Audiological Results Research Articles

Comparison of behind-the-ear vs. off-the-ear speech processors in cochlear implants: A systematic review and narrative synthesis.

Cochlear implants (CI) with off-the-ear (OTE) and behind-the-ear (BTE) speech processors differ in user experience and audiological performance, impacting speech perception, comfort, and satisfaction. This systematic review explores audiological outcomes (speech perception in quiet and noise) and non-audiological factors (device handling, comfort, cosmetics, overall satisfaction) of OTE and BTE speech processors in CI recipients. We conducted a systematic review following PRISMA-S guidelines, examining Medline, Embase, Cochrane Library, Scopus, and ProQuest Dissertations and Theses. Data encompassed recipient characteristics, processor usage, speech perception, and non-audiological factors. Studies were assessed for quality and risk of bias by using Newcastle-Ottawa Scale (NOS). Nine studies involving 204 CI recipients, with a mean age of 49.01 years and 6.62 years of processor use, were included. Audiological results indicated comparable performance in quiet environments, with a slight preference for OTE in noisy conditions. For non-audiological factors, OTE processors excelled in comfort, handling, and aesthetics, leading to higher satisfaction. More data on medical complications and long-term implications is needed. OTE processors may offer comparable performance to BTE processors in certain conditions, though not universally across all audiological outcomes. Interpretation depends on settings, processor generation, and testing paradigms. However, non-audiological factors might favour OTE. Understanding current literature may guide professionals in selecting suitable processors for CI recipients.

Outcomes of Endoscopic versus Microscopic Ossicular Chain Reconstruction-A Systematic Review and Meta-analysis.

The efficacy of the transcanal endoscopic approach in tympanoplasty, cholesteatoma removal, and stapedotomy is detailed. This study reviews evidence on the feasibility of endoscopic ossiculoplasty as a suitable alternative to traditional microscopic ossiculoplasty. PubMed, Embase, and Cochrane Library were searched from inception to 19 June 2024 for articles comparing endoscopic and microscopic ossicular chain reconstruction. This systematic review was conducted in accordance with PRISMA guidelines. The primary outcomes assessed include air bone gap closure, pre-operative and post-operative air bone gap, pure tone audiometry, and word recognition scores. The secondary outcomes include operation time, surgical success, and surgical complications. These outcomes between microscopic and endoscopic techniques were pooled and compared as mean differences using a random-effects model. The Risk of Bias in Non-Randomized Studies of Interventions (ROBINS-I) and Cochrane Risk-of-Bias Tool for Randomized Trials (RoB2) scale were adopted to assess for study bias in observational studies and randomized controlled trials, respectively. This study included five studies comprising 504 patients. While endoscopic ossiculoplasty had shorter operating durations (95% CI -42.97 to -1.57), it conferred comparable air bone gap closure (95% CI -0.34 to 3.76), post-operative pure tone audiogram (95% CI 10.97-18.77), and surgical success. Additional qualitative strengths identified in endoscopic ear surgery include improvements in visualization, decreased need for supplemental incisions, excellent ergonomics, and reduced post-operative pain. Overall, endoscopic ossiculoplasty may confer comparable audiological outcomes to microscopic ossiculoplasty and may serve as a reasonable alternative surgical approach. Laryngoscope, 2025.

Audiologic Outcomes After Cochlear Implantation in Prelingually Deaf Children Who Have Combined Anomalies or Disabilities.

To evaluate the audiologic outcomes after cochlear implantation (CI) in prelingually deaf children with comorbid disorders. Retrospective study. Tertiary care academic center. We enrolled 85 deaf children (111 ears) with comorbid disorders who underwent CI surgery. We selected the most common comorbid disorder and compared the categories of auditory performance (CAP) scores of each comorbidity group with those of the control group. Combined cochlear anomalies were also evaluated using temporal bone computed tomography. The most common comorbid disorder was CHARGE syndrome (n = 17), followed by developmental delay (n = 13), valvular heart disease (including septal defect) (n = 13), Waardenburg syndrome (n = 8), Down syndrome (n = 6), cerebral palsy (n = 5), and cryptorchidism (n = 5). The CAP scores differed significantly between all the groups and the control group after 6 months (p < 0.001). The differences in the CHARGE syndrome (p = 0.004), cerebral palsy (p = 0.001), and Down syndrome (p = 0.004) groups remained significant 2 years after CI. When comparing the presence or absence of anomalies within the syndromic and nonsyndromic groups, significantly poorer outcomes exist when cochlear anomalies with absent modiolus or cochlear nerve deficits were observed, regardless of the presence of syndromic disorders. Compared with those in the control group, the CAP scores in the group with coexisting disabilities increased over time, but their final scores were relatively lower. Combined disabilities as well as the absent modiolus and cochlear nerve deficit may be clinical markers for poor CAP scores.

