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Objective: To compare functional outcome of microscopic and endoscopic approach regarding type of ossiculoplasty. Methods: In this retrospective study, cases who had undergone type-II and type-III tympanoplasty between February 2007 to September 2019 were divided into two groups according to the type of approach as microscopic and endoscopic. In cases with type-II reconstruction; Partial Ossicular chain Replacement Prosthesis (PORP), incus interposition and bone cement were used in order of frequency. Whereas in cases with type-III reconstruction, only Total Ossicular chain Replacement Prosthesis (TORP) was used. The average Air Bone Gap (ABG) was determined pre- and post-operatively for the calculation of Air Conductance Gain (ACG). The ACG, pre- and post-operative ABG values of each group were compared with regard to the type of ossiculoplasty. Results: A total of 79 cases consisting of 32 females and 47 males who had undergone type-II and type-III tympanoplasty were enrolled. No statistically significant difference between microscopic and endoscopic approach was found in terms of ACG (p = 0.42), pre-(p = 0.23) and postoperative ABG (p = 0.99). We did not find any significant difference in terms of ACG, pre- and postoperative ABG between two approaches for type-II and type-III reconstructions (p>0.05). Conclusions: According to the current study, endoscopic approach in type-II and type-III reconstruction is at least reliable as microscopic approach regarding functional outcome. Since both techniques have similar functional results, other factors (anatomic characteristics, habitude of the surgeon and duration of the surgery) should be considered when choosing the technique. Level of evidence: In the current paper we present a retrospective comparative study of two different approaches of a particular type of otologic surgery. Level of evidence corresponds to level III.

Totally-implantable active middle ear devices (AMED) rely on a non-rechargeable battery encased with the implantable sound processor that needs to be replaced with a minor surgical procedure after its depletion.This study aimed to investigate the most significant factors affecting the implant's battery life.The implanted subjects (29 patients) were divided into three groups; group A with 17 patients who underwent one battery change surgery; group B with ten patients who underwent two battery changes; and group C with two patients and three surgeries. The battery life was put in correlation with several variables, including daily use and the auditory threshold.The battery life ranged from 26 to 67 months, with a mean of 48.93 ± 13.47. Pearson's correlation coefficient revealed that the battery life was statistically correlated only with the mean post-implantation bone conduction thresholds (Although the non-rechargeable battery system of the AMED under study overcomes the drawbacks of daily charging, it needs to be surgically changed after its depletion. The different rates of battery life were shown to mainly depend on the post-implantation BC thresholds, which in some cases showed a deterioration concerning the pre-implanting values.

Statistical approaches that could be used as standardized methodology for evaluating reliability and validity of data obtained using remote audiometry are proposed. Using data from the Nurses' Health Study II ( n = 31), the approaches to evaluate the reliability and validity of hearing threshold measurements obtained by a self-administered iPhone-based hearing assessment application (Decibel Therapeutics, Inc., Boston, MA) compared with measurements obtained by clinical (soundbooth) audiometry are described. These approaches use mixed-effects models to account for multilevel correlations, intraclass correlation coefficients (ICCs) of single and averaged measurements, and regression techniques with the generalized estimating equations (GEEs) to account for between-ear correlations. Threshold measurements obtained using the iPhone application were moderately reliable. The reliability was improved substantially by averaging repeated measurements; good reliability was achieved by averaging three repeated measurements. In the linear regression analyses that assessed validity, the range of intercepts (2.3–8.4) and range of slopes (0.4–0.7) indicated that the measurements from the application were likely biased from those obtained by clinical audiometry. When evaluating alternative hearing assessment tools, it is recommended to assess reliability through mixed-effects models and use ICCs to determine the number of repeated assessments needed to achieve satisfactory reliability. When evaluating validity, GEE methods are recommended to estimate regression coefficients.

To investigate the utility and effectiveness of a noise-attenuating, tablet-based mobile health system combined with asynchronous telehealth evaluations for screening rural Nicaraguan schoolchildren for hearing loss.Prospective population-based survey.Rural Nicaraguan communities.There were 3,398 school children 7 to 9 years of age.Diagnostic automated and manual audiometry, detailed asynchronous telehealth evaluations.Referral rates, ambient noise levels, and audiometric results as well as hearing loss prevalence, types, and risk factors.Despite high ambient noise levels during screening (46.7 dBA), no effect of noise on referral rates on automated audiometry or confirmatory manual audiometry in those who failed automated testing was seen. The overall audiometric referral rate was 2.6%. Idiopathic sensorineural hearing loss (SNHL) and cerumen impaction were the most common types of hearing loss in this population with an estimated prevalence of hearing loss (all types) of 18.3 per 1,000 children. SNHL was associated with both drug exposure during pregnancy (p = 0.04) and pesticide exposure in the home (p = 0.03).Hearing screening using a tablet-based, noise-attenuating wireless headset audiometer is feasible and effective in rural low-resource environments with moderately elevated ambient noise levels. The referral rate with noise-attenuating headsets was much lower than that previous reports on this population. In addition, manual audiometry resulted in much lower referral rates than automated audiometry. The confirmed hearing loss rate in this study is comparable to reports from other low-income countries that use some form of noise attenuation during screening. Pesticide exposure and drug exposure during pregnancy are potential causes of SNHL in this population.

Purpose: Down syndrome occurs in one of 700 births, and high rates of hearing loss are reported in this population. This puts children with Down syndrome at risk for communication, learning, and social development difficulties, compounding known language and cognitive vulnerabilities in this population. The purpose of this study was to comprehensively characterize audiological profiles in children with Down syndrome, including the use of extended high-frequency sensitivity and speech intelligibility index assessment. Method: Participants were 18 children with Down syndrome between 5 and 17 years of age. Audiological profiles were characterized using behavioral audiometry, tympanometry, and wideband acoustic immittance (WAI). Audibility was characterized using the speech intelligibility index. Results: Of the participants successfully completing behavioral audiometry, hearing loss of a moderate or greater degree was observed in one or both ears for 46% of the participants at conventional audiometric test frequencies and 85% of the participants at frequencies above 8 kHz. Seven children met criteria for amplification based on the speech intelligibility index, but only two wore hearing aids. Abnormal middle ear function was found in approximately 50% of the participants for whom WAI or tympanometry were successfully measured. Conclusions: Consistent with prior research, high rates of hearing loss and middle ear dysfunction were observed. The high prevalence of hearing loss above 8 kHz suggests the importance of including extended high-frequency assessment in audiologic characterization of children with Down syndrome. Few children meeting audibility-based guidelines for amplification wore hearing aids, putting them at additional risk for speech/language and educational difficulties. Supplemental Material: https://doi.org/10.23641/asha.21200422

Objectives: Despite the prevalence of generalized joint hypermobility (GJH), the audiological functions of individuals with GJH have not been documented. This study aimed to investigate audiological findings in individuals with GJH. Methods: This observational, cross-sectional, controlled study was conducted between May 2017 and August 2017. The mean age of all participants was 20.25 ± 0.75 years (range: 19-22 years). The generalized joint hypermobility consisted of individuals with a Beighton score of ≥ 5, while the controls with a Beighton score of ≤ 4. Pure-tone audiometry, immittance audiometry, and Transient Evoked Otoacoustic Emsission (TEOAE) testing were performed on subjects with generalized joint hypermobility (n = 25, mean age: 20.24 ± 0.72 years) and sex- and age-matched healthy controls (n = 31, mean age: 20.26 ± 0.77 years). Results: There were no significant differences in the mean hearing thresholds between the groups, although six (5.4%) ears in the GJH group had thresholds > 15 dB at one (five ears) or more frequencies. Significant differences were detected between the groups in the left ear for TEOAEs at 4 kHz and acoustic reflex thresholds. Conclusions: Individuals with GJH have some audiological differences that may be a predictor of changes related to future hearing loss. Further studies that involve larger samples and include participants of different ages are needed in order to determine whether individuals with GJH are more prone to hearing loss.

