Air Conduction Thresholds Research Articles

Prevalence, Associated Factors and Health-related Quality of Life of Dual Sensory Impairment in Residential Care Facilities in Singapore

ABSTRACT Purpose: To investigate the prevalence of dual sensory impairment (DSI), its associated factors and relationship with health-related quality of life (HR-QoL) in residential care facilities (RCF) in Singapore. Methods: This was a cross-sectional study of 123 residents aged ≥40 years from six RCFs, conducted between 2016 and 2018. DSI was defined as concomitant presenting visual acuity (better-eye) >0.3 logarithm of the minimum angle of resolution and a pure-tone air conduction threshold (better-ear) >40 dB HL in any of the four tested frequencies (500, 1000, 2000 and 4000 Hz). HR-QoL was quantified using the EuroQol five-dimension questionnaire. Multivariable Poisson regression was used to determine the associated factors of DSI. Multivariable linear regression was used to determine the association between DSI and HR-QoL adjusted for traditional confounders. Results: Of the 123 residents (age [mean±standard deviation] 75.3 ± 10.8 years; 56.9% male), 97 (78.9%[95% confidence interval(CI):71.6%, 86.1%]) had DSI, with 110 (98.2%) not on follow-up care for their sensory disabilities. In multivariable models, male gender (prevalence ratio(PR) [95%CI] = 1.3[1.1, 1.6]), older age (per 10-year increase (1.2[1.1, 1.3])), education ≤6 years (1.3[1.1, 1.7]) and the presence of cataract (1.3[1.0, 1.7]) were independently associated with DSI. DSI was independently associated with a substantial worsening in HR-QoL (β = −0.61; 95%CI: −0.76, −0.45; p < .001). Conclusions: DSI affects four in five residential care residents and is substantially associated with reductions in HR-QoL in these residents. Our finding highlights an urgent need for the implementation of routine vision and hearing screening and follow-up care for residents living in these facilities.

Long-Term, Multicenter Results With the First Transcutaneous Bone Conduction Implant.

Investigation of long-term safety and performance of an active, transcutaneous bone conduction implant in adults and children up to 36 months post-implantation. Prospective, single-subject repeated-measures design. Otolaryngology departments of eight German and Austrian hospitals.∗†‡§||¶#∗∗†† Affiliations listed above that did not participate in the study.‡‡§§||||¶¶. Fifty seven German-speaking patients (49 adults and eight children) suffering from conductive or mixed hearing loss, with an upper bone conduction threshold limit of 45 dB HL at frequencies between 500 and 3000 Hz. Implantation of the Bonebridge transcutaneous bone conduction hearing implant (tBCI). Patients' audiometric pure tone averages (PTA4) (0.5, 1, 2, 4 kHz) thresholds (air conduction, bone conduction, and sound field) and speech perception (word recognition scores [WRS] and speech reception thresholds [SRT50%]) were tested preoperatively and up to 36 months postoperatively. Patients were also monitored for adverse events and administered quality-of-life questionnaires. Speech perception (WRS: pre-op: 17.60%, initial activation [IA]: 74.23%, 3M: 83.65%, 12M: 83.46%, 24M: 84.23%, 36M: 84.42%; SRT50%: pre-op: 65.56 dB SPL, IA: 47.67 dB SPL, 3M: 42.61 dB SPL, 12M: 41.11 dB SPL, 24M: 41.74 dB SPL, 36M: 42.43 dB SPL) and sound field thresholds (pre-op: 57.66 dB HL, IA: 33.82 dB HL, 3M: 29.86 dB HL, 12M: 28.40 dB HL, 24M: 28.22 dB HL, 36M: 28.52 dB HL) improved significantly at all aided postoperative visits. Air and bone conduction thresholds showed no significant changes, confirming preservation of patients' residual unaided hearing. All adverse events were resolved by the end of the study. Safety and performance of the tBCI was demonstrated in children and adults 36 months postoperatively.

Telehealth Audiology and Virtual Hearing Screenings: A Case Report.