Revisiting Age-Related Normative Hearing Levels in Korea.

Hearing level reference values based on the results of recent audiometry have not been established for the general population of South Korea. This study aimed to evaluate the mean hearing levels of each age group and to measure the annual progression of hearing loss. We used the database of the eighth and ninth Korea National Health and Nutrition Examination Survey from 2020 to 2022, and included participants with normal tympanic membranes and without occupational noise exposure. Mean hearing levels were calculated by averaging hearing levels at 0.5 kHz, 1 kHz, 2 kHz, and 4 kHz. Hearing loss was defined as a hearing level exceeding 25 dB in the better ear, and severity of hearing loss was classified as moderate, moderately severe, severe, and profound, following the World Health Organization classification. Hearing levels and the proportions of patients with hearing loss increased with age. Hearing levels were 9.11 ± 6.28 dB, 13.33 ± 7.85 dB, 19.90 ± 10.30 dB, and 31.95 ± 13.37 dB in those in their 40s, 50s, 60s, and 70s, respectively, and the proportions of patients with hearing loss were 1.81%, 7.51%, 25.32%, and 63.94%, respectively. The annual increase in hearing level was 0.71 dB, and increases were greater at higher frequencies. Hearing loss was also worse in men. The present study provides reference values for normal hearing levels by age group, and indirectly reveals the progression of age-related hearing loss. Based on the results, physicians will be able to provide appropriate advice regarding hearing levels and the need for monitoring in the elderly.

A retrospective analysis of the clinical characteristics of 63 patients with vestibular neuritis

Objective:To retrospectively analyze the results of auditory examination,vestibular function examination and laboratory examination of 63 patients diagnosed as vestibular neuritis.Methods:A total of 63 patients diagnosed with vestibular neuritis hospitalized in the Department of Otolaryngology, Head and Neck Surgery of the Third Affiliated Hospital of Sun Yat-sen University, from October 2012 to December 2022 were recruited. All patients met the diagnostic criteria for the 2022 Bárány association vestibular neuritis. Clinical data and the results of pure tone audiometry, electrocochleogram, video electronystagmogram, caloric test, cervical vestibuloevoked myogenic potential（cVEMP）, ocular vestibuloevoked myogenic potential（oVEMP）, video head impulse test（vHIT） was collected.A total of 63 age-and sex-matched healthy subjects in the physical examination center were randomly selected as the control group. The differences of blood indexs and lipid metabolism indexes between the two groups were compared. Results:In patients with vestibular neuritis, 50 out of 63 patients presented normal threshold in pure tone audiometry, 8 out of 63 patients had bilateral high-frequency sensorineural hearing loss and 5 out of 63 patients had unilateral mild high-frequency sensorineural hearing loss, 56 out of 63 cases completed the electrocochleogram, of which 3 cases had a binaural-SP/AP amplitude ratio≥0.4, 5 cases had monaural amplitude ratio ≥0.4. Fifty-five out of 63 patients completed the caloric test with CP values greater than 30% in all. The ratio of patients completed cVEMP, oVEMP and vHIT were 46 cases, 22 cases and 30 cases, respectively. 17 out of 63 cases completed all the four vestibular function tests. According to these tests, 49 patients could determine the extent of injury，including 27 cases with unilateral superior vestibular nerve injury, 21 cases with unilateral superior and inferior vestibular nerve injury and 1 case with unilateral inferior vestibular nerve injury. There were significant differences in neutrophil value（P<0.001）, lymphocyte value（P<0.005）, neutrophil/lymphocyte ratio（P<0.001） and apolipoprotein A1（P<0.001） between patient group and control group. Inflammatory markers were risk factors for patients with vestibular neuritis. The OR values of neutrophil value and blood neutrophil/lymphocyte ratio were 1.81（1.38-2.37, P<0.001） and 2.11（1.41-3.16, P<0.001）, respectively. Apolipoprotein A1 was a protective factor for patients with vestibular neuritis, and the OR value was 0.004（0.001-0.042, P<0.001）. Conclusion:Electrocochleogram could be used in vestibular neuritis patients with normal pure tone threshold to test whether there is hidden hearing loss in these patients. Neutrophil value, lymphocyte value, neutrophil/lymphocyte ratio and apolipoprotein A1 were correlated with vestibular neuritis. The Neutrophil value and neutrophil/lymphocyte ratio were risk factors for morbidity.

