The displacement of a threshold from its measured-in-the-quiet value to the value it takes in the presence of another sound is masking. Measurement of that displacement is masking audiometry. And the measurement of displacements at a large number of ...
Sanjuán Juaristi, Julio
The recording and processing of cochlear microphone potentials in hearing studies is currently in the definitive validation phase against results obtained with other objective procedures. The purpose of this work is to contribute to its validation. The equipment used was exclusively designed for recording cochlear microphone potentials. The study has been carried out in adults to compare subjective audiometric results with those obtained from cochlear microphones. We present a statistical concordance study between subjective audiometry and cochlear microphone audiometry. In view of the results obtained, this method is particularly valid for early diagnosis. We obtained an identical profile to the subjective audiogram at audiometric frequencies of 250, 500, 1000, 2000, and 4000 Hz.
Walker, Jennifer Junnila; Cleveland, Leanne M; Davis, Jenny L; Seales, Jennifer S
.... If offered, screening can be performed periodically by asking the patient or family if there are perceived hearing problems, or by using clinical office tests such as whispered voice, finger rub, or audiometry...
Walker, Jennifer Junnila; Cleveland, Leanne M; Davis, Jenny L; Seales, Jennifer S
The prevalence of hearing loss varies with age, affecting at least 25 percent of patients older than 50 years and more than 50 percent of those older than 80 years. Adolescents and young adults represent groups in which the prevalence of hearing loss is increasing and may therefore benefit from screening. If offered, screening can be performed periodically by asking the patient or family if there are perceived hearing problems, or by using clinical office tests such as whispered voice, finger rub, or audiometry. Audiometry in the family medicine clinic setting is a relatively simple procedure that can be interpreted by a trained health care professional. Pure-tone testing presents tones across the speech spectrum (500 to 4,000 Hz) to determine if the patient's hearing levels fall within normal limits. A quiet testing environment, calibrated audiometric equipment, and appropriately trained personnel are required for in-office testing. Pure-tone audiometry may help physicians appropriately refer patients to an audiologist or otolaryngologist. Unilateral or asymmetrical hearing loss can be symptomatic of a central nervous system lesion and requires additional evaluation.
Yeh, Chung-Hui; Wei, Sung-Tai; Chen, Tsung-Wen; Wang, Ching-Yuang; Tsai, Ming-Hsui; Lin, Chia-Der
To establish a real-time, web-based, customized audiometry database system, we worked in cooperation with the departments of medical records, information technology, and otorhinolaryngology at our hospital. This system includes an audiometry data entry system, retrieval and display system, patient information incorporation system, audiometry data transmission program, and audiometry data integration. Compared with commercial audiometry systems and traditional hand-drawn audiometry data, this ...
Lauris, José Roberto Pereira; Basso, Talita Costa; Marinelli, Érica Juliana Innocenti; Otubo, Karina Aki; Lopes, Andréa Cintra
Introduction: Studies on the occupational exposure show that noise has been reaching a large part of the working population around the world, and NIHL (noise-induced hearing loss) is the second most frequent disease of the hearing system. Objective: To review the audiometry results of employees at the campus of the University of São Paulo, Bauru. Method: 40 audiometry results were analyzed between 2007 and 2008, whose ages comprised between 32 and 59 years, of both sexes and several professio...
Lauris, José Roberto Pereira
Full Text Available Introduction: Studies on the occupational exposure show that noise has been reaching a large part of the working population around the world, and NIHL (noise-induced hearing loss is the second most frequent disease of the hearing system. Objective: To review the audiometry results of employees at the campus of the University of São Paulo, Bauru. Method: 40 audiometry results were analyzed between 2007 and 2008, whose ages comprised between 32 and 59 years, of both sexes and several professions: gardeners, maintenance technicians, drivers etc. The participants were divided into 2 groups: those with tonal thresholds within acceptable thresholds and those who presented auditory thresholds alterations, that is tonal thresholds below 25 dB (NA in any frequency (Administrative Rule no. 19 of the Ministry of Labor 1998. In addition to the Conventional Audiologic Evaluation (250Hz to 8.000Hz we also carried out High Frequencies Audiometry (9000Hz, 10000Hz, 11200Hz, 12500Hz, 14000Hz and 16000Hz. Results: According to the classification proposed by FIORINI (1994, 25.0% (N=10 they presented with NIHL suggestive audiometric configurations. The results of high frequencies Audiometry confirmed worse thresholds than those obtained in the conventional audiometry in the 2 groups evaluated. Conclusion: The use of high frequencies audiometry proved to be an important register as a hearing alteration early detection method.
Yeh, Chung-Hui; Wei, Sung-Tai; Chen, Tsung-Wen; Wang, Ching-Yuang; Tsai, Ming-Hsui; Lin, Chia-Der
To establish a real-time, web-based, customized audiometry database system, we worked in cooperation with the departments of medical records, information technology, and otorhinolaryngology at our hospital. This system includes an audiometry data entry system, retrieval and display system, patient information incorporation system, audiometry data transmission program, and audiometry data integration. Compared with commercial audiometry systems and traditional hand-drawn audiometry data, this web-based system saves time and money and is convenient for statistics research. Copyright © 2013. Published by Elsevier B.V.
Christensen, Christian Bech; Kidmose, Preben
therefore be an enabling technology for objective audiometry out of the clinic, allowing regularly fitting of the hearing aids to be made by the users in their everyday life environment. The objective of this study is to investigate the application of ear-EEG in objective audiometry....
Brown, Denice P.
Eight children (ages 13 days to 5 years) with a diagnosis of Cornelia de Lange syndrome received audiologic evaluation consisting of immittance audiometry and auditory brainstem response audiometry to air and bone conducted "click" stimuli, as behavioral testing was unreliable due to patient age and/or developmental delay. Developmental…
Christensen, Christian Bech; Kidmose, Preben
life. Ear-EEG may therefore be an enabling technology for objective audiometry out of the clinic, allowing regularly fitting of the hearing aids to be made by the users in their everyday life environment. In this study we investigate the application of ear-EEG in objective audiometry....
... It may also be used when you have hearing problems from any cause. Common causes of hearing loss ... Editorial team. Hearing Disorders and Deafness Read more Hearing Problems in Children Read more Latest Health News Read ...
Choi, Jong Min; Lee, Haet Bit; Park, Cheol Soo; Oh, Seung Ha; Park, Kwang Suk
A personal computer (PC)-based audiometer was developed for interactive remote audiometry. This paper describes a tele-audiometric system and evaluates the performance of the device when compared with conventional face-to-face audiometry. The tele-audiometric system is fully PC-based. A sound card featuring a high-quality digital-to-analog converter is used as a pure-tone generator. The audiometric programs were developed based on Microsoft Windows in order to maximize usability. Audiologists and their subjects can use the tele-audiometry system as one would utilize any PC application. A calibration procedure has been applied for the standardization of sound levels in the remote system. The performance of this system was evaluated by comparing PC-based audiometry with the conventional clinical audiometry system for 37 subjects. Also, performance of the PC-based system was evaluated during use at a remote site. The PC-based audiometry system estimated the audiometric threshold with an error of less than 2.3 dBSPL. Only 10.7% of the results exhibited an error greater than 5 dBSPL during use at a remote site. The PC-based tele-audiomerty showed acceptable results for use at a remote site. This PC-based system can be used effectively and easily in many locations that have Internet access but no local audiologists.
Mehrparvar, Amir Houshang; Mirmohammadi, Seyyed Jalil; Davari, Mohammad Hossein; Mostaghaci, Mehrdad; Mollasadeghi, Abolfazl; Bahaloo, Maryam; Hashemi, Seyyed Hesam
Noise most frequently affects hearing system, as it may typically cause a bilateral, progressive sensorineural hearing loss at high frequencies. This study was designed to compare three different methods to evaluate noise-induced hearing loss (conventional audiometry, high-frequency audiometry, and distortion product otoacoustic emission). This was a cross-sectional study. Data was analyzed by SPSS (ver. 19) using chi square, T test and repeated measures analysis. Study samples were workers from tile and ceramic industry. We found that conventional audiometry, extended high-frequency audiometry, low-tone distortion product otoacoustic emission and high-tone distortion product otoacoustic emission had abnormal findings in 29 %, 69 %, 22 %, and 52 % of participants. Most frequently affected frequencies were 4000 and 6000Hz in conventional audiometry, and 14000 and 16000 in extended high-frequency audiometry. Extended high-frequency audiometry was the most sensitive test for detection of hearing loss in workers exposed to hazardous noise compared with conventional audiometry and distortion product otoacoustic.
Veronika Vielsmeier; Astrid Lehner; Jürgen Strutz; Thomas Steffens; Kreuzer, Peter M.; Martin Schecklmann; Michael Landgrebe; Berthold Langguth; Tobias Kleinjung
Objective. The majority of tinnitus patients suffer from hearing loss. But a subgroup of tinnitus patients show normal hearing thresholds in the conventional pure-tone audiometry (125 Hz–8 kHz). Here we explored whether the results of the high frequency audiometry (>8 kHz) provide relevant additional information in tinnitus patients with normal conventional audiometry by comparing those with normal and pathological high frequency audiometry with respect to their demographic and clinical chara...
Mehrparvar, Amir Houshang; Mirmohammadi, Seyyed Jalil; Davari, Mohammad Hossein; Mostaghaci, Mehrdad; Mollasadeghi, Abolfazl; Bahaloo, Maryam; Hashemi, Seyyed Hesam
Background: Noise most frequently affects hearing system, as it may typically cause a bilateral, progressive sensorineural hearing loss at high frequencies. Objectives: This study was designed to compare three different methods to evaluate noise-induced hearing loss (conventional audiometry, high-frequency audiometry, and distortion product otoacoustic emission). Material and Methods: This was a cross-sectional study. Data was analyzed by SPSS (ver. 19) using chi square, T test and repeated m...
Flexer, Carol; Gans, Donald P.
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…
Vielsmeier, Veronika; Lehner, Astrid; Strutz, Jürgen; Steffens, Thomas; Kreuzer, Peter M; Schecklmann, Martin; Landgrebe, Michael; Langguth, Berthold; Kleinjung, Tobias
The majority of tinnitus patients suffer from hearing loss. But a subgroup of tinnitus patients show normal hearing thresholds in the conventional pure-tone audiometry (125 Hz-8 kHz). Here we explored whether the results of the high frequency audiometry (>8 kHz) provide relevant additional information in tinnitus patients with normal conventional audiometry by comparing those with normal and pathological high frequency audiometry with respect to their demographic and clinical characteristics. From the database of the Tinnitus Clinic at Regensburg we identified 75 patients with normal hearing thresholds in the conventional pure-tone audiometry. We contrasted these patients with normal and pathological high-frequency audiogram and compared them with respect to gender, age, tinnitus severity, pitch, laterality and duration, comorbid symptoms and triggers for tinnitus onset. Patients with pathological high frequency audiometry were significantly older and had higher scores on the tinnitus questionnaires in comparison to patients with normal high frequency audiometry. Furthermore, there was an association of high frequency audiometry with the laterality of tinnitus. In tinnitus patients with normal pure-tone audiometry the high frequency audiometry provides useful additional information. The association between tinnitus laterality and asymmetry of the high frequency audiometry suggests a potential causal role for the high frequency hearing loss in tinnitus etiopathogenesis.
Pelmear, P. L.; Hughes, Brenda J.
Pelmear, P. L. and Hughes, Brenda J. (1974).British Journal of Industrial Medicine,31, 304-309. Self-recording audiometry in industry. A study of initial and repeat audiograms of 118 drop forge employees using fixed frequency self-recording audiometry showed that the mean of the differences at the test frequencies 0·5, 1, 2, 3, 4, and 6 kHz ranges from -0·47 dB to +0·61 dB. The largest standard deviation was 6 dB at 6 kHz and the lowest 3 dB at 2 kHz. The results also confirmed that temporary threshold shift effects may be minimized if audiograms are obtained at the beginning of a shift or within two hours provided the subject is protected with ear muff defenders up to the time of the test. The practical advantages to industry of using self-recording audiometry for audiometric screening and the reliability of single audiograms for threshold determination are discussed. PMID:4425632
Audiometry James J. Finneran Space and Naval Warfare Systems Center Pacific, Biosciences Division, Code 71510, 53560 Hull Street, San Diego, CA...DATES COVERED 00-00-2009 to 00-00-2009 4. TITLE AND SUBTITLE Electrophysiological Techniques For Sea Lion Population-Level Audiometry 5a
This report summarises the results of a study analysing audiometry data to determine if noise induced related hearing loss is happening in offshore operations. The background to the study is traced, and details are given of the initial contacts with medical and operational companies holding audiometry data, the confidentiality of the data sources, the questionnaire for the holders of personnel audiometry data, and initial data checking. A descriptive analysis of the study population is presented, and the analysis of audiometry data, hearing threshold levels, and the classification of the data using the Health and Safety Executive (HSE) categorisation scheme are discussed. The questionnaire for the data holders, the audiometry data collection proforma, and guidance for completion of data collection proformas are included in appendices.
Examination of cognitive functions in the framework of speech perception has recently gained increasing scientific and clinical interest. Especially against the background of age-related hearing impairment and cognitive decline potential new perspectives in terms of better individualisation of auditory diagnosis and rehabilitation might arise. This review addresses the relationships of speech audiometry, speech perception and cognitive functions. It presents models of speech perception, discusses associations of neuropsychological with audiometric outcomes and shows recent efforts to consider cognitive functions with speech audiometry.
Foulad, Allen; Bui, Peggy; Djalilian, Hamid
The aim of this study is to determine the feasibility of an Apple iOS-based automated hearing testing application and to compare its accuracy with conventional audiometry. Prospective diagnostic study. Setting Academic medical center. An iOS-based software application was developed to perform automated pure-tone hearing testing on the iPhone, iPod touch, and iPad. To assess for device variations and compatibility, preliminary work was performed to compare the standardized sound output (dB) of various Apple device and headset combinations. Forty-two subjects underwent automated iOS-based hearing testing in a sound booth, automated iOS-based hearing testing in a quiet room, and conventional manual audiometry. The maximum difference in sound intensity between various Apple device and headset combinations was 4 dB. On average, 96% (95% confidence interval [CI], 91%-100%) of the threshold values obtained using the automated test in a sound booth were within 10 dB of the corresponding threshold values obtained using conventional audiometry. When the automated test was performed in a quiet room, 94% (95% CI, 87%-100%) of the threshold values were within 10 dB of the threshold values obtained using conventional audiometry. Under standardized testing conditions, 90% of the subjects preferred iOS-based audiometry as opposed to conventional audiometry. Apple iOS-based devices provide a platform for automated air conduction audiometry without requiring extra equipment and yield hearing test results that approach those of conventional audiometry.
Rakhi Kumari; Priyanko Chakraborty; Jain, R K; Dhananjay Kumar
Background: Early detection of hearing loss has been a long-standing priority in the field of audiology. Currently available auditory testing methods include both behavioural and non-behavioural or objective tests of hearing. This study was planned with an objective to assess hearing loss in children using behavioural observation audiometry and brain stem evoked response audiometry. Methods: A total of 105 cases suffering from severe to profound hearing loss were registered. After proper h...
Brennan-Jones, Christopher G; Eikelboom, Robert H; Bennett, Rebecca J; Tao, Karina Fm; Swanepoel, De Wet
Introduction Remote interpretation of automated audiometry offers the potential to enable asynchronous tele-audiology assessment and diagnosis in areas where synchronous tele-audiometry may not be possible or practical. The aim of this study was to compare remote interpretation of manual and automated audiometry. Methods Five audiologists each interpreted manual and automated audiograms obtained from 42 patients. The main outcome variable was the audiologist's recommendation for patient management (which included treatment recommendations, referral or discharge) between the manual and automated audiometry test. Cohen's Kappa and Krippendorff's Alpha were used to calculate and quantify the intra- and inter-observer agreement, respectively, and McNemar's test was used to assess the audiologist-rated accuracy of audiograms. Audiograms were randomised and audiologists were blinded as to whether they were interpreting a manual or automated audiogram. Results Intra-observer agreement was substantial for management outcomes when comparing interpretations for manual and automated audiograms. Inter-observer agreement was moderate between clinicians for determining management decisions when interpreting both manual and automated audiograms. Audiologists were 2.8 times more likely to question the accuracy of an automated audiogram compared to a manual audiogram. Discussion There is a lack of agreement between audiologists when interpreting audiograms, whether recorded with automated or manual audiometry. The main variability in remote audiogram interpretation is likely to be individual clinician variation, rather than automation.
Malinowski, T.; Klepacki, J.; Wagstyl, R.
The evoked response audiometry method of testing hearing loss is presented and the results of comparative studies using subjective tonal audiometry and evoked response audiometry in tests of 56 healthy men with good hearing are discussed. The men were divided into three groups according to age and place of work: work place without increased noise; work place with noise and vibrations (at drilling machines); work place with noise and shocks (work at excavators in surface coal mines). The ERA-MKII audiometer produced by the Medelec-Amplaid firm was used. Audiometric threshhold curves for the three groups of tested men are given. At frequencies of 500, 1000 and 4000 Hz mean objective auditory threshhold was shifted by 4-9.5 dB in comparison to the subjective auditory threshold. (21 refs.) (In Polish)
Kowalska, Sylwia; Konopka, Wiesław; Słomińska, Renata; Olszewski, Jurek
The aim of this work was to assess the value of impedance audiometry in the differential diagnostics of hearing disorders, especially in patients suffering from tinnitus. The analysis dealt with results of the audiological tests in 198 patients (116 female and 82 male), hospitalised in 2007 due to their hearing deterioration, tinnitus or sudden deafness. The conducted audiological tests covered threshold and suprathreshold pure tone audiometry, speech audiometry, BERA and impedance audiometry. RESULTS OF THE STUDIES: Women (58.5%) and people over 50 years old (58.6%) constituted the majority of the patients. In 166 (83.8%) patients the conducted tests via impedance audiometry did not prove any deviations from the normal condition, the lesions referred to both ears in 32 (16.9%) patients and one ear in 17 (8.5%) patients. An incorrect tympanogram was found in 23 people, including type As in 11, type Ad in 2, type B in 4 and type C in 6 subjects. Low values of acoustic receptivity of the middle ear were noted in 20 ears, whereas high values in 11 ears. In 3 ears we found low values of the gradient (below 0.3), high values--in 11 ears. The middle ear pressure between -170 and -350 daPa was noticed in 20 ears, and positive values, above +50 daPa up to +75 daPa, in 3 ears. Disorders in the stapedial reflex registration were observed in 38 (19.1%) patients. The assessment of the conducted subjective and objective audiological examinations allowed to recognise bilateral perceptive hearing injuries in 139 patients, including 49 (25.9%) of cochlear origin with OWG, in further 70 patients the hearing loss referred to higher frequencies and was rather slight. The own experiences indicated that the impedance audiometry constitutes the integral part of contemporary audiological diagnostics and still remains an objective method facilitating quick, non-invasive evaluation of the functions of particular elements in the middle ear.
Swanepoel, De Wet; Mngemane, Shadrack; Molemong, Silindile; Mkwanazi, Hilda; Tutshini, Sizwe
This study investigated the reliability, accuracy, and time efficiency of automated hearing assessment using a computer-based telemedicine-compliant audiometer. Thirty normal-hearing subjects and eight hearing-impaired subjects were tested with pure-tone air conduction audiometry (125-8,000 Hz) in a manual and automated configuration in a counterbalanced manner. For the normal-hearing group each test was repeated to determine test-retest reliability and recording time, and preference for threshold-seeking method (manual vs. automated) was documented. Test-retest thresholds were not significantly different for manual and automated testing. Manual audiometry test-retest correspondence was 5 dB or less in 88% of thresholds compared to 91% for automated audiometry. Thresholds for automated audiometry did not differ significantly from manual audiometry with 87% of thresholds in the normal-hearing group and 97% in the hearing-impaired group, corresponding within 5 dB or less of each other. The largest overall average absolute difference across frequencies was 3.6 +/- 3.9 dB for the normal-hearing group and 3.3 +/- 2.4 for the hearing-impaired group. Both techniques were equally time efficient in the normal-hearing population, and 63% of subjects preferred the automated threshold-seeking method. Automated audiometry provides reliable, accurate, and time-efficient hearing assessments for normal-hearing and hearing-impaired adults. Combined with an asynchronous telehealth model it holds significant potential for reaching underserved areas where hearing health professionals are unavailable.
Smith, Michael C.F.; Cable, Hugh R.; Wilmot, John F.
Pure tone audiometry was obtained for both ears of 32 children by a general practitioner using a simple audiometer in his surgery, and by audiometricians in a hospital department on the same day. Comparing the worst hearing threshold at any of the three tested frequencies, the general practitioner did not find any ears to hear more than 10 dB better than the hospital (no false negatives). However, there were six false positives (9%) where the general practitioner identified an apparent hearing loss of greater than 15 dB. It is concluded that pure tone audiometry could be carried out accurately in the practice. PMID:3267745
Examination of cognitive functions in the framework of speech perception has recently gained increasing scientific and clinical interest. Especially against the background of age-related hearing impairment and cognitive decline, potential new perspectives in terms of a better individualization of auditory diagnosis and rehabilitation might arise. This review addresses the relationships between speech audiometry, speech perception, and cognitive functions. It presents models of speech perception, discusses associations of neuropsychological and audiometric outcomes, and shows examples of recent efforts undertaken in Germany to consider cognitive functions with speech audiometry.
van Tonder, Jessica; Swanepoel, De Wet; Mahomed-Asmail, Faheema; Myburgh, Hermanus; Eikelboom, Robert H
Smartphone-based threshold audiometry with automated testing has the potential to provide affordable access to audiometry in underserved contexts. To validate the threshold version (hearTest) of the validated hearScreen™ smartphone-based application using inexpensive smartphones (Android operating system) and calibrated supra-aural headphones. A repeated measures within-participant study design was employed to compare air-conduction thresholds (0.5-8 kHz) obtained through automated smartphone audiometry to thresholds obtained through conventional audiometry. A total of 95 participants were included in the study. Of these, 30 were adults, who had known bilateral hearing losses of varying degrees (mean age = 59 yr, standard deviation [SD] = 21.8; 56.7% female), and 65 were adolescents (mean age = 16.5 yr, SD = 1.2; 70.8% female), of which 61 had normal hearing and the remaining 4 had mild hearing losses. Threshold comparisons were made between the two test procedures. The Wilcoxon signed-ranked test was used for comparison of threshold correspondence between manual and smartphone thresholds and the paired samples t test was used to compare test time. Within the adult sample, 94.4% of thresholds obtained through smartphone and conventional audiometry corresponded within 10 dB or less. There was no significant difference between smartphone (6.75-min average, SD = 1.5) and conventional audiometry test duration (6.65-min average, SD = 2.5). Within the adolescent sample, 84.7% of thresholds obtained at 0.5, 2, and 4 kHz with hearTest and conventional audiometry corresponded within ≤5 dB. At 1 kHz, 79.3% of the thresholds differed by ≤10 dB. There was a significant difference (p audiometry test duration (3.23 min, SD = 0.6). The hearTest application with calibrated supra-aural headphones provides a cost-effective option to determine valid air-conduction hearing thresholds.
Visual Reinforcement Audiometry (VRA) is a key behavioural test for young children. It is central to the diagnosis of hearing-impaired infants (1) . Habituation to the visual reinforcement can give misleading results. Medical Illustration ABM University Health Board has designed a collection of Flash animations to overcome this.
Mahomed, Faheema; Swanepoel, De Wet; Eikelboom, Robert H; Soer, Maggi
A systematic literature review and meta-analysis on the validity (test-retest reliability and accuracy) of automated threshold audiometry compared with the gold standard of manual threshold audiometry was conducted. A systematic literature review was completed in peer-reviewed databases on automated compared with manual threshold audiometry. Subsequently a meta-analysis was conducted on the validity of automated audiometry. A multifaceted approach, covering several databases and using different search strategies was used to ensure comprehensive coverage and to cross-check search findings. Databases included: MEDLINE, Scopus, and PubMed; a secondary search strategy was the review of references from identified reports. Reports including within-subject comparisons of manual and automated threshold audiometry were selected according to inclusion/exclusion criteria before data were extracted. For the meta-analysis weighted mean differences (and standard deviations) on test-retest reliability for automated compared with manual audiometry were determined to assess the validity of automated threshold audiometry. In total, 29 reports on automated audiometry (method of limits and the method of adjustment techniques) met the inclusion criteria and were included in this review. Most reports included data on adult populations using air conduction testing with limited data on children, bone conduction testing and the effects of hearing status on automated audiometry. Meta-analysis test-retest reliability for automated audiometry was within typical test-retest variability for manual audiometry. Accuracy results on the meta-analysis indicated overall average differences between manual and automated air conduction audiometry (0.4 dB, 6.1 SD) to be comparable with test-retest differences for manual (1.3 dB, 6.1 SD) and automated (0.3 dB, 6.9 SD) audiometry. No significant differences (p > 0.01; summarized data analysis of variance) were seen in any of the comparisons between test
Tato práce se zabývá realizací počítačové audiometrie pro subjektivní vyšetření sluchu. V práci je popsána implementace audiometru v prostředí C++ Borland Builder. Navržený audiometr se skládá ze standardního počítače s operačním systémem Windows, zvukové karty a sluchátek. Práce také obsahuje rozbor problematiky poruch sluchu a jejích vyšetření, které byly použity při implementaci audiometru. This project describes the implementation of computer audiometry for subjective hearing tests. Th...
Foulad, A; Bui, P; Djalilian, H
Objective. The aim of this study is to determine the feasibility of an Apple iOS-based automated hearing testing application and to compare its accuracy with conventional audiometry. Study Design. Prospective diagnostic study. Setting. Academic medical center. Subjects and Methods. An iOS-based software application was developed to perform automated pure-tone hearing testing on the iPhone, iPod touch, and iPad. To assess for device variations and compatibility, preliminary work was performed ...
Giorgianni, Concetto; Gangemi, Silvia; Tanzariello, Maria Giuseppina; Barresi, Gaetano; Miceli, Ludovica; D'Arrigo, Graziella; Spatari, Giovanna
Occupational exposure to anaestethic gases has been suggested to induce auditory damages. The aim of this study is to investigate high-frequency audiometric responses in subjects exposed to anaesthetic gases, in order to highlight the possible effects on auditory system. The study was performed on a sample of 30 medical specialists of Messina University Anaesthesia and Intensive care. We have used tonal audiometry as well as high-frequency one. We have compared the responses with those obtained in a similar control group not exposed to anaesthetic gases. Results were compared statistically. Results show a strong correlation (p = 0.000) between left and right ear responses to all the audiometric tests. The exposed and the control group run though the standard audiometry analysis plays different audiometric responses up only to higher frequencies (2000 HZ p = 0.009 and 4000 Hz p = 0.04); in high-frequency audiometry, as all other frequencies, the attention is drew to the fact that the sample groups distinguish themselves in a significantly statistic way (10,000 Hz p = 0.025, 12,000 Hz p = 0.008, 14,000 Hz p = 0.026, 16,000 Hz p = 0.08). The highest values are the ones related to exposed subjects both in standard (2000 Hz p = 0.01, 4000 Hz p = 0.02) and in high-frequency audiometry (10,000 Hz p = 0.011, 12,000 Hz p = 0.004, 14,000 Hz p = 0.012, 16,000 Hz p = 0.004). Results, even if preliminary and referred to a low-range sample, show an involvement of the anatomic structure responsible for the perception of high-frequency audiometric responses in subjects exposed to anaesthetic gases. © The Author(s) 2012.
Kumar, Poornima; Upadhyay, Prabhakar; Kumar, Ashok; Kumar, Sunil; Singh, Gautam Bir
Noise exposure leads to high frequency hearing loss. Use of Personal Listening Devices may lead to decline in high frequency hearing sensitivity because of prolonged exposure to these devices at high volume. This study explores the changes in hearing thresholds by Extended High Frequency audiometry in users of personal listening devices. A descriptive, hospital based observational study was performed with total 100 subjects in age group of 15-30years. Subjects were divided in two groups consisting of 30 subjects (Group A) with no history of Personal Listening Devices use and (Group B) having 70 subjects with history of use of Personal Listening Devices. Conventional pure tone audiometry with extended high frequency audiometry was performed in all the subjects. Significant differences in hearing thresholds of Personal Listening Device users were seen at high frequencies (3kHz, 4kHz and 6kHz) and extended high frequencies (9kHz, 10kHz, 11kHz, 13kHz, 14kHz, 15kHz and 16kHz) with p value 5years usage at high volume. Thus, it can be reasonably concluded that extended high frequencies can be used for early detection of NIHL in PLD users. Copyright © 2016 Elsevier Inc. All rights reserved.
Batsoulis, C; Lesinski-Schiedat, A
In the assessment process of hearing impairment the medical expert has to verify its causality and to quantify its severity as hearing loss in percentage. Based on the determined hearing loss in percentage, the degree of impairment/disability or, in the case of work-related noise-induced hearing loss, the reduction in earning capacity is estimated. In Germany the guideline for the expert assessment of work-related noise-induced hearing loss is the Königstein Guideline. Currently, the 5th edition from 2012 is used. Here, the hearing loss quantification depends mainly on the results of speech audiometry. Based on the Freiburg speech test, the hearing loss in percentage is determined using approved tables. For patients with a mild hearing loss, typically characterized by a high-frequency hearing loss, tone audiometry results are consulted additionally. Speech-in-noise tests are available and are frequently used to measure the benefit of hearing systems. They allow for the detection of these patients' hearing impairment, which generally occurs in noisy environments. The first suggestions for a table to determine hearing loss in noise in percent are available. In experimental studies it was shown that tests in quiet, other than the Freiburg speech test, can be used and the same tables can be applied. In this article the current use of speech audiometry for expert assessment is presented, and options of using further developed speech test material are discussed.
Sandström, Josefin; Swanepoel, De Wet; Carel Myburgh, Hermanus; Laurent, Claude
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.
Dreschler, W. A.; van der Hulst, R. J.; Tange, R. A.; Urbanus, N. A.
As a supplement to a previous paper [Dreschler et al.: Audiology 1985; 24:387-395] high-frequency (HF) audiometry was applied to compare the ototoxic effects of two different drug administration protocols for cis-platinum (CDDP). In both subgroups, HF audiometry considerably enhanced the early
Mehrparvar, Amir H; Mirmohammadi, Seyyed J; Ghoreyshi, Abbas; Mollasadeghi, Abolfazl; Loukzadeh, Ziba
Noise-induced hearing loss (NIHL), an irreversible disorder, is a common problem in industrial settings. Early diagnosis of NIHL can help prevent the progression of hearing loss, especially in speech frequencies. For early diagnosis of NIHL, audiometry is performed routinely in conventional frequencies. We designed this study to compare the effect of noise on high-frequency audiometry (HFA) and conventional audiometry. In a historical cohort study, we compared hearing threshold and prevalence of hearing loss in conventional and high frequencies of audiometry among textile workers divided into two groups: With and without exposure to noise more than 85 dB. The highest hearing threshold was observed at 4000 Hz, 6000 Hz and 16000 Hz in conventional right ear audiometry, conventional left ear audiometry and HFA in each ear, respectively. The hearing threshold was significantly higher at 16000 Hz compared to 4000. Hearing loss was more common in HFA than conventional audiometry. HFA is more sensitive to detect NIHL than conventional audiometry. It can be useful for early diagnosis of hearing sensitivity to noise, and thus preventing hearing loss in lower frequencies especially speech frequencies.
Weich, Tainara Milbradt; Tochetto, Tania Maria; Seligman, Lilian
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.
Renne, C; Olthoff, A
Brainstem electric response audiometries (BERA) are in clinical use for a number of years. The aim of our study was to evaluate data regarding the long-term reliability of BERA-determined frequency specific thresholds in hearing disabled children. In a group of 97 hearing disabled children we sought to compare Notched-Noise- (NN) BERA threshold as well as Click-BERA thresholds taken shortly after birth with behavioral audiometry thresholds determined after 3.2 years (mean). We found a significant correlation between both BERA methods and the behavioral tests. However, the correlation coefficients for NN-BERA were higher than for Click-BERA thresholds. Our results provide evidence for a high reliability of the NN-BERA for characterization of early onset hearing disabilities in children. Our data suggest that pathologic findings in the Click-BERA should always be followed by a frequency specific analysis with NN-BERA. © Georg Thieme Verlag KG Stuttgart · New York.
Schmidt, Jesper Hvass; Brandt, Christian; Pedersen, Ellen Raben; Christensen-Dalsgaard, Jakob; Andersen, Ture; Poulsen, Torben; Bælum, Jesper
To create a user-operated pure-tone audiometry method based on the method of maximum likelihood (MML) and the two-alternative forced-choice (2AFC) paradigm with high test-retest reliability without the need of an external operator and with minimal influence of subjects' fluctuating response criteria. User-operated audiometry was developed as an alternative to traditional audiometry for research purposes among musicians. Test-retest reliability of the user-operated audiometry system was evaluated and the user-operated audiometry system was compared with traditional audiometry. Test-retest reliability of user-operated 2AFC audiometry was tested with 38 naïve listeners. User-operated 2AFC audiometry was compared to traditional audiometry in 41 subjects. The repeatability of user-operated 2AFC audiometry was comparable to traditional audiometry with standard deviation of differences from 3.9 dB to 5.2 dB in the frequency range of 250-8000 Hz. User-operated 2AFC audiometry gave thresholds 1-2 dB lower at most frequencies compared to traditional audiometry. User-operated 2AFC audiometry does not require specific operating skills and the repeatability is acceptable and similar to traditional audiometry. User operated 2AFC audiometry is a reliable alternative to traditional audiometry.
Rinindra, A. M.; Zizlavsky, S.; Bashiruddin, J.; Aman, R. A.; Wulani, V.; Bardosono, S.
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.
Fredriksson, Sofie; Hammar, Oscar; Magnusson, Lennart; Kähäri, Kim; Persson Waye, Kerstin
To validate self-reported hearing-related symptoms among personnel exposed to moderately high occupational noise levels at an obstetrics clinic. Sensitivity, specificity, and predictive values were calculated for questionnaire items assessing hearing loss, tinnitus, sound sensitivity, poor hearing, difficulty perceiving speech, and sound-induced auditory fatigue. Hearing disorder was diagnosed by pure-tone audiometry, distortion product otoacoustic emissions, and HINT (Hearing In Noise Test). Fifty-five female obstetrics personnel aged 22-63 participated; including 26 subjects reporting hearing loss, poor hearing, tinnitus, or sound sensitivity, and 29 randomly selected subjects who did not report these symptoms. The questionnaire item assessing sound-induced auditory fatigue had the best combination of sensitivity ≥85% (95% CIs 56 to 100%) and specificity ≥70% (95% CIs 55 to 84%) for hearing disorder diagnosed by audiometry or otoacoustic emission. Of those reporting sound-induced auditory fatigue 71% were predicted to have disorder diagnosed by otoacoustic emission. Participants reporting any hearing-related symptom had slightly worse measured hearing. We suggest including sound-induced auditory fatigue in questionnaires for identification of hearing disorder among healthcare personnel, though larger studies are warranted for precise estimates of diagnostic performance. Also, more specific and accurate hearing tests are needed to diagnose mild hearing disorder.
and BMI of PCOS and control groups were comparable. Each subject was tested with low (250–2000 Hz, high (4000–8000 Hz, and extended high frequency audiometry (8000–20000. Hormonal and biochemical values including LH, LH/FSH, testosterone, fasting glucose, fasting insulin, HOMA-I, and CRP were calculated. Results. PCOS patients showed high levels of LH, LH/FSH, testosterone, fasting insulin, glucose, HOMA-I, and CRP levels. The hearing thresholds of the groups were similar at frequencies of 250, 500, 1000, 2000, and 4000 Hz; statistically significant difference was observed in 8000–14000 Hz in PCOS group compared to control group. Conclusion. PCOS patients have hearing impairment especially in extended high frequencies. Further studies are needed to help elucidate the mechanism behind hearing impairment in association with PCOS.
Lieberth, Ann K; Martin, Douglas R
With distance learning becoming more of a reality than a novelty in many undergraduate and graduate training programs, web-based clinical simulations can be identified as an instructional option in distance education that has both a sound pedagogical foundation and clinical relevance. The purpose of this article is to report on the instructional effectiveness of a web-based pure-tone audiometry simulator by undergraduate and graduate students in speech-language pathology. Graduate and undergraduate majors in communication sciences and disorders practiced giving basic hearing tests on either a virtual web-based audiometer or a portable audiometer. Competencies in basic testing skills were evaluated for each group. Results of our analyses of the data indicate that both undergraduate and graduate students learned basic audiometric testing skills using the virtual audiometer. These skills were generalized to basic audiometric testing skills required of a speech language pathologist using a portable audiometer.
Ross, John A S; Macdiarmid, Jennifer I; Dick, Finlay D; Watt, Stephen J
The aims are to compare hearing loss between professional divers and offshore workers and to study whether hearing loss symptoms reflected physical disorder. A secondary objective was to study total threshold shift assessment as a method of detecting noise-induced hearing loss (NIHL). Participants (151 divers and 120 offshore workers) completed a questionnaire for symptoms and screening audiometry. Audiograms were assessed for total threshold shift at 1, 2, 3, 4 and 6 kHz and the prevalence of referral (within population 5th centile) or warning levels (within population 20th centile) of hearing loss. Audiograms were assessed for an NIHL pattern at four levels by two occupational physicians. Hearing loss symptoms were commoner in divers at all levels of hearing loss regardless of differences between groups on audiometry. Hearing loss in offshore workers was within the population age-adjusted norm. Thirteen per cent of divers were within the 5th percentile for threshold shift for the population norm in contrast to 4% of offshore workers and this was predominantly left sided (OR 3.16, 95% CI 1.13-8.93). This difference was lost after adjustment for history of regular exposure to explosion or gunfire. Divers were more likely to have a pattern of severe NIHL on the left (OR 4.61, 95% CI 1.39-15.39, P < 0.05). Approximately 50% of participants with severe NIHL did not have a referral level of hearing loss. Divers suffer more NIHL than a control population. Current guidance on the assessment of total threshold shift for the detection of significant NIHL was inadequate in the sample studied.
Korres, G S; Balatsouras, D G; Tzagaroulakis, A; Kandiloros, D; Ferekidis, E
The aim of this study was to evaluate hearing in a population of industrial workers exposed to occupational noise by using both conventional and extended high-frequency (EHF) audiometry, and to compare our results with the findings from a control group. A total of 139 industry workers exposed to noise were examined over a period of two years and 32 healthy subjects were used as controls. Conventional audiometry in the frequency range 0.25-8 kHz and EHF audiometry in the frequency range 9-20 kHz were performed. Thresholds in the noise-exposed group were higher than in the control group for both standard and extended high frequencies, but variability was greater in EHF. Larger differences were found in the 4,000-18,000 Hz frequency region, and especially in the 12,500-18,000 frequency zone. A statistically significant correlation between the elevation of puretone thresholds and time of exposure was found across all frequencies (from 250 to 20,000 Hz), with the exception of 10,000 Hz. EHF audiometry is a useful adjunct to conventional audiometry in the audiological assessment of subjects exposed to occupational noise. This test performs well in the frequency range 12,500-18,000 Hz, but there is greater variability in the results compared with conventional audiometry.
Somma, Giuseppina; Pietroiusti, Antonio; Magrini, Andrea; Coppeta, Luca; Ancona, Carla; Gardi, Stefano; Messina, Marco; Bergamaschi, Antonio
It has been suggested that extended high-frequency audiometry (EHFA) might be more sensitive than conventional audiometry in detecting early signs of hearing impairment. However, this technique has not been adequately tested in an occupational environment. We therefore investigated the usefulness of this method in noise-exposed workers. We compared conventional frequency audiometry (0.25-8 kHz) and EHFA (9-18 kHz) in 184 noise-exposed and 98 non-noise-exposed workers. Both methods showed significantly higher threshold levels (P audiometry. Stepwise regression analysis showed that in 21- to 40-year-old workers the noise effect was largely predominant at both conventional audiometry and EHFA, whereas in older subjects the noise effect was predominant up to 6 kHz frequency, the effect of age being significantly greater at higher frequencies. These data indicate that EHFA is more sensitive than conventional audiometry in detecting noise induced hearing loss. However, hearing loss in the EHF range seems an age-dependent phenomenon with progression into the lower speech range frequencies with increasing age. These changes seem to be accentuated in the early years by noise exposure, suggesting that EHFA could represent a useful preventive measure in young exposed workers. Copyright 2008 Wiley-Liss, Inc.
Thakur, J S; Mohindroo, N K; Sharma, D R; Soni, K; Kaushal, S S
To investigate the hypothesis of cochlear and retrocochlear damage in scrub typhus, using evoked response audiometry. Prospective, randomised, case-control study. The study included 25 patients with scrub typhus and 25 controls with other febrile illnesses not known to cause hearing loss. Controls were age- and sex-matched. All subjects underwent pure tone audiometry and evoked response audiometry before commencing treatment. Six patients presented with hearing loss, although a total of 23 patients had evidence of symmetrical high frequency loss on pure tone audiometry. Evoked response audiometry found significant prolongation of absolute latencies of wave I, III, V, and wave I-III interpeak latency. Two cases with normal hearing had increased interpeak latencies. These findings constitute level 3b evidence. Findings were suggestive of retrocochlear pathology in two cases with normal hearing. In other patients, high frequency hearing loss may have led to altered evoked response results. Although scrub typhus appears to cause middle ear cochlear and retrocochlear damage, the presence of such damage could not be fully confirmed by evoked response audiometry.
Rodríguez Valiente, Antonio; Roldán Fidalgo, Amaya; Villarreal, Ithzel M; García Berrocal, José R
Early detection and appropriate treatment of hearing loss are essential to minimise the consequences of hearing loss. In addition to conventional audiometry (125-8,000 Hz), extended high-frequency audiometry (9,000-20,000 Hz) is available. This type of audiometry may be useful in early diagnosis of hearing loss in certain conditions, such as the ototoxic effect of cisplatin-based treatment, noise exposure or oral misunderstanding, especially in noisy environments. Eleven examples are shown in which extended high-frequency audiometry has been useful in early detection of hearing loss, despite the subject having a normal conventional audiometry. The goal of the present paper was to highlight the importance of the extended high-frequency audiometry examination for it to become a standard tool in routine audiological examinations. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Otorrinolaringología y Patología Cérvico-Facial. All rights reserved.
Capozzella, A; Loreti, B; Sacco, C; Casale, T; Pimpinella, B; Andreozzi, G; Bernardini, A; Nieto, H A; Scala, B; Schifano, M P; Bonomi, S; Altissimi, G; De Sio, S; Cianfrone, G; Tomei, F; Rosati, M V; Sancini, A
Literary studies underline the effectiveness of distortion product otoacoustic emissions (DPOAEs), which are not affected by the collaboration of the subject examined, in the early diagnosis of hearing loss. Aim of the study is to compare the objective technique of DPOAEs with respect to the pure-tone audiometry in early diagnosis of hearing loss. The clinical research was carried out on 852 workers. All subjects underwent pure-tone audiometry, tympanometry and distortion products. The results show: a) a prevalence of subjects with impaired DPOAEs higher than the prevalence of subjects with impaired audiometries in the studied samples; and, after division by gender: b) a prevalence of subjects with impaired DPOAEs higher than the prevalence of subjects with impaired audiometries only in men; c) a prevalence of impaired DPOAEs and of impaired audiometries in men higher than in women. The results suggest the higher effectiveness of DPOAEs compared to pure-tone audiometry in making an early diagnosis of hearing loss.
Kohlert, Scott; Bromwich, Matthew
Autoimmune inner ear disease (AIED) is a rare condition characterized by bilateral fluctuating sensorineural hearing loss (SNHL). The labile nature of this hearing loss makes it difficult to accurately quantify with conventional methods, and therefore it is challenging to rehabilitate. Over a 9-month period one pediatric patient with severe AIED was monitored and conducted home audiograms using a previously validated testing system (Shoebox Audiometry). During this period he also underwent several clinical audiograms. The correlation between clinical and home audiograms was analyzed with a Pearson coefficient, and the range and frequency of fluctuations was recorded. Sixty-four automated home audiograms and nine clinical audiograms were conducted. When tested at home using a calibrated system the pure tone average (PTA) fluctuated between 12 dB and 72 dB indicating large variability in hearing. Fluctuations were frequent: on 28 occasions the PTA varied by at least 5 dB when retested within 4 days. The mean PTA was 50 dB and 95% of the thresholds were within 36 dB of the mean. Clinical audiograms obtained on the same day or within 1 day of home testing were highly concordant (with a Pearson coefficient of 0.93). AIED can result in significant fluctuations in hearing over short periods of time. Home testing enables a more granular look at variations over time and correlates well with clinical testing, and thus facilitates rapid action and informed rehabilitation.
Kucur, Cuneyt; Kucur, Suna Kabil; Gozukara, Ilay; Seven, Ali; Yuksel, Kadriye Beril; Keskin, Nadi; Oghan, Fatih
Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder affecting 5-10% of women in reproductive age. Insulin resistance, dyslipidemia, glucose intolerance, hypertension, and obesity are metabolic disorders accompanying the syndrome. PCOS is a chronic proinflammatory state and the disease is associated with endothelial dysfunction. In diseases with endothelial damage, hearing in high frequencies are mostly effected in early stages. We evaluated extended high frequency hearing loss in PCOS patients. Forty women diagnosed as PCOS and 25 healthy controls were included in this study. Age and BMI of PCOS and control groups were comparable. Each subject was tested with low (250-2000 Hz), high (4000-8000 Hz), and extended high frequency audiometry (8000-20000). Hormonal and biochemical values including LH, LH/FSH, testosterone, fasting glucose, fasting insulin, HOMA-I, and CRP were calculated. PCOS patients showed high levels of LH, LH/FSH, testosterone, fasting insulin, glucose, HOMA-I, and CRP levels. The hearing thresholds of the groups were similar at frequencies of 250, 500, 1000, 2000, and 4000 Hz; statistically significant difference was observed in 8000-14000 Hz in PCOS group compared to control group. PCOS patients have hearing impairment especially in extended high frequencies. Further studies are needed to help elucidate the mechanism behind hearing impairment in association with PCOS.
Holtby, I; Forster, D P; Kumar, U
BACKGROUND: Screening for hearing loss in English children at entry to school (age 5-6 years) is usually by pure tone audiometry sweep undertaken by school nurses. This study aimed to compare the validity and screening rates of pure tone audiometry with impedance screening in these children. METHODS: Two stage pure tone audiometry and impedance methods of screening were compared in 610 school entry children from 19 infant schools in north east England. Both procedures were completed by school...
Wooles, N; Mulheran, M; Bray, P; Brewster, M; Banerjee, A R
To examine whether distortion product otoacoustic emissions can serve as a replacement for pure tone audiometry in longitudinal screening for occupational noise exposure related auditory deficit. A retrospective review was conducted of pure tone audiometry and distortion product otoacoustic emission data obtained sequentially during mandatory screening of brickyard workers (n = 16). Individual pure tone audiometry thresholds were compared with distortion product otoacoustic emission amplitudes, and a correlation of these measurements was conducted. Pure tone audiometry threshold elevation was identified in 13 out of 16 workers. When distortion product otoacoustic emission amplitudes were compared with pure tone audiometry thresholds at matched frequencies, no evidence of a robust relationship was apparent. Seven out of 16 workers had substantial distortion product otoacoustic emissions with elevated pure tone audiometry thresholds. No clinically relevant predictive relationship between distortion product otoacoustic emission amplitude and pure tone audiometry threshold was apparent. These results do not support the replacement of pure tone audiometry with distortion product otoacoustic emissions in screening. Distortion product otoacoustic emissions at frequencies associated with elevated pure tone audiometry thresholds are evidence of intact outer hair cell function, suggesting that sites distinct from these contribute to auditory deficit following ototrauma.
Brennan-Jones, Christopher G; Eikelboom, Robert H; Swanepoel, De Wet
Introduction Standard criteria exist for diagnosing different types of hearing loss, yet audiologists interpret audiograms manually. This pilot study examined the feasibility of standardised interpretations of audiometry in a telehealth model of care. The aim of this study was to examine diagnostic accuracy of automated audiometry in adults with hearing loss in an asynchronous telehealth model using pre-defined diagnostic protocols. Materials and methods We recruited 42 study participants from a public audiology and otolaryngology clinic in Perth, Western Australia. Manual audiometry was performed by an audiologist either before or after automated audiometry. Diagnostic protocols were applied asynchronously for normal hearing, disabling hearing loss, conductive hearing loss and unilateral hearing loss. Sensitivity and specificity analyses were conducted using a two-by-two matrix and Cohen's kappa was used to measure agreement. Results The overall sensitivity for the diagnostic criteria was 0.88 (range: 0.86-1) and overall specificity was 0.93 (range: 0.86-0.97). Overall kappa ( k) agreement was 'substantial' k = 0.80 (95% confidence interval (CI) 0.70-0.89) and significant at p audiometry provide accurate identification of disabling, conductive and unilateral hearing loss. This method has the potential to improve synchronous and asynchronous tele-audiology service delivery.
Kiyomizu, Kensuke; Tono, Tetsuya; Yang, Dewen; Haruta, Atsushi; Kodama, Takao; Kato, Eiji; Komune, Shizuo [Miyazaki Medical Coll., Kiyotake (Japan)
Thirty-three patients (62 ears) with surgically confirmed otosclerosis underwent a preoperative CT examination in order to determine the presence of any correlation between the audiometric and CT findings. Based on the CT findings, the ears were classified into five groups as follows: group A; 25 ears (40.3%) with normal CT findings, group B1; 15 ears (24.2%) with demineralization in the region of the fissula antefenestram, group B2; 12 ears (19.4%) with demineralization around the anterior to the oval window, group B3; 4 ears (6.5%) with demineralization surrounding the cochlea, and group C; 6 ears (9.7%) with thick anterior and posterior plaques. The expansion of demineralization led to an increase in average bone conduction hearing level: group A ; 27.1 dB, group B1; 30.6 dB, group B2; 34.6 dB, group B3; 36.7 dB, and group C; 30.3 dB. This increase is most likely due to progressive labyrinthine otosclerosis. Group C in the average air-bone gap was greater (37.5 dB) than that in the patients with demineralization, group B1 (21.6 dB), group B2 (28.2 dB), group B3 (26.7 dB), the Carhart effect of group C was smaller than that of any other groups, thus suggesting the mode of otosclerosis progression in group C to be different from that in patients with demineralization. The results of the present study indicate that the preoperative CT findings of otosclerosis correlate with the audiometry findings, thus proving the usefulness of CT in diagnosing otosclerosis. (author)
Keppler, H; Degeest, S; Dhooge, I
Chronic tinnitus is associated with reduced auditory input, which results in changes in the central auditory system. This study aimed to examine the relationship between tinnitus pitch and parameters of audiometry and distortion product otoacoustic emissions. For audiometry, the parameters represented the edge frequency of hearing loss, the frequency of maximum hearing loss and the frequency range of hearing loss. For distortion product otoacoustic emissions, the parameters were the frequency of lowest distortion product otoacoustic emission amplitudes and the frequency range of reduced distortion product otoacoustic emissions. Sixty-seven patients (45 males, 22 females) with subjective chronic tinnitus, aged 18 to 73 years, were included. No correlation was found between tinnitus pitch and parameters of audiometry and distortion product otoacoustic emissions. However, tinnitus pitch fell mostly within the frequency range of hearing loss. The current study seems to confirm the relationship between tinnitus pitch and the frequency range of hearing loss, thus supporting the homeostatic plasticity model.
Palmay, Lesley; Walker, Sandra A N; Walker, Scott E; Simor, Andrew E
Aminoglycoside-associated auditory toxicity (cochleotoxicity) is a major concern in patients receiving prolonged aminoglycoside therapy. There are no published data comparing symptom monitoring to audiometry testing for the detection of aminoglycoside-induced cochleotoxicity; thus, agreement regarding the optimal monitoring of these patients for early detection of this effect is lacking. To compare the sensitivity of symptom monitoring to that of audiometry in identifying cochleotoxicity in patients on prolonged aminoglycoside therapy. A retrospective chart review of adult inpatients at Sunnybrook Health Sciences Centre prescribed prolonged aminoglycoside therapy (≥21 days) who completed at least 1 audiometry test between January 1, 1999, and December 31, 2009, was conducted. Data pertaining to results of audiometry testing and development of symptoms of auditory toxicity were collected. Symptom monitoring was compared with audiology testing for the detection of cochleotoxicity. Forty eligible patients were included for analysis. Audiometry was significantly better than symptom monitoring to identify early cochleotoxicity (absolute risk reduction = 17.5% and number needed to treat = 6; p = 0.023). Compared to audiometry, symptom monitoring has a sensitivity, negative predictive value, and accuracy for the detection of early cochleotoxicity of 61%, 75%, and 82%, respectively. Audiometry testing is significantly better than monitoring symptoms to identify early aminoglycoside-induced auditory toxicity in patients prescribed prolonged aminoglycoside therapy (≥21 days). Subclinical cochleotoxicity identified with audiometry may allow early termination of aminoglycoside therapy to prevent progression of cochlear damage to the audible frequency range.
Kurakata, Kenji; Mizunami, Tazu; Matsushita, Kazuma; Shiraishi, Kimio
Unwanted sounds from a commercially available audiometer were evaluated in terms of their effects on extended high-frequency (EHF) audiometry. Although the manufacturer reported that the audiometer conformed to relevant International Electrotechnical Commission (IEC) standards, the audiograms obtained using the audiometer were erroneous because the subjects had responded falsely to noise generated with the test tone presentation before detecting the test tone. Analyses of acoustic and electric output signals revealed that the audiometer generated most of the unwanted sounds, not the earphones that were used. Based on the measurement results, clinical implications of the measurement results are discussed for conducting more reliable EHF audiometry.