Clinic closures across the United States in response to the coronavirus disease 2019 (COVID-19) pandemic meant that many audiology services were reduced to phone calls, video visits, and modified services (e.g., curbside, mail-ins, drop offs). Audiologists and other providers needed a way to manage hearing- and ear-related complaints via telehealth. A simple pure tone air conduction threshold test performed at home was used to determine which patients needed to come into the clinic for an in-person appointment. This case will review a 56-year-old male who was being treated for an idiopathic sudden sensorineural hearing loss prior to clinic closure. He had on file a comprehensive audiogram at first onset of symptoms and was treated with oral steroids. Virtual hearing testing was then utilized for a variety of other patients from teenagers to adults to triage hearing- and ear-related complaints while clinics were closed for in-person visits.

Comparison of hearing reconstruction techniques in tympanosclerosis with stapes fixation

Background/Aim: Surgery for tympanosclerosis with stapes fixation for hearing reconstruction is controversial, with many reports in the relevant literature advocate opposing suggestions. The primary aims were to evaluate hearing improvement with varied hearing reconstruction techniques performed for tympanosclerosis with stapes fixation. Methods: Patients with tympanosclerosis and stapes fixation, whose hearing impairment was re-constructed surgically and who were followed for 1-5 years were reviewed in this retrospective cohort study. The audiological outcomes of reconstruction methods, including mobilization, partial ossicular replacement prosthesis (PORP), total ossicular replacement prosthesis (TORP), and teflon pistons (TP) were documented. Results: The study included 76 ears of 76 patients; 29 ears in the mobilization technique group, 28 ears in the PORP technique group, 10 ears in the TORP technique group, and 9 ears in the TP technique group. When postoperative and preoperative hearing were evaluated, the mobilization and PORP techniques showed statistically significant improvement in both air conduction threshold gain and air-bone gap closure (P0.05). Bone conduction threshold showed no significant deterioration in any techniques. Conclusion: For hearing gain, mobilization and PORP were effective in tympanosclerosis patients with stapes fixation after removal of sclerotic plaques, whereas the TORP and TP techniques did not show significant improvement. It can be concluded that, if a functionally mobile stapes cannot be achieved, it is not advisable to perform TORP replacement or a stapedotomy. However, these methods may still be used in carefully selected patients and be successful in some.

Type I Tympanoplasty: surgical success and prognostic factors

ObjectivesTo evaluate success rate of type I tympanoplasty in adults and to investigate the importance of selected prognostic factors on graft uptake. Material and methodsRetrospective medical chart review of 155 patients who underwent Type I Tympanoplasty, in our department, from January 2013 to December 2017. Graft uptake rate was evaluated and the effects of prognostic factors on surgical outcome such as sex, smoking and otological surgery history, status of the contralateral ear, size and location of the perforation, middle ear mucosa status, surgical approach and graft material. Preoperative and postoperative audiometric data were collected, and the functional success was determined. ResultsThe overall surgical anatomical success rate was 75%. Analysis of the selected variables, identified as independent prognostic factors of anatomical unsuccess (95% CI): smoking (OR=3.29, p<.01), middle ear tympanosclerosis (OR=2.96; p=.04). Perforations above 50% of the tympanic membrane area had a borderline effect on graft uptake (p=.05). There was a significative improvement in the average air conduction thresholds of 7.44dB and an ABG closure rate at 10dB and 20dB was achieved in 47% and 84.5%, respectively. Patients who received temporalis fascia graft had similar hearing gain compared to patients who underwent cartilage tympanoplasty (7.7 vs. 7.3dB, p=.79). ConclusionType I tympanoplasty is an effective and safe procedure with a high anatomical success rate in the treatment of mucosal COM. Poorer outcomes were found in patients with smoking habits, in those with tympanosclerosis of middle ear mucosa and in larger perforations. These prognostic factors should be considered in surgical planning and patients should be advised to quit smoking. Tympanoplasty with cartilage graft had a hearing outcome comparable to temporalis fascia graft and should be considered in high-risk patients.