Open cavity mastoidectomy improves audiological outcomes for cholesteatomatous chronic otitis media patients compared to closed cavity mastoidectomy

Open cavity mastoidectomy improves audiological outcomes for cholesteatomatous chronic otitis media patients compared to closed cavity mastoidectomy

Is COVID-19 infection during pregnancy a risk for congenital hearing loss?

Infections during pregnancy can increase the risk of congenital hearing loss. This population-based study investigated the effect of birthing parent COVID-19 infection during pregnancy on risk of congenital hearing loss in infants. Records of infants born in 2022 were reviewed via a retrospective clinical audit of a universal state-wide newborn hearing screening program in Victoria, Australia. The number and timing of COVID-19 infections during pregnancy were collected via self-report at the time of the hearing screen. Infant records (n=75,330) were divided into birthing parent infection group (n=25,547, 33.9%), and non-infection group (n=49,783, 66.1%). Group differences in screen and diagnostic audiology results were estimated by general linear regression models with a binomial distribution. Birthing parent and infant characteristics were similar across groups. Comparable proportions of infants obtained a refer result on their newborn hearing screen, requiring referral to diagnostic audiology (infection group: 1.4%, 95%CI 1.2-1.5 versus non-infection group: 1.3%, 95%CI 1.2-1.4). The proportion of infants diagnosed with any type and degree of hearing loss was also similar (infection group: 0.6%, 95%CI 0.5-0.7 versus non-infection group: 0.6%, 95%CI 0.6-0.7). This epidemiological study is the largest to date and demonstrates that infants whose birthing parent reported COVID-19 infection during pregnancy were not at increased risk of obtaining a refer result on their newborn hearing screen, nor at increased risk of congenital hearing loss. Specific protocols or guidelines to manage the newborn hearing screening pathway of infants born to a parent with COVID-19 during pregnancy are not supported by this study's findings.

Reliability of connectivity for the assessment of hearing perception in cochlear implant recipients

Objective The cochlear implant (CI) is the gold standard treatment for profound hearing loss with insufficient hearing aid benefit. Using regular words and sentences as verbal stimuli showed a ceiling effect in patients with optimal perceptual abilities. The objectives of the study were: (1) to evaluate the reliability of auditory perception through connectivity, comparing it to the regular audiometry in soundbooth and (2) to analyse the use of logatomes to better assess the perceptual abilities of high-performing patients. Design and study sample Cross sectional analytic study Study sample A total of 32 CI patients with high auditory performances underwent pure-tone and speech audiometry in two methods: (1) in an audiometric booth and (2) via direct streaming to the processor using a connectivity system. Correlation and concordance analyses were performed. Results Pure-tone audiometry showed a low correlation between the two methods. Speech audiometry revealed a high correlation at 30 dB HL but a low concordance between the two instruments. The evaluation through connectivity showed better results in pure-tone and speech audiometry than those of regular audiometry in soundbooth. The use of logatomes was useful for discriminating patients with better performances. Conclusions Connectivity might be considered a useful additional method to assess the performance of CI recipients.

Risk of audiologic side effects with teprotumumab treatment for thyroid eye disease: propensity matched analysis.

