strongest predictor of reduced hearing, and significantly reduced hearing was found at the frequencies 1,000, 3,000 and 4,000 Hz. Our results indicate that time spent on board vessels in the RNoN is a predictor of reduced hearing.

Examining in vivo tympanic membrane mobility using smart phone video-otoscopy and phase-based Eulerian video magnification

NASA Astrophysics Data System (ADS)

Janatka, Mirek; Ramdoo, Krishan S.; Tatla, Taran; Pachtrachai, Krittin; Elson, Daniel S.; Stoyanov, Danail

2017-03-01

The tympanic membrane (TM) is the bridging element between the pressure waves of sound in air and the ossicular chain. It allows for sound to be conducted into the inner ear, achieving the human sense of hearing. Otitis media with effusion (OME, commonly referred to as `glue ear') is a typical condition in infants that prevents the vibration of the TM and causes conductive hearing loss, this can lead to stunting early stage development if undiagnosed. Furthermore, OME is hard to identify in this age group; as they cannot respond to typical audiometry tests. Tympanometry allows for the mobility of the TM to be examined without patient response, but requires expensive apparatus and specialist training. By combining a smartphone equipped with a 240 frames per second video recording capability with an otoscopic clip-on accessory, this paper presents a novel application of Eulerian Video Magnification (EVM) to video-otology, that could provide assistance in diagnosing OME. We present preliminary results showing a spatio-temporal slice taken from an exaggerated video visualization of the TM being excited in vivo on a healthy ear. Our preliminary results demonstrate the potential for using such an approach for diagnosing OME under visual inspection as alternative to tympanometry, which could be used remotely and hence help diagnosis in a wider population pool.

Diphtheria and hearing loss.

PubMed

Schubert, C R; Cruickshanks, K J; Wiley, T L; Klein, R; Klein, B E; Tweed, T S

2001-01-01

To determine if infectious diseases usually experienced in childhood have an effect on hearing ability later in life. The Epidemiology of Hearing Loss Study (N = 3,753) is a population-based study of age-related hearing loss in adults aged 48 to 92 years in Beaver Dam, Wisconsin. As part of this study, infectious disease history was obtained and hearing was tested using pure-tone audiometry. Hearing loss was defined as a pure-tone average of thresholds at 500 Hz, 1,000 Hz, 2,000 Hz, and 4,000 Hz greater than 25 decibels hearing level in either ear. After adjusting for confounders, only a history of diphtheria (n = 37) was associated with hearing loss (odds ratio [OR] 2.79; 95% confidence interval [CI] 1.05, 7.36). There was no relationship between hearing loss and history of chickenpox, measles, mumps, pertussis, polio, rheumatic fever, rubella, or scarlet fever. Only two participants with a history of diphtheria and hearing loss reported having a hearing loss before age 20. Diphtheria in childhood may have consequences for hearing that do not become apparent until later in life. A possible biological mechanism for a diphtheria effect on hearing ability exists: The toxin produced by the Corynebacterium diphtheriae bacteria can cause damage to cranial nerves and therefore may affect the auditory neural pathway. These data may have important implications for areas facing a resurgence of diphtheria cases.

The Incidence of Amikacin Ototoxicity in Multidrug-ResistantTuberculosis Patients

PubMed Central

Javadi, Mohammad Reza; Abtahi, Bahareh; Gholami, Kheirollah; Safari Moghadam, Behzad; Tabarsi, Payam; Salamzadeh, Jamshid

2011-01-01

Amikacin has been shown to irreversibly suppressCochlear activity.The aim of this study is to assess the incidence of amikacinototoxicity in multidrug-resistant tuberculosis patients and riskfactors associated withthis ototoxicity.In this cross-sectional study, 41 patientswith multidrug-resistant tuberculosis (MDR-TB) were included.All patients received fixed dose of intravenous amikacin(500 mg/day) and anti-TB medications for six months. Baseline Pure-Tone Audiometry (PTA) was performed on all patients,before and during the drug treatment with the frequency range between 250 Hz and 8000 Hz. Patients were closely observed for the occurrence of symptomatic ototoxicity using a questionnaire .To find an association between the incidence of cochlear damage and patients’ demographics, all patients’ data were recorded. A total of 29 patients suffered from hearing loss (70.1%) (Male: n = 18; Female: n = 20).Using logistic regression, the incidence ofamikacinototoxicity was higher in men than in women. There was a negative correlation between the duration of the amikacin treatment and the difference in hearing thresholds(r = -0.34, p = 0.03). The mean of hearing threshold was significantly increased before and after the amikacin treatment((23.68 ± 19.26 vs. 38.93 ± 22.80) (p < 0.0001)). The incidence of hearing loss was remarkable in MDR-TB patients treating with amikacin. However, risk factors’ determination and monitoring of audiometric result variations could haveinfluenced the incidence of the amikacin ototoxicity. PMID:24250429

Contribution of Vestibular-Evoked Myogenic Potential (VEMP) testing in the assessment and the differential diagnosis of otosclerosis.

PubMed

Tramontani, Ourania; Gkoritsa, Eleni; Ferekidis, Eleftherios; Korres, Stavros G

2014-02-07

The aim of this prospective clinical study was to evaluate the clinical importance of Vestibular-Evoked Myogenic Potentials (VEMPs) in the assessment and differential diagnosis of otosclerosis and otologic diseases characterized by "pseudo-conductive" components. We also investigated the clinical appearance of balance disorders in patients with otosclerosis by correlating VEMP results with the findings of caloric testing and pure tone audiometry(PTA). Air-conducted(AC) 4-PTA, bone-conducted(BC) 4-PTA, air-bone Gap(ABG), AC, BC tone burst evoked VEMP, and calorics were measured preoperatively in 126 otosclerotic ears. The response rate of the AC-VEMPs and BC-VEMPs was 29.36% and 44.03%, respectively. Statistical differences were found between the means of ABG, AC 4-PTA, and BC 4-PTA in the otosclerotic ears in relation to AC-VEMP elicitability. About one-third of patients presented with disequilibrium. A statistically significant interaction was found between calorics and dizziness in relation to PTA thresholds. No relationship was found between calorics and dizziness with VEMPs responses. AC and BC VEMPs can be elicited in ears with otosclerosis. AC-VEMP is more vulnerable to conductive hearing loss. Evaluation of AC-VEMP thresholds can be added in the diagnostic work-up of otosclerosis in case of doubt, enhancing differential diagnosis in patients with air-bone gaps. Otosclerosis is not a cause of canal paresis or vertigo.

Vestibular evoked myogenic potentials in patients with BPPV

PubMed Central

Korres, Stavros; Gkoritsa, Eleni; Giannakakou-Razelou, Dimitra; Yiotakis, Ioannis; Riga, Maria; Nikolpoulos, Thomas P.

2011-01-01

Summary Background The probable cause of Benign Paroxysmal Positional Vertigo (BPPV) is a degeneration of the oto lithic organs (utricle and saccule). The aim of the study is to find possible alterations in Vestibular Evoked Myogenic Potentials (VEMP) recordings in BPPV patients, because the saccule is part of the VEMP pathway. Material/Methods 27 BPPV patients (24 unilateral and 3 bilateral) aged 20 to 70 years and 30 healthy age matched controls. BPPV was diagnosed by the upbeating geotropic nystagmus found in the supine position with the head overextended towards one side. The subjects were investigated with pure tone audiometry, bi-thermal caloric test with electronystagmographic (ENG) recording, and VEMP recording. Results P1 latency and N1 latency did not present any statistical difference between control ears and affected ears of the BPPV population. The percentage of abnormal VEMP in the BPPV population was statistically higher than in the control ears (p<0.005). No significant relationship could be shown between the occurrence of Canal Paresis and abnormal VEMP. No relationship was found between the side (right or left ear) where BPPV appeared clinically and the side where abnormal VEMP was registered. Conclusions BPPV is a clinical entity associated with increased occurrence of abnormal VEMP recordings, possibly due to degeneration of the saccular macula, which is part of the neural VEMP pathway. PMID:21169909

[Effect of the middle ear status on the recording of vestibular evoked myogenic potential--VEMP].

PubMed

Kurzyna, Agnieszka; Hassmann-Poznańska, Elzbieta; Topolska, Małgorzata Maria

2004-01-01

The aim of this study was to assess the effect of age on the recording of air- and bone-conducted vestibular evoked myogenic potential. Forty six young subjects were included in the study, ranging in age from 4 to 18 years. All of them underwent otoscopy, pure tone audiometry, tympanometry and air- and bone-conducted VEMP in response to click. Eighty six ears with normal hearing (pure tone average 20 dB) and type A and C1 tympanogram were studied. There were 2 groups according to age: group I--children aged 4-10 years--52 ears, group II--young subjects aged 11-18 years--34 ears. The threshold, the presence of correct waveform morphology of the response and the latency were evaluated. Above parameters were examined at 95 dB and 100 dB (nHL) air conducted click intensity and 60 dB (nHL) bone conducted click intensity. The age has no significant effect on the percentage of the recording of VEMP and the level of the response threshold with air stimulation, based on the performed studies. However, the age has effect on the prolongation of latency p13 and n23 both with air and bone stimulation. We paid attention to the lower percentage of the recording of bone-conducted VEMP in young subjects aged 11-18 years.

Influence of well-known risk factors for hearing loss in a longitudinal twin study.

PubMed

Johnson, Ann-Christin; Bogo, Renata; Farah, Ahmed; Karlsson, Kjell K; Muhr, Per; Sjöström, Mattias; Svensson, Eva B; Skjönsberg, Åsa; Svartengren, Magnus

2017-01-01

The aim was to investigate the influence of environmental exposures on hearing loss in a twin cohort. Male twins born 1914-1958, representing an unscreened population, were tested for hearing loss at two occasions, 18 years apart. Clinical audiometry and a questionnaire were performed at both time points in this longitudinal study. Noise and solvent exposure were assessed using occupational work codes and a job exposure matrix. Hearing impairment was investigated using two different pure tone averages: PTA4 (0.5, 1, 2, and 4 kHz) and HPTA4 (3, 4, 6, and 8 kHz). Age affected all outcome measures. Noise exposure between time point one and two affected the threshold shifts of PTA4 and HPTA4 more in participants with a pre-existing hearing loss at time point one. Lifetime occupational noise exposure was a risk factor especially for the low-frequency hearing threshold PTA4. Firearm use was a statistically significant risk factor for all outcome measures. Pre-existing hearing loss can increase the risk of hearing impairment due to occupational noise exposure. An increased risk for NIHL was also seen in the group with exposures below 85 dB(A), a result that indicates awareness of NIHL should be raised even for those working in environments where sound levels are below 85 dB(A).

Near-threshold equal-loudness contours for harbor seals (Phoca vitulina) derived from reaction times during underwater audiometry: a preliminary study.

PubMed

Kastelein, Ronald A; Wensveen, Paul J; Terhune, John M; de Jong, Christ A F

2011-01-01

Equal-loudness functions describe relationships between the frequencies of sounds and their perceived loudness. This pilot study investigated the possibility of deriving equal-loudness contours based on the assumption that sounds of equal perceived loudness elicit equal reaction times (RTs). During a psychoacoustic underwater hearing study, the responses of two young female harbor seals to tonal signals between 0.125 and 100 kHz were filmed. Frame-by-frame analysis was used to quantify RT (the time between the onset of the sound stimulus and the onset of movement of the seal away from the listening station). Near-threshold equal-latency contours, as surrogates for equal-loudness contours, were estimated from RT-level functions fitted to mean RT data. The closer the received sound pressure level was to the 50% detection hearing threshold, the more slowly the animals reacted to the signal (RT range: 188-982 ms). Equal-latency contours were calculated relative to the RTs shown by each seal at sound levels of 0, 10, and 20 dB above the detection threshold at 1 kHz. Fifty percent detection thresholds are obtained with well-trained subjects actively listening for faint familiar sounds. When calculating audibility ranges of sounds for harbor seals in nature, it may be appropriate to consider levels 20 dB above this threshold.

Noise and cardiovascular effects in workers of the sanitary fixtures industry.

PubMed

Assunta, Capozzella; Ilaria, Samperi; Simone, De Sio; Gianfranco, Tomei; Teodorico, Casale; Carmina, Sacco; Anastasia, Suppi; Roberto, Giubilati; Francesco, Tomei; Valeria, Rosati Maria

2015-01-01

The aim of the present study is to evaluate whether workers in the sanitary fixtures industry are a category at risk of developing cardiovascular diseases, and in particular, whether chronic noise exposure may play a role in cardiovascular effects in exposed workers. Seventy-five employees engaged in sanitation fixtures production and a control group of sixty-four office workers, who were not exposed to agents that could damage the cardiovascular system, participated in our study. The selected workers completed a clinical-anamnestic questionnaire, and underwent a medical examination, blood pressure test, electrocardiogram (ECG), blood tests, and audiometry. Measurements of environmental noise, dust, and lead were also carried out. The exposed workers, in comparison to the control group, showed a higher frequency of hypertension, systolic and diastolic blood pressure (p<0.05, p<0.05), as well as electrocardiographic abnormalities (p<0.05). There was also a higher frequency of hypertension and electrocardiographic abnormalities among subjects with audiometric deficit compared to normoacoustic subjects (p<0.05 and p<0.05). from our study suggest that work activity in the sanitary fixtures industry can have an influence on the cardiovascular system, and noise can be the main cause of damage for the cardiovascular system in exposed workers, as cardiovascular damage seems to be linked to hearing loss. Copyright © 2014 Elsevier GmbH. All rights reserved.

Individual Differences Reveal Correlates of Hidden Hearing Deficits

PubMed Central

Masud, Salwa; Mehraei, Golbarg; Verhulst, Sarah; Shinn-Cunningham, Barbara G.

2015-01-01

Clinical audiometry has long focused on determining the detection thresholds for pure tones, which depend on intact cochlear mechanics and hair cell function. Yet many listeners with normal hearing thresholds complain of communication difficulties, and the causes for such problems are not well understood. Here, we explore whether normal-hearing listeners exhibit such suprathreshold deficits, affecting the fidelity with which subcortical areas encode the temporal structure of clearly audible sound. Using an array of measures, we evaluated a cohort of young adults with thresholds in the normal range to assess both cochlear mechanical function and temporal coding of suprathreshold sounds. Listeners differed widely in both electrophysiological and behavioral measures of temporal coding fidelity. These measures correlated significantly with each other. Conversely, these differences were unrelated to the modest variation in otoacoustic emissions, cochlear tuning, or the residual differences in hearing threshold present in our cohort. Electroencephalography revealed that listeners with poor subcortical encoding had poor cortical sensitivity to changes in interaural time differences, which are critical for localizing sound sources and analyzing complex scenes. These listeners also performed poorly when asked to direct selective attention to one of two competing speech streams, a task that mimics the challenges of many everyday listening environments. Together with previous animal and computational models, our results suggest that hidden hearing deficits, likely originating at the level of the cochlear nerve, are part of “normal hearing.” PMID:25653371

[The assessment of the clinical effectiveness of fenspiride for the treatment of acute obstruction of the Eustachian tube].

PubMed

Fedin, A V

2015-01-01

The objective of the present study was to estimate the clinical effectiveness of fenspiride used to correct the obstruction of the Eustachian tube in 80 patients presenting with acute tubootitis and exudative otitis media. The algorithm of the examination included the evaluation of the severity of subjective clinical symptoms based on the relevant analog-visual scale, results of tonal audiometry, and tympanometry. The control group was comprised of 34 patients treated with antibacterial preparations, topical decongestants, and transtubal administration of glucocorticoids. The study group included 46 patients who received fenspiride at a dose of 80 mg thrice daily in addition to the above pharmacotherapy. The severity of clinical symptoms in the patients treated with fenspiride decreased faster than in the control subjects. The frequency analysis of dynamics of the air-bone gaps on the audiometric curves revealed the significantly more intensive recovery of the hearing function in the patients treated by basal pharmacotherapy in the combination with fenspiride. Type A tympanograms predominated on day 7 after the onset of the conservative treatment with the use of fenspiride whereas type C tympanograms continued to predominate in the patients of the control group. It is concluded that the introduction of fenspiride into combined therapy of acute tubootitis and exudative otitis media promotes the normalization of the ventilation and drainage functions and relieves the severity of subjective clinical symptoms.

Screening of hearing in elderly people: assessment of accuracy and reproducibility of the whispered voice test.

PubMed

Labanca, Ludimila; Guimarães, Fernando Sales; Costa-Guarisco, Letícia Pimenta; Couto, Erica de Araújo Brandão; Gonçalves, Denise Utsch

2017-11-01

Given the high prevalence of presbycusis and its detrimental effect on quality of life, screening tests can be useful tools for detecting hearing loss in primary care settings. This study therefore aimed to determine the accuracy and reproducibility of the whispered voice test as a screening method for detecting hearing impairment in older people. This cross-sectional study was carried out with 210 older adults aged between 60 and 97 years who underwent the whispered voice test employing ten different phrases and using audiometry as a reference test. Sensitivity, specificity and positive and negative predictive values were calculated and accuracy was measured by calculating the area under the ROC curve. The test was repeated on 20% of the ears by a second examiner to assess inter-examiner reproducibility (IER). The words and phrases that showed the highest area under the curve (AUC) and IER values were: "shoe" (AUC = 0.918; IER = 0.877), "window" (AUC = 0.917; IER = 0.869), "it looks like it's going to rain" (AUC = 0.911; IER = 0.810), and "the bus is late" (AUC = 0.900; IER = 0.810), demonstrating that the whispered voice test is a useful screening tool for detecting hearing loss among older people. It is proposed that these words and phrases should be incorporated into the whispered voice test protocol.

[Communication and noise. Speech intelligibility of airplane pilots with and without active noise compensation].

PubMed

Matschke, R G

1994-08-01

Noise exposure measurements were performed with pilots of the German Federal Navy during flight situations. The ambient noise levels during regular flight were maintained at levels above a 90 dB A-weighted level. This noise intensity requires wearing ear protection to avoid sound-induced hearing loss. To be able to understand radio communication (ATC) in spite of a noisy environment, headphone volume must be raised above the noise of the engines. The use of ear plugs in addition to the headsets and flight helmets is only of limited value because personal ear protection affects the intelligibility of ATC. Whereas speech intelligibility of pilots with normal hearing is affected to only a smaller degree, pilots with pre-existing high-frequency hearing losses show substantial impairments of speech intelligibility that vary in proportion to the hearing deficit present. Communication abilities can be reduced drastically, which in turn can affect air traffic security. The development of active noise compensation devices (ANC) that make use of the "anti-noise" principle may be a solution to this dilemma. To evaluate the effectiveness of an ANC-system and its influence on speech intelligibility, speech audiometry was performed with a German standardized test during simulated flight conditions with helicopter pilots. Results demonstrate the helpful effect on speech understanding especially for pilots with noise-induced hearing losses. This may help to avoid pre-retirement professional disability.

What the neurosurgeon should know about hemangioblastoma, both sporadic and in Von Hippel-Lindau disease: A literature review

PubMed Central

Bamps, Sven; Calenbergh, Frank Van; Vleeschouwer, Steven De; Loon, Johannes Van; Sciot, Raf; Legius, Eric; Goffin, Jan

2013-01-01

Background: Hemangioblastomas are associated with Von Hippel-Lindau disease (VHLD) in 10-40% of cases. Based upon a literature review we state the core features the neurosurgeon should be aware of. Methods: We performed a selective literature (Cochrane and Medline) search for hemangioblastoma, both sporadic and VHL associated. We reviewed general characteristics (epidemiology, symptomatology, diagnosis, and management) and focused on follow-up as well as screening modalities for sporadic and VHL associated lesions. Results: Based upon our literature search, we established guidelines for screening and follow-up in both sporadic and VHL associated hemangioblastoma patients. Conclusions: Screening for retinal angiomas, abdominal masses, and pheochromocytomas as well as genetic analysis is recommended for every patient with a newly diagnosed hemangioblastoma. Follow-up is by magnetic resonance imaging (MRI) of the clinical neuronal region at 6 and at 12-24 months postoperatively. For VHL-associated hemangioblastomas yearly investigation for craniospinal hemangioblastoma by MRI and yearly screening and follow-up for retinal angiomas is recommended. Annual abdominal ultrasound with triennial computed tomography (CT) imaging for abdominal masses is postulated. Annual audiometry is to be performed for possible endolymphatic sac tumor, detailed radiographic imaging of the skull base should be performed upon abnormality in auditory testing. Investigations for cystadenomas of the epidydimis and broad ligament only are mandatory on indication. Annual investigation for pheochromocytoma is recommended. PMID:24340227

Occupational safety threats among dental personnel and related risk factors.

PubMed

Gurbuz, M Kezban; Çatli, Tolgahan; Cingi, Cemal; Yaz, Aytekin; Bal, Cengiz

2013-11-01

Occupational diseases are primarily considered to be important health problems for individuals with occupations in heavy industry fields. Although dentists work in very clean and elegant offices, they are frequently exposed to various chemicals and high-intensity, sound-producing instruments, such as compressors and aerators. In our study, we aimed to investigate the risk for occupational hearing loss of dental personnel, by performing pure-tone audiometry in 40 dentists and comparing the results with those of healthy individuals. We also sampled the nasal mucosa to investigate the effects of occupational chemicals on the nasal mucosa of the dentists. The pure-tone audiometric thresholds at 5 different frequencies (1000, 2000, 4000, 6000, and 8000 Hz) and working time were evaluated as potential risk factors. The pure-tone audiometric results (as decibels) at each frequency and the median values for each side (right and left ears) were significantly higher for dentists than for the control group (P < 0.05). The pure-tone audiometric results did not significantly differ between the women and men in the study group (P > 0.05). The findings in the nasal mucosa (goblet cell hyperplasia, neutrophil/eosinophil/basophil distribution, metaplasia, dysplasia, premalignant or malignant cells) were similar in the study and control groups (P > 0.05). In conclusion, our study indicated that high-intensity, sound-producing equipment is an important occupational threat for dentists, whereas chemical agents have minimal hazardous effects.

Hearing Profile of Brazilian Forestry Workers' Noise Exposure

PubMed Central

Lacerda, Adriana; Quintiliano, Juliana; Lobato, Diolen; Gonçalves, Claudia; Marques, Jair

2014-01-01

Introduction Researchers studying the hearing health of forestry workers have revealed the presence of a noise-induced hearing loss (NIHL) in this population and have concluded that the vibration of the equipment, the carbon monoxide released by motors, and pesticides might also contribute to NIHL. Objective To analyze the noise exposure in the Brazilian forestry industry workers and the effects on hearing. Methods The study sample comprised 109 employees of a company that specialized in reforestation. Their participants' mean age was 35.5 years (21 to 54 years), mean tenure at the company was 3.9 years (1 to 13 years), and mean total duration of noise exposure was 12.3 years (1 to 30 years). The existing documentation reporting on the jobs risk analysis was examined, noise level was measured, and pure tone audiometry was performed in all participants. Participants were divided into three groups according to their noise exposure levels in their current job. Results Of the participants who were exposed to noise levels less than 85 dBA (decibels with A-weighting filter), 23.8% had hearing loss, and 5.5% of the participants who were exposed to noise ranging from 85 to 89.9 dBA and 11% of the participants who were exposed to noise greater than 90 dBA had audiogram results suggestive of NIHL. Conclusion The implementation of a hearing loss prevention program tailored to forestry workers is needed. PMID:25992147

Pitch and Loudness from Tinnitus in Individuals with Noise-induced Hearing Loss

PubMed Central

Flores, Leticia Sousa; Teixeira, Adriane Ribeiro; Rosito, Leticia Petersen Schmidt; Seimetz, Bruna Macagnin; Dall'Igna, Celso

2015-01-01

Introduction  Tinnitus is one of the symptoms that affects individuals suffering from noise induced hearing loss. This condition can be disabling, leading the affected individual to turn away from work. Objective  This literature review aims to analyze the possible association between gender and tinnitus pitch and loudness, the degree of hearing loss and the frequencies affected in subjects with noise-induced hearing loss. Methods  This contemporary cohort study was conducted through a cross-sectional analysis. The study sample consisted of adults with unilateral or bilateral tinnitus, who had been diagnosed with noise-induced hearing loss. The patients under analysis underwent an otorhinolaryngological evaluation, pure tone audiometry, and acuphenometry. Results  The study included 33 subjects with noise-induced hearing loss diagnoses, of which 22 (66.7%) were men. Authors observed no statistical difference between gender and loudness/pitch tinnitus and loudness/pitch in subjects with bilateral tinnitus. Authors found an inverse relation between tinnitus loudness with intensity greater hearing threshold and the average of the thresholds and the grade of hearing loss. The tinnitus pitch showed no association with higher frequency of hearing threshold. Conclusion  Data analysis shows that, among the individuals evaluated, the greater the hearing loss, the lower the loudness of tinnitus. We did not observe an association between hearing loss and tinnitus pitch. PMID:27413408

Brainstem auditory evoked potentials in children with lead exposure.

PubMed

Alvarenga, Katia de Freitas; Morata, Thais Catalani; Lopes, Andrea Cintra; Feniman, Mariza Ribeiro; Corteletti, Lilian Cassia Bornia Jacob

2015-01-01

Earlier studies have demonstrated an auditory effect of lead exposure in children, but information on the effects of low chronic exposures needs to be further elucidated. To investigate the effect of low chronic exposures of the auditory system in children with a history of low blood lead levels, using an auditory electrophysiological test. Contemporary cross-sectional cohort. Study participants underwent tympanometry, pure tone and speech audiometry, transient evoked otoacoustic emissions, and brainstem auditory evoked potentials, with blood lead monitoring over a period of 35.5 months. The study included 130 children, with ages ranging from 18 months to 14 years, 5 months (mean age 6 years, 8 months ± 3 years, 2 months). The mean time-integrated cumulative blood lead index was 12 μg/dL (SD ± 5.7, range: 2.433). All participants had hearing thresholds equal to or below 20 dBHL and normal amplitudes of transient evoked otoacoustic emissions. No association was found between the absolute latencies of waves I, III, and V, the interpeak latencies I-III, III-V, and I-V, and the cumulative lead values. No evidence of toxic effects from chronic low lead exposures was observed on the auditory function of children living in a lead contaminated area. Copyright © 2014 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Factors associated with poor academic achievement among urban primary school children in Malaysia.

PubMed

Ong, L C; Chandran, V; Lim, Y Y; Chen, A H; Poh, B K

2010-03-01

The aim of this study was to identify factors associated with poor academic achievement during the early school years. This was a cross-sectional study of urban Primary Two children. Sociodemographic and medical data were obtained from questionnaires and interviews. Achievement was based on marks obtained in the core subjects of the Primary One examination. All students underwent the Raven's Standard Progressive Matrices test as a general measure of cognitive ability, audiometry and visual tests, and standardised measurements of weight and height. Out of 1,470 eligible children, 206 (14 percent) had poor academic achievement. Of the 919 children who participated in the study, 111 (12.1 percent) had poor achievement compared with 95 (17.2 percent) of the 551 non-participants. Using logistic regression analysis, the factors that were found to be independently associated with poor academic achievement were lower mean Raven scores (p-value is less than 0.001), lower mean socioeconomic status scores (p-value is less than 0.001), larger sibship size (p-value is 0.031), male gender (odds ratio [OR] 1.7; 95 percent confidence interval [CI] 1.1-2.65) and a history of prematurity (OR 14; 95 percent CI 2-97.8). Cognitive ability, gender, prematurity and social factors contribute to poor academic achievement during the early school years. The higher proportion of poor achievers among non-participants warrants further attention.

[Analysis on occupational noise-induced hearing loss of different type workers in underground mining].

PubMed

Liu, Q C; Duo, C H; Wang, Z; Yan, K; Zhang, J; Xiong, W; Zhu, M

2017-11-20

Objective: To investigate hearing loss status of blasters, drillers mechanics and so on in underground mining, and put forward suggestion diagnosis of occupational explosive deafness and occupational deafness. Methods: Underground excavation workers in a metal mine were recruited in this study, those with a history of ear disease and non-occupational deafness were all excluded. Finally, the features of pure tone audiometry of 459 noise-exposed workers were analyzed. Results: High-frequency hearing loss occurred on 351workers and the positive detection rate was 74.29%, workers who had both high-frequency and linguistic frequency hearing loss were 51 and the positive detection rate was 11.11%. The positive detection of high-frequency hearing loss in right ear (χ(2)=9.427 and P = 0.024) and in left ear (χ(2)=14.375, P =0.002) was significantly different between different exposure age groups. The positive detection of high-frequency hearing loss of driving group was the highest, followed by blasting group, mining group and machine repair group. The characteristics of the hearing loss caused by drilling noise of the blasting workers with no accident occurred were in line with that of noise-induced hearing loss. Conclusion: The diagnosis grading should be carried out according to the diagnostic criteria of occupational noise-induced deafness for the employees who engaged in the blasting operation with no record of blast accident.

Transient threshold shift after gunshot noise exposure.

PubMed

Saedi, B; Ghasemi, M; Motiee, M; Mojtahed, M; Safavi, A

2013-01-01

Many people, such as soldiers, are routinely exposed to gunshot noise during target practice. It is suspected that this high-intensity noise may affect audition through repeated Transient Threshold Shifts (TTS); it can also mechanically alter auditory components such as waves. This study investigates the scope of gunshot noise from the AK-47 rifle (Kalashnikov) and the impact on the shooters' audition. Forty soldiers (80 ears) were recruited in this study. They were all young and being exposed to gunshot noise for the first time. Gunshot characteristics were measured before exposure. The soldiers underwent auditory evaluation with Pure Tone Audiometry (PTA) and Oto-Acoustic Emission (OAE) once before exposure and immediately (less than one hour) after exposure. The AK-47 gunshot noise pressure level varied between L(AIm) = 73.7 dBA to L(AIm) = 111.4 dBA. Fourteen participants had subclinical hearing impairment in their pre-exposure evaluation; this number increased to 16 after the exposure. Six months post-exposure and later, the number of cases with impairment had fallen to eight (improvement in 50%). Both pre- and post-exposure OAE results were within normal values, while PTA results indicated a significant threshold alteration only at 6 kHz. The results of this study confirm that exposure to gunshot noise with no ear protection can represent a significant hazard for auditory function, especially at higher frequencies.

Hearing Status in Pediatric Renal Transplant Recipients.

PubMed

Gulleroglu, Kaan; Baskin, Esra; Aydin, Erdinc; Ozluoglu, Levent; Moray, Gokhan; Haberal, Mehmet

2015-08-01

Renal transplant provides a long-term survival. Hearing impairment is a major factor in subjective health status. Status of hearing and the cause of hearing impairment in the pediatric renal transplant group have not been evaluated. Here, we studied to evaluate hearing status in pediatric renal transplant patients and to determine the factors that cause hearing impairment. Twenty-seven pediatric renal transplant recipients were investigated. All patients underwent audiologic assessment by means of pure-tone audiometry. The factors on hearing impairment were performed. Sensorineural hearing impairment was found in 17 patients. There was marked hearing impairment for the higher frequencies between 4000 and 8000 Hz. Sudden hearing loss developed in 2 patients, 1 of them had tinnitus. Decrease of speech understanding was found in 8 patients. The cyclosporine level was significantly high in patients with hearing impairment compared with group without hearing impairment. Cyclosporine levels also were found to be statistically significantly high when compared with the group with decrease of speech understanding and the group without decrease of speech understanding. Similar relations cannot be found between tacrolimus levels and hearing impairment and speech understanding. Sensorineural hearing impairment prevalence was high in pediatric renal transplant recipients when compared with the general population of children. Cyclosporine may be responsible for causing hearing impairment after renal transplant. We suggest that this effect is a dose-dependent toxicity.

Occupational noise-induced tinnitus: does it affect workers' quality of life?

PubMed

Muluk, Nuray Bayar; Oguztürk, Omer

2008-02-01

This prospective study aimed to investigate the quality of life of workers in a steel factory. The study group was composed of 16 male workers with tinnitus and 30 ears. Fifteen male workers without tinnitus and 30 ears were included into the control group. Workers were evaluated by questionnaire, pure-tone audiometry, and the SF-36 Health Survey. In the study group, tinnitus loudness levels (TLLs) were found. In the study group, the domains general mental health and role limitations owing to emotional problems were significantly lower than in the control group. Older age, industrial noise exposure over a long period, higher noise exposure during work, and hearing loss secondary to occupational noise caused workers to experience higher TLLs. Earheadings protected workers more than earplugs, and TLLs were lower. Important factors that affect workers' quality of life are maximum exposed noise levels, daily and total noise exposure time, and exposure to continuous noise. Occupational noise-induced tinnitus mainly causes emotional disability rather than physical disability. Emotionally impaired QOL results may be due to tinnitus-related psychological problems. Workers should have knowledge about the hazardous effects of noise. Periodic health checkups and regular seminars have great importance. Workers must be aware of other ototoxic factors, such as medications and noisy music. In the future, researchers should develop a screening method to detect those with a more hereditary affinity to hearing loss.