Correlation of Status of Mastoid with Outcomes of Myringoplasty with Cortical Mastoidectomy in Mucosal Otitis Media with High Risk Perforation

Introduction: Chronic mucosal otitis media is one of the common disease prevalent in our society. This study was done to correlate the status of mastoid with outcomes of myringoplasty with cortical mastoidectomy in mucosal otitis media with high risk perforation. Methods: This prospective, observational study was done at Department of Otorhinolaryngology and Head and Neck Surgery, Tribhuvan University Teaching Hospital. Thirty-four patients of ag|e 15 and above with chronic mucosal otitis media having high-risk perforation undergoing cortical mastoidectomy with myringoplasty were included. The status of middle ear, aditus, and mastoid air cells were assessed. Post-operatively, patients were assessed for graft uptake and hearing after three months. The post-operative graft uptake and hearing results were correlated with the peroperative status. Four patients who had preoperative sensorineural hearing loss were studied in terms of graft uptake only. Results: The graft success rate in patients with normal mastoid air cells was 90% whereas in diseased cases was 71.4% which was statistically not significant with p value 0.20. The success rate in terms of hearing was 68.8% in normal mastoid whereas it was 64.3% in diseased mastoid which was statistically not significant with p-value of 1. Conclusion: In correlation with the status of mastoid air cells with graft uptake and hearing result, the observed differences were not statistically significant. However, averages of post-operative air conduction threshold and air-bone gap of all cases were better as compared to preoperative levels.

Correlation of Status of Mastoid with Outcomes of Myringoplasty with Cortical Mastoidectomy in Mucosal Otitis Media with High Risk Perforation

Introduction Chronic mucosal otitis media is one of the common disease prevalent in our society. This study was done to correlate the status of mastoid with outcomes of myringoplasty with cortical mastoidectomy in mucosal otitis media with high risk perforation.&#x0D; MethodsThis prospective, observational study was done at Department of Otorhinolaryngology and Head and Neck Surgery, Tribhuvan University Teaching Hospital. Thirty-four patients of ag|e 15 and above with chronic mucosal otitis media having high-risk perforation undergoing cortical mastoidectomy with myringoplasty were included. The status of middle ear, aditus, and mastoid air cells were assessed. Post-operatively, patients were assessed for graft uptake and hearing after three months. The post-operative graft uptake and hearing results were correlated with the peroperative status. Four patients who had preoperative sensorineural hearing loss were studied in terms of graft uptake only.&#x0D; ResultsThe graft success rate in patients with normal mastoid air cells was 90% whereas in diseased cases was 71.4% which was statistically not significant with p value 0.20. The success rate in terms of hearing was 68.8% in normal mastoid whereas it was 64.3% in diseased mastoid which was statistically not significant with p-value of 1.&#x0D; ConclusionIn correlation with the status of mastoid air cells with graft uptake and hearing result, the observed differences were not statistically significant. However, averages of post-operative air conduction threshold and air-bone gap of all cases were better as compared to preoperative levels.

Quality of Life Assessment after Canal Wall Down Mastoidectomy: Our Experiences in Shaheed Ziaur Rahman Medical College Hospital, Bogura

Objective: To determine subjective outcomes after cholesteatoma surgery.&#x0D; Design: Cross sectional observational study&#x0D; Methods: Study place: Shaheed Ziaur Rahman Medical college Hospital (SZMCH), Bogura, Bangladesh&#x0D; Study population: Chronic otitis media (COM) with extensive cholesteatoma. Interventions: Canal wall down mastoidectomy for cholesteatoma.&#x0D; Main Outcome Measures: In this study, the Chronic Ear Survey (CES) was provided to all patients preoperatively and one year after surgery. The preoperative and postoperative score differences were analyzed. We also assessed correlations between chronic ear survey scores and air conduction threshold.&#x0D; Results: Seventy six patients were enrolled in our study &amp; marked improvements were found in total CES score &amp; all subscale scores postoperatively (P value: 0.00). The total CES score and symptom subscale scores were observed greater improvement (P value: 0.00).Significant negative linear correlations were observed among total CES scores, symptom subscale scores and air conduction thresholds (P&lt;.05).&#x0D; Conclusion: The present study suggests that canal wall down mastoidectomy (CWDM) provides a significant improvement in the post-operative Quality of life (QoL) &amp;b there is a significant association between subjective outcomes &amp;the objective audiometric results.&#x0D; Bangladesh J Otorhinolaryngol; April 2021; 27(1): 52-58

Audiological profile of pre-operative and post-operative results in mucosal diseases of the ear: a comparative study