Tziridis, Konstantin; Ahlf, Sönke; Schulze, Holger
In auditory animal research it is crucial to have precise information about basic hearing parameters of the animal subjects that are involved in the experiments. Such parameters may be physiological response characteristics of the auditory pathway, e.g. via brainstem audiometry (BERA). But these methods allow only indirect and uncertain extrapolations about the auditory percept that corresponds to these physiological parameters. To assess the perceptual level of hearing, behavioral methods have to be used. A potential problem with the use of behavioral methods for the description of perception in animal models is the fact that most of these methods involve some kind of learning paradigm before the subjects can be behaviorally tested, e.g. animals may have to learn to press a lever in response to a sound. As these learning paradigms change perception itself 1,2 they consequently will influence any result about perception obtained with these methods and therefore have to be interpreted with caution. Exceptions are paradigms that make use of reflex responses, because here no learning paradigms have to be carried out prior to perceptual testing. One such reflex response is the acoustic startle response (ASR) that can highly reproducibly be elicited with unexpected loud sounds in naïve animals. This ASR in turn can be influenced by preceding sounds depending on the perceptibility of this preceding stimulus: Sounds well above hearing threshold will completely inhibit the amplitude of the ASR; sounds close to threshold will only slightly inhibit the ASR. This phenomenon is called pre-pulse inhibition (PPI) 3,4, and the amount of PPI on the ASR gradually depends on the perceptibility of the pre-pulse. PPI of the ASR is therefore well suited to determine behavioral audiograms in naïve, non-trained animals, to determine hearing impairments or even to detect possible subjective tinnitus percepts in these animals. In this paper we demonstrate the use of this method in a
Holtby, I; Forster, D P
STUDY OBJECTIVE--The aims were (1) to evaluate impedance measurements against pure tone audiometry as a screening method for the detection of middle ear changes associated with hearing loss in infant school children; (2) to estimate the costs of the health authority of each method. DESIGN--The study involved two stage screening in which both methods were offered, pure tone audiometry being carried out by school nurses and impedance screening by a doctor. SETTING--18 infant or primary schools in Langbaurgh, Cleveland, UK. PARTICIPANTS--610 previously unscreened infant school children took part in the study. MEASUREMENTS AND MAIN RESULTS--Main outcome measures were the sensitivity, specificity, and predictive value of each screening method, using clinical assessment and action as the validating technique. The sensitivity and the predictive value of a positive test in two stage impedance screening was markedly superior to that of pure tone audiometry. The specificity was similar using the two methods. In addition the impedance methods was more rapid and estimated to consume less resource as a screening procedure than pure tone audiometry. CONCLUSIONS--The superiority of the use of impedance screening established in this study should be confirmed in a subsequent audit carried out purely by school nurses. PMID:1573355
Margolis, Robert H.; Wilson, Richard H.; Popelka, Gerald R.; Eikelboom, Robert H.; Swanepoel, De Wet; Saly, George L.
Objective Five databases were mined to examine distributions of air-bone gaps obtained by automated and manual audiometry. Differences in distribution characteristics were examined for evidence of influences unrelated to the audibility of test signals. Design The databases provided air- and bone-conduction thresholds that permitted examination of air-bone gap distributions that were free of ceiling and floor effects. Cases with conductive hearing loss were eliminated based on air-bone gaps, tympanometry, and otoscopy, when available. The analysis is based on 2,378,921 threshold determinations from 721,831 subjects from five databases. Results Automated audiometry produced air-bone gaps that were normally distributed suggesting that air- and bone-conduction thresholds are normally distributed. Manual audiometry produced air-bone gaps that were not normally distributed and show evidence of biasing effects of assumptions of expected results. In one database, the form of the distributions showed evidence of inclusion of conductive hearing losses. Conclusions Thresholds obtained by manual audiometry show tester bias effects from assumptions of the patient’s hearing loss characteristics. Tester bias artificially reduces the variance of bone-conduction thresholds and the resulting air-bone gaps. Because the automated method is free of bias from assumptions of expected results, these distributions are hypothesized to reflect the true variability of air- and bone-conduction thresholds and the resulting air-bone gaps. PMID:26627469
Brännström, K Jonas; Grenner, Jan
To examine the efficacy of fixed-frequency Békésy's home audiometry to assess hearing fluctuation and treatment outcomes in patients with subjectively fluctuating hearing loss. SMAPH, a software audiometry program for Windows, was installed and calibrated on laptop computers. Békésy's audiometry was carried out daily in the patients' homes, using sound-attenuating earphones. Seventeen patients with previously or currently subjectively fluctuating hearing loss. Five patients received of treatment for their conditions during the measurement period. Measurement periods ranged from 6 to 60 days. Varying degrees of compliance were seen, some patients measuring less than 50% of the days, others measuring every day. Based on their long-term measurements the patients were classified into three groups: patients with stable recordings, with fluctuating low-frequency hearing loss, or with fluctuating high-frequency hearing loss. In the patients with stable recordings, significant test-retest differences were seen below 10 dB at frequencies 0.125-8 kHz. Home audiometry with Békésy's technique can be used to evaluate disease activity and to monitor hearing results after therapy.
Fulton, Robert T., Ed.; And Others
Directed to professionals with a basic knowledge of audiological principles, the text presents a review of audiological assessment procedures and their applicability to the retarded. Pure-tone, speech, and Bekesy audiometry are described. Also discussed are differential diagnosis of auditory impairments, conditioning and audiological assessment,…
Dreschler, W. A.; vd Hulst, R. J.; Tange, R. A.; Urbanus, N. A.
Ototoxicity is one of the unwanted side-effects of a number of medical drugs. As ototoxicity appears to be most pronounced in the higher frequencies, it can be assessed at an earlier stage by using high-frequency audiometry from 8 to 20 kHz. We have investigated the precision of these measurements.
Helleman, Hiske W; Dreschler, Wouter A
For a noise-exposed group of workers, group-averaged and individual changes were compared for pure-tone audiometry, transient-evoked otoacoustic emissions (TEOAEs), and distortion product otoacoustic emissions (DPOAEs) in order to see if they exhibit the same pattern in time. Baseline and 17-months follow-up hearing status was examined with pure-tone audiometry, TEOAEs, and DPOAEs. A total of 233 noise-exposed employees were measured, while 60 subjects from this group contributed to test-retest reliability measures. Group-averaged changes and individual shifts followed similar patterns: decreases for audiometry at 6-8 kHz and DPOAE at 1.5 kHz, and enhancements for DPOAE at 3 kHz. TEOAEs showed an overall deterioration while both individual deteriorations and enhancements were larger than chance. DPOAE at 6 kHz showed the largest group-averaged change, while the number of individual shifts was not significant. There were no clear relations between changes in audiometry and changes in OAE. Significant individual OAE changes do not necessarily follow the same pattern as the group-averaged results. This limits the applicability of OAE testing for the monitoring of individual subjects. Furthermore, hearing deterioration might manifest itself in a local enhancement of otoacoustic emissions and not only in the form of decreases in amplitude.
van der Hulst, R. J.; Dreschler, W. A.; Urbanus, N. A.
The results of clinical use of routine high frequency audiometry in monitoring the ototoxic side effects of platinum and its derivatives are described in this prospective study. After demonstrating the reproducibility of the technique, we discuss the first results of an analysis of ototoxic side
Margolis, Robert H; Wilson, Richard H; Popelka, Gerald R; Eikelboom, Robert H; Swanepoel, De Wet; Saly, George L
Five databases were mined to examine distributions of air-bone gaps obtained by automated and manual audiometry. Differences in distribution characteristics were examined for evidence of influences unrelated to the audibility of test signals. The databases provided air- and bone-conduction thresholds that permitted examination of air-bone gap distributions that were free of ceiling and floor effects. Cases with conductive hearing loss were eliminated based on air-bone gaps, tympanometry, and otoscopy, when available. The analysis is based on 2,378,921 threshold determinations from 721,831 subjects from five databases. Automated audiometry produced air-bone gaps that were normally distributed suggesting that air- and bone-conduction thresholds are normally distributed. Manual audiometry produced air-bone gaps that were not normally distributed and show evidence of biasing effects of assumptions of expected results. In one database, the form of the distributions showed evidence of inclusion of conductive hearing losses. Thresholds obtained by manual audiometry show tester bias effects from assumptions of the patient's hearing loss characteristics. Tester bias artificially reduces the variance of bone-conduction thresholds and the resulting air-bone gaps. Because the automated method is free of bias from assumptions of expected results, these distributions are hypothesized to reflect the true variability of air- and bone-conduction thresholds and the resulting air-bone gaps.
Tange, R. A.; Dreschler, W. A.
A study was carried out to evaluate the results of stapes surgery in 53 cases of otosclerosis. The hearing function was measured pre- and postoperatively by means of conventional and high-frequency audiometry (Demlar 20K). The operative findings of the gradation of otosclerosis were compared with
Moore, Ernest J.; And Others
An audiometric screening survey was conducted on a severely and profoundly mentally retarded population using noise-makers and pure tone audiometry. Of those tested with noise-makers, 83% gave an identifiable response to sound, 7% did not respond, and 10% were considered difficult-to-test. By contrast, 4% passed, 2% failed, and 94% were…
Di Berardino, Federica; Forti, Stella; Cesarani, Antonio
The aim of this study was to design a complementary speech audiometry test using verbal tasks and motor responses (VTMR) to assess the ability of a subject to understand and perform simple motor tasks with 3-dimensional objects, to describe its construction, and to show the preliminary results of a pilot study on the Italian version of the test. The items used in the test setting included 1 base, 1 hammer, 1 wooden structure with 4 sticks, and 5 rings of different colors and 20 lists with 5 verbal tasks per list. The VTMR test and bisyllabic speech audiometry were evaluated in normal-hearing subjects with and without cognitive impairment and in subjects with sensorineural hearing loss. All normal-hearing subjects without cognitive impairment performed the VTMR tasks (100%) correctly at 35 dB sound pressure level. In subjects with sensorineural hearing loss, the percentage of correct answers was significantly higher for the VTMR test than for bisyllabic speech audiometry above 50 dB sound pressure level. This percentage was higher for the VTMR also in normal-hearing subjects with poor cognitive skills. The VTMR might make it easier to check patients' ability to understand verbal commands than does traditional speech audiometry, in particular in those patients with poor test-taking skills.
Helleman, Hiske W.; Dreschler, Wouter A.
Objective: For a noise-exposed group of workers, group-averaged and individual changes were compared for pure-tone audiometry, transient-evoked otoacoustic emissions (TEOAEs), and distortion product otoacoustic emissions (DPOAEs) in order to see if they exhibit the same pattern in time. Design:
Mahomed-Asmail, Faheema; Swanepoel, De Wet; Eikelboom, Robert H
Poor follow-up compliance from school-based hearing screening typically undermines the efficacy of school-based hearing screening programs. Onsite diagnostic audiometry with automation may reduce false positives and ensure directed referrals. To investigate the validity and time efficiency of automated diagnostic air- and bone-conduction audiometry for children in a natural school environment following hearing screening. A within-subject repeated measures design was employed to compare air- and bone-conduction pure-tone thresholds (0.5-4 kHz), measured by manual and automated pure-tone audiometry. Sixty-two children, 25 males and 37 females, with an average age of 8 yr (standard deviation [SD] = 0.92; range = 6-10 yr) were recruited for this study. The participants included 30 children who failed on a hearing screening and 32 children who passed a hearing screening. Threshold comparisons were made for air- and bone-conduction thresholds across ears tested with manual and automated audiometry. To avoid a floor effect thresholds of 15 dB HL were excluded in analyses. The Wilcoxon signed ranked test was used to compare threshold correspondence for manual and automated thresholds and the paired samples t-test was used to compare test time. Statistical significance was set as p ≤ 0.05. 85.7% of air-conduction thresholds and 44.6% of bone-conduction thresholds corresponded within the normal range (15 dB HL) for manual and automated audiometry. Both manual and automated audiometry air- and bone-conduction thresholds exceeded 15 dB HL in 9.9% and 34.0% of thresholds, respectively. For these thresholds, average absolute differences for air- and bone-conduction thresholds were 6.3 (SD = 8.3) and 2.2 dB (SD = 3.6) and they corresponded within 10 dB across frequencies in 87.7% and 100.0%, respectively. There was no significant difference between manual and automated air- and bone-conduction across frequencies for these thresholds. Using onsite automated diagnostic audiometry
Swanepoel, De Wet; Biagio, Leigh
Computer-based audiometry allows for novel applications, including remote testing and automation, that may improve the accessibility and efficiency of hearing assessment in various clinical and occupational health settings. This study describes the validity of computer-based, diagnostic air and forehead bone conduction audiometry when compared wtih conventional industry standard audiometry in a sound booth environment. A sample of 30 subjects (19 to 77 years of age) was assessed with computer-based (KUDUwave 5000) and industry standard conventional audiometers (GSI 61) to compare air and bone conduction thresholds and test-retest reliability. Air conduction thresholds for the two audiometers corresponded within 5 dB or less in more than 90% of instances, with an average absolute difference of 3.5 dB (3.8 SD) and a 95% confidence interval of 2.6 to 4.5 dB. Bone conduction thresholds for the two audiometers corresponded within 10 dB or less in 92% of instances, with an average absolute difference of 4.9 dB (4.9 SD) and a 95% confidence interval of 3.6 to 6.1 dB. The average absolute test-retest threshold difference for bone conduction on the industry standard audiometer was 5.1 dB (5.3 SD) and for the computer-based audiometer 7.1 dB (6.4 SD). Computer-based audiometry provided air and bone conduction thresholds within the test-retest reliability limits of industry standard audiometry.
Antonioli, Cleonice Aparecida Silva; Momensohn-Santos, Teresa Maria; Benaglia, Tatiana Aparecida Silva
Introduction The literature reports on high-frequency audiometry as one of the exams used on hearing monitoring of individuals exposed to high sound pressure in their work environment, due to the method́s greater sensitivity in early identification of hearing loss caused by noise. The frequencies that compose the exam are generally between 9 KHz and 20KHz, depending on the equipment. Objective This study aims to perform a retrospective and secondary systematic revision of publications on high-frequency audiometry on hearing monitoring of individuals exposed to occupational noise. Data Synthesis This systematic revision followed the methodology proposed in the Cochrane Handbook, focusing on the question: “Is High-frequency Audiometry more sensitive than Conventional Audiometry in the screening of early hearing loss individuals exposed to occupational noise?” The search was based on PubMed data, Base, Web of Science (Capes), Biblioteca Virtual em Saúde (BVS), and in the references cited in identified and selected articles. The search resulted in 6059 articles in total. Of these, only six studies were compatible with the criteria proposed in this study. Conclusion The performed meta-analysis does not definitively answer the study's proposed question. It indicates that the 16 KHz high frequency audiometry (HFA) frequency is sensitive in early identification of hearing loss in the control group (medium difference (MD = 8.33)), as well as the 4 KHz frequency (CA), this one being a little less expressive (MD = 5.72). Thus, others studies are necessary to confirm the HFA importance for the early screening of hearing loss on individuals exposed to noise at the workplace. PMID:27413413
Schmidt, Claus-Michael; am Zehnhoff-Dinnesen, Antoinette; Matulat, Peter; Knief, Arne; Rosslau, Ken; Deuster, Dirk
The term "nonorganic hearing loss" (NOHL) (pseudohypacusis, functional or psychogenic hearing loss) describes a hearing loss without a detectable corresponding pathology in the auditory system. It is characterized by a discrepancy between elevated pure tone audiometry thresholds and normal speech discrimination. The recommended audiological management of NOHL in children comprises history taking, diagnosis, and counseling. According to the literature, prognosis depends on the severity of the patient's school and/or personal problems. Routine referral to a child psychiatrist is discussed as being controversial. The clinical history of 34 children with NOHL was retrospectively evaluated. In 15 children, follow up audiometry was performed. Results of biographical history, subjective and objective audiometry, additional speech and language assessment, psychological investigations and follow up audiometry are presented and discussed. The prevalence of NOHL was 1.8% in children with suspected hearing loss. Mean age at diagnosis was 10.8 years. Girls were twice as often affected as boys. Patient history showed a high prevalence of emotional and school problems. Pre-existing organic hearing loss can be worsened by nonorganic causes. Children with a fast recovery of hearing thresholds (n=6) showed a high rate (4/6) of family, social and emotional problems. In children with continuous threshold elevation (n=9), biographical history showed no recognizable or obvious family, social or emotional problems; learning disability (4/9) was the most frequently presented characteristic. Due to advances in objective audiometry, the diagnosis of NOHL is less challenging than management and counseling. Considering the high frequency of personal and school problems, a multidisciplinary setting is helpful. On the basis of our results, drawing conclusions from hearing threshold recovery on the severity of underlying psychic problems seems inappropriate. As a consequence, a referral to a
Al-Malky, Ghada; Dawson, Sally J; Sirimanna, Tony; Bagkeris, Emmanouil; Suri, Ranjan
Intravenous aminoglycoside (IV AG) antibiotics, widely used in patients with cystic fibrosis (CF), are known to have ototoxic complications. Despite this, audiological monitoring is not commonly performed and if performed, uses only standard pure-tone audiometry (PTA). The aim of this study was to investigate ototoxicity in CF children, to determine the most appropriate audiological tests and to identify possible risk factors. Auditory assessment was performed in CF children using standard pure tone audiometry (PTA), extended high-frequency (EHF) audiometry and distortion-product otoacoustic emissions (DPOAE). 70 CF children, mean (SD) age 10.7 (3.5) years, were recruited. Of the 63 children who received IV AG, 15 (24%) children had ototoxicity detected by EHF audiometry and DPOAE. Standard PTA only detected ototoxicity in 13 children. Eleven of these children had received at least 10 courses of IV AG courses. A 25 to 85 dBHL hearing loss (mean±SD: 57.5±25.7 dBHL) across all EHF frequencies and a significant drop in DPOAE amplitudes at frequencies 4 to 8 kHz were detected. However, standard PTA detected a significant hearing loss (>20 dBHL) only at 8 kHz in 5 of these 15 children and none in 2 subjects who had significantly elevated EHF thresholds. The number of courses of IV AG received, age and lower lung function were shown to be risk factors for ototoxicity. CF children who had received at least 10 courses of IV AG had a higher risk of ototoxicity. EHF audiometry identified 2 more children with ototoxicity than standard PTA and depending on facilities available, should be the test of choice for detecting ototoxicity in children with CF receiving IV AG. Copyright © 2014 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.
Antonioli, Cleonice Aparecida Silva
Full Text Available Introduction The literature reports on high-frequency audiometry as one of the exams used on hearing monitoring of individuals exposed to high sound pressure in their work environment, due to the method́s greater sensitivity in early identification of hearing loss caused by noise. The frequencies that compose the exam are generally between 9 KHz and 20KHz, depending on the equipment. Objective This study aims to perform a retrospective and secondary systematic revision of publications on high-frequency audiometry on hearing monitoring of individuals exposed to occupational noise. Data Synthesis This systematic revision followed the methodology proposed in the Cochrane Handbook, focusing on the question: “Is High-frequency Audiometry more sensitive than Conventional Audiometry in the screening of early hearing loss individuals exposed to occupational noise?” The search was based on PubMed data, Base, Web of Science (Capes, Biblioteca Virtual em Saúde (BVS, and in the references cited in identified and selected articles. The search resulted in 6059 articles in total. Of these, only six studies were compatible with the criteria proposed in this study. Conclusion The performed meta-analysis does not definitively answer the study's proposed question. It indicates that the 16 KHz high frequency audiometry (HFA frequency is sensitive in early identification of hearing loss in the control group (medium difference (MD = 8.33, as well as the 4 KHz frequency (CA, this one being a little less expressive (MD = 5.72. Thus, others studies are necessary to confirm the HFA importance for the early screening of hearing loss on individuals exposed to noise at the workplace.
Antonioli, Cleonice Aparecida Silva; Momensohn-Santos, Teresa Maria; Benaglia, Tatiana Aparecida Silva
The literature reports on high-frequency audiometry as one of the exams used on hearing monitoring of individuals exposed to high sound pressure in their work environment, due to the method́s greater sensitivity in early identification of hearing loss caused by noise. The frequencies that compose the exam are generally between 9 KHz and 20KHz, depending on the equipment. This study aims to perform a retrospective and secondary systematic revision of publications on high-frequency audiometry on hearing monitoring of individuals exposed to occupational noise. This systematic revision followed the methodology proposed in the Cochrane Handbook, focusing on the question: "Is High-frequency Audiometry more sensitive than Conventional Audiometry in the screening of early hearing loss individuals exposed to occupational noise?" The search was based on PubMed data, Base, Web of Science (Capes), Biblioteca Virtual em Saúde (BVS), and in the references cited in identified and selected articles. The search resulted in 6059 articles in total. Of these, only six studies were compatible with the criteria proposed in this study. The performed meta-analysis does not definitively answer the study's proposed question. It indicates that the 16 KHz high frequency audiometry (HFA) frequency is sensitive in early identification of hearing loss in the control group (medium difference (MD = 8.33)), as well as the 4 KHz frequency (CA), this one being a little less expressive (MD = 5.72). Thus, others studies are necessary to confirm the HFA importance for the early screening of hearing loss on individuals exposed to noise at the workplace.
Holtby, I; Forster, D P; Kumar, U
BACKGROUND: Screening for hearing loss in English children at entry to school (age 5-6 years) is usually by pure tone audiometry sweep undertaken by school nurses. This study aimed to compare the validity and screening rates of pure tone audiometry with impedance screening in these children. METHODS: Two stage pure tone audiometry and impedance methods of screening were compared in 610 school entry children from 19 infant schools in north east England. Both procedures were completed by school nurses. The results of screening were validated against subsequent clinical assessment, including otological examination and actions taken by an independent assessor. RESULTS: Both methods produced broadly similar validation indices after two stages of screening: sensitivity was 74.4% for both methods; specificity was 92.1% and 90.0%; and predicted values of a positive test 43.2% and 37.6% respectively for pure tone audiometry and impedance methods. Single stage screening in both methods produced higher sensitivity but lower specificity and predictive values of a positive test than two stage screening. Screening rates were appreciably higher with impedance methods than with pure tone audiometry. CONCLUSIONS: In choosing the method to be used, it must be borne in mind that the impedance method is technically more efficient but takes longer than pure tone audiometry screening. However, the latter method allows opportunity for other health inquiries in these children. PMID:9519138
Yeung, Jeffrey; Javidnia, Hedyeh; Heley, Sophie; Beauregard, Yves; Champagne, Sandra; Bromwich, Matthew
The timely diagnosis of hearing loss in the pediatric population has significant implications for a child's development. However, audiological evaluation in this population poses unique challenges due to difficulties with patient cooperation. Though specialized adaptations exist (such as conditioned play audiometry), these methods can be time consuming and costly. The objective of this study was to validate an iPad-based play audiometer that addresses the shortcomings of existing audiometry. We designed a novel, interactive game for the Apple® iPad® that tests pure tone thresholds. In a prospective, randomized study, the efficacy of this tool was compared to standard play audiometry. 85 consecutive patients presenting to the Audiology Clinic at the Children's Hospital of Eastern Ontario (ages 3 and older) were recruited into this study. Their hearing was evaluated using both tablet and traditional play audiometry. Warble-tone thresholds obtained by both tablet and traditional audiometry. The majority of children in this age group were capable of completing an audiologic assessment using the tablet computer. The data demonstrate no statistically significant difference between warble-tone thresholds obtained by tablet and traditional audiometry (p=0.29). Moreover, the tablet audiometer demonstrates strong sensitivity (93.3%), specificity (94.5%) and negative predictive value (98.1%). The tablet audiometer is a valid and sensitive instrument for screening and assessment of warble-tone thresholds in children.
Lasso de la Vega, Mar; Villarreal, Ithzel María; López Moya, Julio; García-Berrocal, José Ramón
Sensorineural hearing loss must be considered within the clinical picture of systemic lupus erythematosus. The results confirm the usefulness of extended high-frequency audiometry in the audiologic testing of these patients, enabling the possibility of modifying or applying a preventive treatment for a possible hearing loss. Hearing involvement is usually under-diagnosed with routine auditory examination. This study proposes the use of extended high-frequency audiometry to achieve a correct detection of a possible asymptomatic hypoacusis in early stages of the disease. The aim of this study is to analyze the hearing levels in extended high-frequencies in these patients and to correlate the hearing loss with the severity of the disease and the immunological parameters. A descriptive cross-sectional study was performed. Fifty-five patients with systemic lupus erythematosus were included in the study. The control group consisted of 71 patients paired by age and sex with the study population. Both a pure tone audiometry and an extended high-frequency audiometry (8-18 KHz) were performed. In total, 70% were diagnosed with sensorineural hearing loss with extended high-frequency audiometry, overcoming the results obtained with pure tone audiometry (30.9%). Statistically significant correlations were found within the patients regarding sensorineural hearing loss related with age, disease activity and cryoglobulinemia.
Arora, R; Thakur, J S; Azad, R K; Mohindroo, N K; Sharma, D R; Seam, R K
Cisplatin-induced ototoxicity shows high interindividual variability and is often accompanied by transient or permanent tinnitus. It is not possible to identify the susceptible individuals before commencement of the treatment. We conducted a prospective, randomized and observational study in a tertiary care centre and evaluated the effects of different doses of cisplatin on hearing. Fifty-seven patients scheduled for cisplatin-based chemotherapy were included in the study. All patients were divided into three groups depending on the dose of cisplatin infused in 3 weeks. The subjective hearing loss was found in seven patients, while six patients had tinnitus during the chemotherapy. The hearing loss was sensorineural, dose dependent, symmetrical, bilateral and irreversible. Higher frequencies were first to be affected in cisplatin chemotherapy. As use of high-frequency audiometry is still limited in research work only, we need a strict protocol of adding high-frequency audiometry in the cisplatin-based chemotherapy regimen.
Boboshko, M Yu; Zhilinskaya, E V; Golovanova, L E; Legostaeva, T V; Di Berardino, F; Cesarani, A
The aim of the study was to evaluate a new test of speech audiometry while examining aged patients. 32 aged listeners from 60 to 88 years old were examined: 20 hearing aid (HA) users and 12 patients with normal hearing thresholds and mild cognitive impairment according to the results of the mini-mental state examination (MMSE). The speech audiometry consisted of the traditional polysyllabic words discrimination test and a new speech test with motor responses (Verbal Tasks and Motor Responses - VTMR); in both tests the signal was presented in background noise (polyphony) in free field. All listeners performed the VTMR test significantly better than the polysyllabic words discrimination test. In the group of hearing impaired patients the mean result in VTMR test was 73,2±29,2 % without HA and 88,6±20,5 % with it, in traditional test - 34,8±20,9 % without HA and 56±18,4 % with it. All patients of the group with normal hearing and mild cognitive impairment performed the VTMR test with 100 % result, their speech discrimination score in traditional test was 88±12 %. In the practice of the geriatric center the use of both the traditional speech audiometry and the new speech test with motor responses seems to be reasonable, that allows examining the auditory function in patients with significant deterioration of speech intelligibility or cognitive impairment.
Rocha, Rita Leniza Oliveira da; Atherino, Ciríaco Cristóvão Tavares; Frota, Silvana Maria Monte Coelho
The study of high frequencies has proven its importance for detecting inner ear damage. In some cases, conventional frequencies are not sensitive enough to pick up early changes to the inner ear. To analyze the results of threshold high frequency analysis of individuals exposed to noise with normal conventional audiometry. This was a retrospective cross-sectional cohort study, in which we studied 47 firefighters of the Fire Department of Rio de Janeiro, based on Santos Dumont airport and 33 military men without noise exposure. They were broken down into two age groups: 30-39years and 40-49years. The high frequencies were studied immediately after conventional audiometry. The results were most significant in the 40 to 49 years of age range, where the experimental group showed significantly higher threshold values than the control group 14000Hz (p = 0.008) and 16,000Hz (p = 0.0001). We concluded that noise interfered with high frequency thresholds, where all the mean values found in the experimental group were higher than those in the control group. We suggest that these data reinforce the importance of studying high frequencies, even with normal conventional audiometry in the early detection of noise-induced hearing loss.
Masalski, Marcin; Grysiński, Tomasz; Kręcicki, Tomasz
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
Torre, Peter; Hoffman, Howard J; Springer, Gayle; Cox, Christopher; Young, Mary A; Margolick, Joseph B; Plankey, Michael
The purpose of this study was to compare various speech audiometry measures between HIV+ and HIV- adults and to further evaluate the association between speech audiometry and HIV disease variables in HIV+ adults only. Three hundred ninety-six adults from the Multicenter AIDS Cohort Study (MACS) and Women's Interagency HIV Study (WIHS) completed speech audiometry testing. There were 262 men, of whom 117 (44.7%) were HIV+, and 134 women, of whom 105 (78.4%) were HIV+. Speech audiometry was conducted as part of the standard clinical audiological evaluation that included otoscopy, tympanometry, and pure-tone air- and bone-conduction thresholds. Specific speech audiometry measures included speech recognition thresholds (SRT) and word recognition scores in quiet presented at 40dB sensation level (SL) in reference to the SRT. SRT data were categorized in 5-dB steps from 0 to 25dB hearing level (HL) with one category as ≥30dB HL while word recognition scores were categorized as <90%, 90-99%, and 100%. A generalized estimating equations model was used to evaluate the association between HIV status and both ordinal outcomes. The SRT distributions across HIV+ and HIV- adults were similar. HIV+ and HIV- adults had a similar percentages of word recognition scores <90%, a lower percentage of HIV- adults had 90-99%, but HIV- adults had a higher percentage of 100%. After adjusting for covariables, HIV+ adults were borderline significantly more likely to have a higher SRT than HIV- adults (odds ratio [OR]=1.45, p=0.06). Among HIV+ adults, HIV-related variables (i.e., CD4+ T-cell counts, HIV viral load, and ever history of clinical AIDS) were not significantly associated with either SRT or word recognition score data. There was, however, a ceiling effect for word recognition scores, probably the result of obtaining this measure in quiet with a relatively high presentation level. A more complex listening task, such as speech-in-noise testing, may be a more clinically informative
Bromwich, Matthew A; Parsa, Vijay; Lanthier, Nicole; Yoo, John; Parnes, Lorne S
To develop a new method of screening audiometry that reduces the adverse effects of low frequency background noise by using active noise reduction (ANR) headphone technology. Prospective testing within an anechoic chamber evaluated the physical properties of ANR headphones. A prospective clinical crossover study compared standard audiometry with ANR headphone audiometry. Bose Aviation X circum-aural ANR headphones were tested for both active and passive attenuation properties in a hemi-anechoic chamber using a head and torso simulator. Thirty-seven otology clinic patients then underwent standard audiometry and ANR audiometry, which was performed in a 30- and/or 40-dB sound field. Objective ANR headphone attenuation levels of up to 12 dB were achieved at frequencies below 2,000 Hz. In standard audiometric testing, 40 dB of narrow-band background noise decreased patient pure tone thresholds by 24 dB at 250 Hz. The use of ANR technology provided 12 dB of additional attenuation. This resulted in a significant improvement in test results despite the 40 dB of background noise (P = resulted in a significant improvement in results (P = results were identical to those obtained in a quiet sound booth. Despite a 30-dB sound field, ANR audiometry can produce an audiogram identical to that obtained in a double-walled sound booth. ANR headphone audiometry improves the sensitivity of audiometric screening for mild low-frequency hearing loss. This technology may have important applications for screening in schools, industry, and community practices.
Khoza-Shangase, Katijah; Kassner, Lisa
The current study aimed to determine the accuracy of UHear™, a downloadable audiometer on to an iPod Touch©, when compared with conventional audiometry. Participants were enrolled primary school scholars. A total number of eighty-six participants (172 ears) were included. Of these eighty-six participants, forty-four were female and forty-two were male; with the age ranging from 8 years to 10 years (mean age, 9.0 years). Each participant underwent two audiological screening evaluations; one by means of conventional audiometry and the other by means of UHear™. Otoscopy and tympanometry was performed on each participant to determine status of their outer and middle ear before each participant undergoing pure tone air conduction screening by means of conventional audiometer and UHear™. The lowest audible hearing thresholds from each participant were obtained at conventional frequencies. Using the Paired t-test, it was determined that there was a significant statistical difference between hearing screening thresholds obtained from conventional audiometry and UHear™. The screening thresholds obtained from UHear™ were significantly elevated (worse) in comparison to conventional audiometry. The difference in thresholds may be attributed to differences in transducers used, ambient noise levels and lack of calibration of UHear™. The UHear™ is not as accurate as conventional audiometry in determining hearing thresholds during screening of school-aged children. Caution needs to be exercised when using such measures and research evidence needs to be established before they can be endorsed and used with the general public.
Swanepoel, De Wet; Maclennan-Smith, Felicity; Hall, James W
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.
Masalski, Marcin; Kręcicki, Tomasz
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.
Jankowski, Andrzej; Durko, Tomasz; Pajor, Anna; Durko, Marcin
In otosclerosis patients the most common procedure followed at Otosurgical Dept. Medical University of Lodz is stapedotomy with insertion of teflon-piston prosthesis. When surgery is finished a whisper hearing test is done from the 1 meter distance for brief intraoperative hearing improvement assessment. There is a number of patient who report subjective intraoperative hearing improvement which is not confirmed by postoperative pure-tone audiometry (2-3rd post-op day). was the analysis of factors influencing stapedotomy (teflon-piston procedure) patients in which intraoperative hearing improvement was not confirmed by postoperative pure-tone audiometry. Retrospective analysis of postoperative hearing results in patients who underwent stapedotomy (teflon-piston operation) at the Otosurgical Dept. Medical University of Lodz from 2005 to 2009. The total number of 142 stapedotomies were analyzed. In 27 ears no hearing improvement was reported (19.1%). Among them 18 reported intraoperative hearing improvement not confirmed on postoperative pure-tone audiometry and 9 cases intraopertively reported no hearing improvement. Patients in Group A (hearing improvement 1-2 month post stapedotomy)--12 cases (44.4%) with hearing improvement confirmed by pure-tone audiometry and Group B--5 cases (55.6%) in which no sign of hearing improvement in pure-tone audiometry was reported. In patients who intraopertively reported hearing improvement not supported by the pure-tone audiometry the following factors seem to play a vital role: a) strong suggestion and willingness of improvement after surgical treatment, b) specific condition of the whisper hearing test at the operating room environment, c) patient's stress during the surgery and strong fear of possible revision surgery.
Hu, Shirley; Patel, Neha A; Shinhar, Shai
There are no evidence-based guidelines regarding timing of postoperative audiometric follow-up for children undergoing tympanostomy tube insertion. Given the variability of follow-up among physicians, we attempt to guide the timing of postoperative audiograms using objective data. Retrospective chart review. All pediatric patients undergoing primary bilateral myringotomy and tympanostomy tube insertion for otitis media with effusion who had audiometric data available at two follow-up times were identified from 2014. Patients were classified according to the type of audiometry performed and were further categorized into those who had tympanostomy tube insertion only and those who had concurrent adenotonsillectomies. 34 patients were included in the study. Among patients assessed by sound field audiometry, the mean sound field threshold value was 29.2dB preoperatively and improved to 21dB 2 weeks postoperatively and 17.9dB 6 to 10 weeks postoperatively. The difference between the two postoperative means was significant (paudiometry, the mean preoperative air-bone gap was 20.1dB; this improved to 10dB at the first postoperative visit and 7.3dB at the second visit. The difference between the two means was significant (paudiometry underestimates the degree of hearing improvement. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Beck, Roberto Miquelino de Oliveira; Ramos, Bernardo Faria; Grasel, Signe Schuster; Ramos, Henrique Faria; Moraes, Maria Flávia Bonadia B de; Almeida, Edigar Rezende de; Bento, Ricardo Ferreira
Auditory steady-state responses (ASSR) are an important tool to detect objectively frequency-specific hearing thresholds. Pure-tone audiometry is the gold-standard for hearing evaluation, although sometimes it may be inconclusive, especially in children and uncooperative adults. Compare pure tone thresholds (PT) with ASSR thresholds in normal hearing subjects. In this prospective cross-sectional study we included 26 adults (n = 52 ears) of both genders, without any hearing complaints or otologic diseases and normal puretone thresholds. All subjects had clinical history, otomicroscopy, audiometry and immitance measurements. This evaluation was followed by the ASSR test. The mean pure-tone and ASSR thresholds for each frequency were calculated. The mean difference between PTand ASSR thresholdswas 7,12 for 500 Hz, 7,6 for 1000 Hz, 8,27 for 2000 Hz and 9,71 dB for 4000 Hz. There were no difference between PT and ASSR means at either frequency. ASSR thresholds were comparable to pure-tone thresholds in normal hearing adults. Nevertheless it should not be used as the only method of hearing evaluation.
Swanepoel, De Wet; Matthysen, Cornelia; Eikelboom, Robert H; Clark, Jackie L; Hall, James W
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.
Goehring, Jenny L.; Hughes, Michelle L.
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…
Gallaudet Coll., Washington, DC. Office of Demographic Studies.
Reported were descriptive data concerning identification audiometry (hearing screening) and special educational programs for the hearing impaired. Data were provided in tabular format for each state in the country and the District of Columbia. Hearing screening program data included extent of coverage, grade or ages covered annually, year and…
Hope, A J; Luxon, L M; Bamiou, D-E
To assess auditory processing in noise-exposed subjects with normal audiograms and compare the findings with those of non-noise-exposed normal controls. Ten noise-exposed Royal Air Force aircrew pilots were compared with 10 Royal Air Force administrators who had no history of noise exposure. Participants were matched in terms of age and sex. The subjects were assessed in terms of: pure tone audiometry, transient evoked otoacoustic emissions, suppression of transient evoked otoacoustic emissions in contralateral noise and auditory processing task performance (i.e. masking, frequency discrimination, auditory attention and speech-in-noise). All subjects had normal pure tone audiometry and transient evoked otoacoustic emissions amplitudes in both ears. The noise-exposed aircrew had similar pure tone audiometry thresholds to controls, but right ear transient evoked otoacoustic emissions were larger and speech-in-noise thresholds were elevated in the noise-exposed subjects compared to controls. The finding of poorer speech-in-noise perception may reflect noise-related impairment of auditory processing in retrocochlear pathways. Audiometry may not detect early, significant noise-induced hearing impairment.
Full Text Available Introduction: The problem of diagnosis and treatment of sensorineural hearing loss (SHL, including forms developed under the influence of noise, takes one of the leading places in ot¬olaryngology. However, there are not many studies on acoustic trauma, although this problem has recently become more and more important. Objective: A comparison of subjective audiometry in patients with sensorineural hearing loss after acute acoustic trauma and chronic noise exposure. Materials and methods. In the work the results of exa¬mination of 84 patients with acoustic trauma, 15 healthy as the control group and 15 workers employed on 'noise' occupations as a comparison group are given. Subjective audiometry was fully carried out by clinical audiometer AC-40 «Interacoustics» (Denmark. Hearing indices were investigated in the conventional (0,125-8 kHz and extended (9-16 kHz frequency bands. Results: Subjective audiometry showed a reduction in sound perception in all patients. Ac¬cor¬ding to the threshold tone audiometry in patients with acoustic trauma hearing thresholds were authentically (P <0,05 increased by 4, 6 and 8 kHz tones of conventional (0,125-8 kHz frequency band and by 14-16 kHz tones of the extended (9-16 kHz in comparison with the control group, as with workers employed on noise occupations. All the examined patients had deterioration of speech-test audiometry and above-threshold audiometry. Conclusions: According to su¬b¬jective audiometry, the type similar disorders of auditory function are in patients with acoustic trauma as in patients with long-term noise exposure, but they are more pronounced and develop much faster. The most informative features which show the origin and progression of hearing loss in patients with acoustic trauma are: increasing hearing thresholds by 14 and 16 kHz tones of the extended (9-16 kHz frequency band and by 4, 6 and 8 kHz tones of con¬ven¬tional (0,125-8 kHz frequency band plus the reduction of
Zhu, Mei-mei; Sha, Yan; Zhuang, Pei-yun; Olszewski, Aleksandra E; Jiang, Jia-qi; Xu, Jiang-hong; Xu, Chen-mei; Chen, Bing
The aim of this study is to evaluate the usefulness of high-resolution computed tomography (HRCT) densitometry in the diagnosis of otosclerosis and to investigate the relationship between CT densitometry and audiometry. HRCT findings and audiometry were compared among 34 patients (34 ears, the otosclerosis group) with surgically confirmed otosclerosis between January 2007 and December 2007 and 33 patients (33 opposite normal ears, the control group) with facial paralysis diagnosed at the same period of time. Seven regions of interest (ROI) were set manually around the otic capsule on the axial slice of 0.75-mm-thick CT image. The mean CT values of these seven regions were measured. In each ROI, the mean CT value of the otosclerosis group and that of the control group were compared. Based on the CT findings, the ears with otosclerosis were classified into two groups: Group A showed no pathological CT findings; Group B showed low density around the cochlea. In the otosclerosis group, the relationship between the findings of CT and the results of audiometry was analyzed. The mean CT values in the area posterior to the oval window and anterior to the oval window were significantly lower for the otosclerosis group compared with the control group (the former t=-2.030, p=0.046; the latter Z=-4.979, p<0.01). Group A consisted of 30 patients, 7 of which (23.33%) exhibited conductive hearing loss, and 23 of which (76.67%) exhibited mixed hearing loss; Group B had 4 patients, all with mixed hearing loss. For the otosclerosis group, the mean CT value in the area posterior to the oval window was positively correlated with the mean air conduction threshold (r=0.4273, p=0.0117) and with the mean air-bone gap (r=0.3995, p=0.0192). Quantitative evaluation of CT with slices less than 1mm in thickness may provide important information for the diagnosis and assessment of otosclerosis which are unattainable through other methods. Copyright (c) 2010 Elsevier Ireland Ltd. All rights
Knight, Kristin R; Kraemer, Dale F; Winter, Christiane; Neuwelt, Edward A
The objective is to describe progressive changes in hearing and cochlear function in children and adolescents treated with platinum-based chemotherapy and to begin preliminary evaluation of the feasibility of extended high-frequency audiometry and distortion product otoacoustic emissions for ototoxicity monitoring in children. Baseline and serial measurement of conventional pure-tone audiometry (0.5 to 8 kHz) and evoked distortion product otoacoustic emissions (DPOAEs) were conducted for 32 patients age 8 months to 20 years who were treated with cisplatin and/or carboplatin chemotherapy. Seventeen children also had baseline and serial measurement of extended high-frequency (EHF) audiometry (9 to 16 kHz). Audiologic data were analyzed to determine the incidence of ototoxicity using the American Speech-Language-Hearing Association criteria, and the relationships between the different measures of ototoxicity. Of the 32 children, 20 (62.5%) acquired bilateral ototoxicity in the conventional frequency range during chemotherapy treatment, and 26 (81.3%) had bilateral decreases in DPOAE amplitudes and dynamic range. Of the 17 children with EHF audiometry results, 16 (94.1%) had bilateral ototoxicity in the EHF range. Pilot data suggest that EHF thresholds and DPOAEs show ototoxic changes before hearing loss is detected by conventional audiometry. EHF audiometry and DPOAEs have the potential to reveal earlier changes in auditory function than conventional frequency audiometry during platinum chemotherapy in children.
Saliba, Joe; Al-Reefi, Mahmoud; Carriere, Junie S; Verma, Neil; Provencal, Christiane; Rappaport, Jamie M
Objectives (1) To compare the accuracy of 2 previously validated mobile-based hearing tests in determining pure tone thresholds and screening for hearing loss. (2) To determine the accuracy of mobile audiometry in noisy environments through noise reduction strategies. Study Design Prospective clinical study. Setting Tertiary hospital. Subjects and Methods Thirty-three adults with or without hearing loss were tested (mean age, 49.7 years; women, 42.4%). Air conduction thresholds measured as pure tone average and at individual frequencies were assessed by conventional audiogram and by 2 audiometric applications (consumer and professional) on a tablet device. Mobile audiometry was performed in a quiet sound booth and in a noisy sound booth (50 dB of background noise) through active and passive noise reduction strategies. Results On average, 91.1% (95% confidence interval [95% CI], 89.1%-93.2%) and 95.8% (95% CI, 93.5%-97.1%) of the threshold values obtained in a quiet sound booth with the consumer and professional applications, respectively, were within 10 dB of the corresponding audiogram thresholds, as compared with 86.5% (95% CI, 82.6%-88.5%) and 91.3% (95% CI, 88.5%-92.8%) in a noisy sound booth through noise cancellation. When screening for at least moderate hearing loss (pure tone average >40 dB HL), the consumer application showed a sensitivity and specificity of 87.5% and 95.9%, respectively, and the professional application, 100% and 95.9%. Overall, patients preferred mobile audiometry over conventional audiograms. Conclusion Mobile audiometry can correctly estimate pure tone thresholds and screen for moderate hearing loss. Noise reduction strategies in mobile audiometry provide a portable effective solution for hearing assessments outside clinical settings.
Rourke, Ryan; Kong, David Chan Chun; Bromwich, Matthew
Access to hearing health care is limited in many parts of the world, creating a lack of prompt diagnosis, which further complicates treatment. The use of portable audiometry for hearing loss testing can improve access to diagnostics in marginalized populations. Our study objectives were twofold: (1) to determine the prevalence of hearing loss in children aged 4 to 11 years in Iqaluit, Nunavut, and (2) to test and demonstrate the use of our tablet audiometer as a portable hearing-testing device in a remote location. Prospective cross-sectional observational. Remote elementary schools in 3 Canadian Northern communities. Tablet audiometers were used to test hearing in 218 children. Air conduction pure tones thresholds were obtained at 500, 1000, 2000, and 4000 Hz. Children with hearing loss ≥30 dB in either ear were referred for audiology services. Tablet audiometry screening testing revealed abnormal results in 14.8% of the study participants. No significant difference in the rate of hearing loss was seen by sex; however, the rate of hearing loss decreased significantly with increasing age. The median duration of the hearing test was 5 minutes 30 seconds. Of the study population, 14.8% tested positive for hearing loss based on our interactive tablet audiometer. In this setting, the tablet audiometer was both time efficient and largely language independent. This type of testing is valuable for providing much-needed hearing health care for high-risk populations in rural and remote areas where audiology services are often unavailable. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.
Gubbels, Samuel P; Gartrell, Brian C; Ploch, Jennifer L; Hanson, Kevin D
Determining cochlear implant candidacy requires a specific sentence-level testing paradigm in best-aided conditions. Our objective was to determine if findings on routine audiometry could predict the results of a formal cochlear implant candidacy evaluation. We hypothesize that findings on routine audiometry will accurately predict cochlear implant evaluation results in the majority of candidates. Retrospective, observational, diagnostic study. The charts of all adult patients who were evaluated for implant candidacy at a tertiary care center from June 2008 through June 2013 were included. Routine, unaided audiologic measures (pure-tone hearing thresholds and recorded monosyllabic word recognition testing) were then correlated with best-aided sentence-level discrimination testing (using either the Hearing in Noise Test or AzBio sentences test). The degree of hearing loss at 250 to 4,000 Hz and monosyllabic word recognition scores significantly correlated with sentence-level word discrimination test results. Extrapolating from this association, we found that 86% of patients with monosyllabic word recognition scores at or below 32% (or 44% for patients with private insurance) would meet candidacy requirements for cochlear implantation. Routine audiometric findings can be used to identify patients who are likely to meet cochlear implant candidacy upon formal testing. For example, patients with pure-tone thresholds (250, 500, 1,000 Hz) of ≥75 dB and/or a monosyllabic word recognition test score of ≤40% have a high likelihood of meeting candidacy criteria. Utilization of these predictive patterns during routine audiometric evaluation may assist hearing health professionals in deciding when to refer patients for a formal cochlear implant evaluation. 4 Laryngoscope, 127:216-222, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.
Convery, Elizabeth; Keidser, Gitte; Seeto, Mark; Yeend, Ingrid; Freeston, Katrina
A reliable and valid method for the automatic in situ measurement of hearing thresholds is a prerequisite for the feasibility of a self-fitting hearing aid, whether such a device becomes an automated component of an audiological management program or is fitted by the user independently of a clinician. Issues that must be addressed before implementation of the procedure into a self-fitting hearing aid include the role of real-ear-to-dial difference correction factors in ensuring accurate results and the ability of potential users to successfully self-direct the procedure. The purpose of this study was to evaluate the reliability and validity of an automatic audiometry algorithm that is fully implemented in a wearable hearing aid, to determine to what extent reliability and validity are affected when the procedure is self-directed by the user, and to investigate contributors to a successful outcome. Design was a two-phase correlational study. A total of 60 adults with mild to moderately severe hearing loss participated in both studies: 20 in Study 1 and 40 in Study 2. Twenty-seven participants in Study 2 attended with a partner. Participants in both phases were selected for inclusion if their thresholds were within the output limitations of the test device. In both phases, participants performed automatic audiometry through a receiver-in-canal, behind-the-ear hearing aid coupled to an open dome. In Study 1, the experimenter directed the task. In Study 2, participants followed a set of written, illustrated instructions to perform automatic audiometry independently of the experimenter, with optional assistance from a lay partner. Standardized measures of hearing aid self-efficacy, locus of control, cognitive function, health literacy, and manual dexterity were administered. Statistical analysis examined the repeatability of automatic audiometry; the match between automatically and manually measured thresholds; and contributors to successful, independent completion of
Löhler, J; Akcicek, B; Wollenberg, B; Schönweiler, R
Upon review of the statutory health insurance reimbursement guidelines, a specific quality assurance questionnaire concerned with the provision of hearing aids was introduced that assesses elements of patient satisfaction within Germany's public healthcare system. APHAB questionnaire-based patient evaluation of the benefit of hearing aids represents the third pillar of audiological diagnostics, alongside classical pure-tone and speech audiometry. Another new aspect of the national guidelines is inclusion of free-field measurements in noise with and without hearing aids. Part 2 of this review describes new diagnostic aspects of speech audiometry. In addition to adaptive speech audiometry, a proposed method for applying the gold standard of speech audiometry - the Freiburg monosyllabic speech test - in noise is described. Finally, the quality assurance questionnaire will be explained as an appendix to template 15 of the regulations governing hearing aids.
Anoraga, J. S.; Bramantyo, B.; Bardosono, S.; Simanungkalit, S. H.; Basiruddin, J.
Impedance audiometry is not yet routinely used in pressure tests, especially in Indonesia. Direct exposure to pressure in a hyperbaric chamber is sometimes without any assessment of the middle ear or the Eustachian tube function (ETF) of ventilation. Impedance audiometry examinations are important to assess ETF ventilation. This study determined the middle ear pressure value changes associated with the ETF (ventilation) of prospective divers. This study included 29 prospective divers aged 20-40 years without conductive hearing loss. All subjects underwent a modified diving impedance audiometry examination both before and after the pressure test in a double-lock hyperbaric chamber. Using the Toynbee maneuver, the values obtained for changes of pressure in the middle ear were significant before and after the pressure test in the right and left ears: p audiometry examination is necessary for the selection of candidate divers undergoing pressure tests within a hyperbaric chamber.
Singh Chauhan, Rajeev; Saxena, Ravinder Kumar; Varshey, Saurabh
In monitoring patients for drug-induced hearing loss, most audiometric evaluations are limited to the range of frequencies from 0.25 to 8 kHz. However, such testing would fail to detect ototoxicity in patients who have already experienced hearing loss in the ultrahigh frequencies from 10 to 20 kHz. Awareness of ultrahigh-frequency ototoxicity could lead to changes in a drug regimen to prevent further damage. We conducted a prospective study of 105 patients who were receiving a potentially ototoxic drug-either gentamicin, amikacin, or cisplatin-to assess the value of ultrahigh-frequency audiometry in detecting systemic drug-induced hearing loss. We found that expanding audiometry into the ultrahigh-frequency range led to the detection of a substantial number of cases of hearing loss that would have otherwise been missed.
Caballero, Miguel; Mackers, Paula; Reig, Oscar; Buxo, Elvira; Navarrete, Pilar; Blanch, Jose L; Grau, Juan J
To analyze the role of audiometry in considering change to a less ototoxic treatment in head and neck cancer (HNC) patients. Consecutive patients prescribed high-dose cisplatin (100 mg/m2) between January 2013 and February 2015 were enrolled. Audiometry was performed at baseline and before cisplatin. Change to a less ototoxic agent or reduced cisplatin dose was considered with audiometric decreases >25 dB. A total of 103 patients were included; the median age of the patients was 59 years (range 18-75). Cisplatin was intended curative (58%), adjuvant (32%), or palliative (10%). Forty-two participants (41%) did not commence high-dose cisplatin because of baseline audiometric alterations. Of 61 patients treated with high-dose cisplatin, 40 (66%) showed marked ototoxicity at the end of treatment. The mean hearing loss between initial and final audiometries showed a hearing loss at 4 and 8 kHz in both ears (p = 0.002). Thirteen patients switched to carboplatin and 15 to a lower dose of cisplatin. The outcome was not significantly altered when cisplatin was replaced with carboplatin or cetuximab. Audiometric alterations are common in HNC with high-dose cisplatin, and switching to a less ototoxic regimen does not adversely affect outcome. Audiometric examination could help to prevent hearing loss in this population. © 2017 S. Karger AG, Basel.
Delaroche, Monique; Gavilan-Cellié, Isabelle; Maurice-Tison, Sylvie; Kpozehouen, Alphonse; Dauman, René
When carried out in addition to objective tests, behavioral audiometry performed in children with the so-called "Delaroche protocol" [IJORL 68 (2004) 1233-1243] enables to determine hearing thresholds by air and bone conduction over the whole auditory frequency range. In the present report, seventy-three hearing-impaired infants with different levels of motor and cognitive development were tested behaviorally before 6 months of age. Reliability of these early determined behavioral thresholds was then after analyzed using: (a) cross-sectional study, and (b) longitudinal study. Cross-sectional study compared click-evoked ABR thresholds in the better ear with binaural high-frequency hearing thresholds. In longitudinal study, early measured binaural hearing thresholds from 500 through 4000 Hz were reassessed at 18 months. In 13% of babies behavioral testing was not fully completed by 6 months of age. Nevertheless, both cross-sectional and longitudinal studies yielded intraclass correlation coefficients above 0.80, suggesting that behavioral testing is applicable to this very young population. Assessment of hearing after newborn screening should not be restricted to objective tests before 5 ½ months. It should also include bone- and air-conduction behavioral tests adjusted to developmental stage and performed in presence of parents. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
Shaw, Paul; Greenwood, Hannah
Positioning and maintaining the subject's head at the calibration point (CP) of the sound field (SF) during SF assessment remains a challenge. The purpose of this study was to investigate the sound pressure level (SPL) at head positions likely to be encountered in routine audiological practice. Eight National Health Service SF clinics were used to obtain SPL measurements. Part 1 of the study investigated SPL variability at positions around the CP (0.15 m and 0.30 m). Parts 2 and 3 of the study, investigated the SPL at two typical head heights of the infant population. Only sound field measures were obtained. Part 1: 32% and 40% of measurements of SPL around the CP were >2 dB different from the SPL at the CP (0.15 m and 0.30 m). Parts 2 and 3: 55% and 38% of measurements of SPL, at the two infant head heights, were >2 dB from the SPL at the CP. Variability in SPL, due to head movement, is to be expected when performing SF audiometry. Furthermore, the typical head heights of infants will introduce additional variability, unless the position of the CP is chosen carefully.