Patients with thyroid eye disease (TED) taking teprotumumab have reported audiologic symptoms as a side effect; however, limited real world data and large sample sizes have been utilized to evaluate this relationship. A retrospective cohort study was created in TriNetX to identify patients with TED utilizing ICD-10, CPT, and Healthcare Common Procedure coding systems. TED patients with and without teprotumumab treatment were analysed with greedy one-to-one propensity matching. Appearance of one or more new ICD-10 codes corresponding to audiologic outcomes of interest (tinnitus, sensorineural hearing loss, hypoacusis, hyperacusis, autophony, Eustachian tube dysfunction) served as the outcome of interest. Patients with a history of hearing impairment were also evaluated for worsening hearing loss after initiation of teprotumumab. Within the entire TriNetX cohort, 88 out of 441 patients with a diagnosis code for TED treated with teprotumumab had new appearance of an audiologic outcome within TriNetX. After matching, the relative risk for TED patients who were exposed to teprotumumab for new audiologic symptoms was increased with a risk ratio (RR) of 2.85 [95% CI 1.94, 4.20] compared to TED patients not exposed to teprotumumab. Of 51 patients with a history of hearing impairment and TED, 14 had record of new audiologic testing after teprotumumab administration (RR = 1.90 [0.96, 3.78]) compared to unexposed patients. This study affirms previous research stating that TED patients receiving teprotumumab are at an increased risk of new audiologic side effects when compared to TED patients not using teprotumumab.

Hearing Loss in COVID-19 Patients: An Audiological Profile of Symptomatic and Asymptomatic COVID-19 Patients in Qatar.

Background and objective Viral infections caused bycytomegalovirus, lymphocytic choriomeningitis virus, varicella-zoster virus, herpes simplex type 1 and type 2, rubella, measles, rubeola, HIV, West Nile virus, Lassa virus, and mumps are known to be associated with hearing loss. There have been reports of inner ear involvement in coronavirus disease 2019 (COVID-19) patients but the extent and variations in cochlear involvement of symptomatic and asymptomatic patients has not been adequately described. This study aimed to evaluate thehearing status among symptomatic and asymptomatic COVID-19 patientsto address the prospects for routine screening for hearing lossin COVID-19 patients. Methods Patients testing positive for COVID-19between March 2020 and May 2020and August 2020 and October 2020 in Qatarwere screened. A total of 110 patients aged 15-50 years were enrolled and grouped into symptomatic and asymptomatic COVID-19 after telephonic screening. Of them, seven were excluded for various reasons. A questionnaire was administered in person to all included participants. Audiological testing results of symptomatic and asymptomatic patients were analyzed. Results Of the 103 patients included in the study,49 were symptomatic and 54 asymptomatic; 15 (14.6 %) had high-frequency sensorineural hearing loss (SNHL) in one or both ears.Mean thresholds in extended high frequencies 10K-20K were higher in symptomatic patients. Abnormal distortion product otoacoustic emissions (DPOAEs) were seen in 40 (38.8%) patients; 63.3% (31/49) were symptomatic and 16.7% (9/54) were asymptomaticin 3K-8K frequencies (p=0.0001). Conclusions Symptomatic COVID-19 patients had significant involvement of the inner ears with abnormal pure tone audiometry (PTA), extended high-frequency audiometry (EHFA), and DPOAEscompared to asymptomatic COVID-19 patients. The extent of inner-ear involvement suggests the severity of the infection. The lack of audiovestibular symptoms does not rule out normal hearing in such patients. Screening for hearing loss should beroutinelyconsidered in post-COVID-19 patients.

Congenital Cytomegalovirus Infection and Hearing Loss: It's Time to Screen.

Congenital CMV infection is the leading nongenetic cause of sensorineural hearing loss worldwide, yet most parents have never heard of it. The majority of infected newborns have no clinical signs of infection, although a substantial proportion may have hearing loss at birth or develop it later in life. As antiviral treatment with ganciclovir or valganciclovir initiated in the first month of age improves audiologic outcomes, there is an urgent need for timely identification of infected neonates. A targeted approach that tests neonates who refer on the newborn hearing screen has been implemented in many states and hospital programs, but it fails to identify about 40% of children who experience CMV-related hearing loss. A universal screening approach is optimal given the prevalence of congenital CMV infection, its associated sequelae, the availability of a simple saliva screening tool, the available antiviral treatment, and the directed therapies for hearing impairment.

Factors influencing audiologic outcomes in ossiculoplasty for chronic otitis media: a prospective multicentre study.