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; The Objectives of the study were to study pre-operative audiological results in mucosal diseases of ear; to study post-operative audiological results in mucosal diseases of ear and to compare pre-operative and post-operative audiological results in mucosal diseases of ear.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; A prospective study was done on 60 patients presenting to out-patient department of Otorhinolaryngology and Head and Neck Surgery, S.Nijalingappa Medical College and H.S.K Hospital and Research Centre, Bagalkot from May 2018 to April 2020 with CSOM-mucosal disease. Audiological evaluation was done and compared using pure tone audiometry (Amplaid311TypeIEC645) before and after tympanoplasty with cortical mastoidectomy and mean air conduction (AC) threshold improvement and mean air-bone gap (AB gap) closure was analyzed. &lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results:&lt;/strong&gt; Out of 60 patients, 27(45%) patients had medium sized central perforation. Mean pre-operative AC threshold was 44.5958±10.64639 dB HL which improved to 30.100±10.41056 dB HL at 1month and 21.8125±8.6928 dB HL at 3months post-operatively which was statistically significant with p&amp;lt;0.001*. Mean AB gap closure at 1-month was 10.175±6.01098 dB HL and at 3-months was 11.0416±6.3458 dB HL.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; AC threshold gain and AB gap closure at 1month and 3 months post-tympanoplasty with cortical mastoidectomy for CSOM-mucosal disease are significant. Hence surgery is main basic tool which results in improvement of audiological results in mucosal diseases of ear.&lt;/p&gt;

The Effect of the Status of the Ossicular Chain and Choice of Graft Material on Hearing Outcomes in Pediatric Cholesteatoma Surgery

Objective: Compare hearing benefit of incus preservation in primary cholesteatoma surgery versus cartilage-myringostapediopexy.Methods: Prospective cohort study in a tertiary referral center. Tympanoplasty utilizing cartilage or other grafts, with or without intact incus was performed in 195 ears (187 children) with intact stapes. Outcome measures were pre and post-operative four-tone air conduction (AC) threshold (0.5, 1, 2, 4 kHz) and proportion with normal hearing (AC ≤ 30 dB HL) at 12 months.Results: Ears with intact ossicles had better post-operative AC thresholds than those with incus eroded or removed (median 20 dB HL vs. 30 dB HL, Mann–Whitney P < .001). The normal hearing rate was 81/106 (74%) with intact incus and 46/89 (52%) without (Fisher’s exact P = .001). Ears without intact incus and a cartilage-myringostapediopexy had better post-operative thresholds than those with a non-cartilage graft (28.8 dB HL vs. 36.3 dB HL, Mann–Whitney P = .005). Of ears without intact incus, 37/59 (63%) with a cartilage-myringostapediopexy and 9/30 (30%) with a non-cartilage graft had normal hearing post-operatively (Fisher’s exact P = .007). By preserving the incus in 12 ears, 1 more ear would have normal hearing than with incus removal plus cartilage-myringostapediopexy (NNT = 12 (CI 3.6-); Fisher’s exact = 0.1).Conclusion: Preserving an intact ossicular chain conveys a small but significant hearing benefit in cholesteatoma surgery, the magnitude of which should be considered before deciding to remove the intact incus. Cartilage-myringostapediopexy provides a significant gain in hearing when the incus is absent, even without a partial ossicular replacement prosthesis.

Bonebridge implantation combined with simultaneous bilateral auricle reconstruction for bilateral congenital aural atresia

