Audiological Tests Research Articles

Inpatient Audiologic Services Facilitate Early Hearing Detection.

Infants needing neonatal intensive care unit (NICU) intervention have protracted timelines for diagnosis after not passing their newborn hearing screening despite being at higher risk for congenital hearing loss. The primary aim of this study was to evaluate the outcomes of early hearing detection for infants with a history of NICU admission. The secondary aim was to determine if diagnostic audiology services within the NICU setting accelerated diagnosis and intervention. A retrospective chart review was completed for infants referred for diagnostic audiologic testing from 2018 to 2021 at a tertiary urban-setting children's hospital. After exclusion criteria were applied, 367 infants with NICU history were included in the analysis. Various factors were recorded from electronic medical records. Time to diagnosis was derived and compared across (a) NICU location, (b) insurance type, and (c) race/ethnicity. Analysis of infants with NICU history revealed that 70% of infants had a diagnosis by 3 months corrected age. The level of in-NICU audiologic care did not significantly impact corrected age at diagnosis; however, loss to follow-up (LTFU) rates were higher for NICUs that did not provide in-hospital diagnostic services (10.0%) when compared to the NICU setting with inpatient audiology services (6.8%). In-NICU testing occurred on average 5.7 weeks prior to discharge, expediting diagnosis of hearing status compared to having to wait for an outpatient evaluation after discharge. Timely hearing detection is feasible in the medically complex NICU population. Inpatient audiology diagnostic testing may help reduce LTFU and facilitate early hearing detection and intervention.

Psychogenic hearing loss in children and adolescents. Diagnosis and psychotherapy

Introduction Psychogenic hearing loss is often neglected in the differential diagnosis of hearing disorders. In a difficult diagnostic process and treatment of psychogenic hearing loss disorder, the close cooperation of the audiologist, psychologist, patient, and his family is required. The study aimed to improve the knowledge and understanding of psychogenic hearing loss, establish a differential diagnosis in audiological tests in children, determine diagnostic procedures and finally apply adequate therapeutic procedures. The professional knowledge presented in the study will enable adaptation of reliable information which can be transferred to young patients and their families to let them recognize their problems. Material and methods A group of 321 children, admitted to the Department of Pediatric Otorhinolaryngology, Phoniatrics and Audiology, The Children’s Hospital in Lublin, Poland, from January 2019 to December 2021, who complained of hearing loss were analysed in the study. Results Twenty-two patients (15 girls and 7 boys) met the audiological criteria of psychogenic hearing loss and were enrolled to the study. Seventeen children complained of bilateral hearing loss, and five patients presented with a unilateral hearing loss. Conclusions Family and personality problems cause unresolved difficulties in children and can lead to psychogenic deafness. Constant interest demonstrated by a guardian not only when the child is causing troubles or is complaining of disease is the key to avoiding developing psychosomatic disorders such as psychogenic hearing loss.

The Long-Term Effect of Childhood Otitis Media on Speech-in-Noise Testing at Ages 9 and 13.

To investigate the relationship between a history of otitis media (OM) in early childhood and speech reception thresholds (SRT) in later childhood, using the Dutch digits-in-noise (DIN) test at ages 9 and 13 years. This study was conducted within the Generation R study, a prospective birth cohort in Rotterdam, the Netherlands. Children underwent pure-tone audiometry and DIN testing at ages 9 (2011-2015) and 13 (2016-2020) years. Regression analyses and a linear mixed model were used to examine associations between OM history and SRT in noise, accounting for repeated measurements within individuals. At baseline (age 9 years), 2063 children were included with a mean SRT of -5.6 (SD = 2.0). At follow-up (age 13 years), 3382 children were included with a mean SRT of -7.4 (SD = 1.4). A positive association was found between recurrent acute OM (RAOM) and DIN test outcomes, with an estimated coefficient of 0.55 (95% CI = 0.26, 0.84; t-value = 3.70). Socioeconomic status and multilingualism did not significantly predict DIN test performance. A history of RAOM may potentially influence SRT outcomes in later childhood, with higher DIN scores observed in the RAOM group. While the effect sizes between the groups are small to moderate, these findings highlight the importance of considering the potential long-term effects of OM in both clinical practice and future research. Further studies are needed to better understand these relationships. 2 (cohort study).