Video Nasoendoscopic-Assisted Transoral Adenoidectomy with the PEAK PlasmaBlade: A Preliminary Report of a Case Series

PubMed Central

Kuo, Chao-Yin; Lin, Yuan-Yung

2017-01-01

Objectives. The primary objective for this study is to evaluate the advantages, disadvantages, surgical applicability, and outcome of the pulsed electron avalanche knife (PEAK) PlasmaBlade in transoral adenoidectomy under direct visualization using video nasoendoscopy. Patients and Methods. In this series, six cases of adenoid hypertrophy showing varying clinical presentations in relation to its clinical course were surgically treated using a PEAK PlasmaBlade. Before and after surgery, all patients underwent nasal endoscopy to define the grading of hypertrophic adenoids and postoperative outcome. Pure tone audiometry and tympanometry tests were carried out to investigate the change in middle and inner ear functions. Results. The mean follow-up period was 23.8 months. Postoperatively, symptoms of otitis media with effusion were all relieved with closure of the air-bone gap (6/6). Other relevant ear complaints like tinnitus were resolved (1/1) and aural fullness disappeared in 87.5% of ears (7/8). Nasal obstruction (2/2) and postnasal drip (2/2) were improved after surgery. Conclusions. Based on this preliminary report of a case series in a limited sample size, we suggest that using the transoral PEAK PlasmaBlade for adenoidectomy guided by video nasoendoscopy is a safe and feasible surgical technique, allowing remarkable outcomes by providing precise tissue removal, effective hemostasis, and painless postoperative recovery. PMID:28459055

Wideband acoustic immittance in children with Down syndrome: prediction of middle-ear dysfunction, conductive hearing loss and patent PE tubes.

PubMed

Hunter, Lisa L; Keefe, Douglas H; Feeney, M Patrick; Brown, David K; Meinzen-Derr, Jareen; Elsayed, Alaaeldin M; Amann, Julia M; Manickam, Vairavan; Fitzpatrick, Denis; Shott, Sally R

2017-09-01

The purpose of this study was to evaluate pressurised wideband acoustic immittance (WAI) tests in children with Down syndrome (DS) and in typically developing children (TD) for prediction of conductive hearing loss (CHL) and patency of pressure equalising tubes (PETs). Audiologic diagnosis was determined by audiometry in combination with distortion-product otoacoustic emissions, 0.226 kHz tympanometry and otoscopy. WAI results were compared for ears within diagnostic categories (Normal, CHL and PET) and between groups (TD and DS). Children with DS (n = 40; mean age 6.4 years), and TD children (n = 48; mean age 5.1 years) were included. Wideband absorbance was significantly lower at 1-4 kHz in ears with CHL compared to NH for both TD and DS groups. In ears with patent PETs, wideband absorbance and group delay (GD) were larger than in ears without PETs between 0.25 and 1.5 kHz. Wideband absorbance tests were performed similarly for prediction of CHL and patent PETs in TD and DS groups. Wideband absorbance and GD revealed specific patterns in both TD children and those with DS that can assist in detection of the presence of significant CHL, assess the patency of PETs, and provide frequency-specific information in the audiometric range.

Inner ear disorders.

PubMed

Smouha, Eric

2013-01-01

To present a framework for the diagnosis and treatment of inner ear disorders, with an emphasis on problems common to neuro-rehabilitation. Disorders of the inner ear can cause hearing loss, tinnitus, vertigo and imbalance. Hearing loss can be conductive, sensorineural, or mixed; conductive hearing loss arises from the ear canal or middle ear, while sensorineural hearing loss arises from the inner ear or auditory nerve. Vertigo is a hallucination of motion, and is the cardinal symptom of vestibular system disease. It should be differentiated from other causes of dizziness: gait imbalance, disequilibrium, lightheadedness (pre-syncope). Vertigo can be caused by problems in the inner ear or central nervous system. The diagnosis of inner ear disorders begins with a targeted physical examination. The initial work-up of hearing loss is made by audiometry, and vertigo by electronystagmography (ENG). Supplemental tests and MRI are obtained when clinically indicated. The clinical pattern and duration of vertigo are the most important clinical features in the diagnosis. Common inner ear causes of vertigo include: vestibular neuritis (sudden, unilateral vestibular loss), Meniere's disease (episodic vertigo), benign paroxysmal positional vertigo (BPPV), and bilateral vestibular loss. Common central nervous system causes of vertigo include: post concussion syndrome, cervical vertigo, vestibular migraine, cerebrovascular disease, and acoustic neuroma. A basic knowledge of vestibular physiology, coupled with a understanding of common vestibular syndromes, will lead to correct diagnosis and treatment in most cases.

Wideband Acoustic Immittance in Children with Down Syndrome: Prediction of Middle-Ear Dysfunction, Conductive Hearing Loss and Patent PE Tubes

PubMed Central

Hunter, Lisa L.; Keefe, Douglas H.; Feeney, M. Patrick; Brown, David K.; Meinzen-Derr, Jareen; Elsayed, Alaaeldin M.; Amann, Julia M.; Manickam, Vairavan; Fitzpatrick, Denis; Shott, Sally R.

2017-01-01

Objective The purpose of this study was to evaluate pressurized wideband acoustic immittance (WAI) tests in children with Down syndrome (DS) and in typically developing children (TD) for prediction of conductive hearing loss (CHL) and patency of pressure equalizing tubes (PETs). Design Audiologic diagnosis was determined by audiometry in combination with distortion-product otoacoustic emissions, 226-Hz tympanometry and otoscopy. WAI results were compared for ears within diagnostic categories (Normal, CHL and PET) and between groups (TD and DS). Study Sample Children with DS (n=40; mean age 6.4 yrs.), and TD children (n=48; mean age 5.1 yrs.) were included. Results Wideband absorbance was significantly lower at 1–4 kHz in ears with CHL compared to NH for both TD and DS groups. In ears with patent PETs, wideband absorbance and group delay (GD) were larger than in ears without PETs between 0.25–1.5 kHz. Wideband absorbance tests performed similarly for prediction of CHL and patent PETs in TD and DS groups. Conclusions Wideband absorbance and group delay revealed specific patterns in both TD children and those with DS that can assist in detection of the presence of significant CHL, assess the patency of PETs, and provide frequency-specific information in the audiometric range. PMID:28434272

How to Avoid a Learning Curve in Stapedotomy: A Standardized Surgical Technique.

PubMed

Kwok, Pingling; Gleich, Otto; Dalles, Katharina; Mayr, Elisabeth; Jacob, Peter; Strutz, Jürgen

2017-08-01

To evaluate, whether a learning curve for beginners in stapedotomy can be avoided by using a prosthesis with thermal memory-shape attachment in combination with a standardized laser-assisted surgical technique. Retrospective case review. Tertiary referral center. Fifty-eight ears were operated by three experienced surgeons and compared with a group of 12 cases operated by a beginner in stapedotomy. Stapedotomy. Difference of pure-tone audiometry thresholds measured before and after surgery. The average postoperative gain for air conduction in the frequencies below 2 kHz was 20 to 25 dB and decreased for the higher frequencies. Using the Mann-Whitney-U test for comparing mean gain between experienced and inexperienced surgeons showed no significant difference (p = 0.281 at 4 kHz and p > 0.7 for the other frequencies). A Spearman rank correlation of the postoperative gain for air- and bone-conduction thresholds was obtained at each test frequency for the first 12 patients consecutively treated with a thermal memory-shape attachment prosthesis by two experienced and one inexperienced surgeon. This analysis does not support the hypothesis of a "learning effect" that should be associated with an improved outcome for successively treated patients. It is possible to avoid a learning curve in stapes surgery by applying a thermal memory-shape prosthesis in a standardized laser-assisted surgical procedure.

Genetic analysis of PAX3 for diagnosis of Waardenburg syndrome type I.

PubMed

Matsunaga, Tatsuo; Mutai, Hideki; Namba, Kazunori; Morita, Noriko; Masuda, Sawako

2013-04-01

PAX3 genetic analysis increased the diagnostic accuracy for Waardenburg syndrome type I (WS1). Analysis of the three-dimensional (3D) structure of PAX3 helped verify the pathogenicity of a missense mutation, and multiple ligation-dependent probe amplification (MLPA) analysis of PAX3 increased the sensitivity of genetic diagnosis in patients with WS1. Clinical diagnosis of WS1 is often difficult in individual patients with isolated, mild, or non-specific symptoms. The objective of the present study was to facilitate the accurate diagnosis of WS1 through genetic analysis of PAX3 and to expand the spectrum of known PAX3 mutations. In two Japanese families with WS1, we conducted a clinical evaluation of symptoms and genetic analysis, which involved direct sequencing, MLPA analysis, quantitative PCR of PAX3, and analysis of the predicted 3D structure of PAX3. The normal-hearing control group comprised 92 subjects who had normal hearing according to pure tone audiometry. In one family, direct sequencing of PAX3 identified a heterozygous mutation, p.I59F. Analysis of PAX3 3D structures indicated that this mutation distorted the DNA-binding site of PAX3. In the other family, MLPA analysis and subsequent quantitative PCR detected a large, heterozygous deletion spanning 1759-2554 kb that eliminated 12-18 genes including a whole PAX3 gene.

Comparative multivariate analyses of transient otoacoustic emissions and distorsion products in normal and impaired hearing.

PubMed

Stamate, Mirela Cristina; Todor, Nicolae; Cosgarea, Marcel

2015-01-01

The clinical utility of otoacoustic emissions as a noninvasive objective test of cochlear function has been long studied. Both transient otoacoustic emissions and distorsion products can be used to identify hearing loss, but to what extent they can be used as predictors for hearing loss is still debated. Most studies agree that multivariate analyses have better test performances than univariate analyses. The aim of the study was to determine transient otoacoustic emissions and distorsion products performance in identifying normal and impaired hearing loss, using the pure tone audiogram as a gold standard procedure and different multivariate statistical approaches. The study included 105 adult subjects with normal hearing and hearing loss who underwent the same test battery: pure-tone audiometry, tympanometry, otoacoustic emission tests. We chose to use the logistic regression as a multivariate statistical technique. Three logistic regression models were developed to characterize the relations between different risk factors (age, sex, tinnitus, demographic features, cochlear status defined by otoacoustic emissions) and hearing status defined by pure-tone audiometry. The multivariate analyses allow the calculation of the logistic score, which is a combination of the inputs, weighted by coefficients, calculated within the analyses. The accuracy of each model was assessed using receiver operating characteristics curve analysis. We used the logistic score to generate receivers operating curves and to estimate the areas under the curves in order to compare different multivariate analyses. We compared the performance of each otoacoustic emission (transient, distorsion product) using three different multivariate analyses for each ear, when multi-frequency gold standards were used. We demonstrated that all multivariate analyses provided high values of the area under the curve proving the performance of the otoacoustic emissions. Each otoacoustic emission test presented high values of area under the curve, suggesting that implementing a multivariate approach to evaluate the performances of each otoacoustic emission test would serve to increase the accuracy in identifying the normal and impaired ears. We encountered the highest area under the curve value for the combined multivariate analysis suggesting that both otoacoustic emission tests should be used in assessing hearing status. Our multivariate analyses revealed that age is a constant predictor factor of the auditory status for both ears, but the presence of tinnitus was the most important predictor for the hearing level, only for the left ear. Age presented similar coefficients, but tinnitus coefficients, by their high value, produced the highest variations of the logistic scores, only for the left ear group, thus increasing the risk of hearing loss. We did not find gender differences between ears for any otoacoustic emission tests, but studies still debate this question as the results are contradictory. Neither gender, nor environment origin had any predictive value for the hearing status, according to the results of our study. Like any other audiological test, using otoacoustic emissions to identify hearing loss is not without error. Even when applying multivariate analysis, perfect test performance is never achieved. Although most studies demonstrated the benefit of using the multivariate analysis, it has not been incorporated into clinical decisions maybe because of the idiosyncratic nature of multivariate solutions or because of the lack of the validation studies.

[Chronic tinnitus in children and adolescents].

PubMed

Rosanowski, F; Hoppe, U; Pröschel, U; Eysholdt, U

1997-11-01

The problem of tinnitus in adults is reviewed systematically in nearly all standard otolaryngology reference works, whereas textbooks and monographs that focus on pediatric otorhinolaryngology or audiology and hearing in children and adolescents provide only little information concerning the epidemiology, etiology and therapy of tinnitus. The purpose of this study was to evaluate the psychosomatic aspects of chronic tinnitus in this younger age group. A rational diagnostic approach is discussed as to which diagnostic measures are necessary in the pediatric group for deciding which therapeutic option to chose. The therapeutic outcome of tinnitus counselling in non-severe cases and of parenteral lidocaine infusions in cases of a troublesome tinnitus is presented. From January 1992 to December 1995, 31 children and adolescents in the age range from 6 to 17 years were treated for a chronic tinnitus without a measurable hearing loss. In 20 cases the tinnitus was bilateral; in 11 cases it was unilateral, without side preference. In 24 patients the case history gave no hint of a major annoyance by the tinnitus or significant psychological components. In these cases tinnitus counselling was carried out. In 7 cases-3 girls and 4 boys in the age range from 10 to 17 years-the kind and grade of symptom satisfied the ICD-10 criteria of a depressive episode. These patients were hospitalized for 10 days and a lidocaine infusion therapy (2 mg/kg Xylocain Cor in 500 ml HAES 6%) was performed as treatment for the somatic component of the disorder. Data were analyzed catamnestically using the patients' files. In all cases normal hearing threshold and speech intelligibility were ascertained by pure-tone and speech audiometry. Auditory evoked brainstem potentials gave no further information. The measurement of transient evoked otoacoustic emissions gave no consistent results in either of the two groups. Tinnitus measurement and audiometric masking could only be carried out in patients older than 10 years and showed non-reproducible results. In all cases with no major symptoms tinnitus disappeared. During a follow-up of 12-44 months, 4 cases treated with lidocaine achieved complete remission; in 3 cases the tinnitus eased off to such an extent that it was no longer regarded as annoying. In one girl of the lidocaine group a somatisation disorder developed independently of the tinnitus and was treated by psychotherapy. No side-effects of the lidocaine occurred. All aspects of chronic tinnitus in children and adolescents can be covered best when regarding this symptom as a psychosomatic disorder. The diagnostic approach in this age group has to include a detailed case history embracing both organic and psychological and social aspects. It should also include pure-tone and speech audiometry. Only in cases with an uncertain hearing threshold auditory evoked brainstem potentials have to be measured. Otoacoustic emissions give no further information about the development and therapeutic outcome of the tinnitus. In this age group tinnitus measurement and masking is of no diagnostic value. In patients with no signs of a hearing loss and no other organic symptoms there is no need for further diagnostic measures such as imaging or serological investigations. In cases with severe annoyance, tinnitus counselling is sufficient therapy. In cases with severe symptoms, lidocaine infusion therapy may be a therapeutic option for the somatic component of the disorder. In adolescents with chronic tinnitus psychotherapy will be necessary only in rare cases. The overall prognosis of this disorder is good.

Comparative multivariate analyses of transient otoacoustic emissions and distorsion products in normal and impaired hearing

PubMed Central

STAMATE, MIRELA CRISTINA; TODOR, NICOLAE; COSGAREA, MARCEL

2015-01-01

Background and aim The clinical utility of otoacoustic emissions as a noninvasive objective test of cochlear function has been long studied. Both transient otoacoustic emissions and distorsion products can be used to identify hearing loss, but to what extent they can be used as predictors for hearing loss is still debated. Most studies agree that multivariate analyses have better test performances than univariate analyses. The aim of the study was to determine transient otoacoustic emissions and distorsion products performance in identifying normal and impaired hearing loss, using the pure tone audiogram as a gold standard procedure and different multivariate statistical approaches. Methods The study included 105 adult subjects with normal hearing and hearing loss who underwent the same test battery: pure-tone audiometry, tympanometry, otoacoustic emission tests. We chose to use the logistic regression as a multivariate statistical technique. Three logistic regression models were developed to characterize the relations between different risk factors (age, sex, tinnitus, demographic features, cochlear status defined by otoacoustic emissions) and hearing status defined by pure-tone audiometry. The multivariate analyses allow the calculation of the logistic score, which is a combination of the inputs, weighted by coefficients, calculated within the analyses. The accuracy of each model was assessed using receiver operating characteristics curve analysis. We used the logistic score to generate receivers operating curves and to estimate the areas under the curves in order to compare different multivariate analyses. Results We compared the performance of each otoacoustic emission (transient, distorsion product) using three different multivariate analyses for each ear, when multi-frequency gold standards were used. We demonstrated that all multivariate analyses provided high values of the area under the curve proving the performance of the otoacoustic emissions. Each otoacoustic emission test presented high values of area under the curve, suggesting that implementing a multivariate approach to evaluate the performances of each otoacoustic emission test would serve to increase the accuracy in identifying the normal and impaired ears. We encountered the highest area under the curve value for the combined multivariate analysis suggesting that both otoacoustic emission tests should be used in assessing hearing status. Our multivariate analyses revealed that age is a constant predictor factor of the auditory status for both ears, but the presence of tinnitus was the most important predictor for the hearing level, only for the left ear. Age presented similar coefficients, but tinnitus coefficients, by their high value, produced the highest variations of the logistic scores, only for the left ear group, thus increasing the risk of hearing loss. We did not find gender differences between ears for any otoacoustic emission tests, but studies still debate this question as the results are contradictory. Neither gender, nor environment origin had any predictive value for the hearing status, according to the results of our study. Conclusion Like any other audiological test, using otoacoustic emissions to identify hearing loss is not without error. Even when applying multivariate analysis, perfect test performance is never achieved. Although most studies demonstrated the benefit of using the multivariate analysis, it has not been incorporated into clinical decisions maybe because of the idiosyncratic nature of multivariate solutions or because of the lack of the validation studies. PMID:26733749

Revision Stapedectomy with Necrosis of the Long Process of the Incus: Does the Degree of Necrosis Matter? A Retrospective Clinical Study.

PubMed

Ghonim, Mohamed; Shabana, Yousef; Ashraf, Bassem; Salem, Mohamed

2017-04-01

To discuss the different modalities for managing necrosis of the long process of the incus in revision stapedectomy on the basis of the degree of necrosis and compare the results with those reported in the literature. Thirty-six patients underwent revision stapedectomy with the necrosis of the long process of the incus from 2009 to 2016. The patients were divided into three groups on the basis of the degree of necrosis. For group A (minimal necrosis), augmentation technique with bone cement was performed. For group B (partial necrosis), the cement plug technique was performed. For group C (sever necrosis), malleus relocation with malleovestibulopexy was performed using reshaped necrosed incus. Air and bone conduction thresholds at frequencies of 500-3000 Hz were reviewed pre- and postoperatively using conventional audiometry. The air-bone gap (ABG) and bone conduction thresholds were measured. Postoperative ABG was reduced to <10 dB in 28 cases (77.8%) and <20 dB in all cases (100%). There was no significant change in postoperative bone conduction thresholds. The mean patient follow-up duration was 23 (range, 18-36) months. The cement plug technique was used in 75% of cases. Managing necrosis of the long process of the incus in revision stapedectomy should be considered according to the degree of necrosis. The cement plug technique is considered to be a reasonable option in most cases. Malleus relocation with malleovestibulopexy is an effective alternative to prosthesis.

[Assessment of the hearing results in tympanoplasties with the use of palisade-technique].

PubMed

Wielgosz, Romuald; Mroczkowski, Edward

2006-01-01

The cartilage has been successfuly used in reconstructive ear surgery for more than one hundred years. Histologic study of autografts cartilage (tragal or conchal) showed good long-term preservation of cartilage cells. The aim of this paper is to assess the hearing results in tympanoplasties with the use of cartilage palisade technique. The retrospective analysis concerned 108 operated clinical cases. The cartilage palisade technique was performed in 28 tympanoplasties type I, 47 tympanoplasties type II, 21 tympanoplasties type III with columella and in 2 tympanoplasties type IV. Clinical assessment included otoscopy, test for eustachian tube ventilation, test with tuning fork, audiometry on a range 0,5, 1, 2 kHz and subjective evaluation based on questionaire. The Air Bone Gap (ABG) was noted as follows: < 10 dB among 67,8% of patients and 11-20 dB among 21,4% of patients in tympanoplasty type I. In tympanoplasty type II the ABG was responsively: < 10 dB - 80% patients, 11-20 dB - 10% patients. In the type III of tympanoplasty 40,4% of patients showed ABG < 10 dB and 42,5% of patients 11-20 dB. In the type III with columella we noted 15% patients with ABG < 10 dB and 65% of them with ABG 11-20 dB. The cartilage is a good autograft for reconstruction of the tympanic membrane, middle ear and the auditory wall because of stability and lack of secondary perforations. Long-term results in hearing are also satisfactory.

Diabetes mellitus and sensorineural hearing loss: is there an association? Baseline of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).

PubMed

Samelli, Alessandra G; Santos, Itamar S; Moreira, Renata R; Rabelo, Camila M; Rolim, Laurie P; Bensenõr, Isabela J; Lotufo, Paulo A

2017-01-01

Although several studies have investigated the effects of diabetes on hearing loss, the relationship between these two conditions remains unclear. Some studies have suggested that diabetes may cause sensorineural hearing loss, whereas others have failed to find an association. The biggest challenge in investigating the association between diabetes and hearing loss is the presence of confounding variables and the complexity of the auditory system. Our study investigated the association between diabetes and sensorineural hearing loss. We evaluated the influence of time from diabetes diagnosis on this association after controlling for age, gender, and hypertension diagnosis and excluding those subjects with exposure to noise. This cross-sectional study evaluated 901 adult and elderly Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) participants from São Paulo, Brazil who underwent audiometry testing as part of ELSA-Brasil's baseline assessment. Hearing thresholds and speech test results were significantly worse in the group with diabetes than in the group without diabetes. However, no significant differences were found between participants with and without diabetes after adjusting for age, gender, and the presence of hypertension. Hearing thresholds were not affected by occupational noise exposure in the groups with and without diabetes. In addition, no association between the duration of diabetes and hearing thresholds was observed after adjusting for age, gender, and hypertension. We found no association between the duration of diabetes and worse hearing thresholds after models were adjusted for age, gender, and the presence of hypertension.

A software tool for pure‑tone audiometry. Classification of audiograms for inclusion of patients in clinical trials. English version.

PubMed

Rahne, T; Buthut, F; Plößl, S; Plontke, S K

2016-03-01

Selecting subjects for clinical trials on hearing loss therapies relies on the patient meeting the audiological inclusion criteria. In studies on the treatment of idiopathic sudden sensorineural hearing loss, the patient's acute audiogram is usually compared with a previous audiogram, the audiogram of the non-affected ear, or a normal audiogram according to an ISO standard. Generally, many more patients are screened than actually fulfill the particular inclusion criteria. The inclusion criteria often require a calculation of pure-tone averages, selection of the most affected frequencies, and calculation of hearing loss differences. A software tool was developed to simplify and accelerate this inclusion procedure for investigators to estimate the possible recruitment rate during the planning phase of a clinical trial and during the actual study. This tool is Microsoft Excel-based and easy to modify to meet the particular inclusion criteria of a specific clinical trial. The tool was retrospectively evaluated on 100 patients with acute hearing loss comparing the times for classifying automatically and manually. The study sample comprised 100 patients with idiopathic sudden sensorineural hearing loss. The age- and sex-related normative audiogram was calculated automatically by the tool and the hearing impairment was graded. The estimated recruitment rate of our sample was quickly calculated. Information about meeting the inclusion criteria was provided instantaneously. A significant reduction of 30 % in the time required for classifying (30 s per patient) was observed.

A prospective study on radiation-induced changes in hearing function

DOE Office of Scientific and Technical Information (OSTI.GOV)

Herrmann, Franziska; Doerr, Wolfgang; Experimental Center, Medical Faculty Carl Gustav Carus, University of Technology-Dresden, Dresden

Purpose: To quantitate changes in hearing function after radiotherapy for head-and-neck tumors. Methods and Materials: At the Department of Radiotherapy and Radiation Oncology, 32 patients were irradiated for head-and-neck tumors. Three-dimensional treatment planning was applied. Total tumor doses were 30.0-77.6 Gy, local doses to the inner ear (n = 64) ranged from 1.7 to 64.3 Gy. Audiometry was performed before the onset of radiotherapy (RT), at a tumor dose of 40 Gy or at the end of palliative treatment, at the end of curative RT, and 2-6 months post-RT. Assays applied were frequency-specific threshold measurements for air and bone conduction,more » measurements according to Weber and Rinne, tympanometry and assessment of the stapedius reflex. Results: Age and prior disease significantly decreased, whereas previous or concurrent alcohol consumption significantly increased hearing ability. A significant reduction in hearing ability during RT was found for high frequencies (at 40 Gy) and low frequencies (at end of RT), which persisted after RT. No differences were observed for air or bone conduction. None of the other assays displayed time- or dose-dependent changes. Dose-effect analyses revealed an ED50 (dose at which a 50% incidence is expected) for significant changes in hearing thresholds (15 dB) in the range of 20-25 Gy, with large confidence limits. Conclusions: Radiation effects on hearing ability were confined to threshold audiogram values, which started during the treatment without reversibility during 6 months postradiotherapy.« less

Sensorineural Hearing Impairment and Subclinical Atherosclerosis in Rheumatoid Arthritis Patients Without Traditional Cardiovascular Risk Factors

PubMed Central

MACIAS-REYES, Hector; DURAN-BARRAGAN, Sergio; CARDENAS-CONTRERAS, Cynthia R.; CHAVEZ-MARTIN, Cesar G.; GOMEZ-BAÑUELOS, Eduardo; NAVARRO-HERNANDEZ, Rosa E.; YANOWSKY-GONZALEZ, Carlos O.; GONZALEZ-LOPEZ, Laura; GAMEZ-NAVA, Jorge I.

2016-01-01

Objectives This study aims to evaluate the association of hearing impairment with carotid intima-media thickness and subclinical atherosclerosis in rheumatoid arthritis (RA) patients. Patients and methods A total of 41 RA patients (2 males, 39 females; mean age 46.5±10.2 years; range 20 to 63 years) with no known traditional cardiovascular risk factors were included. Routine clinical and laboratory assessments for RA patients were performed. Pure tone air (250-8000 Hz) and bone conduction (250-6000 Hz) thresholds were obtained, tympanograms and impedance audiometry were conducted. Sensorineural hearing impairment was defined if the average thresholds were ≥25 decibels. Carotid intima-media thickness was assessed and classified with a cut-off point of 0.6 mm. Results Thirteen patients (31.7%) had normal audition, while 28 (68.3%) had hearing impairment. Of these, 22 had bilateral sensorineural hearing impairment. Four patients had conductive hearing impairment (right in three patients and left in one patient). Patients with sensorineural hearing impairment had increased carotid intima-media thickness in the media segment of carotid common artery compared to patients with normal hearing (right ear p=0.007; left ear p=0.075). Thickening of the carotid intima-media thickness was associated with sensorineural hearing impairment in RA patients. Conclusion Rheumatoid arthritis patients should be evaluated by carotid intima-media thickness as a possible contributing factor of hearing impairment in patients without cardiovascular risk factors. PMID:29900940

Individual differences reveal correlates of hidden hearing deficits.

PubMed

Bharadwaj, Hari M; Masud, Salwa; Mehraei, Golbarg; Verhulst, Sarah; Shinn-Cunningham, Barbara G

2015-02-04

Clinical audiometry has long focused on determining the detection thresholds for pure tones, which depend on intact cochlear mechanics and hair cell function. Yet many listeners with normal hearing thresholds complain of communication difficulties, and the causes for such problems are not well understood. Here, we explore whether normal-hearing listeners exhibit such suprathreshold deficits, affecting the fidelity with which subcortical areas encode the temporal structure of clearly audible sound. Using an array of measures, we evaluated a cohort of young adults with thresholds in the normal range to assess both cochlear mechanical function and temporal coding of suprathreshold sounds. Listeners differed widely in both electrophysiological and behavioral measures of temporal coding fidelity. These measures correlated significantly with each other. Conversely, these differences were unrelated to the modest variation in otoacoustic emissions, cochlear tuning, or the residual differences in hearing threshold present in our cohort. Electroencephalography revealed that listeners with poor subcortical encoding had poor cortical sensitivity to changes in interaural time differences, which are critical for localizing sound sources and analyzing complex scenes. These listeners also performed poorly when asked to direct selective attention to one of two competing speech streams, a task that mimics the challenges of many everyday listening environments. Together with previous animal and computational models, our results suggest that hidden hearing deficits, likely originating at the level of the cochlear nerve, are part of "normal hearing." Copyright © 2015 the authors 0270-6474/15/352161-12$15.00/0.

Systematic assessment of noise amplitude generated by toys intended for young children.

PubMed

Mahboubi, Hossein; Oliaei, Sepehr; Badran, Karam W; Ziai, Kasra; Chang, Janice; Zardouz, Shawn; Shahriari, Shawn; Djalilian, Hamid R

2013-06-01

To systematically evaluate the noise generated by toys targeted for children and to compare the results over the course of 4 consecutive holiday shopping seasons. Experimental study. Academic medical center. During 2008-2011, more than 200 toys marketed for children older than 6 months were screened for loudness. The toys with sound output of more than 80 dBA at speaker level were retested in a soundproof audiometry booth. The generated sound amplitude of each toy was measured at speaker level and at 30 cm away from the speaker. Ninety different toys were analyzed. The mean (SD) noise amplitude was 100 (8) dBA (range, 80-121 dBA) at the speaker level and 80 (11) dBA (range, 60-109 dBA) at 30 cm away from the speaker. Eighty-eight (98%) had more than an 85-dBA noise amplitude at speaker level, whereas 19 (26%) had more than an 85-dBA noise amplitude at a 30-cm distance. Only the mean noise amplitude at 30 cm significantly declined during the studied period (P < .001). There was no significant difference in mean noise amplitude of different toys specified for different age groups. Our findings demonstrate the persistence of extremely loud toys marketed for very young children. Acoustic trauma from toys remains a potential risk factor for noise-induced hearing loss in this age group, warranting promotion of public awareness and regulatory considerations for manufacture and marketing of toys.

How do teachers with self-reported voice problems differ from their peers with self-reported voice health?

PubMed

Lyberg Åhlander, Viveka; Rydell, Roland; Löfqvist, Anders

2012-07-01

This randomized case-control study compares teachers with self-reported voice problems to age-, gender-, and school-matched colleagues with self-reported voice health. The self-assessed voice function is related to factors known to influence the voice: laryngeal findings, voice quality, personality, psychosocial and coping aspects, searching for causative factors of voice problems in teachers. Subjects and controls, recruited from a teacher group in an earlier questionnaire study, underwent examinations of the larynx by high-speed imaging and kymograms; voice recordings; voice range profile; audiometry; self-assessment of voice handicap and voice function; teaching and environmental aspects; personality; coping; burnout, and work-related issues. The laryngeal and voice recordings were assessed by experienced phoniatricians and speech pathologists. The subjects with self-assessed voice problems differed from their peers with self-assessed voice health by significantly longer recovery time from voice problems and scored higher on all subscales of the Voice Handicap Index-Throat. The results show that the cause of voice dysfunction in this group of teachers with self-reported voice problems is not found in the vocal apparatus or within the individual. The individual's perception of a voice problem seems to be based on a combination of the number of symptoms and of how often the symptoms occur, along with the recovery time. The results also underline the importance of using self-assessed reports of voice dysfunction. Copyright © 2012 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Noise-induced hearing loss in workers exposed to urban stressors.

PubMed

Caciari, Tiziana; Rosati, Maria Valeria; Casale, Teodorico; Loreti, Beatrice; Sancini, Angela; Riservato, Roberto; Nieto, Hector A; Frati, Paola; Tomei, Francesco; Tomei, Gianfranco

2013-10-01

The technological and industrial progress together with the intensification of vehicular traffic and the adoption of new social habits are the cause of an increasing noise pollution with possible negative effects on the auditory system. This study aims to assess the noise exposure levels and the effects on the hearing threshold in outdoor and indoor male workers of a big Italian city. The study was carried out on 357 outdoor male workers, exposed to urban noise and on a control group of 357 unexposed indoor workers. Noise levels were measured in 30 outdoor and indoor areas. The subjects underwent tonal liminal audiometry in order to determine the value of their hearing threshold. During their working activity, outdoor and indoor workers are exposed to different noise levels LEX<80 dB(A). At mid-low frequencies (250-2000 Hz), the results show significant differences in the average values of hearing threshold between the two groups in both ears and for all age classes; there are no significant differences between the two groups at higher frequencies. The outdoor noise levels measured are not usually ototoxic and the hearing loss at mid-low frequencies is not characteristic of the exposure to industrial noise. For these reasons the Authors hypothesize that the results may be due to the combined effect of the exposure to noise and to ototoxic air pollutants. The impairment of speech frequencies is disabling and involves the risk of missed forensic recognition. Copyright © 2013 Elsevier B.V. All rights reserved.

Assessment of noise levels generated by music shops in an urban city in Nigeria.