Objective: To investigate the feasibility and safety of auricle reconstruction combined with Bonebridge implantation for bilateral aural atresia patients. Methods: A retrospective analysis was conducted for 36 cases(72 ears) who underwent Bonebridge implantation combined with bilateral auricle reconstruction from February 1, 2017 to January 15, 2020. All cases were bilateral congenital aural atresia and underwent Nagata auricle reconstruction for both sides simultaneously. Bonebridge implantations were performed during the second stage of auricle reconstruction. Results: All 36 patients healed well and had no surgical complications when discharged. The preoperative average bone conduction threshold of the patients was(8.5±5.8) dB HL and postoperative bone conduction threshold was (8.4±5.2) dB HL. There was no significant change after the implantation (P=0.724). The preoperative average air conduction threshold of was(64.9±7.4)dB HL and postoperative air conduction threshold was (24.0±5.3) dB HL, which had a significant change after the implantation (P<0.001). The hearing threshold with Bonebridge significantly decreased by 40.9 dB HL compared with the preoperative air conduction threshold(P<0.001). The speech recognition rate of monosyllable words, disyllabic words and short sentences in quiet environment increased by 62.5%, 63.5% and 72.2% respectively. The differences were statistically significant (P<0.001). The speech recognition rate of monosyllabic words, disyllabic words and short sentences in noise environment were significantly increased by 55.9%, 58.9% and 69.9% respectively (P<0.001). After a follow-up of 18.3 months in average, the hearing results were stable and the aesthetic outcomes were satisfied. One patient had implant rupture and healed after revision surgery. Conclusions: With an integrated surgical procedure, patients with bilateral congenital aural atresia can complete bilateral auricle reconstruction and hearing implantation within six months. This integrated surgical procedure is safe and efficient, with a stable hearing improvement and good appearance.

Conventional Microscopic Stapedotomy: An Obsolete Technique or Still the Gold Standard for the Management of Otosclerosis?

Background and objectivesClinical otosclerosis is a relatively common entity, accounting for 0.5%-2% of the general population. Otosclerosis is characterized by an abnormal bone formation in the temporal bone that eventually causes conductive hearing loss. Bilateral involvement is fairly common. Treatment can be either conservative with medications and a hearing aid, or surgical. Stapedotomy is considered, nowadays, the most effective surgical technique for the management of otosclerosis. The purpose of the present study is to present our long-term results with stapedectomy, the audiological outcome, as well as the complications encountered.Subjects and methodsThis is a retrospective single-centre study. All patients diagnosed with otosclerosis and treated operatively with a stapedotomy from January 2010 to December 2019 were included in the study. Demographic data, air and bone conduction thresholds, complications and length of the prosthesis were recorded. ResultsThe study included a total of 72 patients. The audiological results showed a statistically significant improvement in the air conduction thresholds in all the affected frequencies (p<0.001). Post-operative complications included deterioration or severe hearing loss up to 100 dB (n=1, 1.39%), loss or distortion of taste (n=4, 5.6%) and tinnitus (n=2, 2.8%).ConclusionsOur results demonstrate that stapedotomy is an effective technique for the management of otosclerosis. Stapedotomy, when performed by an experienced surgeon, provides excellent outcomes, with limited complications.

Hearing Outcomes of Stapes Surgery in Children With Stapes Fixation and Ossicular Anomalies.

To investigate hearing outcomes after stapes surgery in children with stapes fixation. Retrospective study. Tertiary referral center. Forty-nine patients (66 ears) aged less than 15 years who received stapes surgery. Stapes surgery. Preoperative symptoms, bilateral involvement, pure-tone hearing levels, and perioperative complications were analyzed using paired t test and Mann-Whitney U test. The chief complaint of all patients was hearing disturbance. Sixteen ears were diagnosed with stapes fixation and an additional congenital ossicular anomaly and 50 ears had only stapes fixation. Preoperative mean bone conduction and air conduction thresholds were 12.0 ± 5.8 dB and 60.9 ± 10.9 dB, respectively. The mean air-bone gap (ABG) was 48.9 ± 12.0 dB in patients with stapes fixation and an ossicular anomaly. The postoperative mean ABG was 23.6 ± 14.5 dB, and the ABG closure was 25.3 ± 18.2 dB. In patients with stapes fixation only, the preoperative mean bone conduction and air conduction thresholds were 14.3 ± 7.5 dB and 49.6 ± 9.5 dB, respectively, and the mean ABG was 35.5 ± 9.6 dB. The postoperative mean ABG was 14.4 ± 10.3 dB, and the ABG closure was 16.2 ± 16.1 dB. The successful results (ABG <20 dB) were 75.8% overall, 56.3% for fixation and an ossicular anomaly, and 82.0% for fixation only. In children with stapes fixation, hearing loss was worse when the fixation was combined with an ossicular anomaly. Ossicular continuity, especially of the incus, is the most important factor for successful stapes surgery. Appropriate diagnosis and surgical intervention can lead to good results for children with stapes fixation.