Introduction Hearing loss etiology depends on the population studied as well as on the ethnicity and the socio-economic condition of the analyzed region. Etiological diagnosis contributes to the improvement of preventive measures and to the early identification of this deficiency. Objective To identify the etiological factors of hearing loss and its prevalence in a tertiary hospital in southern Brazil, to verify the frequency of mutations in GJB2 and GJB6 genes, and to correlate the degree of hearing loss with the etiological factors of deafness. Methods This prevalence study involved 140 children with bilateral sensorineural or mixed hearing loss. Medical history, physical examination, audiometry, and evoked auditory brainstem response were conducted. Imaging and genetic examinations were also performed. Results Etiologies and their prevalence were as follows: (a) indeterminate causes, 31.4%; (b) conditions related to neonatal period, 22.1%; (c) genetic, 22.1%; (d) auditory neuropathy, 10%; (e) other factors (cortical malformation, intracranial hemorrhage, and internal ear malformations), 7.9% and (f) congenital infections, 6.4%. Within the genetic cases, ten homozygous and seven heterozygotes of the 35delG mutation were identified, besides two cases of rare variants of GJB2: p.Try172* and p.Arg184Pro. One case with homozygosis of del(GJB6-D13S1830) was found. Regarding severity of hearing loss, in 78.6% of the cases the degree of hearing loss was profound and there were no significant differences when comparing between etiologies. Conclusion The number of indeterminate etiologies is still high and congenital CMV infection may be a possible cause of undiagnosed etiology for hearing loss. The predominance of etiologies related to neonatal conditions and infectious causes are characteristic of developing countries. The most prevalent mutation was 35delG, the main GJB2 gene, probably because of the European influence in the genotype of our population. Resumo Introdução A etiologia da perda auditiva depende da população estudada, da etnia e da condição socioeconômica da região analisada. O diagnóstico etiológico contribui para o aprimoramento das medidas preventivas e para a identificação precoce dessa deficiência. Objetivos Identificar os fatores etiológicos da perda auditiva e sua prevalência em um hospital terciário do sul do Brasil, verificar a frequência de mutações nos genes GJB2 e GJB6 e correlacionar o grau da perda auditiva com os fatores etiológicos da deficiência auditiva. Método Este estudo de prevalência avaliou 140 crianças com perda auditiva neurossensorial bilateral ou mista. Foram submetidos a anamnese com histórico médico, exame físico, audiometria e potencial evocado auditivo de tronco encefálico. Exames de imagem e genéticos também foram feitos. Resultados As etiologias e sua prevalência foram as seguintes: (a) causas indeterminadas, 31,4%; (b) condições relacionadas ao período neonatal, 22,1%; (c) genética, 22,1%; (d) neuropatia auditiva, 10%; (e) outros fatores (malformação cortical, hemorragia intracraniana e malformações da orelha interna), 7,9% e (f) infecções congênitas, 6,4%. Entre os casos genéticos, foram identificados dez casos homozigotos e sete heterozigotos da mutação 35delG, além de dois casos de variantes raras do GJB2: p.Try172* e p.Arg184Pro. Foi encontrado um caso homozigoto da mutação del (GJB6‐D13S1830). Em relação à gravidade da perda auditiva, em 78,6% dos casos o grau da perda auditiva foi profundo e não houve diferenças significantes na comparação entre as etiologias. Conclusão O número de etiologias indeterminadas ainda é elevado e a infecção congênita por CMV pode ser uma possível causa de etiologia não diagnosticada para perda auditiva. A predominância das etiologias relacionadas às condições neonatais e às causas infecciosas são características de países em desenvolvimento. A mutação mais prevalente foi a 35delG e o principal gene foi o GJB2, provavelmente devido à influência europeia no genótipo de nossa população.

Nearly 1.5 billion people globally have some decline in hearing ability throughout their lifetime. Many causes for hearing loss are preventable, such as that from exposure to noise and chemicals. According to the World Health Organization, nearly 50% of individuals 12–25 years old are at risk of hearing loss due to recreational noise exposure. In the occupational setting, an estimated 16% of disabling hearing loss is related to occupational noise exposure, highest in developing countries. Ototoxicity is another cause of acquired hearing loss. Audiologic assessment is essential for monitoring hearing health and for the diagnosis and management of hearing loss and related disorders (e.g., tinnitus). However, 44% of the world's population is considered rural and, consequently, lacks access to quality hearing healthcare. Therefore, serving individuals living in rural and under-resourced areas requires creative solutions. Conducting hearing assessments via telehealth is one such solution. Telehealth can be used in a variety of contexts, including noise and ototoxic exposure monitoring, field testing in rural and low-resource settings, and evaluating auditory outcomes in large-scale clinical trials. This overview summarizes current telehealth applications and practices for the audiometric assessment, identification, and monitoring of hearing loss.

This review summarizes the most current information on cause, evaluation and treatment of dizziness in children.There has been an increased understanding of the multifactorial cause of dizziness in the paediatric population. Quantitative vestibular testing is increasingly used and valuable as a diagnostic adjunct. Vestibular rehabilitation, migraine hygiene, psychological therapies, pharmaceuticals and/or surgery can be used as well tolerated and effective treatments for vertigo in children and adolescents when tailored to cause.Paediatric vertigo can be effectively evaluated through careful history taking and physical examination along with adjunctive tests, such as vestibular testing and audiometry, when appropriate. Options for treatment of vestibular disorders in children and adolescents have greatly expanded in recent years allowing for the effective management of nearly all cases of paediatric vertigo, though a multimodal and/or multidisciplinary approach is often needed.

To assess endoscopic and microscopic ossiculoplasty audiometric outcomes.Retrospective review.Tertiary academic center.Adult patients who underwent ossiculoplasty with either partial ossicular replacement prosthesis (PORP) or total ossicular replacement prosthesis (TORP) from 2010 to 2019 with at least 1 year of audiometric follow-up were included.Endoscopic or microscopic ossiculoplasty.Postoperative air-bone gap (ABG) after at least 1 year.A total of 198 patients, 53.5% female, and a median age of 47.5 years, met inclusion criteria. 64.1% of patients were reconstructed with a PORP, and 31.8% were reconstructed using an endoscopic approach. The median audiometric follow-up was 27 months. The median postoperative ABG was 16.9 dB overall, 15.6 dB for PORP reconstruction, and 19.4 dB for TORP reconstruction (PORP versus TORP, p = 0.002). For TORP reconstructions, the median ABG for both endoscopic and microscopic TORP was 19.4 dB ( p = 0.92). For PORP reconstructions, the median ABG for endoscopic PORP was 12.3 dB compared with 16.3 dB for microscopic PORP ( p = 0.02). Using multivariate linear regression to predict postoperative PORP ABG, and controlling for age, prior ossiculoplasty, middle ear mucosal disease (granulation, fibrosis, polyposis), middle ear atelectasis, myringitis, contralateral middle ear disease, and use of byte prostheses, endoscopic PORP reconstruction was associated with improvement in ABG over the microscopic approach by 4.4 dB ( p = 0.04).For PORP ossiculoplasty procedures, endoscopic ossiculoplasty is associated with improved postoperative ABG compared with microscopic ossiculoplasty.

This paper presents reference equivalent threshold sound pressure levels (RETSPLs) for the Wireless Automated Hearing Test System (WAHTS), a recently commercialized device developed for use as a boothless audiometer. Two initial studies were conducted following the ISO 389-9 standard [ISO 389-9 (2009). “Acoustics—Reference zero for the calibration of audiometric equipment. Part 9: Preferred test conditions for the determinations of reference hearing threshold levels” (International Organization for Standardization, Geneva)]. Although the standard recruitment criteria are intended to yield otologically normal test subjects, the recruited populations appeared to have slightly elevated thresholds [5–10 dB hearing level (HL)]. Comparison of WAHTS thresholds to other clinical audiometric equipment revealed bias errors that were consistent with the elevated thresholds of the RETSPL populations. As the objective of RETSPLs is to ensure consistent thresholds regardless of the equipment, this paper presents the RETSPLs initially obtained following ISO 389-9:2009 and suggested correction to account for the elevated HLs of the originally recruited populations. Two additional independent studies demonstrate the validity of these corrected thresholds.

Long commute times are common in big cities.To determine hearing thresholds and their association with commute time in Mexico City.Cross-sectional study that included 177 healthy adults from 2009 to 2011. Demographic information and commute times were recorded. Hearing was assessed by audiometry. Regression models were constructed to determine the predictors of hearing thresholds.There were 101 men (53%) and 76 women (43%). Mean commute time was 43 minutes (1-150 minutes). A hearing threshold drop was observed at 4000 Hz, with recovery at 8000 Hz in both ears when patients were stratified by gender and age groups. A commute time40 min/day increased the hearing threshold at 4000 Hz (β = 2.96 dB HL, p0.01). Men had higher thresholds (β = 2.6 dB HL), as older subjects also did: 25-34 years, β = 2.2 dB HL; 35-44 years, β = 5.2 dB HL; and ≥ 45 years, β = 8.3 dB HL.The hearing pattern, although normal, resembled that of noise-induced hearing loss, associated with long commute times.Los tiempos prolongados de traslado son comunes en las ciudades grandes.Determinar los umbrales auditivos y su asociación con el tiempo de traslado al trabajo en la Ciudad de México.Estudio transversal que incluyó a 177 adultos sanos de 2009 a 2011. Se registró información demográfica y tiempo de traslado al trabajo. La audición se evaluó mediante audiometría. Se realizaron modelos de regresión para determinar los predictores de los umbrales auditivos.Se trató de 101 hombres (53 %) y 76 mujeres (43 %). El tiempo promedio de traslado fue 43 minutos (1 a 150 minutos). Se observó una caída del umbral auditivo en 4000 Hz, con recuperación en 8000 Hz en ambos oídos al estratificar por sexo y grupos de edad. Un tiempo de traslado40 minutos/día incrementó el umbral auditivo en 4000 Hz (b = 2.96 dB HL, p0.01). Los hombres presentaron umbrales mayores (b = 2.6 dB HL), al igual que los sujetos de edad más avanzada: 25 a 34 años, b = 2.2 dB HL; 35 a 44 años, b = 5.2 dB HL y ≥ 45 años, b = 8.3 dB HL.El patrón auditivo, aunque normal, se asemejó a la pérdida auditiva por ruido asociada a tiempo prolongado de traslado al trabajo.