PubMed

Ebare, M N; Omuemu, V O; Isah, E C

2011-09-01

To assess the level of noise generated by music shops in an urban city in Nigeria. Cross-sectional, descriptive study. The study involved music shops in three out of eight identified clusters of market areas in Benin City. A semi-structured, researcher-administered questionnaire was also used to collect data from music shop owners. Noise levels generated by speakers in the music shops were measured using a sound level meter, and blood pressure measurements were taken with a mercury sphygmomanometer. Of the 250 music shops studied, more than 90.0% generated noise levels >85 dB, and 54.8% had a continuous pattern of noise. Longer duration of working years was significantly associated with decreased hearing (P = 0.01), shouting when talking (P = 0.04) and high blood pressure (P = 0.003). The position of music dealers in relation to the speakers was significantly associated with shouting when talking (P = 0.000). A significant association was found between higher levels of noise and high blood pressure (P = 0.004). This study found very high levels of noise in music shops, which could be a source of occupational noise exposure among music dealers. Enlightenment campaigns on the hazards of exposure to loud noise and periodic audiometry examinations are recommended for this occupational group. Copyright © 2011 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Auditory steady-state response in cochlear implant patients.

PubMed

Torres-Fortuny, Alejandro; Arnaiz-Marquez, Isabel; Hernández-Pérez, Heivet; Eimil-Suárez, Eduardo

2018-03-19

Auditory steady state responses to continuous amplitude modulated tones at rates between 70 and 110Hz, have been proposed as a feasible alternative to objective frequency specific audiometry in cochlear implant subjects. The aim of the present study is to obtain physiological thresholds by means of auditory steady-state response in cochlear implant patients (Clarion HiRes 90K), with acoustic stimulation, on free field conditions and to verify its biological origin. 11 subjects comprised the sample. Four amplitude modulated tones of 500, 1000, 2000 and 4000Hz were used as stimuli, using the multiple frequency technique. The recording of auditory steady-state response was also recorded at 0dB HL of intensity, non-specific stimulus and using a masking technique. The study enabled the electrophysiological thresholds to be obtained for each subject of the explored sample. There were no auditory steady-state responses at either 0dB or non-specific stimulus recordings. It was possible to obtain the masking thresholds. A difference was identified between behavioral and electrophysiological thresholds of -6±16, -2±13, 0±22 and -8±18dB at frequencies of 500, 1000, 2000 and 4000Hz respectively. The auditory steady state response seems to be a suitable technique to evaluate the hearing threshold in cochlear implant subjects. Copyright © 2018 Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. Publicado por Elsevier España, S.L.U. All rights reserved.

EFFECT OF SMOKING ON TRASIENTLY EVOKED OTOACOUSTIC EMISSION.

PubMed

Gegenava, Kh; Japaridze, Sh; Sharashenidze, N; Jalabadze, G; Kevanishvili, Z

2016-01-01

Evoked otoacoustic emissions, EOAEs, are proved to be sounds aroused in response to external acoustic stimulus by the cochlear outer hair cells. Transiently evoked otoacoustic emissions, TEOAEs, are the most clinically utilized EOAEs. TEOAEs are detectable in 98% of people with normal hearing, regardless of age or sex, while two ears of any individual produce similar TEOAEs waveforms. The objective of the presented study was the comparison of TEOAE magnitudes in cigarette smokers and nonsmokers. The TEOAE occurrence and characteristics in individuals of both samples with audiometrically proved hearing losses and in those without were also specifically examined. 30 smokers and and 30 nonsmokers within the age range of 30-59 years were involved in the present study after informed concent. OAEs were performed to each subject by Madsen Capella's-OAE/middle ear analyzer-GN Otometrics, (Danmark). After OAE testing each subject was performed routine pure-tone audiometry and tympanometry. Obtained results were statistically treated by the student's t-distribution. According to our results 76.6% of smokers and 3.33% of nonsmokers had marked different level decrease in TEOAE amplitude. Audiographic measurments showed altered audiogram in 6.7% of smokers and in 3.33% of nonsmokers. Based on the above mentioned results we suppose that smoking has significant influence on hearing function, especially on cochlear apparatus; At the same time, TOEAE, as a sensitive method can be used for very early detection of hearing loss, even when there are neither any subjective complains nor some changies on audiogram.

Is it necessary to occlude the ear in bone-conduction testing at 4 kHz, in order to prevent air-borne radiation affecting the results?

PubMed

Tate Maltby, Maryanne; Gaszczyk, David

2015-01-01

To re-evaluate the current BSA recommendation that the test ear should be occluded during the bone-conduction procedure at frequencies above 2 kHz to prevent audible air-borne radiation. Pure-tone audiometry was undertaken during routine hearing tests. The audiograms of fifty-two ears met the criteria for the study and were included. Bone conduction at 4 kHz was tested in three different conditions: test ear open/occluded by earplug and occluded by circumaural earphone. Forty-four adults aged 41-77 years with average hearing levels from normal to severe loss. All complied fully with the test procedure. No audiogram had a significant conductive element. There was no significant difference in each of the three test situations. Only two audiograms showed any (5 dB) difference at 4 kHz when bone conduction was retested with the ear occluded. The errors that result in a false air-bone gap at 4 kHz would not appear to be due to air-borne radiation. Failure to occlude the ear canal at 4 kHz, where air-borne radiation is greatest, makes no significant difference to the audiometric results. It is therefore suggested that it is unnecessary to block the test ear during routine pure-tone bone-conduction testing to prevent audible air-borne radiation, and that this should no longer form part of normal clinical practice.

Clinical characteristics of pediatric granular myringitis.

PubMed

Levi, Jessica R; Ames, Julie A; Gitman, Lyuba; Morlet, Thierry; O'Reilly, Robert C

2013-02-01

To determine the clinical characteristics of children with granular myringitis. Case series with chart review of children with granular myringitis. Tertiary care children's hospitals in Delaware and Florida. From July 1, 2006, to June 30, 2011, 15 patients were identified with granular myringitis based on International Classification of Diseases, Ninth Revision code 384.1 (10 male, 5 female; 10 left-sided, 5 right-sided). Average age at onset was 10 years (range, 4-18 years). Average length of symptoms was 21 months (range, 3-48 months). Thirteen of the 15 patients (87%) had myringotomy tube placement prior to diagnosis of myringitis, and 11 had a previous perforation (73%). Eleven myringoplasties were performed on 8 (53%) patients prior to the onset of granular myringitis (5 fascia, 2 fat, 2 cartilage, 1 paper patch, and 1 at an outside hospital that was unknown). A total of 27 otolaryngologic surgical procedures were done on 14 of 15 patients. Ten patients (67%) had audiometry performed, and 6 (40%) had ear cultures. Medical treatment included ciprofloxacin and dexamethasone otic drops in all patients, oral antibiotics in 4 patients, and additional topical agents in 8 patients. Two patients had laser resurfacing, and 1 patient had surgical curettage. Five patients had long-term remission, 8 had intermittent remission, and 2 had no remission of their symptoms. Granular myringitis is a chronic, recalcitrant disease typically preceded by myringotomy and tube placement or myringoplasty/tympanoplasty. Medical and surgical intervention is varied and often does not lead to permanent resolution of the disease.

Communication benefits of bilateral cochlear implantation. Retrospective study in 12-year-old children.

PubMed

Guerra-Jiménez, Gloria; Viera Artiles, Jaime; Mateos, Mar; González Aguado, Rocío; Falcón González, Juan Carlos; Borkoski Barreiro, Silvia; Ramos Macías, Angel

2013-01-01

Some studies suggest that simultaneous or sequential cochlear implantation in a short period of time offers additional benefits. There is controversy regarding the existence of an age limit after which a second implantation offers less benefit for the acquisition of communication skills. The objectives of this study were to confirm that sequential cochlear implantation offers benefits compared to unilateral implantation and to study whether, at 12 years of age, there are significant differences regarding the age at the time of the second implantation. Descriptive and observational study of a population of 12-year-old children carrying cochlear implants (n=69). A liminal pure tone audiometry and an open-field verbal discrimination test (disyllables, common phrases in an open context, with and without noise) were conducted to evaluate audiological benefits. Verbal discrimination results were better among patients who had been implanted before the age of 2 years, although the differences were not statistically significant (P>.5). Children who had received bilateral cochlear implants before the age of 2 years and with a period less than 4 years between both implants presented better verbal discrimination percentages (P<.05). In our sample, early cochlear implantation with a short period between both implants provided significant benefits regarding intelligibility. There seem to be a specific age and interimplant period, after which the auditory benefit on the first implant becomes reduced. Copyright © 2013 Elsevier España, S.L. All rights reserved.

No Association Between Time of Onset of Hearing Loss (Childhood Versus Adulthood) and Self-Reported Hearing Handicap in Adults.

PubMed

Aarhus, Lisa; Tambs, Kristian; Engdahl, Bo

2015-12-01

This study examined the association between time of onset of hearing loss (childhood vs. adulthood) and self-reported hearing handicap in adults. This is a population-based cohort study of 2,024 adults (mean = 48 years) with hearing loss (binaural pure-tone average 0.5-4 kHz ≥ 20 dB HL) who completed a hearing handicap questionnaire. In childhood, the same persons (N = 2,024) underwent audiometry in a school investigation (at ages 7, 10, and 13 years), in which 129 were diagnosed with sensorineural hearing loss (binaural pure-tone average 0.5-4 kHz ≥ 20 dB HL), whereas 1,895 had normal hearing thresholds. Hearing handicap was measured in adulthood as the sum-score of various speech perception and social impairment items (15 items). The sum-score increased with adult hearing threshold level (p < .001). After adjustment for adult hearing threshold level, hearing aid use, adult age, sex, and socioeconomic status, there was no significant difference in hearing handicap sum-score between the group with childhood-onset hearing loss (n = 129) and the group with adult-onset hearing loss (n = 1,895; p = .882). Self-reported hearing handicap in adults increased with hearing threshold level. After adjustment for adult hearing threshold level, this cohort study revealed no significant association between time of onset of hearing loss (childhood vs. adulthood) and self-reported hearing handicap.

No Association Between Time of Onset of Hearing Loss (Childhood Versus Adulthood) and Self-Reported Hearing Handicap in Adults

PubMed Central

Tambs, Kristian; Engdahl, Bo

2015-01-01

Purpose This study examined the association between time of onset of hearing loss (childhood vs. adulthood) and self-reported hearing handicap in adults. Methods This is a population-based cohort study of 2,024 adults (mean = 48 years) with hearing loss (binaural pure-tone average 0.5–4 kHz ≥ 20 dB HL) who completed a hearing handicap questionnaire. In childhood, the same persons (N = 2,024) underwent audiometry in a school investigation (at ages 7, 10, and 13 years), in which 129 were diagnosed with sensorineural hearing loss (binaural pure-tone average 0.5–4 kHz ≥ 20 dB HL), whereas 1,895 had normal hearing thresholds. Results Hearing handicap was measured in adulthood as the sum-score of various speech perception and social impairment items (15 items). The sum-score increased with adult hearing threshold level (p < .001). After adjustment for adult hearing threshold level, hearing aid use, adult age, sex, and socioeconomic status, there was no significant difference in hearing handicap sum-score between the group with childhood-onset hearing loss (n = 129) and the group with adult-onset hearing loss (n = 1,895; p = .882). Conclusion Self-reported hearing handicap in adults increased with hearing threshold level. After adjustment for adult hearing threshold level, this cohort study revealed no significant association between time of onset of hearing loss (childhood vs. adulthood) and self-reported hearing handicap. PMID:26649831

In-Air Evoked Potential Audiometry of Grey Seals (Halichoerus grypus) from the North and Baltic Seas

PubMed Central

Ruser, Andreas; Dähne, Michael; Sundermeyer, Janne; Lucke, Klaus; Houser, Dorian S.; Finneran, James J.; Driver, Jörg; Pawliczka, Iwona; Rosenberger, Tanja; Siebert, Ursula

2014-01-01

In-air anthropogenic sound has the potential to affect grey seal (Halichoerus grypus) behaviour and interfere with acoustic communication. In this study, a new method was used to deliver acoustic signals to grey seals as part of an in-air hearing assessment. Using in-ear headphones with adapted ear inserts allowed for the measurement of auditory brainstem responses (ABR) on sedated grey seals exposed to 5-cycle (2-1-2) tone pips. Thresholds were measured at 10 frequencies between 1–20 kHz. Measurements were made using subcutaneous electrodes on wild seals from the Baltic and North Seas. Thresholds were determined by both visual and statistical approaches (single point F-test) and good agreement was obtained between the results using both methods. The mean auditory thresholds were ≤40 dB re 20 µPa peak equivalent sound pressure level (peSPL) between 4–20 kHz and showed similar patterns to in-air behavioural hearing tests of other phocid seals between 3 and 20 kHz. Below 3 kHz, a steep reduction in hearing sensitivity was observed, which differed from the rate of decline in sensitivity obtained in behavioural studies on other phocids. Differences in the rate of decline may reflect influence of the ear inserts on the ability to reliably transmit lower frequencies or interference from the structure of the distal end of the ear canal. PMID:24632891

A self-fitting hearing aid: need and concept.

PubMed

Convery, Elizabeth; Keidser, Gitte; Dillon, Harvey; Hartley, Lisa

2011-12-01

The need for reliable access to hearing health care services is growing globally, particularly in developing countries and in remotely located, underserved regions in many parts of the developed world. Individuals with hearing loss in these areas are at a significant disadvantage due to the scarcity of local hearing health care professionals and the high cost of hearing aids. Current approaches to making hearing rehabilitation services more readily available to underserved populations include teleaudiology and the provision of amplification devices outside of the traditional provider-client relationship. Both strategies require access to such resources as dedicated equipment and/or specially trained staff. Another possible strategy is a self-fitting hearing aid, a personal amplification device that is equipped with an onboard tone generator to enable user-controlled, automated, in situ audiometry; an onboard prescription to determine the initial hearing aid settings; and a trainable algorithm to enable user-controlled fine-tuning. The device is thus assembled, fitted, and managed by the user without the need for audiological or computer support. This article details the self-fitting concept and its potential application in both developing and developed countries. Potential advantages and disadvantages of such a device are discussed, and considerations for further investigations into the concept are presented. Overall, the concept is considered technologically viable with the main challenges anticipated to be development of clear, simple user instructions and a delivery model that ensures reliable supplies of instant-fit ear tips and batteries.

Short-Term Audiological Results of Diode Laser in Comparison with Manual Perforation in Stapes Surgery

PubMed Central

Hamerschmidt, Rogerio; Saab, Stephanie Sbizera; Carvalho, Bettina; Carmo, Carolina do

2018-01-01

Introduction  Diode laser is a new alternative in stapes surgery for otosclerosis. The present study is the first to compare the short-term results of the surgery performed using diode laser to those obtained through the conventional fenestration technique. Objective  To use audiometry to establish a comparative analysis between the functional results obtained through surgery for otosclerosis using diode laser and the conventional technique. Method  Audiometric evaluation of 12 patients submitted to stapes surgery for otosclerosis, using diode laser or conventional fenestration by needle and drills, between 2014 and 2015. Each group was composed of 6 patients. Pre and post-operative measures were compared for three months in both groups. The speech recognition threshold, the air and bone conduction threshold, as well as the gap between them at 500 Hz, 1 KHz, 2 KHz and 4 KHz were measured. Results  Significant difference in bone conduction and SRT was observed when compared post- and preoperative results in the diode group. However diode and conventional technique groups presented significant differences in air conduction and air-bone gap, suggesting that both can provide functional improvement. Conclusion  Laser stapedotomy is a safe technique with good results. Both laser surgery and the conventional technique have improved the hearing of patients with a discreet advantage for the diode laser. Further prospective and randomized clinical trials are required to disclose all possible benefits of the stapes surgery using diode laser. PMID:29619098

Short-Term Audiological Results of Diode Laser in Comparison with Manual Perforation in Stapes Surgery.

PubMed

Hamerschmidt, Rogerio; Saab, Stephanie Sbizera; Carvalho, Bettina; Carmo, Carolina do

2018-04-01

Introduction  Diode laser is a new alternative in stapes surgery for otosclerosis. The present study is the first to compare the short-term results of the surgery performed using diode laser to those obtained through the conventional fenestration technique. Objective  To use audiometry to establish a comparative analysis between the functional results obtained through surgery for otosclerosis using diode laser and the conventional technique. Method  Audiometric evaluation of 12 patients submitted to stapes surgery for otosclerosis, using diode laser or conventional fenestration by needle and drills, between 2014 and 2015. Each group was composed of 6 patients. Pre and post-operative measures were compared for three months in both groups. The speech recognition threshold, the air and bone conduction threshold, as well as the gap between them at 500 Hz, 1 KHz, 2 KHz and 4 KHz were measured. Results  Significant difference in bone conduction and SRT was observed when compared post- and preoperative results in the diode group. However diode and conventional technique groups presented significant differences in air conduction and air-bone gap, suggesting that both can provide functional improvement. Conclusion  Laser stapedotomy is a safe technique with good results. Both laser surgery and the conventional technique have improved the hearing of patients with a discreet advantage for the diode laser. Further prospective and randomized clinical trials are required to disclose all possible benefits of the stapes surgery using diode laser.

Evaluation of tinnitus patients by audiometric configuration.

PubMed

Kim, Su Il; Kim, Myung Gu; Kim, Sung Su; Byun, Jae Yong; Park, Moon Suh; Yeo, Seung Geun

2016-01-01

Although tinnitus patients have different audiometric configuration, we evaluated them using the same approach. Thus we analyzed the clinical features of patients with subjective tinnitus classified according to audiometric configuration. The study cohort consisted of 123 patients with subjective tinnitus who visited the tinnitus clinic from April 2013 to April 2014. Patients with a previous history of otologic disease or migrainous vertigo were excluded. Factors evaluated included pure tone audiometry, tinnitogram, auditory brainstem response (ABR), distortion product otoacoustic emissions (DPOAEs) and transient evoked otoacoustic emissions (TEOAEs). Tinnitus patients could be divided into three groups: Flat, high frequency gently sloping (HFGS) and high frequency steeply sloping (HFSS). HFGS showed female predominance and HFSS male predominance (p<0.05 each). THI score was higher in the HFGS than in the other groups (p<0.05). Tinnitus pitch and occupations varied, but showed specific tendencies in each group. On ABR, the HFSS group showed significant prolongation of wave I, III, and V latencies (p<0.05 each). On DPOAEs, the HFSS group showed significantly lower response rates at 3, 4, and 6 kHz (p<0.05 each). TEOAE normal rates were significantly higher in the Flat than in the HFGS and HFSS groups (p<0.05). Average pure tone thresholds were similar, but threshold values at high frequencies, ABR, DPOAEs, and TEOAEs differed among the groups. Therefore, different access to tinnitus patients could be required according to audiometric shape. Copyright © 2016 Elsevier Inc. All rights reserved.

[Bilateral cochlear implants in children: acquisition of binaural hearing].

PubMed

Ramos-Macías, Angel; Deive-Maggiolo, Leopoldo; Artiles-Cabrera, Ovidio; González-Aguado, Rocío; Borkoski-Barreiro, Silvia A; Masgoret-Palau, Elizabeth; Falcón-González, Juan C; Bueno-Yanes, Jorge

2013-01-01

Several studies have indicated the benefit of bilateral cochlear implants in the acquisition of binaural hearing and bilateralism. In children with cochlear implants, is it possible to achieve binaurality after a second implant? When is the ideal time to implant them? The objective of this study was to analyse the binaural effect in children with bilateral implants and the differences between subjects with simultaneous and sequential implants with both short and long intervals. There were 90 patients between 1 and 2 years of age (the first surgery), implanted between 2000 and 2008. Of these, 25 were unilateral users and 65 bilateral; 17 patients had received simultaneous implants, 29 had sequential implants before 12 months after the first one (short interimplant period) and 19 after 12 months (long period). All of them were tested for silent and noisy verbal perception and a tonal threshold audiometry was performed. The silent perception test showed that the simultaneous and short period sequential implant patients (mean: 84.67%) versus unilateral and long period sequential implants (mean: 79.66%), had a statistically-significant difference (P=0,23). Likewise, the noisy perception test showed a difference with statistical significance (P=0,22) comparing the simultaneous implanted and short period sequential implants (mean, 77.17%) versus unilateral implanted and long period sequential ones (mean: 69.32%). The simultaneous and sequential short period implants acquired the advantages of binaural hearing. Copyright © 2012 Elsevier España, S.L. All rights reserved.

Middle cranial fossa approach for the repair of spontaneous cerebrospinal fluid leaks to the middle ear.

PubMed

Altuna, Xabier; Navarro, Juan José; García, Leire; Ugarte, Ane; Thomas, Izaskun

Spontaneous cerebrospinal fluid (CSF) leaks to the middle ear due to tegmen tympani defects can result in hearing loss or hypoacusis and predispose to meningitis as well as other neurological complications. Surgical repair of the defect can be performed through a middle cranial fossa (MCF) approach or a transmastoid approach. We conducted a retrospective study of the patients in our Department due to a spontaneous CSF leak to the middle ear treated using a MCF approach during a 6-year period (2009-2014). Thirteen patients with spontaneous CSF leak to the middle ear were treated with this approach. The primary and first symptom in all of them was conductive hearing loss. In all cases, the defect or defects were closed in a multilayer manner using muscle, temporalis fascia and cortical bone. Minimum follow-up in this series was 14 months, with successful closure in all but one patient (who required reintervention). We found no intra- or postoperative complications due to the craniotomy, and the audiometry improved and normalised in all cases except for the failed case. The MCF approach with a multilayer closure of the defect is an effective technique for repairing spontaneous CSF leaks to the middle ear and for restoring hearing in these patients. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

Comparative study between unilateral and bilateral cochlear implantation in children of 1 and 2 years of age.

PubMed

Escorihuela García, Vicente; Pitarch Ribas, María Ignacia; Llópez Carratalá, Ignacio; Latorre Monteagudo, Emilia; Morant Ventura, Antonio; Marco Algarra, Jaime

2016-01-01

The studies that have evaluated the effectiveness of bilateral cochlear implantation in children suggest an improvement in hearing about sound localization and speech discrimination. In this paper we show the differences in audio-linguistic achievements with early bilateral cochlear implantation versus unilateral, and differences between simultaneous and sequential bilateral implantation. We present 88 children with bilateral profound sensorineural hearing loss, treated with bilateral cochlear implantation in 32 cases and unilateral in 56 cases, during the first 12 months (27 children) of life and between 12 and 24 months (61 children). We conducted a statistical comparison of both groups in the audiometry, IT-Mais, Nottingham, LittlEars scales and verbal tests. No significant differences in hearing thresholds and questionnaires between unilateral and bilateral implantation were detected in either the first or second year. Verbal tests do show statistically significant differences: children with bilateral cochlear implant obtain 100% recognition of disyllabic and phrases within 2-3 years after implantation whilst children with one implant do not obtain those results at 5 years after surgery. No differences between simultaneous and sequential bilateral implantation were detected. We emphasize the importance of ensuring good early audiological screening, to carry out an early and bilateral cochlear implantation with the consequent development of audio-language skills similar to normal hearing children. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

Clinical use of vestibular evoked myogenic potentials in the evaluation of patients with air-bone gaps.

PubMed

Zhou, Guangwei; Poe, Dennis; Gopen, Quinton

2012-10-01

To determine the value of vestibular evoked myogenic potential (VEMP) test in clinical evaluation of air-bone gaps. Retrospective case review. Tertiary referral center. A total of 120 patients underwent VEMP testing during clinical investigation of significant air-bone gaps in their audiograms. Otologic examination and surgeries, high-resolution computerized tomography (CT), air and bone audiometry, tympanometry, acoustic reflex, and VEMP test. Imaging studies demonstrating structural anomalies in the temporal bone. Audiologic outcomes of air-bone gaps and VEMP thresholds. Surgical findings confirming imaging results. Middle ear pathologies, such as otosclerosis and chronic otitis media, were identified in 50 patients, and all of them had absent VEMP responses elicited by air-conduction stimuli. Moreover, 13 of them had successful middle ear surgeries with closures of the air-bone gaps. Abnormally low VEMP thresholds were found in 71 of 73 ears with inner ear anomalies, such as semicircular canal dehiscence and enlarged vestibular aqueduct. Seven patients with superior semicircular canal dehiscence underwent plugging procedure via middle fossa approach, and VEMP thresholds became normalized after the surgery in 3 of them. VEMP test failed to provide accurate diagnosis in only 3 cases. Air-bone gaps may be a result of various otologic pathologies, and the VEMP test is useful during clinical evaluation, better than tympanometry and acoustic reflexes. To avoid unnecessary middle ear surgery for air-bone gaps with unknown or unsure cause, VEMP test should be used in the differential diagnosis before an expensive imaging study.

Characteristics of vestibular evoked myogenic potentials in children with enlarged vestibular aqueduct.

PubMed

Zhou, Guangwei; Gopen, Quinton

2011-01-01

To explore the characteristics of vestibular evoked myogenic potential (VEMP) in children with enlarged vestibular aqueduct (EVA) and to determine the diagnostic value of VEMP testing for this particular inner ear structural anomaly. Retrospective cohort study in a pediatric tertiary care facility. A total of 25 pediatric cases (37 ears) of EVA were identified with complete records, including otologic evaluation, CT scan of the temporal bone, and audiologic assessment. Results of audiometry, tympanometry, and VEMP testing were analyzed. Hearing loss was found in 97% (36/37) of the ears with EVA. Airbone gaps (conductive components) were found in all hearing losses with normal middle ear pressure and mobility. Abnormally low threshold VEMP responses were found in 92% (34/37) of the ears with EVA. VEMP responses were absent unilaterally in three EVA patients who had vestibular complaints. No clear correlation was found between the size of EVA and the audiologic findings. The presence of airbone gaps in children with EVA was found without apparent middle ear pathology. Characteristics of VEMP in EVA were lower thresholds and higher amplitudes despite of the presence of airbone gaps. The abnormally low threshold VEMP responses suggested a "third" window effect in the pathologic condition of EVA. Unilateral absence of VEMP may implicate peripheral vestibular impairment. The findings from our study are helpful in clinical evaluation of young children who usually give limited and ambiguous input regarding their hearing and vestibular problems.

Contribution of Vestibular-Evoked Myogenic Potential (VEMP) testing in the assessment and the differential diagnosis of otosclerosis

PubMed Central

Tramontani, Ourania; Gkoritsa, Eleni; Ferekidis, Eleftherios; Korres, Stavros G.

2014-01-01

Background The aim of this prospective clinical study was to evaluate the clinical importance of Vestibular-Evoked Myogenic Potentials (VEMPs) in the assessment and differential diagnosis of otosclerosis and otologic diseases characterized by “pseudo-conductive” components. We also investigated the clinical appearance of balance disorders in patients with otosclerosis by correlating VEMP results with the findings of caloric testing and pure tone audiometry(PTA). Material/Methods Air-conducted(AC) 4-PTA, bone-conducted(BC) 4-PTA, air-bone Gap(ABG), AC, BC tone burst evoked VEMP, and calorics were measured preoperatively in 126 otosclerotic ears. Results The response rate of the AC-VEMPs and BC-VEMPs was 29.36% and 44.03%, respectively. Statistical differences were found between the means of ABG, AC 4-PTA, and BC 4-PTA in the otosclerotic ears in relation to AC-VEMP elicitability. About one-third of patients presented with disequilibrium. A statistically significant interaction was found between calorics and dizziness in relation to PTA thresholds. No relationship was found between calorics and dizziness with VEMPs responses. Conclusions AC and BC VEMPs can be elicited in ears with otosclerosis. AC-VEMP is more vulnerable to conductive hearing loss. Evaluation of AC-VEMP thresholds can be added in the diagnostic work-up of otosclerosis in case of doubt, enhancing differential diagnosis in patients with air-bone gaps. Otosclerosis is not a cause of canal paresis or vertigo. PMID:24509900

Noise-induced hearing loss still a problem in shipbuilders: a cross-sectional study in goa, India.

PubMed

Bhumika, N; Prabhu, Gv; Ferreira, Am; Kulkarni, Mk

2013-01-01

Workplace safety regulations seek to mitigate noise-induced hearing loss (NIHL), conventionally associated with the shipbuilding industry. Despite this, are workers still predisposed to NIHL? To study the prevalence of NIHL among noise-exposed subjects in the shipbuilding industry in Goa and to compare it with that among the non-exposed population working in the same industry in relation to certain relevant factors. This is a cross-sectional study in the shipbuilding industry, Goa This study examined 552 workers: 276 shipbuilders and 276 office staff, of similar age, duration of employment and socio-economic status working at a shipbuilding enterprise. An interviewer-administered questionnaire was followed by audiometry. Values were presented as percentages, Mean (SD) and odds ratio (OR) and its 95% confidence interval (CI) (Woolfe's method). Fisher's exact test and binary logistic regression were used. P value of < 0.05 was taken as significant. SPSS version 16 was used. NIHL was found in 17 (6%) shipbuilders, while no office staff was detected to have this condition (OR = 37.29, 95% CI 22.42-62.18). The shipbuilders with NIHL were 52.5 years of age and had been employed for 30.4 years, on an average. None of the 17 cases of NIHL were found to be using earplugs consistently; 11 reported using them "sometimes" and six "never" used them. NIHL continues to affect shipbuilders, owing their non-compliance to workplace regulation. Health education is the need of the hour.

[Detection of occupational hazards in a large shipbuilding factory].

PubMed

Du, Weijia; Wang, Zhi; Zhang, Hai; Zhou, Liping; Huang, Minzhi; Liu, Yimin

2014-03-01

To provide evidence for the prevention and treatment of occupational diseases by the analysis of existing major occupational hazards and health conditions of workers in a large shipbuilding factory. Field investigation of occupational conditions was conducted to examine the existence of occupational hazards from 2009 to 2012 in a large shipbuilding factory, and then the results of physical examination among its workers were analyzed. Other than the metal dust (total dust), the levels of other dusts and manganese dioxide were beyond the national standard to various degrees, and through a sampling point detection, it was found that the levels of manganese dioxide exceeded the standard by 42.8%. The maximum time-weighted average concentration in individuals was 27.927 mg/m(3), much higher than the national standard limit. For harmful gas detection in individuals, xylene was 38.4%above the standard level (the highest concentration reached 1447.7 mg/m(3)); moreover, both toluene and ethylbenzene exceeded the national standard at different levels. Among the noise-exposed workers, 71%worked in the environment where the daily noise was above the limit of the national standard (85 dB). Physical examinations in 2010 and 2012 showed that the abnormal rate of audiometry in workers was higher than 15%. Dust (total dust), manganese dioxide, benzene, and noise are the main occupational hazards among the workers in the large shipbuilding factory, and strict protection and control for these hazards should be implemented for the workers in the factory.

Tinnitus in normally hearing patients: clinical aspects and repercussions.

PubMed

Sanchez, Tanit Ganz; Medeiros, Italo Roberto Torres de; Levy, Cristiane Passos Dias; Ramalho, Jeanne da Rosa Oiticica; Bento, Ricardo Ferreira

2005-01-01

Patients with tinnitus and normal hearing constitute an important group, given that findings do not suffer influence of the hearing loss. However, this group is rarely studied, so we do not know whether its clinical characteristics and interference in daily life are the same of those of the patients with tinnitus and hearing loss. To compare tinnitus characteristics and interference in daily life among patients with and without hearing loss. Historic cohort. Among 744 tinnitus patients seen at a Tinnitus Clinic, 55 with normal audiometry were retrospectively evaluated. The control group consisted of 198 patients with tinnitus and hearing loss, following the same protocol. We analyzed the patients' data as well as the tinnitus characteristics and interference in daily life. The mean age of the studied group (43.1 +/- 13.4 years) was significantly lower than that of the control group (49.9 +/- 14.5 years). In both groups, tinnitus was predominant in women, bilateral, single tone and constant, but there were no differences between both groups. The interference in concentration and emotional status (25.5% and 36.4%) was significantly lower in the studied group than that of the control group (46% and 61.6%), but it did not happen in regard to interference over sleep and social life. Patients with tinnitus and normal hearing showed similar characteristics when compared to those with hearing loss. However, the age of the patients and the interference over concentration and emotional status were significantly lower in this group.