Bone-conduction threshold and air-bone gap may predict frequency-specific air-conduction threshold after tympanoplasty.

Postoperative hearing improvement is one of the main expectations for patients receiving tympanoplasty. The capacity to predict postoperative hearing may help to counsel a patient properly and avoid untoward expectations. It is difficult to predict postoperative hearing without knowing the disease process in the middle ear, which can only be assessed intraoperatively. However, the duration and extent of the underlying pathologies may represent in bone-conduction threshold and air-bone gap. Here in patients undergoing tympanoplasty without ossiculoplasty, we sorted and separated the surgery dates into the first group to build the predicting models and the second group to test the predictions. There were 87 and 30 ears, respectively. No specific enrollment or exclusion criteria were based on underlying pathologies such as the perforation size of the tympanic membrane or the middle ear conditions. The results show that bone-conduction threshold and air-bone gap together predicted air-conduction threshold after the surgery, including each frequency of 0.5k, 1k, 2k, and 4k Hz. The discrepancies between the predictions and recordings did not differ among these four frequencies. Of the variance in mean postoperative air-conduction threshold, 56.7% was linearly accounted for by these two preoperative predictors in this sample. The results suggest a trend that, the higher the frequency, the larger the part was accounted for by these two preoperative predictors. These together may help a surgeon to estimate frequency-specific hearing outcome after the surgery, answer patients’ questions with quantitative statistics, and counsel patients with proper expectations.

CT Assessment of Otic Capsule Bone Density in Paget's Disease of the Temporal Bone and Its Relationship With Hearing Loss.

To study computed tomography findings in Paget's disease of temporal bone (PDTB) and analyze the relations between otic capsule bone mineral density values measured in Hounsfield Units (HU) and hearing loss (HL). Observational case-control study. Tertiary referral center. Radiographically confirmed PDTB cases and control group. Diagnostic. Hearing thresholds and computed tomography bone density values. Twenty-three ears in the case group (PDTB) and 27 control ears were included. In the PDTB group, HL was found in 87% of the ears (43% mixed) and an air-conduction threshold of 50.7 dB (SD = 19.8). In the control group, 48% of the ears showed HL (7% mixed) and an air-conduction threshold of 34.5 dB (SD = 20.6) was found; the difference was statistically significant (p < 0.05). Measurements of bone density (HU) in the otic capsule (regions of interest [ROI] 1 and 2) and in the petrous bone (ROI 3) were significantly lower (p < 0.05) in the PDTB group than in controls.The PDTB group presented a significant association between otic capsule bone density in ROI 1 and mean otic capsule density with air and bone-conduction thresholds (p < 0.05). In controls, no association was observed between any density value and audiometric thresholds. PDTB patients showed more frequent HL, lower thresholds, and a higher proportion of mixed HL than controls. Bone density (HU) was decreased in all ROIs in PDTB patients in comparison with controls. Bone density in the otic capsule was associated with HL in PDTB patients, but no association was observed between bone density and HL in controls.

Audiometric Pattern in Moderate and Severe Tympanic Membrane Retraction.

To evaluate the audiometric pattern in moderate/severe retractions of the tympanic membrane and correlate it with the severity of the otoscopy findings. Cross-sectional study. Tertiary hospital. Consecutive patients with moderate or severe tympanic membrane retraction in at least one ear (451 ears) between August 2000 and January 2019, and no surgical history or effusion (mean [standard deviation] age, 32.8 [20.2] yr; 54% female and 42.4% children). Pure-tone audiometry. Air conduction (AC) and bone conduction thresholds, and air-bone gap (ABG) measured at the four-frequency pure-tone average. The median in decibel hearing level (dB HL) (minimum-maximum) of the AC, BC, and ABG were 25 dB HL (0-120 dB HL), 10 dB HL (0-75 dB HL), and 12.5 dB HL (0-55 dB HL), respectively. Seventy-two percent of the ears had an ABG ≤ 20 dB HL. For severity of the retraction of pars flaccida (PF), the AC, bone conduction, and ABG were similar across groups, with a weak correlation. For the pars tensa (PT), there was a global difference in the medians of AC and ABG in terms of the degree of severity, with a moderate correlation. Retraction in PF and PT at the same time was observed in 6 4% of the ears. ABG median was lower in ears with PF retraction (6.25 dB HL) than PT retraction, isolated (15 dB HL) or not (13.75 dB HL; p < 0.05). The ABG pure-tone average median was higher when PT was involved. We found a significant correlation between the retraction severity and worsening of AC and ABG thresholds, only for PT.