Dorresteijn, Paul M; Ipenburg, Norbertus A; Murphy, Kathryn J; Smit, Michelle; van Vulpen, Jonna K; Wegner, Inge; Stegeman, Inge; Grolman, Wilko
To evaluate whether absence of hearing loss on pure-tone audiometry (PTA) is reliable as a diagnostic test for predicting benign paroxysmal positional vertigo (BPPV) in adult patients with vertigo. PubMed, Embase, and the Cochrane Library. A systematic literature search was conducted on December 10, 2013. Relevant publications were selected based on title, abstract, and full text. Selected articles were assessed for relevance and risk of bias using predetermined criteria. Prevalence and the positive and negative predictive value (PPV and NPV) were extracted. Of 603 retrieved publications, 1 article with high relevance and moderate risk of bias was included. In this study, the prevalence of BPPV was 28%. The PPV of hearing loss assessed by PTA was 31% (95% CI, 17-49) and the NPV was 73% (95% CI, 61-83). The absence of hearing loss on PTA decreased the risk of BPPV by 1%. There is insufficient high-quality evidence regarding the diagnostic value of the absence of hearing loss, assessed by PTA, for predicting BPPV in adult patients with vertigo. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014.
Weiss, Allyson D; Karzon, Roanne K; Ead, Banan; Lieu, Judith E C
Efficacy of insert and supra-aural earphones during visual reinforcement audiometry (VRA) was investigated for 12- to 24-month-old children. VRA testing began in the soundfield and transitioned to either insert or supra-aural earphones. Audiologists recorded threshold estimates, participant behaviors, and an overall subjective rating of earphone acceptance. One hundred and eighty-six 12- to 24-month-old children referred to the Department of Audiology at St. Louis Children's Hospital for a variety of reasons. Subjective ratings indicated high acceptance of insert earphones (84%) and supra-aural earphones (80%) despite negative behaviors. There was no significant difference in the number of threshold estimates based on earphone type for 12- to 17-month-old participants. Participants in the 18- to 24-month-old age group provided significantly more threshold estimates with insert earphones (mean = 5.3 threshold estimates, SD = 3.5) than with supra-aural earphones (mean = 2.9 threshold estimates, SD = 2.9). All seven participants who rejected earphone placement were successfully reconditioned for soundfield testing. Data support the use of insert earphones during VRA, especially with 18-to 24-month-old children, to obtain ear-specific information.
Comastri, S. A.; Martin, G.; Simon, J. M.; Angarano, C.; Dominguez, S.; Luzzi, F.; Lanusse, M.; Ranieri, M. V.; Boccio, C. M.
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
Mar Lasso de la Vega
Full Text Available Objective. The aim of this study is to analyze the high-frequency hearing levels in patients with rheumatoid arthritis and to determine the relationship between hearing loss, disease duration, and immunological parameters. Materials and Methods. A descriptive cross-sectional study including fifty-three patients with rheumatoid arthritis was performed. The control group consisted of 71 age- and sex-matched patients from the study population (consecutively recruited in Madrid “Area 9,” from January 2010 to February 2011. Both a pure tone audiometry and an extended-high-frequency audiometry were performed. Results. Extended-high-frequency audiometry diagnosed sensorineural hearing loss in 69.8% of the patients which exceeded the results obtained with pure tone audiometry (43% of the patients. This study found significant correlations in patients with sensorineural hearing loss related to age, sex, and serum anti-cardiolipin (aCL antibody levels. Conclusion. Sensorineural hearing loss must be considered within the clinical context of rheumatoid arthritis. Our results demonstrated that an extended-high-frequency audiometry is a useful audiological test that must be performed within the diagnostic and follow-up testing of patients with rheumatoid arthritis, providing further insight into a disease-modifying treatment or a hearing loss preventive treatment.
Lasso de la Vega, Mar; Villarreal, Ithzel Maria; Lopez-Moya, Julio; Garcia-Berrocal, Jose Ramon
Objective. The aim of this study is to analyze the high-frequency hearing levels in patients with rheumatoid arthritis and to determine the relationship between hearing loss, disease duration, and immunological parameters. Materials and Methods. A descriptive cross-sectional study including fifty-three patients with rheumatoid arthritis was performed. The control group consisted of 71 age- and sex-matched patients from the study population (consecutively recruited in Madrid "Area 9," from January 2010 to February 2011). Both a pure tone audiometry and an extended-high-frequency audiometry were performed. Results. Extended-high-frequency audiometry diagnosed sensorineural hearing loss in 69.8% of the patients which exceeded the results obtained with pure tone audiometry (43% of the patients). This study found significant correlations in patients with sensorineural hearing loss related to age, sex, and serum anti-cardiolipin (aCL) antibody levels. Conclusion. Sensorineural hearing loss must be considered within the clinical context of rheumatoid arthritis. Our results demonstrated that an extended-high-frequency audiometry is a useful audiological test that must be performed within the diagnostic and follow-up testing of patients with rheumatoid arthritis, providing further insight into a disease-modifying treatment or a hearing loss preventive treatment.
Lasso de la Vega, Mar; Villarreal, Ithzel Maria; Lopez-Moya, Julio; Garcia-Berrocal, Jose Ramon
Objective. The aim of this study is to analyze the high-frequency hearing levels in patients with rheumatoid arthritis and to determine the relationship between hearing loss, disease duration, and immunological parameters. Materials and Methods. A descriptive cross-sectional study including fifty-three patients with rheumatoid arthritis was performed. The control group consisted of 71 age- and sex-matched patients from the study population (consecutively recruited in Madrid “Area 9,” from January 2010 to February 2011). Both a pure tone audiometry and an extended-high-frequency audiometry were performed. Results. Extended-high-frequency audiometry diagnosed sensorineural hearing loss in 69.8% of the patients which exceeded the results obtained with pure tone audiometry (43% of the patients). This study found significant correlations in patients with sensorineural hearing loss related to age, sex, and serum anti-cardiolipin (aCL) antibody levels. Conclusion. Sensorineural hearing loss must be considered within the clinical context of rheumatoid arthritis. Our results demonstrated that an extended-high-frequency audiometry is a useful audiological test that must be performed within the diagnostic and follow-up testing of patients with rheumatoid arthritis, providing further insight into a disease-modifying treatment or a hearing loss preventive treatment. PMID:27239375
Baldwin, Stacey M; Gajewski, Byron J; Widen, Judith E
Early intervention to reduce the effects of congenital hearing loss requires accurate description of hearing loss. In pediatric audiology, a cross-check principle is used to compare behavioral and physiological tests. The purpose of this study was to investigate the correspondence of visual reinforcement audiometry (VRA) minimal response levels (MRLs), otoacoustic emissions (OAEs), tympanometry, and VRA test reliability to determine the odds of obtaining the expected cross-check results. We hypothesized that (1) when MRLs were within normal limits (WNL), OAEs would be present; (2) in the event of normal MRLs and absent OAEs, tympanograms would be abnormal; and (3) in the event of elevated MRLs and present OAEs, the tester's confidence in the MRLs would be judged to be only fair, rather than good. This was a retrospective study. A previous study provided data from 993 infants who had diagnostic audiologic evaluations at 8-12 mo of age. The data were analyzed to compare VRA MRLs with OAE signal-to-noise ratios at 1, 2, and 4 kHz. Odds ratios and 95% confidence intervals were calculated to test the three hypotheses related to the correspondence among MRLs, OAEs, tympanometry, and the reliability of MRLs. The probability that OAEs would be present when MRLs were WNL varied from 12 to 26 to 1, depending on the test frequency. When OAEs were absent in the presence of normal MRLs, the odds of abnormal tympanometry varied from 5 to 10 to 1, depending on the test frequency. When MRLs were elevated (>20 dB HL), the odds suggested that examiners judged the MRLs at 1 and 2 kHz to lack reliability. The results suggest that the cross-check principle is effective when employing VRA, OAE, and tympanometry to rule out or determine the degree, type, and configuration of hearing loss in infants. American Academy of Audiology.
Delaroche, Monique; Thiebaut, Rodolphe; Dauman, René
This paper provides the first report in English of original behavioral audiometry protocols for measuring hearing thresholds in very young children, including the multiply handicapped. Based on reactions to one or two well-calibrated acoustic stimulations delivered in the sound field, the protocol first involves the use of a vibrator to measure hearing levels by bone conduction. This measurement technique, which is not affected by middle ear infections, is the key diagnostic step. Moreover, in profoundly hearing loss children, it triggers reactions through vibratory stimulation and sets the scene for the conditioning of responses. Next, hearing levels are assessed by air conduction with the aid of headphones, in order to measure hearing levels in each ear as early as possible. A unique set-up is used to facilitate the emergence of reliable "surprise reactions", which may be interpreted by a sole examiner. Classical visual reinforcement is replaced by a highly interactive, dynamic and playful exchange between child and examiner, which gives meaning to the perception of stimuli and heralds the learning of hearing. The results concern 105 babies suffering from bilateral sensorineural hearing loss and aged 4-18 months at the first behavioral test. Group 1 comprised 91 babies with no other handicap, in whom full bilateral air conduction was obtained in 82.4% before 12 months and in 98.9% before 18 months. In this group, air conduction in each ear was obtained in 47.0% before 12 months and in 70.3% before 18 months. In Group 2, which included 14 multiply handicapped babies, full bilateral air conduction was obtained in 37.5% before 12 months and in 78.6% before 18 months. Air conduction in both ears was obtained in 28.6% before 18 months. The protocols described make it possible, in a minimum number of sessions, to measure hearing thresholds early over the whole range of hearing frequencies, even in multiply handicapped babies and those suffering from developmental
Whitton, Jonathon P; Hancock, Kenneth E; Shannon, Jeffrey M; Polley, Daniel B
To compare hearing measurements made at home using self-administered audiometric software against audiological tests performed on the same subjects in a clinical setting Prospective, crossover equivalence study In experiment 1, adults with varying degrees of hearing loss (N = 19) performed air-conduction audiometry, frequency discrimination, and speech recognition in noise testing twice at home with an automated tablet application and twice in sound-treated clinical booths with an audiologist. The accuracy and reliability of computer-guided home hearing tests were compared to audiologist administered tests. In experiment 2, the reliability and accuracy of pure-tone audiometric results were examined in a separate cohort across a variety of clinical settings (N = 21). Remote, automated audiograms were statistically equivalent to manual, clinic-based testing from 500 to 8,000 Hz (P ≤ .02); however, 250 Hz thresholds were elevated when collected at home. Remote and sound-treated booth testing of frequency discrimination and speech recognition thresholds were equivalent (P ≤ 5 × 10(-5) ). In the second experiment, remote testing was equivalent to manual sound-booth testing from 500 to 8,000 Hz (P ≤ .02) for a different cohort who received clinic-based testing in a variety of settings. These data provide a proof of concept that several self-administered, automated hearing measurements are statistically equivalent to manual measurements made by an audiologist in the clinic. The demonstration of statistical equivalency for these basic behavioral hearing tests points toward the eventual feasibility of monitoring progressive or fluctuant hearing disorders outside of the clinic to increase the efficiency of clinical information collection. 2b. Laryngoscope, 126:2382-2388, 2016. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.
Lin, Hsiang-Yu; Shih, Shou-Chuan; Chuang, Chih-Kuang; Lee, Kuo-Sheng; Chen, Ming-Ren; Lin, Hung-Ching; Chiu, Pao Chin; Niu, Dau-Ming; Lin, Shuan-Pei
Patients with mucopolysaccharidoses (MPS) often have hearing loss. However, the characterization of hearing loss by pure-tone audiometry (PTA) in this rare disease population and its relationship to age and treatment is limited. PTA was performed in 39 patients with MPS (29 males and 10 females; 3 with MPS I, 21 with MPS II, 9 with MPS IVA, and 6 with MPS VI; median age, 11.9 years; age range, 4.4-34.2 years). The degree of hearing loss was classified by the age-independent World Health Organization (WHO) clinical guidelines. Hearing loss by PTA was present in 85% (33/39) of patients and was categorized as mild (26-40 dB) in 18%, moderate (41-60 dB) in 36%, severe (61-80 dB) in 23%, and profound (≥81dB) in 5%. Among the patients with hearing loss, 33% were classified as mixed type (conductive and sensorineural), 30% as pure conductive type, 27% as pure sensorineural type, and 9% were undefined. The means of the right and left ear hearing thresholds at 2000 and 4000 Hz by air conduction (AC) and at 500, 1000, 2000, and 4000 Hz by bone conduction (BC) were all positively correlated with age (p<0.05). In the 6 patients with MPS II or VI who underwent follow-up PTA after ventilation tube insertion and enzyme replacement therapy for 1.9 to 8.5 years, all showed improvements in AC and BC of the better ear, as well as in the air-bone gap. Hearing impairment is common in MPS. Early otolaryngological evaluation and intervention are recommended. These findings and the follow-up data can be used to develop quality of care strategies for patients with MPS. Copyright © 2014 Elsevier Inc. All rights reserved.
Paradis, Justin; Bance, Manohar
The primary objective is to assess the validity of nasal-noise masking audiometry (NNMA) as a clinical diagnostic tool in our patient population. Retrospective case review. Tertiary ambulatory referral center. Patients with patulous Eustachian tube (PET) were identified from referrals to our Eustachian tube disorders clinic primarily with symptoms including autophony, aural fullness, and hearing their own breathing. The healthy subjects had no history of ear disease. NNMA was measured in 20 ears of 10 healthy subjects as well as in 42 ears of 21 patients with suspected PET. NNMA mean auditory thresholds were measured at frequencies ranging from 250 to 8,000 Hz. When stratified as definitive or probable PET based on observed tympanic membrane movement with breathing, both Definitive and Probable PET groups had significantly higher NNMA mean auditory thresholds compared to Normal ears at 250 Hz (p = 0.001, p = 0.003), 1,000 Hz (p = 0.019, p = 0.001), and 6,000 Hz (p = 0.4, p = 0.001). When stratified based on symptoms on the day of testing, both Symptomatic Ears and Non-Symptomatic Ears had significantly higher mean auditory thresholds compared to Normal ears at 250 Hz (p = 0.001, p = 0.015) and at 1,000 Hz (p = 0.002, p = 0.004). Our results demonstrate a larger masking effect in patients with PET compared to normal subjects in the low-frequency region. In clinical practice, the relatively small effect and the wide variability of results between patients have made this test be of little value clinically in our patient population.
Kiessling, Jürgen; Leifholz, Melanie; Unkel, Steffen; Pons-Kühnemann, Jörn; Jespersen, Charlotte Thunberg; Pedersen, Jenny Nesgaard
In-situ audiometry is a hearing aid feature that enables the measurement of hearing threshold levels through the hearing instrument using the built-in sound generator and the hearing aid receiver. This feature can be used in hearing aid fittings instead of conventional pure-tone audiometry (PTA), particularly in places where no standard audiometric equipment is available. Differences between conventional and in-situ thresholds are described and discussed for some particular hearing aids. No previous investigation has measured and compared these differences for a number of current hearing aid models by various manufacturers across a wide range of hearing losses. The purpose of this study was to perform a model-based comparison of conventionally and in-situ measured hearing thresholds. Data were collected for a range of hearing aid devices to study and generalize the effects that may occur under clinical conditions. Research design was an experimental and regression study. A total of 30 adults with sensorineural hearing loss served as test persons. They were assigned to three subgroups of 10 subjects with mild (M), moderate to severe (MS), and severe (S) sensorineural hearing loss. All 30 test persons underwent both conventional PTA and in-situ audiometry with four hearing aid models by various manufacturers. The differences between conventionally and in-situ measured hearing threshold levels were calculated and evaluated by an exploratory data analysis followed by a sophisticated statistical modeling process. At 500 and 1500 Hz, almost all threshold differences (conventional PTA minus in-situ data) were negative, i.e., in the low to mid frequencies, hearing loss was overestimated by most devices relative to PTA. At 4000 Hz, the majority of differences (7 of 12) were positive, i.e., in the frequency range above 1500 Hz, hearing loss was frequently underestimated. As hearing loss increased (M→MS→S), the effect of the underestimation decreased. At 500 and 1500 Hz
Ozdek, Ali; Karacay, Mahmut; Saylam, Guleser; Tatar, Emel; Aygener, Nurdan; Korkmaz, Mehmet Hakan
The objective of this study is to compare pure tone audiometry and auditory steady-state response (ASSR) thresholds in normal hearing (NH) subjects and subjects with hearing loss. This study involved 23 NH adults and 38 adults with hearing loss (HI). After detection of behavioral thresholds (BHT) with pure tone audiometry, each subject was tested for ASSR responses in the same day. Only one ear was tested for each subject. The mean pure tone average was 9 ± 4 dB for NH group and 57 ± 14 for HI group. There was a very strong correlation between BHT and ASSR measurements in HI group. However, the correlation was weaker in the NH group. The mean differences of pure tone average of four frequencies (0.5, 1, 2, and 4 kHz) and ASSR threshold average of same frequencies were 13 ± 6 dB in NH group and 7 ± 5 dB in HI group and the difference was significant (P = 0.01). It was found that 86% of threshold difference values were less than 20 dB in NH group and 92% of threshold difference values were less than 20 dB in HI group. In conclusion, ASSR thresholds can be used to predict the configuration of pure tone audiometry. Results are more accurate in HI group than NH group. Although ASSR can be used in cochlear implant decision-making process, findings do not permit the utilization of the test for medico-legal reasons.
Galarza-Delgado, Dionicio Angel; Villegas Gonzalez, Mario Jesus; Riega Torres, Janett; Soto-Galindo, German A; Mendoza Flores, Lidia; Treviño González, José Luis
The aim of this study is to evaluate the hearing behavior of rheumatoid arthritis (RA) and primary Sjögren syndrome (PSS) patients and compare them with a healthy control group and with each other. A comparative cross-sectional study was performed with a group of 117 female RA patients, a group of 60 female PSS patients, and a 251 female healthy control group. Every subject underwent a series of studies including high-frequency audiometry, speech audiometry, and tympanometry. The high-frequency audiometry measured 250 to 16,000 Hz. The 117 patients with RA and the 60 with PSS were diagnosed according to American College of Rheumatology criteria / ACR 2010, and the validated classification of the American-European Consensus Group. Hearing loss was present in 36.8% of the RA group in 500-3000 Hz, 68.4% in 4000-8000 Hz, and 94.9% in 10,000-16,000 Hz. Hearing loss was present in 60% of the PSS group in 500-3000 Hz, 70% in 4000-8000 Hz, and 100% in 10,000-16,000 Hz. The hearing impairment prevalence of both groups was significantly different (p < 0.05) when compared with the healthy control group. We also compared the hearing thresholds between RA and PSS patients, finding a significant hearing threshold increase in 500-3000 Hz of the PSS group. This study consolidates the association between RA and PSS with hearing impairment. A deeper hearing loss was reported in PSS than in RA patients, demonstrating a greater auditory and speech recognition repercussion.
Yeap, Li-Ling; Lim, Kheng-Seang; Lo, Yoke-Lin; Bakar, Mohd Zukiflee Abu; Tan, Chong-Tin
Hearing loss has been reported with valproic acid (VPA) use. However, this is the first case of VPA-induced hearing loss that was tested and confirmed with a VPA rechallenge, supported by serial audiometry and pharmacokinetic modelling. A 39-year-old truck driver with temporal lobe epilepsy was treated with VPA at 400 mg, twice daily, and developed hearing loss after each dose, but recovered within three hours. Hearing loss fully resolved after VPA discontinuation. Audiometry performed five hours after VPA rechallenge showed significant improvement in hearing thresholds. Pharmacokinetic modelling during the VPA rechallenge showed that hearing loss occurred at a level below the therapeutic range. Brainstem auditory evoked potential at three months after VPA discontinuation showed bilateral conduction defect between the cochlear and superior olivary nucleus, supporting a pre-existing auditory deficit. VPA may cause temporary hearing threshold shift. Pre-existing auditory defect may be a risk factor for VPA-induced hearing loss. Caution should be taken while prescribing VPA to patients with pre-existing auditory deficit.
Schacks, S; Rohn, K; Hauschild, G
Reference values were established for frequency-specific electric response audiometry (ERA) in dogs on the basis of the results of ERA examinations of 200 animals with normal hearing. Air-conducting acoustic tubes with foam stoppers were used in the determination of the following: the latencies of waves I, III and V; interpeak latencies (IPL) I-III, III-V and I-V; amplitudes I and V; and the amplitude difference I-V. A frequency-specific stimulus (tone pip) was used for frequency-specific examination (1 to 4 kHz) over the entire frequency range indicated. These reference values were then used for the clinical examination of 50 dogs with hearing defects. A frequency-specific ERA was conducted and the results evaluated. These findings made it possible to draw objective conclusions about the degree, type and site of the hearing defects. Frequency-specific electric response audiometry was shown to be an important diagnostic tool for the detection of partial high- and low-frequency hearing loss and for the characterisation of hearing defects of otological, otoneurological and neurological origin.
ter Haar, G.|info:eu-repo/dai/nl/304828750
Age-related hearing loss (ARHL) is the most common cause of acquired hearing impairment in dogs. Diagnosis requires objective electrophysiological tests (brainstem evoked response audiometry [BERA]) evaluating the entire audible frequency range in dogs. In our laboratory a method was developed to
textabstractBrainstem Electric Response Audiometry (BERA) is a method to visualize some of the electric activity generated in the auditory nerve and the brainstem during the processing of sound. The amplitude of the Auditory Brainstem Response (ABR) is very small (0.05-0.5 flV). The potentials
Bricker, Diane D.; And Others
To facilitate the use of operant audiometry with low functioning children (psychotic, severely retarded, or multiply handicapped), a procedures manual was developed containing definitions of terms, instructions for determining reinforcers, physical facilities and equipment needs, diagrams, component lists, and technical descriptions. Development…
Schmidt, Jesper Hvass; Brandt, Christian; Pedersen, Ellen Raben
Objective: To create a user-operated pure-tone audiometry method based on the method of maximum likelihood (MML) and the two-alternative forced-choice (2AFC) paradigm with high test-retest reliability without the need of an external operator and with minimal influence of subjects' fluctuating res...
Brennan-Jones, Christopher G; Eikelboom, Robert H; Swanepoel, De Wet; Friedland, Peter L; Atlas, Marcus D
Examine the accuracy of automated audiometry in a clinically heterogeneous population of adults using the KUDUwave automated audiometer. Prospective accuracy study. Manual audiometry was performed in a sound-treated room and automated audiometry was not conducted in a sound-treated environment. 42 consecutively recruited participants from a tertiary otolaryngology department in Western Australia. Absolute mean differences ranged between 5.12-9.68 dB (air-conduction) and 8.26-15 dB (bone-conduction). A total of 86.5% of manual and automated 4FAs were within 10 dB (i.e. ±5 dB); 94.8% were within 15 dB. However, there were significant (p audiometry at 250, 500, 1000, and 2000 Hz (air-conduction) and 500 and 1000 Hz (bone-conduction). The effect of age (≥55 years) on accuracy (p = 0.014) was not significant on linear regression (p > 0.05; R(2) =( ) 0.11). The presence of a hearing loss (better ear ≥26 dB) did not significantly affect accuracy (p = 0.604; air-conduction), (p = 0.218; bone-conduction). This study provides clinical validation of automated audiometry using the KUDUwave in a clinically heterogeneous population, without the use of a sound-treated environment. Whilst threshold variations were statistically significant, future research is needed to ascertain the clinical significance of such variation.
Venail, F; Legris, E; Vaerenberg, B; Puel, J-L; Govaerts, P J; Ceccato, J C
To validate a novel speech audiometry method using customized self-voice recorded word lists with automated scoring. The self-voice effect was investigated by comparing results with prerecorded or self-recorded CVC (consonant-vowel-consonant) word lists. Then customized lists of 3-phoneme words were drawn up using the OTOSPEECH software package, and their scores were compared to those for reference lists. Finally, the customized list scores were compared on automated (Dynamic Time Warping [DTW]) versus manual scoring. Self-voice did not change scores for perception of CVC words at 10, 20 and 30 dB (ANOVA>0.05). Scores obtained with pre-recorded and self-recorded lists correlated (n=10, R(2)=0.76, Paudiometry displayed results similar to conventional audiometric techniques. Copyright © 2016 Elsevier Masson SAS. All rights reserved.
Wadhera, Raman; Hernot, Sharad; Gulati, Sat Paul; Kalra, Vijay
We performed a prospective interventional study to evaluate correlations between hearing thresholds determined by pure-tone audiometry (PTA) and auditory steady-state response (ASSR) testing in two types of patients with hearing loss and a control group of persons with normal hearing. The study was conducted on 240 ears-80 ears with conductive hearing loss, 80 ears with sensorineural hearing loss, and 80 normal-hearing ears. We found that mean threshold differences between PTA results and ASSR testing at different frequencies did not exceed 15 dB in any group. Using Pearson correlation coefficient calculations, we determined that the two responses correlated better in patients with sensorineural hearing loss than in those with conductive hearing loss. We conclude that measuring ASSRs can be an excellent complement to other diagnostic methods in determining hearing thresholds.
Isabella Monteiro de Castro Silva
Full Text Available A audiometria de alta freqüência é capaz de detectar precocemente alterações em sensibilidade advindas de processos como o envelhecimento. Seu uso é limitado, o que recomenda estudos para esclarecer seu desempenho, especialmente entre adultos de mais idade. OBJETIVO: Comparar os limiares para as freqüências de 250Hz a 16kHz, entre adultos jovens e mais velhos normoacúsicos, com e sem queixa audiológica. CASUÍSTICA E MÉTODO: A sensibilidade a tons puros de 250Hz a 16kHz foi avaliada com audiômetro AC-40, em 64 adultos, igualmente distribuídos: jovens (25 a 35 anos e mais velhos (45 a 55 anos de ambos os gêneros, com forma de estudo de coorte transversal. RESULTADOS: Os adultos mais velhos apresentaram limiares mais elevados em todas as freqüências, mais significativamente nas mais altas (8 a 16kHz, quando comparados com os adultos jovens. Homens apresentaram limiares mais elevados do que mulheres entre 3 e 10kHz. CONCLUSÃO: O processo de envelhecimento auditivo, envolvendo perda de sensibilidade auditiva para altas freqüências, pode ser detectado em idades anteriores às tipicamente pesquisadas, uma vez que a audiometria de alta freqüência demonstrou ser instrumento importante para distinguir a sensibilidade auditiva entre adultos jovens e mais velhos, quando audiologicamente normais.High-frequency audiometry can detect early changes in auditory sensitivity resulting from processes such as aging. Nonetheless its use is still limited, and additional studies are required to establish its use, particularly among older adults. AIM: To compare pure tone thresholds for frequencies from 250 Hz to 16 kHz in young and older adults, with or without audiologic complaints. METHOD: Pure tone sensitivity to 250 Hz to 16 kHz was assessed with an AC-40 audiometer in 64 adults, evenly distributed in young (25 to 35 years-old and older (45 to 55 years-old adults of both sexes. This is a cross-sectional study. RESULTS: Although all
Full Text Available Objective: Determining the frequency of hearing disorders and hearing aid using in the clients referring to the Avesina education and health center, audiometry clinic, 1377. Method and Material: This is an assesive-descriptive survey that conducted on more than 2053 (1234 males and 819 females who referred for audiometry after examination by a physician. Case history, otoscopy, PTA, speech and immittance audiometry were conducted for all the clients. The findings were expressed in tables and diagrams of frequency. The age and sex relationship. All types of hearing losses and the number of the hearing-impaired clients need a hearing aid were assessed. Findings: 56% of this population were hearing-impaired and 44% had normal hearing were hearing. 60% were males and 40% females. Of the hearing-impaired, 44% had SNHL, 35.6% CHL and 8.2% mixed hearing loss. The hearing aid was prescribed for 204 (83 females and121 males if they need that only 20 females and 32 males wear it. Conclusion: It this sample, SNHL is of higher frequency. According to this survey, the more the age, the more the hearing aid is accepted (85% of wearer are more than 49 the prevalence of the hearing impaired males are more than females (60% versus 40%. Only 25% of the hearing-impaired wear hearing aids.
Van der Aerschot, Mathieu; Swanepoel, De Wet; Mahomed-Asmail, Faheema; Myburgh, Herman Carel; Eikelboom, Robert Henry
Evaluation of the Sennheiser HD 202 II supra-aural headphones as an alternative headphone to enable more affordable hearing screening. Study 1 measured the equivalent threshold sound pressure levels (ETSPL) of the Sennheiser HD 202 II. Study 2 evaluated the attenuation of the headphones. Study 3 determined headphone characteristics by analyzing the total harmonic distortion (THD), frequency response and force of the headband. Twenty-five participants were included in study 1 and 15 in study 2 with ages ranging between 18 and 25. No participants were involved in study 3. The Sennheiser HD 202 II ETSPLs (250-16000 Hz) showed no significant effects on ETSPL for ear laterality, gender or age. Attenuation was not significantly different (p > 0.01) to TDH 39 except at 8000 Hz (p 3%. Sennheiser HD 202 II supra-aural headphones can be used as an affordable headphone for screening audiometry provided reported MPANLs, maximum intensities and ETSPL values are employed.
Canale, Andrea; Dagna, Federico; Lacilla, Michelangelo; Piumetto, Elena; Albera, Roberto
To assess the reliability of Blackman windowed tone burst auditory brainstem response (ABR) as a predictor of hearing threshold at low frequencies. Fifty-six subjects were divided in to three groups (normal hearing, conductive hearing loss, sensorineural hearing loss) after pure tone audiometry (PTA) testing. Then they underwent tone burst ABR using Blackman windowed stimuli at 0.5 kHz and 1 kHz. Results were compared with PTA threshold. Mean threshold differences between PTA and ABR ranged between 11 dB at 0.5 kHz and 14 dB at 1 kHz. ABR threshold was worse than PTA in each but 2 cases. Mean discrepancy between the two thresholds was about 20 dB in normal hearing, reducing in presence of hearing loss, without any differences in conductive and sensorineural cases. Tone burst ABR is a good predictor of hearing threshold at low frequencies, in case of suspected hearing loss. Further studies are recommended to evaluate an ipsilateral masking such as notched noise to ensure greater frequency specificity.
Honeth, Louise; Bexelius, Christin; Eriksson, Mikael; Sandin, Sven; Litton, Jan-Eric; Rosenhall, Ulf; Nyrén, Olof; Bagger-Sjöbäck, Dan
To investigate the validity and reproducibility of a newly developed internet-based self-administered hearing test using clinical pure-tone air-conducted audiometry as gold standard. Cross-sectional intrasubject comparative study. Karolinska University Hospital, Solna, Sweden. Seventy-two participants (79% women) with mean age of 45 years (range, 19-71 yr). Twenty participants had impaired hearing according to the gold standard test. Hearing tests. The Pearson correlation coefficient between the results of the studied Internet-based hearing test and the gold standard test, the greatest mean differences in decibel between the 2 tests over tested frequencies, sensitivity and specificity to diagnose hearing loss defined by Heibel-Lidén, and test-retest reproducibility with the Pearson correlation coefficient. The Pearson correlation coefficient was 0.94 (p < 0.0001) for the right ear and 0.93 for the left (p = 0.0001). The greatest mean differences were seen for the frequencies 2 and 4 kHz, with -5.6 dB (standard deviation, 8.29), and -5.1 dB (standard deviation, 6.9), respectively. The 75th percentiles of intraindividual test-gold standard differences did not exceed -10 dB for any of the frequencies. The sensitivity for hearing loss was 75% (95% confidence interval, 51%-90%), and the specificity was 96% (95% confidence interval, 86%-99%). The test-retest reproducibility was excellent, with a Pearson correlation coefficient of 0.99 (p < 0.0001) for both ears. It is possible to assess hearing with reasonable accuracy using an Internet-based hearing test on a personal computer with headphones. The practical viability of self-administration in participants' homes needs further evaluation.
Abujamra, Ana Lucia; Escosteguy, Juliana Ribas; Dall'Igna, Celso; Manica, Denise; Cigana, Luciana Facchini; Coradini, Patrícia; Brunetto, André; Gregianin, Lauro José
Cisplatin may cause permanent cochlear damage by changing cochlear frequency selectivity and can lead to irreversible sensorineural hearing loss. High-frequency audiometry (HFA) is able to assess hearing frequencies above 8,000 Hz; hence, it has been considered a high-quality method to monitor and diagnose early and asymptomatic signs of ototoxicity in patients receiving cisplatin. Forty-two pediatric patients were evaluated for hearing loss induced by cisplatin utilizing HFA, and its diagnostic efficacy was compared to that of standard pure-tone audiometry and distortion-product otoacoustic emissions (DPOAEs). The patient population consisted of those who signed an informed consent form and had received cisplatin chemotherapy between 1991 and 2008 at the Hospital de Clínicas de Porto Alegre Pediatric Unit, Brazil. Forty-two patients were evaluated. The median age at study assessment was 14.5 years (range 4-37 years). Hearing loss was detected in 24 patients (57%) at conventional frequencies. Alterations of DPOAEs were found in 64% of evaluated patients and hearing loss was observed in 36 patients (86%) when high-frequency test was added. The mean cisplatin dose was significantly higher (P = 0.046) for patients with hearing impairment at conventional frequencies. The results suggest that HFA is more effective than pure-tone audiometry and DPOAEs in detecting hearing loss, particularly at higher frequencies. It may be a useful tool for testing new otoprotective agents, beside serving as an early diagnostic method for detecting hearing impairment. Copyright © 2012 Wiley Periodicals, Inc.
Corry, Megan; Sanders, Michael; Searchfield, Grant D
To undertake a preliminary evaluation of the test-retest reliability, and accuracy of an iPad audiometer app using commercial earphones as a low-cost alternative to a clinical audiometer in a restricted sample of normal hearing participants. Twenty participants self-reporting normal hearing undertook four pure-tone audiometry tests in a single session. Two tests were performed with a 2-channel Type 1 audiometer (GSI-61) using EAR insert earphones and two tests with an iPad based app (Audiogram Mobile) using Apple earbud headphones. Twenty normal hearing participants (13 female and seven male participants, aged 21-26 years) were recruited for the test-retest and accuracy evaluations. The app resulted in different thresholds to the audiometer (F(1, 19) = 16.635, p headphones need to be addressed before such combinations can be used with confidence.
Lu, Tsun-Min; Wu, Fang-Wei; Chang, Hsiuwen; Lin, Hung-Ching
To examine whether behavioral pure-tone audiometry (PTA) thresholds in children can be accurately estimated from the corresponding infants' click-evoked auditory brainstem response (ABR) thresholds through a retrospective review of data from a universal newborn hearing screening (UNHS) program in Taiwan. According to medical records from Mackay Memorial Hospital, Taipei Hospital District, 45,450 newborns received hearing screening during January 1999-December 2011. Among these newborns, 104 (82, both ears; 22, one ear; total, 186 ears) received regular follow-up and were recruited as subjects. The relationship between infant click-evoked ABR thresholds and the corresponding child PTA thresholds was determined through Pearson correlation coefficient and linear regression analyses. The correlation coefficient between click-evoked ABR thresholds and behavioral PTA thresholds at the average of frequencies of 1-4 and 2-4 kHz was 0.76 and 0.76, respectively. Linear regression analysis showed that behavioral audiometry thresholds at the average of frequencies of 1-4 and 2-4 kHz were accurately estimated from click-evoked ABR thresholds in 57% and 58% children, respectively. Click-evoked ABR testing is a reliable tool to cautiously estimate behavioral PTA thresholds at the average of frequencies of 1-4 and 2-4 kHz. For accurately performing hearing aid fitting and auditory rehabilitation in congenitally deaf infants, a combination of frequency-specific tone-burst ABR and click-evoked ABR should be used. Copyright © 2017 Elsevier B.V. All rights reserved.
An alternative strategy for universal infant hearing screening in tertiary hospitals with a high delivery rate, within a developing country, using transient evoked oto-acoustic emissions and brainstem evoked response audiometry.
Mathur, N N; Dhawan, R
To formulate an alternative strategy for universal infants hearing screening in an Indian tertiary referral hospital with a high delivery rate, which could be extended to similar situations in other developing countries. The system should be able to diagnose, in a timely fashion, all infants with severe and profound hearing losses. One thousand newborn were randomly selected. All underwent testing with transient evoked oto-acoustic emissions (TEOAE) in the first 48 hours of life. All TEOAE failures were followed up and repeat tests were performed at three weeks, three months and six months of age. Infants with acceptable TEOAE results at any of the four ages were discharged from the study. Infants with unacceptable TEOAE results at all the four ages underwent brainstem evoked response audiometry and oto-endoscopy. The 'pass rate' for TEOAE testing was calculated for all four ages. The time taken to perform TEOAE and brainstem evoked response audiometry was recorded for all subjects. These recordings were statistically analysed to find the most suitable strategy for universal hearing screening in our hospital. The pass rate for TEOAE was 79.0 per cent at audiometry. Obstructed and collapsed external auditory canals were the two factors that significantly affected the specificity of TEOAE in infants results are generated, such that a larger number must undergo brainstem evoked response audiometry, wasting time and resources. This can easily be avoided by delaying TEOAE screening until three months of age, when it has a substantially lower false positive outcome. We expect that implementation of this alternative strategy in our hospital will maximise the benefits of such a programme.
Riga, Maria; Korres, George; Balatsouras, Dimitrios; Korres, Stavros
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.
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
Airlangga, T. J.; Mangunatmadja, I.; Prihartono, J.; Zizlavsky, S.
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.
Nelissen, Rik C; Agterberg, Martijn J H; Hol, Myrthe K S; Snik, Ad F M
Bone conduction devices (BCDs) are advocated as an amplification option for patients with congenital conductive unilateral hearing loss (UHL), while other treatment options could also be considered. The current study compared a transcutaneous BCD (Sophono) with a percutaneous BCD (bone-anchored hearing aid, BAHA) in 12 children with congenital conductive UHL. Tolerability, audiometry, and sound localization abilities with both types of BCD were studied retrospectively. The mean follow-up was 3.6 years for the Sophono users (n = 6) and 4.7 years for the BAHA users (n = 6). In each group, two patients had stopped using their BCD. Tolerability was favorable for the Sophono. Aided thresholds with the Sophono were unsatisfactory, as they did not reach under a mean pure tone average of 30 dB HL. Sound localization generally improved with both the Sophono and the BAHA, although localization abilities did not reach the level of normal hearing children. These findings, together with previously reported outcomes, are important to take into account when counseling patients and their caretakers. The selection of a suitable amplification option should always be made deliberately and on individual basis for each patient in this diverse group of children with congenital conductive UHL.
Tainara Milbradt Weich
Full Text Available As drogas ilícitas são conhecidas pelos seus efeitos deletérios no sistema nervoso central; no entanto, elas também podem atingir o sistema auditivo, provocando alterações. OBJETIVOS: Analisar e comparar os resultados dos potenciais evocados auditivos de tronco encefálico (PEATE de frequentadores de grupos de apoio a ex-usuários de drogas. MÉTODO: Estudo transversal, não experimental, descritivo e quantitativo. A amostra foi composta por 17 indivíduos divididos conforme o tipo de droga mais consumida: 10 indivíduos no grupo maconha (G1 e sete no grupo crack/cocaína (G2. Eles foram subdivididos pelo tempo de uso de drogas: um a cinco anos, seis a 10 anos e mais que 15 anos. A avaliação foi feita por meio de anamnese, audiometria tonal liminar, medidas de imitância acústica e PEATE. RESULTADOS: Ao comparar os resultados de G1 e G2, independente do tempo de uso de drogas, não se observou diferença estatisticamente significante nas latências absolutas e nos intervalos interpicos. No entanto, apenas cinco dos 17 indivíduos tiveram PEATE com resultados adequados para a faixa etária. CONCLUSÃO: Independentemente do tempo de utilização das drogas, o uso de maconha e crack/cocaína pode provocar alterações difusas no tronco encefálico, comprometendo a transmissão do estímulo auditivo.Illicit drugs are known for their deleterious effects upon the central nervous system and more specifically for how they adversely affect hearing. OBJECTIVE: 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. METHODS: 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
Yu, Kwang Kyu; Choi, Chi Ho; An, Yong-Hwi; Kwak, Min Young; Gong, Soo Jung; Yoon, Sang Won
Background and Objectives To compare the effectiveness of monitoring cisplatin-induced ototoxicity in adult patients using extended high-frequency pure-tone audiometry (EHF-PTA) or distortion-product otoacoustic emission (DP-OAE) and to evaluate the concurrence of ototoxicity and nephrotoxicity in cisplatin-treated patients. Subjects and Methods EHF-PTA was measured at frequencies of 0.25, 0.5, 1, 2, 3, 4, 6, 8, 9, 11.2, 12.5, 14, 16, 18, and 20 kHz and DP-OAE at frequencies of 0.5, 0.75, 1, 1.5, 2, 3, 4, 6, and 8 kHz in cisplatin-treated patients (n=10). Baseline evaluations were made immediately before chemotherapy and additional tests were performed before each of six cycles of cisplatin treatment. Laboratory tests to monitor nephrotoxicity were included before every cycle of chemotherapy. Results Four of 10 patients showed threshold changes on EHF-PTA. Five of 10 patients showed reductions in DP-OAE, but one was a false-positive result. The results of EHF-PTA and DP-OAE were consistent in two patients. Only one patient displayed nephrotoxicity on laboratory tests after the third cycle. Conclusions In our study, the incidence rate of cisplatin-induced ototoxicity was 40% with EHF-PTA or DP-OAE. Although both EHF-PTA and DP-OAE showed the same sensitivity in detecting ototoxicity, they did not produce the same results in all patients. These two hearing tests could be used to complement one another. Clinicians should use both tests simultaneously in every cycle of chemotherapy to ensure the detection of ototoxicity. PMID:25279227
Martínez-Cruz, Carlos F; Poblano, Adrián; García-Alonso Themann, Patricia
Newborns from Neonatal intensive care units (NICU) are at high-risk for sensorineural hearing loss (SNHL) a follow-up is needed for early diagnosis and intervention. Our objective here was to describe the features and changes of SNHL at different periods during a follow-up of almost 20 years. Risk factors for SNHL during development were analyzed. The audiological examination included: Brainstem auditory evoked potentials (BAEP), and Transient evoked otoacoustic emissions (TEOAE). At birth; tonal audiometry (between 125 and 8000 Hz), and tympanometry were performed at 5, 10, 15, and 20 years of age. Sixty-five percent of cases presented bilateral absence of BAEP. At 5 years of age, the most frequent SNHL level was severe (42.5%), followed by moderate (22.5%), and profound level (20%), in all cases, the SNHL was symmetrical with a predominance of lesion for the high frequencies. Exchange transfusion was associated with a higher degree of SNHL (OR = 6.00, CI = 1.11-32.28, p < 0.02). In 55%, SNHL remained stable, but in 40% of the cases it was progressive. At the end of the study six cases with moderate loss progressed to the severe level and seven cases with severe level progressed to profound. Forty percent of infants with SNHL discharged from NICU may present a progression in the hearing loss. Exchange transfusion was associated with a higher degree of SNHL. NICU graduates with SNHL merit a long-term audiological follow-up throughout their lifespan. Copyright © 2017 Elsevier B.V. All rights reserved.
Eastwood, Mary P; Hoo, Koh H; Adams, David; Hill, Christopher
To determine uptake and outcome of hearing screening in the cleft palate population in Northern Ireland (NI) and the rate of ventilation tube (VT) insertion over a 3-year period. In NI, hearing screening is offered in the neonatal period, at 9 months in the community, and at 2.5 years in the joint cleft clinic. Patients : Eighty-five children with cleft palate born between 2006 and 2008 in NI were eligible for all three screenings. A retrospective case note review was performed of tympanograms, audiometry, and VT insertion rates at each of the three time points. Results : In the neonatal period, all patients eligible were screened; 66 (77.6%) patients passed the screening, with 19 patients (22.4%) failing, resulting in direct referral to ENT for consideration of VT. Results of the 9-month community screening were not made routinely available to the regional cleft service. At the 2.5-year clinic screening, all attending patients (n = 80) had documented screening. Fifty-two (65%) patients passed screening, with 28 patients (35%) failing screening. Forty-six patients (57.5%) had documented VT, and 9 (11.25%) were awaiting ENT review for consideration of VT. Ventilation tubes are not routinely inserted at the time of cleft repair in the NI population, and 57.5% of our cleft population has ventilation tubes inserted by 2.5 years. Cleft patients in NI have regular routine hearing assessments, and our current practice avoids universal ventilation tube insertion while identifying those who need further hearing management. Further research is needed to reach an international consensus on the insertion of VT in cleft patients.
Fabijańska, Anna; Smurzyński, Jacek; Hatzopoulos, Stavros; Kochanek, Krzysztof; Bartnik, Grażyna; Raj-Koziak, Danuta; Mazzoli, Manuela; Skarżynski, Piotr H.; Jędrzejczak, Wiesław W.; Szkiełkowska, Agata; Skarżyński, Henryk
Summary Background 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. Material/Methods 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. Results 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. Conclusions 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
Davies, R A
Hearing tests of the peripheral auditory system are well established and the pure-tone audiogram is generally regarded as the screening test of choice in adults. It allows the distinction to be made between conductive, i.e., outer- and middle-ear, and sensorineural, i.e., cochlear, hearing loss, and also to describe the configuration of the hearing thresholds in terms of severity and the frequency affected. Electrophysiologic testing with auditory potentials, e.g., the auditory brainstem response, can identify sites of lesion in the eighth nerve, brainstem, and more centrally. However, it is only in the last two decades that a battery of central auditory tests has been established that can probe the central pathways in more details, i.e., when the pure-tone audiogram may be normal, and yet the patient still has symptoms of hearing dysfunction. © 2016 Elsevier B.V. All rights reserved.
Daniela R. Sahyeb
Full Text Available Pesquisas recentes apontam a Audiometria Tonal de Alta Freqüência (AT-AF como um instrumento para o diagnóstico precoce de danos auditivos decorrentes de alguns agentes etiológicos principais, como envelhecimento e exposição a drogas ototóxicas e a intensidades elevadas de ruído. OBJETIVO: Apesar de já existirem várias técnicas desenvolvidas para essa avaliação, algumas não se aplicam à rotina clínica, em função da falta de praticidade e, por vezes, falta de consistência nos resultados. Segundo a literatura, ainda estão por emergir uma metodologia adequada a tal avaliação e valores indicados como referência à normalidade. Forma de Estudo: Clínico prospectivo. MATERIAL E MÉTODO: A presente pesquisa observou o comportamento dos limiares auditivos de alta freqüência em indivíduos jovens e audiologicamente normais e analisou variabilidades acústicas, inter e intra-indivíduos, que de acordo com a literatura, podem interferir na estabilidade dos resultados. CONCLUSÃO: Com os dados obtidos, pôde-se estabelecer valores de média, desvio padrão e mediana, além de valores mínimos e máximos para cada freqüência. Os testes estatísticos não identificaram diferenças significantes na maioria das análises realizadas (entre sexo, interaurais, variabilidades acústicas e intra-indivíduos, no mesmo dia de testes. A variabilidade dos resultados entre os exames de um mesmo indivíduo, realizados em dias deferentes de testes, mostrou ser significante, sendo as médias dos limiares no segundo dia sempre melhores que as do primeiro dia.Recent research studies pointed to High-Frequency Audiometry (HFA as a tool for early diagnosis of hearing impairment caused by the main etiological agents, such as aging, exposure to ototoxic drugs, and occupational noise. AIM: Although there are already several techniques developed for this assessment, some of them should not be applied to clinical routine, because of their lack of
Rita Leniza Oliveira da Rocha
Full Text Available O estudo das altas frequências vem demonstrando sua importância para detecção de danos na orelha interna. Em alguns casos, as frequências convencionais não são sensíveis a alterações da orelha interna em seu estágio inicial. OBJETIVO: Analisar os resultados dos limiares das altas frequências de indivíduos expostos ao ruído com audiometria convencional normal. MATERIAL E MÉTODO: Foi realizado um estudo de coorte transversal retrospectivo com 47 combatentes do Corpo de Bombeiros do Rio de Janeiro alocados no aeroporto Santos Dumont e 33 militares sem exposição ao ruído. Os grupos foram divididos em duas faixas etárias: 30-39 anos e 40-49 anos. Imediatamente após a audiometria tonal e vocal eram testadas as altas frequências. RESULTADOS: Os resultados mais significativos ocorreram na faixa de 40 a 49 anos, onde o grupo experimental apresentou limiar significativamente maior que o grupo controle 14000Hz (p = 0,008 e 16000Hz (p = 0,0001. CONCLUSÕES: Concluiu-se que o ruído interferiu nos limiares das altas frequências, onde todas as médias encontradas no grupo experimental foram maiores do que as do grupo controle. Sugeriu-se que esses dados reforçariam a importância da pesquisa das altas frequências, mesmo com a audiometria convencional normal, no diagnóstico precoce da perda auditiva induzida pela exposição ao ruído.The study of high frequencies has proven its importance for detecting inner ear damage. In some cases, conventional frequencies are not sensitive enough to pick up early changes to the inner ear. AIM: To analyze the results of threshold high frequency analysis of individuals exposed to noise with normal conventional audiometry. MATERIALS AND METHODS: This was a retrospective cross-sectional cohort study, in which we studied 47 firefighters of the Fire Department of Rio de Janeiro, based on Santos Dumont airport and 33 military men without noise exposure. They were broken down into two age groups: 30
Audiometria de altas frequências no diagnóstico complementar em audiologia: uma revisão da literatura nacional High-frequency audiometry in audiological complementary diagnosis: a revision of the national literature
Karlin Fabianne Klagenberg
Full Text Available A audiometria de altas frequências (AAF é um exame audiológico importante na detecção precoce de perdas auditivas por lesões na base do ducto coclear. Nos últimos anos, a sua utilização foi facilitada pelo fato de os audiômetros comercializados passarem a incorporar frequências superiores a 8 kHz. Porém, existem diferenças relacionadas aos equipamentos utilizados, às metodologias empregadas e/ou aos resultados e interpretação. Assim, o objetivo deste artigo foi analisar a produção científica nacional sobre a aplicação clínica com AAF, para compreender sua utilização atual. Foram pesquisados textos publicados e indexados nas bases de dados LILACS, SciELO e Medline, num período de tempo de dez anos, utilizando como descritor "audiometria de altas frequências/high-frequency audiometry". Encontraram-se 24 artigos científicos nacionais utilizando AAF, cuja população avaliada, em sua maioria, apresentava de 18 a 50 anos de idade; 13 dos estudos determinaram os limiares utilizando como referência decibel nível de audição (dBNA; alguns estudos realizaram a comparação dos limiares auditivos tonais entre grupos para definir a normalidade; os autores relataram diferenças significativas nos limiares auditivos de altas frequências entre as idades. A AAF é utilizada na clínica audiológica para identificação precoce de alterações auditivas e no acompanhamento da audição de sujeitos expostos a drogas ototóxicas e/ou agentes otoagressores.High-frequency audiometry (HFA is an important audiological test for early detection of hearing losses caused by leasions in the base of the cochlear duct. In recent years, its use was facilitated because audiometers began to identify frequencies higher than 8 kHz. However, there are differences related to the equipment used, the methodologies followed, and/or to the results and their interpretation. Therefore, the aim of this study was to analyze the national scientific production
Primus, Michael A.
Response and reinforcement features of operant discrimination paradigms used in audiometric assessment were investigated with normal 17-month-old children. Findings indicated more responses prior to onset of habituation when response tasks involved complex central processing skills and a twofold increase in number of subject responses when…
Hogan, Donald D.
Averaged auditory evoked responses were obtained from 15 retarded and motor-handicapped subjects and from 15 nonretarded subjects in order to investigate comparative responsiveness and response features. (Author)
Schmidt, Jesper Hvass; Brandt, Christian; Christensen-Dalsgaard, Jakob; Andersen, Ture; Bælum, Jesper; Poulsen, Torben
Background:With a newly developed technique, hearing thresholds can be estimated with a system operated by the test persons themselves. This technique is based on the 2 Alternative Forced Choice paradigm known from the psychoacoustic research theory. Test persons can operate the system very easily themselves. Furthermore the system uses the theories behind the methods of maximum-likelihood fitting of the most probable psychometric function and a modification of the well known up-down method...
Schmidt, Jesper Hvass; Brandt, Christian; Christensen-Dalsgaard, Jakob
Background: With a newly developed technique, hearing thresholds can be estimated with a system operated by the test persons themselves. This technique is based on the 2 Alternative Forced Choice paradigm known from the psychoacoustic research theory. Test persons can operate the system very ea...
Antonio Javier Cortés Aguilera
Full Text Available La Audiometría de tonos puros por conducción aérea es una exploración complementaria que la enfermería del trabajo ejecuta de manera habitual en la consulta de salud laboral para la vigilancia de la salud de los trabajadores. Todo ello, en función de los riesgos profesionales a los que esté expuesto el trabajador objeto de estudio y con una periodicidad relacionada con dicha circunstancia y las condiciones individuales del mismo. Sus resultados tienen como consecuencia la toma de decisiones y, por ello, el enfermero especialista debe manejar los conocimientos necesarios para que el resultado obtenido sea válido y reproducible. En el presente artículo se definen los criterios de aplicación, las características de la cabina y el audiómetro, los conocimientos mínimos que debe manejar el enfermero, los requisitos de la consulta y los previos a la exploración, la técnica de ensayo y la descripción de los métodos ascendente y por encuadre, el registro audiométrico y símbolos usados universalmente, y además se detallan los contenidos del mantenimiento y la calibración a los que se debe someter el equipo de exploración.The Pure-Tone Audiometry via air conduction is a complementary examination which the Occupational Health Nursing carries out frequently in the visit of Occupational Health in order to watch the workers´ health. All that is according to professional risks to which the worker, object of study, is exposed. Such examination is done as often as that circumstance occurs and depending on the worker´s individual conditions. The results have as consequence the decision-making and therefore the specialist nurse must have the necessary knowledge in order to obtain valid and reproducible results. It is proposed in the present article to present the application criteria, the characteristics of the audiometry cabin and the audiometer and the minimum knowledge the health nurse must have. Furthermore, the requirements to visit the
Gutiérrez Martinez, Josefina; Barraza López, Fernando; Guadarrama Lara, Alberto; Núñez Gaona, Marco Antonio; Delgado Esquerra, Ruth; Gutiérrez Farfán, Ileana
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.