A Challenging Form of Non-autoimmune Insulin-Dependent Diabetes in a Wolfram Syndrome Patient with a Novel Sequence Variant

PubMed Central

Paris, Liliana P; Usui, Yoshihiko; Serino, Josefina; Sá, Joaquim; Friedlander, Martin

2015-01-01

Wolfram syndrome type 1 is a rare, autosomal recessive, neurodegenerative disorder that is diagnosed when insulin-dependent diabetes of non-auto-immune origin and optic atrophy are concomitantly present. Wolfram syndrome is also designated by DIDMOAD that stands for its most frequent manifestations: diabetes insipidus, diabetes mellitus, optic atrophy and deafness. With disease progression, patients also commonly develop severe neurological and genito-urinary tract abnormalities. When compared to the general type 1 diabetic population, patients with Wolfram Syndrome have been reported to have a form of diabetes that is more easily controlled and with less microvascular complications, such as diabetic retinopathy. We report a case of Wolfram syndrome in a 16-year-old male patient who presented with progressive optic atrophy and severe diabetes with very challenging glycemic control despite intensive therapy since diagnosis at the age of 6. Despite inadequate metabolic control he did not develop any diabetic microvascular complications during the 10-year follow-up period. To further investigate potential causes for this metabolic idiosyncrasy, we performed genetic analyses that revealed a novel combination of homozygous sequence variants that are likely the cause of the syndrome in this family. The identified genotype included a novel sequence variant in the Wolfram syndrome type 1 gene along with a previously described one, which had initially been associated with isolated low frequency sensorineural hearing loss (LFSNHL). Interestingly, our patient did not show any abnormal findings with audiometry testing. PMID:26819810

Assessment of Impulse Noise Level and Acoustic Trauma in Military Personnel

PubMed Central

Rezaee, Maryam; Mojtahed, Mohammad; Ghasemi, Mohammad; Saedi, Babak

2012-01-01

Background: Military personnel are usually exposed to high levels of impulse noise (IN) which can lead to hearing loss. Objectives: The purpose of this study was to assess the effects of relatively low level exposure of impulse noise (IN) during shooting practice on hearing using pure tone audiometry (PTA) and transiently evoked otoacoustic emission (TEOAE) in military personnel. Materials and Methods: Forty male soldiers (mean age 20.08 years) were recruited for the study. Prior to their first shooting practice, PTA and TEOAE were recorded. After 15 minutes and one week post- practice PTA and TEOAE were compared. Results: Immediately after shooting practice significant differences in PTA at 500, 1000, and 4000 Hz were observed for the right ear and no significant difference at any frequency for the left ear. There was a significant difference in the amplitude of TEOAE 15 minutes after shooting practice at 500, 1000, 2000, 3000, and 4000 Hz in the right ear, while for the left ear the difference was significant at 1000 and 2000 Hz. One week after exposure a significant difference at 500 and 4000 Hz was found only in the right ear and a significant difference in the amplitude of TEOAE was observed at 500, 1000, 2000, 3000, and 4000 Hz. Conclusions: Even exposure lower than permissible levels may lead to acoustic trauma. TEOAE is more sensitive than PTA in detecting early hearing loss after military shooting exercises. Hearing protection equipment and appropriate surveillance programs are recommended. PMID:24749098

Speech-language pathology findings in patients with mouth breathing: multidisciplinary diagnosis according to etiology.

PubMed

Junqueira, Patrícia; Marchesan, Irene Queiroz; de Oliveira, Luciana Regina; Ciccone, Emílio; Haddad, Leonardo; Rizzo, Maria Cândida

2010-11-01

The purpose of this study was to identify and compare the results of the findings from speech-language pathology evaluations for orofacial function including tongue and lip rest postures, tonus, articulation and speech, voice and language, chewing, and deglutition in children who had a history of mouth breathing. The diagnoses for mouth breathing included: allergic rhinitis, adenoidal hypertrophy, allergic rhinitis with adenoidal hypertrophy; and/or functional mouth breathing. This study was conducted with on 414 subjects of both genders, from 2 to 16-years old. A team consisting of 3 speech-language pathologists, 1 pediatrician, 1 allergist, and 1 otolaryngologist, evaluated the patients. Multidisciplinary clinical examinations were carried out (complete blood counting, X-rays, nasofibroscopy, audiometry). The two most commonly found etiologies were allergic rhinitis, followed by functional mouth breathing. Of the 414 patients in the study, 346 received a speech-language pathology evaluation. The most prevalent finding in this group of 346 subjects was the presence of orofacial myofunctional disorders. The most frequently orofacial myofunctional disorder identified in these subjects who also presented mouth breathing included: habitual open lips rest posture, low and forward tongue rest posture and lack of adequate muscle tone. There were also no statistically significant relationships identified between etiology and speech-language diagnosis. Therefore, the specific type of etiology of mouth breathing does not appear to contribute to the presence, type, or number of speech-language findings which may result from mouth breathing behavior.

A Self-Fitting Hearing Aid

PubMed Central

Keidser, Gitte; Dillon, Harvey; Hartley, Lisa

2011-01-01

The need for reliable access to hearing health care services is growing globally, particularly in developing countries and in remotely located, underserved regions in many parts of the developed world. Individuals with hearing loss in these areas are at a significant disadvantage due to the scarcity of local hearing health care professionals and the high cost of hearing aids. Current approaches to making hearing rehabilitation services more readily available to underserved populations include teleaudiology and the provision of amplification devices outside of the traditional provider-client relationship. Both strategies require access to such resources as dedicated equipment and/or specially trained staff. Another possible strategy is a self-fitting hearing aid, a personal amplification device that is equipped with an onboard tone generator to enable user-controlled, automated, in situ audiometry; an onboard prescription to determine the initial hearing aid settings; and a trainable algorithm to enable user-controlled fine-tuning. The device is thus assembled, fitted, and managed by the user without the need for audiological or computer support. This article details the self-fitting concept and its potential application in both developing and developed countries. Potential advantages and disadvantages of such a device are discussed, and considerations for further investigations into the concept are presented. Overall, the concept is considered technologically viable with the main challenges anticipated to be development of clear, simple user instructions and a delivery model that ensures reliable supplies of instant-fit ear tips and batteries. PMID:22143873

PCB exposure and cochlear function at age 6 years.

PubMed

Palkovičová Murínová, Ľubica; Moleti, Arturo; Sisto, Renata; Wimmerová, Soňa; Jusko, Todd A; Tihányi, Juraj; Jurečková, Dana; Kováč, Ján; Koštiaková, Vladimíra; Drobná, Beata; Trnovec, Tomáš

2016-11-01

Epidemiological studies have documented adverse associations between exposure to polychlorinated biphenyls (PCBs) and otological outcomes. Previously, we documented decreased distortion product otoacoustic emission (DPOAE) levels in children exposed to PCBs, up to the age of 45 months, amongst a cohort of children in eastern Slovakia. The objective of the present study is to evaluate cochlear dysfunction at 72 months of age in 214 children from this same cohort and to compare the otoacoustic test sensitivity to that of pure tone audiometry (PTA). The association between DPOAE, PTA, and PCBs was estimated by means of multivariate ANOVA (MANOVA) and linear regression models. ROC curves were computed to estimate the DPOAE-test power in children. The DPOAE level at 72 months was related to PCB-153 serum levels. The DPOAE Input/Output function test at mid-frequency (2kHz) has shown instead nonmonotonic dependence on PCB exposure, for the left ears of children, over the whole growth curve. No significant association was found between PTA hearing levels and PCB-153 concentration. High diagnostic power of the DPOAE-test was found in children, similar to that found by the same authors in adults. In conclusions the DPOAE-PCB correlation obtained at 72 months is similar to that at 45 months suggesting a permanent and stable ototoxic effect of the PCB exposure. The lack of statistical significance of the PCB-PTA correlation suggests that DPOAEs are sensitive biomarkers of cochlear damage. Copyright © 2016 Elsevier Inc. All rights reserved.

The Analysis for Activations in the Brain during Hearing the Amplitude-Modulated Tone by fMRI Measurement

NASA Astrophysics Data System (ADS)

Fukami, Tadanori; Shimada, Takamasa; Akatsuka, Takao; Saito, Yoichi

In audiometry, ABR (Auditory Brainstem Response) is widely used. However, it shows low accuracy in low frequency band. Meanwhile, AMFR (Amplitude-Modulation-Following Response), the response during hearing an amplitude-modulated tone, has high frequency specificity and is brought to attention. As the first step to clinical application of AMFR, we investigated the activated areas in a brain when the subjects hear SAM tone (Sinusoidally Amplitude-Modulated tone) with both ears. We measured following two signals. One is the difference of BOLD (Blood Oxygenation Level Dependent) signal between hearing SAM tone vs. silence, the other is the difference of BOLD signal between hearing SAM tone vs. unmodulated tone. As a result, in the case of SAM vs. silence, the bilaterally auditory cortex (Broadmann Area 41, 42), the biratelally BA 10, left superior frontal gyrus and right superior temporal gyrus were activated (p<0.0037, uncorrected). In the case of SAM vs. unmodulated tone, the bilaterally superior frontal gyrus (BA 6) and precuneus (BA 7), neighboring area including the bilaterally inferior parietal lobule (BA 40), the bilaterally medial frontal gyrus and superior frontal gyrus were activated (p<0.021, uncorrected). Activations of visual perception due to eye-opened state were detected in some parts of activations. As a result, we inferred that modulated tone was recognized in the medial frontal gyrus and inferior parietal lobule was the part related to perception of amplitude-modulation.

[The Influence of Hearing Loss Represented by Standard Audiogram Types to Unaided APHAB Scores].

PubMed

Löhler, J; Akcicek, B; Kappe, T; Wollenberg, B; Schlattmann, P; Schönweiler, R

2016-08-01

Questionnaires as the APHAB (Abbreviated Profile of Hearing Aid Benefit) are besides pure-tone and speech-audiometry the third method of diagnostics in audiology. Up to now there has been no research on the influence of individual hearing loss, represented by standard audiograms, on the scores of the unaided APHAB (APHABu) done with a big number of subjects. This study will investigate whether there does exist such a relationship or not. A total of 2 745 records provided by a database were analysed. First, the subjects' audiograms (air conduction) were allocated to 7 standardised audiogram types. By using a multivariant mixed linear model a potential connection was examined between these standard audiograms and particular APHABu scores for its four subscales: EC - ease of communication, BN - background noise, RV - reverberation, AV - aversiveness of sounds. There was no evidence for a dependency between any type of hearing loss dependence and unaided APHAB-scores. The values on the EC-scale vary between 49.8 and 58.0, on the BN-scale between 45.3 and 46.6, on the RV-scale between 44.4 and 52.4, and on the AV-scale between 47.6 and 50.1. This result confirms earlier studies with other questionnaires. Therefore, the APHABu can be used as an initial instrument for the diagnostics of individual hearing loss independently on whether hearing aids will be fitted subsequently or not. © Georg Thieme Verlag KG Stuttgart · New York.

Hearing status in adult individuals with lifetime, untreated isolated growth hormone deficiency.

PubMed

Prado-Barreto, Valéria M; Salvatori, Roberto; Santos Júnior, Ronaldo C; Brandão-Martins, Mariane B; Correa, Eric A; Garcez, Flávia B; Valença, Eugênia H O; Souza, Anita H O; Pereira, Rossana M C; Nunes, Marco A P; D'Avila, Jeferson S; Aguiar-Oliveira, Manuel H

2014-03-01

To evaluate the hearing status of growth hormone (GH)-naive adults with isolated GH deficiency (IGHD) belonging to an extended Brazilian kindred with a homozygous mutation in the GH-releasing hormone receptor gene. Cross-sectional. Divisions of Endocrinology and Otorhinolaryngology of the Federal University of Sergipe. Twenty-six individuals with IGHD (age, 47.6 ± 15.1 years; 13 women) and 25 controls (age, 46.3 ± 14.3 years; 15 women) were administered a questionnaire on hearing complaints and hearing health history. We performed pure-tone audiometry, logoaudiometry, electroacoustic immittance, and stapedial reflex. To assess outer hair cell function in the cochlea, we completed transient evoked otoacoustic emissions (TEOAEs). To assess the auditory nerve and auditory brainstem, we obtained auditory brainstem responses (ABRs). Misophonia and dizziness complaints were more frequent in those with IGHD than in controls (P = .011). Patients with IGHD had higher thresholds at 250 Hz (P = .005), 500 Hz (P = .006), 3 KHz (P = .008), 4 KHz (P = .038), 6 KHz (P = .008), and 8 KHz (P = .048) and mild high-tones hearing loss (P = .029). Stapedial reflex (P < .001) and TEOAEs (P = .025) were more frequent in controls. There were no differences in ABR latencies. Hearing loss in patients with IGHD occurred earlier than in controls (P < .001). Compared with controls of the same area, subjects with untreated, congenital lifetime IGHD report more misophonia and dizziness, have predominance of mild high-tones sensorineural hearing loss, and have an absence of stapedial reflex and TEOAEs.

[Association between depression and hearing loss in patients with type 2 diabetes].

PubMed

Zamora-Vega, Omar; Gómez-Díaz, Rita Angélica; Delgado-Solís, Margarita; Vázquez-Estupiñán, Felipe; Vargas-Aguayo, Alejandro Martín; Wacher-Rodarte, Niels H

2016-01-01

The association between diabetes, hearing loss and depression is unknown, and needs to be understood clearly and precisely. Our objective was to estimate the association between depression and hearing loss in patients with type 2 diabetes. Cross-sectional analytical study. Patients of 40 years or older with type 2 diabetes were studied. Anthropometric measurements and biochemical parameters were recorded. The Beck Depression Inventory and a pure tone audiometry were applied. Groups were compared with chi squared test and logistic regression for confounders. 150 patients were included (76 % women). Average age was 56 ± 9.3 years, with 12.4 ± 6.5 years of progression of diabetes, weight 67.4 ± 11.6 kg; 31 % were obese; 25.5 % hypertensive (126.3 ± 19.3 / 79.4 ± 19.7 mm Hg) and 80.7 % had poor metabolic control (HbA1c ≥ 7 %). Of all the patients, 45.3 % presented hearing loss and 32.4 % depression. Diagnosis of depression in patients with hearing loss remained significant after adjusting for confounders (odds ratio [OR] = 2.3; 95 % confidence interval [CI] = 1.051-5.333, p = 0.037). Women had greater risk of depression, difference that remained significant (OR = 3.2; 95 % CI = 1.268-8.584, p = 0.014) after adjustment. Almost half of the patients with diabetes presented hearing loss and more than three times the risk of depression. Subjects with depression and diabetes presented more hearing loss (> 20 dB) than those without diabetes and/or without depression.

Cochlear dysfunction in hyperuricemia: otoacoustic emission analysis.

PubMed

Hamed, Sherifa A; El-Attar, Amal M

2010-01-01

The objective of this study is to provide evidence that primary hyperuricemia is associated with cochlear dysfunction as other metabolic diseases that interfere with cell metabolism. Cochlear function was evaluated in 25 subjects with asymptomatic hyperuricemia using routine diagnostic audiometry along with transient evoked and distortion product otoacoustic emissions (TEOAE and DPOAE, respectively). To support the notion that vascular compromise was a significant underlying factor for such cochlear dysfunction, we assessed vascular anatomical and functional states through measuring the common carotid artery intima-media thickness and flow velocity of the basal intracranial vessels. Compared with control subjects, reduced response levels of TEOAEs (P < .01) and amplitudes of DPOAEs (P < .001) were detected at higher frequencies. The reduced DPOAE levels at 5 kHz and TEOAEs at 4 kHz correlated significantly with uric acid (P < .05; P < .01), patients' age (P < .06; P < .05), duration since diagnosis of hyperuricemia (P < .05; P < .001), common carotid artery intima-media thickness (P < .05), mean flow velocities of middle cerebral arteries (P < .05), and vertebral arteries (P < .01). Multivariate analysis showed that the abnormalities at higher frequencies were significantly correlated with the duration and degree of hyperuricemia. These data suggest that subclinical changes in cochlear function are associated with hyperuricemia. They support the usefulness of otoacoustic emissions in early detection of cochlear dysfunction. It is possible that hyperuricemia could be accompanied by increased stiffness and/or compromise of blood supply of the outer hair cells, which will impair their electromotile response. Copyright (c) 2010 Elsevier Inc. All rights reserved.

Childhood otitis media is associated with dizziness in adulthood: the HUNT cohort study.

PubMed

Aarhus, Lisa; Tambs, Kristian; Hoffman, Howard J; Engdahl, Bo

2016-08-01

The objective of the study was to examine the association between otitis media in childhood and dizziness in adulthood. Longitudinal, population-based cohort study of 21,962 adults (aged 20-59 years, mean 40) who completed a health questionnaire in the Nord-Trøndelag Hearing Loss Study was conducted. At 7, 10 and 13 years of age, the same individuals underwent screening audiometry in a longitudinal school hearing investigation. Children found with hearing loss underwent an ear, nose and throat specialist examination. Adults diagnosed with childhood chronic suppurative otitis media (n = 102) and childhood hearing loss after recurrent acute otitis media (n = 590) were significantly more likely to have increased risk of reported dizziness when compared to adults with normal hearing as children at the school investigation and also a negative history of recurrent otitis media (n = 21,270), p < 0.05. After adjusting for adult age, sex and socio-economic status, the odds ratios were 2.1 [95 % confidence interval (CI): 1.4-3.3] and 1.3 (95 % CI: 1.0-1.5), respectively. This longitudinal cohort study suggests that childhood chronic suppurative otitis media and childhood hearing loss after recurrent acute otitis media are associated with increased risk of dizziness in adulthood. This might reflect a permanent effect of inflammatory mediators or toxins on the vestibular system. The new finding stresses the importance of treatment and prevention of these otitis media conditions.

[Association between interleukin-6 polymorphism in the -174 G/C region and hearing loss in the elderly with a history of occupational noise exposure].

PubMed

Braga, Miula Portelinha; Maciel, Sandra Mara; Marchiori, Luciana Lozza de Moraes; Poli-Frederico, Regina Célia

2014-01-01

The biological processes involved in noise-induced hearing loss (NIHL) are still unclear. The involvement of inflammation in this condition has been suggested. To investigate the association between interleukin - 6 (IL-6) polymorphism and susceptibility to NIHL. This was a cross-sectional study with a sample of 191 independent elderly individuals aged >60 years of age. Information on exposure to occupational noise was obtained by interviews. Audiological evaluation was performed using pure tone audiometry and genotyped through PCR by restriction fragment length polymorphism - PCR-RFLP. Data were analyzed using the chi-square test and the odds ratio (OR), with the significance level set at 5%. Among elderly with hearing loss (78.0%), 18.8% had a history of exposure to occupational noise. There was a statistically significant association between the genotype frequencies of the IL-6 -174 and NIHL. The elderly with the CC genotype were less likely to have hearing loss due to occupational noise exposure when compared to those carrying the GG genotype (OR=0.0124; 95% CI 0.0023-0.0671; p<0.001). This study suggests there is an association of polymorphisms in the IL-6 gene at position - G174C with susceptibility to noise-induced hearing loss. Copyright © 2014 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Standards on medical fitness examinations for Navy divers.

PubMed

Weiss, Michael

2003-01-01

The German Navy employs approximately 480 divers in their primary and secondary role. Before entering diving training, every diver has to pass an intensive physical examination programme at the German Naval Medical Institute (NMI) in Kiel-Kronshagen. Annual follow-ups ensure the currency of the medical findings. Criteria of medical fitness for diving reflect industrial medical standards for hyperbaric workers as well as the general medical guidelines for NATO divers. A diving examination consists of the individual medical history, a physical examination including the neurological status and the assessment of the cardiovascular fitness by ECG and bicycle ergometry. The respiratory system is screened by regular chest x-rays and spirometry or body plethysmography. Blood and urine samples are taken to look for abnormal haematological and metabolic conditions as well as disorders of the genito-urinary system. In order to determine visual fitness, diver's visual acuity, colour vision and stereopsis as well as eye fundi are examined by an eye specialist. Also the ENT examination involves a speciality consultant and consists of audiometry, inspection of the external ear and tympanic membrane and functional tests. To ensure a high standard of dental fitness, screening by a dental officer is part of the annual check-up. Every routine diving medical examination at the NMI includes a pressure test in the hyperbaric chamber. Divers who use nitrox or oxygen-rebreather devices have to pass successfully an oxygen tolerance test under hyperbaric conditions. The annual routine diving medical examination contributes to minimize the risk of accidents in military diving operations.

Hearing-impaired adults are at increased risk of experiencing emotional distress and social engagement restrictions five years later.

PubMed

Gopinath, Bamini; Hickson, Louise; Schneider, Julie; McMahon, Catherine M; Burlutsky, George; Leeder, Stephen R; Mitchell, Paul

2012-09-01

we aimed to assess both cross-sectional and temporal links between measured hearing impairment and self-perceived hearing handicap, and health outcomes. in total, 811 Blue Mountains Hearing Study participants (Sydney, Australia) aged ≥55 years were examined twice (1997-99 and 2002-04). Hearing levels were measured with pure-tone audiometry. The shortened version of the hearing handicap inventory (HHIE-S) was administered, scores ≥8 defined hearing handicap. baseline hearing impairment was strongly associated with 7 of the 10 HHIE-S questions, 5 years later. Individuals with and without hearing impairment at baseline reported that they felt embarrassed and/or frustrated by their hearing problem, and that it hampered their personal/social life, multivariable-adjusted OR: 11.5 (CI: 3.5-38.1), OR: 6.3 (CI: 2.5-15.7) and OR: 6.0 (CI: 2.1-17.5), respectively, 5 years later. Hearing-impaired, compared with non-hearing-impaired adults had a significantly higher risk of developing moderate or severe hearing handicap, OR: 3.35 (CI: 1.91-5.90) and OR: 6.60 (CI: 1.45-30.00), respectively. Cross-sectionally (at wave 2), hearing handicap increased the odds of depressive symptoms and low self-rated health by 80 and 46%, respectively. older, hearing-impaired adults were significantly more likely to experience emotional distress and social engagement restrictions (self-perceived hearing handicap) directly due to their hearing impairment.

Evidence-based guideline summary: Evaluation, diagnosis, and management of facioscapulohumeral muscular dystrophy

PubMed Central

Tawil, Rabi; Kissel, John T.; Heatwole, Chad; Pandya, Shree; Gronseth, Gary; Benatar, Michael

2015-01-01

Objective: To develop recommendations for the evaluation, diagnosis, prognostication, and treatment of facioscapulohumeral muscular dystrophy (FSHD) from a systematic review and analysis of the evidence. Methods: Relevant articles were analyzed in accordance with the American Academy of Neurology classification of evidence schemes for diagnostic, prognostic, and treatment studies. Recommendations were linked to the strength of the evidence and other factors. Results and recommendations: Available genetic testing for FSHD type 1 is highly sensitive and specific. Although respiratory insufficiency occurs rarely in FSHD, patients with severe FSHD should have routine pulmonary function testing. Routine cardiac screening is not necessary in patients with FSHD without cardiac symptoms. Symptomatic retinal vascular disease is very rare in FSHD. Exudative retinopathy, however, is potentially preventable, and patients with large deletions should be screened through dilated indirect ophthalmoscopy. The prevalence of clinically relevant hearing loss is not clear. In clinical practice, patients with childhood-onset FSHD may have significant hearing loss. Because undetected hearing loss may impair language development, screening through audiometry is recommended for such patients. Musculoskeletal pain is common in FSHD and treating physicians should routinely inquire about pain. There is at present no effective pharmacologic intervention in FSHD. Available studies suggest that scapular fixation is safe and effective. Surgical scapular fixation might be cautiously offered to selected patients. Aerobic exercise in FSHD appears to be safe and potentially beneficial. On the basis of the evidence, patients with FSHD might be encouraged to engage in low-intensity aerobic exercises. PMID:26215877

A randomised controlled trial comparing fresh, dried, and dried-then-rehydrated temporalis fascia in myringoplasty.

PubMed

Loock, J W; Naude, N

2008-04-01

To determine whether the way in which temporalis fascia is treated during myringoplasty affects the rate of successful perforation closure. A randomised controlled trial. A tertiary ENT Department within the Tygerberg Academic Hospital. One hundred and fifty patients with perforations between 30% and 70% of the surface area of the eardrum undergoing elective myringoplasty were randomised into three groups by the way in which the temporalis fascia used was treated prior to insertion: fresh fascia; dried fascia; and fascia which was dried and then rehydrated. The outcome measure was intactness of the tympanic membrane 6 weeks after surgery. Preoperative and follow-up audiometry was obtained, but was not evaluated as an outcome measure. Successful closure of the perforation was achieved in 89% in the dried fascia group (42 of 47 patients), 84% in the fresh fascia group (37 of 44 patients), and 85% in the dried and rehydrated group (39 of 46 patients). The study showed no statistically significant difference between the three groups (P = 0.728). The study would have to had more than 800 patients in each group to have the power to show a 5% difference in take rates. While the dessication of temporalis fascia prior to use in myringoplasy results in degeneration of cellular and stromal elements histologically, this does not affect the successful closure of perforations. Clinicians should feel free to prepare the fascia in whichever way they find easiest to work with.

Association of Age Related Macular Degeneration and Age Related Hearing Impairment

PubMed Central

Ghasemi, Hassan; Pourakbari, Malihe Shahidi; Entezari, Morteza; Yarmohammadi, Mohammad Ebrahim

2016-01-01

Purpose: To evaluate the association between age-related macular degeneration (ARMD) and sensory neural hearing impairment (SHI). Methods: In this case-control study, hearing status of 46 consecutive patients with ARMD were compared with 46 age-matched cases without clinical ARMD as a control group. In all patients, retinal involvements were confirmed by clinical examination, fluorescein angiography (FA) and optical coherence tomography (OCT). All participants were examined with an otoscope and underwent audiological tests including pure tone audiometry (PTA), speech reception threshold (SRT), speech discrimination score (SDS), tympanometry, reflex tests and auditory brainstem response (ABR). Results: A significant (P = 0.009) association was present between ARMD, especially with exudative and choroidal neovascularization (CNV) components, and age-related hearing impairment primarily involving high frequencies. Patients had higher SRT and lower SDS against anticipated presbycusis than control subjects. Similar results were detected in exudative, CNV and scar patterns supporting an association between late ARMD with SRT and SDS abnormalities. ABR showed significantly prolonged wave I and IV latency times in ARMD (P = 0.034 and 0.022, respectively). Average latency periods for wave I in geographic atrophy (GA) and CNV, and that for wave IV in drusen patterns of ARMD were significantly higher than controls (P = 0.030, 0.007 and 0.050, respectively). Conclusion: The association between ARMD and age-related SHI may be attributed to common anatomical components such as melanin in these two sensory organs. PMID:27195086

Rinne revisited: steel versus aluminum tuning forks.

PubMed

MacKechnie, Cheryl A; Greenberg, Jesse J; Gerkin, Richard C; McCall, Andrew A; Hirsch, Barry E; Durrant, John D; Raz, Yael

2013-12-01

(1) Determine whether tuning fork material (aluminum vs stainless steel) affects Rinne testing in the clinical assessment of conductive hearing loss (CHL). (2) Determine the relative acoustic and mechanical outputs of 512-Hz tuning forks made of aluminum and stainless steel. Prospective, observational. Outpatient otology clinic. Fifty subjects presenting May 2011 to May 2012 with negative or equivocal Rinne in at least 1 ear and same-day audiometry. Rinne test results using aluminum and steel forks were compared and correlated with the audiometric air-bone gap. Bench top measurements using sound-level meter, microphone, and artificial mastoid. Patients with CHL were more likely to produce a negative Rinne test with a steel fork than with an aluminum fork. Logistic regression revealed that the probability of a negative Rinne reached 50% at a 19 dB air-bone gap for stainless steel versus 27 dB with aluminum. Bench top testing revealed that steel forks demonstrate, in effect, more comparable air and bone conduction efficiencies while aluminum forks have relatively lower bone conduction efficiency. We have found that steel tuning forks can detect a lesser air-bone gap compared to aluminum tuning forks. This is substantiated by observations of clear differences in the relative acoustic versus mechanical outputs of steel and aluminum forks, reflecting underlying inevitable differences in acoustic versus mechanical impedances of these devices, and thus efficiency of coupling sound/vibratory energy to the auditory system. These findings have clinical implications for using tuning forks to determine candidacy for stapes surgery.

Hearing impairment related to age in Usher syndrome types 1B and 2A.

PubMed

Wagenaar, M; van Aarem, A; Huygen, P; Pieke-Dahl, S; Kimberling, W; Cremers, C

1999-04-01

To evaluate hearing impairment in 2 common genetic subtypes of Usher syndrome, USH1B and USH2A. Cross-sectional analysis of hearing threshold related to age in patients with genotypes determined by linkage and mutation analysis. Otolaryngology department, university referral center. Nineteen patients with USH1B and 27 with USH2A were examined. All participants were living in the Netherlands and Belgium. Pure tone audiometry of the best ear at last visit. The patients with USH1B had residual hearing without age dependence, with minimum thresholds of 80, 95, and 120 dB at 0.25, 0.5, and 1 to 2 kHz, respectively. Mean thresholds of patients with USH2A were about 45 to 55 dB better than these minimum values. Distinctive audiographic features of patients with USH2A were maximum hearing thresholds of 70, 80, and 100 dB at 0.25, 0.5, and 1 kHz, respectively, only at younger than 40 years. Progression of hearing impairment in USH2A was 0.7 dB/y on average for 0.25 to 4 kHz and could not be explained by presbyacusis alone. The USH1B and USH2A can be easily distinguished by hearing impairment at younger than 40 years at the low frequencies. Hearing impairment in our patients with USH2A could be characterized as progressive.

Reduction in high-frequency hearing loss following technical modifications to microvascular decompression for hemifacial spasm.

PubMed

Thirumala, Parthasarathy; Frederickson, Andrew M; Balzer, Jeffrey; Crammond, Donald; Habeych, Miguel E; Chang, Yue-Fang; Sekula, Raymond F

2015-10-01

Microvascular decompression is a safe and effective procedure to treat hemifacial spasm, but the operation poses some risk to the patient's hearing. While severe sensorineural hearing loss across all frequencies occurs at a low rate in experienced hands, a recent study suggests that as many as one-half of patients who undergo this procedure may experience ipsilateral high-frequency hearing loss (HFHL), and as many as one-quarter may experience contralateral HFHL. While it has been suggested that drill-related noise may account for this finding, this study was designed to examine the effect of a number of techniques designed to protect the vestibulocochlear nerve from operative manipulation on the incidence of HFHL. Pure-tone audiometry was performed both preoperatively and postoperatively on 67 patients who underwent microvascular decompression for hemifacial spasm during the study period. A change of greater than 10 dB at either 4 kHz or 8 kHz was considered to be HFHL. Additionally, the authors analyzed intraoperative brainstem auditory evoked potentials from this patient cohort. The incidence of ipsilateral HFHL in this cohort was 7.4%, while the incidence of contralateral HFHL was 4.5%. One patient (1.5%; also included in the HFHL group) experienced an ipsilateral nonserviceable hearing loss. The reduced incidence of HFHL in this study suggests that technical modifications including performing the procedure without the use of fixed retraction may greatly reduce, but not eliminate, the occurrence of HFHL following microvascular decompression for hemifacial spasm.

Predictors of vertigo in patients with untreated vestibular schwannoma.

PubMed

Andersen, Jan Fredrik; Nilsen, Kathrin Skorpa; Vassbotn, Flemming Slinning; Møller, Per; Myrseth, Erling; Lund-Johansen, Morten; Goplen, Frederik Kragerud

2015-04-01

Previous studies have shown that vertigo is the most powerful negative predictor of quality of life in patients with vestibular schwannomas, but the variability in vertigo symptom severity is still poorly understood. We wanted to find out whether vertigo could be related to objective parameters such as tumor size, location, vestibular nerve function, hearing, and postural stability in patients with untreated vestibular schwannomas. Baseline data from prospective cohort study. Tertiary referral center. Four hundred thirty-four consecutive patients with unilateral VS diagnosed on MRI. Mean age 56 years (range 16-84 yr). Fifty-three percent women. Diagnostic, with a medical history, otolaryngological examination, pure-tone and speech audiometry, MRI, posturography, and videonystagmography with bithermal caloric tests. Dizziness measured on a 100-mm visual analog scale (VAS). Secondary outcome measures were canal paresis and postural imbalance (static and dynamic posturography). Three hundred three patients (70%) completed the VAS. Severe dizziness, defined as VAS 75 or greater, was reported by 9% of the patients. Larger tumors were associated with higher risk of postural instability and canal paresis. Moderate to severe dizziness was associated with postural imbalance and canal paresis, and possibly with small to medium-sized tumors. Postural instability was related to tumor size and canal paresis when measured by dynamic, but not with static, posturography. A minority of VS patients experience severe vestibular symptoms related to canal paresis and postural instability. A curvilinear relationship is hypothesized between tumor size and dizziness.

Follow-up of extreme neonatal hyperbilirubinaemia in 5- to 10-year-old children: a Danish population-based study.

PubMed

Vandborg, Pernille Kure; Hansen, Bo Moelholm; Greisen, Gorm; Mathiasen, Rene; Kasper, Frederikke; Ebbesen, Finn

2015-04-01

To investigate whether infants with neonatal hyperbilirubinaemia but without intermediate or advanced bilirubin encephalopathy develop long-term sequelae, with impairment of motor development, executive function, or hearing. This nested double-cohort study included 167 exposed children (107 males, 60 females) born in Denmark 2000 to 2005 at gestational age ≥35 weeks with a total serum bilirubin ≥450 μmol/L (26.3mg/dL) and 163 age-, sex-, and gestational age-matched unexposed children (103 males, 60 females). The children were examined at a mean age of 7.7 years (SD 1.7y) using the Movement Assessment Battery for Children-Second Edition (MABC-2), pure tone audiometry, and the Behavioural Regulation Inventory of Executive Function (BRIEF) questionnaire. The follow-up rate was 70% of the eligible infants in the exposed group and 45% in the unexposed group. Mean difference was -0.2 (95% confidence interval [CI] -1.1 to 0.8) in adjusted standard score for MABC-2 and 0.3 (95% CI -2.9 to 3.5) in adjusted BRIEF executive composite standard score. No children had significant hearing impairment or a diagnosis of cerebral palsy, attention-deficit-hyperactive disorder, or autism spectrum disorder recorded in national registries. No evidence was found of an increased risk of deficits in motor development, executive function, or hearing in children with extreme hyperbilirubinaemia who did not have intermediate or advanced bilirubin encephalopathy. © 2014 Mac Keith Press.