Chronic otitis media (COM) is a prevalent condition affecting auditory function. Ossiculoplasty is a known treatment strategy, but its effectiveness concerning the presence of cholesteatoma has not been extensively studied. We conducted a multicentre study involving 153 patients diagnosed with COM without cholesteatoma (ncCOM) and with cholesteatoma (cCOM). Patients underwent ossiculoplasty, and postoperative hearing outcomes were analysed. After patient selection, 133 participants were included. Postoperatively, significant improvements in hearing function were observed in both groups, substantiating the role of ossiculoplasty in treatment of COM. However, different outcomes were noted between ncCOM and cCOM. Patients with cCOM demonstrated a slightly lesser degree of hearing improvement post-surgery compared to their ncCOM counterparts. Our findings confirm ossiculoplasty as a standard and effective treatment strategy for COM. The presence of cholesteatoma may influence the effectiveness of surgery, underscoring the need for individualised surgical planning. Future research should focus on confirming these results and more comprehensively exploring the impact of cholesteatoma on surgical outcomes.

Split-Thickness Cartilage Graft Combined With Perichondrium for Endoscopic Repair of Total and Subtotal Drum Perforations.

This study aims to describe our new modification to cartilage tympanoplasty for endoscopic repair of total and subtotal tympanic membrane perforations and evaluate its outcomes. Retrospective case series. Multiple institutions. The study was conducted using records of patients who underwent tympanoplasty for subtotal and total perforations from January 2018 to June 2022. Utilizing an endoscopic transcanal approach, we employed a double graft consisting of outer tragal perichondrium supported by inner split-thickness tragal cartilage as separate layers, both placed in an underlay fashion lateral to the malleus, without the need to elevate a tympanomeatal flap. Anatomical success was defined as complete primary closure of the perforation, while functional success was defined as achieving an air-bone gap of ≤20 dB at 12 months postoperative. The series involved 64 patients, predominantly males (53%). The mean age was 30.8 years. 56.3% of patients had subtotal perforations. The anatomical success rate was 90.6% while the functional success rate was 87.5%. Postoperative speech discrimination scores significantly increased in all patients. Our modification provides effective anatomical and audiological outcomes. This technique reliably resists graft displacement and shrinkage before adequate healing. It avoids problems of elevating tympanomeatal flaps with comparable results to traditional approaches.

Revisions after prior stapes surgery: aspects on indication, intraoperative findings and surgical strategies.

Primary stapes surgery is considered a challenging intervention in ear surgery. Despite an risk of deafness in 0.5-1 percent, this procedure has still a good benefit-risk ratio due to the improvement in hearing and quality of life that is usually achieved. However, revision after prior stapes surgery is considered even more challenging. Revisions after stapes surgery are very heterogeneous procedures, both in terms of the indication and the surgical strategy and are generally considered to be significantly more demanding. Reasons for complications after prior stapes surgery as well as strategies for successful revisions are not well described in the literature. Retrospective cohort study, tertiary referral center. 124 cases of revisions after prior stapes surgery were identified between 2011-2022 and are analyzed based on biographic data, clinical, audiological, and intraoperative findings as well as the eventual therapy. Cases were analyzed regarding indication, intraoperative finding and the surgical strategy chosen. Acute, subacute, and long-term complications of the primary intervention as well as other incidental reasons such as progressive hearing loss can be identified as indication for revision surgery. Preoperative clinical findings were correlated to intraoperative findings and surgical strategies. Audiological results are discussed. Different recommendations for the indication of a surgical revision can be derived depending on the individual preoperative case history and findings. In addition, there are patterns regarding the chances of success of a revision, especially in cases of persistent conductive hearing loss chances of hearing improvement seem possible in more than 80% of cases.

Endoscopic versus microscopic approach in the treatment of atelectatic otitis media

Background endoscopic ear surgery in patients Chronic Otitis Media(COM) media with eardrum atelectasis. Objective to compare the postoperative outcomes and audiological results of the endoscopic approach versus the microscopic approach for treatment of COM media with eardrum atelectasis, using a randomized prospective model. Methods Sixty patients were consecutively enrolled in the study and randomized into two groups: Group A 32 patients underwent canal wall up tympanoplasty (CWA); Group B 28 patients underwent tympanoplasty with an exclusive trans-meatal endoscopic approach. Audiological results and preoperative, intraoperative and postoperative outcomes were evaluated. Results No statistical difference emerged between distribution of middle ear atelectasis patients grade 3 and 4 between the two surgical groups (p > 0.05). The group B appeared to have shorter surgical times than group A (69.8 min vs. 88.9 min). The graft success rate was estimated in 90.6% and 92.8% in group A and B respectively, without statistical differences between groups (p = 1). The Overall success rate was therefore calculated in 87.5% and 92.8% for both groups. Conclusion and significance Endoscopic ear surgery could be a suitable approach for treating COM media with eardrum atelectasis with similar results compared with the Microscopic surgery.