Few studies have defined the risk of hearing impairment and tinnitus after retirement. This report measures hearing impairment and tinnitus prevalence among older construction trades workers.The study cohort included 21,340 participants in a national medical screening program (www.btmed.org). Audiometric hearing impairment was classified according to the Global Burden of Disease Study. Tinnitus was determined by self-report. An internal subcohort of nonconstruction trades workers served as a reference group. Stratified analyses and multivariate analyses were used to measure the prevalence of hearing impairment and tinnitus by age, sex, and job category.Prevalence of any hearing impairment was 55.2% (males, 57.7%; females, 26.8%) and increased rapidly with age. Construction trades workers were 40% more likely to have hearing impairment than the reference group. The overall prevalence of tinnitus was 46.52% and followed patterns similar to hearing impairment. Workers with hearing impairment were more likely to also have tinnitus, but tinnitus was frequently reported in the absence of measured hearing impairment.Hearing impairment and tinnitus prevalence were much higher in this study than in previous research. A significant reason for the difference is that BTMed follows participants after they have retired. To draw conclusions about the risk for work-related chronic diseases and disorders it is important to monitor workers through their lifetimes. Also, tinnitus by itself should be given greater significance. These findings reinforce the need to promote noise reduction and hearing conservation in construction.

The study aimed to analyse the hearing levels of patients with gout using extended high frequencies (EHFs) audiometry. Thus, we aimed to reveal the early detectability of potential hearing losses.Comparative cross-sectional study.A single centre patient was diagnosed with gout disease.Two groups consisted of 32 patients with gout and 32 healthy volunteers.The primary outcome was hearing thresholds in pure tone (PT) audiometry and EHFs audiometry. Also, the association between audiometric results and haematological and biochemical parameters were evaluated.There was no significant difference between groups in terms of mean hearing thresholds in PT audiometry. But, at all frequencies above 4000 Hz (4000-18 000 Hz), the hearing thresholds were significantly higher in patients with gout. Also, the hearing thresholds above 8000 Hz were positively correlated with serum uric acid levels. Hearing thresholds at higher frequencies were positively correlated with haemoglobin levels and negatively correlated with high-density lipoprotein levels.To our knowledge, this is the first study in the literature demonstrating the high frequency of hearing loss in patients with gout using EHFs audiometry. We consider that using EHFs audiometry should have an important place in the early detection of potential hearing losses in gout patients.

The aim of this study is to compare machine learning algorithms and established rule-based evaluations in screening audiograms for the purpose of diagnosing vestibular schwannomas. A secondary aim is to assess the performance of rule-based evaluations for predicting vestibular schwannomas using the largest dataset in the literature.Retrospective case-control study.Tertiary referral center.Seven hundred sixty seven adult patients with confirmed vestibular schwannoma and a pretreatment audiogram on file and 2000 randomly selected adult controls with audiograms.Audiometric data were analyzed using machine learning algorithms and standard rule-based criteria for defining asymmetric hearing loss.The primary outcome is the ability to identify patients with vestibular schwannomas based on audiometric data alone, using machine learning algorithms and rule-based formulas. The secondary outcome is the application of conventional rule-based formulas to a larger dataset using advanced computational techniques.The machine learning algorithms had mildly improved specificity in some fields compared with rule-based evaluations and had similar sensitivity to previous rule-based evaluations in diagnosis of vestibular schwannomas.Machine learning algorithms perform similarly to rule-based evaluations in identifying patients with vestibular schwannomas based on audiometric data alone. Performance of established rule-based formulas was consistent with earlier performance metrics, when analyzed using a large dataset.

Background Otitis media with effusion (OME) is the most common cause of acquired hearing loss and surgery in children. Autoinflation has been suggested as an alternative treatment for OME. Objectives The aim of the study was to compare treatment outcome with a new autoinflation device versus ventilation tube (VT) surgery or watchful waiting in children with chronic bilateral OME from the waiting list for surgery. Methods Forty-five children performed autoinflation during four weeks, forty-five were submitted to VT surgery, and twenty-three were enrolled as control group. Tympanometry was performed in the autoinflation and the control groups and audiometry in all groups. Results An equivalent hearing improvement was achieved in the autoinflation and the VT group at one (p=.19), six (p=.23) and twelve (p=.31) months with no significant alteration in the control group. In the autoinflation group 80% of the children avoided surgery and no complications were reported compared to 34% complication rate in the VT group. Conclusion Autoinflation achieved an equivalent improvement in hearing thresholds compared to VT surgery for treating OME. Significance Autoinflation may be a reasonable first-line treatment for children with OME to potentially avoid surgery. Article Summary: The Moniri autoinflation device is well tolerated and an effective alternative to ventilation tubes for treatment of chronic otitis media with effusion in young children. What's known on this subject: Previous studies have shown that autoinflation may reduce effusion in children with otitis media with effusion; however limited compliance to treatment, lack of adequate hearing evaluation, short follow-up time and also lack of comparative data to ventilation tube surgery have been reported. What this study adds: A new device was developed to allow for the performance of autoinflation in young children. The effect is compared to ventilation tube surgery and equivalent improvement in hearing is achieved in the short and the long-term follow-up. info:eu-repo/semantics/publishedVersion

Objective Because of the anatomically close relationship between the cochlea and the vestibular organs, cochlear function disorders may be accompanied by vestibular disorders. This study aimed to evaluate vestibular functions in patients with idiopathic sudden sensorineural hearing loss using VEMP, caloric test, and VNG test battery and its relation to prognosis. Materials and Methods For this study, 42 patients aged 18–55 years with idiopathic sudden sensorineural hearing loss and 30 volunteers who had no hearing and balance problems were included. Audiometry, cVEMP, oVEMP, caloric tests, and VNG tests were performed. Moreover, the effects of age, sex, time of admission, degree and configuration of hearing loss, accompanying vertigo, tinnitus, and ear fullness on improvement in hearing were evaluated. Results Of the 42 patients in the study group, 26 (56.52%) were male, 20 (43.48%) were female, and the mean age was 41.54 ± 12.23 years. Of the 30 individuals in the control group, 19 (63.3%) were male, 11 (36.7%) were female, and the mean age was 39.53 ± 13.03 years. There was no significant difference in the incidence of sudden sensorineural hearing loss in terms of sex and age, and the prognosis was better for female patients. Early admission to treatment was a factor of good prognosis; profound hearing loss, bilateral hearing loss and vertigo were factors of poor prognosis. Prognosis was better in patients with rising type audiogram configuration, while the prognosis was worse in patients with flat, descending and total hearing loss. Tinnitus and ear fullness had no effect on the prognosis. No anomalies were observed in VNG findings. Moreover, abnormal caloric response was higher in patients with profound hearing loss and total hearing configuration. Shortening was observed in cVEMP / oVEMP P1 and N1 latency after treatment. Furthermore, there was an improvement in abnormal responses after treatment. Conclusion In this study, vestibular function was affected in patients with idiopathic sudden sensorineural hearing loss. The present study can help the development of a clinical strategy in the evaluation of the vestibular system in idiopathic SSNHL, patient follow-up, patient information, and the implementation of vestibular rehabilitation. Note that additional studies involving larger patients series are required.

Pediatric hearing impairment, regardless of degree and type, has a detrimental effect on speech perception, cognition, oral language development, academic outcomes, and literacy. Hearing assessment in the clinic is limited to 8 kHz although humans can hear up to 20 kHz. Hearing impairment in the extended high frequencies (EHFs8 kHz) can occur despite clinically normal hearing. However, to date, the nature and effects of EHF hearing impairment in children remain unknown. The goals of the present study were to determine the effects of EHF hearing impairment on speech-in-noise recognition in children and to examine whether hearing impairment in the EHFs is associated with altered cochlear functioning in the standard frequencies.A volunteer sample of 542 participants (4 to 19 years) with clinically normal audiograms were tested. Participants identified with EHF impairment were assigned as cases in a subsequent case-control study. EHF loss was defined as hearing thresholds greater than 20 dB in at least one EHFs (10, 12.5, or 16 kHz). Speech recognition thresholds in multi-talker babble were measured using the digit triplet test. Distortion product otoacoustic emissions ( f2 = 2, 3, 4, and 5 kHz) were measured to assess cochlear functioning.Thresholds in the EHFs were as reliable as those in the standard frequency range. Thirty-eight children had EHF hearing impairment regardless of a clinically normal audiogram. A linear mixed-effects model revealed that children with EHF hearing impairment had higher (poorer) mean speech recognition threshold than children with normal EHF sensitivity ( estimate = 2.14 dB, 95% CI: 1.36 to 3.92; effect size = small). The overall magnitude of distortion product otoacoustic emissions was lower for children with EHF impairment ( estimate = -2.47 dB, 95% CI: -4.60 to -0.73; effect size = medium). In addition, the pure-tone average for standard audiometric frequencies was relatively higher for EHF-impaired children ( estimate = 3.68 dB, 95% CI: 2.56 to 4.80; effect size = small).Hearing impairment in the EHFs is common in children despite clinically normal hearing and can occur without a history of otitis media. EHF impairment is associated with poorer speech-in-noise recognition and preclinical cochlear deficits in the lower frequencies where hearing thresholds are normal. This study highlights the clinical need to identify EHF impairments in children.