Hearing loss in very preterm and very low birthweight infants at the age of 5 years in a nationwide cohort.

PubMed

Veen, S; Sassen, M L; Schreuder, A M; Ens-Dokkum, M H; Verloove-Vanhorick, S P; Brand, R; Grote, J J; Ruys, J H

1993-02-01

In a geographically defined population of very preterm and very low birthweight infants (gestational age < 32 weeks and/or birthweight < 1500 g) hearing was evaluated in 890 children by pure-tone audiometry at the age of 5 years. Hearing loss was conductive/unspecified in 123 (13.8%) and sensorineural in 13 (1.5%) children. The prevalence of sensorineural hearing loss was 15 times as high as in 5-7 year old children in the Dutch population at large. The sensorineural hearing loss prevalence in very low birthweight and extremely low birthweight infants was similar. On account of communication disorders 10 (1.1%) children were classified as disabled and 6 (0.7%) as handicapped, following the definitions of the International Classification of Impairments, Disabilities, and Handicaps of the World Health Organisation. Children with conductive hearing loss had a higher risk of impairments, disabilities and handicaps of language and speech development, than children with normal hearing, the difference being statistically significant. The same holds for children with sensorineural hearing loss; moreover they had a significantly higher risk of impairments, disabilities and handicaps of mental development. Overall comparison of children with and without sensorineural hearing loss proved that the children with sensorineural hearing loss had a significantly less favourable outcome, based on 15 perinatal factors simultaneously. The age at which sensorineural hearing loss in very preterm and/or very low birthweight infants is detected has to be improved.

Monitoring auditory cortical plasticity in hearing aid users with long latency auditory evoked potentials: a longitudinal study.

PubMed

Leite, Renata Aparecida; Magliaro, Fernanda Cristina Leite; Raimundo, Jeziela Cristina; Bento, Ricardo Ferreira; Matas, Carla Gentile

2018-02-19

The objective of this study was to compare long-latency auditory evoked potentials before and after hearing aid fittings in children with sensorineural hearing loss compared with age-matched children with normal hearing. Thirty-two subjects of both genders aged 7 to 12 years participated in this study and were divided into two groups as follows: 14 children with normal hearing were assigned to the control group (mean age 9 years and 8 months), and 18 children with mild to moderate symmetrical bilateral sensorineural hearing loss were assigned to the study group (mean age 9 years and 2 months). The children underwent tympanometry, pure tone and speech audiometry and long-latency auditory evoked potential testing with speech and tone burst stimuli. The groups were assessed at three time points. The study group had a lower percentage of positive responses, lower P1-N1 and P2-N2 amplitudes (speech and tone burst), and increased latencies for the P1 and P300 components following the tone burst stimuli. They also showed improvements in long-latency auditory evoked potentials (with regard to both the amplitude and presence of responses) after hearing aid use. Alterations in the central auditory pathways can be identified using P1-N1 and P2-N2 amplitude components, and the presence of these components increases after a short period of auditory stimulation (hearing aid use). These findings emphasize the importance of using these amplitude components to monitor the neuroplasticity of the central auditory nervous system in hearing aid users.

Variation in the Hearing Threshold in Women during the Menstrual Cycle

PubMed Central

Souza, Dayse da Silva; Luckwu, Brunna; Andrade, Wagner Teobaldo Lopes de; Pessoa, Luciane Spinelli de Figueiredo; Nascimento, João Agnaldo do; Rosa, Marine Raquel Diniz da

2017-01-01

Introduction  The hormonal changes that occur during the menstrual cycle and their relationship with hearing problems have been studied. However, they have not been well explained. Objective  The objective of our study is to investigate the variation in hearing thresholds in women during the menstrual cycle. Method  We conducted a cohort and longitudinal study. It was composed of 30 volunteers, aged 18–39 years old, of which 20 were women during the phases of the menstrual cycle and 10 were men (control group) who underwent audiometry and impedance exams, to correlate the possible audiological changes in each phase of the menstrual cycle. Results  There were significant changes in hearing thresholds observed during the menstrual cycle phases in the group of women who used hormonal contraceptives and the group who did not use such contraceptives. Improved hearing thresholds were observed in the late follicular phase in the group who did not use hormonal contraceptives and the hearing thresholds at high frequencies were better. Throughout the menstrual cycle phases, the mean variation was 3.6 db HL between weeks in the group who used hormonal contraceptives and 4.09 db HL in the group who did not use them. Conclusions  The present study found that there may be a relationship between hearing changes and hormonal fluctuations during the menstrual cycle based on changes in the hearing thresholds of women. In addition, this study suggests that estrogen has an otoprotective effect on hearing, since the best hearing thresholds were found when estrogen was at its maximum peak. PMID:29018493

Monitoring auditory cortical plasticity in hearing aid users with long latency auditory evoked potentials: a longitudinal study

PubMed Central

Leite, Renata Aparecida; Magliaro, Fernanda Cristina Leite; Raimundo, Jeziela Cristina; Bento, Ricardo Ferreira; Matas, Carla Gentile

2018-01-01

OBJECTIVE: The objective of this study was to compare long-latency auditory evoked potentials before and after hearing aid fittings in children with sensorineural hearing loss compared with age-matched children with normal hearing. METHODS: Thirty-two subjects of both genders aged 7 to 12 years participated in this study and were divided into two groups as follows: 14 children with normal hearing were assigned to the control group (mean age 9 years and 8 months), and 18 children with mild to moderate symmetrical bilateral sensorineural hearing loss were assigned to the study group (mean age 9 years and 2 months). The children underwent tympanometry, pure tone and speech audiometry and long-latency auditory evoked potential testing with speech and tone burst stimuli. The groups were assessed at three time points. RESULTS: The study group had a lower percentage of positive responses, lower P1-N1 and P2-N2 amplitudes (speech and tone burst), and increased latencies for the P1 and P300 components following the tone burst stimuli. They also showed improvements in long-latency auditory evoked potentials (with regard to both the amplitude and presence of responses) after hearing aid use. CONCLUSIONS: Alterations in the central auditory pathways can be identified using P1-N1 and P2-N2 amplitude components, and the presence of these components increases after a short period of auditory stimulation (hearing aid use). These findings emphasize the importance of using these amplitude components to monitor the neuroplasticity of the central auditory nervous system in hearing aid users. PMID:29466495

Glucocorticoids improve acute dizziness symptoms following acute unilateral vestibulopathy.

PubMed

Batuecas-Caletrío, Angel; Yañez-Gonzalez, Raquel; Sanchez-Blanco, Carmen; Pérez, Pedro Blanco; González-Sanchez, Enrique; Sanchez, Luis Alberto Guardado; Kaski, Diego

2015-11-01

Acute unilateral vestibulopathy (AUV) is characterized by acute vertigo, nausea, and imbalance without neurological deficits or auditory symptomatology. Here, we explore the effect of glucocorticoid treatment on the degree of canal paresis in patients with AUV, and critically, establish its relationship with dizziness symptom recovery. We recruited consecutive patients who were retrospectively assigned to one of the two groups according to whether they received glucocorticoid treatment (n = 32) or not (n = 44). All patients underwent pure-tone audiometry, bithermal caloric testing, MRI brain imaging, and were asked to complete a dizziness handicap inventory on admission to hospital and just prior to hospital discharge. In the treatment group, the canal paresis at discharge was significantly lower than in the control group (mean ± SD % 38.04 ± 21.57 versus 82.79 ± 21.51, p < 0.001). We also observed a significant reduction in the intensity of nystagmus in patients receiving glucocorticoid treatment compared to the non-treatment group (p = 0.03). DHI test score was significantly lower at discharge in the treatment group (mean ± SD % 23.15 ± 12.40 versus 64.07 ± 12.87, p < 0.001), as was the length of hospital stay (2.18 ± 1.5 days versus 3.6 ± 1.7 days, p = 0.002). Glucocorticoid treatment leads to acute symptomatic improvement, with a reduced hospital stay and reduction in the intensity of acute nystagmus. Our findings suggest that glucocorticoids may accelerate vestibular compensation via a restoration of peripheral vestibular function, and therefore has important clinical implications for the treatment of AUV.

How well can centenarians hear?

PubMed

Mao, Zhongping; Zhao, Lijun; Pu, Lichun; Wang, Mingxiao; Zhang, Qian; He, David Z Z

2013-01-01

With advancements in modern medicine and significant improvements in life conditions in the past four decades, the elderly population is rapidly expanding. There is a growing number of those aged 100 years and older. While many changes in the human body occur with physiological aging, as many as 35% to 50% of the population aged 65 to 75 years have presbycusis. Presbycusis is a progressive sensorineural hearing loss that occurs as people get older. There are many studies of the prevalence of age-related hearing loss in the United States, Europe, and Asia. However, no audiological assessment of the population aged 100 years and older has been done. Therefore, it is not clear how well centenarians can hear. We measured middle ear impedance, pure-tone behavioral thresholds, and distortion-product otoacoustic emission from 74 centenarians living in the city of Shaoxing, China, to evaluate their middle and inner ear functions. We show that most centenarian listeners had an "As" type tympanogram, suggesting reduced static compliance of the tympanic membrane. Hearing threshold tests using pure-tone audiometry show that all centenarian subjects had varying degrees of hearing loss. More than 90% suffered from moderate to severe (41 to 80 dB) hearing loss below 2,000 Hz, and profound (>81 dB) hearing loss at 4,000 and 8,000 Hz. Otoacoustic emission, which is generated by the active process of cochlear outer hair cells, was undetectable in the majority of listeners. Our study shows the extent and severity of hearing loss in the centenarian population and represents the first audiological assessment of their middle and inner ear functions.

Use of Hearing Aids and Functional Capacity in Middle-Aged and Elderly Individuals

PubMed Central

Carioli, Juliana; Teixeira, Adriane Ribeiro

2014-01-01

Introduction Hearing loss is among the sensory changes strongly associated with loss of functional capacity. Objective It aims to determine whether the use of hearing aid contributes to the improvement of instrumental activities of daily living (IADL) for middle aged and elderly hearing-impaired individuals. Methods This is a descriptive, longitudinal, and interventional study. We evaluated 17 subjects, 13 (76.5%) female, aged between 58 and 96 years old (mean 77.1 ± 10.4 years). All were new users of hearing aids. Evaluation included social history, pure tone audiometry, and scale of IADL developed by Lawton and Brody. The subjects were presented daily life situations and were expected to respond if they could do them without assistance (3 points), partially assisted (2 points) or if they were unable to perform them (1 point). IADL was applied before the use of hearing aids adaptation and after a three- and six-month period of use. Results Data analysis revealed that before the use of hearing aids the average score obtained by the subjects was 22.94 ± 4.04 points. Three months after beginning the use the average score was 23.29 ± 4.12 and after six months the average score was 23.71 ± 3.69 points. Statistical analysis revealed a significant difference between scores obtained before the use of hearing aids and six months post-fitting (p = 0.015*) Conclusion The use of hearing aids among the subjects evaluated promoted positive changes in performing IADL, especially to using the telephone. PMID:25992101

Hearing and loud music exposure in a group of adolescents at the ages of 14-15 and retested at 17-18.

PubMed

Biassoni, Ester C; Serra, Mario R; Hinalaf, María; Abraham, Mónica; Pavlik, Marta; Villalobo, Jorge Pérez; Curet, Carlos; Joekes, Silvia; Yacci, María R; Righetti, Andrea

2014-01-01

Young people expose themselves to potentially damaging loud sounds while leisure activities and noise induced hearing loss is diagnosed in increasing number of adolescents. Hearing and music exposure in a group of adolescents of a technical high school was assessed at the ages of: 14-15 (test) and 17-18 (retest). The aims of the current study were: (1) To compare the auditory function between test and retest; (2) to compare the musical exposure levels during recreational activities in test and retest; (3) to compare the auditory function with the musical exposure along time in a subgroup of adolescents. The participants in the test were 172 male; in the retest, this number was reduced to 59. At the test and retest the conventional and extended high frequency audiometry, transient evoked otoacoustic emissions (TEOAEs) and recreational habits questionnaire were performed. In the test, hearing threshold levels (HTLs) were classified as: Normal (Group 1), slightly shifted (Group 2), and significantly shifted (Group 3); the Musical General Exposure (MGE), categorized in: Low, moderate, high, and very high exposure. The results revealed a significant difference (P < 0.0001) between test and retest in the HTL and global amplitude of TEOAEs in Group 1, showing an increase of the HTL and a decrease TEOAEs amplitude. A subgroup of adolescents, with normal hearing and low exposure to music in the test, showed an increase of the HTL according with the categories of MGE in the retest. To implement educational programs for assessing hearing function, ear vulnerability and to promote hearing health, would be advisable.

Variation in the Hearing Threshold in Women during the Menstrual Cycle.

PubMed

Souza, Dayse da Silva; Luckwu, Brunna; Andrade, Wagner Teobaldo Lopes de; Pessoa, Luciane Spinelli de Figueiredo; Nascimento, João Agnaldo do; Rosa, Marine Raquel Diniz da

2017-10-01

Introduction  The hormonal changes that occur during the menstrual cycle and their relationship with hearing problems have been studied. However, they have not been well explained. Objective  The objective of our study is to investigate the variation in hearing thresholds in women during the menstrual cycle. Method  We conducted a cohort and longitudinal study. It was composed of 30 volunteers, aged 18-39 years old, of which 20 were women during the phases of the menstrual cycle and 10 were men (control group) who underwent audiometry and impedance exams, to correlate the possible audiological changes in each phase of the menstrual cycle. Results  There were significant changes in hearing thresholds observed during the menstrual cycle phases in the group of women who used hormonal contraceptives and the group who did not use such contraceptives. Improved hearing thresholds were observed in the late follicular phase in the group who did not use hormonal contraceptives and the hearing thresholds at high frequencies were better. Throughout the menstrual cycle phases, the mean variation was 3.6 db HL between weeks in the group who used hormonal contraceptives and 4.09 db HL in the group who did not use them. Conclusions  The present study found that there may be a relationship between hearing changes and hormonal fluctuations during the menstrual cycle based on changes in the hearing thresholds of women. In addition, this study suggests that estrogen has an otoprotective effect on hearing, since the best hearing thresholds were found when estrogen was at its maximum peak.

Epidemiology and Risk Factors for Leisure Noise-Induced Hearing Damage in Flemish Young Adults

PubMed Central

Degeest, Sofie; Clays, Els; Corthals, Paul; Keppler, Hannah

2017-01-01

Context: Young people regularly expose themselves to leisure noise and are at risk for acquiring hearing damage. Aims: The objective of this study was to compare young adults’ hearing status in relation to sociodemographic variables, leisure noise exposure and attitudes and beliefs towards noise. Settings and Design: A self-administered questionnaire regarding hearing, the amount of leisure noise exposure and attitudes towards noise and hearing protection as well as an audiological test battery were completed. Five hundred and seventeen subjects between 18 and 30 years were included. Subject and Methods: Hearing was evaluated using conventional audiometry, transient evoked and distortion product otoacoustic emissions. On the basis of their hearing status, participants were categorised into normal hearing, sub-clinical or clinical hearing loss. Statistical Analysis Used: Independent samples t-tests, chi-square tests and multiple regression models were used to evaluate the relation between groups based on hearing status, sociodemographics, leisure noise and attitudes towards noise. Results: Age was significantly related to hearing status. Although, the subjects in this study frequently participated in leisure activities, no significant associations between leisure noise exposure and hearing status could be detected. No relation with subjects’ attitudes or the use of hearing protection devices was found. Conclusions: This study could not demonstrate clinically significant leisure noise-induced hearing damage, which may lead to more non-protective behaviour. However, the effects of leisure noise may become noticeable over a long-term use since age was found to be related with sub-clinical hearing loss. Longitudinal studies are needed to evaluate the long-term effects of noise exposure. PMID:28164934

Comparative analysis of performance in reading and writing of children exposed and not exposed to high sound pressure levels.

PubMed

Santos, Juliana Feitosa dos; Souza, Ana Paula Ramos de; Seligman, Lilian

2013-01-01

To analyze the possible relationships between high sound pressure levels in the classroom and performance in the use of lexical and phonological routes in reading and writing. This consisted on a quantitative and exploratory study. The following measures were carried out: acoustic measurement, using the dosimeter, visual inspection of the external auditory canal, tonal audiometry thresholds, speech recognition tests and acoustic immittance; instrument for evaluation of reading and writing of isolated words. The non-parametric χ² test and Fisher's exact test were used for data analysis. The results of acoustic measurements in 4 schools in Santa Maria divided the sample of 87 children of third and fourth years of primary school, aged 8 to 10 years, in 2 groups. The 1st group was exposed to sound levels higher than 80 dB(A) (Study group) and the 2nd group at levels lower than 80 dB(A) (Control group). Higher prevalence of correct answers in reading and writing of nonwords, reading irregular words and frequency effect were observed. Predominance of correct answers in the writing of irregular words was observed in the Control group. For the Study group, a higher number of type errors neologism in reading and writing were observed, especially regarding the writing of nonwords and the extension effect; fewer errors of lexicalization type and verbal paragraphy in writing were observed. In assessing the reading and writing skills, children in the Study group exposed to high noise levels had poorer performance in the use of lexical and phonological routes, both in reading and in writing.

Tinnitus and Its Effect on the Quality of Life of Sufferers: A Nigerian Cohort Study.

PubMed

Ukaegbe, Onyinyechi C; Orji, Foster T; Ezeanolue, Basil C; Akpeh, James O; Okorafor, Ijeoma A

2017-10-01

Objectives To evaluate the quality of life of patients with ongoing tinnitus. Study Design This was a cross-sectional study of patients with ongoing tinnitus. Setting The study was carried out in a tertiary hospital in southeastern Nigeria. Subjects and Methods Subjects are adults who presented to the otorhinolaryngology clinic with tinnitus as their primary complaint. Pure-tone audiometry, tinnitus pitch, and loudness matching were done. The Tinnitus Handicap Inventory (THI) questionnaire was used in assessing their quality of life. Results There were 63 participants within the age range of 16 to 74 years; 20 (31.7%) were male and 43 (68.3%) were female. The mean duration of tinnitus was 26.7 ± 38.1 months. Nineteen (30.2%) participants had bilateral tinnitus while 44 (69.8%) had unilateral tinnitus. The mean THI score was 36.6 ± 19.7. The most reported handicap was anxiety and difficulty with concentration followed by depression and irritability. There was no correlation between the disability shown by the THI score and the age, sex, duration of the tinnitus, the tinnitus pitch, tinnitus loudness, or the laterality of the tinnitus. There was a significant positive correlation between the grade of hearing loss and the level of disability reported in the THI ( P = .01). Conclusion Tinnitus sufferers appear to have poorer quality of life compared with nonsufferers. This quality-of-life affectation is likely to be worse in those with disabling hearing loss but does not appear to be related to their age, sex, symptom duration, or the loudness and pitch of their tinnitus.

Hearing acuity as a predictor of walking difficulties in older women.

PubMed

Viljanen, Anne; Kaprio, Jaakko; Pyykkö, Ilmari; Sorri, Martti; Koskenvuo, Markku; Rantanen, Taina

2009-12-01

To examine whether hearing acuity correlates with walking ability and whether impaired hearing at baseline predicts new self-reported walking difficulties after 3 years. Prospective follow-up. Research laboratory and community. Four hundred thirty-four women aged 63 to 76. Hearing was measured using clinical audiometry. A person was defined as having a hearing impairment if a pure-tone average of thresholds at 0.5 to 4 kHz in the better ear was 21 dB or greater. Maximal walking speed was measured over 10 m (m/s), walking endurance as the distance (m), covered in 6 minutes and difficulties in walking 2 km according to self-report. At baseline, women with hearing impairment (n=179) had slower maximal walking speed (1.7 +/- 0.3 m/s vs 1.8 +/- 0.3 m/s, P=.007), lower walking endurance (520 +/- 75 m vs 536 +/- 75 m, P=.08), and more selfreported major difficulties in walking 2 km (12.8% vs 5.5%, P=.02) than those without hearing impairment. During follow-up, major walking difficulties developed for 33 participants. Women with hearing impairment at baseline had a twice the age-adjusted risk for new walking difficulties as those without hearing impairment (odds ratio=2.04, 95% confidence interval=0.96-4.33). Hearing acuity correlated with mobility, which may be explained by the association between impaired hearing and poor balance and greater risk for falls, both of which underlie decline in mobility. Prevention of hearing loss is not only important for the ability to communicate, but may also have more wide-ranging influences on functional ability.

Otologic manifestations of Fanconi anemia and other inherited bone marrow failure syndromes.

PubMed

Kalejaiye, Adedoyin; Giri, Neelam; Brewer, Carmen C; Zalewski, Christopher K; King, Kelly A; Adams, Charleen D; Rosenberg, Philip S; Kim, H Jeffrey; Alter, Blanche P

2016-12-01

The inherited bone marrow failure syndromes (IBMFSs) are diverse disorders with syndrome-specific features; their otologic and audiologic manifestations have not been well described. Our objective was to characterize these in patients with Fanconi anemia (FA), dyskeratosis congenita (DC), Diamond-Blackfan anemia (DBA), and Shwachman-Diamond syndrome (SDS), and to determine the association between physical findings and hearing loss. Patients with an IBMFS underwent comprehensive clinical and laboratory evaluations and testing for syndrome-specific gene mutations. Hearing loss was measured by pure tone audiometry and otologic abnormalities by otomicroscopy. Patients included 33 with FA, 37 with DC, 32 with DBA, and nine with SDS. Hearing loss was most frequent in patients with FA (45%) and DBA (14%). The most common type of hearing loss in FA was conductive (65%). Absent or hypoplastic radius, noted in 21% of the patients with FA, was associated with hearing loss in all cases. Otomicroscopy was abnormal in 66% of patients with FA. Characteristic ear abnormalities included small tympanic membrane (66%), malformed malleus (57%), aberrant tympanic bony island (48%), narrow external auditory canal (EAC) (32%), and abnormal course of chorda tympani (34%). Ear malformations were almost always associated with hearing loss. Hearing loss was rare in patients with DC and SDS. FA is the major IBMFS with associated hearing loss, which is most commonly conductive. Radial hypoplasia or aplasia and characteristic congenital ear malformations are associated with hearing loss in patients with FA. Recognition of these syndrome-specific abnormalities should lead to earlier management of hearing loss. © 2016 Wiley Periodicals, Inc.

Improving Measurement Efficiency of the Inner EAR Scale with Item Response Theory.

PubMed

Jessen, Annika; Ho, Andrew D; Corrales, C Eduardo; Yueh, Bevan; Shin, Jennifer J

2018-02-01

Objectives (1) To assess the 11-item Inner Effectiveness of Auditory Rehabilitation (Inner EAR) instrument with item response theory (IRT). (2) To determine whether the underlying latent ability could also be accurately represented by a subset of the items for use in high-volume clinical scenarios. (3) To determine whether the Inner EAR instrument correlates with pure tone thresholds and word recognition scores. Design IRT evaluation of prospective cohort data. Setting Tertiary care academic ambulatory otolaryngology clinic. Subjects and Methods Modern psychometric methods, including factor analysis and IRT, were used to assess unidimensionality and item properties. Regression methods were used to assess prediction of word recognition and pure tone audiometry scores. Results The Inner EAR scale is unidimensional, and items varied in their location and information. Information parameter estimates ranged from 1.63 to 4.52, with higher values indicating more useful items. The IRT model provided a basis for identifying 2 sets of items with relatively lower information parameters. Item information functions demonstrated which items added insubstantial value over and above other items and were removed in stages, creating a 8- and 3-item Inner EAR scale for more efficient assessment. The 8-item version accurately reflected the underlying construct. All versions correlated moderately with word recognition scores and pure tone averages. Conclusion The 11-, 8-, and 3-item versions of the Inner EAR scale have strong psychometric properties, and there is correlational validity evidence for the observed scores. Modern psychometric methods can help streamline care delivery by maximizing relevant information per item administered.

Analysis of wave III of brain stem auditory evoked potential waveforms during microvascular decompression of cranial nerve VII for hemifacial spasm.

PubMed

Thirumala, Parthasarathy D; Krishnaiah, Balaji; Crammond, Donald J; Habeych, Miguel E; Balzer, Jeffrey R

2014-04-01

Intraoperative monitoring of brain stem auditory evoked potential during microvascular decompression (MVD) prevent hearing loss (HL). Previous studies have shown that changes in wave III (wIII) are an early and sensitive sign of auditory nerve injury. To evaluate the changes of amplitude and latency of wIII of brain stem auditory evoked potential during MVD and its association with postoperative HL. Hearing loss was classified by American Academy of Otolaryngology - Head and Neck Surgery (AAO-HNS) criteria, based on changes in pure tone audiometry and speech discrimination score. Retrospective analysis of wIII in patients who underwent intraoperative monitoring with brain stem auditory evoked potential during MVD was performed. A univariate logistic regression analysis was performed on independent variables amplitude of wIII and latency of wIII at change max and On-Skin, or a final recording at the time of skin closure. A further analysis for the same variables was performed adjusting for the loss of wave. The latency of wIII was not found to be significantly different between groups I and II. The amplitude of wIII was significantly decreased in the group with HL. Regression analysis did not find any increased odds of HL with changes in the amplitude of wIII. Changes in wave III did not increase the odds of HL in patients who underwent brain stem auditory evoked potential s during MVD. This information might be valuable to evaluate the value of wIII as an alarm criterion during MVD to prevent HL.

Patient-reported speech in noise difficulties and hyperacusis symptoms and correlation with test results.

PubMed

Spyridakou, Chrysa; Luxon, Linda M; Bamiou, Doris E

2012-07-01

To compare self-reported symptoms of difficulty hearing speech in noise and hyperacusis in adults with auditory processing disorders (APDs) and normal controls; and to compare self-reported symptoms to objective test results (speech in babble test, transient evoked otoacoustic emission [TEOAE] suppression test using contralateral noise). A prospective case-control pilot study. Twenty-two participants were recruited in the study: 10 patients with reported hearing difficulty, normal audiometry, and a clinical diagnosis of APD; and 12 normal age-matched controls with no reported hearing difficulty. All participants completed the validated Amsterdam Inventory for Auditory Disability questionnaire, a hyperacusis questionnaire, a speech in babble test, and a TEOAE suppression test using contralateral noise. Patients had significantly worse scores than controls in all domains of the Amsterdam Inventory questionnaire (with the exception of sound detection) and the hyperacusis questionnaire (P < .005). Patients also had worse TEOAE suppression test results in both ears than controls; however, this result was not significant after Bonferroni correction. Strong correlations were observed between self-reported symptoms of difficulty hearing speech in noise and speech in babble test results in the right ear (ρ = 0.624, P = .002), and between self-reported symptoms of hyperacusis and TEOAE suppression test results in the right ear (ρ = -0.597 P = .003). There was no significant correlation between the two tests. A strong correlation was observed between right ear speech in babble and patient-reported intelligibility of speech in noise, and right ear TEOAE suppression by contralateral noise and hyperacusis questionnaire. Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.

Correlation between bithermal caloric test results and vestibular evoked myogenic potentials (VEMPs) in normal subjects.

PubMed

Andrade, Isabel Vaamonde Sanchez; Santos-Perez, Sofia; Diz, Pilar Gayoso; Caballero, Torcuato Labella; Soto-Varela, Andrés

2013-05-01

Bithermal caloric testing and vestibular evoked myogenic potentials (VEMPs) are both diagnostic tools for the study of the vestibular system. The first tests the horizontal semicircular canal and the second evaluates the saccule and lower vestibular nerve. The results of these two tests can therefore be expected to be correlated. The aim of this study was to compare bithermal caloric test results with VEMP records in normal subjects to verify whether they are correlated. A prospective study was conducted in 60 healthy subjects (30 men and 30 women) who underwent otoscopy, pure tone audiometry, bithermal caloric testing and VEMPs. From the caloric test, we assessed the presence of possible vestibular hypofunction, whether there was directional preponderance and reflectivity of each ear (all based on both slow phase velocity and nystagmus frequency). The analysed VEMPs variables were: p1 and n1 latency, corrected amplitude, interaural p1 latency difference and p1 interaural amplitude asymmetry. We compared the reflectivity, hypofunction and directional preponderance of the caloric tests with the corrected amplitudes and amplitude asymmetries of the VEMPs. No correlations were found in the different comparisons between bithermal caloric testing results and VEMPs except for a weak correlation (p = 0.039) when comparing preponderance based on the number of nystagmus in the caloric test and amplitude asymmetry with 99 dB tone burst in the VEMPs test. The results indicate that the two diagnostic tests are not comparable, so one of them cannot replace the other, but the use of both increases diagnostic success in some conditions.

Aural symptoms in patients with temporomandibular joint disorders: multiple frequency tympanometry provides objective evidence of changes in middle ear impedance.

PubMed

Riga, Maria; Xenellis, John; Peraki, Eleni; Ferekidou, Elisa; Korres, Stavros

2010-12-01

The association of temporomandibular joint (TMJ) disorders with aural symptoms, such as tinnitus, otic fullness, and subjective decrease of hearing acuity, is a well-established clinical observation. Although several hypotheses have been made about the otic-conductive origin of these complaints, conventional 226-Hz tympanometry has failed to demonstrate any middle ear abnormalities. The aim of this study was to evaluate patients with TMJ disorders with multiple frequency tympanometry (MFT). Prospective clinical study. Outpatient clinic. The population of this study consisted of 40 patients with unilateral TMJ disorders diagnosed for longer than 1 month. After verifying that there were no abnormal otoscopic findings, 226-Hz tympanometry, conventional pure-tone audiometry, brainstem auditory evoked potentials, and MFT were performed. Resonant frequency (RF) values. With the exception of MFT, no abnormal audiologic findings were revealed. The ear ipsilateral to the lesion demonstrated significantly higher (p = 0.002) RF values in comparison to the contralateral ear. The difference in RF values was more obvious in patients aged 45 years or younger. The results of this study imply an increase in the stiffness of the middle ear, which has not been detected by conventional tympanometry. This represents the first concrete documentation of minor alterations in the conductive properties of the middle ear and seems to support the various hypotheses on the middle-ear origin of aural complaints in patients with TMJ disorders. Further studies are needed before a clear insight on the presumably multifactorial pathophysiology of these complaints can finally be reached.

Transtympanic injections of N-acetylcysteine for the prevention of cisplatin-induced ototoxicity: a feasible method with promising efficacy.

PubMed

Riga, Maria G; Chelis, Leonidas; Kakolyris, Stylianos; Papadopoulos, Stergios; Stathakidou, Sofia; Chamalidou, Eleni; Xenidis, Nikolaos; Amarantidis, Kyriakos; Dimopoulos, Prokopios; Danielides, Vasilios

2013-02-01

Ototoxicity is a common and irreversible adverse effect of cisplatin treatment with great impact on the patients' quality of life. N-acetylcysteine is a low-molecular-weight agent which has shown substantial otoprotective activity. The role of transtympanic infusions of N-acetylcysteine was examined in a cohort of patients treated with cisplatin-based regimens. Twenty cisplatin-treated patients were subjected, under local anesthesia, to transtympanic N-acetylcysteine (10%) infusions in 1 ear, during the hydration procedure preceding intravenous effusion of cisplatin. The contralateral ear was used as control. The number of transtympanic infusions was respective to the number of administered cycles. Hearing acuity was evaluated before each cycle with pure tone audiometry by an audiologist blinded to the treated ear. A total of 84 transtympanic infusions were performed. In treated ears, no significant changes in auditory thresholds were recorded. In the control ears cisplatin induced a significant decrease of auditory thresholds at the 8000 Hz frequency band (P=0.008). At the same frequency (8000 Hz), the changes in auditory thresholds were significantly larger for the control ears than the treated ones (P=0.005). An acute pain starting shortly after the injection and lasting for a few minutes seemed to be the only significant adverse effect. Transtympanic injections of N-acetylcysteine seem to be a feasible and effective otoprotective strategy for the prevention of cisplatin-induced ototoxicity. Additional studies are required to further clarify the efficiency of this treatment and determine the optimal dosage and protocol.

Association between polymorphism of tumor necrosis factor alpha (tnfα) in the region -308 g/a with tinnitus in the elderly with a history of occupational noise exposure.