Boboshko, M Yu; Zhilinskaia, E V; Warzybok, A; Maltseva, N V; Zokoll, M; Kollmeier, B
The matrix sentence test in which the five-word semantically unpredictable sentences presented under the background noise conditions are used as the speech material was designed and validated for many languages. The objective of the present study was to evaluate the Russian version of the matrix sentence test (RuMatrix test) in the listeners of different ages with normal hearing. At the first stage of the study, 35 listeners at the age from 18 to 33 year were examined. The results of the estimation of the training effect dictated the necessity of conducting two training tracks before carrying out the RuMatrix test proper. The signal-to-noise ratio at which 50% speech recognition (SRT50) was obtained was found to be -8.8±0.8 dB SNR. A significant effect of exposure to the background noise was demonstrated: the noise level of 80 and 75 Db SPL led to a considerably lower intelligibility than the noise levels in the range from 45 to 70 dB SPL; in the subsequent studies, the noise level of 65 dB SPL was used. The high test-retest reliability of the RuMatrix test was proved. At the second stage of the study, 20 young (20-40 year old) listeners and 20 aged (62-74 year old) ones were examined. The mean SRT50 in the aged patients was found to be -6.9±1.1 dB SNR which was much worse than the mean STR50 in the young subjects (-8.7±0.9 dB SNR). It is concluded that, bearing in mind the excellent comparability of the results of the RUMat rix test across different languages, it can be used as a universal tool in international research projects.
Billings, Curtis J; Penman, Tina M; Ellis, Emily M; Baltzell, Lucas S; McMillan, Garnett P
Understanding speech in background noise is difficult for many individuals; however, time constraints have limited its inclusion in the clinical audiology assessment battery. Phoneme scoring of words has been suggested as a method of reducing test time and variability. The purposes of this study were to establish a phoneme scoring rubric and use it in testing phoneme and word perception in noise in older individuals and individuals with hearing impairment. Words were presented to 3 participant groups at 80 dB in speech-shaped noise at 7 signal-to-noise ratios (-10 to 35 dB). Responses were scored for words and phonemes correct. It was not surprising to find that phoneme scores were up to about 30% better than word scores. Word scoring resulted in larger hearing loss effect sizes than phoneme scoring, whereas scoring method did not significantly modify age effect sizes. There were significant effects of hearing loss and some limited effects of age; age effect sizes of about 3 dB and hearing loss effect sizes of more than 10 dB were found. Hearing loss is the major factor affecting word and phoneme recognition with a subtle contribution of age. Phoneme scoring may provide several advantages over word scoring. A set of recommended phoneme scoring guidelines is provided.
Doggett, Sheryl; Gans, Donald P.; Stein, Ramona
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)
von Hapsburg, Deborah; Pena, Elizabeth D.
This tutorial reviews auditory research conducted with monolingual and bilingual speakers of Spanish and English. Based on a functional view of bilingualism and on auditory research findings showing that the bilingual experience may affect the outcome of auditory research, it discusses methods for improving descriptions of linguistically diverse…
J.F.C. van der Drift (Frank)
textabstractThe earlier hearing disorders are diagnosed in infants and children the sooner treatment and revalidation can be organised. Consequently. determining the hearing at the youngest age possible is important to promote the development of language and communication. Brainstern response
Primus, Michael A.; Thompson, Gary
An operant conditioning discrimination paradigm was evaluated of relationships between response behavior of young children and two stimulus components of the paradigm, the discriminative stimulus and the reinforcing stimulus. Findings revealed the effects of schedules of reinforcement, novel reinforcement, and age. (Author/CL)
Veispak, Anneli; Jansen, Sofie; Ghesquière, Pol; Wouters, Jan
Currently, there is no up-to-date speech perception test available in the Estonian language that may be used to diagnose hearing loss and quantify speech intelligibility. Therefore, based on the example of the Nederlandse Vereniging voor Audiologie (NVA)-lists ( Bosman, 1989 ; Wouters et al, 1994 ) an Estonian words in noise (EWIN) test has been developed. Two experimental steps were carried out: (1) selection and perceptual optimization of the monosyllables, and (2) construction of 14 lists and an evaluation in normal hearing (NH) subjects both in noise and in quiet. Thirty-six normal-hearing (NH) native speakers of Estonia (age range from 17 to 46 years). The reference psychometric curve for NH subjects was determined, with the slope and speech reception threshold being well in accordance with the respective values of the NVA lists. The 14 lists in noise yielded equivalent scores with high precision. The EWIN test is a reliable and valid speech intelligibility test, and is the first of its kind in the Estonian language.
Noise-induced hearing loss (NIHL) is a highly prevalent public health problem, caused by exposure to loud noises both during leisure time, e.g. by listening to loud music, and during work. In the past years NIHL was the most commonly reported occupational disease in the Netherlands. Hearing damage
Thompson, Gary; Folsom, Richard C.
Results indicated no significant differences between conditioning procedures in regard to obtained MRLs (minimum response levels) number of stimulus presentations required to establish MRL (discounting conditioning trials), and number of false-positive responses observed during control trial for 60 premature infants at one or two years of age.…
MacLurg, K; McCaughan, J; McQuillan, P
High frequency hearing loss is related to noise-induced deafness. We decided to develop a method of recording serial audiogram results that would provide an accessible overview of trends for an individual. Health & Safety Executive (HSE...
Rodríguez Valiente, A; García Berrocal, J R; Roldán Fidalgo, A; Trinidad, A; Ramírez Camacho, R
To determine common reference equivalent threshold sound pressure levels (RETSPL) for the earphones used in the extended high-frequency (EHF) range, as different earphones are commercially available, but there are not RETSPLs for each model. Hearing threshold sound pressure levels were measured up to 20 kHz for the Sennheiser HDA 200 audiometric earphone, and were compared to the ISO 389-5 (2006) norm and other investigations using that earphone and different ones. A total of 223 otologically-normal subjects (aged 5-25 years old) participated in the hearing determination. The results are in good agreement with previous studies of hearing thresholds using the same and other earphones. The results of the present investigation are relevant for the international standard for the calibration of audiometric equipment in the 8 to 16 kHz frequency range, ISO 389-5. The data may be used for a future update of the RETSPL for circumaural and insert audiometric earphones.
Farah I. Corona-Strauss
Full Text Available 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.
Nielzén, Sören; Holmberg, Jens; Sköld, Mia; Nehlstedt, Sara
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.
Smoorenburg, G. F.; Vanraaij, J. L.; Mimpen, A. M.
An automatic audiometer which runs fully automatically a customer tailored audiometric program using a microprocessor is described. It can be used as an independent unit, or it can be linked to an ITT 2020 microcomputer to control four audiomats simultaneously and asynchronously. The measurement procedure is based on the von Bekesy method optimized by research with test subjects and computer simulation. Two audiograms (left and right ears) based on 8 frequencies are measured within 8 min with an accuracy of 3dB. The audiomat is supplied with a transducer mounted in an earmuff, which makes it possible to measure thresholds in a not completely quiet environment.
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.
Audiometric monitoring is an important element in hearing conservation programs. Nearly every existing hearing conservation standard dictate that hearing thresholds should be measured at specific frequencies, and that 500 Hz be among those frequencies tested. Actual and estimated noise-induced permanent threshold shifts were evaluated as a function of exposure duration and exposure level. The results demonstrate 500 Hz to be of little value in assessing noise-induced hearing loss for typical industrial noise exposures of up to 40 years, at least for time-weighted average exposures of up to 100 dBA. Furthermore, few hearing conservation programs currently require audiometric monitoring to be performed in an environment that meets ANSI standards for maximum permissible background noise levels. This is particularly likely to compromise hearing testing at 500 Hz. As a result, this paper argues against the need for testing at 500 Hz, and recommends it be eliminated as a required test frequency in audiometric monitoring for noise-induced occupational hearing loss.
Tange, R. A.; Dreschler, W. A.; van der Hulst, R. J.
Early detection of ototoxicity is of vital importance in cases in which ototoxic drugs are administered. Ototoxicity as a result of cis-platinum administration is well documented. Auditory damage may be reduced by changes in dose, drugs or methods of treatment. As ototoxicity appears to be most
Müller, A; Hocke, T; Hoppe, U; Mir-Salim, P
Hearing loss is one of the most common disabilities in the elderly. The aim of this study was to investigate the relationship between pure-tone hearing loss and maximum monosyllabic perception and speech perception with hearing aids. The focus of the investigation was elderly patients. In this prospective study, 188 patients with sensorineural hearing loss were included. The pure-tone audiogram (4FPTA), the Freiburg speech intelligibility test with headphones and the word recognition score with hearing aids at 65 dB SPL were measured and evaluated. An increasing age was associated with higher discrepancy between the maximum speech perception and speech understanding with hearing aids. The mean difference between maximum monosyllabic perception and speech perception with hearing aids is about 20% in the elderly population. The intended goal of hearing aid prescription, the match between maximum monosyllabic perception and word recognition score with hearing aids within 5 to 10%, is not achieved in the elderly population.
Mateijsen, DJM; Van Hengel, PWJ; Van Huffelen, WM; Wit, HP; Albers, FWJ
The aim of this study was to reinvestigate many of the claims in the literature about hearing loss in patients with Meniere's disease, We carried this out on a well-defined group of patients under well-controlled circumstances. Thus, we were able to find support for sonic claims and none for many
Hey, M; Hocke, T; Ambrosch, P
As part of postoperative cochlear implant (CI) diagnostics, speech comprehension tests are performed to monitor audiological outcome. In recent years, a trend toward improved suprathreshold speech intelligibility in quiet and an extension of intelligibility to softer sounds has been observed. Parallel to audiometric data, analysis of the patients' acoustic environment can take place by means of data logging in modern CI systems. Which speech test levels reflect the individual listening environment in a relevant manner and how can these be reflected in a clinical audiometric setting? In a retrospective analysis, data logs of 263 adult CI patients were evaluated for sound level and the listening situation (quiet, speech in quiet, noise, speech in noise, music, and wind). Additionally, monosyllabic word comprehension in quiet was analyzed in experienced CI users at presentation levels of 40-80 dB. For the sound level in the acoustic environment of postlingually deafened adult CI users, data logging shows a maximum occurrence of speech signals in the range of 50-59 dB. This demonstrates the relevance of everyday speech comprehension at levels below 60 dB. Individual optimization of speech intelligibility with a CI speech processor should not be performed in the range of 65-70 dB only, but also at lower levels. Measurements at 50 dB currently seem to be a useful addition.
Hey, M; Hocke, T; Ambrosch, P
As part of postoperative cochlear implant (CI) diagnostics, speech comprehension tests are performed to monitor audiological outcome. In recent years, a trend toward improved suprathreshold speech intelligibility in quiet and an extension of intelligibility to softer sounds has been observed. Parallel to audiometric data, analysis of the patients' acoustic environment can take place by means of data logging in modern CI systems. Which test levels reflect the individual listening environment in a relevant manner and how can these be reflected in a clinical audiometric setting? In a retrospective analysis, data logs of 263 adult CI patients were evaluated for sound level and the listening situation (quiet, speech in quiet, noise, speech in noise, music, and wind). Additionally, monosyllabic word comprehension in quiet was analyzed in experienced CI users at presentation levels of 40-80 dB. For the sound level in the acoustic environment of postlingually deafened adult CI users, data logging shows a maximum occurrence of speech signals in the range 50-59 dB. This demonstrates the relevance of everyday speech comprehension at levels below 60 dB. Individual optimization of speech intelligibility with a CI speech processor should not be performed in the range of 65-70 dB only, but also at lower levels. Measurements at 50 dB currently seem to be a useful addition.
eardrum-ossicle component. It is desirable to plug the ear against extraneous ambient sound during BC testing, but it is not desirable at the same...time to affect the BC threshold. It is found that one of the new circumaural earmuffs does a superior job of insulating the ear from ambient sounds
Rodríguez Valiente, A; Trinidad, A; García Berrocal, J R; Górriz, C; Ramírez Camacho, R
The aim of the present study was to study patterns in the extended spectrum of the human hearing (0.125 to 20 kHz) in order to obtain reference thresholds. Then, we compare our values with existing results at extended high-frequencies (8 to 20 kHz) in an attempt to establish new standards for potential international adoption. A prospective study in a group of otologically healthy subjects. A total of 645 subjects aged between 5 and 90 years were recruited. Pure-tone thresholds were determined for conventional and extended high-frequencies. There was an increase in the hearing thresholds as a function of frequency and age. For the 20 to 69 years old group, thresholds were lower in females than in males, especially at 12.5 and 16 kHz. Our threshold values are comparable to those presented in previous studies that used different instrumentation and populations. When comparing different studies the hearing thresholds were found to be similar. Therefore, it would be possible to establish international standard thresholds.
Ruser, A.; Daehne, M.; Sundermeyer, J.; Lucke, K.; Houser, D.S.; Finneran, J.J.; Driver, J.; Pawliczka, I.; Rosenberger, T.; Siebert, U.
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
Full Text Available 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.
Kawase, Setsuko; Naganawa, Shinji; Ishigaki, Takeo [Nagoya University Graduate School of Medicine, Department of Radiology, Nagoya (Japan); Sone, Michihiko [Nagoya University Graduate School of Medicine, Department of Otorhinolaryngology, Nagoya (Japan); Ikeda, Mitsuru [Nagoya University School of Health Sciences, Department of Radiological Technology, Nagoya (Japan)
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. (orig.)
Dobie, Robert A; Wojcik, Nancy C
The US Occupational Safety and Health Administration (OSHA) Noise Standard provides the option for employers to apply age corrections to employee audiograms to consider the contribution of ageing when determining whether a standard threshold shift has occurred. Current OSHA age-correction tables are based on 40-year-old data, with small samples and an upper age limit of 60 years. By comparison, recent data (1999-2006) show that hearing thresholds in the US population have improved. Because hearing thresholds have improved, and because older people are increasingly represented in noisy occupations, the OSHA tables no longer represent the current US workforce. This paper presents 2 options for updating the age-correction tables and extending values to age 75 years using recent population-based hearing survey data from the US National Health and Nutrition Examination Survey (NHANES). Both options provide scientifically derived age-correction values that can be easily adopted by OSHA to expand their regulatory guidance to include older workers. Regression analysis was used to derive new age-correction values using audiometric data from the 1999-2006 US NHANES. Using the NHANES median, better-ear thresholds fit to simple polynomial equations, new age-correction values were generated for both men and women for ages 20-75 years. The new age-correction values are presented as 2 options. The preferred option is to replace the current OSHA tables with the values derived from the NHANES median better-ear thresholds for ages 20-75 years. The alternative option is to retain the current OSHA age-correction values up to age 60 years and use the NHANES-based values for ages 61-75 years. Recent NHANES data offer a simple solution to the need for updated, population-based, age-correction tables for OSHA. The options presented here provide scientifically valid and relevant age-correction values which can be easily adopted by OSHA to expand their regulatory guidance to include older workers. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
van der Hulst, R. J.; Boeschoten, E. W.; Nielsen, F. W.; Struijk, D. G.; Dreschler, W. D.; Tange, R. A.
Ototoxicity affects the higher frequencies first and extends to the lower frequencies during continuation of the ototoxic treatment. Peritonitis due to continuous ambulatory peritoneal dialysis (CAPD) regularly demands ototoxic antibiotic treatment, e.g. with gentamicin and vancomycin. In this study
Ruser, Andreas; Dähne, Michael; Sundermeyer, Janne; Lucke, Klaus; Houser, Dorian S; Finneran, James J; Driver, Jörg; Pawliczka, Iwona; Rosenberger, Tanja; Siebert, Ursula
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.
Reijden, C.S. van der; Mens, L.H.M.; Snik, A.F.M.
Tone-evoked Auditory Brainstem Responses (tone-burst ABRs) and Auditory Steady-State Responses (ASSRs) with 40 or 90 Hz amplitude modulation (AM) were compared, using the same equipment and recording parameters, to determine which of these three methods most accurately approached the behavioural
Full Text Available HEALTH SOUTHERN AFRICA WWW.OCCHEALTH.CO.ZA MAY/JUNE 2010 7 Table 2. Comparison of signal-to-noise ratio between emission levels and noise fl oor at the two testing venues f2 Frequency 633 Hz 797 Hz 996 Hz 1266 Hz 1605 Hz 2027 Hz 2555 Hz 3234 Hz... 4055 Hz 5133 Hz 6434 Hz Clinic 8.9 11.3 13.3 14.6 15.6 14.6 12.6 13.7 19.9 15.2 7.9 Mine 10.0 12.8 13.4 15.9 15.2 14.9 12.5 14.2 20.3 17.1 6.4 S/N ratio is expressed as decibel sound pressure level (dBSPL) Table 3. Correlations between screening...
Mar Lasso de la Vega; Ithzel Maria Villarreal; Julio Lopez-Moya; Jose Ramon Garcia-Berrocal
Objective. The aim of this study is to analyze the high-frequency hearing levels in patients with rheumatoid arthritis and to determine the relationship between hearing loss, disease duration, and immunological parameters. Materials and Methods. A descriptive cross-sectional study including fifty-three patients with rheumatoid arthritis was performed. The control group consisted of 71 age- and sex-matched patients from the study population (consecutively recruited in Madrid “Area 9,” from Jan...
Edmir Américo Lourenço
Full Text Available A audiometria de respostas evocadas (ABR é um registro não-invasivo de potenciais elétricos auditivos nos primeiros 12 milissegundos, da orelha média ao córtex auditivo. ABR é importante na avaliação otoneurológica. OBJETIVO: Esclarecer as utilidades do exame, faixas etárias e sexo com maior incidência e topodiagnóstico segundo as latências absolutas e os intervalos interpicos. CASUÍSTICA E MÉTODO: Neste estudo retrospectivo foram analisados 403 prontuários de ABR realizados em clínica particular na cidade de Jundiaí/SP, Brasil, suspeitos de alteração auditiva e/ou doença do SNC, com os pacientes divididos por sexo e faixa etária. RESULTADOS E CONCLUSÕES: ABR é um importante exame para determinar a integridade da via auditiva, limiares eletrofisiológicos e topodiagnóstico, embora o teste não indique a etiologia das alterações. Foi demonstrado que ocorreu maior incidência de achados retrococleares na faixa etária de 12-20 anos e sexo masculino, contudo crianças menores de um ano com fatores de risco não apresentaram um aumento na incidência de alterações condutivas, cocleares e retrococleares em relação à população geral estudada. As latências absolutas das ondas I, III e V foram maiores no sexo masculino e as alterações dos intervalos interpicos foram similares em ambos os sexos, sendo que o intervalo I-III foi o mais freqüentemente alterado.Auditory evoked brainstem responses (ABR is a non-invasive electrical potential registration which evaluates the auditory tract from the middle ear to the auditory cortex in the first 12 milliseconds (ms. The ABR is an important otoneurological evaluation. AIM: confirm the test's usefulness, major incidence and topography according to are range gender considering the absolute latencies of the waves and interpeak intervals. MATERIALS AND METHOD: we retrospectively analyzed 403 tests from a private clinic in the city of Jundiaí-São Paulo State-Brazil, from patients suspected of auditory damage or central nervous disorder, and the patients were broken down according to gender and age. RESULTS AND CONCLUSIONS: ABR is an important test to determinate the soundness of the auditory tract, the electrophysiological thresholds and topodiagnosis. We found no differences between type of loss and gender; there was a major incidence of retrocochlear findings among male patients between 12-20 years old; children under one year with risk factors did not present higher incidences of auditory findings when compared with all the population analyzed. The absolute latencies of waves I, III and V were higher in males, but the interpeak intervals were similar in both genders, showing that interval I-III was more frequently altered.
Full Text Available Background and Aim: Among all auditory assessment tools, auditory steady state response (ASSR is a modern test. Modulation frequency for this test is usually 80 Hz. The purpose of this study, was to examined adult subjects with 40 Hz and 80 Hz ASSR and compare the results.Materials and Methods: Thirty adult (60 ears were evaluated by ASSR and PTA test, Results were divided into three groups: normal hearing, mild and moderate sensorineural hearing loss. Results: In all groups, forty hertz ASSR thresholds were relatively closer to behavioral threshold than those of 80 Hz ASSR(p<0.05. Besides, the more severe hearing loss, the lower the difference between those two thresholds. Correlation coefficients were also higher in 40 Hz ASSR(p<0.05. Conclusion: Frequency modulation thresholds with 40 Hz are more likely to be closer to the behavioral thresholds. Moreover, it has better results than the thresholds with 80 Hz.
Kastelein, R.A.; Wensveen, P.J.; Terhune, J.M.; Jong, C.A.F. de
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
analysis. Source: Defense Medical Surveillance System (DMSS). Prepared by Armed Forces Health Surveillance Center (AFHSC). RESULTS : Results are shown...Used in the Data Summaries AUDIO CPT codes 92552 PURE TONE AUDIOMETRY (THRESHOLD); AIR ONLY AUDIO CPT codes 92555 SPEECH AUDIOMETRY THRESHOLD; AUDIO CPT...codes 92556 SPEECH AUDIOMETRY THRESHOLD; WITH SPEECH RECOGNITION AUDIO CPT codes 92557 COMPREHENSIVE AUDIOMETRY THRESHOLD EVALUATION AND SPEECH
by Armed Forces Health Surveillance Center (AFHSC). RESULTS : Results are shown in Appendix C. SUMMARY AND CONCLUSIONS: AFHSC and the Army Institute of...TINNITUS CPT Codes Used in the Data Summaries AUDIO CPT codes 92552 PURE TONE AUDIOMETRY (THRESHOLD); AIR ONLY AUDIO CPT codes 92555 SPEECH... AUDIOMETRY THRESHOLD; AUDIO CPT codes 92556 SPEECH AUDIOMETRY THRESHOLD; WITH SPEECH RECOGNITION AUDIO CPT codes 92557 COMPREHENSIVE AUDIOMETRY THRESHOLD
Rita Leniza Oliveira da Rocha; Ciríaco Cristóvão Tavares Atherino; Silvana Maria Monte Coelho Frota
O estudo das altas frequências vem demonstrando sua importância para detecção de danos na orelha interna. Em alguns casos, as frequências convencionais não são sensíveis a alterações da orelha interna em seu estágio inicial. OBJETIVO: Analisar os resultados dos limiares das altas frequências de indivíduos expostos ao ruído com audiometria convencional normal. MATERIAL E MÉTODO: Foi realizado um estudo de coorte transversal retrospectivo com 47 combatentes do Corpo de Bombeiros do Rio de Janei...
Defense Medical Surveillance System (DMSS) Aggregated data prepared by Armed Forces Health Surveillance Center (AFHSC) RESULTS : Results are shown in...TINN Tinnitus 38832 OBJECTIVE TINNITUS CPT Codes Used in the Data Summaries AUDIO CPT codes 92552 PURE TONE AUDIOMETRY (THRESHOLD); AIR ONLY AUDIO CPT...codes 92555 SPEECH AUDIOMETRY THRESHOLD; AUDIO CPT codes 92556 SPEECH AUDIOMETRY THRESHOLD; WITH SPEECH RECOGNITION AUDIO CPT codes 92557 COMPREHENSIVE
Argollo, Nayara; Lessa, Ines; Ribeiro, Suely; Abreu, Katiusha C; Pinto, Juliana M S; Faria, Raquel P; Telles, Tatiana G; Santos, Gabriel B
... (hyponatremia, anemia, infection, retinopathy, broncopulmonary dysplasia, hypoalbuminemia, persistence of the arterial canal, altered audiometry, early respiratory distress, birth weigh below 2,500 g...
Square, Regina; And Others
A bone conduction hearing screening test using frontal bone oscillator placement was compared with pure-tone air-conduction screening and impedance audiometry with 114 preschoolers. Unoccluded frontal bone conduction testing produced screening results not significantly different from results obtained by impedance audiometry. (CL)!
procedures and tests as were performed during session 1 and served as post-experimental audiometry , tympanometry, and SFOAE evaluations. Audiometry results ...Distribution Unlimited. Exposure to hazardous noise results in increased reactive oxygen species (ROS) activity within the cochlea that causes damage to...the outer hair cells, the result is noise-induced, sensorineural hearing loss. Evoked otoacoustic emissions (EOAEs) are an electrophysiological
Derin, S; Cam, O H; Beydilli, H; Acar, E; Elicora, S S; Sahan, M
This study aimed to compare an Apple iOS mobile operating system application for audiological evaluation with conventional audiometry, and to determine its accuracy and reliability in the initial evaluation of hearing loss. The study comprised 32 patients (16 females) diagnosed with hearing loss. The patients were first evaluated with conventional audiometry and the degree of hearing loss was recorded. Then they underwent a smartphone-based hearing test and the data were compared using Cohen's kappa analysis. Patients' mean age was 53.59 ± 18.01 years (range, 19-85 years). The mobile phone audiometry results for 39 of the 64 ears were fully compatible with the conventional audiometry results. There was a statistically significant concordant relationship between the two sets of audiometry results (p < 0.05). Ear Trumpet version 1.0.2 is a compact and simple mobile application on the Apple iPhone 5 that can measure hearing loss with reliable results.
Margolis, Robert H.; Wilson, Richard H.; Popelka, Gerald R.; Eikelboom, Robert H.; Swanepoel, De Wet; Saly, George L.
Objective This study examined the statistical properties of normal air-conduction thresholds obtained with automated and manual audiometry to test the hypothesis that thresholds are normally distributed and to examine the distributions for evidence of bias in manual testing. Design Four databases were mined for normal thresholds. One contained audiograms obtained with an automated method. The other three were obtained with manual audiometry. Frequency distributions were examined for four test frequencies (250, 500, 1000, and 2000 Hz). Study Sample The analysis is based on 317,569 threshold determinations of 80,547 subjects from four clinical databases. Results Frequency distributions of thresholds obtained with automated audiometry are normal in form. Corrected for age, the mean thresholds are within 1.5 dB of Reference Equivalent Threshold Sound Pressure Levels. Frequency distributions of thresholds obtained by manual audiometry are shifted toward higher thresholds. Two of the three datasets obtained by manual audiometry are positively skewed. Conclusions The positive shift and skew of the manual audiometry data may result from tester bias. The striking scarcity of thresholds below 0 dB HL suggests that audiologists place less importance on identifying low thresholds than they do for higher-level thresholds. We refer to this as the Good Enough Bias and suggest that it may be responsible for differences in distributions of thresholds obtained by automated and manual audiometry. PMID:25938502
: NIHL continues to affect shipbuilders, owing their non.compliance to workplace regulation. Health education is the need of the hour. Keywords: Asia, Audiometry, Earplugs, Hearing loss, Noise, Occupational health, Smoking, Welding ...
Lüders, Débora; Gonçalves, Cláudia Giglio de Oliveira; Lacerda, Adriana Bender de Moreira; Ribas, Ângela; Conto, Juliana de
.... 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...
... auditory potentials; Brainstem auditory evoked potentials; Evoked response audiometry; Auditory brainstem response; ABR; BAEP ... Normal results vary. Results will depend on the person and the instruments used to perform the test.
Keywords: Acute otitis media, hearing loss, tympanometry, Pure-tone Audiometry. INTRODUCTION. Middle ear infection is eminently amenable to treatment, and early effective management will prevent progression to Chronic Suppurative. Otitis Media and subsequent Cholesteatoma and Sensorineural hearing loss.
McWalter, Richard Ian; Dau, Torsten
Many challenges exist when it comes to understanding and compensating for hearing impairment. Traditional methods, such as pure tone audiometry and speech intelligibility tests, offer insight into the deficiencies of a hearingimpaired listener, but can only partially reveal the mechanisms...
monitoring audiometry portion is a key part of this program. Each noise-exposed 3 ili. .; Air Forcq member is given an annual audiogram, and the results ... audiometry reports, on AF Forms 1490 (Hearing Conservation Data) to a central Repository. In 1973, a revised regulation (3) (52-pages) was issued and...AF Forms 1490 are used to record all followup audiometric results and have the reference audiogram transcribed onto them so that threshold shift at
Botasso, Maine; Sanches, Seisse Gabriela Gandolfi; Bento, Ricardo Ferreira; Samelli, Alessandra Giannella
OBJECTIVE: To compare the efficacy and feasibility of teleaudiometry with that of sweep audiometry in elementary school children, using pure-tone audiometry as the gold standard. METHODS: A total of 243 students with a mean age of 8.3 years participated in the study. Of these, 118 were boys, and 125 were girls. The following procedures were performed: teleaudiometry screening with software that evaluates hearing at frequencies of 1,000, 2000 and 4000 Hz at 25 dBHL; sweep audiometry screening in an acoustic booth (20 dBHL at the same frequencies); pure-tone audiometry thresholds in an acoustic booth (frequencies of 500, 1000, 2000 and 4000 Hz); and acoustic immittance measurements. RESULTS: The diagnostic capacities of the teleaudiometry/sweep audiometry screening methods were as follows: sensitivity ϝ 58%/65%; specificity ϝ 86%/99%; positive predictive value ϝ 51%/91%; negative predictive value ϝ 89%/92%; and accuracy ϝ 81%/92%. Teleaudiometry and sweep audiometry showed moderate agreement. Furthermore, the use of these methods in series with immittance testing improved the specificity, whereas parallel testing improved the sensitivity. CONCLUSION: Teleaudiometry was found to be reliable and feasible for screening hearing in school children. Moreover, teleaudiometry is the preferred method for remote areas where specialized personnel and specific equipment are not available, and its use may reduce the costs of hearing screening programs. PMID:26017796
Matas, Carla Gentile; Angrisani, Rosanna Giaffredo; Magliaro, Fernanda Cristina Leite; Segurado, Aluisio Augusto Cotrim
OBJECTIVE: To characterize the findings of behavioral hearing assessment in HIV-positive individuals who received and did not receive antiretroviral treatment. METHODS: This research was a cross-sectional study. The participants were 45 HIV-positive individuals (18 not exposed and 27 exposed to antiretroviral treatment) and 30 control-group individuals. All subjects completed an audiological evaluation through pure-tone audiometry, speech audiometry, and high-frequency audiometry. RESULTS: The hearing thresholds obtained by pure-tone audiometry were different between groups. The group that had received antiretroviral treatment had higher thresholds for the frequencies ranging from 250 to 3000 Hz compared with the control group and the group not exposed to treatment. In the range of frequencies from 4000 through 8000 Hz, the HIV-positive groups presented with higher thresholds than did the control group. The hearing thresholds determined by high-frequency audiometry were different between groups, with higher thresholds in the HIV-positive groups. CONCLUSION: HIV-positive individuals presented poorer results in pure-tone and high-frequency audiometry, suggesting impairment of the peripheral auditory pathway. Individuals who received antiretroviral treatment presented poorer results on both tests compared with individuals not exposed to antiretroviral treatment. PMID:25029578
Wiatr, Maciej; Gawlik, Renata; Boroń, Aleksandra; Wiatr, Agnieszka; Składzień, Jacek
Otosclerosis is the most common cause of condactive hearing loss between 15 and 50 years old. The most common symptoms are hearinglosss and tinnitus. Surgery is currently the preferred treatment method. The aim of our study was to analyze the outcomes of patients treated surgically due to otosclerosis in terms of the observed changes in pure tone audiometry and speech audiometry Material and methods: We observated 300 patients operated on middle ear for the fist time in the Department of Otolarygology at the Jagiellonian University of Cracow from 2010 to 2011. We used a special questinnaire which includes diagnostics of the ear"s disease,pure tone audiometry, speech audiometrii and longterm effects. We discuss 53 operated ears and analyze changes in pure tone audiometry. We divided patients into 2 groups depending on 100% speech understanding in speech auodiometry or not. 1. Lack of 100% speech understanding in speech audiometry correlated with greater sensorineural hearing loss than in patients who achieved 100% speech understanding prior to surgery. 2. Lack of 100% speech understanding in speech audiometry is a predictive factor for worse prognosis in improving hearing in patients operated on for otosclerosis. 3. Reconstruction of the ossicular chain in patients, regardless of the degree of speech understanding, did not produce significant changes in the average values of bone conduction.
Bükülmez, Ayşegül; Dalgiç, Buket; Gündüz, Bülent; Sari, Sinan; Bayazit, Yildirim Ahmet; Kemaloğlu, Yusuf Kemal
Celiac disease (CD) is an autoimmune enteropathy. The disease may be presented with extraintestinal manifestations including neurological findings. Epilepsy and ataxia are well known neurological disorders in CD. But there are very limited numbers of reports on sensory-neural hearing loss in CD in the literature. The aim of this study was to investigate the hearing functions in children with newly diagnosed CD. Ninety-seven (194 ears) [56 girls, 41 boys (age range: 1.5-17 years)] newly diagnosed celiac disease patients and 85 sex and age-matched controls (170 ears) were included in this study. Hearing function was assessed by pure-tone audiometry, speech audiometry, tympanometry and otoacoustic emissions measurements. No significant difference were found between the patients and control groups measurements including the pure-tone audiometry, speech audiometry, tympanometry and otoacoustic emissions No significant difference was found for pure-tone audiometry, speech audiometry, tympanometry and otoacoustic emissions measurements in celiac patients according to the Marsh-Oberhuber classification (P>0.05). Our results showed that hearing functions of children with newly diagnosed CD were similar to healthy controls. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
Full Text Available INTRODUCTION: Research has shown that hearing loss in musicians may cause difficulty in timbre recognition and tuning of instruments. AIM: 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. METHODS: 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. RESULTS: 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. CONCLUSION: The periodic evaluation of high-frequency thresholds may be useful in the early detection of hearing loss in musicians.
Plaza, Guillermo; Durio, Enrique; Herráiz, Carlos; Rivera, Teresa; García-Berrocal, José Ramón
Idiopathic sudden sensorineural hearing loss is an unexplained unilateral hearing loss with onset over a period of less than 72 hours, without other known otological diseases. We present a consensus on the diagnosis, treatment and follow-up of this disease, designed by AMORL, after a systematic review of the literature from 1966 to June 2010. Diagnosis of sudden sensorineural hearing loss is based on mandatory otoscopy, acoumetry, tonal audiometry, speech audiometry, and tympanometry. After clinical diagnosis is settled, and before treatment is started, a full analysis should be done and an MRI should be requested later. Treatment is based on systemic corticosteroids (orally in most cases), helped by intratympanic doses as rescue after treatment failures. Follow-up should be done at day 7, with tonal and speech audiometries, and regularly at 15, 30, and 90 days after start of therapy, and after 12 months. By consensus, results after treatment should be reported as absolute dBs recovered in pure tonal audiometry, as improvement in the recovery rate in unilateral cases, and as improvement in speech audiometry. Copyright © 2010 Elsevier España, S.L. All rights reserved.
Lüders, Débora; Gonçalves, Cláudia Giglio de Oliveira; Lacerda, Adriana Bender de Moreira; Ribas, Ângela; Conto, Juliana de
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.
Lucia Bencke Geyer
Full Text Available ABSTRACT INTRODUCTION: The treatment of patients with cystic fibrosis involves the use of ototoxic drugs, mainly aminoglycoside antibiotics. Due to the use of these drugs, fibrocystic patients are at risk of developing hearing loss. OBJECTIVE: To evaluate the hearing of patients with cystic fibrosis by High Frequency Audiometry and Distortion Product Otoacoustic Emissions. METHODS: Cross-sectional study. The study group consisted of 39 patients (7-20 years of age with cystic fibrosis and a control group of 36 individuals in the same age group without otologic complaints, with normal audiometric thresholds and type A tympanometric curves. High Frequency Audiometry and Distortion Product Otoacoustic Emissions tests were conducted. RESULTS: The study group had significantly higher thresholds at 250, 1000, 8000, 9000, 10,000, 12,500, and 16,000 Hz (p = 0.004 as well as higher prevalence of otoacoustic emission alterations at 1000 and 6000 Hz (p = 0.001, with significantly lower amplitudes at 1000, 1400, and 6000 Hz. There was a significant association between alterations in hearing thresholds in High Frequency Audiometry with the number of courses of aminoglycosides administered (p = 0.005. Eighty-three percent of patients who completed more than ten courses of aminoglycosides had hearing loss in High Frequency Audiometry. CONCLUSION: A significant number of patients with cystic fibrosis who received repeated courses of aminoglycosides showed alterations in High Frequency Audiometry and Distortion Product Otoacoustic Emissions. The implementation of ten or more aminoglycoside cycles was associated with alterations in High Frequency Audiometry.
Geyer, Lucia Bencke; Menna Barreto, Sergio Saldanha; Weigert, Liese Loureiro; Teixeira, Adriane Ribeiro
The treatment of patients with cystic fibrosis involves the use of ototoxic drugs, mainly aminoglycoside antibiotics. Due to the use of these drugs, fibrocystic patients are at risk of developing hearing loss. To evaluate the hearing of patients with cystic fibrosis by High Frequency Audiometry and Distortion Product Otoacoustic Emissions. Cross-sectional study. The study group consisted of 39 patients (7-20 years of age) with cystic fibrosis and a control group of 36 individuals in the same age group without otologic complaints, with normal audiometric thresholds and type A tympanometric curves. High Frequency Audiometry and Distortion Product Otoacoustic Emissions tests were conducted. The study group had significantly higher thresholds at 250, 1000, 8000, 9000, 10,000, 12,500, and 16,000Hz (p=0.004) as well as higher prevalence of otoacoustic emission alterations at 1000 and 6000Hz (p=0.001), with significantly lower amplitudes at 1000, 1400, and 6000Hz. There was a significant association between alterations in hearing thresholds in High Frequency Audiometry with the number of courses of aminoglycosides administered (p=0.005). Eighty-three percent of patients who completed more than ten courses of aminoglycosides had hearing loss in High Frequency Audiometry. A significant number of patients with cystic fibrosis who received repeated courses of aminoglycosides showed alterations in High Frequency Audiometry and Distortion Product Otoacoustic Emissions. The implementation of ten or more aminoglycoside cycles was associated with alterations in High Frequency Audiometry. Copyright © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.
Full Text Available Objective : To assess neonates and children suffering from meningitis , during the critical and recovery periods , using ABR , EOAE and Behavioral Audiometry. Method and Material: 40 neonates to 12-year-old children were assessed. Using ABR test, the hearing of these cases was evaluated during the critical period-that is , 24-72 hours following the diagnosis. This test was repeated when patients recovered from meningitis-that is 24 hours before discharge (recovery period Hearing function , again , was assessed 7-14 days following discharge through Immittance Audiometry, Behavioral Audiometry (PTA , SF and BOA. And EOAE (TEOAE and DPOAE tests procedures. Findings: During the critical period , ABR test revealed normal hearing in 35 patients (87.5% and severe to profound sensorineural hearing loss (unilateral and bilateral in 5 patients (12.5%-girl=4, boy=1. The same result were obtained in re-evaluation in the recovery period. On the other hand , 7-14 days after of discharge , Immittance Audiometry and Behavioral Audiometry (including PTA , S.F and BOA tests, confirmed the mentioned results (cross - gcheck. EOAE test (DPOAE and TEOAE in 35 normal hearing patients (according to ABR test , showed normal cochlear function. 2 out of 5 cases suffering from severe to profound sensorineural hearing loss revealed normal cochlear function. According to EOAE results , abnormal cochlear function was evident in 3 patients. Conclusion: ABR , EOAE tests , and Behavioral Audiometry in children meningitis during the critical period and recovery period can be used to diagnose any degree of hearing loss with a high level accuracy. The results of persent study is confirmed by previous investigations.
Colding, H; Andersen, E A; Prytz, S
Audiometry was performed at four years of age in 69 of 105 surviving children who had received continuous intravenous infusion of gentamicin during neonatal intensive care. A hearing loss of 20 dB was found in 2 of them (3%), corresponding to that shown in other studies of survivors following...... neonatal intensive care. Free field audiometry performed in another 7 children and questionnaires returned from 13 of the remaining 29 gave no suspicion of hearing loss. Thus there is no indication that continuous 24 hours intravenous infusion of gentamicin causes more hearing impairment than intermittent...
Full Text Available Radiography (conventional and contrasted - canalography and audioelectrophysiologic (impedance audiometry tests were correlated with otitis media in 12 middle ear affected and 12 healthy dogs. When comparing both diagnostic methods, it was found that the reliability in the detection of otitis media in dogs was 100% for the first and 58.3-60.0% for the latter. Thus, it was possible to attest that the impedance audiometry was the most accurate method in the identification of otitis media in dogs when compared with radiographic assessments.
Worsøe, Lise Lotte; Caye-Thomasen, P.; Brandt, C.T.
-tone hearing threshold levels were compared with normative data. Results. Of 240 patients examined by use of audiometry, 129 (54%) had a hearing deficit, and 50 (39%) of these 129 patients were not suspected of hearing loss at discharge from hospital. Of the 240 patients, 16 (7%) had profound unilateral...... is common after pneumococcal meningitis, and audiometry should be performed on all those who survive pneumococcal meningitis. Important risk factors for hearing loss are advanced age, female sex, severity of meningitis, and bacterial serotype...
Full Text Available Objective: determining difference limen for Frequency (DLFin string musicians. Materials &Methods: This case-control study was conducted on 15 string musicians with musicianship > 10 years (30 ears and 15 normal hearing subjects (30 ears. They all were male and 20-30 years old. DLF was measured after otoscopy and immitance audiometry and pure tone audiometry. Results: DLF was significantly different between two groups of case and control. DLF in musicians is less than the normal hearing subjects. Conclusion: It seems that familiarization with notes results in better DLF in musicians comparing to others.
Weibel, H P; Kiessling, J
Speech audiometry investigations were carried out in silence and under action of cocktail party noise in 44 soldiers. The testing subjects were grouped according to age and degree of noise lesion. The statistical evaluation of discrimination losses measured in silence and under acting party noise indicated that noise lesions induced considerable discrimination losses even in young subjects particularly under cocktail party noise conditions. Discrimination decreases significantly as the degree of noise trauma increases. In order to assess the real effect of the hearing loss caused by noise trauma upon speech discrimination, the tests of speech audiometry should be performed under noise conditions.
Parodi, M; Rouillon, I; Rebours, C; Denoyelle, F; Loundon, N
Psychogenic hearing loss, formerly known as functional or non-organic hearing loss, is a classic cause of consultation in infantile audiology. Risk factors include female gender, and age 8 or 12 years. Onset is relatively sudden, without impact on schooling or voice quality. Audiometric signs comprise non-superimposable audiometric thresholds (variable audiometric results), bilaterality, flat mean audiometric curve, and discrepancy between pure-tone and speech audiometry. The child needs reassuring during audiometric examination: attention-diversion techniques may be effective. Objective audiometry allows positive diagnosis, followed by rehabilitation and psychological care. Copyright © 2017 Elsevier Masson SAS. All rights reserved.
Methods: Patients who met the inclusion criteria for the study were enrolled and Pure Tone Audiometry (PTA) threshold for each ear with wax impaction was determined at 250Hz, 500Hz, 1KHz, 2KHz, 4KHz and 8KHz by air conduction, Also bone conduction measurements were obtained at 500Hz, 1KHz, 2KHz and 4KHz.
testing, audiometry, dilating pupils, excision of foreign bodies, suturing, ear piercing, gastric lavage , bone marrow aspirations, thoracentesis, lumbar ...staff inservice, hernia exams, mass casualty triage, nutrition counseling , pelvic exams, pap smears, school physicals, testicular examination...sigmoidoscopies, thoracentesis, bone marrow aspiration, and lumbar punctures . Casting , assisting with surgery, gastric lavage , performing minor surgery
Zekveld, A.A.; Deijen, J.B.; Goverts, S.T.; Kramer, S.E.
Purpose: This study investigated the relationship between hearing loss and memory and attention when nonverbal, visually presented cognitive tests are used. Method: Hearing loss (pure-tone audiometry) and IQ were measured in 30 participants with mild to severe hearing loss. Participants performed
Thodi, C.; Parazzini, M.; Kramer, S.E.; Davis, A.; Stenfelt, S.; Janssen, T.; Smith, P.; Stephens, D.; Pronk, M.; Anteunis, L.I.; Schirkonyer, V.; Grandori, F.
Purpose: To screen hearing and evaluate outcomes in community-dwelling older adults. Method: Three thousand and twenty-five adults responded to an invitation to be screened by questionnaire, otoscopy, and pure-tone audiometry. Pure-tone average (PTA) >35 dB HL in the worse ear, unilateral hearing
of working years, etc; Rhine's test, Webers test, otoscopy and pure tone audiometry were done for each of the participants. Workers in the generator house, loading bay and production plant were regarded as noise exposed workers while others were non-noise exposed. Forty-one of the noise exposed workers in flour mill ...
Aura Teresa Palacios-Pérez
Full Text Available Objective: To determine the sensitivity and specificity of five available scales to the qualification of the Tonal Audiometry for the detection of occupationally induced hearing loss. Methods: A descriptive cross-sectional study was conducted. The study population was 92 adult workers. Participants underwent the application of the different formats of registration of the results and qualification of the tonal audiometry. Participants received a hearing evaluation by clinical audiometry. Sixty four cases met the inclusion criteria and were selected for the final analysis.Once the tonal audiometry was complete, evaluation of occupationally induced hearing loss was done by using the ELI, salt, modified LARSEN, KLOCKHOFF and NIOSH classification scales. Results were compared to FREQUENCIAL analysis. Results: The LARSEN scale was noted to detect more cases of occupationally induced hearing loss. The LARSEN modified, represented detection in 54.69% of cases for right ear and 56.25% of cases for left ear. On the other hand, noted the direct relationship of hearing loss with regard to the age. No direct correlation to time of noise exposure was found.. Conclusions: The rating scale that presented greater sensitivity was the LARSEN modified. It was represented by 93.1% and a specificity of 100%.
Schlauch, Robert S.; Carney, Edward
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…
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…
Pang-Ching, Glenn; And Others
Native Hawaiian preschoolers (n=172) received a battery of tests that included pure-tone audiometry, tympanometry, acoustic reflectometry, and pneumatic otoscopy. Approximately 15% of children failed a majority of the tests. Results are discussed in comparison to other indigenous groups at risk for middle ear disorders and hearing loss.…
Wegner, Inge; Swartz, Justin E; Bance, Manohar L; Grolman, Wilko
OBJECTIVES/HYPOTHESIS To evaluate the effect of crimping techniques in stapes surgery for otosclerosis patients measured by hearing outcomes on pure-tone audiometry. DATA SOURCES PubMed, EMBASE, and the Cochrane Library. METHODS A systematic search was conducted. Studies comparing the effect of
Bárbara Cristiane Sordi Silva
Full Text Available Abstract Introduction: Diabetes mellitus (DM is a chronic metabolic disorder of various origins that occurs when the pancreas fails to produce insulin in sufficient quantities or when the organism fails to respond to this hormone in an efficient manner. Objective: To evaluate the speech recognition in subjects with type I diabetes mellitus (DMI in quiet and in competitive noise. Methods: It was a descriptive, observational and cross-section study. We included 40 participants of both genders aged 18-30 years, divided into a control group (CG of 20 healthy subjects with no complaints or auditory changes, paired for age and gender with the study group, consisting of 20 subjects with a diagnosis of DMI. First, we applied basic audiological evaluations (pure tone audiometry, speech audiometry and immittance audiometry for all subjects; after these evaluations, we applied Sentence Recognition Threshold in Quiet (SRTQ and Sentence Recognition Threshold in Noise (SRTN in free field, using the List of Sentences in Portuguese test. Results: All subjects showed normal bilateral pure tone threshold, compatible speech audiometry and "A" tympanometry curve. Group comparison revealed a statistically significant difference for SRTQ (p = 0.0001, SRTN (p < 0.0001 and the signal-to-noise ratio (p < 0.0001. Conclusion: The performance of DMI subjects in SRTQ and SRTN was worse compared to the subjects without diabetes.
Full Text Available reflex testing and pure-tone screening audiometry were considered for 181 gold mine workers, within the context of the employer’s medical surveillance programme for noise-induced hearing loss (NIHL). Different screening procedures were compared...
Larsen, Dalia Gustaityté; Ovesen, Therese
In this study literature search was performed on tinnitus guidelines and treatment. Tinnitus can be described as the perception of sound in the absence of external acoustic stimulation, and validated questionnaires, oto-neurological examination, audiometry tests, MRI and angiography are necessary...
comparable to acid rain or ozone layer depletion, it is never the less of significant social impact at the individual level. noted. All workers were examined by a battery otoscope to assess the condition of the external ear and tympanic membrane. Audiometry was performed using a damplex 67 audiometre. Sound levels were ...
embarked upon included noise measurements, routine Audiometry, display of posters and warning signals at hazardous noise areas in the company to alert workers use of hearing protectors and education primarily in the use of hearing protectors. The purpose of this investigation was to examine the first audiogram.
Lancioni, Giulio E.; And Others
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…
ABR, OAE and Behavioural Audiometry performed in children with meningitis during the critical period and recovery period was found to diagnose any degree of hearing loss with a high level of accuracy. The efficacy of OAEs as a screening tool for children recovering from acute bacterial meningitis was researched by ...
Fereczkowski, Michal; Jepsen, Morten Løve; Dau, Torsten
It is well known that pure-tone audiometry does not sufficiently describe individual hearing loss (HL) and that additional measures beyond pure-tone sensitivity might improve the diagnostics of hearing deficits. Specifically, forward masking experiments to estimate basilarmembrane (BM) input...
Hospital, lbadan through 1986 to 2000. The following data were retrieved from clinical files: Bio data; Clinical features, results of investigations, surgical procedures. operative findings, postoperative complications and postoperative pure tone audiometry. Patients were grouped into social class using occupation according to ...
Reuter, Karen; Hammershøi, Dorte
losses than puretone audiometry. The distortion product otoacoustic emission (DPOAE) fine structure is obtained when the ear is stimulated by dual tone stimuli using a high frequency resolution. It is characterized by quasi-periodic variations across frequency, as it can be observed in the hearing...
with hearing-loss. Reported measurements of OAEs before and after noise exposure suggest that OAE is a more sensitive measure for the hearing function than pure-tone audiometry and therefore might be a measure for the early identification of hearing loss. No individual diagnosis of OAEs is possible today...
Lookabaugh, Sarah; Niesten, Marlien E F; Owoc, Maryanna; Kozin, Elliott D.; Grolman, Wilko; Lee, Daniel J.
OBJECTIVE:: To assess the change in hearing, vestibular function, and size of superior canal dehiscence (SCD) in patients with SCD syndrome over time. PATIENTS:: Adult patients with SCD in one or both ears with documented sign and symptom progression, as shown by the medical record, audiometry,
Audiometry confirmed a mixed hearing loss with a Carrhart notch at 2kHz typical for otosclerosis and all had normal tympanic membrane. All of these patients had a unilateral stapedectomy done. Schucknet wire prosthesis was used for surgical reconstruction. The outcome of surgery in all of these patients was satisfactory.
A thorough clinical examination and otoscopy done followed by tuning fork tests, Pure Tone Audiometry and tympanometric tests. This was compared with 124 HIV negative subjects matched for age and sex who were recruited from the voluntary counseling and testing centre. The world health organization staging of the ...
pure tone air and bone audiometry. Trainees' experience: A total of 9 Ethiopian ENT surgeons who had previously lacked operative experience as the primary surgeon performed these operations. Three were already in practice, and 6 were recent graduates. All 3 senior Ethiopian doctors returned to their local sites and ...
Audiologists and ENT registrars examined 2 036 children aged 10 years or younger by means of pure-tone audiometry, tympanometry and otoscopic examinations. Twenty per cent of these children had ear pathology and 7,5% had impaired hearing. Forty-three pus swabs taken from patients with suppurative otitis media ...
To describe the ABR results in a group of neurologically compromised children and to establish a relationship between ABR findings and behavioural audiometry results, where these existed. Methods. A retrospective review was conducted on 40 ABR patient records of neurologically compromised participants aged 5 ...
Reuter, Karen; Hammershøi, Dorte
losses than pure-tone audiometry. The distortion product otoacoustic emission (DPOAE) fine structure is obtained when the ear is stiumulated by dual tone stimuli using a high frequency resolution. It is characterized by quasi-periodic variations across frequency, as it can be observed in the hearing...
Jun 2, 2001 ... Pure-tone audiometry was carried out using an Amplaid. 300 clinical audiometer calibrated to ISO standards, in a sound - proof booth, at the frequency range of 250 — 8000 Hz, and the thresholds recorded, whilst tympanometry and acoustic reﬂex tests were done with Welch — Allyn. Autotymp 262 middle - ...
Müller-Wehlau, Matthias; Mauermann, Manfred; Dau, Torsten
This study investigates the acoustic reflex threshold (ART) dependency on stimulus phase utilizing low-level reflex audiometry [Neumann et al., Audiol. Neuro-Otol. 1, 359–369 (1996)]. The goal is to obtain optimal broadband stimuli for elicitation of the acoustic reflex and to obtain objective...
Efforts to alter the molecular structure of aminoglycosides have shown a potential path to reducing ototoxicity while preserving antibacterial properties, but these drugs are not clinically available. On the other hand, application of preemptive audiometry provides the most readily available method to both monitor and reduce ...
Alanin, Mikkel Christian; Klausen, Camilla; Caye-Thomasen, Per
/kg was administered every third week. Patients were evaluated with repeated audiometries, MR scans and clinical evaluations. Radiological response was defined as a 20 % or greater reduction in VS volume. A total of 398 treatments (median 36) were administered and the median duration on therapy was 22 months (range 7...
Jun 6, 2010 ... study after informed consent. A thorough clinical examination and otoscopy done followed by tuning fork tests, Pure Tone Audiometry and tympanometric tests. This was compared with 124. HIV negative subjects matched for age and sex who were recruited from the voluntary counseling and testing centre.
physical exam include medical history, medical examination, vision, audiometry, spirometry , and electrocardiogram. The laboratory analysis includes... spirometry , a measure of the respiratory system status. No personnel may be assigned to the use of, or withdraw from stock, any respira- tory protective...health. These limits are determined either from animal studies or from epidemiological data. Unfortunately, animal studies can only approximate human
examination b. dipstick urinalysis, vision screen and vital signs c. spirometry d. audiometry e. blood chemistry (complete blood count, liver...Personal protective equipment (coverall), personnel awareness of animal behavior, insect repellant - Spiders, ticks FINAL 5-1 TASK HAZARD CONTROL...breathing zone; personal protective equipment Personal protective equipment (coverall), personnel awareness of animal behavior, insect repellant
A study to determine the impact of hazardous noise on workers was conducted in a surface gold mining company in Ghana. The procedure adopted included noise survey, case history, otoscopy and conventional pure-tone audiometry. Five main areas were surveyed for hazardous noise namely, Pit, Processing, Ana ...