Adenoid hypertrophy (AH) has been identified as a cause of otitis media with effusion (OME), which is the most common cause of childhood hearing loss. Indeed, there may be other upper airway-related predisposing factors such as, location of the adenoid, accompanying tonsillar hypertrophy (TH) and nasal septal deviation (NSD) for the development of OME. In this study, we aimed to evaluate the associations between the upper airway physicals and OME with auditory functions.Eighty-six ears of 43 children, aged 3-11 years were included in this prospective clinical study. Findings of otolaryngologic examinations were noted. Data of pure tone audiometry (PTA), traditional tympanometry (TT) and wideband tympanometry (WBT) parameters were collected. Cluster analysis was performed to the following variables: age, sex; the adenoid choana percentage (ACP), the presences of adenoid around torus tubarius (AATT), TH, NSD and OME; peak pressure (PP) values on TT, resonance frequencies (RF) on WBT, ambient pressure absorbance ratios (APAR) and PTA hearing thresholds.Two groups of ears revealed by clustering; cluster-1 (n = 46) and cluster-2 (n = 40), at the similarity level of 0.662. The presences of AH, AATT, OME and the medians of ACP, PP, RF, WBT APARs at all frequencies except 5656 Hz and 8000 Hz, all PTA thresholds were significantly different between two clusters (p0.05). The lower WBT APARs and higher PTA thresholds were associated with higher levels of ACP and higher frequencies of the presence of AATT and OME in cluster-1.There are associations between AH, AATT and OME together with decline in hearing and SEA. Whereas, TH and NSD are not related to the formation of clusters and they are insignificant factors.

До настоящего времени остаются мало изученными механизмы раннего и позднего развития профессиональной нейросенсорной тугоухости (ПНСТ). Между тем, анализ ассоциаций клинико-биохимических маркеров со сроками развития заболевания позволяет обосновывать и разрабатывать меры эффективного лечения, реабилитации и профилактики. Цель исследования – провести оценку результатов клинико-функциональных методов исследований у больных ПНСТ с ранними и поздними сроками развития заболевания. Материалы и методы. Проведено обследование 238 мужчин. Из них 152 человека с ПНСТ и 86 человек – рабочие шумоопасных профессий без ПНСТ. Больные ПНСТ были разделены на две группы в зависимости от сроков развития заболевания. 1 группа – 58 человек с ранними сроками развития заболевания (стаж работы в шуме менее 15 лет), 2 группа – 94 человека с поздними сроками развития заболевания (стаж работы в шуме более 15 лет). Проведен анализ результатов клинико-функциональных и инструментальных методов исследований. Результаты. В статье представлена клинико-функциональная характеристика больных с ранними и поздними сроками развития ПНСТ. При анализе клинико-функциональных характеристик больных ПНСТ было установлено, что по частоте и интенсивности предъявляемых жалоб группы обследованных не различались. По данным аудиологического исследования не было получено статистических различий между данными группами, как и по стадиям нейросенсорной тугоухости. Статистически значимых различий по результатам биохимического исследования обследованных групп не обнаружено. Выявлены статистически значимые различия по метаболическим изменениям миокарда по данным ЭКГ и по частоте встречаемости очагов глиоза по данным МРТ головного мозга. Заключение. Результаты клинико-функциональных методов исследования показали, что существенных различий между группами пациентов с ранними и поздними сроками развития ПНСТ не было. Наличие атеросклеротических сосудистых изменений не влияет на сроки формирования ПНСТ., To date, the mechanisms of early and late development of professional sensorineural hearing loss (PNST) remain poorly understood. Meanwhile, the analysis of associations of clinical and biochemical markers with the timing of the development of the disease allows us to justify and develop measures for effective treatment, rehabilitation and prevention. The aim of the research – to evaluate the results of clinical and functional research methods in patients with PNS with early and late stages of disease development. Materials and methods: 238 men were examined. Of these, 152 people with PNST and 86 people are workers of noise–hazardous professions without PNST. Patients with PNST were divided into two groups depending on the timing of the development of the disease. Group 1 – 58 people with early stages of disease development (work experience in noise less than 15 years), group 2 – 94 people with late stages of disease development (work experience in noise more than 15 years). The analysis of the results of clinical, functional and instrumental research methods was carried out. Results: The article presents the clinical and functional characteristics of patients with early and late stages of the development of PNST. When analyzing the clinical and functional characteristics of patients with PNST, it was found that the groups of examined patients did not differ in frequency and intensity of complaints. According to the audiological study, there were no statistical differences between these groups, as well as for the stages of sensorineural hearing loss. There were no statistically significant differences in the results of the biochemical study among the study group. Statistically significant differences were found in metabolic changes of the myocardium according to ECG data and in the frequency of occurrence of foci of gliosis according to MRI of the brain. Conclusion: The results of clinical and functional research methods showed that there were no significant differences between the groups of patients with early and late stages of the development of PNST. The presence of atherosclerotic vascular changes does not affect the timing of the formation of PNST.

Compliance with noise regulations in the past three decades has significantly reduced workplace noise exposures, particularly in the loudest industries and occupations. However, the overall effectiveness of hearing conservation programs in preventing occupational noise-induced hearing loss remains uncertain and unquantified, while the incidence and cost of occupational hearing loss remain inexplicably high. This review/commentary critically explores this paradox by examining why the billions of annual audiograms conducted worldwide have not been aggregately utilized or applied to predict early NIHL in groups of workers or to measure the efficacy of exposure controls. Principal contributory reasons include regulation of noise as a safety standard rather than as a health standard, the inherent complexity of audiometric data, and the lack of a standardized method of interpretation for audiograms. The unsuccessful history of efforts to develop and adopt methods and tools to analyze aggregate audiometric data is described. Consequently, the Standard Threshold Shift-a regulatorily defined, lagging indicator of individual, irreversible hearing loss that is not an effective preventive metric-remains the de facto standard of care. A population-based Best Practices approach is proposed to leverage the raw audiometric data already available and turn it into actionable data for effective secondary prevention to strategically manage and reduce occupational hearing loss risk. This approach entails statistical methods and information management tools necessary to transform audiometry from a compliance-driven, individual screening test with limited preventive capability into a medical surveillance process directly linked to aggregate corrective and prevention actions.

Understanding how sensorineural hearing loss (SNHL) impacts postural balance in patients is important, as postural balance predicts the risk of falls.We aimed to clarify the relationship between characteristics in the configuration of audiograms and static postural balance as measured by posturography.We evaluated 385 outpatients (mean [± standard deviation] age, 58.4 ± 18.4 years) with SNHL by audiometry and posturography. Data were analysed by multiple regression models with the outcome of postural sway area with eyes closed (PSA) and predictive variables of audiometric data, adjusted for sex, age and the presence of nystagmus.The increased hearing threshold in the better hearing ear was associated with poorer or higher PSA (beta coefficient [Postural balance in neurotologic patients may be associated with middle-high-frequency hearing levels during ageing.

Objectives We examined the association between birthweight and objectively measured hearing loss in older men and women. Study design 893 community-dwelling participants aged 50+ years with pure-tone audiometry data and self-reported birthweight were included for cross-sectional analysis. Participants were asked how much they weighed at birth either in pounds and ounces or in kilograms and grams. Main outcome measures The pure-tone average of frequencies 0.5, 1.0, 2.0 and 4.0 kHz (PTA0.5-4kHz) >25 dB HL in the better ear established the presence of hearing loss. Results Around 31.9% and 50.0% of participants who self-reported low ( 4.5 kg), respectively, had hearing loss. The odds of experiencing any level of hearing loss (>25 dB HL) after multivariate adjustment was: OR 2.00 (95% CI 1.13-3.56) for low birthweight and OR 2.43 (95% CI 1.23-4.82) for high birthweight, compared with participants in the reference group who self-reported normal birthweight (3.1-4.0 kg). Additionally, participants with high birthweight had 2.4-fold greater odds of having mild hearing loss (25-40 dB HL), while participants with low birthweight had 2.6-fold greater odds of moderate to severe hearing loss. Conclusions We observed an independent U-shaped association between birthweight and age-related hearing loss, that is, persons born with low or high birthweight had a greater likelihood of experiencing any level of hearing loss in older age. These findings provide further evidence to address an important gap in the literature regarding the influence of foetal growth on the auditory system in later life.