The role of audiological features and horizontal semicircular canal function at various frequencies in vestibular migraine and Menière’s disease

Background Vestibular migraine (VM) and Menière’s disease (MD) have numerous overlapping symptoms. Distinguishing the two common recurrent vestibulopathies was challenging. Objectives To assess the characteristics of hearing loss and the horizontal semicircular canal function in VM and MD. Materials and methods Various frequency horizontal semicircular canal function tests, including caloric test, video head impulse test (vHIT), and rotatory chair test, as well as multifrequency audiological test with pure-tone average (PTA), were carried out. Results The hearing threshold of all frequencies in VM is lower than that of MD (p < .05). The phase shift at 0.01 Hz, 0.02 Hz, 0.04 Hz, 0.08 Hz and 0.64 Hz was significantly different in VM and MD patients. The gain at 0.01 Hz differed between VM and MD (p < .05); the time constant (RTc) in VM patients was longer than that of MD patients (p < .05). The incidence of caloric test abnormality was 40% in VM patients and 68.3% in MD patients. The abnormal rate of horizontal semicircular canal vHIT was 3.2% in VM and 5.8% in the MD, and the rates of overt/cover saccades were 9.7% and 17.6%, respectively. Conclusions The degree and type of hearing loss were conducive to distinguishing between VM and MD, and the rotatory chair test was a necessary supplement.

Analysis on trend of hearing changes in infants with p.V37I mutation in GJB2 gene at different months of age

Objective:To explore the trend of hearing changes in infants with GJB2 gene p.V37I mutation at different months. Methods:The subjects were 54 children（108 ears） with p.V37I homozygous or compound heterozygous mutation in GJB2 gene. All the subjects underwent auditory brainstem response, auditory steady-state response, acoustic immittance and other audiological tests. Children were divided into three groups according to their age, 26 cases in group A were ≤3 months old, 17 cases in group B were>3~≤6 months old, and 11 cases in group C were>6 months old. Statistical analysis was performed on the three groups of ABR response threshold, hearing degree, the ASSR average response threshold of four frequencies and the ASSR response thresholds for each frequency of 500, 1 000, 2 000 and 4 000 Hz. Results:Among the 54 cases, 35 were male and 19 were female, with an age rang of 2-27 months and a median age of 4 months. The ABR response threshold of the three groups were ranked from low to high as group A, group B and group C, and the difference was statistically significant（P<0.05）. The ABR response thresholds of the three groups were ranked from low to high as group A, group B, and group C. The comparison between groups showed that the ABR response thresholds of group C was higher than that of group A（P=0.006）. The proportion of confirmed hearing loss in the three groups was 34.61%, 50.00% and 63.64%, respectively, and the difference of hearing level among the three groups was statistically significant（P<0.05）. The comparison between groups showed that the difference between group A and group C was statistically significant（P=0.012）, normal hearing accounted for the highest proportion in group A（65.39%）, while mild hearing loss accounted for the highest proportion in group C（45.46%）. The ASSR average response thresholds of the four frequencies in the three groups were ranked from low to high as group A, group B and group C, and the difference is statistically significant（P<0.05）. The comparison between groups showed that response ASSR thresholds of group C was higher than that of group A（P=0.002）. Response thresholds of ASSR in each frequency in the three groups were all ranked from low to high as in group A, group B and group C, and the differences were statistically significant（P<0.05）. Compared with each other between groups, response ASSR thresholds of group C was higher than those of group A（P=0.003） and group B（P=0.015） at 500 Hz, while response ASSR thresholds of group C was higher than group A at 1 000 Hz（P=0.010） and 2 000 Hz（P<0.001）, and there was no statistical difference at 4 000 Hz. Conclusion:The incidence of hearing loss in GJB2 gene p.V37I mutation increased with age, and the degree of hearing loss increased, the hearing progression was mainly 500, 1 000 and 2 000 Hz suggesting regular follow-up and alert to hearing changes.

Is the Otolithic Function Affected in Patients with Obstructive Sleep Apnea Syndrome?