Guastini, Luca; Mora, Renzo; Dellepiane, Massimo; Santomauro, Valentina; Giorgio, Manini; Salami, Angelo
These findings provide the basis for understanding the duration of the effect after the last use of the drug and encourage a larger clinical trial to collect additional evidence on the effect of coenzyme Q10 (CoQ10) in preventing the development of hearing loss in subjects with presbycusis. The aim of this study was to evaluate the long-term effects of a water-soluble formulation of CoQ10 (Q-TER) in subjects with presbycusis. Sixty patients with presbycusis were included and divided at random into three numerically equal groups. For 30 days, group A underwent therapy with Q-TER, group B underwent therapy with vitamin E, and group C received placebo. Before, at the end, and 6 months after the end of the treatment, all patients underwent evaluation of pure tone audiometry, transient evoked otoacoustic emissions and otoacoustic products of distortion, auditory brainstem response, and speech audiometry. Compared with group B, at the end of the treatment in group A the pure tone audiometry showed a significant (p < 0.05) improvement of the audiometric thresholds at 1000, 2000, 4000, and 8000 Hz. This improvement was confirmed by the speech audiometry and last check. We found no significant differences in the other parameters and in group C.
STRUBBE, EH; CREMERS, CWRJ; DIKKERS, FG; WILLEMSEN, WNP
The hearing of 51 female patients with the Mayer-Rokitansky-Kuster-Hauser syndrome was examined using otoscopy and standard audiometry. A unilateral or bilateral hearing loss of more than 15 dB Fletcher index was found in 13 of 51 (25.5%). Four of these 13 patients had a hearing loss of less than 20
Kurniawan, C.; Westendorp, R.G.J.; Craen, A.J.M.; Gussekloo, J.; de Laat, J.; van Exel, E.
Next to outer hair cell dysfunction, age-related hearing loss may be explained by apolipoprotein E (APOE) genotype. In the Leiden 85-plus Study, a population-based study, the participants were 85 years old. We measured hearing loss by pure-tone audiometry in 435 participants in relation to APOE.
Hearing-Impairment Among Workers in a Surface Gold Mining. Company in Ghana. Geoffrey .... detailed case history, otoscopic examination and audiometry. The audiometric tests were conducted in a quiet room located near the hospital at the mines. The tests were ..... safety standards, but to date, there are no laws, which ...
as were the facies, eyes, hair, skin and nails. 0 abnor- mality was detected in the nose, mouth, pharynx or neck. Reflexes were intact and nystagmus could not be elicited. The abdomen and cardiovascular, respiratory and musculo- skeletal systems were unremarkable. Pure tone audiometry revealed a mixed perceptive and.
There was positive history of ototoxic drugs usage in 24.6 %, family history in 11.6 %, hypertension in 34.8% and ... Keywords: Presbycusis, Nigerians, Audiometry, Clinical features, Elderly ... presence of other chronic diseases like diabetes, hypertension .... hearing threshold levels in adults suggested that age related high ...
Pure tone audiometry revealed profound sensorineural hearing loss in both ears( see attached PTA results), CT scan of the temporal bone showed normal inner ear anatomy bilaterally and mild sclerotic changes in both mastoid bones. He then had surgery on his right ear which included cochlear implantation. The cochlear ...
Sep 26, 2013 ... Fluorescein angiography (Panel C) revealed multiple punctate hyperfluorescent dots (white arrowheads) with dye leakage and disc hyperfluorescence indicating severe papillitis (black arrowheads).Findings on audiometry were within normal limits. The patient was diagnosed with VKH disease. High dose.
c. Audiometricassessment. All subjects had 5 an otological examination and audiometric assessment carried out by an audiologist. The assessment was done in the staff clinic of each industry. The objective of the examination was to determine the integrity of ., the external ear, and the tympanic membrane. The audiometry.
Thümmler, R; Liebscher, T; Hoppe, U
Pure tone and speech audiometry are essential methods for examining the indication for hearing aids, as well as for hearing aid evaluation. Additionally, the subjective benefit of hearing aids has to be evaluated with appropriate questionnaires. The aim of the present study was to investigate the correlation between speech audiometry data and the results of a simple and user-friendly questionnaire, as well as to provide normative data for subjective benefit. Data from 136 hearing aid users with bilateral sensorineural hearing loss were analyzed retrospectively. Pure tone thresholds and Freiburg monosyllabic speech perception in the binaural situation were measured at 65 dB in quiet and in noise (signal-to-noise ratio, SNR = +5 dB), with and without hearing aids. Additionally, subjective hearing in everyday life was recorded using the 12-item Oldenburg Inventory. Improvement of speech perception with hearing aids for the Freiburg monosyllabic test in quiet was 32.0 percentage points on average; in noise, there was an average improvement of 16.4 percentage points. There was a strong correlation between the results of pure tone and speech audiometry. With hearing aids, patients scored their everyday hearing using the Oldenburg Inventory on average 1.4 scale points better than without hearing aids. Results of the Oldenburg Inventory correlate with both pure tone and speech audiometry. Hearing aid evaluation should include both speech audiometry and systematic measurement of the subjective benefit using a suitable questionnaire. In combination, the Freiburg monosyllabic test and the Oldenburg Inventory allow for quick and comprehensive evaluation.
Kapul, A. A.; Zubova, E. I.; Torgaev, S. N.; Drobchik, V. V.
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.
Adjei, George O; Goka, Bamenla Q; Kitcher, Emmanuel
evident between treated children and controls after 9 months. The hearing thresholds of children treated with the two ACT regimens were comparable but lower than those of amodiaquine-treated children during acute illness. Interpretation. Malaria is the likely cause of the elevated hearing threshold levels......Background. Plasmodium falciparum malaria, as well as certain antimalarial drugs, is associated with hearing impairment in adults. There is little information, however, on the extent, if any, of this effect in children, and the evidence linking artemisinin combination therapies (ACTs) with hearing...... is inconclusive. Methods. Audiometry was conducted in children with uncomplicated malaria treated with artesunate-amodiaquine (n = 37), artemether-lumefantrine (n = 35), or amodiaquine (n = 8) in Accra, Ghana. Audiometry was repeated 3, 7, and 28 days later and after 9 months. Audiometric thresholds were compared...
Ahmadzadeh, A; Daraei, M; Jalessi, M; Peyvandi, A A; Amini, E; Ranjbar, L A; Daneshi, A
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.
da Silva, Valéria Gomes; de Oliveira, Carlos Augusto Costa Pires; Tauil, Pedro Luíz; de Castro Silva, Isabella Monteiro; Sampaio, André Luiz Lopes
To investigate the association between changes in the outer hair cells and exposure to amplified music in a group of high-school students. In this retrospective, case-control study, 86 subjects underwent audiometry, immittance audiometry, and distortion-product otoacoustic emission tests. The subjects were questioned about their listening habits and divided into 2 groups: exposed and unexposed. Most of the subjects had reduced function in their outer hair cells, mainly beginning at 8 kHz. Among 60 subjects-30 cases and 30 controls-75% were considered exposed and 25% unexposed. The exposed subjects were 9.33 times more likely to have altered outer hair cells than the unexposed subjects were. Exposure to amplified music is associated with reduced function in the hair cells. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.
de España, R; Biurrun, O; Lorente, J; Traserra, J
The results of the audiological evaluation of 47 diabetics are presented. The patients were divided into two groups: A (17/47), type I early diabetics, and B (30/47), type I chronic diabetics. The evaluation included puretone audiometry, high-frequency audiometry and auditory brainstem response. There was a control group consisting of 30 healthy subjects. In group 1 the audiological assessment was normal in all cases. In group 2 hearing loss was found in 30% of cases (9/30). Hearing loss was significantly correlated with age (p = 0.0019) and duration of diabetes (p = 0.0143), but not with diabetic microangiopathy (p = 0.1506). The authors conclude that hearing loss is not a usual feature in diabetic patients. When present, hearing loss should be attributed to the effect of diabetes on the age-related physiological impairment of the inner ear. The pathogenic mechanisms remain obscure.
Kumar, Aman; Sinha, Amrita; Al-Waa, Ahmad M
We report a case of sudden unilateral sensorineural hearing loss of sudden onset during an aeroplane flight, which completely resolved during a roller coaster ride at Alton Towers theme park. A review of the literature concerning sudden idiopathic sensorineural hearing loss and spontaneous resolution are discussed. Initially, pure-tone audiometry showed a profound sensorineural hearing loss in the right ear and mild sensorineural hearing loss in the left ear (of note, the hearing was normal prior to the episode). Following resolution of the patient's symptoms during a roller coaster ride, pure-tone audiometry showed normal hearing thresholds in both ears. Sudden sensorineural hearing loss is a symptom of cochlear injury and the mechanism of the patient's symptoms was attributed to a patent cochlear aqueduct.
normalize tubal function, and cochlear implants which partially correct hear- ing losses thus reducing the devastating effect of OME in the hearing...screening method. Impedance audiometry (tympanometry and assessment of the middle ear reflex): This method stimulates the most controversy in...development of greater penetrating anti-microbials specifically designed for use in the middle ear space, development of scilastic eustachian tube implants to
Coral Tapia, César Alfredo
Thirsted was conducted in the Maintenance Department of the Provincial General Teaching Hospital in Riobamba, aiming to determine the prevalence of hearing loss induced by noise (NIHL) by its acronym in English (Noise Induced Hearing Loss), the public servants who are exposed to noise in the roundhouse For this study were required measurements of noise in the workplace such as dosimeter measurements in broadband and octave band and audiometry The analysis of the measurements resulted ...
hearing conservation program (HCP) and as a result of noise induced hearing loss (NIHL) sustained by the sailor. Calculation of associated economic costs...entry hearing test, results in a screened population, baseline audiogram established No Basic training and advanced training Assume not noise...exposed No Assigned to high noise occupation Annual monitoring audiometry , noise exposure documented on permanent medical record Yes, Navy Sustains
audiometry , and anatomical models. Experts in the topic areas, but which do not work with marine mammals, will be selected to serve as external...needs), assess how research results have met critical data gaps, and formulate recommendations for future research based on the current state of...posted on the National Marine Mammal Foundation website for download (http://nmmf.org/resources/publications/). RESULTS Discussion outcomes
hazard value accepted unless counter- provided the sound originates outside the hearing indicated by audiometry . protector. The benefit of the survey...worn. As a result of the uncertainties associated with high C. Specific Details of the Proposed Standard level exposures, the auditory modeling method...impairment and risk of conditions prevailing during the measurements shall be hearing handicap as a result of exposure to noise, the carefully recorded
changes resulted in the usage of older baseline audiograms to calculate significant threshold shifts if the most current baseline audiogram was...incorrect baseline records, 27% (14,171 individuals) developed a positive shift that could have been the result of the baseline audiogram error. However...significant threshold shift as defined by OSHA. 2 Permanent Threshold Shift—Any STS found on monitoring audiometry that is still present after a
frequency analysis every 20 msec, com- bined the results into critical bands, Integrated for 200 msec, and then searched to find the 200 msec period...arrives. To allow for this variable in the detection model, pure tone thresholds were measured for each ear. Audiometry was conducted for each ear with...product-moment correla- tion coefficient was calculated for each sound. RESULTS AND DISCUSSION Spectra of the Test Sounds Examples of the sound spectra
shift (STS). These results imply need for modifications to NIHI prevention strategies and continued monitoring for improvements (reductions) in NIHI...trend was defined using an alpha = 0.05. 11 RESULTS Overall: Analysis is provided for data from the Army Diagnostic Summary data table and Army Detail...may tie to changes in hearing thresholds between pre-and post-deployment hearing tests. Pre- deployment monitoring audiometry has been mandated in
Full Text Available Introduction: Auditory Steady State Response (ASSR is an objective method for determining the auditive threshold, applicable and necessary especially in children. The test is extremely important for recommending cochlear implant in children. The aim of the study was to compare pure tone audiometry responses and auditory steady-state thresholds. Materials and method: The study was performed on a group including both patients with normal hearing and with hearing loss. The main inclusion criteria accepted only patients with normal otomicroscopic aspect, normal tympanogram, capable to respond to pure tone audiometry, and with ear conduction thresholds between 0 and 80 dB NHL. The patients with suppurative otic processes or ear malformations were excluded. The research protocol was followed, the tests being performed in soundproofed rooms, starting with pure tone audiometry followed, after a pause, by ASSR determinations at frequencies of 0.5, 1.2 and 4 KHz. The audiological instruments were provided by a single manufacturer. ASSR was recorded at least two times for both borderline intensities, namely the one defining the auditory threshold and the first no-response intensity. The recorded responses were stored in a database and further processed in Excel. Discussion: The differences observed between pure tone audiometry and ASSR thresholds are important at 500 Hz and insignificant at the other frequencies. When approaching the PTA-ASSR relation, whatever the main characteristic between the PTA and ASSR thresholds in one ear, the profile of the lines gap maintains the same shape on the opposite ear. Conclusions: ASSR is a confident objective test, maintaining attention to low frequencies, where some differences might occur.
Full Text Available Manual pure tone audiometry is considered to be the gold standard for the assessment of hearing thresholds and has been in consistent use for a long period of time. An increased legislative requirement to monitor and screen workers, and an increasing amount of legislation relating to hearing loss is putting greater reliance on this as a tool. There are a number of questions regarding the degree of accuracy of pure tone audiometry when undertaken in field conditions, particularly relating to the difference in conditions between laboratory calibration and clinical or industrial screening use. This study analyzed the output sound pressure level of four different commercial audiometers, all using TDH39 headphones and each of which had recently undergone calibration at an appropriate laboratory. Levels were measured using a Bruël and Kjaer Head and Torso simulator, which accurately replicates the size and shape of a human head, including the ears. A clinical environment was simulated by a trained audiometrist replacing the headphones for each test. Tests were undertaken at three presentation levels, and at the frequencies of 250 Hz, 500 Hz, 1 kHz, 2 kHz, 4 kHz and 6 kHz. The results showed a high level of test-retest variability, both between different audiometers and within the same audiometer. Maximum variation of sound pressure level at the ear for the same tone presentation was 21 decibels, with a particularly high level of variation at 6 kHz for all meters. An audiometer with attenuating cups exhibited significantly higher variation than ones using supral-aural headphones. Overall the variation exhibited suggests that there is a higher degree of potential error with screening pure tone audiometry than is commonly assumed and that results particularly at the 6 kHz frequency need to be assessed carefully alongside other methods such as speech audiometry.
Yeung, Jeffrey C; Heley, Sophie; Beauregard, Yves; Champagne, Sandra; Bromwich, Matthew A
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
Lüders,Débora; Gonçalves, Cláudia Giglio de Oliveira; de Moreira Lacerda, Adriana Bender; Ribas,Ângela; Conto,Juliana de
INTRODUCTION: Research has shown that hearing loss in musicians may cause difficulty in timbre recognition and tuning of instruments. AIM: 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. METHODS: Study design was a retrospective observational cohort. Conventional and high-frequency audio...
Barlow, Christopher; Davison, Lee; Ashmore, Mark; Weinstein, Ray
Manual pure tone audiometry is considered to be the gold standard for the assessment of hearing thresholds and has been in consistent use for a long period of time. An increased legislative requirement to monitor and screen workers, and an increasing amount of legislation relating to hearing loss is putting greater reliance on this as a tool. There are a number of questions regarding the degree of accuracy of pure tone audiometry when undertaken in field conditions, particularly relating to the difference in conditions between laboratory calibration and clinical or industrial screening use. This study analyzed the output sound pressure level of four different commercial audiometers, all using TDH39 headphones and each of which had recently undergone calibration at an appropriate laboratory. Levels were measured using a Bruël and Kjaer Head and Torso simulator, which accurately replicates the size and shape of a human head, including the ears. A clinical environment was simulated by a trained audiometrist replacing the headphones for each test. Tests were undertaken at three presentation levels, and at the frequencies of 250 Hz, 500 Hz, 1 kHz, 2 kHz, 4 kHz and 6 kHz. The results showed a high level of test-retest variability, both between different audiometers and within the same audiometer. Maximum variation of sound pressure level at the ear for the same tone presentation was 21 decibels, with a particularly high level of variation at 6 kHz for all meters. An audiometer with attenuating cups exhibited significantly higher variation than ones using supral-aural headphones. Overall the variation exhibited suggests that there is a higher degree of potential error with screening pure tone audiometry than is commonly assumed and that results particularly at the 6 kHz frequency need to be assessed carefully alongside other methods such as speech audiometry.
Vinish Agarwal; Saurabh Varshney; Sampan Singh Bist; Sanjiv Bhagat; Sarita Mishra; Vivek Jha
Auditory neuropathy (AN)/auditory dyssynchrony (AD) is a very often missed diagnosis, hence an underdiagnosed condition in clinical practice. Auditory neuropathy is a condition in which patients, on audiologic evaluation, are found to have normal outer hair cell function and abnormal neural function at the level of the eighth nerve. These patients, on clinical testing, are found to have normal otoacoustic emissions, whereas auditory brainstem response audiometry reveals the absence of neural ...
Wang, Fen; Roy, Amit; Badkul, Rajeev; John, Park; Kumar, Parvesh; Staecker, Hinrich
PURPOSE: To determine the impact of hypofractionated stereotactic radiotherapy (fSRT) scheme upon early auditory functions in the treatment of vestibular schwannomas (VSs). MATERIALS AND METHODS: 21 VS patients treated with a Linac-based frameless fSRT to 25 Gy in 5 daily fractions were retrospectively reviewed. Serial audiometry tests including auditory thresholds and speech discrimination (SD) were conducted prior to fSRT and then at regular intervals post-fSRT to determine the impact of ou...
Caumo, Debora T M; Geyer, Lúcia B; Teixeira, Adriane R; Barreto, Sérgio S M
High-frequency audiometry may contribute to the early detection of hearing loss caused by ototoxic medications. Many ototoxic drugs are widely used in the treatment of patients with cystic fibrosis. Early detection of hearing loss should allow known harmful drugs to be identified before the damage affects speech frequencies. The damage caused by ototoxicity is irreversible, resulting in important social and psychological consequences. In children, hearing loss, even when restricted to high frequencies, can affect the development of language. To investigate the efficacy and effectiveness of hearing monitoring through high-frequency audiometry in pediatric patients with cystic fibrosis. Electronic databases PubMed, MedLine, Web of Science and LILACS were searched, from January to November 2015. The selected studies included those in which high-frequency audiometry was performed in patients with cystic fibrosis, undergoing treatment with ototoxic drugs and published in Portuguese, English and Spanish. The GRADE system was chosen for the evaluation of the methodological quality of the articles. During the search process carried out from January 2015 to November 2015, 512 publications were identified, of which 250 were found in PubMed, 118 in MedLine, 142 in Web of Science and 2 in LILACS. Of these, nine articles were selected. The incidence of hearing loss was identified at high frequencies in cystic fibrosis patients without hearing complaints. It is assumed that high-frequency audiometry can be an early diagnostic method to be recommended for hearing investigation of patients at risk of ototoxicity. Copyright © 2016 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.
Binderup, Marie Louise Mølgaard; Gimsing, Steen; Kosteljanetz, Michael
Endolymphatic sac tumours (ELSTs) of the inner ear occur in 16% of patients with the hereditary tumor syndrome von Hippel-Lindau disease (vHL). ELSTs of all sizes can cause irreversible hearing loss which can, however, be prevented through early diagnosis and treatment. We aim to emphasize the ch...... the challenges of prophylactic ELST screening and to explore the role of audiometry in pre-symptomatic ELST screening....
Noise is an environmental health problem that has not received sufficient attention. Physicians should become knowledgeable about the medical consequences of excessive noise, support legislation to reduce the problem and promote programs aimed at noise control and prevention of hearing loss. Questions about noise and hearing should be incorporated into the medical history, and pure-tone audiometry should be a part of periodic physical evaluations.
Results: Referral rate was reduced to 6.7% from 17% when using 25 dB HL as opposed to 20 dB HL as screening intensity. Referral rate was reduced to 4.4% when employing 30 dB HL as screening intensity. An immediate rescreen reduced the overall referral rate by more than one-third. Diagnostic audiometry confirmed ...
Goto, Fumiyuki; Arai, Miki; Kitamura, Mitusru; Otomo, Tomoko; Nagai, Ryoto; Minami, Shuujiro; Shimada, Takanobu; Matsunaga, Tatsuo; Tsunoda, Kouichi; Fujii, Masato
Introduction: The aim of this case report was to investigate the relationship between sleep disorders and audio vestibular symptoms. Case Report: A case of undiagnosed sleep disorder, presenting as a temporary auditory processing difficulty, is presented. The disorder was initially treated as sudden deafness with dizziness. A 23-year-old male patient complained of acute hearing disturbance despite normal results on pure tone audiometry. The patient was initially administered a steroid injec...
Augusto Muñoz-Caicedo; Helmer Zapata-Ossa; Liliana María Pérez-Tenorio; Sonia Illera
Objective: to establish the prevalence institutional alterations in hearing and languaje in children aged 4 and 5 years, attending the Growth and Development program at the Social Institution of Popayan in 2012. Methodology: We performed a cross-sectional study in sample of 96 children who attended four points ESE Care Popayan, during the months of december 2011 and January 2012. Were evaluated by Fonoaudiología, who applied the Reynell test to assess languaje and tone audiometry and otoacous...
Bergman, B; Rosenhall, U
The concomitant occurrence of hearing and visual impairment was investigated as part of an epidemiological longitudinal study of elderly people. An age cohort. originally consisting of 973 elderly people, was examined with visual and hearing tests three times at ages 70, 81-82 and 88. The best-corrected visual acuity was assessed. The hearing was measured by pure-tone audiometry and whispered and spoken voice (WSV). At age 70 there was no co-existence of visual and hearing impairments, and about 70% had normal vision and hearing. At 81-82 years 3-6% (WSV and audiometry. respectively) had low vision (VA hearing loss, and more than one-tenth had normal vision and hearing. At 88 years 8-13% had low vision and moderate to severe hearing loss, and none of the men and less than one-tenth of the women had normal vision and hearing. At age 88 three times as many women as men had the combination of low vision and normal hearing. Normal vision with the combination of moderate to severe hearing loss was more often found in 88-year-old men. Mild impairments of the two senses were found in 0.5% at age 70 in 22%, 11% (WSV, audiometry) at age 81-82 and in 23%, 9% at age 88 years. At age 70 there was a statistical correlation between visual acuity and hearing measured with pure-tone audiometry in the male group. Those men with better hearing had slightly better visual capacity than those with hearing loss. No correlations were found for women at age 70 nor for women and men at ages 81-82 and 88. Ophthalmologists and audiology physicians should cooperate closely in the rehabilitation process to reduce disability and improve function and wellbeing among the oldest old.
Debora T.M. Caumo
Full Text Available Abstract Introduction: High-frequency audiometry may contribute to the early detection of hearing loss caused by ototoxic medications. Many ototoxic drugs are widely used in the treatment of patients with cystic fibrosis. Early detection of hearing loss should allow known harmful drugs to be identified before the damage affects speech frequencies. The damage caused by ototoxicity is irreversible, resulting in important social and psychological consequences. In children, hearing loss, even when restricted to high frequencies, can affect the development of language. Objective: To investigate the efficacy and effectiveness of hearing monitoring through high-frequency audiometry in pediatric patients with cystic fibrosis. Methods: Electronic databases PubMed, MedLine, Web of Science and LILACS were searched, from January to November 2015. The selected studies included those in which high-frequency audiometry was performed in patients with cystic fibrosis, undergoing treatment with ototoxic drugs and published in Portuguese, English and Spanish. The GRADE system was chosen for the evaluation of the methodological quality of the articles. Results: During the search process carried out from January 2015 to November 2015, 512 publications were identified, of which 250 were found in PubMed, 118 in MedLine, 142 in Web of Science and 2 in LILACS. Of these, nine articles were selected. Conclusion: The incidence of hearing loss was identified at high frequencies in cystic fibrosis patients without hearing complaints. It is assumed that high-frequency audiometry can be an early diagnostic method to be recommended for hearing investigation of patients at risk of ototoxicity.
S Soheilipour; S Nemati
Background: Otosclerosis (OS) is the most common cause of conductive hearing loss in young population, and we determined incidence of OS among 1st and 2 nd degree relatives of surgically proved otosclerotic patients. Methods: In a cross sectional study among 43 surgically proved otosclerotic patients, positive family history of OS was determined. In suspicious cases, physical exam, tunning fork tests, and audiometry were performed. We also reviewed medical sheaths of admitted OS patients...
Sharma, K; Pannu, M S; Arora, A; Sharma, V
A late detection of hearing impairment in children can affect speech and language development. Otitis media with effusion (OME) associated with risk factors like recurrent upper respiratory tract infections (URTI) is considered the most common cause of silent hearing impairment among children. So this study was carried out to screen such at risk children for hearing impairment. The study was conducted on 1000 children in the age group of 2-12 years who presented to the OPD of ENT and Pediatrics Department, Govt Medical College with the complaint of recurrent URTI. The children were screened by history taking, general physical examination and local ENT examination. This was followed by impedance audiometry and pure tone audiometry (PTA, wherever indicated). Children with discharging ears and perforated tympanic membrane (TM) were excluded from the study. The most common presenting complaint was nasal discharge (67.9 %), followed by mouth breathing (66.3 %) and snoring (65 %). Only 16.2 % cases actually complained of some hearing impairment on exploratory history indicating the silent nature of OME. On examination 52.65 % cases had a normal looking TM whereas 41.2 % had a dull retracted TM. Results of impedance audiometry showed Type A graph in 56.75 %, Type B in 33.4 % indicating OME and Type C in 9.85 % indicating Eustachian tube dysfunction. PTA showed a mild conductive hearing loss in 26.7 % cases. OME is quite prevalent in high risk children and incidence of OME resulting in silent hearing impairment is quite high especially in young children having recurrent URTI. Impedance audiometry has been proved to be an objective screening tool for the same with a diagnostic accuracy of 87 % and thus under preventive audiology, it has a definite role in young children having recurrent URTI.
Sushil Razdan; Sunil Kumar Raina; Pandita, Kamal K.; Shiveta Razdan; Renu Nanda; Rajni Kaul; Sandeep Dogra
Background: We report on the higher prevalence of deaf-mutes from a village in Jammu and Kashmir State of India. Materials and Methods: A cross-sectional study among 79 deaf mutes using pedigree analysis, audiometry, imaging and molecular analysis. Results: A high rate of hereditary deafness with 79 individuals diagnosed to be suffering from non-syndrome deafness in a total population of 2452 individuals residing in the village. Interpretation: Flourishing of intermarriages led t...
Harish Chandra Reddy
Full Text Available INTRODUCTION Interpersonal communication, day to day activities, learning language and acquiring grades in the school are important parts in the life of school going children. Unilateral or bilateral Loss of hearing affects education and the child feels handicapped socially, emotionally, and scholastically. Such children lose grades and retained in the same class affecting them emotionally. The present study was conducted in order to find out the various causes of unilateral Sensorineural Hearing Loss (USNHL in children and to study role of various audiological findings in diagnosing the cause of impaired hearing in children. AIMS AND OBJECTIVES To find out the possible etiological causes and study the role of various audiological tests in finding the causes of unilateral impaired hearing in children. MATERIALS AND METHODS A prospective study was conducted in the Department of ENT of a tertiary Hospital attached to a Medical College in Warangal, Telangana. A total of 346 children aged between 4 and 15 years attended presenting with complaints of impaired hearing. Among them 73 children with unilateral sensorineural deafness were included in the study. After a thorough ENT examination subjective tests like pure tone audiometry and behavioral observation audiometry and objective tests like impedance audiometry, Oto-acoustic emissions (OAE, and brainstem evoked response audiometry (BERA were performed. RESULTS While identifying the possible etiological cause of USNHL, OAE revealed 56.16% REFER and 43.83% PASS results. Impedance audiometric results showed 71.22% as Type A Tympanogram. Pure tone audiometric results were mostly showed severe and profound hearing losses together accounting to 87.66%. BERA findings were mostly on severe and profound hearing loss (90.40%. No children with syndromic or cranio-facial abnormalities were found. CONCLUSIONS A prospective Hospital based study of school children with USNHL showed acquired nature of the
Chaparro Narváez, Pablo E.; Guerrero, Juan
A cross-sectional descriptive study was carried out. Aimed at identifying the working conditions of the drivers of a public transportation company in Bogotá. A technical inspection was done in some of the routes covered by the company. 194 drivers were included; all of them were interviewed, and submitted to medical and physiotherapeutic exams, audiometry, examination of visual acuity and visual field, spirometry and biochemical tests (glycemia, lipid profile, glycosylated hemoglobin and carb...
Lin, Yow-Sien; Chen, Chiung-Mei; Soong, Bing-Wen; Wu, Yih-Ru; Chen, Hui-Mei; Yeh, Wen-Ying; Wu, Dai-Rong; Lin, Yi-Jun; Poon, Paul Wai-Fung; Cheng, Mei-Ling; Wang, Chih-Hung; Chern, Yijuang
Huntington disease (HD) is a degenerative disorder caused by expanded CAG repeats in exon 1 of the huntingtin gene (HTT). Patients with late-stage HD are known to have abnormal auditory processing, but the peripheral auditory functions of HD patients have yet to be thoroughly assessed. In this study, 19 HD patients (aged 40–59 years) were assessed for hearing impairment using pure-tone audiometry and assessment of auditory brainstem responses (ABRs). PTA thresholds were markedly elevated in H...
Richard, Céline; Ferrary, Evelyne; Borel, Stéphanie; Sterkers, Olivier; Grayeli, Alexis Bozorg
This study aimed to evaluate the interaction of electric and acoustic cues in diotic condition in cochlear implantees. Five adult cochlear implantees with residual contralateral hearing were prospectively evaluated in hearing aid only (HA), cochlear implant only (CI), and HA + CI modes by audiometry (pure tone, dissyllabic words, and sentences), and sound quality questionnaires. CI electrodes corresponding to preserved frequencies in the contralateral ear (free-field aided thresholds, electric diotic cues but also some redundancy affecting the sound quality.
Mikkola, Tuija M; Hannele Polku; Päivi Sainio; Päivikki Koponen; Seppo Koskinen; Anne Viljanen
Abstract Background Older adults with hearing difficulties face problems of communication which may lead to underuse of health services. This study investigated the association of hearing loss and self-reported hearing difficulty with the use of health services and unmet health care needs in older adults. Methods Data on persons aged 65 and older (n = 2144) drawn from a population-based study, Health 2000, were analyzed. Hearing loss was determined with screening audiometry (n = 1680). Struct...
Mikkola, Tuija; Polku, Hannele; Sainio, Päivi; Koponen, Päivikki; Koskinen, Seppo; Viljanen, Anne
Background Older adults with hearing difficulties face problems of communication which may lead to underuse of health services. This study investigated the association of hearing loss and self-reported hearing difficulty with the use of health services and unmet health care needs in older adults. Methods Data on persons aged 65 and older (n?=?2144) drawn from a population-based study, Health 2000, were analyzed. Hearing loss was determined with screening audiometry (n?=?1680). Structured face...
Silveira, Marcela Rosana Maia da; Gil, Daniela
BACKGROUND: hearing and mitochondriopathy. PROCEDURE: this case report aims at describing audiological evaluation results of two children diagnosed with mitochondrial disease referred to Clinical Audiology Out-patient Clinic of UNIFESP/EPM. Children were referred to audiology department from metabolic diseases out-patient clinic of UNIFESP. Both have undergone pure tone audiometry, behavioral observation, immittance measures and otoacoustic emissions. RESULTS: either behavioral or physiologic...
Full Text Available Background: Cerebrovasular diseases (CVD are one of the most common anomalies which may affect on auditory cortex. In this research we have tried to evaluate the function of CANS in a group of 50-70 years old cerebrovascular accident (CVA patients without hearing problem by using Persian version of C.S.T. Materials and Methods: This cross-sectional analytic study was established at Loghman-e-Hakim Hospital on a group of 30 normal subject (15 male, 14 female and a group of 40 patients with CVA including 30 patients (16 male, 14 female with abnormal CT scan and 10 patients with normal CT scan. Results: Routine audiologic test including: Pure tone audiometry, Immitance audiometry and speech audiometry were nearly normal in all cases. There were significant differences between mean scores of CST in the patients with CVA and control group (P 0.05. In spite of nearly normal hearing and high scores in the simple speech tests such as SDS, there were significant differences in mean scores of CST in both ears of CVA patients (P< 0.05. Another important point is that in some of patients with CVA. Conclusion: Although common radiologic evaluations such as CT scan showed no anatomic or structural anomaly but central auditory assessments such as CST can show dysfunctions of CANS. Therefore, CST might be a valuable test in CANS batteries for the cerebrovascular diseases.
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
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.
Full Text Available Introduction and objective: Osseointegrated implants are nowadays a good therapeutic option for patients suffering from transmission or mixed hearing loss. The aims of this study are both to assess audiology benefits for patients with osseointegrated implants and quantify the change in their quality of life. Method: The study included 10 patients who were implanted in our hospital between March 2013 and September 2014. The instrument used to quantify their quality of life was the Glasgow Benefit Inventory (GBI and a questionnaire including three questions: use of implant, postoperative pain and whether they would recommend the operation to other patients. Audiology assessment was performed through tone audiometry and free field speech audiometric testing. Results: The average total benefit score with the Glasgow Benefit Inventory was +58, and the general, social and physical scores were +75, +18 and +29, respectively. The improvement with the implant regarding free-field tonal audiometry at the frequencies of 500, 1000 and 2000 Hz was found to be statistically significant, as was the difference between verbal audiometry before and after implantation. Discussion: Improvements in surgical technique for osseointegrated implants, at present minimally invasive, foregrounds the assessment of functional and social aspects as a measure of their effectiveness. Conclusions: The use of the osseointegrated implant is related to an important improvement in the audiological level, especially in patients with conductive or mixed hearing loss, together with a great change in the quality of life of implanted patients.
François, M; Dehan, E; Carlevan, M; Dumont, H
In patients who cannot or will not cooperate in behavioral hearing assessment, electrophysiological examinations are used, but are time-consuming because the subject has to remain immobile. The aim of this study was to assess whether auditory steady-state responses (ASSR) are sufficiently reliable, compared to auditory brainstem responses (ABR) and free-field audiometry, for assessment to begin with ASSR instead of ABR. A retrospective study was performed between January 2012 and April 2013, including children less than 6 years of age who could not be tested via headphones. ASSR and ABR were measured during natural sleep or under phenobarbital-alimemazine sedation. Subjective pure-tone audiometry was performed, using the visual reinforcement audiometry method, in 69 children who were able and willing to cooperate. A total of 175 children were included. ASSR and ABR thresholds showed good positive correlation (338 ears; Pearson's correlation coefficient, 0.87). Behavioral thresholds correlated significantly with ASSR thresholds (Student t-test for matched series; Phearing threshold rather than latency is to be determined. Copyright © 2016 Elsevier Masson SAS. All rights reserved.
Núñez-Batalla, Faustino; Noriega-Iglesias, Sabel; Guntín-García, Maite; Carro-Fernández, Pilar; Llorente-Pendás, José Luis
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.
Xia, Yin; Zhang, Hua; Gong, Shu-sheng; Wang, Dan-ni; Zheng, Ya-li; Li, Yu-ling; Dong, Bo-ya; Han, De-min
To discuss the indications, surgery methods and effects of the BAHA implantation by analyzing the patients' medical records of bone-anchored hearing aids(BAHA). Retrospective analyzed the records of 16 patients of BAHA implantation, including nine males and seven females. Their average age was 31 years old (8-53ys). Nine of them were congenital ear malformation, two were chronic suppurative otitis media, two were otosclerosis and three were unilateral severe sensorineural deafness. We evaluated their pure tone audiometry (PTA), speech audiometry and temporal CT before the surgery, and evaluated the aided PTA in soundfield and speech audiometry in sound field. These patients received BAHA implantation and installed the speech processor their months later. The average preoperative PTA measurements (PTA at 0.5, 1, 2, 4 kHz) was (63.2 ± 19.0) dB HL and postoperative aided PTA in sound field was (35.5 ± 10.9)dB HL. The average improvement in Hearing In Noise Test (HINT) was 37.0% ± 31.7%. The average improvement in Mandarin Speech Test was 76.0% ± 19.7%. After 4-16 months' follow-up, no significant complications were recorded. BAHA is a safe and effective bone implantable hearing device.
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.
Full Text Available Hearing function can affect communication skills and especially speech and language abilities.As a result, most of the attempts in behavioral audiometry have focused on the improvement and rectification of the techniques for hearing evaluations of the infants and children.Crib-O-gram and the methods suggested by northern & Downs are some of the mentined protocoles.For years a significant advance for evaluating hearing sensitivity of children have been taken place. say, behavoral visual audiometry, VRA, TROCA and play audiometry. some studies also have been performed regarding to the use of BOA technique in mental retarded children and its success in evaluating hearing sensitivity in such children.other protocoles use rewarding thechniques for reinforcing child's responses which have been demonstrated to be success in the evaluation.In addition,by comparying the results of frequency and intensity discrimination (by means of Luescher test, the changes in the resonance frequency of the outer ear and loudness conmfortable level(LDL, one can study the process of hearing development in children.
Salami, Angelo; Mora, Renzo; Dellepiane, Massimo; Manini, Giorgio; Santomauro, Valentina; Barettini, Luciano; Guastini, Luca
These preliminary data are encouraging for a larger clinical trial to collect additional evidence on the effect of Q-TER(®) in preventing the development of hearing loss in subjects with presbycusis. The purpose of this study was to evaluate the efficiency and applicability of a water-soluble formulation of CoQ10 (Q-TER(®)) in subjects with presbycusis. A total of 60 patients with presbycusis were included and divided into three numerically equal groups. Group A underwent therapy with Q-TER(®), 160 mg, once a day for 30 days; group B underwent therapy with vitamin E (50 mg), once a day for 30 days; group C received placebo, once a day for 30 days. Before and at the end of the treatment, all patients underwent pure tone audiometry, transient evoked otoacoustic emissions, otoacoustic products of distortion, auditory brainstem response, and speech audiometry. Compared with group B, at the end of the treatment in group A the liminar tonal audiometry showed a significant improvement of the air and bone thresholds at the 1000 (14/20 vs 9/20), 2000 (14/20 vs 7/20), 4000 (15/20 vs 6/20), and 8000 Hz (13/20 vs 5/20). We found no significant differences in the other parameters and in group C.
Matschke, R G
Frequency selectivity represents an important contributory factor in the understanding of human speech. It refers to the ability of the ear to discriminate between two simultaneously occurring sounds of different spectral composition. The capabilities of frequency selection, time pattern analysis, and information processing can be determined generally only by speech audiometry. Schorn and co-workers (1977) published a simplified method for audiological investigations whereby results obtained at two different frequency values are sufficient. The test tone frequencies of 0.5 and 4 kHz were selected because they are representative of the frequency range of normal speech. To determine the influence of ageing on frequency selectivity we investigated three groups of patients between the ages of 20-30, 40-50 and 60-70 years. All of the subjects had normal hearing according to ISO 7029 standards. The measurements of pure-tone audiometry, speech audiometry, and the psychoacoustic tuning curves were performed sequentially on the same day. The influence of ageing on frequency selectivity mainly concerns frequencies above 2 kHz. This is related to the progressive loss of outer hair cells in the basal parts of the cochlea in old age. Our investigations show that particular attention must be paid to a loss of frequency selectivity in old age. This becomes evident mainly after the 60th year. Frequency selectivity is not significantly disturbed before that age, although pure tone audiograms show high frequency inner ear hearing loss earlier in life.
Dutra, Marilene Danieli Simões; Cavadas, Marcia; Jesus, Iracina Maura de; Santos, Elisabeth Oliveira; Silva, Evelyn Almeida da; Câmara, Volney de Magalhães
To evaluate hearing thresholds in children with a history of exposure to mercury during the prenatal period. Participants were 90 children of both genders with ages from 8 to 10 years, divided into two groups according to prenatal mercury exposure levels. The study group was composed by 57 children who had mercury levels in the umbilical cord equal or above 8 µg/L, and the comparison group comprised 33 children who had mercury levels in the umbilical cord below 8 µg/L. Investigation procedures included the application of a questionnaire, pure-tone audiometry, speech reception threshold, and mercury level analysis in cord blood collected at birth. The study group showed a median mercury level in the umbilical cord of 14.63 µg/L, and the median threshold for 500 Hz, 1 kHz and 2 kHz in pure-tone audiometry was 10 dB for both ears. The comparison group had a median cord blood mercury level of 4.88 µg/L, and the median threshold for 500 Hz, 1 kHz and 2 kHz in pure-tone audiometry was 10 dB for both ears. When the hearing thresholds were compared, both by the tritonal mean and by each frequency separately, there were no significant differences between groups. The children had hearing thresholds within normal limits and there was no significant difference between the hearing thresholds of children exposed and not exposed prenatally to mercury.
The impact of hearing loss on the ability to participate in verbal communication can be directly quantified through the use of speech audiometry. Advances in technology and the associated reduction in background noise interference for hearing aids have allowed the reproduction of very complex acoustic environments, analogous to those in which conversations occur in daily life. These capabilities have led to the creation of numerous advanced speech audiometry measures, test procedures and environments, far beyond the presentation of isolated words in an otherwise noise-free testing booth. The aim of this study was to develop a set of systematic criteria for the appropriate selection of speech audiometric material, which are presented in this article in relationship to the most widely used test procedures. Before an appropriate speech test can be selected from the numerous procedures available, the precise aims of the evaluation should be basically defined. Specific test characteristics, such as validity, objectivity, reliability and sensitivity are important for the selection of the correct test for the specific goals. A concrete understanding of the goals of the evaluation as well as of specific test criteria play a crucial role in the selection of speech audiometry testing procedures.
Full Text Available Background. Keratitis-ichthyosis-deafness (KID syndrome is a syndrome which presents with hearing loss and visual and keratinization disorders. In such patients, hearing aids cannot be effectively used in the rehabilitation of hearing loss because of the frequent blockage of the external ear canal with epithelial debris and due to dry and tense skin of the external ear canal. Moreover, severe or profound hearing loss also limits the benefits gained from the conventional hearing aids. On the other hand, cochlear implantation is a method that has been used in limited cases in the literature. Case Report. This study presents the results of cochlear implantation applied in our clinic to two children who had been diagnosed with KID. Audiological assessments before and after the cochlear implant operation were performed using pure-tone audiometry, immittance audiometry, and auditory brainstem response (ABR, and the postoperative follow-up was conducted using pure-tone audiometry. Conclusion. Skin problems, visual disturbances, and other additional problems complicate the short-term and long-term rehabilitation after implantation in individuals with KID syndrome. Close monitoring should be exercised due to possible skin complications that may develop during the postoperative period. The families and rehabilitation teams should be warned about the possible visual disturbances and skin complications.
Full Text Available The aim of this cross-sectional study among Swedish hunters was to examine the association between shooting history and presence of high-frequency hearing impairment (HFHI. All hunters registered with an e-mail address in the membership roster of the Swedish Hunters′ Association were invited via e-mail to a secure website with a questionnaire and an Internet-based audiometry test. Associations, expressed as prevalence ratio (PR, were multivariately modelled using Poisson regression. The questionnaire was answered by 1771 hunters (age 11-91 years, and 202 of them also completed the audiometry test. Subjective severe hearing loss was reported by 195/1771 (11%, while 23/202 (11% exhibited HFHI upon testing with Internet-based audiometry. As many as 328/1771 (19% had never used hearing protection during hunting. In the preceding 5 years, 785/1771 (45%, had fired >6 unprotected gunshots with hunting rifle calibers. The adjusted PR of HFHI when reporting 1-6 such shots, relative to 0, was 1.5 [95% confidence interval (CI 1.1-2.1; P = 0.02]. We could not verify any excessive HFHI prevalence among 89 hunters reporting unprotected exposure to such gunshot noise >6 times. Nor did the total number of reported rifle shots seem to matter. These findings support the notion of a wide variation in individual susceptibility to impulse noise; that significant sound energy, corresponding to unprotected noise from hunting rifle calibers, seems to be required; that susceptible individuals may sustain irreversible damage to the inner ear from just one or a few shots; and that use of hearing protection should be encouraged from the first shot with such weapons.
Furushima, Wakana; Kaga, Makiko; Nakamura, Masako; Gunji, Atsuko; Inagaki, Masumi
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.
Song, Xinyu D.; Wallace, Brittany M.; Gardner, Jacob R.; Ledbetter, Noah M.; Weinberger, Kilian Q.; Barbour, Dennis L.
Objectives Pure-tone audiometry has been a staple of hearing assessments for decades. Many different procedures have been proposed for measuring thresholds with pure tones by systematically manipulating intensity one frequency at a time until a discrete threshold function is determined. The authors have developed a novel nonparametric approach for estimating a continuous threshold audiogram using Bayesian estimation and machine learning classification. The objective of this study is to assess the accuracy and reliability of this new method relative to a commonly used threshold measurement technique. Design The authors performed air conduction pure-tone audiometry on 21 participants between the ages of 18 and 90 years with varying degrees of hearing ability. Two repetitions of automated machine learning audiogram estimation and 1 repetition of conventional modified Hughson-Westlake ascending-descending audiogram estimation were acquired by an audiologist. The estimated hearing thresholds of these two techniques were compared at standard audiogram frequencies (i.e., 0.25, 0.5, 1, 2, 4, 8 kHz). Results The two threshold estimate methods delivered very similar estimates at standard audiogram frequencies. Specifically, the mean absolute difference between estimates was 4.16 ± 3.76 dB HL. The mean absolute difference between repeated measurements of the new machine learning procedure was 4.51 ± 4.45 dB HL. These values compare favorably to those of other threshold audiogram estimation procedures. Furthermore, the machine learning method generated threshold estimates from significantly fewer samples than the modified Hughson-Westlake procedure while returning a continuous threshold estimate as a function of frequency. Conclusions The new machine learning audiogram estimation technique produces continuous threshold audiogram estimates accurately, reliably, and efficiently, making it a strong candidate for widespread application in clinical and research audiometry. PMID
Adriztina, Indri; Adnan, Adlin; Adenin, Ichwanul; Haryuna, Siti Hajar; Sarumpaet, Sorimuda
Introduction There is only limited information from previous studies that suggest that auditory function may be influenced by hormones. Recent advances in the field have exposed the potential role of hormones in modulating the auditory system. Objective This study aims to investigate the relationship between menstrual cycle and outer hair cell function with audiological examination. Methods This is an analytic study with a cross-sectional design. The sampling was a systematic random sampling. We found 49 women with normal menstrual cycle and collected their data through interviews, physical examination, and examination of the ear, with otoscopic and other routine otorhinolaryngology examinations. We evaluated Tympanometry, distortion-product otoacoustic emissions (DPOAE), and pure tone audiometry. Results We found the audiometric threshold worse in the follicular phase than other phases at 4000 Hz of the right ear, and in the ovulation was found best than any other phases at 1000 Hz of the left ear with significant difference. We found significant difference of DPOAE between ovulation time and follicular phase at 3000 Hz and 1000 Hz in the left ear and between ovulation and luteal phased at 2000 Hz, 3000 Hz and 5000 Hz in the right ear and at 1000 Hz in the left ear with p result of this study showed that only a small part of audiometry threshold had a significant difference between each menstrual phase. In other words, we found no correlation between menstrual and audiometry threshold. Nonetheless, there is a correlation between menstrual cycle phase and DPOAE amplitude. PMID:27746829
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
Bright, Tess; Pallawela, Danuk
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. 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. 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. 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. 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.
Campelo, Victor Eulálio Sousa
Full Text Available Introduction: The auditory screening' benefits has been demonstrated, however these programs has been restricted to the big centers. Objectives: (a Developing a auditory screening method to distance; (b Testing its accuracy and comparing to the screening audiometry test (AV. Method: The teleaudiometry (TA, consists in a developed software, installed in a computer with phone TDH39. It was realized a study in series in 73 individuals between 17 and 50 years, being 57,%% of the female sex, they were randomly selected between patients and companions of the Hospital das Clínicas. Before were subjected to a symptom questionnaire and otoscopy, the individuals realized the tests of TA AV, with scanning in 20dB in the frequencies of 1,2 and 4kHz following the ASHA (1997 protocol and to the gold standard test of audiometry of pure tones in soundproof booth in aleatory order. Results: the TA has lasted average 125+11s and the AV 65+18s. 69 individuals (94,5% declaring to be found difficult or very easy to performing the TA and 61 (83,6% have considered easy or very easy the AV. The accuracy results of TA and AV were respectively: sensibility (86,7% / 86,7%, specificity (75,9%/ 72,4% and negative predictive value (95,7% / 95,5%, positive predictive value (48,1% / 55,2%. Conclusion: The teleaudiometry has showed a good option as an auditory screening method, presenting accuracy next to screening audiometry. In comparison with this method, the teleaudiometry has presented a similar sensibility, major specificity, negative predictive value and endurance time and, under positive predictive value.
Lopes, Andréa Cintra
Full Text Available 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.
Austad, Bjarne; Hetlevik, Irene; Bugten, Vegard; Wennberg, Siri; Olsen, Anita Helene; Helvik, Anne-Sofie
A university hospital in Mid-Norway has modified their guidelines for follow-up after insertion of ventilation tubes (VTs) in the tympanic membrane, transferring the controls of the healthiest children to general practitioners (GPs). The aim of this study was to evaluate the implementation of these guidelines by exploring audiological outcome and subjective hearing complaints two years after surgery, assessing if follow-ups in general practice resulted in poorer outcome. A retrospective observational study was performed at the university hospital and in general practice in Mid-Norway. Children below 18 years who underwent surgery with VTs between Nov 1st 2007 and Dec 31st 2008 (n = 136) were invited to participate. Pure tone audiometry, speech audiometry and tympanometry were measured. A self-report questionnaire assessed subjective hearing, ear complaints and the location of follow-ups. This study includes enough patients to observe group differences in mean threshold (0.5-1-2-4 kHz) of 9 dB or more. There were no preoperative differences in audiometry or tympanometry between the children scheduled for follow-ups by GPs (n = 23) or otolaryngologists (n = 50). Two years after surgery there were no differences between the GP and otolaryngologist groups in improvement of mean hearing thresholds (12.8 vs 12.6 dB, p = 0.9) or reduction of middle ears with effusion (78.0 vs 75.0%, p = 0.9). We found no differences between the groups in terms of parental reports of child hearing or ear complaints. Implementation of new clinical guidelines for follow-ups after insertion of VTs did not negatively affect audiological outcomes or subjective hearing complaints two years after surgery.
Pérez-Lázaro, J J; Urquiza, R; Cabrera, A; Guerrero, C; Navarro, E
The epidemiological characteristics of otosclerosis and its treatment in Andalusia resemble those of other populations with similar socioeconomic levels. Two complementary approaches, such as questionnaires and pure-tone audiometry, are required to assess the effectiveness of otosclerosis surgery (OS) reliably and precisely. We describe a new method to assess effectiveness in OS. It is based on the results of pure-tone audiometry and a specially designed quality of hearing questionnaire (QHQ). The objectives of the study are: (i) to report the general epidemiologic profile of otosclerosis in Andalusia; (ii) to study the effectiveness of OS in our community using conventional methods; and (iii) to study the outcomes of OS using the QHQ and to compare them to those obtained using conventional methods. All 31 hospitals in the public healthcare system of Andalusia were studied. They were graded into four groups using a specially designed grouping system. The data were obtained from the minimum basic dataset. The prevalence of otosclerosis in Andalusia was calculated from the incidence data, the duration of the disease and life expectancy. To assess the effectiveness of OS, 475 clinical records from 15 hospitals representing all 4 groups were analysed. Effectiveness was assessed by conventional methods, using data obtained from pure-tone audiometry, and by using version 1.02 p of the QHQ. The incidence of clinical otosclerosis was 5.67 patients/100,000 inhabitants/year. The calculated prevalence was 0.287%. The number of cases increased progressively during the study period (p 65 years age group showed the best gap improvement but the largest variability. The quality of hearing measured by the QHQ showed that, in general, a better gap improvement was associated with a higher quality of hearing (Pearson correlation r=0.183; p<0.05). The 15-45-year age group had the worst gap improvement but, in contrast, the better quality of hearing.
Treviño-González, José Luis; Villegas-González, Mario Jesús; Muñoz-Maldonado, Gerardo Enrique; Montero-Cantu, Carlos Alberto; Nava-Zavala, Arnulfo Hernán; Garza-Elizondo, Mario Alberto
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.
Löhler, J; Wollenberg, B; Schlattmann, P; Hoang, N; Schönweiler, R
The Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire reports subjective hearing impairments in four typical conditions. We investigated the association between the frequency-specific probability of hearing loss and scores from the unaided APHAB (APHABu) to determine whether the APHABu could be useful in primary diagnoses of hearing loss, in addition to pure tone and speech audiometry. This retrospective study included database records from 6558 patients (average age 69.0 years). We employed a multivariate generalised linear mixed model to analyse the probabilities of hearing losses (severity range 20-75 dB, evaluated in 5-dB steps), measured at different frequencies (0.5, 1.0, 2.0, 4.0, and 8.0 kHz), for nearly all combinations of APHABu subscale scores (subscale scores from 20 to 80%, evaluated in steps of 5%). We calculated the probability of hearing loss for 28,561 different combinations of APHABu subscale scores (results available online). In general, the probability of hearing loss was positively associated with the combined APHABu score (i.e. increasing probability with increasing scores). However, this association was negative at one frequency (8 kHz). The highest probabilities were for a hearing loss of 45 dB at test frequency 2.0 kHz, but with a wide spreading. We showed that the APHABu subscale scores were associated with the probability of hearing loss measured with audiometry. This information could enrich the expert's evaluation of the subject's hearing loss, and it might help resolve suspicious cases of aggravation. The 0.5 and 8.0 kHz frequencies influenced hearing loss less than the frequencies in-between, and 2.0 kHz was most influential on intermediate degree hearing loss (around 45 dB), which corresponded to the frequency-dependence of speech intelligibility measured with speech audiometry.
Grocoske, Francisco Luiz Busato
Full Text Available Introduction: The vascular compression by redundant vessels under the VIII cranial nerves has been studied since the 80's, and many authors proposed correlations between the compression and the otoneurological findings (vertigo, tinnitus, hypoacusis, audiometry and electrophysiological findings. Objective: Analyze and correlate the different signs and otoneurological symptoms, the audiological findings and its incidence over individuals with Vascular Loop (VL diagnosis of VIII cranial nerves by magnetic resonance imaging (MRI. Method: Retrospective study through the analysis of medical records of 47 patients attended in the otoneurology clinic of Clinical Hospital of UFPR. All the patients have MRI exams with compatible pictures of VL of the VIII cranial nerves. Results: The tinnitus was the most frequent symptom, in 83% of the patients, followed by hypoacusis (60% and vertigo (36%. The audiometry presented alterations in 89%, the brainstem evoked auditory potential in 33% and the vecto-electronystagmography in 17% of the patients. Was not found statistically significant relation between the buzz or hypoacusis, and the presence of VL in MRI. Only 36% of patients had complaints of vertigo, the main symptom described in theory of vascular compression of the VIII pair of nerve. As in the audiometry and in brainstem evoked auditory potential was not found a statistically significant relation between the exam and the presence of the VL in the RMI. Conclusion: The results show independence between the findings of the RMI, clinical picture and audiological results (p>0,05 suggesting that there are no exclusive and direct relation between the diagnosis of vascular loop in the MRI and the clinical picture matching.