PubMed

Marchiori, Luciana L M; Dias, Ana C M; Gonçalvez, Alyne S; Poly-Frederico, Regina C; Doi, Marcelo Y

2018-01-01

Tinnitus is a common disorder that occurs frequently across all strata of population and has an important health concern and is often associated with different forms of the hearing loss of varying severity. To investigate the association between the polymorphism of tumor necrosis factor alpha (TNFα) in the region -308 G/A with the susceptibility to tinnitus in individuals with the history of exposure to occupational noise. This was a cross-sectional study with a sample of 179 independent elderly people above 60 years of age. Information on exposure to occupational noise was obtained by interviews. Audiological evaluation was performed using pure tone audiometry and genotyped through polymerase chain reaction by restriction fragment length polymorphism. Data were analyzed using the chi-square test and the odds ratio (OR), with the significance level set at 5%. Among elderly with tinnitus (43.01%), 33.76% had a history of exposure to occupational noise. A statistically significant association was found between genotype frequencies of the TNFα gene in the -308 G/A region and the complaint of tinnitus (P = 0.04 and χ 2  = 4.19). The elderly with the G allele were less likely to have tinnitus due to occupational noise exposure when compared to those carrying the A allele (OR = 2.74; 95% CI: 1.56-4.81; P < 0.0005). This study suggests an association between the TNFα with susceptibility to tinnitus in individuals with a history of exposure to occupational noise.

Contralateral Occlusion Test: The effect of external ear canal occlusion on hearing thresholds.

PubMed

Reis, Luis Roque; Fernandes, Paulo; Escada, Pedro

Bedside testing with tuning forks may decrease turnaround time and improve decision making for a quick qualitative assessment of hearing loss. The purpose of this study was to quantify the effects of ear canal occlusion on hearing, in order to decide which tuning fork frequency is more appropriate to use for quantifying hearing loss with the Contralateral Occlusion Test. Twenty normal-hearing adults (forty ears) underwent sound field pure tone audiometry with and without ear canal occlusion. Each ear was tested with the standard frequencies. The contralateral ear was suppressed with by masking. Ear occlusion was performed by two examiners. Participants aged between 21 and 30 years (25.6±3.03 years) showed an increase in hearing thresholds with increasing frequencies from 19.94dB (250Hz) to 39.25dB (2000Hz). The threshold difference between occluded and unoccluded conditions was statistically significant and increased from 10.69dB (250Hz) to 32.12dB (2000Hz). There were no statistically significant differences according to gender or between the examiners. The occlusion effect increased the hearing thresholds and became more evident with higher frequencies. The occlusion method as performed demonstrated reproducibility. In the Contralateral Occlusion Test, 256Hz or 512Hz tuning forks should be used for diagnosis of mild hearing loss, and a 2048Hz tuning fork should be used for moderate hearing loss. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

[A comparative study on efficacy of glucocorticoids, mineralocorticoids and vasoactive drugs on reversing hearing loss in patients suffering idiopathic sensorineural cochlear hypoacusis. A preliminary clinical trial].

PubMed

Campos-Bañales, Eugenia María; López-Campos, Daniel; de Serdio-Arias, José Luis; Esteban-Rodriguez, J; García-Sáinz, Mar; Muñoz-Cortés, Álvaro; López-Aguado, Daniel

2015-01-01

Sensory neural hearing loss (SNHL) is a disorder characterised by an important deterioration of the auditory function. Re-establishing normal ion homeostasis of the endolymph could be related to hearing recovery and it might be mediated by mineralocorticoids. The main purpose of this preliminary, randomized controlled clinical trial was assessing the recovery of idiopathic sensory neural cochlear hearing loss (SNHL) by comparing the efficacy of 2 types of steroids versus vasodilators. The 3-month intervention involved 70 patients, allocated into 4 different groups: a control with no medication, consisting of 14 patients (8 men and 6 women); a vasodilator group of 21 patients (11 men and 10 women); a glucocorticoid group with 16 patients (10 men and 6 women); and a mineralocorticoid therapy group, consisting of 19 patients (11 men and 8 women). The level of hearing loss and its topography were estimated using Liminal Tone Audiometry (LTA) and Auditory Brainstem Response (ABR). Our research found overall greater efficacy of mineralocorticoids versus glucocorticoids and vasodilators. There was better response in women than in men and it was higher from the left ear, regardless of patient gender. The hearing gain was significantly superior in the mineralocorticoid group, followed by the glucocorticoid group. However, the responses to vasodilators were lesser and of low statistical significance. Copyright © 2014 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Patología Cérvico-Facial. All rights reserved.

Noise-Induced Hearing Loss Still a Problem in Shipbuilders: A Cross-Sectional Study in Goa, India

PubMed Central

Bhumika, N; Prabhu, GV; Ferreira, AM; Kulkarni, MK

2013-01-01

Background: Workplace safety regulations seek to mitigate noise-induced hearing loss (NIHL), conventionally associated with the shipbuilding industry. Despite this, are workers still predisposed to NIHL? Aims: To study the prevalence of NIHL among noise-exposed subjects in the shipbuilding industry in Goa and to compare it with that among the non-exposed population working in the same industry in relation to certain relevant factors. Subjects and Methods: This is a cross-sectional study in the shipbuilding industry, Goa This study examined 552 workers: 276 shipbuilders and 276 office staff, of similar age, duration of employment and socio-economic status working at a shipbuilding enterprise. An interviewer-administered questionnaire was followed by audiometry. Values were presented as percentages, Mean (SD) and odds ratio (OR) and its 95% confidence interval (CI) (Woolfe's method). Fisher's exact test and binary logistic regression were used. P value of < 0.05 was taken as significant. SPSS version 16 was used. Results: NIHL was found in 17 (6%) shipbuilders, while no office staff was detected to have this condition (OR = 37.29, 95% CI 22.42-62.18). The shipbuilders with NIHL were 52.5 years of age and had been employed for 30.4 years, on an average. None of the 17 cases of NIHL were found to be using earplugs consistently; 11 reported using them “sometimes” and six “never” used them. Conclusions: NIHL continues to affect shipbuilders, owing their non-compliance to workplace regulation. Health education is the need of the hour. PMID:23634321

The influence of jet engine noise on hearing of technical staff.

PubMed

Konopka, Wiesław; Pawlaczyk-Luszczyńska, Małgorzata; Śliwińska-Kowalska, Mariola

2014-01-01

Due to high sound pressure levels (SPLs), noise produced by jet planes may be harmful to hearing of people working in their proximity. The aim of this study was to assess the effects of exposure to jet engine noise on technical staff hearing. The study comprised 60 men, aged 24-50 years, employed in army as technical staff and exposed to jet engine noise for 6-20 years. The control group were 50 non-noise exposed males, aged 25-51 years. Exposure to noise emitted by jet engines was evaluated. Pure-tone audiometry (PTA) and distortion product otoacoustic emissions (DPOAE) were recorded in both groups. Jet engines emitted broadband noise with spectrum dominated by components in the frequency range 315-6300 Hz (1/3-octave bands). Maximum A-weighted SPL during tests reached values of approx. 120-130 dB. Consequently, engine-servicing personnel (even in the case of a single engine test) was exposed to noise (at A-weighted daily noise exposure level above 95 dB) exceeding permissible levels. Averaged audiometric hearing threshold levels of technical staff were higher (≤ 17 dB HL, p < 0.001) than in the control group. Similarly, the DPOAE amplitude was lower (≤ 17 dB SPL, p < 0.01) in the noise-exposed subjects compared to the non-exposed ones. Significant reduction of DPOAE levels was mainly noted for high frequencies (3-6 kHz). Despite the usage of hearing protection devices, both PTA and DPOAE consistently showed poorer hearing in engine-servicing personnel vs. control group.

Hearing loss associated with repeated MRI acquisition procedure-related acoustic noise exposure: an occupational cohort study.

PubMed

Bongers, Suzan; Slottje, Pauline; Kromhout, Hans

2017-11-01

To study the effects of repeated exposure to MRI-related acoustic noise during image acquisition procedures (scans) on hearing. A retrospective occupational cohort study was performed among workers of an MRI manufacturing facility (n=474). Longitudinal audiometry data from the facility's medical surveillance scheme collected from 1973 to 2010 were analysed by studying the association of cumulative exposure to MRI-related acoustic noise from voluntary (multiple) MRI scans and the hearing threshold of the volunteer. Repeated acoustic noise exposure during volunteer MRI scans was found to be associated with a small exposure-dependent increased rate change of hearing threshold level (dB/year), but the association was only found related to the number of voluntary MRI scans and not to modelled cumulative noise exposure (dB*hour) based on MRI-system type. The increased rate change of hearing threshold level was found to be statistically significant for the frequencies 500, 1000, 2000, 3000 and 4000 Hz in the right ear. From our longitudinal cohort study, it appeared that exposure to noise from voluntarily MRI scans may have resulted in a slight amount of hearing loss. Mandatory use of hearing protection might have prevented more severe hearing loss. Lack of consistency in findings between the left and right ears and between the two exposure measures prohibits definitive conclusions. Further research that addresses the study's methodological limitations is warranted to corroborate our findings. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

[Analysis of the speech discrimination scores of patients with congenital unilateral microtia and external auditory canal atresia in noise].

PubMed

Zhang, Y; Li, D D; Chen, X W

2017-06-20

Objective: Case-control study analysis of the speech discrimination of unilateral microtia and external auditory canal atresia patients with normal hearing subjects in quiet and noisy environment. To understand the speech recognition results of patients with unilateral external auditory canal atresia and provide scientific basis for clinical early intervention. Method: Twenty patients with unilateral congenital microtia malformation combined external auditory canal atresia, 20 age matched normal subjects as control group. All subjects used Mandarin speech audiometry material, to test the speech discrimination scores (SDS) in quiet and noisy environment in sound field. Result: There's no significant difference of speech discrimination scores under the condition of quiet between two groups. There's a statistically significant difference when the speech signal in the affected side and noise in the nomalside (single syllable, double syllable, statements; S/N=0 and S/N=-10) ( P <0.05). There's no significant difference of speech discrimination scores when the speech signal in the nomalside and noise in the affected side. There's a statistically significant difference in condition of the signal and noise in the same side when used one-syllable word recognition (S/N=0 and S/N=-5) ( P <0.05), while double syllable word and statement has no statistically significant difference ( P >0.05). Conclusion: The speech discrimination scores of unilateral congenital microtia malformation patients with external auditory canal atresia under the condition of noise is lower than the normal subjects. Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.

Fit for the frontline? A focus group exploration of auditory tasks carried out by infantry and combat support personnel.

PubMed

Bevis, Zoe L; Semeraro, Hannah D; van Besouw, Rachel M; Rowan, Daniel; Lineton, Ben; Allsopp, Adrian J

2014-01-01

In order to preserve their operational effectiveness and ultimately their survival, military personnel must be able to detect important acoustic signals and maintain situational awareness. The possession of sufficient hearing ability to perform job-specific auditory tasks is defined as auditory fitness for duty (AFFD). Pure tone audiometry (PTA) is used to assess AFFD in the UK military; however, it is unclear whether PTA is able to accurately predict performance on job-specific auditory tasks. The aim of the current study was to gather information about auditory tasks carried out by infantry personnel on the frontline and the environment these tasks are performed in. The study consisted of 16 focus group interviews with an average of five participants per group. Eighty British army personnel were recruited from five infantry regiments. The focus group guideline included seven open-ended questions designed to elicit information about the auditory tasks performed on operational duty. Content analysis of the data resulted in two main themes: (1) the auditory tasks personnel are expected to perform and (2) situations where personnel felt their hearing ability was reduced. Auditory tasks were divided into subthemes of sound detection, speech communication and sound localization. Reasons for reduced performance included background noise, hearing protection and attention difficulties. The current study provided an important and novel insight to the complex auditory environment experienced by British infantry personnel and identified 17 auditory tasks carried out by personnel on operational duties. These auditory tasks will be used to inform the development of a functional AFFD test for infantry personnel.

The Socioeconomic Impact of Hearing Loss in US Adults

PubMed Central

Emmett, Susan D.; Francis, Howard W.

2014-01-01

Objective To evaluate the associations between hearing loss and educational attainment, income, and unemployment/underemployment in US adults. Study design National cross-sectional survey. Setting Ambulatory examination centers. Patients Adults aged 20-69 years who participated in the 1999-2002 cycles of the National Health and Nutrition Examination Survey (NHANES) audiometric evaluation and income questionnaire (n = 3379). Intervention(s) Pure tone audiometry, with hearing loss defined by World Health Organization criteria of bilateral pure tone average >25 decibels (0.5,1,2,4 kHz). Main outcome measure(s) Low educational attainment, defined as not completing high school; low income, defined as family income less than $20,000/year, and unemployment or underemployment, defined as not having a job or working less than 35 hours per week. Results Individuals with hearing loss had 3.21 times higher odds of low educational attainment (95% CI: 2.20-4.68) compared to normal-hearing individuals. Controlling for education, age, sex, and race, individuals with hearing loss had 1.58 times higher odds of low income (95% CI: 1.16-2.15) and 1.98 times higher odds of being unemployed or underemployed (95% CI: 1.38-2.85) compared to normal-hearing individuals. Conclusions Hearing loss is associated with low educational attainment in US adults. Even after controlling for education and important demographic factors, hearing loss is independently associated with economic hardship, including both low income and unemployment/underemployment. The societal impact of hearing loss is profound in this nationally representative study and should be further evaluated with longitudinal cohorts. PMID:25158616

Hearing in young adults. Part II: The effects of recreational noise exposure

PubMed Central

Keppler, Hannah; Dhooge, Ingeborg; Vinck, Bart

2015-01-01

Great concern arises from recreational noise exposure, which might lead to noise-induced hearing loss in young adults. The objective of the current study was to evaluate the effects of recreational noise exposure on hearing function in young adults. A questionnaire concerning recreational noise exposures and an audiological test battery were completed by 163 subjects (aged 18-30 years). Based on the duration of exposure and self-estimated loudness of various leisure-time activities, the weekly and lifetime equivalent noise exposure were calculated. Subjects were categorized in groups with low, intermediate, and high recreational noise exposure based on these values. Hearing was evaluated using audiometry, transient-evoked otoacoustic emissions (TEOAEs), and distortion-product otoacoustic emissions (DPOAEs). Mean differences in hearing between groups with low, intermediate, and high recreational noise exposure were evaluated using one-way analysis of variance (ANOVA). There were no significant differences in hearing thresholds, TEOAE amplitudes, and DPOAE amplitudes between groups with low, intermediate, or high recreational noise exposure. Nevertheless, one-third of our subjects exceeded the weekly equivalent noise exposure for all activities of 75 dBA. Further, the highest equivalent sound pressure levels (SPLs) were calculated for the activities visiting nightclubs or pubs, attending concerts or festivals, and playing in a band or orchestra. Moreover, temporary tinnitus after recreational noise exposure was found in 86% of our subjects. There were no significant differences in hearing between groups with low, intermediate, and high recreational noise exposure. Nevertheless, a long-term assessment of young adults’ hearing in relation to recreational noise exposure is needed. PMID:26356366

Longitudinal development of wideband reflectance tympanometry in normal and at-risk infants

PubMed Central

Hunter, Lisa L.; Keefe, Douglas H.; Feeney, M. Patrick; Fitzpatrick, Denis F.; Lin, Li

2016-01-01

Purpose The goals of this study were to measure normal characteristics of ambient and tympanometric wideband acoustic reflectance, which was parameterized by absorbance and group delay, in newborns cared for in well-baby and Neonatal Intensive Care Unit (NICU) nurseries, and to characterize the normal development of reflectance over the first year after birth in a group of infants with clinically normal hearing status followed longitudinally from birth to one year of age. Methods Infants were recruited from a well-baby and NICU nursery, passed newborn otoacoustic emissions (OAE) and automated auditory brainstem response (ABR) tests as well as follow-up diagnostic ABR and audiometry. They were tested longitudinally for up to one year using a wideband middle ear acoustic test battery consisting of tympanometry and ambient-pressure tests. Results were analyzed for ambient reflectance across frequency and tympanometric reflectance across frequency and pressure. Results Wideband absorbance and group delay showed large effects of age in the first 6 months. Immature absorbance and group delay patterns were apparent in the low frequencies at birth and one month, but changed substantially to a more adult-like pattern by age 6 months for both ambient and tympanometric variables. Area and length of the ear canal estimated acoustically increased up to age 1 year. Effects of race (African American and others compared to Caucasian) were found in combination with age effects. Mean and confidence intervals are provided for use as a normative longitudinal database for newborns and infants up to one year of age, for both well-baby and NICU infants. PMID:26712451

Congenital middle ear abnormalities with absence of the oval window: diagnosis, surgery, and audiometric outcomes.

PubMed

Su, Yu; Yuan, Hu; Song, Yue-shuai; Shen, Wei-dong; Han, Wei-ju; Liu, Jun; Han, Dong-yi; Dai, Pu

2014-08-01

Congenital absence of the oval window (CAOW) is a rare condition in which the stapes footplate fails to develop, resulting in a significant conductive hearing loss in the affected ear. The purpose of this study was to describe the surgical management and outcomes of patients with CAOW undergoing the oval window drill-out (OWD) procedure. A retrospective chart review of patients with CAOW between 1996 and 2011 was performed. Clinical data of patients who underwent OWD were collected. Seventy-nine patients (103 ears) were confirmed using exploratory tympanotomy as having congenital stapes anomalies and CAOW without any anomalies of the tympanic membrane and external auditory canal. Demographic data, CT findings, operative findings, complications, and preoperative/postoperative audiometry data of patients who underwent OWD were collected. The preoperative and postoperative audiologic findings were analyzed in 42 patients (56 ears) with complete data. Hearing restoration surgery was aborted for various reasons in 14 cases. Six patients underwent revision operations for worsening hearing after their first surgery. The average preoperative 4 tone air conduction threshold was 67 dB; the average 6-month postoperative four tone air conduction threshold was 49 dB, and the average postoperative hearing gain was 18 dB. For the 56 ears, the average 4 tone air conduction threshold 6 months after surgery was significantly lower than the preoperative threshold. The oval window drill-out procedure is a viable operation for patients with congenital absence of the oval window, and it is important for surgeons to develop personalized treatment programs to improve patients' hearing with minimal complications.

Masking Treatment and its Effect on Tinnitus Parameters.

PubMed

Aytac, Ismail; Baysal, Elif; Gulsen, Secaattin; Tumuklu, Koray; Durucu, Cengiz; Mumbuc, Lütfi Semih; Kanlikama, MUzaffer

2017-12-01

Tinnitus is described as the perception of sound without any external acoustic stimulation. Any pathology of auditory pathways or any system of the human body may result with tinnitus. The pathophysiology of tinnitus accompanying the disorders of auditory system is not fully understood and there is not any particular effective treatment method has been specified. Tinnitus masking therapy has been reported as an effective treatment modality in the treatment of tinnitus. In this study, the results of tinnitus masking treatment on the parameters were evaluated prospectively. Patients with normal physical examination was enrolled in the study. Blood tests (complete blood count, biochemical analysis of lipid profile, and thyroid hormones), pure tone audiometry, tympanometric measurement of the middle ear pressure and stapedial reflexes were performed, Sixty six patients with normal results of blood tests and normal hearing thresholds with type A tympanogram were included. Tinnitus sufferers questionnaires (socio-demographics, clinical information, Tinnitus Handicap Inventory (THI), Beck Depression Inventory (BDI) was filled, audiological tests were performed, tinnitus parameters (frequency, intensity, minimal masking levels, residual inhibition) were measured. After four weeks of the treatment the questionnaires were repeated. Masking treatment for tinnitus patients resulted with significant decrease in Tinnitus Handicap Inventory and VAS scores. After four weeks of the masking treatment the questionnaire was repeated. Twenty patients did not respond to treatment. Masking therapy is one of the most effective methods of treatment for tinnitus patients. Masking therapy, that is not invasive and cost-effective has an important place in the treatment of tinnitus. Especially in a short time provides a significant reduction in tinnitus parameters.

Fractionated Stereotactic Radiotherapy of Vestibular Schwannomas Accelerates Hearing Loss

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rasmussen, Rune, E-mail: rune333@gmail.com; Claesson, Magnus; Stangerup, Sven-Eric

2012-08-01

Objective: To evaluate long-term tumor control and hearing preservation rates in patients with vestibular schwannoma treated with fractionated stereotactic radiotherapy (FSRT), comparing hearing preservation rates to an untreated control group. The relationship between radiation dose to the cochlea and hearing preservation was also investigated. Methods and Materials: Forty-two patients receiving FSRT between 1997 and 2008 with a minimum follow-up of 2 years were included. All patients received 54 Gy in 27-30 fractions during 5.5-6.0 weeks. Clinical and audiometry data were collected prospectively. From a 'wait-and-scan' group, 409 patients were selected as control subjects, matched by initial audiometric parameters. Radiation dosemore » to the cochlea was measured using the original treatment plan and then related to changes in acoustic parameters. Results: Actuarial 2-, 4-, and 10-year tumor control rates were 100%, 91.5%, and 85.0%, respectively. Twenty-one patients had serviceable hearing before FSRT, 8 of whom (38%) retained serviceable hearing at 2 years after FSRT. No patients retained serviceable hearing after 10 years. At 2 years, hearing preservation rates in the control group were 1.8 times higher compared with the group receiving FSRT (P=.007). Radiation dose to the cochlea was significantly correlated to deterioration of the speech reception threshold (P=.03) but not to discrimination loss. Conclusion: FSRT accelerates the naturally occurring hearing loss in patients with vestibular schwannoma. Our findings, using fractionation of radiotherapy, parallel results using single-dose radiation. The radiation dose to the cochlea is correlated to hearing loss measured as the speech reception threshold.« less

Evaluation of the olivocochlear efferent reflex strength in the susceptibility to temporary hearing deterioration after music exposure in young adults.

PubMed

Hannah, Keppler; Ingeborg, Dhooge; Leen, Maes; Annelies, Bockstael; Birgit, Philips; Freya, Swinnen; Bart, Vinck

2014-01-01

The objective of the current study was to evaluate the predictive role of the olivocochlear efferent reflex strength in temporary hearing deterioration in young adults exposed to music. This was based on the fact that a noise-protective role of the medial olivocochlear (MOC) system was observed in animals and that efferent suppression (ES) measured using contralateral acoustic stimulation (CAS) of otoacoustic emissions (OAEs) is capable of exploring the MOC system. Knowing an individual's susceptibility to cochlear damage after noise exposure would enhance preventive strategies for noise-induced hearing loss. The hearing status of 28 young adults was evaluated using pure-tone audiometry, transient evoked OAEs (TEOAEs) and distortion product OAEs (DPOAEs) before and after listening to music using an MP3 player during 1 h at an individually determined loud listening level. CAS of TEOAEs was measured before music exposure to determine the amount of ES. Regression analysis showed a distinctive positive correlation between temporary hearing deterioration and the preferred gain setting of the MP3 player. However, no clear relationship between temporary hearing deterioration and the amount of ES was found. In conclusion, clinical measurement of ES, using CAS of TEOAEs, is not correlated with the amount of temporary hearing deterioration after 1 h music exposure in young adults. However, it is possible that the temporary hearing deterioration in the current study was insufficient to activate the MOC system. More research regarding ES might provide more insight in the olivocochlear efferent pathways and their role in auditory functioning.

An animal model for the analysis of cochlear blood flow [corrected] disturbance and hearing threshold in vivo.

PubMed

Canis, Martin; Arpornchayanon, Warangkana; Messmer, Catalina; Suckfuell, Markus; Olzowy, Bernhard; Strieth, Sebastian

2010-02-01

Impairment of cochlear blood flow (CBF) is considered to be important in inner ear pathology. However, direct measurement of CBF is difficult and has not been investigated in combination with hearing function. Six guinea pigs were used to show feasibility of an animal model for the analysis of cochlear microcirculation by intravital microscopy in combination with investigation of the hearing threshold by brainstem response audiometry (ABR). By the application of sodium nitroprusside (SNP), CBF was increased over 30 min. Reproducibility of measurements was shown by retest measurements. Mean baseline velocity of CBF was 109 +/- 19 mum/s. Vessel diameters had a mean value of 9.4 +/- 2.7 mum. Mean hearing threshold was 19 +/- 6 dB. In response to SNP, CBF velocity increased significantly to 161 +/- 26 mum/s. Mean arterial pressure decreased significantly to 36 +/- 11 mmHg. After the end of the application, CBF velocity recovered to a minimum of 123 +/- 17 microm/s. Within the retest, CBF velocity significantly increased to a maximum of 160 +/- 31 microm/s. Second recovery of CBF velocity was 125 +/- 14 mum/s. Within the second retest, CBF increased significantly to 157 +/- 25 microm/s. ABR thresholds did not change significantly. The increase in blood flow velocity occurred in spite of substantial hypotension as induced by a vasodilator. This may explain the fact that ABR threshold remained unchanged reflecting a maintained blood supply in this part of the brain. This technique can be used to evaluate effects of treatments aimed at cochlear microcirculation in inner ear pathologies.

Utility of Adjunctive Procedures With Balloon Dilation of the Eustachian Tube.

PubMed

Ashry, Yehia; Kawai, Kosuke; Poe, Dennis

2017-12-01

To assess the role and effect of concomitant adjunctive procedures when combined with balloon dilation of the Eustachian tube (BDET), including a new technique for treating obstructive disease within the bony Eustachian tube (ET). Retrospective case series. Tertiary medical center. Adults with persistent (≥2 years): 1) OME or non-fixed TM retraction AND type B or C tympanogram OR 2) Consistent symptoms of barochallenge with flights or diving, all despite medical treatment for ≥6 weeks. Balloon dilation of the cartilaginous ET (BDET) was performed under general anesthesia using concomitant myringotomy with or without tube placement if indicated. Adjunctive turbinectomy, adenoidectomy, and/or tympanoplasty were used in selected cases. For suspected disease in the bony ET, an illuminated guidewire was used for probing and clearing the lumen. Outcome measures were tympanogram, otomicroscopy, ET mucosal inflammation score, Valsalva maneuver, and PTA audiometry. 67 ETs (48 patients) underwent BDET: 1) 30/67 balloon w/wo myringotomy, w/wo tube, 2) 20/67 plus adjunctive procedure or 3) 17/67 plus guidewire. Follow-up was ranging from 0.4 to 3.4 years (mean 1.3 year, SD = 0.7). Significant improvement occurred in 79%. There was no significant difference in the failure rate comparing balloon dilation with adjunctive procedures 5/20 (25%) or without adjunctive procedures; 4/30 p  = 0.45 (13%). Failure rate for BDET plus guide wire was 5/17 (29%) and resistance within the bony ET occurred in 8/17 (47%). Balloon dilation of the cartilaginous ET demonstrated significant improvement despite expansion of indications that necessitated the addition of adjunctive procedures. 4.

Balloon Dilation of the Cartilaginous Portion of the Eustachian Tube.

PubMed

Silvola, Juha; Kivekäs, Ilkka; Poe, Dennis S

2014-07-01

Studies of balloon Eustachian tuboplasty (BET) have shown encouraging results in small series with short follow-ups. Our pilot study suggested that patients with protracted otitis media with effusion (OME) or atelectasis of the tympanic membrane (TM) could benefit from BET. A prospective study where subjects act as their own controls. Patients from the pilot study and additional cases were enrolled in this cohort with long-term follow-up. Regional Academic Center. Out of 80 patients who underwent BET, 41 consecutive Eustachian tube (ET) operations were included. Subjects' inclusion criteria were OME and/or TM atelectasis, type B or C tympanograms, and inability to inflate their middle ears by Valsalva maneuver. All patients had longstanding ET dysfunction relieved only by repeated tympanostomies. Outcomes included ability to perform a Valsalva maneuver, audiometry, tympanometry, videoendoscopy of the ET with mucosal inflammation rating scores, and otomicroscopy. All cases were dilated successfully, without significant complications. Mean follow-up was 2.5 years (range, 1.5-4.2 years). Eighty percent (33/41) could do a Valsalva maneuver postoperatively; none of these ears required new tympanostomy tubes and subjective symptoms were relieved. Tympanometry results showed overall improvement. Nine patients had persistent perforations and 3 declined removal of the tube. Subjective symptoms were not relieved for 10% (4/41). The results show that BET can effectively improve ET function in ears with OME or atelectasis. The procedure is well tolerated and without significant complications. The follow-up continues and we are investigating possible reasons for failures. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014.

Children with chronic lung diseases have cognitive dysfunction as assessed by event-related potential (auditory P300) and Stanford-Binet IQ (SB-IV) test.

PubMed

Kamel, Terez Boshra; Abd Elmonaem, Mahmoud Tarek; Khalil, Lobna Hamed; Goda, Mona Hamdy; Sanyelbhaa, Hossam; Ramzy, Mourad Alfy

2016-10-01

Chronic lung disease (CLD) in children represents a heterogeneous group of many clinico-pathological entities with risk of adverse impact of chronic or intermittent hypoxia. So far, few researchers have investigated the cognitive function in these children, and the role of auditory P300 in the assessment of their cognitive function has not been investigated yet. This study was designed to assess the cognitive functions among schoolchildren with different chronic pulmonary diseases using both auditory P300 and Stanford-Binet test. This cross-sectional study included 40 school-aged children who were suffering from chronic chest troubles other than asthma and 30 healthy children of similar age, gender and socioeconomic state as a control group. All subjects were evaluated through clinical examination, radiological evaluation and spirometry. Audiological evaluation included (basic otological examination, pure-tone, speech audiometry and immittancemetry). Cognitive function was assessed by auditory P300 and psychological evaluation using Stanford-Binet test (4th edition). Children with chronic lung diseases had significantly lower anthropometric measures compared to healthy controls. They had statistically significant lower IQ scores and delayed P300 latencies denoting lower cognitive abilities. Cognitive dysfunction correlated to severity of disease. P300 latencies were prolonged among hypoxic patients. Cognitive deficits in children with different chronic lung diseases were best detected using both Stanford-Binet test and auditory P300. P300 is an easy objective tool. P300 is affected early with hypoxia and could alarm subtle cognitive dysfunction.

Impact of control of blood glucose level during treatment of sudden deafness in diabetics: relationship with prognosis.

PubMed

Min, Sang-Ki; Shin, Ji-Ho; Chang, Mun-Young; Min, Hyun-Jin; Kim, Kyung-Soo; Lee, Sei-Young; Yang, Hoon-Shik; Hong, Young-Ho; Mun, Seog-Kyun

2017-03-01

The objective of this study is to investigate the impact of control of blood glucose level during treatment of sudden deafness. A retrospective study was performed involving 197 patients from January, 2011 to September, 2015. All patients were administrated prednisolone (Pharmaprednisolone tab ® , 5 mg/T; KoreaPharma) p.o under the following regimen: 60 mg/day for 4 days, 40 mg/day for 2 days, 30 mg/day for 1 day, 20 mg/day for 1 day, and 10 mg/day for 2 days. During treatment, pure tone audiometry and blood glucose level were investigated for each patient and the results were statistically analyzed. Mean hearing improvement was 19.2 dB for the non-diabetes group and 24.8 dB for the diabetes group. The greater improvement for diabetics was not statistically significant (p = 0.146). Hearing improvement was 25.1 dB for subjects with mean blood glucose <200 mg/dl and 24.6 dB for subjects with mean blood glucose >200 mg/dl; the difference was not statistically significant (p = 0.267). Mean blood glucose level was 200.8 mg/dl for subjects with hearing improvement >20 dB and 181.8 mg/dl for subjects with hearing improvement <20 dB; the difference was not statistically significant (p = 0.286). Control of blood glucose level during treatment of sudden deafness does not have a direct effect on prognosis.

A systematic review of studies measuring and reporting hearing aid usage in older adults since 1999: a descriptive summary of measurement tools.

PubMed

Perez, Elvira; Edmonds, Barrie A

2012-01-01

A systematic review was conducted to identify and quality assess how studies published since 1999 have measured and reported the usage of hearing aids in older adults. The relationship between usage and other dimensions of hearing aid outcome, age and hearing loss are summarised. Articles were identified through systematic searches in PubMed/MEDLINE, The University of Nottingham Online Catalogue, Web of Science and through reference checking. (1) participants aged fifty years or over with sensori-neural hearing loss, (2) provision of an air conduction hearing aid, (3) inclusion of hearing aid usage measure(s) and (4) published between 1999 and 2011. Of the initial 1933 papers obtained from the searches, a total of 64 were found eligible for review and were quality assessed on six dimensions: study design, choice of outcome instruments, level of reporting (usage, age, and audiometry) and cross validation of usage measures. Five papers were rated as being of high quality (scoring 10-12), 35 papers were rated as being of moderate quality (scoring 7-9), 22 as low quality (scoring 4-6) and two as very low quality (scoring 0-2). Fifteen different methods were identified for assessing the usage of hearing aids. Generally, the usage data reviewed was not well specified. There was a lack of consistency and robustness in the way that usage of hearing aids was assessed and categorised. There is a need for more standardised level of reporting of hearing aid usage data to further understand the relationship between usage and hearing aid outcomes.

Acoustic Reflex and House-Brackmann Rating Scale as Prognostic Indicators of Peripheral Facial Palsy in Neuroborreliosis.