While cardiovascular and neurological diseases induced by obstructive sleep apnea syndrome (OSAS) hypoxia are well established, the association between neuro-otological diseases and OSAS is not entirely understood. Vestibular and audiological tests have been used to evaluate the degeneration of neurons in the brainstem caused by recurrent hypoxia. Evaluation of the vestibular-evoked myogenic potential (VEMP) test findings applied to detect the possible influence on the vestibular reflex arc due to hypoxia in patients diagnosed with OSAS using Activity-Specific Balance Confidence (ABC) and Berg Balance Scale (BBS) scales determination of scores. This was a cross-sectional study. Participants aged 18 to 60 who underwent polysomnography due to snoring/sleep apnea were divided into an OSAS, and a control group of subjects were also included. Each group consisted of 20 participants. All participants were evaluated with cervical VEMP (cVEMP) and ocular VEMP (oVEMP) tests. The groups were compared regarding variables such as the rate of oVEMP and cVEMP waves obtained, the interval between the waves, and the latency and amplitude. Also, BBS and ABC scales were applied to all participants. The cVEMP (50%) and oVEMP (45%) response rates and amplitudes were significantly lower in the OSAS group. No significant difference was found between the groups when comparing other VEMP parameters. However, a statistically significant decrease was observed in the ABC and BBS scores in the OSAS group. The identification of VEMP alterations in the OSAS group is a clear indication that the vestibular reflex pathways may be adversely affected by hypoxia. Personal rehabilitation programs can be created by evaluating activities of daily living with the ABC and static and dynamic balances with BBS in patients with OSAS.

Changes in Plasma Levels of Prestin and Otolin-1 in Dental Students.

Dentists and dental professionals report a high prevalence of noise-induced hearing loss (NIHL) and related symptoms. Chronic exposure to high-frequency dental instrument sounds, which can damage the outer hair cells (OHCs) of the cochlea, is strongly linked to their NIHL. Similarly, dental students in teaching clinics often report symptoms associated with NIHL. In this study, we measured plasma levels of prestin and otolin-1, two biomarkers associated with inner ear health, in first-year (D1) and third-year (D3) dental students. D1 students were selected for their relatively short exposure to dental clinics, while D3 students represented a group with substantial cumulative exposure. First-year (M1) medical students, who have no exposure to dental instruments, served as the negative controls, while dental faculty, many of whom are diagnosed with NIHL or self-report hearing problems, served as the positive controls. Thirty-one students (D1=11, D3=8, M1=12) and 10 dental faculty volunteered for the study. Participating students completed an online survey about their hearing health, exposure to excessive sounds within and outside school, and use of hearing protection. Sound levels of medical Osteopathic Manipulative Medicine (OMM) and dental Simulation (SIM) labs while in session were recorded with a calibrated sound meter. Plasma levels of prestin and otolin-1 were quantitated using commercial ELISA kits. The sound level of in-session OMM lab was significantly higher (72.64 ± 1.69 dBA) than SIM lab (65.37 ± 3.97 dBA). Both medical and dental students experienced similar exposure to outside school noises; however, dental students had significantly longer exposure to high-frequency dental instrument sounds in the SIM lab (12.3 hours/week; 74.93-80.51 dBA). Plasma prestin levels were lowest in D3 students (559.88 ± 24.91 ng/ml), followed by D1 students (576.27 ± 71.44 ng/ml). Negative control M1 students had higher levels (675.73 ± 90.23 ng/ml), while the positive control dental faculty group exhibited the highest prestin levels (727.71 ± 128.65 ng/ml). Prestin levels in D3 students were significantly lower than those in M1 students, and the dental faculty group had significantly higher prestin levels than both D1 and D3 students. No differences in otolin-1 levels were observed among the groups. Our finding that D3 students, with greater experience using dental instruments in the SIM lab, exhibited the lowest plasma prestin levels may indicate a protective mechanism by the OHCs, downregulating its expression to reduce the risk of NIHL. This is in line with the findings in the dental faculty, who self-reported NIHL or hearing problems and exhibited the highest prestin levels. The lack of changes in plasma otolin-1 levels across groups, combined with students self-reporting excellent hearing health, may offer alternate view of subclinical inner ear damage among dental students. Future studies incorporating audiometry and otoacoustic emission tests along with the inner ear biomarkers may provide better understanding of NIHL in dental students.