Honeth, Louise; Ström, Peter; Ploner, Alexander; Bagger-Sjöbäck, Dan; Rosenhall, Ulf; Nyrén, Olof
The aim of this cross-sectional study among Swedish hunters was to examine the association between shooting history and presence of high-frequency hearing impairment (HFHI). All hunters registered with an e-mail address in the membership roster of the Swedish Hunters' Association were invited via e-mail to a secure website with a questionnaire and an Internet-based audiometry test. Associations, expressed as prevalence ratio (PR), were multivariately modelled using Poisson regression. The questionnaire was answered by 1771 hunters (age 11-91 years), and 202 of them also completed the audiometry test. Subjective severe hearing loss was reported by 195/1771 (11%), while 23/202 (11%) exhibited HFHI upon testing with Internet-based audiometry. As many as 328/1771 (19%) had never used hearing protection during hunting. In the preceding 5 years, 785/1771 (45%), had fired >6 unprotected gunshots with hunting rifle calibers. The adjusted PR of HFHI when reporting 1-6 such shots, relative to 0, was 1.5 [95% confidence interval (CI) 1.1-2.1; P = 0.02]. We could not verify any excessive HFHI prevalence among 89 hunters reporting unprotected exposure to such gunshot noise >6 times. Nor did the total number of reported rifle shots seem to matter. These findings support the notion of a wide variation in individual susceptibility to impulse noise; that significant sound energy, corresponding to unprotected noise from hunting rifle calibers, seems to be required; that susceptible individuals may sustain irreversible damage to the inner ear from just one or a few shots; and that use of hearing protection should be encouraged from the first shot with such weapons.
Kanzaki, Jin; Harada, Tatsuhiko; Kanzaki, Sho
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.
Rendl, J.; Rohler, R.; Sieger, C.
To get quantitative information about principal aspects of the near-field propagation of sound in bone conduction, model experiments were performed with transparent silicon rubber as a vibrating material. Using the transparent silicon rubber instead of the bone itself made it possible to measure amplitudes and phases on interior planes of a solid medium of finite extent. To this end several holographic techniques were employed, among them speckle interferometry for analysing in-plane vibrations. A theory was developed which describes the basic features of wave propagation and shows the influence of the viscosity of the material on propagation behaviour. The application of the results on pracitcal audiometry will be discussed.
Roman, Stéphane; Elziere, Maya; Nicollas, Richard; Triglia, Jean-Michel
The hearing disorders of the child between 3 and 12 years are dominated by the conductive hearing loss. The questioning, looking for risk factors, as well as the otoscopy are essential to detect and diagnose a hearing disorder. Screening tests help to identify the children with risk of hearing loss. Then, the child is sent for diagnosis towards an ENT specialist or a specialized structure. In spite of the frequency of the conductive hearing loss, in case of the slightest doubt, a sensorineural hearing loss must be always looked for by a puretone audiometry examination via the headphones.
Eugen Constant Ionescu
Full Text Available A 60-year-old man was referred to the ENT department for intense episodic vertigo triggered by loud sounds. Pure tone audiometry and otoneurological assessment, including videonystagmography using auditory stimulation and cervical vestibular evoked myogenic potential measures, conducted to the hypothesis of a third window syndrome in the left ear. Results from the high-resolution computed tomography of the petrous bone confirmed the hypothesis and revealed the presence of a submillimeter semicircular canal dehiscence, located between the left lateral and superior semicircular canal ampullae on the left side.
Charfi, Afifa; Ben Hadj Yahia, Sihem; Kharrat, Salima; Zouari, Mourad; Bouchama, Jihen; Naziha, Khouja; Abdelmajid, Larnaout; Hentati, Fayçal; Hachicha, Slah
Dyslexia is a reading problem disorder. It can be a direct result of epilepsia for some kids. The researchers have done the study on 30 school kids that suffer from epilepsia. All the children had Audiometry which was normal in all cases. The orthophonic exam has done in all cases, founding a prononciation and speaker disorder also there is disorder at the psychometric test The purpose of the study research is to define the different profiles of dyslexia on the epileptics, then to check the importance of collaboration between Otorhinolaryngologists, Neurologists and Orthophonists to take care of the epileptic kids having dyslexia.
Lauritsen, Maj-Britt Glenn; Kreiner, Svend; Söderström, Margareta
model it was examined whether the total score of the Galker test validly reflected item responses across subgroups defined by sex, age, bilingualism, tympanometry, audiometry and verbal comprehension. Results: A total of 370 children (95%) accepted testing and 339 (87%) completed all 50 items...... ear 2%, and parental education another 2%. Other variable did not reach significance. Conclusion: The Galker-35 was well accepted by children down to the age of 3 years and results indicate that the scale represents construct valid and reliable measurement....
Daniel Paganini Inoue
Full Text Available Inúmeros métodos de análise da recuperação auditiva na perda auditiva neurossensorial súbita idiopática (PANSI dificultam a comparação adequada dos diversos tratamentos encontrados na Literatura. OBJETIVO: Comparar diversos critérios de recuperação auditiva na PANSI, baseados na Literatura. MATERIAL E MÉTODO: Foi realizado um estudo clínico observacional de coorte, a partir de um protocolo prospectivo, em pacientes com PANSI, atendidos entre 2000 e 2010. Foram comparados cinco critérios de recuperação auditiva significativa e quatro critérios para recuperação completa, pela audiometria tonal, por meio de teste não paramétrico e de comparações múltiplas, ambos com um nível de significância de 5%. Após determinação do critério de recuperação auditiva mais rígido, foram adicionados parâmetros da audiometria vocal. RESULTADOS: Houve diferença significativa, entre esses critérios (p The countless methods available to analyze hearing recovery in idiopathic sudden sensorineural hearing loss (ISSHL cases hinder the comparison of the various treatments found in the literature. OBJECTIVE: This paper aims to compare the different criteria for hearing recovery in ISSHL found in the literature. MATERIALS AND METHODS: This is an observational clinical cohort study from a prospective protocol in patients with ISSHL, treated between 2000 and 2010. Five criteria were considered for significant hearing recovery and four for complete recovery by pure tone audiometry, using non-parametric tests and multiple comparisons at a significance level of 5%. After determining the stricter criteria for hearing recovery, vocal audiometry parameters were added. RESULTS: There was a significant difference between the criteria (p < 0.001 as they were analyzed together. Mild auditory recovery occurred in only 35 (27.6% patients. When speech audiometry was added, only 34 patients (26.8% showed significant improvement. CONCLUSIONS: There is a
Wanscher, Jens; Faber, Christian
We present a case in which a patient infected with human immunodeficiency virus (HIV) developed a sensorineural hearing loss and tinnitus due to inner-ear syphilis affection. The patient had normal otomicroscopy, tympanometry, ear, nose & throat examination, caloric test and intracranial magnetic...... resonance imagining. Relevant serological blood samples and lumbal puncture indicated syphilis in its secondary stage or the early latent phase. Audiometry demonstrated a considerable improvement and tinnitus decreased after ten days of treatment with antibiotics and prednisone. Udgivelsesdato: 2010-Jul-12...
Luís Cláudio do Carmo
Full Text Available A população idosa brasileira cresce e representa 8,6% do total populacional. Fatores ambientais, hábitos de vida, sexo e fatores genéticos interferem na evolução da presbiacusia que reduz a qualidade de vida. OBJETIVO: Investigar queixas audiológicas e vestibulares em idosos, executar audiometria tonal, verificar se há diferenças entre os sexos. FORMA DE ESTUDO: Clínico prospectivo de corte transversal. MATERIAL E MÉTODO: 320 pacientes idosos (160 homens e 160 mulheres foram submetidos a anamnese audiológica e audiometria tonal. Análise estatística dos resultados pelos testes ANOVA, Mann-Whitney e Qui-Quadrado. RESULTADO: As queixas audiológicas e vestibulares (perda auditiva, tinnitus, plenitude auricular, tontura foram similares entre os sexos (exceção, a tontura: pThe Brazilian elderly population is growing, and already represents 8,6% of our total population. Environmental factors, lifestyle, gender and genetics impact the development of presbycusis, which reduces quality of life. AIM: investigate audiologic and vestibular complaints in the elderly; perform tonal audiometry and check to see if there are differences between genders. STUDY: Cross-sectional clinical prospective study. MATERIALS AND METHODS: 320 elderly patients (160 men and 160 women were submitted to audiologic interview and tonal audiometry. The results were statistically analyzed by the following methods: ANOVA, Mann-Whitney and Chi-Squared. RESULTS: audiologic and vestibular complaints (hearing loss, tinnitus, ear fullness, dizziness were similar between the genders (except for dizziness: p<0,05; tonal audiometry showed a significant difference, with hearing loss in the high frequencies among men; and among women the curves were descending and flat. These results were statistically significant (P<0,001. CONCLUSION: our results lead us to conclude that, when the genders are compared, hearing loss in the elderly has similar symptoms; however, there are
Schubert, C. R.; Cruickshanks, K. J.; Wiley, T. L.; Klein, R.; Klein, B E; Tweed, T. S.
OBJECTIVE: To determine if infectious diseases usually experienced in childhood have an effect on hearing ability later in life. METHODS: 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,...
Full Text Available A 28-year-old female born to consanguineous parents, presented with progressive palmoplantar keratoderma since the age of six months and a constricting band on right fourth finger of one year duration. There was history of similar complaints being present in two other family members. Associated clinical findings included starfish-shaped cornified plaques on knuckles, resorption of distal phalanges and keratotic plaques on elbows, groins and knees. The patient was mentally sound and had normal audiometry. Biopsy from hyperkeratotic plaque showed hyperkeratosis, parakeratosis, increased granular layer and papillomatosis. Gene mapping for loricrin mutation was found to be negative.
E. S. Azarov
Full Text Available An implementation of digital hearing aid based on the mobile computing platform iPhone is proposed. The developed signal processing scheme has a low delay, takes into account characteristics of the computing platform and allows to perform the correction of sensorineural hearing loss. The cor-rection is carried out by linear frequency-dependent amplification and wideband dynamic range com-pression of the signal. In order to take into consideration magnitude characteristic of loudspeakers, the audiometry is performed using iPhone directly. The experimental results of with proposed hearing aid are given.
Martínez-Wbaldo, María del Consuelo; Soto-Vázquez, Claudia; Ferre-Calacich, Ivonne; Zambrano-Sánchez, Elizabeth; Noguez-Trejo, Lucía; Poblano, Adrián
The aim of this study was to measure the frequency of hearing loss in a sample of typical public high-school students exposed to recreational noise, and determine associated risk factors. The sample was made up of 214 teenagers from a high-school in Mexico City; subjects were selected randomly per strata. We applied a questionnaire to identify risk factors for hearing loss and performed a battery of audiologic tests consisting of otoscopy, tympanometry, and pure-tone audiometry. The mean age ...
Park, Sun Young; Kim, Young Hyun; Kim, Yeo Hyang; Hyun, Myung Chul; Lee, Young Hwan
Kawasaki disease involves acute febrile systemic vasculitis that can cause a variety of symptoms by affecting various organs. Here, we aimed to evaluate the prevalence, causes, and prognosis of sensorineural hearing loss (SNHL) occurring in children with Kawasaki disease. Patients who were diagnosed with Kawasaki disease and received inpatient treatment in the Pediatrics Department at one of three university hospitals in Daegu city from February 2012 to September 2012 were enrolled in the study. The clinical features, hematological results, echocardiography results, audiometry results, and aspirin and salicylic acid serum levels of the patients were evaluated. Of the 59 children enrolled in the study, three showed mild bilateral SNHL on audiometry tests conducted after 48 hours of defervescence; these patients demonstrated normal patterns of recovery on follow-up tests 8 weeks later. Aspirin serum levels were significantly higher in the SNHL group after 48 hours of afebrile condition with high dose aspirin intake (P=0.034). However, no significant differences were found in other laboratory tests or for fever duration (P>0.05). Upon echocardiography, coronary artery abnormality was observed in 9 cases, but none of these patients showed hearing loss. The results indicate that SNHL in children with Kawasaki disease might occur during treatment of the acute phase; this SNHL usually involves mild bilateral hearing loss and recovers naturally. However, this study suggests that determination of the causes and clinical implications of hearing loss in Kawasaki disease requires long-term follow-up studies with more cases.
Andréa Cintra Lopes1, , , ,
Full Text Available Introduction: Work-related hearing loss is one of the most common occupational illness progresses over the years of noise exposure associated with the work environment, may cause damage to undertake physical activity, the individual's physiological and mental besides causing hearing damage irreversible interfering with communication and quality of life. With high prevalence of male evaluates which is the second leading cause of hearing loss. Since there is no medical treatment for this type of hearing loss, it is evident the importance of preventive and conferences aimed at preserving hearing and health as a whole. Objective: To assess the prevalence of hearing loss in audiometry admission of drivers. Methods: Retrospective study. By 76 charts of professional drivers in leased transport companies. We analyzed data from specific interview and pure tone audiometry. Results: The prevalence of abnormal tests was 22.36% with the lowest thresholds for tritonal average of 3,000, 4,000 and 6,000 Hz. The higher the age, the higher thresholds. Conclusion: This study has highlighted the occurrence of hearing in the absence of complaints. Considering that PAIR is preventable, justifies the importance of coordinated and multidisciplinary involving not only health teams and safety, but also the institutions involved in preserving the health of workers, as the team SESMET, unions or prosecutors.
María Consuelo Cháves
Full Text Available Hearing is one of the psycho- physiological process that gives to human beings the capacity of hearing, when hearing is affected a deafness is got, which may be caused by different factors. Such as the exposure to noise when we use sound players. Objective: the purpose of this research is to establish the threshold of undergraduates who often use sound players to find out a possible deafness. Material and methods: a descriptive study of transverse cut was carried out with 92 students who were polled. An anamnesis of exposure to noise by sound players, for register of results and tonal audiometry qualification. 70 anamnesis were carried out, 29 cares were selected based on an inclusion and exclusion criterion. A tonal audiometry and the measurement of sound of the personal sound player were carried out to the students who were selected. Results: it was found out that 13.8% of the assessed students presented a little deafness and 86.2% presented a normal hearing. Conclusions: it was found out that even intensity and the time of use of the sound players have influence on the deafness, in exchange music and some kinds of hearphones are not risky factors for deafness caused by the use of sound players.
Blanco, Pedro; González, Francisco; Holguín, Jorge; Guerra, Claudia
In the surgical management of cholesteatoma, one can opt for a closed technique (simple mastoidectomy) or open surgery (radical mastoidectomy). Open mastoidectomy with reconstruction of the posterior wall and the middle ear in a single surgery combines the advantages of both techniques, namely, adequate surgical exposure, eradication of cholesteatoma, and anatomical reconstruction of the middle ear structures. To evaluate the surgical results in the management of cholesteatoma through the technique of open mastoidectomy with reconstruction of the posterior wall and the middle ear in a single surgery. Prospective analytical observational study conducted between 2009 and 2012 with patients undergoing this surgical technique in the Hospital Universitario del Valle [University Hospital of Valle], performing preoperative clinical monitoring and quarterly postoperative tomography with previous assessments of hearing and pre- and postoperative audiometry. Forty-five patients were studied. Mean postoperative follow-up was 28 months. Surgical success was achieved in 93.3% of patients, as measured by clinical and radiological follow-up. Hearing preservation was found after reconstruction of the hearing mechanism, based on measured audiometry, i.e., pure-tone average (PTA), using the statistical test for paired samples between preoperative and postoperative PTA. (95%CI -1.47-12.15). Residual cholesteatoma was present in 6.6% of cases; three to four times lower than the rate reported in the literature. This type of surgery can be considered a successful technique in the treatment of cholesteatoma in selected cases.
Nolan, Ryan M.; Shelton, Ryan L.; Monroy, Guillermo L.; Spillman, Darold R.; Novak, Michael A.; Boppart, Stephen A.
Otolaryngologists utilize a variety of diagnostic techniques to assess middle ear health. Tympanometry, audiometry, and otoacoustic emissions examine the mobility of the tympanic membrane (eardrum) and ossicles using ear canal pressure and auditory tone delivery and detection. Laser Doppler vibrometry provides non-contact vibrational measurement, and acoustic reflectometry is used to assess middle ear effusion using sonar. These technologies and techniques have advanced the field beyond the use of the standard otoscope, a simple tissue magnifier, yet the need for direct visualization of middle ear disease for superior detection, assessment, and management remains. In this study, we evaluated the use of portable optical coherence tomography (OCT) and pneumatic low-coherence interferometry (LCI) systems with handheld probe delivery to standard tympanometry, audiometry, otoacoustic emissions, laser Doppler vibrometry, and acoustic reflectometry. Comparison of these advanced optical imaging techniques and current diagnostics was conducted with a case study subject with a history of unilateral eardrum trauma. OCT and pneumatic LCI provide novel dynamic spatiotemporal structural data of the middle ear, such as the thickness of the eardrum and quantitative detection of underlying disease pathology, which could allow for more accurate diagnosis and more appropriate management than currently possible.
Homann, Georg; Vieth, Volker; Weiss, Daniel; Nikolaou, Konstantin; Heindel, Walter; Notohamiprodjo, Mike; Böckenfeld, Yvonne
Magnetic resonance imaging enhances the clinical diagnosis of Menière's disease. This is accomplished by in vivo detection of endolymphatic hydrops, which are graded using different semi-quantitative grading systems. We evaluated an established, semi-quantitative endolymphatic hydrops score and with a quantitative method for volumetric assessment of the endolymphatic size. 11 patients with Menière's disease and 2 healthy subjects underwent high resolution endolymphatic hydrops 3 Tesla MRI with highly T2 weighted FLAIR and T2DRIVE sequences. The degree of endolymphatic hydrops was rated semi-quantitatively and compared to the results of 3D-volumetry. Moreover, the grade of endolymphatic hydrops was correlated with pure tone audiometry. Semi-quantitative grading and volumetric evaluation of the endolymphatic hydrops are in accordance (r = 0.92) and the grade of endolymphatic hydrops correlates with pure tone audiometry. Patients with a sickness duration of ≥ 30 months showed a significant higher total labyrinth fluid volume (p = 0.03). Fast, semi-quantitative evaluation of endolymphatic hydrops is highly reliable compared to quantitative/volumetric assessment. Endolymphatic space is significantly higher in patients with longer sickness duration. PMID:25768940
Andrade, Gláucia Manzan Queiroz de; Resende, Luciana Macedo de; Goulart, Eugênio Marcos Andrade; Siqueira, Arminda Lucia; Vitor, Ricardo Wagner de Almeida; Januario, José Nelio
Congenital toxoplasmosis may cause sensorineural deficit in up to 20% of the patients and proper treatment in the first year improves prognosis. In Brazil, this infections impact on hearing impairment is unknown. To evaluate hearing of newborns with congenital toxoplasmosis identified by the newborn screening service. This prospective study analyzed children with congenital toxoplasmosis identified by newborn screening (IgM anti-T.gondii) in Belo Horizonte during 2003/2004. The presence of IgM and/or IgA in the first 6 months or IgG at 12 months-of age in serology was used as case definition. Hearing tests were carried out at the time of diagnosis and 12 months later, including behavioral audiometry, evoked otoacoustic emission and brainstem evoked responses audiometry. Among 30.808 screened children (97% of live births), 20 had congenital toxoplasmosis, 15 (75%) were asymptomatic at birth. Nineteen children were evaluated by hearing tests. Four had sensorineural impairment (21.1%). One child had other risk factors for hearing impairment; the other three had no other risk factors but toxoplasmosis. Two properly children treated still had hearing loss, in disagreement with current literature. Results suggest that congenital toxoplasmosis, common in Brazil, is a risk factor for hearing impairment and its impact on hearing loss deserves further studies.
Kieran, S M; Dunne, J; Hughes, J P; Fenton, J E
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.
Ozdirim, E; Topçu, M; Ozön, A; Cila, A
Clinical and laboratory findings of 25 patients with classical Cockayne syndrome (CS) are reviewed. A history of consanguinity was present in 21 patients, and 15 patients had at least 1 affected sibling. Apart from the cardinal features of dwarfism, microcephaly, and mental retardation, the most consistent clinical features included photosensitivity (84%), gait disturbances (84%), progeroid appearance (84%), and ocular abnormalities (88%). The most consistent laboratory findings comprised abnormal nerve conduction (slowed conduction in 13 of the 16 cases with an ENMG), and an abnormal brainstem auditory evoked response (BAER) and/or audiometry (abnormal in 13 of the 17 cases in whom either one of them were available). Cerebral atrophy and calcification of the basal ganglia were the next more common laboratory findings. Clinical criteria are useful in most instances in the diagnosis of CS. In patients in whom the clinical features are controversial for a diagnosis of Cockayne syndrome, studies directed to disorders of myelination involving both peripheral and central nervous systems in conjunction with audiometry may aid in the diagnosis.
Båsjö, Sara; Möller, Claes; Widén, Stephen; Jutengren, Göran; Kähäri, Kim
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.
Swanepoel, De Wet; Myburgh, Hermanus C; Howe, David M; Mahomed, Faheema; Eikelboom, Robert H
To determine if a smartphone application could be used as a calibrated screening audiometer with real-time noise monitoring for school screening using automated test sequences. The investigation comprised three studies. Study 1 evaluated calibration accuracy across four Samsung S5301 smartphones (Android v4.0.4) using commercial Sennheiser HD202 headphones. Study 2 involved referencing smartphone microphone sensitivity to narrowband noise intensity as measured in octave bands by a sound-level meter between 30 and 75 dB SPL (5 dB increments). Study 3 compared screening outcomes of smartphone based and conventional hearing screening. Study 2: 15 normal-hearing subjects (age range, 18-22 years; all female). Study 3: 162 children (324 ears) aged 5 to 7 years. Smartphone calibration at 20, 30, and 40 dB was within 1 dB of recommended reference equivalent thresholds levels. Microphone calibration for noise monitoring had maximum variability across phones of 0.9, 0.6, and 2.9 dB at 1, 2, and 4 kHz, respectively, from reference intensities (30 to 75 dB SPL). Screening outcomes demonstrated no significant difference between smartphone and conventional audiometry with an overall referral rate of 4.3% and 3.7%, respectively. The newly developed smartphone application can be accurately calibrated for audiometry with valid real-time noise monitoring, and clinical results are comparable to conventional screening.
Theunissen, Eleonoor A R; Zuur, Charlotte L; Bosma, Sophie C J; Lopez-Yurda, Marta; Hauptmann, Michael; van der Baan, Sieberen; de Boer, Jan Paul; van der Molen, Lisette; Rasch, Coen R N; Dreschler, Wouter A; Balm, Alfons J M
The purpose of this study was to determine whether concomitant chemoradiation (CCRT)-induced hearing loss is progressive over time or not. Long-term (LT) follow-up study. Between 1999 and 2004, 158 patients with head and neck cancer were treated with intravenous (IV) CCRT (n = 80) or intraarterial CCRT (n = 78). Audiometry was performed before, short-term (ST), and LT posttreatment. Differences in hearing were assessed with a multivariable linear regression analysis, incorporating the effect of aging. Long-term audiometry (median 4.5 years) was available in 67 patients (42%). At ST follow-up, a deterioration of 21.6 decibel was seen compared to baseline at pure-tone averages (PTA) 8-10-12.5 kHz. At LT follow-up, this deterioration further increased with 5 decibel (P = 0.005). Only in CCRT-IV patients was a significant progressive treatment-induced hearing loss seen, at PTA 8-10-12.5 kHz (P = 0.005), PTA 1-2-4 kHz air conduction (P = 0.014), and PTA 0.5-1-2 kHz bone conduction (P = 0.045). CCRT-induced hearing impairment was progressive over time, especially in higher frequencies and only in CCRT-IV patients, with a modest deterioration of 5 decibel 4.5 years post-treatment. 4. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.
George O. Adjei
Full Text Available Background. Plasmodium falciparum malaria, as well as certain antimalarial drugs, is associated with hearing impairment in adults. There is little information, however, on the extent, if any, of this effect in children, and the evidence linking artemisinin combination therapies (ACTs with hearing is inconclusive. Methods. Audiometry was conducted in children with uncomplicated malaria treated with artesunate-amodiaquine (n=37, artemether-lumefantrine (n=35, or amodiaquine (n=8 in Accra, Ghana. Audiometry was repeated 3, 7, and 28 days later and after 9 months. Audiometric thresholds were compared with those of a control group of children (n=57 from the same area. Findings. During the acute stage, hearing threshold levels of treated children were significantly elevated compared with controls (P<0.001. The threshold elevations persisted up to 28 days, but no differences in hearing thresholds were evident between treated children and controls after 9 months. The hearing thresholds of children treated with the two ACT regimens were comparable but lower than those of amodiaquine-treated children during acute illness. Interpretation. Malaria is the likely cause of the elevated hearing threshold levels during the acute illness, a finding that has implications for learning and development in areas of intense transmission, as well as for evaluating potential ototoxicity of new antimalarial drugs.
[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].
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.
Samuel, Paola Angelica; Goffi-Gomez, Maria Valéria Schmidt; Bittencourt, Aline Gomes; Tsuji, Robinson Koji; Brito, Rubens de
To verify the effectiveness of remote programming of cochlear implants by stimulation levels and results in the perception of speech and free-field audiometry tests. Twelve patients from both genders, aged between 18 and 59 years, users of internal cochlear implant and speech processor of the same model for at least 12 months, were selected. Both the remote programming (RP) and the live programming (LP) were performed on the same day, measuring the minimum (T) and maximum (C) stimulation levels of five electrodes with the interpolation of the remaining ones. Speech perception tests were applied using 65 dBSPL (recorded open context sentences and monosyllables). The patients were submitted to free-field audiometry at 250-8,000 Hz frequencies. The results for the RP and LP were compared. Differences in mean of the T levels for three electrodes and the C levels for one electrode were found. No difference between the results was obtained in the speech perception tests and audiometric thresholds in the RP and LP. The RP is a simple and effective procedure for programming cochlear implant devices and, although there were differences in the stimulation levels of some electrodes, it did not interfere in the speech perception outcomes.
Reitsma, Sietze; Stokroos, Robert; Weber, Jacobiene W; van Tongeren, Joost
To present the rare case of a young boy with idiopathic intracranial hypertension presenting with bilateral sensorineural hearing loss developing over several months. This was accompanied by headaches, otalgia, tinnitus, and vertigo. Furthermore, we aim to provide a concise review on this matter, as this report represents the second case in literature of pediatric idiopathic intracranial hypertension presenting with hearing loss. Workup of a 9-year-old boy with bilateral sensorineural hearing loss, including (among others) physical examination, audiometry, diagnostic imaging, and lumbar puncture. Physical examination including fundoscopy as well as imaging showed no abnormalities. At presentation, pure tone audiometry revealed bone conduction thresholds of about 30 dB HL in both ears. Two months later, this declined to about 35 dB HL in both ears. Lumbar puncture revealed an increased intracranial pressure. The boy was thus diagnosed with idiopathic intracranial hypertension. After the lumbar puncture, the otological complaints gradually resolved, and the hearing normalized (bone conduction thresholds of 0-5 dB HL). Although rare, sensorineural hearing loss in the pediatric population together with otalgia, tinnitus, and vertigo can be due to idiopathic intracranial hypertension and as such can be reversible. © The Author(s) 2015.
Dünne, A A; Bien, S; Folz, B J; Werner, J A
Muenke's syndrome is a rarely seen craniosynostosis syndrome. Bilateral or unilateral coronal craniosynostosis, brachydactyly, tarsal and carpal coalitions are the typical clinical findings. Sensorineural hearing loss is reported in more than 30% of the affected patients. In patients with Muenke's syndrome intracranial vascular dysplasia has not been reported yet. A 13-year-old boy suffering from Muenke's syndrome reported a pulsating left-sided light tinnitus. Clinically a bluish formation was found at the lower part of the left-sided ear drum. In order to clarify the cause of the tinnitus and the bluish formation, extensive diagnostics (e.g. audiometry, magnet resonance tomography, magnet resonance phlebography, angiography) were carried out. Audiometry found a left sensorineural hearing loss with a conductive component. Radiological investigations found a standard variant venous dysplasia of the left petrous bone to be the reason for the tinnitus. Awareness of intracranial vascular dysplasia should be noted in individuals with Muenke's syndrome especially in cases of clinically suggestive symptoms like pulsating tinnitus.
Hollingsworth, J.W.; Ishii, Goro
Audiometry observations were analyzed for 290 irradiated survivors of the 1945 atomic bomb in Hiroshima and in 293 nonirradiated subjects. The study was undertaken in order to determine the age changes in audiology in irradiated and nonirradiated subjects as well as to investigate the pattern of hearing levels in a Japanese population for comparison with patterns in Caucasians. The following statistical observations were made. Correlation between hearing levels for right and left ear. Correlation between hearing levels at various cycles. Changes in hearing levels by age and sex. The relation between age and decibel loss was not linear and correlation ratios with age were 0.45 to 0.72. Audiometry seems to be of some value as one of a battery of tests of physiologic aging designed for detection of irradiation induced nonspecific aging acceleration. In this relatively small sample, no differences in hearing acuity were detected in the atomic bomb survivors as compared with the control sample. 6 references, 3 figures, 9 tables.
Full Text Available Background and Aim: Auditory neuropathy (AN can be diagnosed by abnormal auditory brainstem response (ABR, in the presence of normal cochlear microphonic (CM and otoacoustic emissions (OAEs.The aim of this study was to investigate the ABR and other electrodiagnostic test results of 6 patients suspicious to AN with problems in speech recognition. Materials and Methods: this cross sectional study was conducted on 6 AN patients with different ages evaluated by pure tone audiometry, speech discrimination score (SDS , immittance audiometry. ElectroCochleoGraphy , ABR, middle latency response (MLR, Late latency response (LLR, and OAEs. Results: Behavioral pure tone audiometric tests showed moderate to profound hearing loss. SDS was so poor which is not in accordance with pure tone thresholds. All patients had normal tympanogram but absent acoustic reflexes. CMs and OAEs were within normal limits. There was no contra lateral suppression of OAEs. None of cases had normal ABR or MLR although LLR was recorded in 4. Conclusion: All patients in this study are typical cases of auditory neuropathy. Despite having abnormal input, LLR remains normal that indicates differences in auditory evoked potentials related to required neural synchrony. These findings show that auditory cortex may play a role in regulating presentation of deficient signals along auditory pathways in primary steps.
Kobayashi, Toshimitsu; Okitsu, Takuji; Sakurai, Tokio; Ikeda, Katsuhisa; Taniguchi, Kazuhiko; Takahashi, Kuniaki; Kusakari, Jun
The usefulness of CT in preoperative examinations for middle ear surgery was evaluated on the basis of whether or not it can provide a surgon with useful information not available from the other preoperative examinations, such as microscopic examination, pure tone audiometry, impedance audiometry, equilibrium tests, conventional X-ray films, etc. The findings of CT were compared with those obatained during operations and the following conclusions were reached: CT is especially useful for the three purposes indicated below. (1) to determine the patency of the attic air route to the mastoid antrum. (2) to make differential diagnoses of middle ear diseases in the presence of obstructive pathology of the external auditory meatus. (3) to make a rough estimate of the extent of cholesteatoma growth in the middle ear cleft, and to diagnose labyrinthine fistulae. CT proved less effective or useless for the following three purposes. (1) to secure detailed information on the status of the ossicular chain. (2) to determine the precise extent of the growth of cholesteatoma. (3) to evaluate the postoperative status of the ear. (author).
Safavi Naini, Ali; Ghorbani, Jahangir; Montazer Lotfe Elahi, Sima; Beigomi, Mohsen
Introduction: Granulomatosis with polyangiitis (GPA; also known as Wegener’s granulomatosis) is a primary systemic vasculitis involving the ear, nose and throat system (ENT) and lower respiratory tract. Because of the lack of knowledge regarding the clinical findings of GPA due to the limited number of studies, the current study was designed to investigate the prevalence and nature of the otology manifestations in the disease course. Materials and Methods: In the current prospective study, patients with a diagnosis of GPA from 2012–2016 were included. A definitive diagnosis was made based on the history, physical examination (otomicroscopy, Rinne and Weber test), audiometry, tympanometry, cytoplasmic and perinuclear anti-neutrophil cytoplasmic antibody (C-ANCA and P-ANCA) investigations, and pathologic studies. Results: Twenty-seven male and 28 female patients aged 41.6±15.3 years were enrolled. Ear involvement was found in 20 patients (36.3%), and the most prevalent symptom was loss of hearing followed by otalgia and tinnitus. Tinnitus improved in none of the patients. The most prevalent sign was otitis serous followed by mastoiditis and external otitis. The most important audiometry finding was sensorineural hearing loss. Pathological studies using pulmonary samples were more useful for diagnosis. Conclusions: Precise clinical examination is crucial for the early diagnosis of GPA. Otological manifestations are common, especially loss of hearing and otitis serous, and can be the first sign of this disease. Early diagnosis can lead to better treatment of Wegener’s granulomatosis. PMID:29383313
Full Text Available Introduction: Sudden deafness or sudden sensorineural hearing loss (SSNHL is defined as sensorineural hearing loss of more than 30 dB at three consecutive frequencies within 3 days of onset, often unilateral and idiopathic. Etiology of sudden deafness is still not known, but there are many theories put forward by the experts as a risk factor for sudden deafness. The prevalence of sudden deafness 5-30 per 100,000 people per year. Distribution of men and women almost equally, with the peak age of 50-60 years. Sudden deafness diagnosis is made based on history, physical examination and audiometry. Sudden deafness has three characteristics; acute, sensorineural hearing loss and unknown etiology. Additional characteristics may include vertigo, tinnitus and the absence of cranial nerve involvement. Management of sudden deafness include conservative therapy with multiple modalities. Case: Patient male, 40 years, Bali, Hindu present with hearing loss since ± 2 weeks ago. Patients previously complained of heat in the ear ± 2 days ago accompanied by a downward hearing and ears. A history of vomiting, coughs and colds denied. History of treatment at the hospital and was hospitalized for ± 2 weeks. Patients had never suffered from the same disease. No history of sinusitis, allergy, anemia, autoimmune and other systemic diseases. Patients also had never experienced trauma and underwent nasal surgery before. Keywords:sudden deafness, sensorineural, audiometry.
Ihler, Friedrich; Volbers, Laura; Blum, Jenny; Matthias, Christoph; Canis, Martin
To review functional results and quality of life of the first patients implanted with a newly introduced bone conduction implant system. Retrospective chart analysis of 6 patients (6 ears) implanted for conductive hearing loss (CHL) and mixed hearing loss (MHL) in 1 tertiary referral center between July 2012 and February 2013. Implantation of a new bone conduction hearing device. Pure tone audiometry (air conduction and bone conduction thresholds, pure tone average, air-bone gap, and functional gain), speech audiometry (Freiburg Monosyllabic Test), intraoperative and postoperative complication rate, and patient satisfaction (Glasgow benefit inventory [GBI]) were assessed. Air-conduction pure tone average (PTA) was 58.8 ± 8.2 dB HL. Unaided average air-bone gap (ABG) was 33.3 ± 6.2 dB. Aided air-conduction PTA in sound field was 25.2 ± 5.1 dB HL. Aided average ABG was -0.3 ± 7.3 dB. Average functional gain was 33.6 ± 7.2 dB. Mean improvement of GBI was +36.1. No intraoperative complications occurred. During a follow-up period of 8.5 ± 2.2 months, no device failure and no need for revision surgery occurred. Audiometric results of the new bone conduction hearing system are satisfying and comparable to the results of devices that have been applied previously for CHL and MHL. Intraoperatively and postoperatively, no complications were noted.
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
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
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
We estimate the prevalence of hearing-aid use in Iceland and identify sex-specific factors associated with use. Population-based cohort study. 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. 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. 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.
Lu, C D; Ding, Q F; Wang, Z X; Shao, H; Sun, X C; Zhang, F
Objective: To explore occupational-disease-inductive in a carbon enterprise workplace and personnel occupational health examination, providing the basis for occupational disease prevention and control of the industry. Methods: Field occupational health survey and inspection law were used to study the the situation and degree of occupational disease hazards in carbon enterprise from 2013 to 2015.Occupational health monitoring was used for workers, physical examination, detection of occupational hazard factors and physical examination results were analyzed comprehensive. Results: Dust, coal tar pitch volatiles, and noise in carbon enterprise were more serious than others. Among them, the over standard rate of coal tar pitch volatiles was 76.67%, the maximum point detection was 1.06 mg/m(3), and the maximum of the individual detection was 0.67 mg/m(3). There was no statistical difference among the 3 years (P>0.05) . There were no significant differences in the incidence of occupation health examination, chest X-ray, skin audiometry, blood routine, blood pressure, electrocardiogram between 3 years (P>0.05) , in which the skin and audiometry abnormal rate was higher than 10% per year. Conclusion: Dust, coal tar, and noise are the main occupational hazard factors of carbon enterprise, should strengthen the corresponding protection.
Full Text Available Conversion deafness is a somatoform disorder characterized by hearing loss without an anatomic or pathophysiologic lesion. Clinically, discrepancies between behavior hearing thresholds and objective electrophysiologic examinations, such as impedance audiometry, otoacoustic emissions (OAE, and auditory brainstem response (ABR, will raise the suspicion of this disorder. It is judged to be due to psychological factors and that patients do not intentionally produce the symptom. Conversion deafness is sometimes reported in children but is extremely rare among adults. Two young adults with this disease are presented. These 2 patients were both under enormous stress from the national entrance examinations for universities. Pure tone audiometry showed bilateral hearing deterioration, but OAE and ABR were normal. The hearing of both patients recovered after treatment. The diagnosis, prognosis and treatment of this disorder are also discussed. It is important to discover the psychological stress in patients with conversion deafness. This report aims to increase awareness of this condition and avoid unnecessary steroid use in its treatment.
E. E. Savel'eva
Full Text Available Objective: comparative analysis of objective hearing function examination methods in children and identification of the factors affecting examination results. Patients and methods. We studied hearing in 473 children of 3 months – 5 years of age with sensorineural hearing loss and surdity. The control group was comprised of 30 children with normal hearing. Along with the standard clinical examination of ENT-organs, we performed tympanometry and reflexometry, examination of delayed evoked otoacoustic emission and reflection-source frequency otoacoustic emission, registered short-latency auditory evoked potentials and auditory steady state response (ASSR in all children. We also conducted behavioral audiometry in children of 2-3 years of age and play audiometry in older children. Results. Various hearing loss risk factors are revealed in anamneses of most children (77% with sensorineural hearing loss and surdity. The most sensitive (Se = 100% and specific (Sp = 98.3% method of diagnosing hearing level in children is the registration of short-latency brainstem auditory evoked potentials. Conclusions. The most reliable results of hearing thresholds identification are obtained when classic psychoacoustic hearing function examination methods are combined with modern electrophysiological examination method and hearing loss grade verification using surdopedagogic tests.
Wu, Wufang; Zhang, Hua; Chen, Jing; Chen, Jianyong; Lin, Changyan
This study reports the development and evaluation of a Computerized Mandarin Speech Test System (CMSTS). Taking into account the rules for developing speech materials and the unique linguistic characteristics of Mandarin, we designed and digitally recorded a set of materials comprised of seven lists of monosyllabic words, nine lists of disyllabic words, and fifteen lists of sentences with a high degree of subject familiarity. The CMSTS was developed with Visual Studio 2008, Access 2003 and DirectX 9. The system included five functions: listener management, a speech test, list management, data management, and system settings. We used the system to measure the speech recognition threshold (SRT) of 76 participants with normal hearing (age range: 20-28 years), and measured performance-intensity functions (PI) for all stimuli. The SRT results were in accord with pure-tone results obtained by pure-tone audiometry. In a speech recognition score (SRS) test, changing the presentation level had the strongest effect on sentence recognition, followed by the presence of disyllabic words. Monosyllabic words were least affected by changes in presentation level. The slopes of the linear portion of the PI using the system were in accord with the findings of previous studies using audiometers and CDs with similar materials. The CMSTS has sufficient sensitivity, and can facilitate the wider use of speech audiometry in Chinese audiology clinics. Copyright © 2011 Elsevier Ltd. All rights reserved.
Sousa, Cláudia Simônica de; Castro Júnior, Ney de; Larsson, Erkki Juhani; Ching, Ting Hui
Presbycusis, or the aging ear, involves mainly the inner ear and the cochlear nerve, causing sensorineural hearing loss. Risk factors include systemic diseases and poor habits that cause inner ear damage and lead to presbycusis. Correct identification of these risk factors is relevant for prevention. To evaluate the prevalence and to identify the risk factors of presbycusis in a sample aged over 40 years. A retrospective case series. medical records of 625 patients were evaluated. Presbycusis was identified using pure tone audiometry, speech audiometry and impedance testing of all patients. The prevalence of presbycusis was 36.1%; the mean age was 50.5 years ranging from 40 to 86 years; 85.5% were male and 14.5% werf female. Age, the male gender, diabetes mellitus, and hereditary hearing loss were identified as risk factors. Cardiovascular diseases, smoking and consumption of alcohol were not confirmed as risk factors, although these have often been mentioned as risk factors for presbycusis. Notwithstanding the idea that presbycusis has multiple risk factors, this study identified few risk factors for this disease.
Kim, H. N.; Kim, S. G.; Lee, H. K.; Ohrr, H.; Moon, S. K.; Chi, J.; Lee, E. H.; Park, K.; Park, D. J.; Lee, J. H.; Yi, S. W.
Presbycusis, a bilateral sensorineural hearing loss caused by changes in the inner ear, is related to multiple factors such as noise exposure and otologic disease. In institute-based studies, we tried to determine the incidence of presbycusis in Korean populations living in Seoul, Kyunggi and Kangwon provinces by gender and age groups. The subjects were people who had visited health promotion centers. Pure tone audiometry was done over 20 years on 6,028 subjects. In a community-based study, the subjects were elderly residents of Kanghwa-do area. There were no obvious factors that could cause hearing impairment in the subjects. For the pure tone audiometry, hearing threshold was obtained by using the six-dimension method. The incidence of presbycusis for subjects aged 65 years and older was 37.8% and 8.3% for > or = 27 dB HL criterion and > or = 41 dB HL criterion, respectively. The incidence increased with age. A statistically significant difference in the hearing threshold was found between men and women aged 65 years or older. No differences were found between the community-based study and the institute- based studies. There was a high incidence (about 40%) of presbycusis among Koreans aged 65 years or older (for > or = 27 dB HL criterion). With an aging population, we anticipate that this report could be used to provide a basic data for the study of presbycusis. PMID:11068997
Proupín Vázquez, Norberto; Lorenzo Martínez, Ana; Del Río Valeiras, María; Alvarez Alonso, Lorena; Segade Buceta, Xosé; Labella Caballero, Torcuato
Presbycusis is one of the causes of deafness that has increased most in our society. To show the levels of presbycusis in people over 60 who attend our health centre for other reasons and to assess the utility of certain tests employed in primary care to detect hearing problems. One-hundred and ten people. prior specialist diagnosis, lack of consent or impossibility of running the tests. Assessment of auditory invalidity: otoscopy, Weber, Rinne, whispered voice, auditory disability test. Audiological validation by audiometry assessed by ORL. Results analysed with SPSS statistical packet. Mean age 714 (6.1). Otoscopy was normal in 81.8%. Weber's test had no significant relationship with the otoscopy, but did with the Rinne. Presbycusis was seen in 68.2% of the audiometries. Everyone (100%) who had worked in a noisy environment had audiometric deficit. There were high figures (87%) for hypoacusis in our population of elderly people. In 68.2%, this was due to presbycusis. The sensitivity and negative predictive value (Vp-) of most of the tests used in primary care to detect auditory disorders are low.
Pereira, José Roberto
Full Text Available Introduction: The industrial technological advance has brought benefits and a series of implications that may commit the worker's health and life quality. The exposure to physical, chemical agents and organizational stressors contribute for the increase of work accidents risks. The noise, taken as the most frequent physical agent in the work environment, may cause auditory alterations called Noise-Induced Hearing Loss that affect the communication and life quality of the workers. Objective: To research the auditory health of employees in a funeral urns factory. Method: 90 workers took part in this study, aged between 16 and 52 years, exposed to sound pressure levels equal or higher than 85 dBNPS, vibration and/or chemical agents in the work environment. We carried out a specific interview and Threshold Tonal Audiometry. Results: This study identified altered audiometry results in 13.33% the right ear and 16.67% in the left ear and the age also influenced these auditory thresholds. Conclusion: The accomplishment of a workers' health surveillance program with all people involved is critical and will contribute for the human resources formation, in the management to proceed with actions as well as those by the proper workers being careful of their health.
Durán-Padilla, Carmen Lucía; Martínez-Chávez, Jaime; Amador-Licona, Norma; Pereyra-Nobara, Texar Alfonso
The tympanoplasty for high-risk tympanic membrane perforation is a challenge. It is necessary to compare the most useful and feasible surgical technics in our environment for these patients. The objective was to compare the cartilage island tympanoplasty for the treatment of high-risk tympanic membrane perforations versus the use of temporalis fascia. Randomized controlled clinical trial in 69 patients of ten years or older, diagnosed with high-risk tympanic membrane perforation in a third level hospital. The MERI index was determined and an initial audiometry was obtained. 7, 30 and 60 days after the tympanoplasty the tympanic graft integrity was evaluated. The audiometry was only repeated at 60 days. 69 patients were included, 33 received cartilage island (group 1) and 36 temporalis fascia (group 2). 93.9% was the success rate for group 1 at 30 and 60 days and 83.3% for group 2 (p = 0.17). Hearing improvement was neither different between groups (33.1 vs. 33.6 dB; p = 0.88), for group 1 and 2, respectively. No difference in morphological and audiological outcomes using cartilage island tympanoplasty or temporalis fascia for the treatment of high-risk tympanic membrane perforation was found.
Full Text Available The programming of CIs is essential for good performance. However, no Good Clinical Practice guidelines exist. This paper reports on the results of an inventory of the current practice worldwide. A questionnaire was distributed to 47 CI centers. They follow 47600 recipients in 17 countries and 5 continents. The results were discussed during a debate. Sixty-two percent of the results were verified through individual interviews during the following months. Most centers (72% participated in a cross-sectional study logging 5 consecutive fitting sessions in 5 different recipients. Data indicate that general practice starts with a single switch-on session, followed by three monthly sessions, three quarterly sessions, and then annual sessions, all containing one hour of programming and testing. The main focus lies on setting maximum and, to a lesser extent, minimum current levels per electrode. These levels are often determined on a few electrodes and then extrapolated. They are mainly based on subjective loudness perception by the CI user and, to a lesser extent, on pure tone and speech audiometry. Objective measures play a small role as indication of the global MAP profile. Other MAP parameters are rarely modified. Measurable targets are only defined for pure tone audiometry. Huge variation exists between centers on all aspects of the fitting practice.
Full Text Available Objective: to establish the prevalence institutional alterations in hearing and languaje in children aged 4 and 5 years, attending the Growth and Development program at the Social Institution of Popayan in 2012. Methodology: We performed a cross-sectional study in sample of 96 children who attended four points ESE Care Popayan, during the months of december 2011 and January 2012. Were evaluated by Fonoaudiología, who applied the Reynell test to assess languaje and tone audiometry and otoacoustic emissions to assess hearing. Results: the mean age of the population was 59.34 months, while 50% was made up of men. The 78.1% had alterations in expressive language and 41.7% in language understanding, 29.2% showed changes of left ear as otoacoustic emissions and according to tone audiometry, high frequency of right are the most affected. Conclusions: the high prevalence of alterations in speech and hearing in children found to initiate processes that are more complex as the acquisition of reading and writing, could trigger negative consequences such as poor school performance and even dropouts.
Full Text Available Abstract Background Fabry disease (FD, OMIM 301500 is an X-linked inborn error of glycosphingolipid metabolism due to the deficient activity of alpha-galactosidase A, a lysosomal enzyme. While the progressive systemic deposition of uncleaved glycosphingolipids throughout the body is known to have protean clinical manifestations, few data are available regarding the cochlear involvement. Methods We non-invasively investigated cochlear functions in 22 consecutive hemizygous males (age 19–64 years, mean 39 affected with classic FD. Conventional audiometry, tympanometry, ABR audiometry, otoacoustic emissions were performed in all patients, together with medical history record and physical examination as part of an exhaustive baseline evaluation prior to enzyme replacement therapy. Results A total of 12 patients (54.5% with classic FD were found to have abnormal audition. Five patients had progressive hearing loss and seven patients (32% experienced sudden deafness. In addition, a hearing loss on high-tone frequencies was found in 7 out of the 10 remaining patients without clinical impairment, despite their young age at time of examination. The incidence of hearing loss appeared significantly increased in FD patients with kidney failure (P tinnitus aurium was also found in six patients (27%. Conclusion This is the first evidence of a high incidence of both progressive hearing loss and sudden deafness in a cohort of male patients affected with classic Fabry disease. The exact pathophysiologic mechanism(s of the cochlear involvement deserves further studies.
Full Text Available Introduction Oculo-auriculo-vertebral spectrum, also referred to as Goldenhar syndrome, is a condition characterized by alterations involving the development of the structures of the first and second branchial arches. The abnormalities primarily affect the face, the eyes, the spine, and the ears, and the auricular abnormalities are associated with possible hearing loss. Objective To analyze the audiological findings of patients with oculo-auriculo-vertebral spectrum through liminal pure-tone audiometry and speech audiometry test. Methods Cross-sectional study conducted on 10 patients with oculo-auriculo-vertebral spectrum and clinical findings on at least two of the following areas: orocraniofacial, ocular, auricular, and vertebral. All patients underwent tonal and vocal hearing evaluations. Results Seven patients were male and three were female; all had ear abnormalities, and the right side was the most often affected. Conductive hearing loss was the most common (found in 10 ears, followed by sensorineural hearing loss (in five ears, with mixed hearing loss in only one ear. The impairment of the hearing loss ranged from mild to moderate, with one case of profound loss. Conclusions The results show a higher frequency of conductive hearing loss among individuals with the oculo-auriculo-vertebral spectrum phenotype, especially moderate loss affecting the right side. Furthermore, research in auditory thresholds in the oculo-auriculo-vertebral spectrum is important in speech therapy findings about the disease to facilitate early intervention for possible alterations.
Sam, Gerben; Chung, Dick Wong; van der Hoeven, Ruud; Verweij, Sjoerd; Becker, Matthijs
Background The intratympanic application of the ototoxic aminoglycoside gentamicin has shown promising results as an ablative treatment for vertigo associated with Ménière's disease. Objective To evaluate the efficacy and safety of intratympanic gentamicin and to specifically analyse the effect of this treatment on high and low hearing frequencies in patients with unilateral definite Ménière's disease. Method Subjects were treated with intratympanic gentamicin and were evaluated on vertigo, tinnitus, mean pure tone audiometry threshold and speech discrimination score. Subjects were followed for evaluation for up to 2 years after treatment. Results The number of vertigo spells per month decreased and subjects experienced less tinnitus. During follow up there was an increase of hearing loss in the low (0.25-, 0.5-, 1-kHz) frequency range (13.3 dB; p = 0.03). There was no significant increase of hearing loss in the high (2-, 4-, 8-kHz) frequency range. A clinically significant change in speech discrimination score was found in 50 % of the subjects. Conclusion Our results indicate that intratympanic gentamicin especially affects the mean pure tone audiometry threshold in the low frequency range, which may have clinical implications. Though many of our results are (statistically) substantial the study was limited by the small cohort size.
Gattu, Ramtilak; Akin, Faith W; Cacace, Anthony T; Hall, Courtney D; Murnane, Owen D; Haacke, E Mark
Case reports are presented on four Veterans, aged 29-46 years, who complained of chronic dizziness and/or postural instability following blast exposures. Two of the four individuals were diagnosed with mild traumatic brain injury and three of the four were exposed to multiple blasts. Comprehensive vestibular, balance, gait, audiometry and neuroimaging procedures were used to characterize their injuries. Vestibular assessment included videonystagmography, rotary chair and cervical and ocular vestibular evoked myogenic potentials. Balance and gait testing included the sensory organization test, preferred gait speed and the dynamic gait index. Audiometric studies included pure tone audiometry and middle-ear measurements. Neuroimaging procedures included high resolution structural magnetic resonance imaging, susceptibility-weighted imaging and diffusion-tensor imaging. Based on the neuroimaging and vestibular and balance test results, it was found that all individuals had diffuse axonal injuries and all had one or more micro-hemorrhages or vascular anomalies. Three of the four individuals had abnormal vestibular function, all had abnormally slow walking speeds and two had abnormal gait and balance dysfunction. The use of contemporary neuroimaging studies in conjunction with comprehensive vestibular and balance assessment provided a better understanding of the pathophysiology and pathoanatomy of dizziness following blast exposures than standard vestibular and balance testing alone.