PubMed

Sekelj, Alen; Đanić, Davorin

2017-09-01

Lyme borreliosis is a vector-borne infectious disease characterized by three disease stages. In the areas endemic for borreliosis, every acute facial palsy indicates serologic testing and implies specific approach to the disease. Th e aim of the study was to identify and confirm the value of acoustic refl ex and House-Brackman (HB) grading scale as prognostic indicators of facial palsy in neuroborreliosis. Th e study included 176 patients with acute facial palsy divided into three groups based on serologic testing: borreliosis, Bell's palsy, and facial palsy caused by herpes simplex virus type 1 (HSV-1). Study patients underwent baseline audiometry with tympanometry and acoustic reflex, whereas current state of facial palsy was assessed by the HB scale. Subsequently, the same tests were obtained on three occasions, i.e. in week 3, 6 and 12 of presentation. Th e patients diagnosed with borreliosis, Bell's palsy and HSV-1 differed according to the time to acoustic refl ex recovery, which took longest time in patients with borreliosis. Th ese patients had the highest percentage of suprastapedial lesions at all time points and recovery was achieved later as compared with the other two diagnoses. Th e mean score on the HB scale declined with time, also at a slower rate in borreliosis patients. Th e prognosis of acoustic refl ex and facial palsy recovery according to HB scale was not associated with the length of elapsed time. The results obtained in the present study strongly confirmed the role of acoustic reflex and HB grading scale as prognostic indicators of facial palsy in neuroborreliosis.

High-resolution audiometry: an automated method for hearing threshold acquisition with quality control.

PubMed

Bian, Lin

2012-01-01

In clinical practice, hearing thresholds are measured at only five to six frequencies at octave intervals. Thus, the audiometric configuration cannot closely reflect the actual status of the auditory structures. In addition, differential diagnosis requires quantitative comparison of behavioral thresholds with physiological measures, such as otoacoustic emissions (OAEs) that are usually measured in higher resolution. The purpose of this research was to develop a method to improve the frequency resolution of the audiogram. A repeated-measure design was used in the study to evaluate the reliability of the threshold measurements. A total of 16 participants with clinically normal hearing and mild hearing loss were recruited from a population of university students. No intervention was involved in the study. Custom developed system and software were used for threshold acquisition with quality control (QC). With real-ear calibration and monitoring of test signals, the system provided accurate and individualized measure of hearing thresholds that were determined by an analysis based on signal detection theory (SDT). The reliability of the threshold measure was assessed by correlation and differences between the repeated measures. The audiometric configurations were diverse and unique to each individual ear. The accuracy, within-subject reliability, and between-test repeatability are relatively high. With QC, the high-resolution audiograms can be reliably and accurately measured. Hearing thresholds measured as ear canal sound pressures with higher frequency resolution can provide more customized hearing-aid fitting. The test system may be integrated with other physiological measures, such as OAEs, into a comprehensive evaluative tool. American Academy of Audiology.

Cochlear implant surgery in patients more than seventy-nine years old.

PubMed

Eshraghi, Adrien A; Rodriguez, Michael; Balkany, Thomas J; Telischi, Fred F; Angeli, Simon; Hodges, Annelle V; Adil, Eelam

2009-06-01

To evaluate the surgical complications, auditory performance, and hearing handicap following cochlear implantation in patients greater than 79 years of age. Retrospective trial, tertiary referral center. The study group was comprised of 21 patients implanted after 79 years of age from 1996 through 2006 with follow-ups past their 8th decade. Pre-op evaluation consisted of pure-tone audiometry and speech discrimination scores (Hearing in Noise Test and City University of New York sentence test). The results of these tests were compared to similar tests taken post-op. A validated hearing handicap questionnaire was used to evaluate the outcome. There were no permanent medical or surgical complications. However, two patients developed exacerbations of previous comorbid conditions (i.e., urinary retention and acute delirium). Implanted patients experienced a significant improvement in audiologic performance, post-op pure tone average, and post-op speech scores (P < .001). A majority of them were able to use the phone and reported that the cochlear implant was of great benefit to them. The post-op hearing handicap inventory for the elderly demonstrated a significant decrease of hearing handicap scores. This is the first study to focus on a patient group this advanced in age. With increasing life expectancy, we should begin to stratify risk versus benefit of cochlear implantation in this age group. Cochlear implantation improved audiologic performance and the quality of life in patients older than 79 years old. There were no permanent medical or surgical complications. Chronic pain and temporary vertigo were the most common complications reported in this elderly group. Laryngoscope, 2009.

Therapeutic role of Vitamin B12 in patients of chronic tinnitus: A pilot study.

PubMed

Singh, Charu; Kawatra, Rahul; Gupta, Jaya; Awasthi, Vishnu; Dungana, Homnath

2016-01-01

True tinnitus is a phantom auditory perception arising from a source or trigger in the cochlea, brainstem, or at higher centers and has no detectable acoustic generator. The most accepted is the famous neurophysiologic model of Jastreboff, which stresses that tinnitus, is a subcortical perception and results from the processing of weak neural activity in the periphery. The aim of this study is to determine the role of Vitamin B12 in treatment of chronic tinnitus. In this randomized, double-blind pilot study, total 40 patients were enrolled, of which 20 in Group A (cases) received intramuscular therapy of 1 ml Vitamin B12 (2500 mcg) weekly for a period of 6 weeks and Group B (20) patients received placebo isotonic saline 01 ml intramuscular. The patients were subjected to Vitamin B12 assay and audiometry pre- and post-therapy. Of the total patients of tinnitus, 17 were Vitamin B12 deficient that is 42.5% showed deficiency when the normal levels were considered to be 250 pg/ml. A paired t-test showed that in Group A, patients with Vitamin B12 deficiency showed significant improvement in mean tinnitus severity index score and visual analog scale (VAS) after Vitamin B12 therapy. This pilot study highlights the significant prevalence of Vitamin B12 deficiency in North Indian population and improvement in tinnitus severity scores and VAS in cobalamin-deficient patients receiving intramuscular Vitamin B12 weekly for 6 weeks further provides a link between cobalamin deficiency and tinnitus thereby suggestive of a therapeutic role of B12 in cobalamin-deficient patients of tinnitus.

Inner ear anomalies and conductive hearing loss in children with Apert syndrome: an overlooked otologic aspect.

PubMed

Zhou, Guangwei; Schwartz, Lynn Thomas; Gopen, Quinton

2009-02-01

To identify the occurrence of inner ear structural anomalies and conductive hearing loss (CHL) in children with Apert syndrome. Retrospective review. Pediatric tertiary referral center. Twenty pediatric patients with Apert syndrome were found; all patients (38/40 ears) had inner ear anomalies. Computerized tomography of the head/temporal bone, pure-tone (including air and bone conduction) audiometry, and tympanometry. Imaging demonstrating inner ear anomalies, including malformations of the cochlea, dilated vestibule, and/or semicircular canal; audiologic findings of air-bone gap(s). Hearing loss was found in 90% of the patients with Apert syndrome, and 80% of them had CHL. Air-bone gaps were found at all frequencies, with larger gaps at low frequencies. Fifty percent (20/40) of the ears had better than 0 dB hearing level bone conduction thresholds at 250 and/or 500 Hz. Normal middle ear pressure and mobility were found in all ears with intact eardrum. Inner ear anomalies were found in all patients, and 90% of them had bilateral involvement. Most frequently observed inner ear anomalies were dilated vestibule, malformed lateral semicircular canal, and cochlear dysplasia. Children with Apert syndrome may present with significant CHL that cannot be explained by minor middle ear pathologies alone. This conductive loss may be, at least partially, attributed to the inner ear anomalies; however, these structural anomalies are usually not recognized in these patients. Failure to close air-bone gap after surgical intervention may raise the suspicion of inner ear anomalies, and computed tomographic scan of the temporal bone can provide definitive proof.

Relationship between Auditory and Cognitive Abilities in Older Adults

PubMed Central

Sheft, Stanley

2015-01-01

Objective The objective was to evaluate the association of peripheral and central hearing abilities with cognitive function in older adults. Methods Recruited from epidemiological studies of aging and cognition at the Rush Alzheimer’s Disease Center, participants were a community-dwelling cohort of older adults (range 63–98 years) without diagnosis of dementia. The cohort contained roughly equal numbers of Black (n=61) and White (n=63) subjects with groups similar in terms of age, gender, and years of education. Auditory abilities were measured with pure-tone audiometry, speech-in-noise perception, and discrimination thresholds for both static and dynamic spectral patterns. Cognitive performance was evaluated with a 12-test battery assessing episodic, semantic, and working memory, perceptual speed, and visuospatial abilities. Results Among the auditory measures, only the static and dynamic spectral-pattern discrimination thresholds were associated with cognitive performance in a regression model that included the demographic covariates race, age, gender, and years of education. Subsequent analysis indicated substantial shared variance among the covariates race and both measures of spectral-pattern discrimination in accounting for cognitive performance. Among cognitive measures, working memory and visuospatial abilities showed the strongest interrelationship to spectral-pattern discrimination performance. Conclusions For a cohort of older adults without diagnosis of dementia, neither hearing thresholds nor speech-in-noise ability showed significant association with a summary measure of global cognition. In contrast, the two auditory metrics of spectral-pattern discrimination ability significantly contributed to a regression model prediction of cognitive performance, demonstrating association of central auditory ability to cognitive status using auditory metrics that avoided the confounding effect of speech materials. PMID:26237423

Speech recognition index of workers with tinnitus exposed to environmental or occupational noise: a comparative study

PubMed Central

2012-01-01

Introduction Tinnitus is considered the third worst symptom affecting humans. The aim of this article is to assess complaints by workers with tinnitus exposed to environmental and occupational noise. Methodology 495 workers went through an epidemiological survey at the Audiology Department of the Center for Studies on Workers’ Health and Human Ecology, from 2003 to 2007. The workers underwent tonal and vocal audiometry, preceded by a clinical and occupational history questionnaire. Two-factor ANOVA and Tukey were the statistical tests used. All the analysis set statistical significance at α=5%. Findings There was a higher prevalence of occupational tinnitus (73.7%), a predominance of female domestic workers (65.4%) in cases of environmental exposure, and predominance of male construction workers (71.5%) for occupational exposure. There was a significant difference in workers with hearing loss, who showed a mean speech recognition index (SRI) of 85%, as compared to healthy workers with a mean SRI greater than 93.5%. Signs and symptoms, speech perception, and interference in sound localization with the type of noise exposure (environmental versus occupational) comparisons found no significant differences. Conclusion Studied group’s high prevalence of tinnitus, major difficulties in speech recognition with hearing loss and the presence of individuals with normal hearing with both types of exposure justify the importance of measures in health promotion, prevention, and hearing surveillance. The findings highlight the importance of valuing the patients’ own perception as the first indication of tinnitus and hearing loss in order to help develop appropriate public policies within the Unified National Health System (SUS). PMID:23259813

Self-Assessment of Hearing and Purchase of Hearing Aids by Middle-Aged and Elderly Adults

PubMed Central

Otavio, Andressa Colares da Costa; Coradini, Patricia Pérez; Teixeira, Adriane Ribeiro

2015-01-01

Introduction Presbycusis is a consequence of aging. Prescription of hearing aids is part of the treatment, although the prevalence of use by elderly people is still small. Objective To verify whether or not self-assessment of hearing is a predictor for purchase of hearing aids. Methods Quantitative, cross-sectional, descriptive, and observational study. Participants were subjects who sought a private hearing center for selection of hearing aids. During the diagnostic interview, subjects answered the following question: “On a scale of 1 to 10, with 1 being the worst and 10 the best, how would you rate your overall hearing ability?” After that, subjects underwent audiometry, selected a hearing aid, performed a home trial, and decided whether or not to purchase the hearing aid. The variables were associated and analyzed statistically. Results The sample was comprised of 32 subjects, both men and women, with a higher number of women. Mean age was 71.41 ± 12.14 years. Self-assessment of hearing ranged from 2 to 9 points. Overall, 71.9% of the subjects purchased hearing aids. There was no association between scores in the self-assessment and the purchase of hearing aids (p = 0.263). Among those who scored between 2 and 5 points, 64.7% purchased the device; between 6 and 7 points, 76.09% purchased the device; and between 8 and 9 points, 50% purchased the device, respectively. Conclusion There is evidence that low self-assessment scores lead to the purchase of hearing aids, although no significant association was observed in the sample. PMID:26722346

Noise-induced hearing loss and combined noise and vibration exposure.

PubMed

Turcot, A; Girard, S A; Courteau, M; Baril, J; Larocque, R

2015-04-01

While there is a wide body of literature addressing noise-induced hearing loss (NIHL) and hand-arm vibration syndrome (HAVS) independently, relatively few studies have considered the combined effects of noise and vibration. These studies have suggested an increased risk of NIHL in workers with vibration white finger (VWF), though the relationship remains poorly understood. To determine whether hearing impairment is worse in noise-exposed workers with VWF than in workers with similar noise exposures but without VWF. The Quebec National Institute of Public Health audiometric database was used in conjunction with work-related accident and occupational diseases data from the Quebec workers' compensation board to analyse differences in audiometry results between vibration-exposed workers in the mining and forestry industries and the overall source population, and between mining and forestry workers with documented VWF and those without VWF. The International Organization for Standardization (ISO) 7029 standards were used to calculate hearing loss not attributable to age. 15751 vibration-exposed workers were identified in an overall source population of 59339. Workers with VWF (n = 96) had significantly worse hearing at every frequency studied (500, 1000, 2000 4000 Hz) compared with other mining and forestry workers without VWF. This study confirms previous findings of greater hearing loss at higher frequencies in workers with VWF, but also found a significant difference in hearing loss at low frequencies. It therefore supports the association between combined noise and hand-arm vibration (HAV) exposure and NIHL. © The Author 2015. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Achieving a Successful Closure of an Anterior Tympanic Membrane Perforation: Evidence-Based Systematic Review.

PubMed

Visvanathan, Vikranth; Vallamkondu, Vamsidhar; Bhimrao, Sanjiv K

2018-06-01

Objectives Surgical repair of a tympanic membrane perforation is a common otologic procedure. However, achieving a successful closure can be challenging, especially if the anterior margin of the tympanic membrane is involved. The aim of this study was to systematically review the literature on evidence published in closure of anterior tympanic membrane perforations. Data Sources The following data sources were searched: Cochrane Central Register of Controlled Trials (1997 to August, 3 2017), MEDLINE (February 1948 to August 3, 2017), and Embase (1975 to August 3, 2017). Data Extraction Two authors independently reviewed titles and abstracts. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines were followed. For the purpose of this study, the inclusion criteria were as follows; (1) studies reporting surgical technique for closure of anterior tympanic membrane perforations, (2) primary cases only, (3) articles published in the English language, (4) minimum 6-month follow-up, and (5) recorded pre- and postoperative audiometry. The exclusion criteria were non-English language articles, revision surgery, and no audiometric outcomes. Results On initial search, a total of 181 articles were identified (PubMed, n = 136; Cochrane, n = 28; Embase, n = 17). Based on the criteria, 136 articles were excluded. Full text of 45 articles was reviewed, and a further 24 articles were excluded. A total of 21 articles fulfilled the criteria for study inclusion. Conclusions All published evidence is level 4. High-quality controlled studies are required to determine the most effective method for closure of anterior tympanic membrane perforation.

Dichotic Hearing in Elderly Hearing Aid Users Who Choose to Use a Single-Ear Device

PubMed Central

Ribas, Angela; Mafra, Nicoli; Marques, Jair; Mottecy, Carla; Silvestre, Renata; Kozlowski, Lorena

2014-01-01

Introduction Elderly individuals with bilateral hearing loss often do not use hearing aids in both ears. Because of this, dichotic tests to assess hearing in this group may help identify peculiar degenerative processes of aging and hearing aid selection. Objective To evaluate dichotic hearing for a group of elderly hearing aid users who did not adapt to using binaural devices and to verify the correlation between ear dominance and the side chosen to use the device. Methods A cross-sectional descriptive study involving 30 subjects from 60 to 81 years old, of both genders, with an indication for bilateral hearing aids for over 6 months, but using only a single device. Medical history, pure tone audiometry, and dichotic listening tests were all completed. Results All subjects (100%) of the sample failed the dichotic digit test; 94% of the sample preferred to use the device in one ear because bilateral use bothered them and affected speech understanding. In 6%, the concern was aesthetics. In the dichotic digit test, there was significant predominance of the right ear over the left, and there was a significant correlation between the dominant side with the ear chosen by the participant for use of the hearing aid. Conclusion In elderly subjects with bilateral hearing loss who have chosen to use only one hearing aid, there is dominance of the right ear over the left in dichotic listening tasks. There is a correlation between the dominant ear and the ear chosen for hearing aid fitting. PMID:25992120

Refractory episodic vertigo: role of intratympanic gentamicin and vestibular evoked myogenic potentials.

PubMed

Celis-Aguilar, Erika; Hinojosa-González, Ramon; Vales-Hidalgo, Olivia; Coutinho-Toledo, Heloisa

Even today, the treatment of intractable vertigo remains a challenge. Vestibular ablation with intratympanic gentamicin stands as a good alternative in the management of refractory vertigo patients. To control intractable vertigo through complete saccular and horizontal canal vestibular ablation with intratympanic gentamicin treatment. Patients with refractory episodic vertigo were included. The inclusion criteria were: unilateral ear disease, moderate to profound sensorineural hearing loss, and failure to other treatments. Included patients underwent 0.5-0.8mL of gentamicin intratympanic application at a 30mg/mL concentration. Vestibular ablation was confirmed by the absence of response on cervical vestibular evoked myogenic potentials and no response on caloric tests. Audiometry, electronystagmography with iced water, and vestibular evoked myogenic potentials were performed in all patients. Ten patients were included; nine patients with Meniere's disease and one patient with (late onset) delayed hydrops. Nine patients showed an absent response on vestibular evoked myogenic potentials and no response on caloric tests. The only patient with low amplitude on cervical vestibular evoked myogenic potentials had vertigo recurrence. Vertigo control was achieved in 90% of the patients. One patient developed hearing loss >30dB. Cervical vestibular evoked myogenic potentials confirmed vestibular ablation in patients treated with intratympanic gentamicin. High-grade vertigo control was due to complete saccular and horizontal canal ablation (no response to iced water in electronystagmography and no response on cervical vestibular evoked myogenic potentials). Copyright © 2016 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Audiometric notch and extended high-frequency hearing threshold shift in relation to total leisure noise exposure: An exploratory analysis.

PubMed

Wei, Wenjia; Heinze, Stefanie; Gerstner, Doris G; Walser, Sandra M; Twardella, Dorothee; Reiter, Christina; Weilnhammer, Veronika; Perez-Alvarez, Carmelo; Steffens, Thomas; Herr, Caroline E W

2017-01-01

Studies investigating leisure noise effect on extended high frequency hearing are insufficient and they have inconsistent results. The aim of this study was to investigate if extended high-frequency hearing threshold shift is related to audiometric notch, and if total leisure noise exposure is associated with extended high-frequency hearing threshold shift. A questionnaire of the Ohrkan cohort study was used to collect information on demographics and leisure time activities. Conventional and extended high-frequency audiometry was performed. We did logistic regression between extended high-frequency hearing threshold shift and audiometric notch as well as between total leisure noise exposure and extended high-frequency hearing threshold shift. Potential confounders (sex, school type, and firecrackers) were included. Data from 278 participants (aged 18-23 years, 53.2% female) were analyzed. Associations between hearing threshold shift at 10, 11.2, 12.5, and 14 kHz with audiometric notch were observed with a higher prevalence of threshold shift at the four frequencies, compared to the notch. However, we found no associations between total leisure noise exposure and hearing threshold shift at any extended high frequency. This exploratory analysis suggests that while extended high-frequency hearing threshold shifts are not related to total leisure noise exposure, they are strongly associated with audiometric notch. This leads us to further explore the hypothesis that extended high-frequency threshold shift might be indicative of the appearance of audiometric notch at a later time point, which can be investigated in the future follow-ups of the Ohrkan cohort.

[Acute sensorineural hearing loss at the Otorhinolaryngology Department of the General Hospital in Subotica 1991-1996].

PubMed

Rakić, N

1999-01-01

Sudden sensorineural hearing loss is an acute hearing loss of a perceptive type, of unknown etiology, in most cases one-sided, or, a every sudden sensorineural deafness that occurs in the period of three days or less. Modern scientific literature points to three possible etiological factors: viral cochleitis, vascular lesion of the labyrinth and unrecognized rupture of the membranous labyrinth. The therapy for this disease is extremely various. There are dozens of reported different (or similar) healing protocols, including vasodilators, Hydroxyethyl starch, low molecular dextran, diuretics, defibrinogenation, fibrmolytic therapy, steroids, prostacyclin, oxygen therapy, hyperbaric oxygen therapy, vitamins, etc. The aim of the study was to recapitulate in brief modern views of etiology and therapy of the sudden sensorineural hearing loss, to analyze cases of this illness within the period of 1991-1996 in our Otorhinolaryngology Department and to compare these data with the same or similar data of other authors. In this study, medical records of patients admitted in the period of 1991-1996 in the Otorhinolaryngology Department of the Health Center in Subotica with a diagnosis of sudden sensorineural hearing loss were used. There were 53 patients with this diagnosis. All patients were treated in the hospital with infusions of rheoactive drugs. During the diagnostic procedure, all patients underwent a complete clinical otorhinolaryngologic examination, detailed anamnesis was taken, acoustic impedance tests (tympanometry) and tonal liminal audiometry were performed. Routine blood test was made (including complete blood picture, sedimentation rate, blood sugar) and a complete urine examination. Sometimes we demanded x-ray of the temporal bones (Schnller and Stenwers). A short increment sensitivity index (SISI) test and Carhart test were also made, if necessary. Function of the vestibular system was tested in cases when the vestibular symptoms were more strongly expressed. This test was made after passing an acute attack of vertiginous symptoms. Control audiometry was made on the seventh and on the fourteenth day after admission. This therapy consisted of an infusion of physiologic solution (NaCl) 250 or 500 ml twice daily to which 300 mg xanthinol nicotinate ampulla, paracetam 1 g ampulla, dipyridamole 10 mg ampulla and C-vitamin 10% 500 mg ampulla were applied. The number of paracetam and xanthinol nicotinate ampullas was raised on the 14/day, and then it fell to the starting value. The therapy lasted 17 days. Patients were given multivitamine peroral therapy, tranquilizers and diet without coffee, smoking and allergenic food. The study included 53 patients, 27 (50.94%) female and 26 (49.06%) males (Graph 1). Their age (Graph 2) ranged between 16-71 years. The biggest group of patients was between 40-49 (39.62%) years of age. Distribution per year (Graph 3) shows that the incidence of the acute sensorineural hearing loss differs from the findings of other authors, especially in the period of 1991-1994, due to very few cases. Connection of this illness with seasons is shown in Graph 4. We had most cases during summer time (August, 16.98%). There is a mild rise in winter (December, 13.21%). The degree of the hearing loss in decibels is shown in the Graph 5. Most of the patients (75.47%) had mild or severely damaged hearing (40-85 dB). Period of the deafness before patients were admitted to the hospital, is shown in Graph 7. Most of them came in the first seven days after they experienced acute deafness (52.83%). Symptomatology of the persons with acute hearing loss is shown in Table 1. All of them had the feeling of deafness, and 50.94% also had tinnitus. Table 2 shows that only two patients had a pathologic finding (hypo function) on the vestibular caloric test. 57.14% of patients tested by this method showed a normal function of the vestibular apparatus. The recovery of he

A cross-sectional study of hearing thresholds among 4627 Norwegian train and track maintenance workers

PubMed Central

Lie, Arve; Skogstad, Marit; Johnsen, Torstein Seip; Engdahl, Bo; Tambs, Kristian

2014-01-01

Objective Railway workers performing maintenance work of trains and tracks could be at risk of developing noise-induced hearing loss, since they are exposed to noise levels of 75–90 dB(A) with peak exposures of 130–140 dB(C). The objective was to make a risk assessment by comparing the hearing thresholds among train and track maintenance workers with a reference group not exposed to noise and reference values from the ISO 1999. Design Cross-sectional. Setting A major Norwegian railway company. Participants 1897 and 2730 male train and track maintenance workers, respectively, all exposed to noise, and 2872 male railway traffic controllers and office workers not exposed to noise. Outcome measures The primary outcome was the hearing threshold (pure tone audiometry, frequencies from 0.5 to 8 kHz), and the secondary outcome was the prevalence of audiometric notches (Coles notch) of the most recent audiogram. Results Train and track maintenance workers aged 45 years or older had a small mean hearing loss in the 3–6 kHz area of 3–5 dB. The hearing loss was less among workers younger than 45 years. Audiometric notches were slightly more prevalent among the noise exposed (59–64%) group compared with controls (49%) for all age groups. They may therefore be a sensitive measure in disclosing an early hearing loss at a group level. Conclusions Train and track maintenance workers aged 45 years or older, on average, have a slightly greater hearing loss and more audiometric notches compared with reference groups not exposed to noise. Younger (<45 years) workers have hearing thresholds comparable to the controls. PMID:25324318

Hearing outcomes in patients with cleft lip/palate.

PubMed

Skuladottir, Hildur; Sivertsen, Ase; Assmus, Jorg; Remme, Asa Rommetveit; Dahlen, Marianne; Vindenes, Hallvard

2015-03-01

Objective : Children with cleft lip and palate or cleft palate only have a high incidence of conductive hearing loss from otitis media with effusion. Studies demonstrating longitudinal results are lacking. This study was undertaken to investigate long-term longitudinal hearing outcomes of children with cleft lip and/or cleft palate and cleft palate only. Design : Retrospective chart review. Setting : Clinical charts of patients born with cleft lip and palate or cleft palate only in 1985 to 1994 who were referred to the cleft team in Bergen, Norway. Study findings include 15 years of follow-up. Participants : The study population consisted of 317 children of whom 159 had nonsyndromic cleft lip and palate and 158 had nonsyndromic cleft palate. Main Outcome Measures : Pure tone average calculated from pure tone audiometry at ages 4, 6, and 15 years. Results : The median pure tone average significantly improved with increasing age. For the cleft lip and palate group, the median pure tone average at ages 4, 6, and 15 years was 16 dB hearing level (HL), 13 dB HL, and 9 dB HL, respectively (P ≤ .001). In the cleft palate group the median pure tone average at ages 4, 6, and 15 years was 15 dB HL, 12 dB HL, and 9 dB HL, respectively (P ≤ .001). There was no significant difference in the hearing levels between the two groups. Patients who had surgical closure of the palate at age 18 months had a significantly better pure tone average outcome at age 15 compared with patients who had surgery at 12 months. Conclusions : Hearing improves significantly from childhood to adolescence in patients with cleft lip and palate and cleft palate only.

Factors contributing to hearing impairment in patients with cleft lip/palate in Malaysia: A prospective study of 346 ears.

PubMed

Cheong, Jack Pein; Soo, Siew Shuin; Manuel, Anura Michelle

2016-09-01

To determine the factors contributing towards hearing impairment in patients with cleft lip/palate. A prospective analysis was conducted on 173 patients (346 ears) with cleft lip and palate (CL/P) who presented to the combined cleft clinic at University Malaya Medical Centre (UMMC) over 12 months. The patients' hearing status was determined using otoacoustic emission (OAE), pure tone audiometry (PTA) and auditory brainstem response (ABR). These results were analysed against several parameters, which included age, gender, race, types of cleft pathology, impact and timing of repair surgery. The patients' age ranged from 1-26 years old. They comprised 30% with unilateral cleft lip and palate (UCLP), 28% with bilateral cleft lip and palate (BCLP), 28% with isolated cleft palate (ICP) and 14% with isolated cleft lip (ICL). Majority of the patients (68.2%) had normal otoscopic findings. Out of the 346 ears, 241 ears (70%) ears had passed the hearing tests. There was no significant relationship between patients' gender and ethnicity with their hearing status. The types of cleft pathology significantly influenced the outcome of PTA and ABR screening results (p < 0.001). There was no significant difference between the repaired and unrepaired cleft groups and the outcome of hearing tests. However, hearing improvement occurred when palatal repair was performed at the age of <1year old (OR = 2.37, CI 1.2 = 4.6, p = 0.01). Majority of the cleft patients had normal hearing (70%). Hearing threshold varied significantly between the different types of cleft pathology. Surgery conferred no significant impact on the hearing outcome unless surgery was performed at the age of <1 year old. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Results obtained with a low cost software-based audiometer for hearing screening.

PubMed

Ferrari, Deborah Viviane; Lopez, Esteban Alejandro; Lopes, Andrea Cintra; Aiello, Camila Piccini; Jokura, Pricila Reis

2013-07-01

 The implementation of hearing screening programs can be facilitated by reducing operating costs, including the cost of equipment. The Telessaúde (TS) audiometer is a low-cost, software-based, and easy-to-use piece of equipment for conducting audiometric screening.  To evaluate the TS audiometer for conducting audiometric screening.  A prospective randomized study was performed. Sixty subjects, divided into those who did not have (group A, n = 30) and those who had otologic complaints (group B, n = 30), underwent audiometric screening with conventional and TS audiometers in a randomized order. Pure tones at 25 dB HL were presented at frequencies of 500, 1000, 2000, and 4000 Hz. A "fail" result was considered when the individual failed to respond to at least one of the stimuli. Pure-tone audiometry was also performed on all participants. The concordance of the results of screening with both audiometers was evaluated. The sensitivity, specificity, and positive and negative predictive values of screening with the TS audiometer were calculated.  For group A, 100% of the ears tested passed the screening. For group B, "pass" results were obtained in 34.2% (TS) and 38.3% (conventional) of the ears tested. The agreement between procedures (TS vs. conventional) ranged from 93% to 98%. For group B, screening with the TS audiometer showed 95.5% sensitivity, 90.4% sensitivity, and positive and negative predictive values equal to 94.9% and 91.5%, respectively.  The results of the TS audiometer were similar to those obtained with the conventional audiometer, indicating that the TS audiometer can be used for audiometric screening.

A novel DFNB31 mutation associated with Usher type 2 syndrome showing variable degrees of auditory loss in a consanguineous Portuguese family.

PubMed

Audo, Isabelle; Bujakowska, Kinga; Mohand-Saïd, Saddek; Tronche, Sophie; Lancelot, Marie-Elise; Antonio, Aline; Germain, Aurore; Lonjou, Christine; Carpentier, Wassila; Sahel, José-Alain; Bhattacharya, Shomi; Zeitz, Christina

2011-01-01

To identify the genetic defect of a consanguineous Portuguese family with rod-cone dystrophy and varying degrees of decreased audition. A detailed ophthalmic and auditory examination was performed on a Portuguese patient with severe autosomal recessive rod-cone dystrophy. Known genetic defects were excluded by performing autosomal recessive retinitis pigmentosa (arRP) genotyping microarray analysis and by Sanger sequencing of the coding exons and flanking intronic regions of eyes shut homolog-drosophila (EYS) and chromosome 2 open reading frame 71 (C2orf71). Subsequently, genome-wide homozygosity mapping was performed in DNA samples from available family members using a 700K single nucleotide polymorphism (SNP) microarray. Candidate genes present in the significantly large homozygous regions were screened for mutations using Sanger sequencing. The largest homozygous region (~11 Mb) in the affected family members was mapped to chromosome 9, which harbors deafness, autosomal recessive 31 (DFNB31; a gene previously associated with Usher syndrome). Mutation analysis of DFNB31 in the index patient identified a novel one-base-pair deletion (c.737delC), which is predicted to lead to a truncated protein (p.Pro246HisfsX13) and co-segregated with the disease in the family. Ophthalmic examination of the index patient and the affected siblings showed severe rod-cone dystrophy. Pure tone audiometry revealed a moderate hearing loss in the index patient, whereas the affected siblings were reported with more profound and early onset hearing impairment. We report a novel truncating mutation in DFNB31 associated with severe rod-cone dystrophy and varying degrees of hearing impairment in a consanguineous family of Portuguese origin. This is the second report of DFNB31 implication in Usher type 2.

Hearing and loud music exposure in 14-15 years old adolescents.

PubMed

Serra, Mario R; Biassoni, Ester C; Hinalaf, María; Abraham, Mónica; Pavlik, Marta; Villalobo, Jorge Pérez; Curet, Carlos; Joekes, Silvia; Yacci, María R; Righetti, Andrea

2014-01-01

Adolescent exposure to loud music has become a social and health problem whose study demands a holistic approach. The aims of the current study are: (1) To detect early noise-induced hearing loss among adolescents and establish its relationship with their participation in musical recreational activities and (2) to determine sound immission levels in nightclubs and personal music players (PMPs). The participants consisted in 172 14-15 years old adolescents from a technical high school. Conventional and extended high frequency audiometry, transient evoked otoacoustic emissions and questionnaire on recreational habits were administered. Hearing threshold levels (HTLs) were classified as: normal (Group 1), slightly shifted (Group 2), and significantly shifted (Group 3). The musical general exposure (MGE), from participation in recreational musical activities, was categorized in low, moderate, and high exposure. The results revealed an increase of HTL in Group 2 compared with Group 1 (P < 0.01), in Group 3 compared with Group 2 (P < 0.05) only in extended high frequency range, in Group 3 compared with Group 1 (P < 0.01). Besides, a decrease in mean global amplitude, reproducibility and in frequencies amplitude in Group 2 compared with Group 1 (P < 0.05) and in Group 3 compared with Group 1 (P < 0.05). A significant difference (P < 0.05) was found in Group 1's HTL between low and high exposure, showing higher HTL in high exposure. The sound immission measured in nightclubs (107.8-112.2) dBA and PMPs (82.9-104.6) dBA revealed sound levels risky for hearing health according to exposure times. It demonstrates the need to implement preventive and hearing health promoting actions in adolescents.