ObjectiveTinnitus is a common auditory disorder in which patients experience noise in the absence of an external source. It is a consequence of irreversible cochlear damage. This study examined the distortion product otoacoustic emissions and P300 components of event-related potentials.MethodThis study included a control group of 25 normal-hearing adults not complaining of tinnitus and a study group that consisted of 45 normal-hearing adults complaining of tinnitus. Measures included patient history, basic audiological evaluation, the Arabic version of Tinnitus Handicap Inventory, distortion product otoacoustic emissions testing and P300 recording.ResultsThe study group showed significantly higher hearing thresholds at all frequencies as well as delayed latencies and reduced amplitude of P300. The Tinnitus Handicap Inventory showed mean scores of 35.2 ± 16.9, and the distortion product gram showed higher amplitudes in the control group.ConclusionPatients with tinnitus might have neural dysfunction at either peripheral or central levels of the auditory pathway.

The aim of the research: study of the features of the clinical course of acute otitis media (AOM) in patients with impaired carbohydrate metabolism. Materials and methods. We examined 140 patients with AOM aged 19 to 72 years, of which 75 patients with impaired carbohydrate metabolism constituted the main group and 65 patients were included in the comparison group. Taking into account the peculiarities of the pathogenesis of AOM and disorders of carbohydrate metabolism, patients were randomized into 4 groups: 1 – patients with AOM (36), 2 – patients with AOM on the background of sinusitis (29), 3 – patients with AOM on the background of non-insulin-dependent diabetes mellitus (DM type II) (37), 4 – AOM patients with impaired glucose metabolism (38). The patients underwent a general clinical examination, determination of glycosylated hemoglobin, leukocyte indices of intoxication, audiometry, computed tomography (CT) of the temporal bones (if indicated). Results. The proportion of patients with impaired carbohydrate metabolism in 2020 was 32.6 %, of which DM type II was diagnosed in 49.3 % earlier. It was shown that a feature of the clinical course of AOM against the background of impaired carbohydrate metabolism is the discrepancy between the duration of the disease history, complaints and objective data to the state of the cellular structure of the mastoid process according to CT data and impaired auditory function mainly by the type of sound perception, which indicates the formation of latent mastoiditis. Clinically significant complaints and objective data for the differential diagnosis of latent mastoiditis in these patients were determined. The absence of statistical significance of differences in indicators in patients with DM type II and against the background of transient hyperglycemia was revealed, and the concept of the latter was characterized. A direct correlation between blood glucose levels and glycated hemoglobin levels was established in patients with DM type II and AOM. Conclusions. DM type II creates a favorable background for the formation of the clinical course of AOM complicated by latent mastoiditis. From the general contingent of patients with AOM, patients should be distinguished not only with DM type II, but also with transient hyperglycemia for its timely diagnosis. Significant symptoms: pain and a feeling of “heaviness” in the behind-the-ear region in the absence of reactive phenomena, a feeling of “pulsation” in the ear, dizziness, a cloudy eardrum with a protrusion or perforation in the posterior or posterior-upper section, an asymmetric increase in sound perception thresholds above 25 dB. Such patients should be observed with “early” CT scan of the temporal bones.

Contains fulltext : 251701.pdf (Publisher’s version ) (Closed access) Autosomal dominant non-syndromic hearing loss (ADNSHL) displays gene-specific progression of hearing loss, which is amenable to sequential audioprofiling. We sought to refine the natural history of ADNSHL by examining audiometric data in 5-year increments. 2175 audiograms were included from four genetic causes of ADNSHL-KCNQ4 (DFNA2), GSDME (DFNA5), WFS1 (DFNA6/14/38), and COCH (DFNA9). Annual threshold deterioration (ATD) was calculated for each gene: for the speech-frequency pure tone average, the ATD, respectively, was 0.72 dB/year, 0.94 dB/year, 0.53 dB/year, and 1.41 dB/year, with the largest drops occurring from ages 45-50 (0.89 dB/year; KCNQ4), 5-10 (1.42 dB/year; GSDME), 40-45 (0.83 dB/year; WFS1), and 50-55 (2.09 dB/year; COCH). 5-year interval analysis of audiograms reveals the gene specific natural history of KCNQ4, GSDME, WFS1 and COCH-related progressive hearing loss. Identifying ages at which hearing loss is most rapid informs clinical care and patient expectations. Natural history data are also essential to define outcomes of clinical trials that test novel therapies designed to correct or ameliorate these genetic forms of hearing loss.

Background. Nasopharyngeal carcinoma is a malignant tumor that grows in the nasopharyngeal area with predilection in the fossa Rossenmuller and the nasopharyngeal roof adjacent to the Eustachian tube, so one of NPC’s early symptoms is ear symptoms. Hearing loss is a common symptom found in people with NPC due to dysfunction of the Eustachian tube, a continuing middle ear disorder that can result in conductive hearing loss.This study aims to find out the relationship between primary tumor of NPC and the degree of conductive hearing loss at dr. Mohammad Hoesin Hospital Palembang. Methods. This is a cross sectional study that obtained 42 samples from the medical records at Dr. Mohammad Hoesin Hospital Palembang that met the inclusion and exclusion criteria. The study subjects collected in total sampling have been conducted audiometry examinations at the ORLHNS clinic of Dr. Mohammad Hoesin Hospital Palembang during the period January 2019 - April 2021. Results. The proportion of hearing loss in NPC patients in this study was 30 subjects (71.4%) with the highest proportion of hearing loss complaints being 33.3%. The proportion of conductive hearing loss of nasopharyngeal carcinoma patients in the study was 33 subjects (78.5%) right ear and 28 subjects (66.7%) left ear. There was a significant association between the degree of the NPC primary tumor and the incidence of conductive deafness of the left ear, but there was no significant association in the right ear. There is a significant correlation between NPC primary tumors and left ear hearing thresholds at frequencies of 500 Hz and 4000 Hz, but there is no significant association between the degree of NPC primary tumor and right ear hearing loss. Conclusions. There is significant correlation between the primary tumor of NPC and the hearing threshold of the left ear but there was no significant association in the right ear.

ObjectiveCleft palates are one of the most common congenital malformations. Because of the loss of Eustachian tube function, middle-ear ventilation is reduced. The aim of this study was to determine if middle-ear effusions were present at birth or at the three-month audiological evaluation.MethodA total of 53 children with a cleft palate were included. Data review included the results of newborn hearing screening, microscopic findings, a tympanometry, a free field audiometry and intra-operative findings.ResultsA total of 58.4 per cent of patients had a median, 26.4 per cent had a bilateral, 11.3 per cent had a unilateral and 3.8 per cent had a limited soft palate cleft. Newborn hearing screening showed a pass in 83.1 per cent of newborns bilaterally. The first ear microscopy showed a bilateral middle-ear effusion in 90.6 per cent of cases. During cleft surgery, bilateral paracentesis was performed in all cases, and in 90.6 per cent middle-ear effusion was sucked out.ConclusionThe majority of children with a cleft palate do not present with middle-ear effusion at birth. It develops within several days or weeks of life.

Background There is an increasing need to administer hearing tests outside of sound-attenuating rooms. Maximum permissible ambient noise levels (MPANLs) from published in standards (Occupational Health and Safety Administration [OSHA] 1983; American National Standards Institute [ANSI] S3.1–1999 (R2018)) can be modified to account for the additional attenuation provided by circumaural earphones (relative to supra-aural earphones) that are used for pure-tone audiometry. Ambient noise can influence the results of pure-tone audiometry by elevating thresholds by direct masking and by producing distractions that affect the accuracy of the test. The effects of these distractions have not been studied in relation to pure-tone audiometry in adult listeners. Purpose In Part I MPANLs provided by ANSI and OSHA standards are extended to account for the greater attenuation provided by circumaural earphones. Rules (“alerts”) were developed taking into account the listeners' thresholds. In Part II effects of distracting noise on pure-tone thresholds are reported. Methods and Results In Part I MPANLs two standards were modified for circumaural earphones by adding the additional attenuation provided by three circumaural earphones (relative to supra-aural earphones). A set of rules (“alerts”) is provided for identifying masking effects from ambient noise in a variety of conditions (earphone type, threshold elevation, uncovered ear). In Part II the distracting effects of an industrial noise sample on thresholds obtained from five listeners with normal hearing are described. Pure-tone thresholds were measured in quiet and in distracting noise presented at various levels. The effects of the distracting noise on the following variables were measured: time per trial, number of trials required to measure threshold, threshold shift, and perceived distractibility of the noise. Time per trial was unaffected by distracting noise. Number of trials required for threshold, threshold shift, and perceived distractibility increased with distracting noise level. Conclusion Part I: The modified MPANLs provide more relevant determinations of the potential effects of ambient noise on pure-tone thresholds than the values in the standards. Part II: Distracting noise affects pure-tone threshold measurements in a manner that is different from direct masking. The potential contaminating effect of distracting noise can be measured and reported.