Outcomes of Concurrent Balloon Eustachian Tuboplasty and Tympanostomy Tube Placement in Children.

Balloon dilation eustachian tuboplasty (BDET) has been proven to be a safe treatment option for children with eustachian tube dysfunction (ETD). This study aims to analyze the long-term outcomes of children who underwent concurrent BDET and tympanostomy tube (TT) placement. We hypothesize that patients who underwent simultaneous therapy have experienced a low overall rate of middle ear pathology and have consistent hearing quality at subsequent office visits. Retrospective chart review of 19 pediatric patients (36 ears) who previously underwent concurrent BDET and TT placement. Patient charts within the extended postoperative period were reviewed. Specific data points included need for reoperation, rates of middle ear pathology, audiological outcomes, and number of previous TT placements. Pediatric patients who underwent concurrent BDET and TT placement had long-term success in 34/36 ears (94.4%). All postoperative tympanograms and audiograms (100%) were normal when performed within 12 months after the procedure. Notably, 34/36 ears (94.4%) had history of tube placement in the past. Patients had an average of three sets of tympanostomy tubes prior to undergoing concurrent BDET and TT. Concurrent BDET and TT placement may be an effective treatment option for pediatric patients with persistent eustachian tube dysfunction. Specifically, BDET may be a useful adjunct tool in pediatric patients with refractory ETD despite having multiple sets of tympanostomy tubes. This study aims to strengthen the argument of performing multimodal therapy in pediatric patients with recurrent middle ear disease. 4 Laryngoscope, 134:4799-4802, 2024.

Auditory and Speech Outcomes Following Transcutaneous Bone Conduction Hearing Implantation.

Implantable bone conduction hearing devices offer excellent auditory rehabilitation. Transcutaneous devices, which use an implanted magnet, are gaining popularity due to higher skin complications associated with traditional percutaneous devices. The CochlearTM Baha® Attract System (Cochlear Corporation, Sydney, Australia) is a transcutaneous device and is regarded as a passive transcutaneous implant. This study, encompassing children and adults, aims to evaluate audiological and speech outcomes, as well as postoperative complications after the implantation of the CochlearTM Baha® Attract System. This is a retrospective cohort analysis of patients who underwent the CochlearTM Baha® Attract procedure from January 2017 to December 2020. Demographics, pre-and postoperative hearing thresholds, speech discrimination testing, hearing-aided thresholds, and complications were assessed. A total of 13 patients underwent the CochlearTM Baha® Attract surgery. The most common cause of implantation was microtia and aural atresia. Seven patients had mixed hearing loss (MHL), four had conductive hearing loss (CHL), and two patients had single-sided sensorineural deafness (SSD). A statistically significant improvement in hearing and speech understanding was observed with the device compared to preoperative unaided hearing (p-value = 0.00001). The overall mean for the gain at frequencies 0.5 to 4 kilohertz (kHz) was 31 decibels (dB). On average, speech discrimination scores improved by 36% after surgery. Postoperative wound healing and skin condition remained stable, with no major soft tissue-related complications. A patient developed a skin reaction at the implant site and was treated conservatively. All patients were satisfied and maintained device usage. The CochlearTM Baha® Attract System, classified as a passive transcutaneous bone conduction hearing implant, provides excellent auditory outcomes in patients with conductive, mixed, or single-sided sensorineural hearing loss, with minimal soft tissue complications in both children and adults. More research is necessary to directly compare passive and active transcutaneous bone conduction devices.