Human amygdala activation by the sound produced during dental treatment: A fMRI study.

PubMed

Yu, Jen-Fang; Lee, Kun-Che; Hong, Hsiang-Hsi; Kuo, Song-Bor; Wu, Chung-De; Wai, Yau-Yau; Chen, Yi-Fen; Peng, Ying-Chin

2015-01-01

During dental treatments, patients may experience negative emotions associated with the procedure. This study was conducted with the aim of using functional magnetic resonance imaging (fMRI) to visualize cerebral cortical stimulation among dental patients in response to auditory stimuli produced by ultrasonic scaling and power suction equipment. Subjects (n = 7) aged 23-35 years were recruited for this study. All were right-handed and underwent clinical pure-tone audiometry testing to reveal a normal hearing threshold below 20 dB hearing level (HL). As part of the study, subjects initially underwent a dental calculus removal treatment. During the treatment, subjects were exposed to ultrasonic auditory stimuli originating from the scaling handpiece and salivary suction instruments. After dental treatment, subjects were imaged with fMRI while being exposed to recordings of the noise from the same dental instrument so that cerebral cortical stimulation in response to aversive auditory stimulation could be observed. The independent sample confirmatory t-test was used. Subjects also showed stimulation in the amygdala and prefrontal cortex, indicating that the ultrasonic auditory stimuli elicited an unpleasant response in the subjects. Patients experienced unpleasant sensations caused by contact stimuli in the treatment procedure. In addition, this study has demonstrated that aversive auditory stimuli such as sounds from the ultrasonic scaling handpiece also cause aversive emotions. This study was indicated by observed stimulation of the auditory cortex as well as the amygdala, indicating that noise from the ultrasonic scaling handpiece was perceived as an aversive auditory stimulus by the subjects. Subjects can experience unpleasant sensations caused by the sounds from the ultrasonic scaling handpiece based on their auditory stimuli.

Human amygdala activation by the sound produced during dental treatment: A fMRI study

PubMed Central

Yu, Jen-Fang; Lee, Kun-Che; Hong, Hsiang-Hsi; Kuo, Song-Bor; Wu, Chung-De; Wai, Yau-Yau; Chen, Yi-Fen; Peng, Ying-Chin

2015-01-01

During dental treatments, patients may experience negative emotions associated with the procedure. This study was conducted with the aim of using functional magnetic resonance imaging (fMRI) to visualize cerebral cortical stimulation among dental patients in response to auditory stimuli produced by ultrasonic scaling and power suction equipment. Subjects (n = 7) aged 23-35 years were recruited for this study. All were right-handed and underwent clinical pure-tone audiometry testing to reveal a normal hearing threshold below 20 dB hearing level (HL). As part of the study, subjects initially underwent a dental calculus removal treatment. During the treatment, subjects were exposed to ultrasonic auditory stimuli originating from the scaling handpiece and salivary suction instruments. After dental treatment, subjects were imaged with fMRI while being exposed to recordings of the noise from the same dental instrument so that cerebral cortical stimulation in response to aversive auditory stimulation could be observed. The independent sample confirmatory t-test was used. Subjects also showed stimulation in the amygdala and prefrontal cortex, indicating that the ultrasonic auditory stimuli elicited an unpleasant response in the subjects. Patients experienced unpleasant sensations caused by contact stimuli in the treatment procedure. In addition, this study has demonstrated that aversive auditory stimuli such as sounds from the ultrasonic scaling handpiece also cause aversive emotions. This study was indicated by observed stimulation of the auditory cortex as well as the amygdala, indicating that noise from the ultrasonic scaling handpiece was perceived as an aversive auditory stimulus by the subjects. Subjects can experience unpleasant sensations caused by the sounds from the ultrasonic scaling handpiece based on their auditory stimuli. PMID:26356376

[Study of generational risk in deafness inflicted couples using deafness gene microarray technique].

PubMed

Wang, Ping; Zhao, Jia; Yu, Shu-yuan; Jin, Peng; Zhu, Wei; DU, Bo

2011-06-01

To explored the significance of screening the gene mutations of deafness related in deaf-mute (deaf & dumb) family using DNA microarray. Total of 52 couples of deaf-mute were recruited from Changchun deaf-mute community. With an average age of (58.3 ± 6.7) years old (x(-) ± s). Blood samples were obtained with informed consent. Their genomic DNA was extracted from peripheral blood and PCR was performed. Nine of hot spot mutations in four most common deafness pathologic gene were examined with the DNA microarray, including GJB2, GJB3, PDS and mtDNA 12S rRNA genes. At the same time, the results were verified with the traditional methods of sequencing. Fifty of normal people served as a control group. All patients were diagnosed non-syndromic sensorineural hearing loss by subjective pure tone audiometry. Thirty-two of 104 cases appeared GJB2 gene mutation (30.7%), the mutation sites included 35delG, 176del16, 235delC and 299delAT. Eighteen of 32 cases of GJB2 mutations were 235delC (59.1%). Seven of 104 cases appeared SLC26A4 gene IVS7-2 A > G mutation. Questionnaire survey and gene diagnosis revealed that four of 52 families have deaf offspring (7.6%). When a couple carries the same gene mutation, the risk of their children deafness was 100%. The results were confirmed with the traditional methods of sequencing. There is a high risk of deafness if a deaf-mute family is planning to have a new baby. It is very important and helpful to avoid deaf newborns again in deaf-mute family by DNA microarray.

Comparison of tinnitus and psychological aspects between the younger and older adult patients with tinnitus.

PubMed

Park, So Young; Han, Jung Ju; Hwang, Jae Hyung; Whang, Eul Sung; Yeo, Sang Won; Park, Shi Nae

2017-04-01

To explore the differences in various tinnitus-related features and psychological aspects between the younger and older adult patients with tinnitus. We retrospectively reviewed the clinical data of the adult patients who visited our tinnitus clinic in 2013 and completed full tinnitus assessment including audiometry, tinnitus matching, standardized tinnitus questionnaires, and psychometric questionnaires. The younger group included patients aged 20-45 years (n=64), and the older group, those older than 65 years (n=76). Clinical features, hearing levels, matched tinnitus pitches and loudness, self-report tinnitus severity scores, Beck depression inventory scores, and stress scores were compared between the groups. Tinnitus duration was longer in the older group (p=0.002). Mean PTAs were 16dB HL in the younger, and 38dB HL in the older groups (p<0.001). Eighty-nine percent of the younger patients had normal hearing, while 82% of the older patients had hearing loss (p<0.001). Matched tinnitus loudness was greater in the older group (64dB HL vs. 36dB HL, p<0.001). All of the self-report tinnitus, depression, and stress scores did not differ between the groups. The older patients seemed to be more receptive to tinnitus. The majority of older tinnitus patients had concomitant hearing loss, and thus hearing rehabilitation should be considered preferentially for tinnitus management in this age group. Subjective tinnitus severity, depressive symptoms, and the stress levels were similar between the younger and older tinnitus patients. Therefore, treatment could be planned based upon the comprehensive understanding of the tinnitus characteristics and psychological aspects in each patient irrespective of age. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Hearing Loss in Children With Asymptomatic Congenital Cytomegalovirus Infection

PubMed Central

Chung, Winnie; Flores, Marily; Blum, Peggy; Caviness, A. Chantal; Bialek, Stephanie R.; Grosse, Scott D.; Miller, Jerry A.; Demmler-Harrison, Gail

2017-01-01

OBJECTIVES: To assess the prevalence, characteristics, and risk of sensorineural hearing loss (SNHL) in children with congenital cytomegalovirus infection identified through hospital-based newborn screening who were asymptomatic at birth compared with uninfected children. METHODS: We included 92 case-patients and 51 controls assessed by using auditory brainstem response and behavioral audiometry. We used Kaplan–Meier survival analysis to estimate the prevalence of SNHL, defined as ≥25 dB hearing level at any frequency and Cox proportional hazards regression analyses to compare SNHL risk between groups. RESULTS: At age 18 years, SNHL prevalence was 25% (95% confidence interval [CI]: 17%–36%) among case-patients and 8% (95% CI: 3%–22%) in controls (hazard ratio [HR]: 4.0; 95% CI: 1.2–14.5; P = .02). Among children without SNHL by age 5 years, the risk of delayed-onset SNHL was not significantly greater for case-patients than for controls (HR: 1.6; 95% CI: 0.4–6.1; P = .5). Among case-patients, the risk of delayed-onset SNHL was significantly greater among those with unilateral congenital/early-onset hearing loss than those without (HR: 6.9; 95% CI: 2.5–19.1; P < .01). The prevalence of severe to profound bilateral SNHL among case-patients was 2% (95% CI: 1%–9%). CONCLUSIONS: Delayed-onset and progression of SNHL among children with asymptomatic congenital cytomegalovirus infection continued to occur throughout adolescence. However, the risk of developing SNHL after age 5 years among case-patients was not different than in uninfected children. Overall, 2% of case-patients developed SNHL that was severe enough for them to be candidates for cochlear implantation. PMID:28209771

Cigarette- and snus-modified association between unprotected exposure to noise from hunting rifle caliber weapons and high frequency hearing loss. A cross-sectional study among swedish hunters.

PubMed

Honeth, Louise; Ström, Peter; Ploner, Alexander; Bagger-Sjöbäck, Dan; Rosenhall, Ulf; Nyrén, Olof

2016-01-01

To investigate in this cross-sectional study among Swedish hunters if tobacco use modifies the previously observed association, expressed as prevalence ratio (PR), between unprotected exposure to impulse noise from hunting rifle caliber (HRC) weapons and high-frequency hearing impairment (HFHI). A nationwide cross-sectional epidemiologic study was conducted among Swedish sport hunters in 2012. The study was Internet-based and consisted of a questionnaire and an Internet-based audiometry test. In all, 202 hunters completed a questionnaire regarding the hearing test. Associations were modeled using Poisson regression. Current, daily use of tobacco was reported by 61 hunters (19 used cigarettes, 47 moist snuff, and 5 both). Tobacco users tended to be younger, fire more shots with HRC weapons, and report more hunting days. Their adjusted PR (1-6 unprotected HRC shots versus 0) was 3.2 (1.4-6.7), P < 0.01. Among the nonusers of tobacco, the corresponding PR was 1.3 (0.9-1.8), P = 0.18. P value for the interaction was 0.01. The importance of ear protection could not be quantified among hunters with HRC weapons because our data suggested that the HFHI outcome had led to changes in the use of such protection. Among hunters using weapons with less sound energy, however, no or sporadic use of hearing protection was linked to a 60% higher prevalence of HFHI, relative to habitual use. Tobacco use modifies the association between exposure to unprotected impulse noise from HRC weapons and the probability of having HFHI among susceptible hunters. The mechanisms remain to be clarified, but because the effect modification was apparent also among the users of smokeless tobacco, combustion products may not be critical for this effect.

Assessment of potential effects of the electromagnetic fields of mobile phones on hearing

PubMed Central

Uloziene, Ingrida; Uloza, Virgilijus; Gradauskiene, Egle; Saferis, Viktoras

2005-01-01

Background Mobile phones have become indispensable as communication tools; however, to date there is only a limited knowledge about interaction between electromagnetic fields (EMF) emitted by mobile phones and auditory function. The aim of the study was to assess potential changes in hearing function as a consequence of exposure to low-intensity EMF's produced by mobile phones at frequencies of 900 and 1800 MHz. Methods The within-subject study was performed on thirty volunteers (age 18–30 years) with normal hearing to assess possible acute effect of EMF. Participants attended two sessions: genuine and sham exposure of EMF. Hearing threshold levels (HTL) on pure tone audiometry (PTA) and transient evoked otoacoustic emissions (TEOAE's) were recorded before and immediately after 10 min of genuine and/or sham exposure of mobile phone EMF. The administration of genuine or sham exposure was double blind and counterbalanced in order. Results Statistical analysis revealed no significant differences in the mean HTLs of PTA and mean shifts of TEOAE's before and after genuine and/or sham mobile phone EMF 10 min exposure. The data collected showed that average TEOAE levels (averaged across a frequency range) changed less than 2.5 dB between pre- and post-, genuine and sham exposure. The greatest individual change was 10 dB, with a decrease in level from pre- to post- real exposure. Conclusion It could be concluded that a 10-min close exposure of EMFs emitted from a mobile phone had no immediate after-effect on measurements of HTL of PTA and TEOAEs in young human subjects and no measurable hearing deterioration was detected in our study. PMID:15840162

Hearing loss and tinnitus in rock musicians: A Norwegian survey.

PubMed

Størmer, Carl Christian Lein; Laukli, Einar; Høydal, Erik Harry; Stenklev, Niels Christian

2015-01-01

Our focus in this study was to assess hearing thresholds and the prevalence and characteristics of tinnitus in a large group of rock musicians based in Norway. A further objective was to assess related factors such as exposure, instrument category, and the preventive effect of hearing protection. The study was a cross-sectional survey of rock musicians selected at random from a defined cohort of musicians. A random control group was included for comparison. We recruited 111 active musicians from the Oslo region, and a control group of 40 nonmusicians from the student population at the University of TromsØ. The subjects were investigated using clinical examination, pure tone audiometry, tympanometry, and a questionnaire. We observed a hearing loss in 37.8% of the rock musicians. Significantly poorer hearing thresholds were seen at most pure-tone frequencies in musicians than controls, with the most pronounced threshold shift at 6 kHz. The use of hearing protection, in particular custom-fitted earplugs, has a preventive effect but a minority of rock musicians apply them consistently. The degree of musical performance exposure was inversely related to the degree of hearing loss in our sample. Bass and guitar players had higher hearing thresholds than vocalists. We observed a 20% prevalence of chronic tinnitus but none of the affected musicians had severe tinnitus symptomatology. There was no statistical association between permanent tinnitus and hearing loss in our sample. We observed an increased prevalence of hearing loss and tinnitus in our sample of Norwegian rock musicians but the causal relationship between musical exposure and hearing loss or tinnitus is ambiguous. We recommend the use of hearing protection in rock musicians.

Decreased auditory GABA+ concentrations in presbycusis demonstrated by edited magnetic resonance spectroscopy

PubMed Central

Gao, Fei; Wang, Guangbin; Ma, Wen; Ren, Fuxin; Li, Muwei; Dong, Yuling; Liu, Cheng; Liu, Bo; Bai, Xue; Zhao, Bin; Edden, Richard A.E.

2014-01-01

Gamma-aminobutyric acid (GABA) is the main inhibitory neurotransmitter in the central auditory system. Altered GABAergic neurotransmission has been found in both the inferior colliculus and the auditory cortex in animal models of presbycusis. Edited magnetic resonance spectroscopy (MRS), using the MEGA-PRESS sequence, is the most widely used technique for detecting GABA in the human brain. However, to date there has been a paucity of studies exploring changes to the GABA concentrations in the auditory region of patients with presbycusis. In this study, sixteen patients with presbycusis (5 males/11 females, mean age 63.1 ± 2.6 years) and twenty healthy controls (6 males/14 females, mean age 62.5 ± 2.3 years) underwent audiological and MRS examinations. Pure tone audiometry from 0.125 to 8 KHz and tympanometry were used to assess the hearing abilities of all subjects. The pure tone average (PTA; the average of hearing thresholds at 0.5, 1, 2, and 4 kHz) was calculated. The MEGA-PRESS sequence was used to measure GABA+ concentrations in 4 × 3 × 3 cm3 volumes centered on the left and right Heschl’s gyri. GABA+ concentrations were significantly lower in the presbycusis group compared to the control group (left auditory regions: p = 0.002, right auditory regions: p = 0.008). Significant negative correlations were observed between PTA and GABA+ concentrations in the presbycusis group (r = −0.57, p = 0.02), while a similar trend was found in the control group (r = −0.40, p = 0.08). These results are consistent with a hypothesis of dysfunctional GABAergic neurotransmission in the central auditory system in presbycusis, and suggest a potential treatment target for presbycusis. PMID:25463460

Prevalence and causes of hearing impairment in Fundong Health District, North-West Cameroon.

PubMed

Ferrite, Silvia; Mactaggart, Islay; Kuper, Hannah; Oye, Joseph; Polack, Sarah

2017-04-01

To estimate the prevalence and causes of hearing impairment in Fundong Health District, North-West Cameroon. We selected 51 clusters of 80 people (all ages) through probability proportionate to size sampling. Initial hearing screening was undertaken through an otoacoustic emission (OAE) test. Participants aged 4+ years who failed this test in both ears or for whom an OAE reading could not be taken underwent a manual pure-tone audiometry (PTA) screening. Cases of hearing impairment were defined as those with pure-tone average ≥41 dBHL in adults and ≥35 dBHL in children in the better ear, or children under age 4 who failed the OAE test in both ears. Each case with hearing loss was examined by an ear, nose and throat nurse who indicated the main likely cause. We examined 3567 (86.9%) of 4104 eligible people. The overall prevalence of hearing impairment was 3.6% (95% confidence interval [CI]: 2.8-4.6). The prevalence was low in people aged 0-17 (1.1%, 0.7-1.8%) and 18-49 (1.1%, 0.5-2.6%) and then rose sharply in people aged 50+ (14.8%, 11.7-19.1%). Among cases, the majority were classified as moderate (76%), followed by severe (15%) and profound (9%). More than one-third of cases of hearing impairment were classified as unknown (37%) or conductive (37%) causes, while sensorineural causes were less common (26%). Prevalence of hearing impairment in North-West Cameroon is in line with the WHO estimate for sub-Saharan Africa. The majority of cases with known causes are treatable, with impacted wax playing a major role. © 2017 John Wiley & Sons Ltd.

Hearing Loss in the Elderly: Is the Hearing Handicap Inventory for the Elderly - Screening Version Effective in Diagnosis When Compared to the Audiometric Test?

PubMed Central

Servidoni, Alexandre Barbosa; Conterno, Lucieni de Oliveira

2018-01-01

Introduction  Hearing losses inherent to the natural process of aging represent today a major public health issue, despite the little attention that their adequate care still receives. Early recognition and proper management of these shortcomings can significantly improve hearing, as well as the patient's general quality of life, reducing the overall impact of this important and prevalent condition of the aging process. Objective  The aim of this research was to evaluate the accuracy of the Hearing Handicap Inventory for the Elderly - Screening Version (HHIE-S) in the diagnosis of hearing loss in the elderly when compared with the audiometric test. Methods  Through a cross-sectional study, our target population was composed of 138 individuals, aged over 60 and with any otorhinolaryngological complaints, recruited at the Clinic of Otorhinolaryngology and Speech Therapy of the Faculdade de Medicina de Marília (Famema), in the city of Marília, SP, Brazil. Patients already in the process of auditory rehabilitation were excluded, as well as those who did not demonstrate the minimum level of oral understanding necessary to allow the interview. Results  The prevalence of hearing loss according to the questionnaire was of 76.1%, while audiometry showed 79.7%. We found the diagnostic accuracy of the instrument to be of 86.2%, with a sensitivity of 89.1% and a specificity of 75.0%, regardless of gender. Conclusion  Thereby, we conclude that the standardized questionnaire under rating is suitable for the screening of hearing loss in the elderly, given its high accuracy and user-friendly quality. PMID:29371892

Psychometric Properties of the Persian Version of the Tinnitus Handicap Inventory (THI-P)

PubMed Central

Jalali, Mir Mohammad; Soleimani, Robabeh; Fallahi, Mahnaz; Aghajanpour, Mohammad; Elahi, Masoumeh

2015-01-01

Introduction: Tinnitus can have a significant effect on an individual’s quality of life, and is very difficult quantify. One of the most popular questionnaires used in this area is the Tinnitus Handicap Inventory (THI). The aim of this study was to determine the reliability and validity of a Persian translation of the Tinnitus Handicap Inventory (THI-P). Materials and Methods: This prospective clinical study was performed in the Otolaryngology Department of Guilan University of Medical Sciences, Iran. A total of 102 patients aged 23–80 years with tinnitus completed the (THI-P). The patients were instructed to complete the Beck Depression Inventory (BDI) and the State-Trait Anxiety Inventory (STAI). Audiometry was performed. Eight-five patients were asked to complete the THI-P for a second time 7–10 days after the initial interview. We assessed test–retest reliability and internal reliability of the THI-P. Validity was assessed by analyzing the THI-P of patients according to their age, tinnitus duration and psychological distress (BDI and STAI). A factor analysis was computed to verify if three subscales (functional, emotional, and catastrophic) represented three distinct variables. Results: Test–retest correlation coefficient scores were highly significant. The THI-P and its subscales showed good internal consistency reliability (α = 0.80 to 0.96). High-to-moderate correlations were observed between THI-P and psychological distress and tinnitus symptom ratings. A confirmatory factor analysis failed to validate the three subscales of THI, and high inter-correlations found between the subscales question whether they represent three distinct factors. Conclusion: The results suggest that the THI-P is a reliable and valid tool which can be used in a clinical setting to quantify the impact of tinnitus on the quality of life of Iranian patients. PMID:25938079

Hearing handicap, rather than measured hearing impairment, predicts poorer quality of life over 10 years in older adults.

PubMed

Gopinath, Bamini; Schneider, Julie; Hickson, Louise; McMahon, Catherine M; Burlutsky, George; Leeder, Stephen R; Mitchell, Paul

2012-06-01

We aimed to determine the prospective association between measured hearing impairment, self-reported hearing handicap and hearing aid use with quality of life. 829 Blue Mountains Hearing Study participants (≥ 55 years) were examined between 1997-1999 and 2007-2009. The shortened version of the hearing handicap inventory was administered. Hearing levels were measured using pure-tone audiometry. Quality of life was assessed using the 36-Item Short-Form Survey (SF-36); higher scores reflect better quality of life. Hearing impairment at baseline compared with no impairment was associated with lower mean SF-36 mental composite score 10 years later (multivariable-adjusted p=0.03). Physical composite score and mean scores for seven of the eight SF-36 domains after 10-year follow-up were significantly lower among participants who self-reported hearing handicap at baseline. Differences in the adjusted means between participants with and without hearing handicap ranged from 2.7 (physical composite score) to 10.4 units ('role limitations due to physical problems' domain). Individuals who developed incident hearing impairment compared to those who did not, had adjusted mean scores 9.5- and 7.7-units lower in the 'role limitation due to physical problems', and 'bodily pain' domains, respectively, at the 10-year follow-up. Hearing aid users versus non-users at baseline showed a 1.82-point (p=0.03) and 3.32-point (p=0.01) increase in SF-36 mental composite score and mental health domain over the 10-year follow-up, respectively. Older adults with self-perceived hearing handicap constitute a potential risk group for overall deterioration in quality of life, while hearing aid use could help improve the well-being of hearing impaired adults. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Management of chronic otitis media by subtotal petrosectomy.

PubMed

Altuna, Xabier; Navarro, Juan José; Goiburu, Miren; Palicio, Idoia

2016-01-01

Subtotal petrosectomy is the complete exenteration of all air cell tracts of the temporal bone. The isthmus of the Eustachian tube is obliterated and the external auditory canal is closed. The aim of this study was to describe the use of this technique in the management of certain cases of chronic otitis media. We conducted a retrospective revision of the patients treated in our Institution with this technique for chronic otitis media in a 5-year period (2008-2012). All charts were reviewed and data from the otomicroscopy, audiometry, radiology, surgical findings, postoperative complications and follow-up (including diffusion magnetic resonance imaging, MRI) of a minimum of 24 months were collected. In this period petrosectomy was performed on 28 patients for chronic otitis media. We treated 13 cases as primary cases, while 15 cases were secondary (patients that had already undergone another procedure in that ear). Fifteen cases had no serviceable hearing. Only 1 case had an immediate postoperative complication (infection); during the posterior follow-up, 2 cases had to be reoperated for diffusion restriction in the mastoid area revealed in the MRI 2 years after surgery. A subtotal petrosectomy is rarely performed for the treatment of chronic otitis media. However, it is a technique that we have to keep in mind for the treatment of certain cases where there is recurrence and deep hearing loss, as well as in cases with good cochlear reserve if the disease coexists with other complications. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

Otitis Media and Its Sequelae in Kenyan Schoolchildren.

PubMed

Simões, Eric A F; Kiio, Francis; Carosone-Link, Phyllis J; Ndegwa, Serah N; Ayugi, John; Macharia, Isaac M

2016-12-01

The goal of this study was to obtain representative Kenyan data on the point prevalence of acute otitis media (AOM) and its sequelae (otitis media with effusion [OME] and chronic suppurative otitis media [CSOM]), a major cause of preventable hearing loss in children in developing countries. In Africa, there are limited studies on the prevalence of AOM and its sequelae in children. Study subjects were children aged 2 to 15 years and were enrolled from randomly selected preprimary and primary schools. After parental or guardian consent, subjects had a questionnaire administered, otoscopy and tympanometry were done, and audiometry was performed on those with ear problems detected on these examinations. A total of 9825 (75%) children was from rural schools. The prevalence of CSOM was 15 of 1000, OME was 15 of 1000, and AOM was 7 of 1000 children. Rural Rift Valley schoolchildren had the highest prevalence of CSOM (24 of 1000) compared with other regions (12 of 1000; P < .0001). Ear discharge occurred before 3.5 years in 50% of 901 children with ear discharge. A history of ear discharge was associated with abnormal tympanograms (odds ratio [OR], 11.9-19.2) and mild-to-severe hearing loss (OR, 21.6-38.6), even in children without ear disease (OR, 10.7-24.4). The burden of AOM sequelae in Kenyan preschool and schoolchildren is significant, and it occurs mostly in the first 4 years of life. By preventing early recurrent AOM, pneumococcal vaccination might partly avert nonreversible sequelae. © The Author 2015. Published by Oxford University Press on behalf of the Pediatric Infectious Diseases Society. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Otitis media.

PubMed

Schilder, Anne G M; Chonmaitree, Tasnee; Cripps, Allan W; Rosenfeld, Richard M; Casselbrant, Margaretha L; Haggard, Mark P; Venekamp, Roderick P

2016-09-08

Otitis media (OM) or middle ear inflammation is a spectrum of diseases, including acute otitis media (AOM), otitis media with effusion (OME; 'glue ear') and chronic suppurative otitis media (CSOM). OM is among the most common diseases in young children worldwide. Although OM may resolve spontaneously without complications, it can be associated with hearing loss and life-long sequelae. In developing countries, CSOM is a leading cause of hearing loss. OM can be of bacterial or viral origin; during 'colds', viruses can ascend through the Eustachian tube to the middle ear and pave the way for bacterial otopathogens that reside in the nasopharynx. Diagnosis depends on typical signs and symptoms, such as acute ear pain and bulging of the tympanic membrane (eardrum) for AOM and hearing loss for OME; diagnostic modalities include (pneumatic) otoscopy, tympanometry and audiometry. Symptomatic management of ear pain and fever is the mainstay of AOM treatment, reserving antibiotics for children with severe, persistent or recurrent infections. Management of OME largely consists of watchful waiting, with ventilation (tympanostomy) tubes primarily for children with chronic effusions and hearing loss, developmental delays or learning difficulties. The role of hearing aids to alleviate symptoms of hearing loss in the management of OME needs further study. Insertion of ventilation tubes and adenoidectomy are common operations for recurrent AOM to prevent recurrences, but their effectiveness is still debated. Despite reports of a decline in the incidence of OM over the past decade, attributed to the implementation of clinical guidelines that promote accurate diagnosis and judicious use of antibiotics and to pneumococcal conjugate vaccination, OM continues to be a leading cause for medical consultation, antibiotic prescription and surgery in high-income countries.

Developmental outcome of the use of etamsylate for prevention of periventricular haemorrhage in a randomised controlled trial

PubMed Central

Schulte, J; Osborne, J; Benson, J; Cooke, R; Drayton, M; Murphy, J; Rennie, J; Speidel, B

2005-01-01

Objective: To compare neurodevelopmental outcome of survivors of the multicentre trial of etamsylate (the iRNN for ethamsylate) for prevention of periventricular haemorrhage in very low birthweight infants. Design: Double blind, single observer, prospective follow up of placebo controlled study. Setting: Six neonatal intensive care units in the United Kingdom. Neurodevelopmental outcome was assessed in health premises or children's homes. Subjects: 268 of 276 survivors of the original study were seen between 3.5 and 4.2 years of age. All were inborn and weighed 1500 g or less at birth. Intervention: Etamsylate 12.5 mg/kg or placebo six hourly from within one hour of delivery for four days. Main outcome measures: McCarthy scales of children's abilities, standardised neurological examination, full physical examination, functional assessment, seven letter Stycar vision test, and audiometry. Results: There was no difference between the groups in neuromotor outcome (cerebral palsy) or in the general cognitive index (GCI) of the McCarthy scales (mean GCI was 93.3 for the etamsylate group (n  =  133) and 89.7 for the placebo group (n  =  131); p  =  0.10). There were more children with GCI < 70 (9 v 19; p  =  0.047) or ⩽ 50 (3 v 11; p  =  0.03) in the placebo group. Fewer children in the etamsylate group had squints (17 v 30; p  =  0.042) or required surgery for patent ductus arteriosus (1 v 8; p  =  0.036). Conclusions: Etamsylate was not associated with a reduction in cerebral palsy. Severe cognitive impairment was reduced, but more children died and the improvement may be because fewer survived with low GCI. PMID:15613570

The effects of a hearing education program on recreational noise exposure, attitudes and beliefs toward noise, hearing loss, and hearing protector devices in young adults.

PubMed

Keppler, Hannah; Ingeborg, Dhooge; Sofie, Degeest; Bart, Vinck

2015-01-01

Excessive recreational noise exposure in young adults might result in noise-induced hearing loss (NIHL) and tinnitus. Inducing behavioral change in young adults is one of the aims of a hearing conservation program (HCP). The goal of the current study was to evaluate the effect of a hearing education program after 6 months in young adults in relation to knowledge regarding their individual hearing status. The results of a questionnaire regarding the weekly equivalent recreational noise exposure, attitudes and beliefs toward noise, and hearing loss and hearing protector devices (HPDs) were compared between both sessions. Seventy-eight young adults completed the questionnaire concerning recreational noise exposure, youth attitude to noise scale (YANS), and beliefs about hearing protection and hearing loss (BAHPHL). Their hearing status was evaluated based on admittance measures, audiometry, transient-evoked otoacoustic emissions (TEOAEs), and distortion-product otoacoustic emissions (DPOAEs). The main analysis consisted of a mixed model analysis of variance with dependent variables of either the noise exposure or the scores on (subscales of) YANS and BAHPHL. The independent variables were hearing status and session one versus session two. There was a significant decrease in recreational noise exposure and several (sub) scales of YANS and BAHPHL between both the sessions. This behavioral change resulted in a more frequent use of HPDs in 12% of the participants. However, the behavioral change was not completely related to the knowledge of young adults' individual hearing status. To prevent hearing damage in young people, investing in HCPs is necessary, apart from regulating sound levels and its compliance at various leisure-time activities. Also, the long-term effect of HCPs and their most cost-efficient repetition rates should be further investigated.

Hearing in young adults. Part I: The effects of attitudes and beliefs toward noise, hearing loss, and hearing protector devices.

PubMed

Keppler, Hannah; Dhooge, Ingeborg; Vinck, Bart

2015-01-01

There is great concern regarding the development of noise-induced hearing loss (NIHL) in youth caused by high sound levels during various leisure activities. Health-orientated behavior of young adults might be linked to the beliefs and attitudes toward noise, hearing loss, and hearing protector devices (HPDs). The objective of the current study was to evaluate the effects of attitudes and beliefs toward noise, hearing loss, and HPDs on young adults' hearing status. A questionnaire and an audiological test battery were completed by 163 subjects (aged 18-30 years). The questionnaire contained the Youth Attitude to Noise Scale (YANS) and Beliefs about Hearing Protection and Hearing Loss (BAHPHL). A more positive attitude or belief represented an attitude where noise or hearing loss is seen as unproblematic and attitudes and beliefs regarding HPDs is worse. Hearing was evaluated using (high frequency) pure tone audiometry (PTA), transient evoked and distortion product otoacoustic emissions. First, mean differences in hearing between the groups with different attitudes and beliefs were evaluated using one-way analysis of variance (ANOVA). Second, a χ² test was used to examine the usage of HPDs by the different groups with different attitudes and beliefs. Young adults with a positive attitude had significantly more deteriorated hearing and used HPDs less than the other subjects. Hearing conservation programs (HCPs) for young adults should provide information and knowledge regarding noise, hearing loss, and HPDs. Barriers wearing HPDs should especially be discussed. Further, those campaigns should focus on self-experienced hearing related symptoms that might serve as triggers for attitudinal and behavioral changes.