Long term results and evaluation of device satisfaction in patients used the vibrant sound bridge (VSB)

Background Patients' satisfaction with the device is as important as the audiological gains in patients using these devices. Objective In this study, we aimed to evaluate the hearing aid satisfaction of individuals using The Vibrant Sound Bridge (VSB) (Vibrant Med-El, Innsbruck, Austria) and to compare this result with audiologic results ​​with and without devices. Material and methods Patients who were using VSB were included in the study. Preoperative and postoperative pure tone averages and demographic datas of the patients to be included in the study were recorded. A shortened version of Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire, was used to evaluate patients’ device satisfaction. Results Fifteen patients with VSB were included in the study. The mean follow-up was 9.13 years. The preoperative air conduction threshold and the air-bone gap in all frequencies were significantly higher than postoperative values (p < .05). The functional gain was found as 28 dB. In the APHAB questionnaire, there was a significant difference between total score results and EC, BN, RV subscales in the patients using the device (p < .01). Conclusion and significance Patients with VSB give satisfactory results in auditory gains. In particular, good indication and long-term use of the device increases the suitability and satisfaction of the patients.

Community-Based Hearing and Vision Screening in Schools in Low-Income Communities Using Mobile Health Technologies.

Introduction Globally, more than 50 million children have hearing or vision loss. Most of these sensory losses are identified late due to a lack of systematic screening, making treatment and rehabilitation less effective. Mobile health (mHealth), which is the use of smartphones or wireless devices in health care, can improve access to screening services. mHealth technologies allow lay health workers (LHWs) to provide hearing and vision screening in communities. Purpose The aim of the study was to evaluate a hearing and vision school screening program facilitated by LHWs using smartphone applications in a low-income community in South Africa. Method Three LHWs were trained to provide dual sensory screening using smartphone-based applications. The hearScreen app with calibrated headphones was used to conduct screening audiometry, and the Peek Acuity app was used for visual acuity screening. Schools were selected from low-income communities (Gauteng, South Africa), and children aged between 4 and 9 years received hearing and vision screening. Screening outcomes, associated variables, and program costs were evaluated. Results A total of 4,888 and 4,933 participants received hearing and vision screening, respectively. Overall, 1.6% of participants failed the hearing screening, and 3.6% failed visual acuity screening. Logistic regression showed that female participants were more likely to pass hearing screening (OR = 1.61, 95% CI [1.11, 2.54]), while older children were less likely to pass visual acuity screening (OR = 0.87, 95% CI [0.79, 0.96]). A third (32.5%) of referred cases followed up for air-conduction threshold audiometry, and one in four (25.1%) followed up for diagnostic vision testing. A high proportion of these cases were confirmed to have hearing (73.1%, 19/26) or vision loss (57.8%, 26/45). Conclusions mHealth technologies can enable LHWs to identify school-age children with hearing and/or vision loss in low-income communities. This approach allows for low-cost, scalable models for early detection of sensory losses that can affect academic performance.

Tinnitus and 3-Year Change in Audiometric Hearing Thresholds.