Outcomes with transcutaneous bone conduction implants in patients with mixed hearing loss

ObjectiveTo evaluate audiological outcomes of transcutaneous devices among individuals with mixed hearing loss (MHL) who underwent implantation with the Cochlear™ Osia® and Med-El Bonebridge™ devices. MethodsAdults with MHL in at least one ear, including a best bone conduction (BBC) threshold of 30 dB HL or poorer, and air-bone gaps of 15 dB HL or more at one or more frequencies were implanted with the Cochlear™ Osia® or Med-El Bonebridge™ devices for MHL. Four-frequency pure tone average (PTA) was calculated for aided thresholds and compared to preoperative PTAs for BBC thresholds. ResultsAmong the study participants, 11 were implanted with Osia, and 11 were implanted with Bonebridge. In the Osia group, the BBC PTA averaged 23.6 dB, which was not significantly different from the aided PTA of 27.0 dB (P = 0.2). In the Bonebridge group, the BBC PTA averaged 23.3 dB while the aided PTA was significantly poorer at 32.9 dB (P = 0.03). In both groups, aided sound field thresholds were worse than BBC thresholds overall except for a 7 dB improvement at 2000 Hz in the Osia group (P < 0.05). ConclusionWe highlight important limitations of current transcutaneous bone conduction systems for rehabilitation of MHL. Sound field outcomes for Osia and Bonebridge devices are limited by the BBC thresholds of either ear; these devices do not provide significant gain or “overclosure” beyond BBC thresholds. While both groups generally experienced declines in aided thresholds compared to best conduction thresholds, the Osia implant exhibited an exception of a 7 dB improvement at 2000 Hz.

Long-term outcomes of childhood otitis media and hearing loss: a systematic review

ABSTRACT Otitis media (OM) is a common childhood illness which can cause hearing loss and developmental delays. This is the first systematic review to investigate the long-term, longitudinal health and social outcomes of OM and hearing loss in childhood. The study was registered in PROSPERO (CRD42023396318). A structured search strategy identified literature in the following databases: CINAHL, Scopus, Medline, PsychInfo, and EmCare. Articles were independently dual-screened and extracted data were synthesised. From 2825 potential studies, 25 were selected for inclusion. These assessed broad outcomes: physical health, audiological health academic, behavioural, social function, service use, and housing. Overall, 28% of papers found no difference between those with a childhood history of OM and those without, 40% found poorer outcomes for those with a history of OM, and 32% found mixed results. This is the first study of its kind to explore the long-term effects of otitis media and resultant hearing loss in children. Trends of poor academic, behavioural, and audiological outcomes were identified in children with OM and hearing loss. Multiple gaps in the literature were identified including a paucity of recent research, studies extending into adulthood, and studies focusing on high-risk populations.

Follow-Up of Neonatal Hearing Screening in the Risk Factor Group for Hearing Loss: Results from a Tertiary Medical Center.

Universal newborn hearing screening has been successfully implemented in many places around the world, and it is recommended that cases with risk factors for hearing loss be followed-up regardless of hearing screening results. However, there is a need for clarity regarding the recommended rate of follow-up and which tests should be performed. The aim of this study was to assess the audiologic follow-up program for the group with risk factors. Our retrospective study involved children of various ages with a risk factor for hearing loss who passed the initial neonatal hearing test but were later diagnosed with hearing loss. Out of 113,708 children born at Hadassah University Medical Center during the years 2013-2021, 6763 were at risk of hearing loss, and their follow-up audiologic test results were studied. Audiologic testing including ABR, OAE, tympanometry and behavioral audiometry was performed in 1534 of 6763 (23%) of the risk factor group that returned to the hospital. In total, 73 children (4.7%) were diagnosed with hearing loss, 54 of whom failed the initial screening and 19 who had passed it. Further examination of the children that passed the initial screening and were later diagnosed with a hearing loss revealed that four cases had been missed in screening (one familial mild hearing loss, one familial progressive loss, one premature infant with a high tone loss, and one NICU graduate with CNS involvement). Another nine cases had late-onset hearing loss (three meningitis, five CMV, and one with a mitochondrial disease). An additional six cases were diagnosed late, and the age of onset of the hearing loss was unknown (two intubated, two with hydrocephalus, one with Cerebral Palsy, and one with general developmental delay). These results reveal the importance of implementing a refined protocol for monitoring hearing in the high-risk group of children that pass neonatal hearing screening with respect to which hearing tests should be conducted, at what age, and the duration of follow-up. Also, barriers to follow-up must be dealt with, and parents should be more involved in the monitoring process.