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.

Tympanic Pre-Operative Electrically Evoked Auditory Late Response (TympEALR) as an Alternative to Trans-Tympanic Tests Using Anesthesia in Cochlear Implant Candidacy.

Background/Objectives: Before a cochlear implant is considered, patients undergo various audiological tests to assess their suitability. One key test measures the auditory brainstem response (ABR) to acoustic stimuli. However, in some cases, even with maximum sound stimulation, no response is detected. Methods: The promontory test involves electrical stimulation near the auditory nerve, allowing patients to associate the sensation. Ideally, the electrode is placed in the middle ear after opening the eardrum. This method, along with trans-tympanic electrically evoked ABR in local anesthesia (LA-TT-EABR) and the cortical equivalent (LA-TT-EALR), helps assess the auditory nerve's existence and excitability. The TympEALR test, utilizing a "tympanic LA-TT-EALR", provides an alternative measurement. Previous research has shown the possibility of deriving brainstem and cortical potentials through trans-tympanic electrical stimulation, allowing for objective assessment of the auditory nerve's integrity and potentially objectifying patient sensations. Results: Sixteen patients have been tested using TympEALR. In seven of these, we found a positive response. The morphology was similar to other electrically evoked cortical auditory responses (EALR), e.g., using cochlear implants or trans-tympanic stimulation electrodes. We observed a higher influence of electrical artifacts than in other EALRs. Conclusions: TympEALR showed positive results in nearly half of the study participants, potentially avoiding invasive procedures. TympEALR can be a valuable alternative to trans-tympanic methods. More research is needed to determine if a negative result suggests against cochlear implantation.

Cortical bone total ossicular graft supported with crescent-shaped cartilage.

This study aimed to compare the hearing outcomes of patients who underwent different type 4 tympanoplasty techniques. Patients who underwent tympanoplasty for chronic otitis media and were treated with cortical bone total ossicular prosthesis supported with crescent-shaped cartilage (Group 1), cortical bone total ossicular prosthesis (Group 2) and titanium total ossicular prosthesis (Group 3) were included in the study. Hearing outcomes were evaluated and compared with audiological tests performed before and at least 1 year after surgery. There were 12 patients in Group 1 (6 males and 6 females), 14 patients in Group 2 (6 males and 8 females) and 18 patients in Group 3 (10 males and 8 females). After reconstruction, the air conduction threshold changed from 56.83 ± 13.63 to 32.25 ± 13.55dB in Group 1, from 57.43 ± 15.3 to 40.07 ± 18.8dB in Group 2 and from 55.39 ± 15.59 to 42.22 ± 17.32dB in Group 3. Air-bone gap (ABG) changed from 37.58 ± 9.56 to 15.08 ± 9.58dB in Group 1, from 36.71 ± 10.84 to 21.07 ± 11.16dB in Group 2 and from 34.5 ± 11.72 to 22.28 ± 10.13dB in Group 3. Preoperative and postoperative outcomes of all three groups in terms of both air conduction threshold and air-bone gap were significantly different (p < 0.01). Preoperative and postoperative changes in air conduction threshold of the three groups were also significantly different (p = 0.037). However, the differences among the three groups in terms of preoperative and postoperative changes in ABG were not significant (p = 0.057). Cortical bone supported with crescent-shaped cartilage total ossicular prosthesis had better hearing outcomes than other groups.

Syndromic Association of Depigmentation With Congenital Hearing Loss: A Review of Three Children With Auditory Pigmentary Disorders.

Background: Congenital depigmentation may be associated with congenital sensorineural hearing loss leading to non-development of verbal speech. Objective: To illustrate the clinical features and work-up of 3 children diagnosed with auditory pigmentary disorders (APDs). Methodology: Case series with a review of the literature. Results: The APDs presented here in the 3 children include Waardenburg syndrome type 1, Clouston syndrome, and Waardenburg syndrome type 4 (Waardenburg-Shah syndrome). The characteristic clinical features, audiologic tests, imaging, and the necessary genetic tests carried out subsequently were noted and evaluated. All the children were male and were aged 2 years, 1 year, and 14 months, respectively. All of them had hearing loss and non-development of verbal speech and had some form of oculocutaneous depigmentation. The challenges in the diagnosis, the work-up, and the close differentials were discussed, and the relevant literature was reviewed. Conclusions: The APDs connect congenital depigmentation with prelingual hearing loss through various syndromic disorders. These disorders are not commonly encountered in routine clinical practice; therefore, their proper knowledge is essential for early diagnosis of congenital hearing loss and timely initiation of auditory and speech rehabilitation. This case series deals with a detailed illustration of a few syndromes of the APDs and highlights their clinical presentation and genetic background.