Grégoire, Anaïs; Van Damme, Jean-Philippe; Gilain, Chantal; Bihin, Benoit; Garin, Pierre
After 20 years of experience with different types of middle ear implants, we analyzed our database about the Vibrant Soundbridge (VSB) to know the rate of complications, the effect on the residual hearing and the audiometric gain in our center. The study was retrospective and included all VSB implants bound to the long process of the incus in our tertiary medical center between january 1999 and february 2015. We observed the effect of surgery on residual hearing by comparing bone and air conduction thresholds before and after implantation. The functional results of the implant were quantified by measuring, at several post-operative intervals, the thresholds with the VSB in pure tone audiometry and speech audiometry, in quiet and in noise. 53 VSB were implanted in 46 patients aged between 22 and 81 years old (average 53.9). 48 patients (90%) suffered from a sensorineural hearing loss, and 5 patients from a mixed hearing loss due to an otosclerosis (but only 3 of them have undergone stapedotomy). There were no major complications (e.g. facial palsy, dead ear or postoperative infection). The placement of the implant created an insignificant deterioration of the air conduction thresholds (5,6 dB HL) and bone conduction thresholds (2.2 dB HL) at 6 weeks post-implantation. The bone conduction thresholds increased by 4.7 dB HL 2.5 years after surgery in comparison with the preoperative results, which is also considered clinically insignificant. With the implant turned on, the pure tone audiometry thresholds in open field, in quiet, were significantly improved (gain of 13.9 dB on average on frequencies from 250 to 8000 Hz), particularly at frequencies of 1000, 2000 and 4000 Hz as the average gain on these frequencies amounted to 19.4 dB. The speech intelligibility in a cocktail party noise was also improved by 18.3% on average at 6, 52 and 104 weeks post-implantation. The Vibrant Soundbridge with the electromagnetic vibrator fixed to the long process of the incus is a safe
Full Text Available Abstract Harboyan syndrome is a degenerative corneal disorder defined as congenital hereditary endothelial dystrophy (CHED accompanied by progressive, postlingual sensorineural hearing loss. To date, 24 cases from 11 families of various origin (Asian Indian, South American Indian, Sephardi Jewish, Brazilian Portuguese, Dutch, Gypsy, Moroccan, Dominican have been reported. More than 50% of the reported cases have been associated with parental consanguinity. The ocular manifestations in Harboyan syndrome include diffuse bilateral corneal edema occurring with severe corneal clouding, blurred vision, visual loss and nystagmus. They are apparent at birth or within the neonatal period and are indistinguishable from those characteristic of the autosomal recessive CHED (CHED2. Hearing deficit in Harboyan is slowly progressive and typically found in patients 10–25 years old. There are no reported cases with prelinglual deafness, however, a significant hearing loss in children as young as 4 years old has been detected by audiometry, suggesting that hearing may be affected earlier, even at birth. Harboyan syndrome is caused by mutations in the SLC4A11 gene located at the CHED2 locus on chromosome 20p13-p12, indicating that CHED2 and Harboyan syndrome are allelic disorders. A total of 62 different SLC4A11 mutations have been reported in 98 families (92 CHED2 and 6 Harboyan. All reported cases have been consistent with autosomal recessive transmission. Diagnosis is based on clinical criteria, detailed ophthalmological assessment and audiometry. A molecular confirmation of the clinical diagnosis is feasible. A variety of genetic, metabolic, developmental and acquired diseases presenting with clouding of the cornea should be considered in the differential diagnosis (Peters anomaly, sclerocornea, limbal dermoids, congenital glaucoma. Audiometry must be performed to differentiate Harboyan syndrome from CHED2. Autosomal recessive types of CHED (CHED2 and
Full Text Available INTRODUCTION: Age Related Hearing Loss (ARHL is defined as loss of hearing in elderly persons not influe nced by the extraneous factors like noise trauma etc or intrinsic like CVS related diseases or endocrinal disorders like Diabetes. Also termed as Presbycusis it is defined as the loss of hearing due to age related changes taking place in the auditory syste m starting from the pinna to the cortical centers in the brain. It does not include any other factor contributing or initiating the pathological changes in the auditory system resulting in hearing loss. All these changes in the tissues are not pathological but truly age related. The threshold of hearing is defined as the pure tone average across the frequencies of 0.5 to 8 kHz. The severity of hearing loss is graded as profound hearing loss : more than 90dB , severe to severe loss : 71 - 90 dB or more ; Moderate to severe hearing loss : 56 - 70 , Moderate hearing loss : 41 - 55 dB HL ; Mild hearing loss : 26 - 40 dB HL. Present study is to evaluate hearing loss in persons aged above 65 years both of those attending the Hospital for loss of hearing and those screened in a sur vey. AIM: To evaluate the hearing thresholds in individuals aged above 65 years attending the Government General Hospital and among the people attending the hearing screening done in the city of Warangal. The study also includes the review of the literature on ARHL. MATERIALS AND METHODS: 185 individuals aged above 65 years are evaluated for hearing thresholds with the help of pure tone audiometry and speech audiometry. Among the 185 individuals 102 are patients attending the Department of ENT for the compla ints of loss of hearing. The remaining 83 individuals are from the survey conducted to screen for hearing loss in the city of Warangal for the population aged above 65 years. Demographic data about the 185 individuals is collected. Pure tone audiogram and speech audiometry is done in all the patients. CONCLUSIONS
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
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
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 handicap and effort (r = 0.73, p 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.
Feder, Katya; Michaud, David; McNamee, James; Fitzpatrick, Elizabeth; Davies, Hugh; Leroux, Tony
The aim of this study was to estimate the prevalence of hearing loss (HL), self-reported occupational noise exposure, and hearing protection usage among Canadians. In-person household interviews were conducted with 3666 participants, aged 16 to 79 years (1811 males) with 94% completing audiometry and distortion-product otoacoustic emission (DPOAE) evaluations. Occupational noise exposure was defined as hazardous when communicating with coworkers at an arm's length distance required speaking in a raised voice. An estimated 42% of respondents reported hazardous occupational noise exposure; 10 years or more was associated with HL regardless of age, sex or education. Absent DPOAEs, tinnitus, and the Wilson audiometric notch were significantly more prevalent in hazardous workplace noise-exposed workers than in nonexposed. When mandatory, 80% reported wearing hearing protection. These findings are consistent with other industrialized countries, underscoring the need for ongoing awareness of noise-induced occupational HL.
Williams, Warwick; Carter, Lyndal; Seeto, Mark
This paper reports on the examination of the relationship between self-reported historical noise exposure during leisure activities and audiological indicators: Measured hearing threshold levels (HTLs) and otoacoustic emissions (OAEs). The research was conducted by a cross-sectional survey of 1,432 individuals whose ages ranged from 11 years to 35 years. Methodology included a comprehensive audiometric assessment including otoscopy, pure tone audiometry (PTA) (air- and bone-conduction), OAEs, and tympanometry. A comprehensive questionnaire gathered information on demographics, hearing health status, and participation in work, non-work, and leisure activities. Using the history of work, non-work, and leisure noise exposure, a cumulative lifetime noise exposure was estimated. No correlation was found between cumulative lifetime noise exposure and audiometric PTA or OAE parameters.
Full Text Available This paper reports on the examination of the relationship between self-reported historical noise exposure during leisure activities and audiological indicators: Measured hearing threshold levels (HTLs and otoacoustic emissions (OAEs. The research was conducted by a cross-sectional survey of 1,432 individuals whose ages ranged from 11 years to 35 years. Methodology included a comprehensive audiometric assessment including otoscopy, pure tone audiometry (PTA (air- and bone-conduction, OAEs, and tympanometry. A comprehensive questionnaire gathered information on demographics, hearing health status, and participation in work, nonwork, and leisure activities. Using the history of work, nonwork, and leisure noise exposure, a cumulative lifetime noise exposure was estimated. No correlation was found between cumulative lifetime noise exposure and audiometric PTA or OAE parameters.
Ellingson, Roger M; Dille, Marilyn L; Leek, Marjorie R; Fausti, Stephen A
The development and digital waveform synthesis of a multiple-frequency tone-burst (MFTB) stimulus is presented. The stimulus is designed to improve the efficiency of monitoring high-frequency auditory-brainstem-response (ABR) hearing thresholds. The pure-tone-based, fractional-octave-bandwidth MFTB supports frequency selective ABR audiometry with a bandwidth that falls between the conventional click and single-frequency tone-burst stimuli. The MFTB is being used to identify high frequency hearing threshold change due to ototoxic medication which most generally starts at the ultra-highest hearing frequencies and progresses downwards but could be useful in general limited-bandwidth testing applications. Included is a Mathcad implementation and analysis of our MFTB synthesis technique and sample performance measurements of the MFTB stimulus configuration used in a clinical research ABR system.
Suh, Hyee; Shin, Yong-Il; Kim, Soo Yeon; Kim, Sook Hee; Chang, Jae Hyeok; Shin, Yong Beom; Ko, Hyun-Yoon
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.
Full Text Available Scope of the study: Vestibular pathology is a complex one, requiring a minute clinical evaluation, as well as numerous paraclinical investigations. The present study analyzes the contribution of the modern methods of vestibular and auditive investigation to the diagnosis of dizziness. Materials and method: The results of the investigations performed on 84 patients with peripheric vestibular syndrome, on whom a complete audiological and vestibular assessment had been also made, have been retrospectively analyzed. Results: Anamnestic data and the results of evaluation permitted classification of peripheric vestibular pathology according to topo-lesional and etiological criteria. The most frequently diagnosed diseases were: benign paroxysmal positional vertigo, Ménière syndrome and vestibular neuronitis. Conclusions: Testing of the vestibulo-ocular and vestibulo-spinal reflexes through videonystagmoscopy and, respectively, computerized dynamic posturography, besides tonal vocal audiometry and precocious auditive potentials, is especially important for a positive diagnosis and etiological differentiation of vestibular syndromes.
Full Text Available Introduction: We estimated the noise in an industrial shoe factory to determine the effect of noise in the workplace on the hearing status of the workers in such environments.Materials and method: the intensity of noise in dB in different parts of the factory was estimated. Then working people in each part was selected randomly and their hearing thresholds were evaluated by Conventional audiometry.Results: The results demonstrated that 23% were required to estimate thresholds more precisely and 95 needed close examination by Otolaryngologist. Besides, 10% of the workers suffered sensory neural hearing loss whose 2% of them diagnosed as NIHL.Discussion: Since the mentioned factory has good hearing conservation program for the workers, it seems that promoting the program can decline the number of noise induced hearing losses to the least numbers.
Robinson, Tim; Whittaker, Joshua; Acharya, Aanand; Singh, Devesh; Smith, Michael
The woodworking industry represents an important cause of occupational noise-induced hearing loss (NIHL), a significant yet underappreciated problem in many developing countries. To describe the prevalence of occupational NIHL among woodworkers in Nepal and measure noise levels at workplaces. 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. 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. 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.
Full Text Available Background. Sudden sensorineural hearing loss (SSHL caused by opiate abuse or overuse has been well documented in the medical literature. Most documented case reports have involved either heroin or hydrocodone/acetaminophen. Recently, case reposts of methadone induced SSHL have been published. Case Report. We present the case of a 31-year-old man who developed SSHL after a methadone overdose induced stupor. He was subsequently restarted on methadone at his regular dose. On follow-up audiometry exams, he displayed persistent moderately severe sensorineural hearing loss bilaterally. Discussion. This case is notable because unlike all but one previously reported case, the patient—who was restated on methadone—did not make a complete recovery. Conclusion. Methadone overuse in rare cases causes SSHL.
Paschoal, Carolina Pamplona; Azevedo, Marisa Frasson de
Smoking is a public health concern and we are still unsure of its relation with auditory problems. To study the effects of cigarette smoking in auditory thresholds, in otoacoustic emissions and in their inhibition by the efferent olivocochlear medial system. 144 adults from both genders, between 20 and 31 years of age, smoking and non-smoking individuals were submitted to conventional and high-frequency audiometry, transient stimuli otoacoustic emissions and suppression effect investigation. smokers presented worse auditory thresholds in the frequencies of 12.500Hz in the right ear and 14,000 kHz in both ears. Regarding the otoacoustic emissions, smokers group presented a lower response level in the frequencies of 1,000Hz in both ears and 4,000Hz in the left ear. Among smokers there were more cases of cochlear dysfunction and tinnitus. Our results suggest that cigarette smoking has an adverse effect on the auditory system.
Carmona, C; Casado, I; Fernández-Rojas, J; Garín, J; Rayo, J I
Verbal auditory agnosia are rare in clinical practice. Clinically, it characterized by impairment of comprehension and repetition of speech but reading, writing, and spontaneous speech are preserved. So it is distinguished from generalized auditory agnosia by the preserved ability to recognize non verbal sounds. We present the clinical picture of a forty-years-old, right handed woman who developed verbal auditory agnosic after an bilateral temporal ischemic infarcts due to atrial fibrillation by dilated cardiomyopathie. Neurophysiological studies by pure tone threshold audiometry: brainstem auditory evoked potentials and cortical auditory evoked potentials showed sparing of peripheral hearing and intact auditory pathway in brainstem but impaired cortical responses. Cranial CT-SCAN revealed two large hypodenses area involving both cortico-subcortical temporal lobes. Cerebral SPECT using 99mTc-HMPAO as radiotracer showed hypoperfusion just posterior in both frontal lobes nect to Roland's fissure and at level of bitemporal lobes just anterior to Sylvian's fissure.
Infant and small children are not always able to cooperate in impedance measurements. For this reason it was decided, -in special cases, -to perform acoustic reflex examination under general anaesthesia. The first report on stapedius reflex and general anaesthesia was published by Mink et al. in 1981. Under the effect of Tiobutabarbital, Propanidid and Diazepam there is no reflex response. Acoustic reflex can be elicited with Ketamin-hydrochlorid and Alphaxalone-alphadolone acetate narcosis. The reflex threshold remains unchanged and the amplitude of muscle contraction is somewhat increased. The method was used: 1. to assess the type and degree of hearing loss in children with cleft palate and/or lip prior to surgery. 2. to exclude neuromuscular disorders with indication of pharyngoplasties. 3. to quantify hearing level in children--mostly multiply handicapped--with retarded speech development. The results of Behavioral Observation and Impedance Audiometry are discussed and evaluated.
Carter, N.L.; Waugh, R.L.; Keen, K.; Murray, N.; Bulteau, V.G.
We gave 944 young people (aged 16 to 20 years) pure-tone audiometry, electroacoustic impedance tests, and ear, nose and throat examination. We questioned them about their histories of exposure to occupational and recreational noise. The data do not support the view that there is wide-spread hearing loss caused by exposure to amplified music in young people under the age of 21 years. However, the accumulated exposure of some of them to noise is such that, if their recreational patterns remain the same, they are at risk of some noise-induced hearing loss by their mid-twenties. Further empirical studies are necessary to determine whether these hearing losses will eventuate.
Margolis, Robert H; Saly, George L; Le, Chap; Laurence, Jessica
As audiology strives for cost containment, standardization, accuracy of tests, and accountability, greater use of automated tests is likely. Highly skilled audiologists employ quality control factors that contribute to test accuracy, but they are not formally included in test protocols, resulting in a wide range of accuracy, owing to the various skill and experience levels of clinicians. A method that incorporates validated quality indicators may increase accuracy and enhance access to accurate hearing tests. This report describes a quality assessment method that can be applied to any test that (1) requires behavioral or physiologic responses, (2) is associated with factors that correlate with accuracy, and (3) has an available independent measure of the dimension being assessed, including tests of sensory sensitivity, cognitive function, aptitude, academic achievement, and personality. In this report the method is applied to AMTAS, an automated method for diagnostic pure-tone audiometry.
Full Text Available Deafness has been considered a non - resolving problem until the invention of cochlear implantation (CI. We are reporting the pre- and post-operative results of 14 patients underwent CI, for the first time in Iran, at the cochlear implantation Clinic of Tehran University of Medical Sciences. Four of our patients were able to hold a telephone conversation without difficulty 3 months post-operatively and the rest achieved considerable scores on audiologic tests and a remarkable improvement over 9 month interval between the two sets of tests. Also we have addressed the dramatic improvement in the quality of life of these patients in this paper as well as the results of promontory stimulation and audiometry.
Çoban, Kübra; Aydın, Erdinç; Özlüoğlu, Levent Naci
Idiopathic intracranial hypertension (IIH) can be manifested by audiological and vestibular complaints. The aim of the present study is to determine the audio-vestibular pathologies and their pathophysiologies in this syndrome by performing current audio-vestibular tests. The study was performed prospectively on 40 individuals (20 IIH patients, 20 healthy volunteers). Pure tone audiometry, tympanometry, vestibular evoked myogenic potentials, and electronystagmography tests were performed in both groups and the results were compared. The mean age of both groups was found to be 30.2±18.7. There were 11 females and 9 males in each group. The study group patients had significantly worse hearing levels. Pure tone averages were significantly higher in both ears of the study group (pintracranial pressure may affect the inner ear with similar mechanisms as in hydrops.
Schwartz, J.; Otto, D.
NHANES II audiometry data were used to confirm a previously observed link between blood lead (PbB) level and hearing threshold. Other indicators of neurological development, such as age at which a child first sat up, walked, and spoke, and the presence of speech difficulties and hyperactivity were also examined to determine if they were significantly related to lead exposure. The probability of elevated hearing thresholds at 500, 1000, 2000 and 4000 Hz increased significantly (P<0.0001) with increasing PbB for both ears. PbB levels were also significantly related to delays in the age at which children first sat up, walked, and spoke and to the probability that a child was hyperactive. Lead was not related to the probability of a child having a previously diagnosed speech impairment.
Hollingsworth, J.W.; Hashizume, Asaji; Jablon, Seymour
Nine physiologic functions which change with age were measured in 437 subjects during their regular visits to the Atomic Bomb Casualty Commission clinic in Hiroshima, Japan. This pilot study was undertaken to determine the feasibility of collecting such data in a population sample physiologic age score. Tests conducted consisted of: skin elasticity, systolic blood pressure, vital capacity, hand grip strength, light extinction time, vibrometer, visual activity, audiometry, and serum cholesterol. The study demonstrated that adequate sample data could be obtained, and that statistical treatment could construct a physiologic age for individual subjects. However, the tests were of limited value below age 40, and the validation of the concept of physiologic age requires eventual correlation with mortality. Since the ABCC program includes a highly accurate mortality survey, it is hoped that data on physiologic aging can be collected and eventually related to mortality. 11 references, 3 figures, 6 tables.
Full Text Available This study presents the treatment of 68 children with secretory otitis media. Children underwent adenoid vegetations, nasal speech, conductive hearing loss, ventilation disturbance in Eustachian tube. In all children adenoidectomy was indicated.38 boys and 30 girls at the age of 3-17 were divided in two main groups: * 29 children without hypertrophic (enlarged adenoids, * 39 children with enlarged (hypertrophic adenoids.The surgical treatment included insertion of ventilation tubes and adenoidectomy where there where hypertrophic adenoids.Clinical material was analyzed according to hearing threshold, hearing level, middle ear condition estimated by pure tone audiometry and tympanometry before and after treatment. Data concerning both groups were compared.The results indicated that adenoidectomy combined with the ventilation tubes facilitates secretory otitis media heeling as well as decrease of hearing impairments. That enables prompt restoration of the hearing function as an important precondition for development of the language, social, emotional and academic development of children.
Cabral, Jamile; Tonocchi, Rita; Ribas, Ângela; Almeida, Gleide; Rosa, Marine; Massi, Giselle; Berberian, Ana Paula
The use of hearing aids has been one of the strategies to reduce tinnitus perception and improve sufferers' quality of life when this symptom is associated to hearing impairment. To assess the remission of emotional and auditory tinnitus impacts on users of hearing aids. It is an experimental, descriptive study carried out with 17 users of unilateral or bilateral hearing aids, reporting tinnitus, submitted to otorhinolaryngological screening, tonal audiometry, logoaudiometry and acoustic imittance testing, who also answered the Iowa Tinnitus Activities Questionnaire, as well as the Iowa Tinnitus Handicap Questionnaire. There was significant difference in tinnitus data scoring before the use of hearing aids and after fitting the hearing aids. Analysis of the results evidences that the use of hearing aids improves tinnitus patients' quality of life, mainly regarding their emotional and auditory aspects.
Worsøe, Lise Lotte; Caye-Thomasen, P.; Brandt, C.T.
Background. On the basis of a nationwide registration during a 5-year period (1999-2003), the frequency and severity of hearing loss was investigated retrospectively in 343 consecutive Danish patients who survived pneumococcal meningitis, to identify important risk factors (including the pneumoco......Background. On the basis of a nationwide registration during a 5-year period (1999-2003), the frequency and severity of hearing loss was investigated retrospectively in 343 consecutive Danish patients who survived pneumococcal meningitis, to identify important risk factors (including...... hearing loss, and another 16 (7%) had bilateral profound hearing loss. Significant risk factors for hearing loss were advanced age, the presence of comorbidity, severity of meningitis, a low CSF glucose level, a high CSF protein level, and a certain pneumococcal serotype (P ... is common after pneumococcal meningitis, and audiometry should be performed on all those who survive pneumococcal meningitis. Important risk factors for hearing loss are advanced age, female sex, severity of meningitis, and bacterial serotype...
Matsuzawa, Shingo; Iino, Yukiko; Yamamoto, Daiki; Hasegawa, Masayo; Hara, Mariko; Shinnabe, Akihiro; Kanazawa, Hiromi; Yoshida, Naohiro
We report three patients with pars flaccida-type cholesteatoma (attic cholesteatoma) with closure of the entrance to the cholesteatoma at the time of surgery. These patients were diagnosed with attic cholesteatoma requiring surgery on the basis of abnormal findings of the pars flaccida, audiometry, and temporal bone computed tomography during the clinical course. Intraoperatively, cholesteatoma matrix and granulation tissue were observed behind the intact pars flaccida epithelium, which suggested that the entrance had apparently closed and the continuity with the cholesteatoma matrix disappeared after resolution of inflammation at the pars flaccida. In such patients, a normal pars flaccida may cause cholesteatoma to be initially overlooked, or misdiagnosed as congenital cholesteatoma. The diagnosis should be carefully made on the basis of the clinical course and the results of various examinations. Copyright © 2016 Elsevier B.V. All rights reserved.
Han, Demin; Wang, Shuo; Zhang, Hua; Chen, Jing; Jiang, Wenbo; Mannell, Robert; Newall, Philip; Zhang, Luo
In this study, monosyllabic Mandarin speech test materials (MSTMs) were developed for use in word recognition tests for speech audiometry in Chinese audiology clinics. Mandarin monosyllabic materials with high familiarity were designed with regard to phonological balance and recorded digitally with a male voice. Inter-list equivalence of difficulty was evaluated for a group of 60 subjects (aged 18-25 years) with normal hearing. Seven lists with 50 words each were found to be equivalent. These seven equivalent lists were used to measure performance-intensity (PI) functions for a group of 32 subjects with normal hearing and a group of 40 subjects with mild to moderate sensorineural hearing loss. The mean slope of PI function was found to be 4.1%/dB and 2.7%/dB, respectively. The seven lists of Mandarin monosyllabic materials were found to have sufficient reliability and validity to be used in clinical situations.
Canzi, P; Manfrin, M; Locatelli, G; Nopp, P; Perotti, M; Benazzo, M
In recent years the increasing development of hearing devices has led to a critical analysis of the standard methods employed to evaluate hearing function. Being too far from reality, conventional investigation of hearing loss based on pure-tone threshold audiometry and on mono/disyllabic word lists, presented in quiet conditions, has been shown to be inadequate. A speech-in-noise test using a roving-level adaptive method employs target and competing signals varying in level in order to reproduce everyday life speaking conditions and explore a more complete sound range. Up to now, only few roving-level adaptive tests have been published in the literature. We conducted a rovinglevel adaptive test in healthy Italian adults to produce new normative data on a language of Latin origin. © Copyright by Società Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale, Rome, Italy.
Harada, T; Namiki, S; Kawabata, I
This paper reports an unusual case in which acute lymphocytic leukemia presented acute profound sensorineural hearing loss as the initial manifestation of the disease. The patient is a 55-year-old woman who complained of left hearing loss of sudden onset. Pure tone audiometry revealed profound sensorineural hearing loss of the left ear at mid and low frequencies. The patient was tentatively diagnosed as idiopathic sudden deafness and admitted for the treatment, but her laboratory data indicated that she was at an advanced stage of leukemia. The patient's hearing loss did not improve subjectively until she deceased 1 year after the admission. The mechanism producing acute hearing loss in leukemic patients is reviewed and discussed, and the importance of differentiating possible underlying diseases before we diagnose idiopathic sudden deafness is stressed.
Song, Yijin; Chen, Jing; Yi, Zhuwen; Dang, Xiqiang; Cheng, Dehua; Wu, Xiaochuan; Tan, Yueqiu
In this study, we report the case of a 12-year-old male with X-linked ichthyosis (XLI) in association with glomerular sclerosis, and our investigation into the deletion pattern of the STS gene and the flanking regions in DNA samples of family members. We observed no features typical of renal osteodystrophy or rickets, with the exception of short stature, in the three afffected male family members. Audiometry, visual acuity and olfactory sensation were normal. By performing PCR analysis of the steroid sulfatase (STS) gene and flanking regions on our patients, we discovered a complete deletion that involved the entire region from DXS1139 to DXF22S1. Further studies are required to determine whether the STS gene or the co-deleted flanking sequences are the cause of renal disease associated with XLI.
Lau, S.K.; Wei, W.I.; Sham, J.S.T.; Choy, D.T.K.; Hui, Y. (Queen Mary Hospital, Hong Kong (Hong Kong))
A prospective study of the effect of radiotherapy for nasopharyngeal carcinoma on hearing was carried out on 49 patients who had pure tone, impedance audiometry and auditory brain stem evoked response (ABR) recordings before, immediately, three, six and 12 months after radiotherapy. Fourteen patients complained of intermittent tinnitus after radiotherapy. We found that 11 initially normal ears of nine patients developed a middle ear effusion, three to six months after radiotherapy. There was mixed sensorineural and conductive hearing impairment after radiotherapy. Persistent impairment of ABR was detected immediately after completion of radiotherapy. The waves I-III and I-V interpeak latency intervals were significantly prolonged one year after radiotherapy. The study shows that radiotherapy for nasopharyngeal carcinoma impairs hearing by acting on the middle ear, the cochlea and the brain stem auditory pathway. (Author).
Shelke BN, Aundhkar VG, Adgaonkar BD, Somwanshi SD, Gavkare AM, Ghuge SH
Full Text Available Introduction: Noise is one of the causes of preventable sensori-neural loss. The traffic police personnel (TPP busy in controlling traffic at heavy traffic junctions suffer from the ill effects of noise and air pollution. Aim and objectives: The objective of this study was to assess the hearing threshold at various frequencies of the traffic police persons exposed to the vehicular noise and comparison with controls not exposed to noise. Material and methods: Thirty TPP and thirty controls were evaluated by clinical methods and subjected to the Pure Tone Audiometry (PTA in ENT department. Audiogram recorded by using conventional techniques in both ears. RESULTS: There was a significant difference in the hearing thresholds at frequency 2000 Hz, 4000 Hz and 8000 Hz of right and left ear between the two groups. Conclusion: This study concludes an increased risk of noise induced hearing loss (NIHL for the environmental noise exposed subjects.
Full Text Available Objective: OAE an audiologic study for diagnosis of exteracochlear auditory neuropathy. Method & Material: Immitance audiometry, OAE and ABR and rehabilitation Intervention was performed for 3 children suffered from kernictrus. Conclusion: 1 OAE in the from of screening, distorted product and transient evoked-otoacoustic emission has to be added to our audiology test battery. 2 OAE studies have their own merit when we are clinically involved with the diagnosis of especial clinical entities like neonatal hypoxia, kernicterus, multiple sclerosis, meningitides and meningoencephalitis. 3 Case selection for cochlear implantation needs a knowledge of patients OAE results. 4 In the case of intracerebral auditory neuropathy the need for other rehabilitative measures will be better understood.
van Capelle, Carine I; Goedegebure, Andre; Homans, Nienke C; Hoeve, Hans L J; Reuser, Arnold J; van der Ploeg, Ans T
Little information is available regarding the auditory function in Pompe patients. Hearing loss has been reported in classic infantile patients, but it is still unknown whether central nervous system involvement interferes with auditory function and whether enzyme replacement therapy can improve hearing. Auditory function has not been studied in children with milder forms of the disease. We analyzed repetitive auditory brainstem response measurements and pure tone audiometry in 24 children with Pompe disease. Only 1 of 13 patients with milder phenotypes showed recurrent conductive hearing loss, while 10 out of 11 classic infantile patients had sensorineural hearing defects. These patients also had a high prevalence of conductive hearing loss. Five patients showed evidence of mild retrocochlear pathology, suggestive of glycogen accumulation in the central nervous system. Hearing loss persisted during therapy in all patients. The results emphasize the need for careful monitoring of auditory function in classic infantile Pompe patients, and for early implementation of hearing aids to protect speech and language development.
Ghasem Mohammad khani
Full Text Available In this article we aimed at studying the function of Melanin in the inner ear. To reach this goal TTS was studied in people with blue or brown eye color. Subjects were 68 male teenagers with normal hearing. Auditory thresholds were obtained by means of high frequency audiometry (.8-8KHzbefore and after TTS. We used narrowband noise with frequency width of 1665-2335Hz, central frequency of 2 KHz, intensity of 105dBSPL and duration of 10 minutes. A significant difference was discovered in the average TTS of this two group in the frequency range of 2-8 KHz. Brown-colored eye boys manifested the least TTS and the blue- colored eyes one the most discovered TTS.
Muñoz-Proto, F; Carnevale, C; Bejarano-Panadés, N; Ferrán-de la Cierva, L; Mas-Mercant, S; Sarría-Echegaray, P
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.
Hussein, A; Fathy, H; Amin, S M; Elsisy, N
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.
Forton, G; Verlooy, J; Cras, P; Parizel, P; Van de Heyning, P
A rare case of cerebellar astrocytoma presenting as a cerebellopontine angle tumour is discussed. A 35-year old woman noticed a bizarre twitching and fatigability of the left upper lip while playing the flute. There was also a mild hearing loss on the left side and she sometimes felt unsure of herself when walking. A thorough examination by means of speech audiometry, electronystagmography, ABR, CT-scan and MRI revealed a large, partly calcified mass occupying the cerebellopontine angle. Only the histological examination of the surgical specimen revealed the true nature of the tumour. The special characteristics of this tumour and the unusual clinical course are discussed. The importance of a good histological diagnosis is stressed.
Liberman, Patricia Helena Pecora; Goffi-Gomez, Maria Valéria Schmidt; Schultz, Christiane; Novaes, Paulo Eduardo; Lopes, Luiz Fernando
To characterize the hearing loss after cancer treatment, according to the type of treatment, with identification of predictive factors. Two hundred patients who had cancer in childhood were prospectively evaluated. The mean age at diagnosis was 6 years, and at the audiometric assessment, 21 years. The treatment of the participants included chemotherapy without using platinum derivatives or head and neck radiotherapy in 51 patients; chemotherapy using cisplatin without radiotherapy in 64 patients; head and neck radiotherapy without cisplatin in 75 patients; and a combined treatment of head and neck radiotherapy and chemotherapy with cisplatin in ten patients. Patients underwent audiological assessment, including pure tone audiometry, speech audiometry, and immittancemetry. The treatment involving chemotherapy with cisplatin caused 41.9% and 47.3% hearing loss in the right and left ear, respectively, with a 11.7-fold higher risk of hearing loss in the right ear and 17.6-fold higher in the left ear versus patients not treated with cisplatin (p<0.001 and p<0.001, respectively). Children whose cancer diagnosis occurred after the age of 6 have shown an increased risk of hearing loss vs. children whose diagnosis occurred under 6 years of age (p=0.02). The auditory feature found after the cancer treatment was a symmetrical bilateral sensorineural hearing loss. Chemotherapy with cisplatin proved to be a risk factor, while head and neck radiotherapy was not critical for the occurrence of hearing loss. Copyright © 2016 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.
Mardassi, Ali; Turki, Senda; Mbarek, Hajer; Hachicha, Amani; Benzarti, Sonia; Abouda, Maher
The consequence of an exposure to intense sounds can be a temporary or permanent hearing loss and even with a rapid therapeutic management, severe sensorineural sequelae may persist. the authors report a retrospective study about 64 patients followed for an acute acoustic trauma during a period of 8 years (2006 to 2013). For all the cases, a clinical examination associated to a pure-tone audiometry was conducted. Hearing levels were measured at the frequencies 500, 1000, 2000 and 3000 Hertz. Auditory evoked potentials were performed in 17 cases. The therapeutic and evolutive data were detailed and discussed. All our patients were male with a mean age of 34 years. The cause of acoustic trauma was a firing of a gun near the ear in 48 cases, an explosion near the ear in 5 cases and a sudden exposure to loud noises near military planes in 11 cases. Clinical complaints were acute hearing loss with tinnitus. Audiometric exams found a sensorineural hearing loss with a hearing level average of 38 decibels (dB) +/- 14 SD. The therapy consisted of systemic cortisteroids associated in all the cases to peripheral vasodilators. It was given intravenously during 10 days and then orally with vasodilators during one to 3 months. Hyperbaric oxygenotherapy have been administrated for 25 patients. The follow-up consisted of questioning about symptoms, clinical examination and pure-tone audiometry. A good evolution was noted in 52 cases (81%) and the mean of hearing level after therapy was: 24 dB +/- 12 dB. Despite a prolonged therapy with vaso-active drugs, tinnitus persisted in 36 cases. Controlling noise and its harmful effects through technical devices and safety professionals programs are the best way to reduce the frequency and the sensorineural sequelae due to acute acoustic trauma.
Lacerda, Adriana Bender Moreira de; Facco, Caroline; Zeigelboim, Bianca Simone; Cristoff, Killian; Stechman, José; Fonseca, Vinícius Ribas
The most common otological symptoms in patients with temporomandibular disorders (TMD) are ear fullness, tinnitus and ear pain. To evaluate the impact of tinnitus on the quality of life for patients with TMD. This is a quantitative, cross-sectional retrospective study. The sample consisted of 19 individuals with TMD, 17 (89.47%) females and 2 (10.53%) male, mean age 53.5 years. Data collection consisted of: anamnesis, pure tone audiometry, acuphenometry and application of the Portuguese version of the Tinnitus Handicap Inventory (Brazilian THI). 63.12% had had tinnitus for less than five years, and 15.79% had tinnitus that sounded like whistling, rain and/or a cricket. There was a predominance of laterality in the right ear (42.11%). 52.63% of the subjects reported that their tinnitus is continuous, while 31.58% stated that it lasts for days, and 47.37% report that it is common. The audiometry revealed mean audiometric thresholds above 25 dB HL in the high frequencies (3000, 4000, 6000 and 8000 Hz) bilaterally. In acuphenometry, the average loudness of the tinnitus was 21 dB SL the right ear and 17.85 dB SL in the left ear, and the average tinnitus pitch was 3775 Hz in the right ear and 3750 Hz in the left ear. The total THI score was 37.8 points. It appears that there is significant correlation between the THI scale, time of tinnitus duration and its occurrence. Tinnitus reported in patients with TMD caused moderate impact on quality of life and can be seen in the presence of background noise although daily activities can still be performed.
Kyle, Meghann E.; Wang, James C.; Shin, Jennifer J.
Objective To perform a systematic review evaluating the association between sensorineural hearing loss and (1) nonsteroidal anti-inflammatory drugs (NSAIDs) as a class, (2) NSAIDs available over the counter, (3) NSAIDs in short intravenous courses, (4) prescription NSAIDs utilized by patients without systemic inflammatory conditions, (5) prescription NSAIDs in patients with arthritides, and (6) acetaminophen with and without concomitant narcotic usage. Data Sources Computerized searches of PubMed, EMBASE, and the Cochrane Library were updated through May 2014, along with manual searches and inquiries to topic experts. Review Methods The systematic review was performed according to an a priori protocol. Data extraction was performed by 2 independent investigators, and it focused on relevant audiologic measurements, methodological elements related to risk of bias, and potential confounders. Results The 23 criterion-meeting studies included a total of 92,532 participants, with mixed results. Sulindac was the only specific agent to have been studied with formal audiometry in a randomized double-blind placebo-controlled trial in which hearing was the reported primary outcome: Although an effect was seen in the unadjusted analysis (pure tone threshold > 15 dB, 9.3% vs 2.9%; relative risk [RR], 3.2; confidence interval [CI], 1.09-9.55; P = .02), the effect dissipated in the adjusted analysis (P = .09). There was a significant effect on self-reported hearing loss from NSAIDs as a class (RR, 1.21; CI, 1.11-1.33), ibuprofen (RR, 1.13; CI, 1.06-1.19), and acetaminophen (RR, 1.21; CI, 1.11-1.33), but no formal audiometric data confirm or refute this suggested effect. Audiometry has demonstrated profound loss in some instances of acetaminophen-narcotic combination ingestions. Conclusions Data are varied regarding the impact of NSAIDs and acetaminophen on population hearing health. PMID:25560405
Bettina Poggi Almeida
Full Text Available ABSTRACT INTRODUCTION: One of the problems observed in pure-tone audiometry tonal has been the variation in test results of a same individual, particularly at frequencies of 4 kHz, 6 kHz and/or 8 kHz. Improper placement of headphones is one of the factors that can cause alterations in results. OBJECTIVE: To compare differences in auditory thresholds using earphones positioned by the examiner and by the worker. METHODS: Clinical and experimental study conducted in 2009, with 324 workers aged between 19 and 61 years, with a mean of 33.29 years and mean exposure time of 7.67 years. All subjects were familiar with audiometry procedures. Auditory thresholds were obtained at frequencies of 0.25-8 kHz, with earphones positioned by the examiners, and at frequencies of 4, 6 and 8 kHz, with earphones placed by workers in a comfortable position, following the examiner's instructions. The thresholds obtained in these two situations were compared. RESULTS: The three frequencies exhibited better responses with earphones placed by the workers themselves (p < 0.001. At a frequency of 8 kHz a greater difference was found (p < 0.001, with a mean of 13.89 dB and standard deviation of 6.07 dB. CONCLUSION: Earphone placement by the workers themselves under supervision of the examiner results in improved mean auditory thresholds at frequencies of 4, 6 and 8 kHz, the last one significantly higher than the other two.
Morán, E; Martínez, M; Budía, A; Broseta, E; Cámara, R; Boronat, F
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.
Beltrame, Achille M; Martini, Alessandro; Prosser, Silvano; Giarbini, Nadia; Streitberger, Christian
To assess the functional results of the Vibrant Soundbridge (VBS) placed on the round window (RW) in patients with mixed hearing loss. Retrospective evaluation of functional hearing, with measurements performed 7 to 9 months postoperatively. Two tertiary referral hospital centers. Twelve individuals with mixed severe hearing loss associated with chronic suppurative otitis media and otosclerosis. Surgical placement of the VBS mechanical effector in close contact with the RW membrane to directly drive the inner ear fluids. Functional hearing gain as analyzed via pure-tone audiometry and speech audiometry with VBS off and on in quiet and in noise. We observed a mean gain of 37.5 dB (0.5-4 kHz) with wide individual differences. The overall gain is mainly due to the air-bone gap recovery, whereas a further 12-dB mean improvement of air-conducted threshold is evident at 2 kHz. The speech reception threshold in quiet shows a mean gain of 24 dB, whereas in noise, it requires a signal-to-noise ratio 7 to 13 dB greater than normal-hearing controls. All patients are daily users of their VBS device. A middle ear implant capable of directly driving the cochlear fluids seems to be a promising alternative for individuals with a severe to profound mixed hearing loss. However, variability in hearing recovery is great, likely reflecting variability in responsiveness of the cochlea associated with chronic pathologic findings and, possibly, variability in how the VBS effector interfaces with the RW. Modifying the shape of the VBS effector can improve the mechanical coupling to the RW to better exploit the device's amplification power.
Kamalesh J Dube
Full Text Available Cotton ginning workers have a risk of hearing loss due to excessive noise levels at the workplace environment. In this study, estimates of typical sound levels prevailing at the workplace environment and its effects on hearing ability of the exposed workers were made among cotton ginning workers. Data on self-reported health status was collected by a questionnaire survey at 10 cotton ginning industries located at Jalgaon district of Maharashtra state, India. The cotton ginning workers were exposed to continuous noise levels between 89 and 106 dBA. The hearing ability of the subjects was accessed by pure tone audiometry. The results of audiometry show mild, moderate and moderately severe degree of hearing impairment among the cotton ginning workers. The data generated during the study show that hearing loss was significantly associated with period of exposure to the workplace noise (P <0.0001. The prevalence of audiometric hearing impairment defined as a threshold average greater than 25 dB hearing level was 96% for binaural low-frequency average, 97% for binaural mid frequency average and 94% for binaural high-frequency average in the cotton ginning workers. We recommend the compulsory use of personal protective equipment like ear plug by the cotton ginning workers at the workplace environment. A regular maintenance of ginning and pressing machineries will avoid the emission of excessive noise at the workplace environment of cotton gins. A regular periodic medical examination is necessary to measure the impact of workplace noise on the health of cotton ginning workers.
Full Text Available Background: Among patients who have sensorineural hearing loss of unknown etiology, diabetes is one of the diseases to be routinely investigated. The relationship between diabetes mellitus and hearing loss is still controversial. The purpose of this study was to examine the prevalence of sensorineural hearing loss in patients with insulin-dependent diabetes mellitus (IDDM compared to control group.Methods: In a cross-sectional study pure tone audiometry (PTA and speech audiometry was performed in 62 patients with insulin-dependent diabetes mellitus (IDDM, aged under 40 years, and in 62 randomly selected age-matched non-diabetic control subjects. Subjects with otological and other metabolic diseases were excluded from the study. We applied the SPSS.10 statistical analysis software Chi-square and student's test. Results: Statistical analysis showed that the hearing of the diabetic patients were significantly worsen than the control subjects. The hearing level tended to be worsen in the diabetic patients than that in control subjects, but the differences were statistically significant only at frequencies of 250,500, 4000 and 8000 Hz p>0.05(. There wasn't statistical significant difference between sex in two study groups p>0.05(. The mean duration of diabetes was no statistically significant with hearing loss p>0.05(. The frequency of complications such as retinopathy, nephropathy, and neuropathy in the diabetic groups had no correlation with speech threshold (p>0.05(. There were no significant differences between speech reception threshold, speech discrimination score and acoustic reflex in two groups.Conclusions: We conclude that type I diabetes mellitus can cause sensorineural hearing loss.
Almeida, Bettina Poggi; Menezes, Pedro de Lemos; Andrade, Kelly Cristina Lira de; Teixeira, Cleide Fernandes
One of the problems observed in pure-tone audiometry tonal has been the variation in test results of a same individual, particularly at frequencies of 4kHz, 6kHz and/or 8kHz. Improper placement of headphones is one of the factors that can cause alterations in results. To compare differences in auditory thresholds using earphones positioned by the examiner and by the worker. Clinical and experimental study conducted in 2009, with 324 workers aged between 19 and 61 years, with a mean of 33.29 years and mean exposure time of 7.67 years. All subjects were familiar with audiometry procedures. Auditory thresholds were obtained at frequencies of 0.25-8kHz, with earphones positioned by the examiners, and at frequencies of 4, 6 and 8kHz, with earphones placed by workers in a comfortable position, following the examiner's instructions. The thresholds obtained in these two situations were compared. The three frequencies exhibited better responses with earphones placed by the workers themselves (p<0.001). At a frequency of 8kHz a greater difference was found (p<0.001), with a mean of 13.89dB and standard deviation of 6.07dB. Earphone placement by the workers themselves under supervision of the examiner results in improved mean auditory thresholds at frequencies of 4, 6 and 8kHz, the last one significantly higher than the other two. Copyright © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.
Karina Aki Otubo
Full Text Available Tocar um instrumento musical requer a integração das habilidades perceptiva, motora, e cognitiva, desenvolvidas modularmente, de forma gradativa e hierarquicamente coordenada. Na realização de uma obra musical, a audição atua de forma marcante na sua complexa associação com o cérebro, capaz de produzir mudanças comportamentais e emocionais nos humanos. O presente estudo analisa o perfil audiológico de estudantes de graduação em Música, que foram submetidos à Avaliação Audiológica (Entrevista, Audiometria Tonal Liminar, Logoaudiometria, e Imitanciometria, além dos exames complementares de Audiometria Tonal de Altas Frequências (AT-AF e Emissões Otoacústicas Evocadas por Estímulo Transiente (EOAT. Os resultados indicaram que os estudantes apresentam audição dentro da normalidade. Entretanto, ações educativas e preventivas são essenciais para promover a conscientização sobre alterações auditivas nesse grupo de risco.Playing a musical instrument demands integration of perceptive, motor and cognitive skills, modularly and gradually developed and in a hierarchically coordinated fashion. In music performance, the complex association between hearing and the brain is central, one capable of producing behavioral and emotional changes in human beings. The present study analyzes audiological profiles of music students, who were submitted to Audiological Assessment (Interview, Threshold Tonal Audiometry, Logoaudiometry and Imitanciometry, besides the complementary examinations of High Frequencies Tonal Audiometry and Transient Evoked Otoacustic Emissions. The results indicated normal hearing for the students. Nevertheless, preventive and educative actions are essential to promote awareness of auditory alterations within this risk group.
Yamazaki, Masahiro; Naganawa, Shinji; Kawai, Hisashi; Nihashi, Takashi [Nagoya University, Department of Radiology, Graduate School of Medicine, Nagoya (Japan); Fukatsu, Hiroshi [Aichi Medical University Hospital, Department of Medical Informatics, Nagakute (Japan); Nakashima, Tsutomu [Nagoya University, Department of Otorhinolaryngology, Graduate School of Medicine, Nagoya (Japan)
In the vestibular schwannoma patients, the pathophysiologic mechanism of inner ear involvement is still unclear. We investigated the status of the cochleae in patients with vestibular schwannoma by evaluating the signal intensity of cochlear fluid on pre- and post-contrast enhanced thin section three-dimensional fluid-attenuated inversion recovery (3D-FLAIR). Twenty-eight patients were retrospectively analyzed. Post-contrast images were obtained in 18 patients, and 20 patients had the records of their pure-tone audiometry. Regions of interest of both cochleae (C) and of the medulla oblongata (M) were determined on 3D-FLAIR images by referring to 3D heavily T2-weighted images on a workstation. The signal intensity ratio between C and M on the 3D-FLAIR images (CM ratio) was then evaluated. In addition, correlation between the CM ratio and the hearing level was also evaluated. The CM ratio of the affected side was significantly higher than that of the unaffected side (p < 0.001). In the affected side, post-contrast signal elevation was observed (p < 0.005). In 13 patients (26 cochleae) who underwent both gadolinium injection and the pure-tone audiometry, the post-contrast CM ratio correlated with hearing level (p < 0.05). The results of the present study suggest that alteration of cochlear fluid composition and increased permeability of the blood-labyrinthine barrier exist in the affected side in patients with vestibular schwannoma. Furthermore, although weak, positive correlation between post-contrast cochlear signal intensity on 3D-FLAIR and hearing level warrants further study to clarify the relationship between 3D-FLAIR findings and prognosis of hearing preservation surgery. (orig.)
Jereczek-Fossa, Barbara A. [European Inst. of Oncology, Milan (Italy). Division of Radiotherapy; Milan Univ. (Italy). Faculty of Medicine; Rondi, Elena [European Inst. of Oncology, Milan (Italy). Division of Medical Physics; Zarowski, Andrzej [Univ. Dept. of Otolaryngology, Head and Neck Surgery, St. Augustinus Hospital, Antwerp (BE)] (and others)
To analyze dose distribution in the hearing organ and to evaluate the dose effect on the hearing thresholds in patients treated with post-parotidectomy 3-dimensional conformal radiotherapy (3D-CRT). A total of 17 patients received post-parotidectomy 3D-CRT (median dose: 63 Gy). The audiometric evaluation comprised pure tone audiometry and tympanometry performed before radiotherapy (RT) and 3, 6, and 24 months after RT. The ear structures were delineated on planning computer tomography scans. Mean and maximum doses were calculated and dose-volume histograms were plotted. Before RT, the median baseline audiometric thresholds were normal. At 3 months post-RT, 3 patients were diagnosed as having middle ear underpressure and/or effusion that resolved completely by 6 months. During 2-year follow-up, none of the ears showed perceptive hearing loss at speech frequencies. The mean doses at ipsilateral external auditory canal, mastoids cells, tympanic case, Eustachian tube, semicircular canals, and cochlea were 44.8 Gy, 39.0 Gy, 30.9 Gy, 33.0 Gy, 19.6 Gy, and 19.2 Gy, respectively. The doses to the contralateral ear were negligible, except for the Eustachian tube (up to 28.2 Gy). Post-parotidectomy 3D-CRT is associated with relatively low doses to the ear and the surrounding structures. Post-RT audiometry did not show any permanent (neither conductive nor perceptive) hearing impairment. Only in 3 patients were there signs of transient unilateral dysfunction of the Eustachian tube observed during the first few months after RT. Longer follow-up and larger patient series are warranted to confirm these preliminary findings. (orig.)
Kim, Jung Hee; Kim, Hyung Jin; Kim, Jae Hyoung [College of Medicine, Gyeongsang National University, Jinju (Korea, Republic of)
To assess how accurately computed tomography (CT) can demonstrate the abnormal findings which are believed to cause the clinical signs and symptoms of hearing loss (HL), vertigo and facial paralysis (FP) in patients with temporal bone trauma. The authors studied CT scans of 39 ears in 35 patients with temporal bone trauma. CT scans were performed with 1-1.5 mm slice thickness and table incrementation. Both axial and coronal scans were obtained in 32 patients and in three patients only axial scans were obtained. We analyzed CT with special reference to the structural abnormalities of the external auditory canal, middle ear cavity, bony labyrinth, and facial nerve canal, and correlated these findings with the actual clinical signs and symptoms. As to hearing loss, we evaluated 32 ears in which pure tone audiometry or brainstem evoked response audiometry had been performed. With respect to the specific types of HL, CT accurately showed the abnormalities in 84% (16/19) in conductive HL, 100% (2/2) in sensorineural HL, and 25% (2/8) for mixed HL. When we categorized HL simply as conductive and sensorineural, assuming that mixed be the result of combined conductive and sensorineural HL, CT demonstrated the abnormalities in 89% (24/27) for conductive HL and 50% (5/10) for sensorineural HL. Concerning vertigo and FP, CT demonstrated abnormalities in 67%(4/6), and 29% (4/14), respectively. Except for conductive HL, CT seems to have a variable degree of limitation for the demonstration of the structural abnormalities resulting sensorineural HL, vertigo or facial paralysis. It is imperative to correlate the CT findings with the signs and symptoms in those clinical settings.
Chen, David S; Genther, Dane J; Betz, Joshua; Lin, Frank R
To determine whether hearing impairment, defined by using objective audiometry, is associated with multiple categories of self-reported physical functioning in a cross-sectional, nationally representative sample of older adults. Multivariate secondary analysis of cross-sectional data. The 2005-06 and 2009-10 cycles of the National Health and Nutrition Examination Survey. Adults aged 70 and older who completed audiometric testing (N = 1,669). Hearing was measured using pure-tone audiometry. Physical functioning was assessed using a structured interview. In a model adjusted for age and demographic and cardiovascular risk factors, greater hearing impairment (per 25 dB hearing level (HL)) was associated with greater odds of physical disability in activities of daily living (odds ratio (OR) = 1.4, 95% confidence interval (CI) = 1.1-1.9), instrumental activities of daily living (OR = 1.6, 95% CI = 1.2-2.2), leisure and social activities (OR = 1.5, 95% CI = 1.1-2.0), lower extremity mobility (OR = 1.4, 95% CI = 1.1-1.7), general physical activities (OR = 1.3, 95% CI = 1.1-1.6), work limitation (OR = 1.4, 95% CI = 1.0-1.9), walking limitation (OR = 1.6, 95% CI = 1.3-2.0), and limitation due to memory or confusion (OR = 1.4, 95% CI = 1.1-1.8). Hearing impairment was not associated with limitations in amount or type of work done (OR = 1.2, 95% CI = 1.0-1.6). Hearing impairment in older adults is independently associated with greater disability and limitations in multiple self-reported categories of physical functioning. © 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.
Full Text Available Objective. The paper aims to demonstrate the feasibility of defining a substantial set of psychoacoustic outcome measures with preset targets and to adopt a systematic methodology for reaching these targets in a large group of subjects, by more than one clinical centre. Design. Retrospective data analysis. Setting. Multicentre with 14 participating centres. Patients. 255 adults and children using the Advanced Bionics HiRes90k cochlear implant. Intervention. Target driven fitting with the fitting to outcomes expert (FOX system. Main Outcome Measures. For each patient, 66 measurable psychoacoustical outcomes were recorded several times after cochlear implantation: free field audiometry (6 measures and speech audiometry (4, spectral discrimination (20, and loudness growth (36, defined from the A§E test battery. These outcomes were reduced to 22 summary variables. The initial results were compared with the latest results. Results. The state of the fitting process could be well monitored by means of the measured variables. The use of the FOX computer assisted CI-programming significantly improved the proportion of the 22 variables on target. When recipients used the automated MAPs provided at switch-on, more than half (57% of the 22 targets were already achieved before any further optimisation took place. Once the FOX system was applied there was a significant 24% (P<0.001 increase in the number of targets achieved. Conclusions. This study demonstrates that it is feasible to set targets and to report on the effectiveness of a fitting strategy in terms of these targets. FOX provides an effective tool for achieving a systematic approach to programming, allowing for better optimisation of recipients' MAPs. The setting of well-defined outcome targets allowed a range of different centres to successfully apply a systematic methodology to monitoring the quality of the programming provided.
Aarhus, Lisa; Tambs, Kristian; Nafstad, Per; Bjørgan, Eskil; Engdahl, Bo
The aim of the study was to examine childhood high-frequency sensorineural hearing loss (HF-SNHL) and the effects of combined exposure with aging or noise exposure on HF hearing thresholds in adulthood. Population-based cohort study of 30,003 adults (mean age 40 years) underwent an audiometry and completed a hearing questionnaire. At age 7-13 years, the same people had participated in a longitudinal school hearing investigation, in which 283 participants were diagnosed with HF-SNHL [PTA 3-8 kHz ≥ 25 dB HL (mean 45 dB HL), worse hearing ear], and 29,720 participants had normal hearing thresholds. The effect of childhood HF-SNHL on adult hearing threshold was significantly moderated by age. Age stratified analyses showed that the difference in HF hearing thresholds between adults with and without childhood HF-SNHL was 33 dB (95 % CI 31-34) in young adults (n = 173, aged 20-39 years) and 37 dB (95 % CI 34-39) in middle-aged adults (n = 110, aged 40-56 years). The combined exposure of childhood HF-SNHL and noise exposure showed a simple additive effect. It appears to be a super-additive effect of childhood-onset HF-SNHL and aging on adult hearing thresholds. An explanation might be that already damaged hair cells are more susceptible to age-related degeneration. To exclude possible birth cohort effects, the finding should be confirmed by a study with several audiometries in adulthood.