Free-field correction values were measured for RadioEar DD65v2 audiometric headphones.Free-field correction values, that is, the differenceThe study was based on 17 otologically normal test subjects.Frequency-dependent free-field correction values are provided. The free-field correction of the speech level was determined to be 3.2 dB.Free-field correction values were determined for RadioEar DD65v2 audiometric headphones with an expanded measurement uncertainty.

Objective The role of ideal cardiovascular health (CVH) metrics in developing hearing loss remains uncertain. Thus, our objective was to analyze the connection between hearing loss and ideal CVH metrics in a 10-year retrospective cohort. Study design Retrospective cohort study. Setting A health management center in Taiwan. Participants Participants who underwent the first annual health check-up between 2000 and 2006 and with a follow-up check-up more than ten years later. Main outcome measures Hearing thresholds were measured at 500 Hz, 1000 Hz, 2000 Hz, and 4000 Hz. Individuals with a best ear pure-tone audiometry four-frequency average of >25 dB HL were defined as having hearing loss. The ideal CVH metrics were classified into 7 categories based on the American Heart Association's definition. The associations of hearing loss with the sum of the ideal CVH metrics and each ideal CVH metric were examined by multiple logistic regression analysis. Results The present study consisted of 6,974 participants. The 10-year follow-up showed that the odds ratio (OR) of hearing loss was 0.74 for participants with 5-7 ideal CVH metrics (95% CI, 0.59-0.93, p=0.01) compared to those with 0-2 ideal CVH metrics. Among the CVH metrics, participants with an ideal smoking status might have reduced odds of developing hearing loss; the OR was 0.72 (95% CI, 0.58-0.89, p=0.003). Conclusions Participants with an increased number of ideal CVH metrics and better performance on the smoking metric had a significantly protective effect regarding hearing loss development.

Frequency-specific audiometry and tympanometry are widely considered the foundation of the pediatric hearing evaluation. However, additional behavioral and objective measures are needed to cross-check findings and ensure an accurate and timely diagnosis. This is particularly important in the pediatric population, wherein a delay in diagnosis can have a significant impact on language development, learning, and educational outcomes. The following discussion emphasizes the importance of performing a comprehensive test battery in the pediatric audiology clinic through 5 unique case studies.

Ménière’s disease (MD) is an idiopathic inner ear disease, which is characterized by noise in the ears, periodic attacks of vertigo and the development of sensorineural hearing loss. MD is characterized by endolymphatic hydrops – an increase in the volume of endolymph that fills the membered labyrinth of the inner ear. Currently highlighted subtypes MD. The first subtype meets most often and is characterized by classical manifestations of MD. The second subtype is characterized by the development of sensorineural hearing loss, to which only after a long time are joined by the episodes of dizziness. The third subtype of MD includes family cases of the disease. The fourth and fifth subtypes of MD is observed in patients with migraine and autoimmune diseases. The diagnosis of definite MD is based on the 2 or more spontaneous episodes of vertigo with each lasting 20 minutes to 12 hours, low-to medium-frequency sensorineural hearing loss in one ear, fluctuating aural symptoms (fullness, hearing, tinnitus) located in the affected ear, and lack of data for other reasons for dizziness. There are no effective treatment for auditory disorders MD, therapy is aimed at preventing dizziness attacks. The first line of MD’s therapy includes a dietary salt restriction, the use of betahistine and diuretics. Betahistine (Betaserc) is usually used in a daily dose of 48 mg for 3–6 months to reduce the frequency of vertigo. For long-term treatment, it is convenient to use a betahistine modified-released (Betaserc Long) 48 mg, taken once a day. With the ineffectiveness of conservative therapy, other methods of therapy are possible: intratympanic administration of corticosteroids or gentamicin, labyrinthectomy or vestibular neurectomy. Unfortunately, many patients suffering from BM mistakenly makes a diagnosis of cerebrovascular disease, vertebrobasilar insufficiency, cervical osteochondrosis. Diagnostic errors are usually caused by the fact that the patients with MD are not conducted audiometry, vestibular tests, and the signs of cerebral microangiopathy identified when MRI brain are mistakenly regarded as confirmation of vascular dizziness genesis.

BACKGROUND Hearing loss is highly prevalent among older adults with cognitive impairment and may exacerbate neuropsychiatric symptoms and affect interactions with others. Although audiometry is the gold standard for measuring hearing, it is not always used in research or clinical settings focused on the care of individuals with cognitive impairment. Subjective assessments of hearing, both self- and proxy-rated, are widespread but may not adequately capture the presence of hearing loss as compared to audiometry. This study investigates the concordance between subjective and objective hearing assessments among older adults with and without cognitive impairment and evaluates factors associated with concordance. METHODS Participants were a subset of the Atherosclerosis Risk in Communities Neurocognitive Study (ARIC-NCS), a prospective cohort study representing four US communities with adjudicated cognitive diagnoses and audiometric data, totaling 3326 self-rated and 520 proxy-rated hearing assessments. Sensitivity and specificity were calculated, and multivariable logistic regression estimated the magnitude of the association between the concordance of hearing assessments and variables of interest. RESULTS Sensitivity and specificity for self-rated hearing status were 71.2% and 85.9% among cognitively normal older adults, 61.1% and 84.9% among persons with MCI, and 52.6% and 81.2% among persons with dementia, respectively. For proxy-rated hearing, sensitivity and specificity were 65.7% and 83.3% for persons with MCI and 73.3% and 60.3% for persons with dementia, respectively. Female sex was positively associated with concordance for self-rated hearing assessments. CONCLUSIONS The low sensitivity of self- and proxy-rated hearing assessments compared to audiometry suggests that hearing loss among older adults with cognitive impairment may go underreported and unaddressed in subjective assessments. Clinicians and researchers should recognize the limitations of using self- and proxy-rated hearing assessments as measures of hearing status and incorporate objective audiometric evaluation whenever possible.

Objective: Viral infections are known to be a risk factor for neonatal hearing loss. COVID-19 infection has been reported to affect hearing test results in one small sample sized study. We aimed to investigate the incidence the risk of neonatal hearing loss in infants of mothers who had COVID-19 infection during pregnancy, regarding their trimesters, by evaluating the neonatal hearing screening results. Design: In this retrospective case-control study, neonatal hearing test results of 458 women with a history of COVID-19 infection in pregnancy were compared with 339 women who gave birth before the pandemic. Data of pregnant women who attended the COVID-19 outpatient clinic of the emergency service of a tertiary pandemic hospital and who had confirmed infection with a reverse transcriptase–polymerase chain reaction (RT-PCR) test were determined from the hospital’s records and their neonatal hearing screening results were analyzed from the national database. Neonates born before

Background and objective Teprotumumab is a fully human IgG1 monoclonal antibody against insulin-like growth factor-1 receptor (IGF-1R). It has been approved by the FDA to treat thyroid eye disease (TED) by reducing extraocular muscle and orbital fat volume. In clinical trials, hearing loss was noted as a side effect in 7 to 12% of patients, but no formal audiometric investigations of these patients were reported. Furthermore, the FDA and manufacturer offer no formal guidelines for audiometric monitoring. This case report is the first to describe sensorineural hearing loss (SNHL) in a patient undergoing treatment with teprotumumab. Patient A 77-year-old woman presenting with bilateral SNHL after treatment with teprotumumab therapy for TED. Intervention Audiometric testing was performed due to worsening and prolonged SNHL after subsequent teprotumumab infusions. Main outcome measures Word recognition scores, pure tone average. Results Audiometry after discontinuation of therapy showed moderate to moderate-severe SNHL with word recognition scores of 64% in the right ear and 68% in the left ear. Conclusions There are currently no formal guidelines for routine audiograms before, during, and after infusion of teprotumumab. Given that such guidelines exist for ototoxic medications such as gentamicin and cisplatin, we strongly encourage audiometric monitoring for patients undergoing treatment with teprotumumab.