Tinnitus and hearing loss commonly coexist, however, the temporal relation between tinnitus and hearing loss is complex and not fully understood. Our objective was to examine the longitudinal association between persistent tinnitus, bothersome tinnitus, and 3-year elevation of audiometric hearing thresholds. We conducted a longitudinal cohort study among 3106 women (mean age 59 years) who were participants in the Nurses' Health Study II (2012-2018). Information on tinnitus was obtained from biennial questionnaires. Longitudinal changes in air conduction thresholds (0.5 to 8 kHz) were assessed by pure-tone audiometry conducted by licensed audiologists at 19 audiology testing sites across the United States. Logistic regression was used to estimate multivariable-adjusted odds ratios (MVORs, 95% confidence interval [CI]) and evaluate the relations of persistent tinnitus (several days per week or more), bothersome tinnitus (interferes with work, sleep, or daily activities), and risk of 3-year elevation of hearing thresholds. Persistent tinnitus was associated with higher risk of 3-year elevation of hearing thresholds across a broad range of frequencies. Compared with women without tinnitus, the MVORs (95% CI) for ≥5-dB threshold elevation among women with persistent tinnitus were 1.01 (0.81, 1.25) at 0.5 kHz, 1.45 (1.17, 1.81) at 1 kHz, 1.25 (1.00, 1.56) at 2 kHz, 1.34 (1.07, 1.69) at 3 kHz, 1.34 (1.06, 1.70) at 4 kHz, 1.49 (1.16, 1.91) at 6 kHz, and 1.63 (1.25, 2.12) at 8 kHz. The magnitudes of the associations for ≥10-dB threshold elevation were similar. The magnitudes of the associations were substantially greater among women with bothersome tinnitus. For example, compared with women without tinnitus, the MVORs (95% CI) for a ≥5- and ≥10-dB elevation of hearing thresholds at 4 kHz were 2.97 (1.50, 5.89) and 2.79 (1.38, 5.65), respectively. The risk was elevated even among women with tinnitus who had clinically normal hearing thresholds at baseline. In analyses that examined the association of tinnitus and elevation of low-, mid- and high-frequency pure-tone average (PTA) hearing thresholds, the results were similar. Compared with women without tinnitus, the MVORs (95% CI) for ≥5-dB PTA elevation among women with persistent tinnitus were 1.29 (0.99,1.67) for LPTA(0.5,1,2 kHz); 1.44 (1.16, 1.78) for MPTA(3,4 kHz); and 1.38 (1.11, 1.71) for HPTA(6,8 kHz). For ≥10-dB elevation, the MVORs were 2.85 (1.55, 5.23), 1.52 (1.10, 2.09), and 1.41 (1.10, 1.82), respectively. Persistent tinnitus was associated with substantially higher risk of 3-year hearing threshold elevation, even among women with clinically normal baseline hearing. The magnitudes of the associations were greater among those with bothersome tinnitus. Monitoring hearing sensitivities may be indicated in patients with tinnitus, including those without audiometric evidence of hearing impairment.

A study to assess hearing improvement after fat graft myringoplasty

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Tympanic membrane perforations result mainly from infectious and traumatic etiologies. Postoperative outcomes of reconstructive surgeries of hearing mechanism have routinely been assessed by take up rates and air bone gap closure on pure tone testing. The present study was conducted to assess hearing improvement after fat graft myringoplasty.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; The present prospective study was conducted from 1&lt;sup&gt;st&lt;/sup&gt; January 2017 to 30&lt;sup&gt;th&lt;/sup&gt; June 2018. The study population consists of patients of age 18 to 60 years. The subjects with safe or tubotympanic type of chronic suppurative otitis media with small dry central perforation or perforation of the pars tensa less than 3 mm were included in the study. Pure tone audiometry (PTA) was consigned to an audiologist who was blind to the study. Air conduction threshold level was measured at frequencies 0.25 to 8 kHz and bone conduction threshold level was measured at frequencies 0.5 to 4 kHz; average air bone gap of each patient was calculated preoperatively and postoperatively at one and three months at the frequencies 500 Hz, 1000 Hz and 2000 Hz. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Among 30 patients, 15 (50.00%) had pre-operative bone conduction threshold in the range of 0-10 dB HL and rest 15 (50.00%) had between 11-20 dB HL. Majority of them i.e. 20 had post-operative air bone gap in the range of 0-10 dB HL whereas 02 had pre op air bone gap in this range, followed by 07 with air bone gap in the range of 11-20 dB HL as compared to 18 in the pre op and 03 in the range of 21-30 dB HL as compared to 10 in the pre op. Paired t test reveals results are significant.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Postoperative audiometry at the end of 1 month revealed majority i.e. 14 had air bone gap in range of 0-10 dB HL thus showing improvement in hearing. Postoperative audiometry at the end of 3 months revealed maximum number of patients i.e. 20 in the range of 0-10 dB HL which showed further improvement in hearing in the form of decrease in air bone gap.&lt;/p&gt;&lt;p class="Default"&gt; &lt;/p&gt;