Evaluating the Auditory and Vestibular Functions of Patients with Multiple Sclerosis

Objective: Multiple sclerosis, a demyelinating disease of the central nervous system, is characterized by weakness of the arms and legs, sensory symptoms, ataxia, fatigue, diplopia, memory, concentration, attention disorder, and motor speech disorder. Common symptoms include epileptic seizures, cognitive impairment, hearing loss, and cortical symptoms. Materials and Methods: This study evaluated patients' mental functions with multiple sclerosis (MS) by considering their auditory and vestibular functions. A total of 30 patients, 15 healthy and 15 diseased, were recruited. In contrast, the experimental group consisted of individuals diagnosed with MS who had not had an attack for the last two months, over the age of 18, under the age of 60, and with similar characteristics in terms of gender. The audiological and vestibular tests on the experimental and patient groups were applied and the data obtained from these two groups were compared. Impedance audiometry test was performed on patients simultaneously. Result: The data obtained from our study, significant results were obtained for the right and left ears of MS patients to whom we applied the pure tone audiometry test. In the ABR test, unilateral hearing loss was observed in seven patients. In the VHIT test, while the VOR gains of 9 MS patients were outside the normal limits, the VOR gains of one patient in the left lateral canal were low. In the VEMP test, the wave latencies of 12 patients in the patient group were delayed, and the two patients' left-side P1 and N1 waveforms were not observed.

Clinical hearing phenotypes analysis of GJB2 gene p.V37I homozygote and compound heterozygote mutation in infants

Objective:To analyze the hearing phenotypes of p. V37I homozygote and compound heterozygote mutation in GJB2 gene, and to provide basis for genetic counseling. Methods:Fifty-three subjects with p. V37I homozygote and compound heterozygote mutation were recruited at Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital from January 2023 to March 2024. All subjects received universal newborn hearing screening（UNHS）, 23-site chip neonatal deafness genetic screening and audiological tests, including ABR, acoustic immittance, DPOAE, ASSR. The results of newborn hearing screening and hearing diagnosis were compared between homozygous mutation group of 30 cases and compound heterozygous mutation group of 23 cases. Results:In 53 cases, the overall refer rate of UNHS was 64.15%（34/53）, the refer rate of homozygous mutation group was 80.00%（24/30）, which was higher than that of compound heterozygous mutation group（43.48%, 10/23）, the difference between the two groups was statistically significant（P<0.05）. Three subjects with p. V37I compound heterozygous mutation had passed UNHS and diagnosed with unilateral mild hearing loss. The average age of diagnosis of 53 cases was （3.77±1.40） months, 25 cases with hearing loss accounted for 47.17%, including 13 cases with unilateral, 12 cases with bilateral, 28 cases with normal hearing accounted for 52.83%. There was no significant difference between homozygous mutation group（56.67%, 17/30） and compound heterozygous mutation group（34.78%, 8/23） in the proportion of confirmed hearing loss（P>0.05）. Among 37 ears of 25 patients with hearing loss, the proportion of mild, moderate and profound hearing loss were 70.27%（26/37）, 27.03%（10/37） and 2.70%（1/37）, respectively. The hearing loss degree of the homozygous mutation group and the compound heterozygous mutation group were mainly mild, accounting for 70.37%（19/27） and 70.00%（7/10） respectively. There was no significant difference between the two groups in the distribution of hearing loss degree（P>0.05）. Conclusion:The probability of hearing loss was 47.17% in infants of GJB2 gene p. V37I homozygote and compound heterozygote mutation, mainly mild hearing loss. There was no difference in the probability of hearing loss and the distribution of hearing loss degree between the two groups. Patients with p. V37I homozygous and compound heterozygous mutation currently diagnosed as normal hearing need continuous clinical follow-up.