A common complaint of older adults is difficulty understanding speech, particularly in challenging listening conditions. Accumulating evidence suggests that these difficulties may reflect a loss and/or dysfunction of auditory nerve (AN) fibers. We used a novel approach to study age-related changes in AN structure and several measures of AN function, including neural synchrony, in 58 older adults and 42 younger adults. AN activity was measured in response to an auditory click (compound action potential; CAP), presented at stimulus levels ranging from 70 to 110 dB pSPL. Poorer AN function was observed for older than younger adults across CAP measures at higher but not lower stimulus levels. Associations across metrics and stimulus levels were consistent with age-related AN disengagement and AN dyssynchrony. High-resolution T2-weighted structural imaging revealed age-related differences in the density of cranial nerve VIII, with lower density in older adults with poorer neural synchrony. Individual differences in neural synchrony were the strongest predictor of speech recognition, such that poorer synchrony predicted poorer recognition of time-compressed speech and poorer speech recognition in noise for both younger and older adults. These results have broad clinical implications and are consistent with an interpretation that age-related atrophy at the level of the AN contributes to poorer neural synchrony and may explain some of the perceptual difficulties of older adults.SIGNIFICANCE STATEMENTDifferences in auditory nerve (AN) pathophysiology may contribute to the large variations in hearing and communication abilities of older adults. However, current diagnostics focus largely on the increase in detection thresholds, which is likely because of the absence of indirect measures of AN function in standard clinical test batteries. Using novel metrics of AN function, combined with estimates of AN structure and auditory function, we identified age-related differences across measures that we interpret to represent age-related reductions in AN engagement and poorer neural synchrony. Structure-function associations are consistent with an explanation of AN deficits that arise from age-related atrophy of the AN. Associations between neural synchrony and speech recognition suggest that individual and age-related deficits in neural synchrony contribute to speech recognition deficits.

This study aimed to evaluate the efficacy of video head impulse test (VHIT) and Videonystagmography (VNG) diagnostic tests in the diagnosis of vertigo caused by Meniere's disease. In this cross-sectional study 20 patients (10 in Meniere's group and 10 in control group) with vertigo attacks were involved. Patients were diagnosed with Meniere's disease (according to clinical criteria) or acute vertigo due to other causes after taking a history, complete examination, audiometry screening, and recording patient information in a pre-prepared checklist. Patients were referred to an audiology clinic for performing ECOG, VHIT, and VNG. All variables and sensitivity, specificity, positive predictive value, and negative predictive value were recorded and analyzed. There was no statistical difference between two groups regarding the mean age and gender of the patients (p > 0.05). The results showed no statistically significant difference between the study groups regarding the frequency distribution of ECOG, VNG, VHIT results. Also the results showed no statistically significant difference between the study groups regarding the frequency distribution of combined VNG and VHIT results. Combined VNG and VHIT had a relatively low sensitivity but high specificity in diagnosing Meniere’s disease compared with the ECOG test, which had a sensitivity of 70% and a specificity of 90%. At the time of attack in this study, combined VNG and VHIT had a sensitivity of 50% and a specificity of 90%. According to the results of the current study, it can be concluded that patients in whom the result of combined VNG and VHIT was positive for Meniere’s were more likely to have Meniere’s disease based on clinical criteria.

Audiometry is a branch of acoustical measurements that concentrated on testing the devices related to hearing and used in medical part such as audiometer. It is substantial to calibrate the audiometer to assure the measurement traceability and to safe human health. So, it is considered as a major claim. The importance of calibration comes from the request for advanced instrument to test accurately the hearing loss for human, especially for those people who might be at risk due to noise. The conventional audiometry covered from 125 to 8 kHz, while the extended high-frequency (EHF) audiometry above 8 up to 20 kHz, the last-mentioned type may be useful in early diagnosis of hearing loss. The audiometer calibration performed using ear simulator, standard or working microphone, sound level meter, and frequency analyzer according to IEC60645-1. The physical parameters such as sound pressure level, frequency and distortion may be affected by environmental conditions such as temperature change. The gained results observed that the measured value of all the tests performed was affected by temperature variation. There were deviations observed from each performed test’s nominal values in the calibration process as the temperature varies from 16 to 40°C. So, this is a detailed study for the significance, method, and uncertainty estimation for audiometer calibration covering the EHF ranges within the temperature from 16 to 40°C.

OBJECTIVE To report the audiological, rehabilitative, and surgical outcomes of revision surgery for pediatric auditory brainstem implant (ABI) users. STUDY DESIGN Retrospective cohort. SETTING Tertiary referral center. PATIENTS Five pediatric ABI users who had revision surgery for device malfunctions. INTERVENTIONS Revision surgery for ABI malfunctions. MAIN OUTCOME MEASURES The findings of free-field audiometry with the device, the Meaningful Auditory Integration Scale, and the pattern discrimination, word identification, sentence recognition, and expressive and receptive language tests before the device failure and after revision surgery were obtained from the patient records and compared. RESULTS The revision rate for pediatric ABI was 6.45%. The Meaningful Auditory Integration Scale and expressive-receptive language scores showed improvements following revision surgery, while the aided thresholds, pattern perception, and word identification scores did not change. Individual differences in performance for these measures were observed. CONCLUSION Equal or improved performance after the revision surgeries in the current study showed that revision surgery is successful and important for pediatric ABI users. It is essential to consider remedying the loss of auditory input in sensitive periods of pediatric development.

Purpose The purpose of this review article is to discuss how boothless audiometry may help address changes in hearing health care services and provide progressive tools to expand beyond traditional audiology clinic visits. The primary drivers for these changes include the COVID-19 pandemic, our aging population, comorbid effects of unidentified hearing loss, and the critical need for effective communication between patients and providers. This review article highlights key features and technical specifications of boothless audiometry, provides an overview of Food and Drug Administration (FDA)–approved boothless audiometry products, and describes how to leverage these products to increase access to hearing health services across the continuum of health care. Method Boothless audiometry literature was reviewed using PubMed and audiometry technology websites. FDA-approved boothless audiometry products were reviewed, and audiological features were categorized. Civilian and Department of Defense subject matter experts were consulted. Conclusions Boothless audiometry technology introduces opportunities for early audiometric assessment outside of the audiology clinic, in settings where traditional testing has been less possible, or even impossible, such as military environments, clinic waiting areas, schools, and nursing homes. This technology allows health care providers to identify individuals with significant hearing loss early and seek comprehensive services to prevent and treat hearing loss. By expanding the current hearing health care delivery model via boothless audiometry technology, the following benefits may be achieved, which can result in better outcomes overall: increased access to care, early identification and treatment of hearing loss, and reduced impact from the comorbid effects of hearing impairment.

Purpose Several military occupations, particularly those within the U.S. Air Force, require working with or around jet fuels. Jet fuels contain components that are known to affect central nervous function, yet effects of these fuels on auditory function, specifically auditory processing of sound, are not well understood at this time. Animal studies have demonstrated that exposure to jet fuels prior to noise exposure can exacerbate the noise exposure's effects, and service members exposed to jet fuels are at risk of noise exposure within their work environments. The purpose of this article was to give a brief synopsis of the evidence on the ototoxic effects due to jet fuel exposure to aid audiologists in their decision making when providing care for populations who are occupationally exposed to fuels or while during military service. Conclusions Exposure to jet fuels impacts central nervous function and, in combination with noise exposure, may have detrimental auditory effects that research has yet to fully explain. Additional longitudinal research is needed to explain the relationships, which have clinical implications for service members and others exposed to jet fuels. In the meantime, audiologists can gain useful information by screening for chemical exposures when obtaining patient case histories. If jet fuel exposure is suspected, the Lifetime Exposure to Noise and Solvents Questionnaire can be used to estimate a noise exposure ranking and identify other potentiating agents such as jet fuel and industrial chemicals. A history of jet fuel exposure should inform the selection of hearing tests in the audiometric evaluation and when devising the treatment plan.

Purpose Individuals with cystic fibrosis (CF) are often treated with intravenous (IV) aminoglycoside (AG) antibiotics to manage life-threatening bacterial infections. Preclinical animal data suggest that, in addition to damaging cochlear hair cells, this class of antibiotics may cause cochlear synaptopathy and/or damage to higher auditory structures. The acoustic reflex growth function (ARGF) is a noninvasive, objective measure of neural function in the auditory system. A shallow ARGF (small reflex-induced changes in middle ear function with increasing elicitor level) has been associated with synaptopathy due to noise exposure in rodent and human studies. In this study, the ARGF was obtained in CF patients with normal hearing, some of whom have been treated with IV AGs, and a control group without CF. The hypothesis was that patients with IV-AG exposure would have a shallow ARGF due to cochlear synaptopathy caused by ototoxicity. Method Wideband ARGFs were examined in four groups of normal-hearing participants: a control group of 29 individuals without CF; and in 57 individuals with CF grouped by lifetime IV-AG exposure: 15 participants with no exposure, 21 with low exposure, and 21 with high exposure. Procedures included pure-tone audiometry, clinical immittance, wideband acoustic immittance battery, including ARGFs, and transient evoked otoacoustic emissions. Results CF subjects with normal pure-tone thresholds and either high or low lifetime IV-AG exposure had enhanced ARGFs compared to controls and CF participants without IV-AG exposure. The groups did not differ in transient evoked otoacoustic emission signal-to-noise ratio. Conclusion These results diverge from the shallow ARGF pattern observed in studies of noise-induced cochlear synaptopathy and are suggestive of a central mechanism of auditory dysfunction in patients with AG-induced ototoxicity.