Verstraeten, Nadia; Zarowski, Andrzej J; Somers, Thomas; Riff, Daphna; Offeciers, Erwin F
1) To quantify the audiometric differences between the preoperative tests with the Bone-Anchored Hearing Aid (BAHA) attached to the headband or the testband and the final postoperative result with the BAHA positioned at the implanted abutment. 2) To compare the results obtained with the headband and the testband. 3) To quantify the magnitude of the damping through the skin for the BAHA placed at the testband (important for comparison with the implantable hearing aids). Prospective. Tertiary otological referral centre. Ten adult (> or = 14 yr old) BAHA patients (6 male and 4 female subjects) with bilateral air-bone gaps of minimum 40-dB hearing loss and with more than 6 months of BAHA experience with the BAHA "Compact." Audiometric free-field thresholds and speech audiometry scores (Consonant-Vowel-Consonant lists, phonemic score) have been evaluated for 3 conditions: BAHA attached to the implanted "Snap" abutment, to the headband, or to the testband. For frequencies 1 to 4 kHz, significant differences in the range of 5 to 20 dB were found between the BAHA coupled with the Snap abutment and the preoperative testing conditions with the BAHA positioned at the headband or the testband. These differences were also reflected in the speech audiometry with a difference in speech reception threshold of approximately 4 to 7 dB. 1) Significant differences in the audiometric thresholds and the speech understanding scores were found between the preoperative test conditions and the final postoperative result. 2) Audiometric results obtained with the headband and the testband are comparable; therefore, the more comfortable headband is also suitable for the preoperative audiologic evaluation. 3) The magnitude of the skin damping must be accounted for when referring to the audiometric results obtained with the BAHA attached to the testband or headband.
Lauritsen, Maj-Britt Glenn; Söderström, Margareta; Kreiner, Svend; Dørup, Jens; Lous, Jørgen
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.
Keppler, Hannah; Dhooge, Ingeborg; Maes, Leen; D'haenens, Wendy; Bockstael, Annelies; Philips, Birgit; Swinnen, Freya; Vinck, Bart
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.
Nedić, O; Rodić-Strugar, J; Solak, Z; Filipović, D
Noise is one of the commonest environmental pollutants and it is defined as a sound which bothers, irritates, which is unpleasant and can damage hearing. The degree of negative effects of noise depends on its intensity, spectrum of frequency, nature, duration of exposition and individual sensibility. This work is supposed to establish the degree of correlation between hearing damage and professional exposition to one of physical stressors of work environment--noise. Investigation regarding work conditions included intensity and frequency analysis of noise at workplaces. The examination sample included 101 workers of "NIS--Naftagas" section "Hidrosonda" employed as drilling workers. The control group consisted of 50 workers not exposed to noise or any other professional influences, like workers from the examination sample. The results on the observed workplaces show that noise is of high intensity and bad frequency spectrum. Exposition of workers to noise is a highly important factor for hearing damages (p = 0.002). The relative risk for hearing damage is four times greater in relation to the control group (odds ratio 4.1). Attributable fraction (preventive potential) of noise factor is 61%. Smoking associated with exposition to noise multiplies the risk of hearing damage (odds ratio 5.8) while with non-smokers the risk decreases (odds ratio 3.0). Professional hearing disorders occur slowly and increase with time spent at noisy workplaces. At the beginning it presents with buzzing in ears and dizziness followed by latent phase after which hearing disorders occur. Tone audiometry is used to register first signs of hearing loss, whereas manifestations in social contacts come later. Once diagnosed hearing disorders cannot be cured so a lot more care should be paid to this problem. It is necessary to provide adequate work conditions by applying appropriate technologies, tools, work organisation, personal protection equipment, as well as previous and periodical
Schaffartzik, W; Hirsch, J; Frickmann, F; Kuhly, P; Ernst, A
Hearing loss has been described after spinal anesthesia. We examined the hearing in patients before and after spinal and general anesthesia by pure tone audiometry (LdB: 125-1500 Hz; HdB: 2000-8000 Hz). Tympanic membrane displacement analysis was used to noninvasively monitor the intralabyrinthine and intracranial pressure. Eighteen patients received spinal anesthesia (G(SA)); 19 patients general anesthesia (G(GA)). Pure tone audiometry and TMD data were obtained preoperatively ((0)) and postoperatively on day 1 ((1)) and 2 ((2)). The mean threshold differences (Delta) in LdB(10) and LdB(20) were significantly different in G(SA) compared with G(GA) (DeltaLdB(10) + 0.15+/-3.07 dB vs. -1.34+/-3.77 dB, P = 0.05; DeltaLdB(20) -0.54+/-2.24 dB vs. -2.45+/-3.39 dB, P<0.01). However, there were no differences in DeltaHdB(10) between G(SA) and G(GA), but in DeltaHdB(20) (-1.40+/-3.95 dB vs -5.12+/- 6.35 dB, P = <0.01). We found a significant correlation between the magnitude of intraoperative intravascular volume replacement and low-frequency hearing loss. Tympanic membrane displacement values were not different pre- and postoperatively. Hearing was impaired after spinal and general anesthesia. Low-frequency hearing loss was correlated with intraoperative volume replacement. Tympanic membrane recordings did not reveal significant changes.
Full Text Available Abstract Background Due to increasing drug resistance, artemisinin-based combination chemotherapy (ACT has become the first-line treatment of falciparum malaria in many endemic countries. However, irreversible ototoxicity associated with artemether/lumefantrine (AL has been reported recently and suggested to be a serious limitation in the use of ACT. The aim of the study was to compare ototoxicity, tolerability, and efficacy of ACT with that of quinine and atovaquone/proguanil in the treatment of uncomplicated falciparum malaria. Methods Ninety-seven patients in south-west Ethiopia with slide-confirmed malaria were randomly assigned to receive either artemether/lumefantrine or quinine or atovaquone/proguanil and followed-up for 90 days. Comprehensive audiovestibular testing by pure tone audiometry (PTA, transitory evoked (TE and distortion product (DP otoacoustic emissions (OAE and brain stem evoked response audiometry (BERA was done before enrolment and after seven, 28 and 90 days. Results PTA and DP-OAE levels revealed transient significant cochlear hearing loss in patients treated with quinine but not in those treated with artemether/lumefantrine or atovaquone/proguanil. TE-OAE could be elicited in all examinations, except for three patients in the Q group on day 7, who suffered a transient hearing loss greater than 30 dB. There was no evidence of drug-induced brain stem lesions by BERA measurements. Conclusion There was no detrimental effect of a standard oral regimen of artemether/lumefantrine on peripheral hearing or brainstem auditory pathways in patients with uncomplicated falciparum malaria. In contrast, transient hearing loss is common after quinine therapy and due to temporary outer hair cell dysfunction.
Keleş, Erol; Kapusuz, Zeliha; Gürsu, Mehmet Ferit; Karlıdag, Turgut; Kaygusuz, Irfan; Bulmuş, Funda Gülcü; Yalcın, Sinasi
To determine the presence of a relationship between metabolic presbycusis and serum paraoxonase/arylesterase activity. A total of 30 patients who had been admitted to the Ear, Nose, and Throat (ENT) Clinic of Fırat University Medical Faculty and diagnosed as metabolic presbycusis were included in the study. The control group was composed of 30 healthy volunteers. Pure tone audiometry and impedencemeter were performed on all subjects included in the study at the audiometry laboratory of the ENT clinic. The presence of a regular hearing curve, a symmetrical sensorineural hearing loss more than 25 dB with preserved speech discrimination were accepted as criteria for metabolic presbycusis. Blood samples were drawn from the patients prior to the hearing tests. The sera were separated for measurements of total cholesterol, triglyceride, high-density lipoprotein, very low-density lipoprotein, low-density lipoprotein, human serum paraoxonase and arylesterase levels, respectively. No statistically significant difference was found between the patient and the control groups in terms of age and gender. Paraoxonase, arylesterase and paraoxonase/arylesterase, high-density lipoprotein levels were found to decrease in the study group and the difference was found to be statistically significant compared to the control group (P presbycusis. Furthermore, the results of this study make us think that there could be a relationship between metabolic presbycusis and cardiovascular diseases. In this case, metabolic presbycusis may be a determining parameter in the early diagnosis of cardiovascular diseases. We consider that this study may be the pioneer for further studies conducted with larger patient numbers.
Full Text Available Objectives: Hearing loss is a major public health problem and has higher prevalence in elderly persons. Present study was conducted with the aim of characterizing age-related changes on audiometric thresholds and word discrimination ability of people with age range of 30 to 100 years. Methods & Materials: Hundred ninty persons (male 53.68% and female 46.32% in seven aged decades were studied from May 2005 to Oct 2007 in Tehran. Individuals who referred for auditory evaluation had concern regarding presence of a kind of hearing problem. Pure tone audiometry, word discrimination score and immittance audiometry were performed for those people who has no previous history of auditory impairment and/or experiencing hearing hazardous agents. Results: There was a significant reverse correlation between recording of acoustic reflexes with both age and hearing loss average. Loss of hearing sensitivity among seven aged decades was significant statistically. Hearing loss showed more decrement in men than women in all audiometric frequencies, and the difference between them was significant in higher frequencies. Decrease of word discrimination score with age growth was significant, and with 12.63% permanent tinnitus, 6.84% vertigo/dizziness and 4.21% history of hearing aid usage were reported in all individuals. Conclusion: Hearing sensitivity declines gradually and progressively with aging. Effects of hearing loss and some of it's associated disorders specially tinnitus and vertigo/ dizziness on degree of communication and quality of life in such individuals and higher prevalence in aged people reveals the necessity of scientific and executive programming for identification and treatment of auditory problems in such population.
Sziklai, István; Szilvássy, Judit; Szilvássy, Zoltán
Since the concept of tinnitus dopaminergic pathway emerged, studies have been proposed to investigate if dopaminergic agents influence tinnitus. We hypothesized that pramipexole, an agonist on D2/D3 receptors, may antagonize tinnitus in the presbycusis patients (in the frequency range of 250 to 8,000 Hz) in a dose schedule accepted for the treatment of Parkinson's disease in elderly people. We designed a randomized, prospective, placebo-controlled and double-blind trial. Forty presbycusis patients aged 50 years or older with subjective tinnitus were randomized to two groups (20 patients in both). Patients in the drug group took pramipexole over a period of 4 weeks according to a treatment schedule as follows: week 1, 0.088 mg t.i.d.; week 2, 0.18 mg t.i.d.; week 3, 0.7 mg t.i.d.; week 4, 0.18 mg t.i.d. over 3 days and 0.088 mg t.i.d. the rest of the week. Patients in the second group received placebo. Determination of subjective grading of tinnitus perception, the tinnitus handicap inventory (THI) questionnaire and electrocochleography (ECOG) examinations served as the end points. Subjective audiometry was used to produce secondary data. A significant improvement in tinnitus annoyance is found in the group treated with pramipexole versus placebo with respect to inhibition of tinnitus and a decrease of tinnitus loudness greater than 30 dB. However, neither ECOG nor subjective pure-tone threshold audiometry revealed any change in hearing threshold in response to either pramipexole or placebo. Pramipexole is an effective agent against subjective tinnitus associated with presbycusis at a dose schedule used for the treatment of Parkinson's disease. The drug did not change hearing threshold. Copyright © 2011 The American Laryngological, Rhinological, and Otological Society, Inc.
Lycke, Michelle; Debruyne, Philip R; Lefebvre, Tessa; Martens, Evi; Ketelaars, Lore; Pottel, Hans; Van Eygen, Koen; Derijcke, Sofie; Werbrouck, Patrick; Vergauwe, Philippe; Stellamans, Karin; Clarysse, Philippe; Dhooge, Ingeborg; Schofield, Patricia; Boterberg, Tom
We previously validated uHear™ to screen for hearing loss in older patients with cancer without a known hearing loss, as part of a comprehensive geriatric assessment (CGA). In view of low specificity, we tested a new modified uHear™ scoring system as described by Handzel. Patients, aged ≥70 years, were evaluated by uHear™ and conventional audiometry, which is considered the gold standard, as part of a CGA. The pass or fail screening cut-off for uHear™ was defined as having ≥2 consecutive hearing grades starting from the moderate-severe threshold zone ranging from 0.5 to 2.0 kHz (modified Handzel-uHear™ scoring system). To accept the modified Handzel-uHear™ as screening tool, it was predefined that the combined sensitivity (S) and specificity (Sp) of the test (S + Sp/2) was at least 80% and that an actual combined (S + Sp)/2 of 90% would be found. Ninety ears (45 subjects) were tested. Of those ears, 24.4% were identified as impaired by conventional audiometry. Modified Handzel-uHear™ identified 26.7% of tested ears as impaired. The combined (S + Sp)/2 of the modified Handzel-uHear™ was calculated as 77.5%, while in previous cohort, this was retrospectively calculated as 94.6%. A new uHear™ scoring system was proposed and tested in current and previous cohort. A (S + Sp)/2 of 80.2 and 78.8%, respectively, were obtained. uHear™ is a feasible tool for use within the CGA and shows promising results. However, further research is warranted to optimize the cut-off method before it could be routinely implemented within geriatric oncology.
Maller, Tomer; Goldenstein, Sonia; Ronen, Ohad
To assess the incidence of hearing loss in patients diagnosed with Bell's palsy (BP) and to characterize its clinical features. Patients with BP who underwent audiometry testing in our institute were included. Bone hearing level differences between the ipsilateral and the contralateral ears to the palsied side were calculated for 6 frequencies: 250, 500, 1000, 2000, 4000 and 8000 Hz. Subjects with interaural differences higher than 5 dB in at least one frequency were considered as having ipsilateral unilateral sensorineural hearing loss (uSNHL). Twenty-four cases of subjects with BP who underwent hearing exams were included. Thirteen were women (54.2%) and the average age was 37.4 years. Nine patients (37.5%) were found to have an ipsilateral uSNHL (group A); a maximal interaural difference of 5dB in all the frequencies was found in 15 subjects (62.5%, group B). The interaural maximal difference was found to be significantly higher between the two groups (p = 0.0295, n = 24). Group A showed a mean of maximal difference of 18.9 ± 9.3 dB compared to 3 ± 2.5 dB in group B (p < 0.001). A higher difference was calculated in the higher frequencies (2000, 4000, 8000 Hz) (R-spearman = 0.226, p = 0.003). We have demonstrated significant ipsilateral uSNHL in our cohort of patients diagnosed with BP. We, therefore, believe that all patients who are diagnosed with BP should undergo an audiometry examination. Further prospective studies with larger cohorts are necessary to support our observations.
Dayasiri, Mbkc; Dayasena, Rp; Jayasuriya, C; Perera, Dsc; Kuruppu, K Amp; Peris, Mnp
Presbyacusis is the most common type of hearing loss, often having profound effects on the quality of life in old age. The objectives of this study were: To analyse of the effect of demographic factors on presbyacusis in Sri Lanka.To quantify the effect of non-demographic risk factors on presbyacusis. An observational cross-sectional study was carried out involving all the patients who presented to the National Hospital ENT clinic with hearing loss between April 2007 and April 2010. Patients whose pure-tone audiometry results were suggestive of sensorineural hearing deficit and whose tympanometry testing did not show any middle ear problems were assessed using an interviewer-administered questionnaire. Among the 567 participants studied, the mean age was 63.4yrs. Fifty eight percent were females. The majority of the patients were from the Colombo district (59.3%), however, participants came from ten districts of Sri Lanka. Most of the study participants (64.2%) were married and living with their partners, but 24.7% were widowed and the rest were either unmarried or divorced. 6.1% had communication difficulties leading to disrupted social relationships and 21% felt that hearing impairment (HI) had adversely affected their psychological well-being. The onset of impaired hearing, as perceived by the patients initially and later confirmed by pure-tone audiometry and tymanometry, had occurred at an average age of 62.9yrs. There was no significant association between presbyacusis and other demographic factors such as gender, education level and marital status. A significant proportion of the participants had been widowed and that fact, too, can reduce their quality of life.
Bencze, Gábor; Claussen, Claus-Frenz; Heid, Lóránt; Kersebaum, Michael; Nagy, Elemér; Bencsik, Beáta
Geriatrics defines the branch of medicine that treats all problems peculiar to old age and the aging, including the clinical problems of senescence and senility. In the full chain of years of the human life, a special period is humans' last decade of professional life (i.e., 51-60 years) and their first decade of retirement (i.e., 61-70 years). For this study aimed at comparing neurootological complaints of persons in this period of their lives, we examined large samples of European neurootological patients: Group A consisted of 1,965 persons aged 51-60 years, and group B consisted of 1,032 persons aged 61-70 years. Of the 11 vertigo and nausea symptoms evaluated, group A demonstrated 2.68 signs and group B 2.49 signs per individual. Acoustic subjective symptoms of tinnitus were exhibited in 55.42% of group A patients, and hearing loss was present in 63.92% of these patients. In group B, 52.62% of patients exhibited tinnitus, and 68.31% of patients had hearing loss. Our experimental neurootometric investigations exhibited the following rates of abnormal test findings in group A: butterfly calorigrams, 71.86%; stepping craniocorpography, 72.01%; and pure-tone audiometry of bone conduction, 37.66% in the right and 47.07% in the left ear. Among group B patients, abnormal test findings were noted as follows: butterfly calorigrams, 69.86%; stepping craniocorpography, 74.03%; and pure-tone audiometry of bone conduction, 44.57% in the right and 55.43% in the left ear.
Sanches, Seisse Gabriela Gandolfi; Samelli, Alessandra Giannella; Nishiyama, Anne Kellie; Sanchez, Tanit Ganz; Carvallo, Renata Mota Mamede
the Gaps-in-Noise (GIN) test assesses the auditory temporal resolution skill. Studies have described the GIN test an instrument of easy application and with good sensitivity and specificity. to compare the results of the GIN test in normal listeners with and without tinnitus and to correlate the obtained results with pure tone thresholds and age. hearing tests were performed in 44 subjects (hearing threshold up to 25 dB HL in the frequencies of 0.25 to 8 kHz). Two groups were considered for comparison: the Control Group with 23 subjects, 8 men and 15 women, aged between 22-40 (mean 29.7), and the Research Group with 18 tinnitus patients, 3 men and 15 women, aged between 21-45 (mean 31.3). All subjects underwent pure tone audiometry, speech tests, acoustic immittance measurements and the GIN test. For the statistical analysis, the significance level of 0.05 was adopted. considering pure tone audiometry, the overall mean for hearing thresholds was significantly higher for the Research Group when compared to the Control Group (p = 0.001). The comparison between the groups for the performance in the GIN test indicated that the Control Group detected gaps with a shorter time interval than the Research Group (p GIN test. the GIN test identified deficit in the hearing skill of temporal resolution in patients with tinnitus. In the studied age group (21 to 45 years) there was no correlation between age and the results obtained in the GIN test.
Aguilera-Tello, Silvia A; Gutiérrez-Farfán, Ileana; Chamlati-Aguirre, Laura E; Alatorre-Miguel, Efrén; Durand-Rivera, Alfredo
Speech perception that takes place in the cochlea is involved in the process of language. The objective was to describe the findings in transient otoacoustic emissions in children with language problems before and after 6 months of speech therapy. There were 17 children with language problems between 3 and 6 years of age diagnosed with anarthric language delay (expressive and mixed language disorder). They underwent medical history, otoscopy, intelligence level testing, initial language test, tympanometry of 226Hz, audiometry and transient otoacoustic emission test. We evaluated the 17 patients again after 6 months of attending speech therapy. The percentage of overall reproducibility of transient otoacoustic emissions in both ears was adequate to perform frequency analysis. We found a statistically significant difference (P≤0.01) in the frequency of 1kHz reproducibility when comparing results before and after therapy in the right ear. There was a significant difference (P≤0.05) when comparing the results of audiometry at frequencies of 0.5, 1.5, 2, 4 and 8kHz in the right ear and a highly significant difference (P=0.001) in the frequency of 3kHz in the left ear. The analysis of sound through the cochlea is involved in the process of language acquisition. A poor processing of speech sounds in the peripheral system could result in poor processing at the central level. Consequently, it is important to consider our results when making a diagnosis and carrying out rehabilitation treatment in children with language disorders. Copyright © 2014 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Patología Cérvico-Facial. All rights reserved.
Full Text Available It has long been known that some listeners experience hearing difficulties out of proportion with their audiometric losses. Notably, some older adults as well as auditory neuropathy patients have temporal-processing and speech-in-noise intelligibility deficits not accountable for by elevated audiometric thresholds. The study of these hearing deficits has been revitalized by recent studies that show that auditory deafferentation comes with aging and can occur even in the absence of an audiometric loss. The present study builds on the stochastic undersampling principle proposed by Lopez-Poveda and Barrios (2013 to account for the perceptual effects of auditory deafferentation. Auditory threshold/duration functions were measured for broadband noises that were stochastically undersampled to various different degrees. Stimuli with and without undersampling were equated for overall energy in order to focus on the changes that undersampling elicited on the stimulus waveforms, and not on its effects on the overall stimulus energy. Stochastic undersampling impaired the detection of short sounds ( 50 ms did not change or improved, depending on the degree of undersampling. The results for short sounds show that stochastic undersampling, and hence presumably deafferentation, can account for the steeper threshold/duration functions observed in auditory neuropathy patients and older adults with (near normal audiometry. This suggests that deafferentation might be diagnosed using pure-tone audiometry with short tones. It further suggests that that the auditory system of audiometrically normal older listeners might not be ‘slower than normal’, as is commonly thought, but simply less well afferented. Finally, the results for both short and long sounds support the probabilistic theories of detectability that challenge the idea that auditory threshold occurs by integration of sound energy over time.
Bellier, Ludovic; Veuillet, Evelyne; Vesson, Jean-François; Bouchet, Patrick; Caclin, Anne; Thai-Van, Hung
Millions of people across the world are hearing impaired, and rely on hearing aids to improve their everyday life. Objective audiometry could optimize hearing aid fitting, and is of particular interest for non-communicative patients. Speech Auditory Brainstem Response (speech ABR), a fine electrophysiological marker of speech encoding, is presently seen as a promising candidate for implementing objective audiometry; yet, unlike lower-frequency auditory-evoked potentials (AEPs) such as cortical AEPs or auditory steady-state responses (ASSRs), aided-speech ABRs (i.e., speech ABRs through hearing aid stimulation) have almost never been recorded. This may be due to their high-frequency components requesting a high temporal precision of the stimulation. We assess here a new approach to record high-quality and artifact-free speech ABR while stimulating directly through hearing aids. In 4 normal-hearing adults, we recorded speech ABR evoked by a /ba/ syllable binaurally delivered through insert earphones for quality control or through hearing aids. To assess the presence of a potential stimulus artifact, recordings were also done in mute conditions with the exact same potential sources of stimulus artifacts as in the main runs. Hearing aid stimulation led to artifact-free speech ABR in each participant, with the same quality as when using insert earphones, as shown with signal-to-noise (SNR) measurements. Our new approach consisting in directly transmitting speech stimuli through hearing aids allowed for a perfect temporal precision mandatory in speech ABR recordings, and could thus constitute a decisive step in hearing impairment investigation and in hearing aid fitting improvement. Copyright © 2015 Elsevier B.V. All rights reserved.
Oldenburg, Jan; Klepp, Olbjørn; Bremnes, Roy M.; Wist, Erik A.; Wentzel-Larsen, Tore; Hauge, Erik R.; Dahl, Olav; Fosså, Sophie D.
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
quality of life. METHODS: Cross-sectional study, conducted with 56 elderly individuals with dizziness. Subjects' mean age was 71.2 years, and they were submitted to otoneurologic assessment, which involved: pure-tone, speech and impedance audiometry, balance assessment, testing for positional and positioning vertigo and nystagmus, and vectoelectronystagmography. A specific questionnaire for dizziness was used to assess the quality of life, the Dizziness Handicap Inventory (DHI, which verifies the handicap effects provoked by this symptom. RESULTS: Rotatory dizziness was reported by 29 patients (51.8%, 75% presented some hearing complaint, and 69.6% had altered results in audiometry. Patients with vestibular complaints of positional dizziness presented significant difference for the physical aspect of the DHI. Patients with vestibular complaints of imbalance showed significant difference for the functional and emotional aspects. The computerized vectoelectronystagmography was altered in 47 patients (83.9%, indicating peripheral vestibular disorder in all cases. In the post-caloric assessment, hyperreflexia was the most prevalent alteration, and the most frequent diagnosis was Deficient Peripheral Vestibular Syndrome to the Left. Regarding quality of life, the functional aspect had the highest average score among the three aspects evaluated, and there was a significant difference between the functional and emotional aspects. CONCLUSION: Most elderly patients with dizziness present alterations in audiometry and vectoelectronystagmography, which indicate a disorder in the vestibulocochlear system; they also present impaired quality of life.
Full Text Available AbstrakSebagian besar keganasan kepala dan leher terdiagnosis sudah dalam stadium lanjut dan sering sudah inoperable. Kemoradiasi merupakan pengobatan pada keadaan seperti ini. Kemoterapi neoadjuvan (induksi dengan cisplatin pada karsinoma kepala leher telah terbukti dapat mempreservasi organ dan menurunkan angka metastasis jauh, namun di sisi lain cisplatin menyebabkan berbagai efek samping berupa toksik terhadap berbagai organ, salah satunya ototoksikPenelitian ini bertujuan untuk mengetahui gambaran audiogram nada murni penderita karsinoma kepala dan leher yang mendapat kemoterapi cisplatin.Penelitian ini merupakan uji potong lintang untuk mengetahui gambaran audiogram nada murni terhadap 25 orang penderita karsinoma kepala dan leher yang mendapat kemoterapi cisplatin 100 mg/m2 di bagian Telinga Hidung Tenggorok Bedah Kepala Leher (THT-KL rumah sakit (RS Dr. M. Djamil Padang, mulai bulan April sampai bulan Desember 2009.Dari 50 audiogram yang diperiksa didapatkan nilai rerata perubahan nilai ambang dengar hantaran tulang pada masing-masing frekuensi yaitu 3,4±5,84 dB pada frekuensi 250 Hz, 2,0±3,91dB (500 Hz, 2,6±4,87 dB (1000 Hz, 3,4±5,10 dB (2000 Hz, 4,9±9,23 dB (4000 Hz, 4,7±5,84 dB (6000 Hz dan 6,5±9,85 dB pada 8000 Hz.Setelah pemberian satu siklus kemoterapi cisplatin 100 mg/m2 sebagian besar sampel tidak mengalami perubahan ambang dengar pada frekuensi 250, 500, 1000, 2000, 4000 dan 6000 Hz, sedangkan pada frekuensi 8000 Hz, sebagian besar mengalami kenaikan nilai ambang dengar. Namun demikian nilai rerata hantaran tulang sebelum dengan setelah kemoterapi terdapat perbedaan yang bermakna pada semua frekuensi.Kata kunci : ototoksik, kemoterapi neoadjuvan, cisplatin, audiometri nada murniARTIKEL PENELITIAN52Abstract The majority of head and neck malignancy was diagnosed in an advanced stage and often had inoperable. Chemoradiation is a treatment in this state. Neoadjuvan chemotherapy with cisplatin in carcinoma of the head and neck
Audiometria de tronco encefálico (abr: o uso do mascaramento na avaliação de indivíduos portadores de perda auditiva unilateral Auditory brainstem response (abr: use of masking in unilateral hearing loss patients
Melissa M. T. Toma
prospective. MATERIA AND METHOD: The sample was constituded of 22 persons with unilateral hearing loss, being 10 female and 12 male, ranging from 9 to 44 years old. All persons were submited to the following audiological exams: pure - tone and speech audiometry, accoustic impendance tests and audiometry brainstem response in absence and presence of masking. RESULTS: In general, all persons had profound sensorineural unilateral hearing loss and bilateral type - A tympanometric curves. In ABR evaluation, it was possible to observe in 100% of the sample the presence of wave V in poor ear. As soon as the masking was introduced, these waves has not been viewed. CONCLUSION: As might be expected that masking must be used with ABR evaluation on unilateral hearing loss to obtain authentical results. In ABR, interaural attenuation to clicks (65 dB was greater the examined in pure-tone audiometry. Thence it follows that less intensity of masking was needed to eliminate the contralateral response.
Pilar Gómez Mur
Full Text Available Introducción: A pesar del ruido existente en las obras de la construcción no está extendido el uso de protectores auditivos en este sector. Objetivo: Estudiar las pérdidas auditivas inducidas por ruido (PAIR en las audiometrías de estos trabajadores. Material y métodos: Se realiza un estudio descriptivo de las audiometrías de tonos puros realizadas a 223 trabajadores del sector y se comparan con las de 262 administrativos. Para clasificar las PAIR se ha utilizado el método desarrollado por Klockhoff (K y modificado por la clínica del Lavoro de Milan. Se analiza también la presencia de escotomas en las frecuencias 3000, 4000 ó 6000 Hz. Resultados: La prevalencia de PAIR y escotomas bilaterales ha sido significativamente superior en el grupo de la construcción (K: OR =3,1. IC95%:1,801-5,435. Escotoma audiométrico bilateral: OR=3,8. IC95%:2.244- 6.606. Aunque el escotoma en 6000 Hz ha sido el más frecuente, la diferencia entre los dos grupos únicamente ha sido significativa en el de 4000 Hz. Discusión: Entre un 20,7 (K y un 24,3% (escotomas de los trabajadores de la construcción presentan PAIR bilaterales (8,4 y 8,8% en administrativos. Es necesario incidir en las medidas preventivas, fundamentalmente en el uso de protectores auditivos adecuados. Se recomienda profundizar en la etiología de los diferentes escotomas en futuros estudios.Introduction: Despite the noise produced in constructions works, the utilization of hearing protection devices is not common in this sector. Aim: To study the noise induced hearing loss (NIHL present on the audiometries of the construction workers. Methodology: A descriptive study is made on the pure tone audiometries done to 223 construction workers, comparing them with those coming from 262 administrative ones. For audiometries classification purposes, the method developed by Klockhoff (K and modified by Clinica del Lavoro in Milan, is used. Presence of a notch in 3.000, 4.000 or 6.000 Hz
Tania Maria Tochetto
used the Pure Tone Audiometry, high frequency audiometry and acoustic immitance assessment to evaluate the sample. The time of exposition ranged from one to seventeen years. The control group was composed by 24 not exposed subjects. RESULTS: the average of the thresholds of the PTA and of the high frequency audiometry was superior in the study group in all the tested frequencies. A statistically significant difference of thresholds was verified on the frequencies of 0,5 (p=0,004, 2 (p=0,001, 3 kHz (p=0,025, and frequencies of 9 (p=0,007 e 10 kHz (p=0,026. In 16, 18, 20 kHz a greater absence of responses was observed in the study group (p>0, 05. Also it was observed a greater absence of acoustic reflexes (ipsilateral and contralateral at the study group, on the right ear. On the left ear, there was no difference between the groups, for the occurrence of ipsilateral reflex. The absence of the contralateral reflex was superior in the study group on all frequencies tested. CONCLUSION: individuals exposed to fuels with normal hearing thresholds may have cochlear and central alterations.
Patrícia Cotta Mancini
Full Text Available OBJETIVO: Investigar a existência de alterações na audição de crianças com fenilcetonúria diagnosticadas e tratadas precocemente e comparar os resultados com os encontrados nas avaliações auditivas de crianças normais de mesma idade. MÉTODOS: Foram realizadas imitanciometria e audiometria tonal e vocal em 63 crianças, sendo 30 no grupo controle, com média de idade de 8,1 anos, e 33 com fenilcetonúria no grupo de estudo, com média de idade de 7,7 anos. O grupo de estudo foi subdividido em 15 crianças com controle adequado da dieta e 18 crianças com controle inadequado da dieta, com médias de idade 8,1 e 7,2, respectivamente. A análise estatística utilizou o Teste t ou ANOVA. RESULTADOS: A audiometria revelou 83,3% de crianças com audição normal no grupo controle e 16,7% de perdas auditivas condutivas uni ou bilaterais. No grupo com fenilcetonúria, 66,7% das crianças apresentaram audição normal e 33,3% com perdas auditivas condutivas. Na imitanciometria, observou-se curvas normais em 91,7% das crianças do grupo controle e em 72,7% das crianças do grupo com fenilcetonúria. Houve diferença na comparação entre grupos para limiares aéreos, reflexos estapedianos, limiares de recepção da fala e índice de reconhecimento de fala. Não foi observada diferença entre os resultados das avaliações auditivas de crianças fenilcetonúricas com dieta adequada e inadequada. CONCLUSÃO: As crianças com fenilcetonúria diagnosticadas e tratadas precocemente apresentaram piores limiares de audibilidade por via aérea, limiares de recepção de fala e índice de reconhecimento de fala evidenciados à audiometria tonal e vocal, quando comparadas com crianças normais.PURPOSE: To investigate the existence of hearing impairments in infants with phenylketonuria with early diagnose and treatment, and to compare the audiological findings with those of their normal peers. METHODS: Vocal and pure-tone audiometry and acoustic immitance
Ana Emilia Linares
Full Text Available A principal questão que envolve o diagnóstico audiológico infantil é a determinação de procedimentos que configurem resultados confiáveis e objetivos, que possam ser utilizados na predição dos limiares auditivos por frequência específica. OBJETIVO: Correlacionar os achados do potencial evocado auditivo de estado estável (PEAEE com outros exames em crianças com perda auditiva neurossensorial. MATERIAL E MÉTODO: Estudo prospectivo de coorte contemporânea com corte transversal. 23 crianças de ambos os gêneros e com idades entre 1 e 7 anos realizaram PEAEE, audiometria de reforço visual, potencial evocado auditivo de tronco encefálico (PEATE clique e tone burst e medida do reflexo acústico para aplicação da regra de predição do limiar auditivo a partir do reflexo acústico. RESULTADOS: A correlação entre o PEAEE e audiometria variou de 0.70 a 0.93, para o PEATE-clique (2k e 4kHz variou de 0.83 a 0.89, para o tone burst variou de 0.73 a 0.93. A concordância entre o PEAEE e a regra de predição do limiar auditivo foi considerada moderada. CONCLUSÃO: Houve correlação significativa entre o PEAEE e audiometria, assim como para o PEATE clique (2k e 4kHz e para o PEATE tone burst. O reflexo acústico pode ser usado para acrescentar informações ao diagnóstico infantil.The main issue regarding pediatric audiology diagnosis is determining procedures to configure reliable results which can be used to predict frequency-specific hearing thresholds. AIM: To investigate the correlation between auditory steady-state response (ASSR with other tests in children with sensorineural hearing loss. METHODS: Prospective cross-sectional contemporary cohort study. Twenty-three children (ages 1 to 7; mean, 3 years old were submitted to ASSR, behavioral audiometry, click audiometry brain stem response (ABR, tone burst ABR, and predicting hearing level from the acoustic reflex. RESULTS: the correlation between behavioral thresholds and ASSR was
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
Lilian Cassia Bornia Jacob
pertaining literature analysis identified two procedures often used worldwide for the early detection of auditory lesions induced by ototoxic pharmaceutical drugs: high-frequency audiometry and evoked otoacoustic emissions. Both allow early identification of hearing disorders before changes are seen in conventional pure-tone audiometry and, consequently, before speech understanding is compromised. CONCLUSION: we suggest a hearing monitoring protocol, considering the patient’s capability to respond to behavioral tests and monitoring timing (first test/follow up. For cancer patients, hearing monitoring should be performed in the patient’s treatment venue.
Hansen, Mads Christian Tofte; Schmidt, Jesper Hvass; Brøchner, Anne C; Johansen, Jakob Kjersgaard; Zwisler, Stine; Mikkelsen, Søren
Prehospital personnel are at risk of occupational hearing loss due to high noise exposure. The aim of the study was to establish an overview of noise exposure during emergency responses in Mobile Emergency Care Units (MECU), ambulances and Helicopter Emergency Medical Services (HEMS). A second objective was to identify any occupational hearing loss amongst prehospital personnel. Noise exposure during work in the MECU and HEMS was measured using miniature microphones worn laterally to the auditory canals or within the earmuffs of the helmet. All recorded sounds were analysed in proportion to a known tone of 94 dB. Before and after episodes of noise exposure, the physicians underwent a hearing test indicating whether the noise had had any impact on the function of the outer sensory hair cells. This was accomplished by measuring the amplitude level shifts of the Distortion Product Otoacoustic Emissions. Furthermore, the prehospital personnels' hearing was investigated using pure-tone audiometry to reveal any occupational hearing loss. All prehospital personnel were compared to ten in-hospital controls. Our results indicate high-noise exposure levels of ≥80 dB(A) during use of sirens on the MECU and during HEMS operations compared to in-hospital controls (70 dB(A)). We measured an exposure up to ≥90 dB(A) under the helmet for HEMS crew. No occupational hearing loss was identified with audiometry. A significant level shift of the Distortion Product Otoacoustic Emissions at 4 kHz for HEMS crew compared to MECU physicians was found indicating that noise affected the outer hair cell function of the inner ear, thus potentially reducing the hearing ability of the HEMS crew. Further initiatives to prevent noise exposure should be taken, such as active noise reduction or custom-made in-ear protection with communication system for HEMS personnel. Furthermore, better insulation of MECU and ambulances is warranted. We found that the exposure levels exceeded the
Gilles, Annick; Schlee, Winny; Rabau, Sarah; Wouters, Kristien; Fransen, Erik; Van de Heyning, Paul
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 audiometry, OAE, and ABR.However, tinnitus patients showed decreased speech-in-noise reception. The results are discussed in the light of previous
Tokar-Prejna, S; Meinzen-Derr, J
To determine the relationship between the type of transducer used to perform pure-tone audiometry and the appearance of low-frequency hearing loss at 250Hz and 500Hz for patients with ventilation tubes. Air conduction thresholds at 250Hz and 500Hz were measured using Telephonics TDH-49 supra-aural headphones and EARTONE 3-A insert earphones for patients with normal ears (N=16) and patients with ventilation tubes (N=114). Tympanometry was performed on each patient prior to audiometric testing. Audiometric test results obtained in normal ears were compared to results for patients with ventilation tubes. For analysis, the ventilation tube patients were separated into two groups, representative of ventilation tube type. Audiometric results obtained using the two transducer types at 250Hz and 500Hz revealed significant differences in threshold for patients with ventilation tubes. Thresholds obtained using insert earphones were generally worse than thresholds obtained using supra-aural headphones for this group. On average, difference in threshold was 14.15dB worse with insert earphones at 250Hz and 9.75dB worse with insert earphones at 500Hz for patients with Sheehy tubes. Average difference in threshold for patients with Donaldson tubes was 13.93dB worse with insert earphones at 250Hz and 8.93dB worse with insert earphones at 500Hz. In addition, thresholds were more variable for patients with ventilation tubes than normal ears at 500Hz. There were no significant differences in threshold for normal ears using both transducers. When performing pure-tone audiometry, choice of transducer can influence the accurate identification of a low-frequency hearing loss in patients with ventilation tubes. Low-frequency thresholds were generally worse using insert-style earphones to test subjects with tubes, resulting in the apparent identification of a hearing loss. However, with supra-aural headphones, no low-frequency hearing loss existed. There were no significant differences in
Rolim, Laurie Penha; Samelli, Alessandra Giannella; Moreira, Renata Rodrigues; Matas, Carla Gentile; Santos, Itamar de Souza; Bensenor, Isabela Martins; Lotufo, Paulo Andrade
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
Aline Mizozoe de Amorim
Full Text Available OBJETIVO: descrever os resultados da avaliação auditiva de uma família com perda auditiva de caráter hereditário autossômico dominante. MÉTODOS: foram avaliados 17 indivíduos, por meio da audiometria tonal, audiometria vocal, timpanometria e pesquisa dos reflexos acústicos, além de acompanhamento genético. RESULTADOS: Dos 17 sujeitos avaliados, 11 apresentaram algum grau de perda auditiva neurossensorial (64,7%, sendo oito do sexo feminino (73% e três do sexo masculino (27%. A idade dos sujeitos avaliados variou de cinco a 68 anos (média=29,6 e a idade do aparecimento da queixa variou de 20 a 38 anos (média=26,1. Ocorreu a progressão da perda auditiva com o aumento da idade, sendo que a partir dos 41 anos, não houve indivíduos com audição normal na família. CONCLUSÃO: a investigação audiológica de todos os membros da família, independentemente da queixa, é imprescindível, pois a perda auditiva pode existir, mesmo que esta ocorra em freqüências isoladas.PURPOSE: to describe the hearing findings of a family with autosome dominant hereditary hearing loss. METHODS: we evaluated 17 subjects. The evaluation was made by pure tone audiometry, Speech audiometry, tympanometry and acoustic reflex testing, in addition to genetic follow-up. RESULTS: from 17 evaluated subjects, 11 showed some degree of neurosensorial hearing loss (64.7%, being 8 female gender (73% and 3 male gender (27%. The subject age varied from 5 to 68 years (average = 39.6 and the time from the complaint's appearance varied from 20 to 38 years. The hearing loss was modified with age. We did not find normal hearing after the age of 41 years in the family. CONCLUSION: the hearing investigation regarding all members of the family regardless of any complaint is extremely indispensable due to the existence of hearing loss even when limited to isolated frequencies.
Wind, Joshua J; Leonetti, John P; Raffin, Michael J M; Pisansky, Marc T; Herr, Brian; Triemstra, Justin D; Anderson, Douglas E
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 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
Lisa E Wolber
Full Text Available Age-related hearing impairment (ARHI affects 25-40% of individuals over the age of 65. Despite the high prevalence of this complex trait, ARHI is still poorly understood. We hypothesized that variance in hearing ability with age is largely determined by genetic factors. We collected audiologic data on females of Northern European ancestry and compared different audiogram representations. A web-based speech-to-noise ratio (SNR hearing test was compared with pure-tone thresholds to see if we could determine accurately hearing ability on people at home and the genetic contribution to each trait compared. Volunteers were recruited from the TwinsUK cohort. Hearing ability was determined using pure-tone audiometry and a web-based hearing test. Different audiogram presentations were compared for age-correlation and reflection of audiogram shape. Using structural equation modelling based on the classical twin model the heritability of ARHI, as measured by the different phenotypes, was estimated and shared variance between the web-based SNR test and pure-tone audiometry determined using bivariate modelling. Pure-tone audiometric data was collected on 1033 older females (age: 41-86. 1970 volunteers (males and females, age: 18-85 participated in the SNR. In the comparison between different ARHI phenotypes the difference between the first two principle components (PC1-PC2 best represented ARHI. The SNR test showed a sensitivity and specificity of 89% and 80%, respectively, in comparison with pure-tone audiogram data. Univariate heritability estimates ranged from 0.70 (95% CI: 0.63-0.76 for (PC1-PC2 to 0.56 (95% CI: 0.48-0.63 for PC2. The genetic correlation of PC1-PC2 and SNR was -0.67 showing that the 2 traits share variances attributed to additive genetic factors. Hearing ability showed considerable heritability in our sample. We have shown that the SNR test provides a useful surrogate marker of hearing. This will enable a much larger sample to be
Metternich, F U; Brusis, T
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.
Elaheh Gholami Parizad
Full Text Available Introduction: Hepatitis B virus is a virus that creates significant hepatic and extra-hepatic complications, with widespread prevalence across the community and body systemic involvement, and can impact on hearing performance. This study aims to evaluate hearing loss among individuals with hepatitis B compared with healthy subjects. Materials and Methods: In this case-control study, 83 HBsAg-positive patients with a 1-year history of disease were selected for pure tone audiometry (PTA testing, while 108 HBsAg-negative patients were selected as the control group. Subjects in both groups were aged 20–40 years. The threshold was set at 25 db for hearing loss. Final data were analyzed using SPSS software. Results: Significant differences were found between the case group and control group in average PTA and hearing loss. There was also a significant difference between the two groups in average PTA at frequencies of 250, 4,000, and 8,000 Hz, but not at speech frequencies of 500, 1,000 and 2,000 Hz, despite the difference in average PTA. Conclusion: According to significant differences in average PTA between patients with hepatitis B virus and healthy subjects in this study, hearing loss may be attributed to the presence HBV of in the patient group.
Novaes, Beatriz C Albuquerque Caiuby; Versolatto-Cavanaugh, Maria Carolina; Figueiredo, Renata de Souza Lima; Mendes, Beatriz de Castro Andrade
To establish relationships between age at onset of individual hearing aid use, functional hearing, communication skills, family involvement and family expectations regarding language development of children diagnosed with hearing loss during the first three years of life. Thirty-five babies diagnosed with moderate to severe hearing loss who were receiving treatment at the Children's Hearing Center/Derdic (CeAC) were evaluated during a period of 24 months. Assessments were carried out every six months and included: VRA--Visual reinforcement audiometry (with and without amplification); IT-MAIS; MUSS; and satisfaction of family regarding child development. Cluster analysis was performed among the subjects. Consistent use of hearing aids was the only variable that exhibited a strong relationship with hearing and language skills. Children whose parents were not satisfied exhibited severe hearing loss and limited auditory capacity even with the use of hearing aid, and, consequently, poor auditory skills and speech production. Datalogging monitoring can guide the knowledge of speech-language pathologists and audiologists and it can also be used on strategic planning. Family involvement, quality of parental participation in the intervention program as well as expectations about the future are also important aspects to consider as these can aid therapists and researchers on the assessment of deaf babies intervention effectiveness.
Aarhus, Lisa; Tambs, Kristian; Engdahl, Bo
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 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.
Saito, Hideyuki; Nishiwaki, Yuji; Michikawa, Takehiro; Kikuchi, Yuriko; Mizutari, Kunio; Takebayashi, Toru; Ogawa, Kaoru
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 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.
Oliveira, Priscila Feliciano de; Oliveira, Camila Silva; Andrade, Joice Santos; Santos, Tamara Figueiredo do Carmo; Oliveira-Barreto, Aline Cabral de
Chemotherapy and radiotherapy in oncology have repercussions in hearing health, and can damage structures of the inner ear. These repercussions usually, result in a bilateral and irreversible hearing loss. To identify sensorineural hearing loss cases with complaints of tinnitus and difficulty in speech understanding and investigate their relationship with the types of chemotherapy and radiotherapy the patients received. Cross-sectional, clinical, observational, analytical, historical cohort study of 58 subjects treated in a public hospital in the state of Sergipe, diagnosed with neoplasia. The subjects were submitted to anamnesis, conventional pure tone audiometry, and speech recognition threshold. Of the 116 ears, 25.9% presented sensorioneural hearing loss characterized by changes in high frequencies. There was a positive correlation between hearing loss and the association of chemotherapy and radiotherapy (p=0.035; R=0.196). The auditory complaint analysis shows that most of the subjects had tinnitus and speech understanding difficulty, even with a normal auditory threshold. Cancer treatment causes hearing loss, associated with the administration of chemotherapy and radiotherapy. Cyclophosphamide increased the risk of causing hearing loss. Complaints of tinnitus and speech understanding difficulty were observed. Copyright © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.
Full Text Available Objective: Survery and comparison between the physical characteristics of Distortion-Product Otoacoustic Emissions of 1-59 day-old normal-hearing newborns refered to TUMS, Rehabilitation School , Audiology department , 2002 Method & Material : This analytical-descriptive study was conducted on the ears of 102 easy method selected newborns. The tests included: otoscopy , BOA, Immittance audiometry , DPOAEs, and ABR if necessary. The amplitude and frequency of 2f1-f2 emissions of DPOAEs evoked by two pure tones (L1=65 dBSPL , L2=50 dBSPL and f2/f1=1.2 were also calculated. Results: 1-All normal hearing newborns have normal DPOAEs. No significant difference was observed in test-retest. 2- The amplitude of the DPOAEs to the right ear is significantly greater than the amplitude of the left ear (P<00.05. 3- No significant difference was observed between newborn’s DPOAEs in terms of their gender. Conclusion: DPOAEs could be measured quickly and noninvasively and are excellent tools for the screening of newborn hearing loss. The results are valid only within the Context of this research.
Full Text Available Background: Hearing impairment has a devastating, detrimental and an invariably adverse impact on the development of the newborns and the psychological well-being of their families. It also adversely affects development of the central auditory nervous system, and can affect speech perception that interferes with growth in social, emotional, behavioural and cognitive spheres, academic achievement, vocational options, employment opportunities and economic selfsufficiency. Objectives: To find out incidence of hearing impairment in high risk neonates in Neonatal Intensive Care Unit (NICU, prevalence of hearing impairment with and without high risk factors in newborns and to correlate the risk factors with hearing impairment. Material and Methods: A cohort study was carried out at a tertiary care hospital of Surat, Gujarat, India consisting of 190 normal newborns and 163 newborns with high risk factors. These newborns underwent a systematized Transient Otoacoustic Emissions Examination (TOAE and Brain Stem Evoked Audiometry (BERA examination according to designed protocol and were followed up with repeated ear examinations. Data were recorded and analyzed statistically. Results: The incidence of hearing impairment in NICU, newborns were 3.6% and the prevalence of hearing impairment was 13%. Hearing impairment was statistically significant in newborns with high risk factors such as low birth weight, preterms 5 days when compared to normal newborns. Conclusion: Presence of risk factors in newborns predisposes them to hearing impairment more as compared to normal newborns and the more the number of risk factors they are exposed to, the more will be the chances of hearing impairment.
Al-Batanony, M A; Abdel-Rasul, G M; Abu-Salem, M A; Al-Dalatony, M M; Allam, H K
With the fast growth in the market of fluorescent lamps, particularly compact fluorescent light, the associated risk of mercury exposure, which is an essential component in all types of fluorescent lamps, has received increasing public attention worldwide. Even low doses of mercury are toxic. To study the health consequences of occupational exposure to mercury in workers of a fluorescent lamp factory. In a cross-sectional study 138 workers of a fluorescent lamp factory and 151 people who had no occupational exposure to mercury (the comparison group) were studied. Environmental study of mercury and noise levels was done. For all participants a neurobehavioral test battery was administered, spirometry was performed and air conduction audiometry was done. Urinary mercury level was also measured for all participants. Prominent symptoms among workers exposed to mercury included tremors, emotional lability, memory changes, neuromuscular changes, and performance deficits in tests of cognitive function. Among the exposed group, the mean urinary mercury level was significantly higher in those who had personality changes or had manifestations of mercury toxicity. With increasing duration of employment and urinary mercury level, the performance of participants in neurobehavioral test battery and spirometric parameters deteriorated. Neurobehavioral test battery must be used for studying subclinical central nervous system dysfunction in those with chronic exposure to mercury. The test is especially useful for evaluating the severity of mercury effects in epidemiological studies. This study also reinforces the need for effective preventive programs for fluorescent lamp industry workplaces especially in developing countries with the lowest unhygienic work conditions.
Alessandra B Fioretti
Full Text Available 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.
Guerra-Jiménez, Gloria; Viera Artiles, Jaime; Mateos, Mar; González Aguado, Rocío; Falcón González, Juan Carlos; Borkoski Barreiro, Silvia; Ramos Macías, Angel
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 (Pcochlear 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.
Jiang, Wen; Zhao, Fei; Guderley, Nicola; Manchaiah, Vinaya
This systematic review aimed to explore the evidence on whether the preferred listening levels (PLLs) and durations of music listening through personal listening devices (PLDs) in adolescents and young adults exceed the current recommended 100% daily noise dose; together with the impact on hearing and possible influential factors of such listening behaviours. A systematic search was conducted using multiple online bibliographic databases. The 26 studies were included on the basis of the inclusion and exclusion criteria. The results showed that up to 58.2% of participants exceeded the 100% daily noise dose, particularly in the presence of background noise. Significantly positive correlations were found among background noise levels and mean PLLs, as well as the proportion of participants exceeding the 100% daily noise dose. Moreover, significantly worse hearing thresholds were found in PLD users using audiometry, and significantly poor results in otoacoustic emission (OAE), even in the participants with self-reported 'normal hearing'. It is crucial to develop appropriate standards and safe recommendations for daily music exposure dose in future studies. Providing an essential guide and effective education to adolescents and young adults will help raise awareness, increase knowledge, and consequently change attitudes and listening habits.
Iliadou, Vasiliki (Vivian); Ptok, Martin; Grech, Helen; Pedersen, Ellen Raben; Brechmann, André; Deggouj, Naïma; Kiese-Himmel, Christiane; Śliwińska-Kowalska, Mariola; Nickisch, Andreas; Demanez, Laurent; Veuillet, Evelyne; Thai-Van, Hung; Sirimanna, Tony; Callimachou, Marina; Santarelli, Rosamaria; Kuske, Sandra; Barajas, Jose; Hedjever, Mladen; Konukseven, Ozlem; Veraguth, Dorothy; Stokkereit Mattsson, Tone; Martins, Jorge Humberto; Bamiou, Doris-Eva
Current notions of “hearing impairment,” as reflected in clinical audiological practice, do not acknowledge the needs of individuals who have normal hearing pure tone sensitivity but who experience auditory processing difficulties in everyday life that are indexed by reduced performance in other more sophisticated audiometric tests such as speech audiometry in noise or complex non-speech sound perception. This disorder, defined as “Auditory Processing Disorder” (APD) or “Central Auditory Processing Disorder” is classified in the current tenth version of the International Classification of diseases as H93.25 and in the forthcoming beta eleventh version. APDs may have detrimental effects on the affected individual, with low esteem, anxiety, and depression, and symptoms may remain into adulthood. These disorders may interfere with learning per se and with communication, social, emotional, and academic-work aspects of life. The objective of the present paper is to define a baseline European APD consensus formulated by experienced clinicians and researchers in this specific field of human auditory science. A secondary aim is to identify issues that future research needs to address in order to further clarify the nature of APD and thus assist in optimum diagnosis and evidence-based management. This European consensus presents the main symptoms, conditions, and specific medical history elements that should lead to auditory processing evaluation. Consensus on definition of the disorder, optimum diagnostic pathway, and appropriate management are highlighted alongside a perspective on future research focus.
Kitajima, Naoharu; Sugita-Kitajima, Akemi; Kitajima, Seiji
A 28-year-old female diver presented with dizziness and difficulty clearing her left ear whilst scuba diving. Her pure-tone audiometry and tympanometry were normal. Testing of Eustachian tube function revealed tubal stenosis. Video-oculography revealed a predominantly torsional nystagmus while the patient was in the lordotic position. Fistula signs were positive. High-resolution computed tomography (HRCT) of the temporal bone revealed a diagnosis of bilateral superior semicircular canal dehiscence (SCDS). Cervical vestibular-evoked myogenic potential (cVEMP) testing showed that the amplitude of the cVEMP measured from her left ear was larger than that from the right. In electronystagmography (ENG), nose-pinched Valsalva manoeuvres caused eye movements to be mainly directed counterclockwise with a vertical component. Tullio phenomenon was also positive for both ears. SCDS patients tend to be misdiagnosed and misunderstood; common misdiagnoses in these cases are alternobaric vertigo (AV), inner ear barotrauma, and inner-ear decompression sickness. It is difficult to diagnose vertigo attacks after scuba diving as SCDS; however, when the patient develops sound- and/or pressure-induced vertical-torsional nystagmus, HRCT should be conducted to confirm a diagnosis of SCDS.