Why does tinnitus vary with naps? A polysomnographic prospective study exploring the somatosensory hypothesis

(1) BackgroundTinnitus, defined as the conscious awareness of a noise without any identifiable corresponding external acoustic source, can be modulated by various factors. Among these factors, tinnitus patients commonly report drastic increases of tinnitus loudness following nap sleep. Previous studies have suggested that this clinical pattern could be attributed to a somatosensory modulation of tinnitus. To our knowledge, no polysomnographic study has been carried out to assess this hypothesis. (2) MethodsFor this observational prospective study, 37 participants reporting frequent increases of tinnitus following naps were recruited. They participated to six full-polysomnography nap attempts over two days. Audiological and kinesiologic tests were conducted before and after each nap attempt. (3) Results197 naps were collected. Each nap at each time of day elicited an overall significant increase in tinnitus minimum masking level (MML). Each inter nap period elicited an overall significant decrease. Tinnitus modulations were found significantly correlated with nap sleep duration (Visual numeric scale on tinnitus loudness, VNS-L, p< 0.05), with snoring duration (MML, p< 0.001), with snoring average sound level (VNS on tinnitus intrusiveness, VNS-I, p< 0.05) and with sleep apnea count (VNS-I, p< 0.001). (4) ConclusionsThis study confirms objectively that tinnitus may increase following naps. No association was found between these modulations and somatosensory modulations involving the temporomandibular joint and cervical areas. However, it may be possible that nap-induced tinnitus modulations are a hidden form of somatosensory modulation as snoring and sleep apnea events are often related to tensor veli palatini muscle dysfunction.

Evaluation of the montreal cognitive assessment in idiopathic tinnitus patients with mild hearing loss

Objective:To explore the effect of mild hearing loss on cognitive function by evaluating the Montreal Cognitive Assessment（MoCA） in idiopathic tinnitus patients with mild hearing loss. Methods:102 patients with idiopathic tinnitus（68 patients with normal hearing and 34 patients with mild hearing loss） whose first complaint is tinnitus and 34 healthy volunteers（control group） were included. All subjects were asked to fill the MoCA, Tinnitus Handicap Inventory（THI）, Self-rating Anxiety Scale（SAS）, Self-rating Depression Scale（SDS）, and Pittsburgh Sleep Index（PQSI） after collecting medical history, pure tone audiometry, tinnitus matching and masking test. The clinical characteristics and scores of each scale were compared among the groups. Results:The score and each dimension score of MoCA in idiopathic tinnitus patients with normal hearing were significantly lower than the normal population（P<0.05）; compared with patients with idiopathic tinnitus with normal hearing, patients with mild hearing loss were older（P<0.01） and had lower MoCA scores（P<0.05）. There was no significant difference in MoCA scores（P>0.05） between tinnitus patients with normal hearing and mild hearing loss after correcting confounding factors（age, gender, years of education, duration of tinnitus, frequency of tinnitus tones, side of tinnitus, THI score, SAS score, SDS score, and PQSI score）; idiopathic tinnitus patients with mild hearing loss scored significantly lower in attention and working memory dimensions than idiopathic tinnitus patients with normal hearing（P<0.01）. Conclusion:Patients with idiopathic tinnitus may have cognitive dysfunction, and mild hearing loss may not be a factor that promotes the further aggravation of cognitive dysfunction in patients with idiopathic tinnitus. The role of hearing loss in cognitive dysfunction in patients with idiopathic tinnitus needs further research.

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.