Purpose The purpose of this study is to better understand the prevalence of ototoxicity-related hearing loss and its functional impact on communication in a pediatric and young adult cohort with cystic fibrosis (CF) and individuals without CF (controls). Method We did an observational, cross-sectional investigation of hearing function in children, teens, and young adults with CF ( n = 57, M = 15.0 years) who received intravenous aminoglycoside antibiotics and age- and gender-matched controls ( n = 61, M = 14.6 years). Participants completed standard and extended high-frequency audiometry, middle ear measures, speech perception tests, and a hearing and balance questionnaire. Results Individuals with CF were 3–4 times more likely to report issues with hearing, balance, and tinnitus and performed significantly poorer on speech perception tasks compared to controls. A higher prevalence of hearing loss was observed in individuals with CF (57%) compared to controls (37%). CF and control groups had similar proportions of slight and mild hearing losses; however, individuals with CF were 7.6 times more likely to have moderate and greater degrees of hearing loss. Older participants displayed higher average extended high-frequency thresholds, with no effect of age on average standard frequency thresholds. Although middle ear dysfunction has not previously been reported to be more prevalent in CF, this study showed that 16% had conductive or mixed hearing loss and higher rates of previous otitis media and pressure equalization tube surgeries compared to controls. Conclusions Individuals with CF have a higher prevalence of conductive, mixed, and sensorineural hearing loss; poorer speech-in-noise performance; and higher rates of multiple symptoms associated with otologic disorders (tinnitus, hearing difficulty, dizziness, imbalance, and otitis media) compared to controls. Accordingly, children with CF should be asked about these symptoms and receive baseline hearing assessment(s) prior to treatment with potentially ototoxic medications and at regular intervals thereafter in order to provide otologic and audiologic treatment for hearing- and ear-related problems to improve communication functioning.

Background: Good hearing is essential to learning and rehabilitation of adolescent and young adults in juvenile correctional facilities. Hearing screening programme is not commonly in place for this incarcerated group. Objective: To evaluate hearing threshold among inmates of a juvenile correctional facility in Nigeria and compare pattern of hearing loss with a control group. Methods: A total of 135 inmates and equal number of age and sex matched control responded to interviewer-administered questionnaire followed by otoscopy and audiometry. Results: Mean age of inmates was 19 years ±2.0, while that of control was 18yrs ± 2.5. (p-value 0.077). Four (3%) inmates had bleeding from the ear; otoscopy revealed traumatic tympanic membrane perforation in 2(1.5%) of them. Prevalence of hearing loss was 19.2% and for disabling hearing loss it was 1.4%. Conductive hearing loss was the most common 33(24.4%). Inmates had consistently worse mean hearing thresholds than controls across all frequencies tested in both ears (p-value

The aim of the study was a comparative analysis of subjective assessments and audiological parameters of patients with hearing loss obtained before and after the course of transcranial electrical stimulation (TES). The study group included 99 patients (45 men and 54 women) with chronic mono- (16%) and bilateral (76%) sensorineural hearing loss (SNHL) aged 20 to 85 years. Groups of young and middle age (20-59 years old) amounted to 37 people; elderly (60-74 years old) - 48 and senile (75-90 years old) - 14 people. The observation included: anamnesis, ENT survey, tone threshold audiometry, impedancemetry, and questioning. All patients underwent a course of 10 TES procedures using the «Transair-7» device. The data indicated an improvement in subjective assessments regarding auditory perception in 54%, speech intelligibility in 53%, tinnitus in 24% and general well-being in 36% of patients in the study group. The distribution of hearing thresholds in the region of speech frequencies before and after the course also turned out to be significantly different (p0,01). At the same time, gender and age-specific features of the effect of TES on hearing and general well-being were revealed, the most pronounced in senile patients who showed minimal positive dynamics. In general, taking into account age restrictions, the results confirm the feasibility of using TES in SNHL, even outside the combined (with audio loading) stimulation.Цель исследования — сравнительный анализ субъективных оценок и аудиологических показателей у пациентов сурдологического профиля, полученных до и после прохождения курса транскраниальной электростимуляции (ТЭС). В группу обследования вошли 99 пациентов 20–85 лет (45 мужчин и 54 женщины) с хронической одно- (16%) и двусторонней (76%) сенсоневральной тугоухостью (СНТ). Группа молодого и среднего возраста (20–59 лет) составила 37 человек, пожилого (60–74 лет) — 48, старческого (75–90 лет) — 14. Обследование включало сбор анамнеза, ЛОР-осмотр, тональную пороговую аудиометрию, импедансометрию, анкетирование. Все пациенты прошли курс из 10 процедур ТЭС с применением прибора «Трансаир-7». Данные свидетельствовали об улучшении субъективных оценок в отношении слухового восприятия у 54% пациентов, разборчивости речи — у 53%, ушного шума — у 24%, общего самочувствия — у 36%. Распределение порогов слуха в области речевых частот до и после курса также оказалось достоверно различным (p0,01). При этом были выявлены гендерные и возрастные особенности влияния ТЭС на показатели слуха и общего самочувствия, наиболее выраженные у пациентов старческого возраста, продемонстрировавших минимальную положительную динамику. В целом, с учетом возрастных ограничений, результаты подтверждают целесообразность применения ТЭС при хронической СНТ даже вне режима комбинированной (с аудионагрузкой) стимуляции.

Purpose As bone-conduction thresholds vary with the coupling force between the vibrator and the head, it is important that the coupling force be within the range specified by audiometer standards. The development and validation of AMBAND, an elastic headband for coupling an audiometric bone vibrator to the head, in either the mastoid or forehead position, is described. Methods The headband was constructed from woven, fold-over elastic with Velcro attachment points to produce the proper force on the head for various head sizes. Force measurements were made with a digital force gauge on five artificial heads, representing adult females, adult males, children (age 6 years), infants (age 6 months), and newborns with the bone vibrator in the mastoid and forehead positions. Additional measurements were made with the Radioear P-3333 spring band that is in common use. Results Force measurements were highly repeatable within a given headband and across headbands. Force measurements for AMBAND were within the range specified by the ANSI S3.6-2018. The Radioear P-3333 spring band produced force levels that exceeded the specified range and had higher variability compared with AMBAND. Conclusion AMBAND can be used to couple audiometric bone vibrators to the head in the forehead and mastoid positions during bone-conduction testing to provide accurate threshold measurements.

Age-related hearing loss (ARHL) is a devastating public health issue. To successfully address ARHL using existing and future treatments, it is imperative to detect the earliest signs of age-related auditory decline and understand the mechanisms driving it. Here, we explore early signs of age-related auditory decline by characterizing cochlear function in 199 ears aged 10–65 years, all of which had clinically defined normal hearing (i.e., behavioral thresholds ≤ 25 dB HL from .25 to 8 kHz bilaterally) and no history of noise exposure. We characterized cochlear function by measuring behavioral thresholds in two paradigms (traditional audiometric thresholds from .25 to 8 kHz and Békésy tracking thresholds from .125 to 20 kHz) and distortion product otoacoustic emission (DPOAE) growth functions at f(2) = 2, 4, and 8 kHz. Behavioral thresholds through a standard clinical frequency range (up to 8 kHz) showed statistically, but not clinically, significant declines across increasing decades of life. In contrast, DPOAE growth measured in the same frequency range showed clear declines as early 30 years of age, particularly across moderate stimulus levels (L(2) = 25–45 dB SPL). These substantial declines in DPOAE growth were not fully explained by differences in behavioral thresholds measured in the same frequency region. Additionally, high-frequency Békésy tracking thresholds above ~11.2 kHz showed frank declines with increasing age. Collectively, these results suggest that early age-related cochlear decline (1) begins as early as the third or fourth decade of life, (2) is greatest in the cochlear base but apparent through the length of the cochlear partition, (3) cannot be detected fully by traditional clinical measures, and (4) is likely due to a complex mix of etiologies.

ObjectiveTo assess the influence of presbylarynx and presbycusis on Voice Handicap Index and emotional status.MethodsA case–control, prospective, observational, cross-sectional study was conducted of patients aged 65 years or older referred to an otorhinolaryngology department from January to September 2020. Presbycusis was assessed by pure tone and vocal audiometry. Each subject underwent fibre-optic videolaryngoscopy with stroboscopy, and presbylarynx was considered when two or more of the following endoscopic findings were identified: vocal fold bowing, prominence of vocal processes in abduction, and a spindle-shaped glottal gap. Each subject completed two questionnaires: Voice Handicap Index and Geriatric Depression Scale (short-form).ResultsThe studied population included 174 White European subjects, with a mean age of 73.99 years, of whom 22.8 per cent presented both presbylarynx and presbycusis. Multivariate linear regression revealed that only presence and severity of presbylarynx had an influence on Voice Handicap Index-30 scores. However, both spindle-shaped glottal gap and presbycusis influenced Geriatric Depression Scale scores.ConclusionPresbylarynx has a strong association with the impact of voice on quality of life. Presbylarynx and presbycusis seem to have a cumulative effect on emotional status.