Misdiagnosis of a fungus ball in the middle ear as chronic suppurative otitis media

Background: Middle ear infections caused by fungi are commonly identified through laboratory tests like fungal smears, culture, and DNA detection. There are two types of ear infections caused by fungi: middle ear fungal infections and fungal otitis media. Both fungal otitis media and fungus balls in the middle ear are increasingly rare. Case Description: A middle-aged immunocompetent woman suffered from long-term recurrent pus formation in the middle ear and associated hearing loss. Physical examination revealed a perforation in the pars tensa of the tympanic membrane; a pure tone audiometry test revealed mild conductive hearing loss. The woman had previously self-medicated with oral antibiotics and/or ear drops multiple times in the past. She did not have a history of diabetes mellitus. She was diagnosed with chronic suppurative otitis media and surgical treatment (tympanoplasty) was advised. Otoscopy-guided tympanoplasty revealed a fungal mass with a cheese-like consistency filling the entire mesotympanum, and important structures such as the ossicular chain and the facial nerve were unharmed. Lesions were meticulously excised from the tympanic cavity of the affected ear. The patient no longer experienced pus formation in the middle ear and loss of hearing was restored after the surgery. After tympanoplasty, the patient did not experience any symptom recurrence during the 10-month follow-up period. Conclusions: If a patient has good immune function and no history of diabetes mellitus, despite repeated antibiotic use resulting in a diagnosis of chronic otitis media, doctors should consider the possibility of a fungal infection in the middle ear.

Evaluation of a research hearing aid for audiological testing

Objective Open-source hearing aid (HA) research tools provide avenues for testing new audiological concepts. This study compared a wearable research HA (RHA) – the “Portable Hearing Laboratory” – to a high-end commercial HA (CHA) in terms of aided outcome. Using this RHA, it also evaluated a fitting approach based on non-individualised gain presets. Design Using a randomised repeated-measures design, participants completed speech recognition and speech quality assessments under unaided and several aided (RHA and CHA with omnidirectional and directional microphone settings) conditions. Furthermore, two approaches for prescribing amplification were evaluated with the RHA: (1) a preset approach based on non-verified clinical gain targets calculated for three standard audiograms, and (2) a best-practice approach based on individually prescribed and verified clinical gain targets. Study sample Fifteen adults aged 50–78 years with symmetrical, mild-to-moderate sensorineural hearing losses. Results The RHA and CHA gave similar audibility, speech recognition in quiet and in noise, and speech quality ratings in quiet and in noise. Relative to the best-practice approach, the preset approach resulted in less audibility but similar speech recognition in quiet and in noise. Conclusion The RHA appears suited for testing new audiological concepts such as preset-based approaches to HA fitting.

Hearing impairment following surgically repaired congenital heart disease in children: a prospective study

ObjectivesTo determine the prevalence of sensorineural hearing loss (SNHL) in children who underwent congenital cardiac surgery (CCS) by using a pre- and postoperative hearing test, a conventional audiometry, an extended...

Effects of Noise Exposure on Video Ocular Counter Roll Measurements.

The purpose of this study was to evaluate the effect of noise exposure on otolith function measures of video ocular counter roll (vOCR), ocular vestibular evoked myogenic potential (oVEMP), cervical VEMP (cVEMP), and subjective visual vertical (SVV). Additionally, this study compared the vOCR results with other otolith function measures: cVEMP, oVEMP, and SVV. This was a cross-sectional, between-group prospective study that compared otolith function tests between noise exposure groups. Thirty-three adults between the ages of 40-60 years with no middle ear pathology, history of balance disorder, neurologic pathology, systemic diseases, or receiving ototoxic medications were included in the study. Group 1 included 17 adults (34 ears) with low-risk noise exposure, and Group 2 included 16 adults (32 ears) with high-risk noise exposure. Independent samples t tests were used to assess group mean differences for dependent variables. The independent variable was group with two levels (low risk and high risk). The dependent variables were Noise Exposure Structured Interview (NESI) score, vOCR torsion, cVEMP amplitude, oVEMP amplitude, and SVV angle. Additional analyses were completed using Pearson correlation to evaluate the relationship of vOCR to the other otolith function tests and NESI score to the otolith function tests. The results indicated significantly decreased vOCR torsion, cVEMP amplitude, and oVEMP amplitude in individuals with high-risk noise exposure compared with those in the low-risk group. Significant correlations were found for NESI scores as well as vOCR and oVEMP measures. This study describes the concomitant degeneration of the auditory and vestibular systems from noise exposure affecting otolith function, as measured by audiologic testing and otolith testing. vOCR appears to be sensitive to this degeneration, indicating that vOCR could be used as a vestibular screening measure for patients with noise exposure and/or suspected utricle dysfunction.