Audiometric Testing Research Articles

Association of Hearing Loss Onset and Etiology with Psychosocial Outcomes Among US Older Adults.

Understand the differential association of onset and etiology of hearing loss with psychosocial outcomes among older adults. This is a cross-sectional cohort study based on 2017-2020 National Health and Nutrition Examination Survey. Adults aged ≥70 years who completed audiometric testing and questionnaires on onset and etiologies of hearing loss were included (n = 612). Outcomes included report of social avoidance and major depressive disorder (MDD, PHQ-9). Multivariable regression was utilized to examine differential associations of onset and etiology of hearing loss on psychosocial outcomes while adjusting for relevant factors. In this nationally representative sample of US older adults with hearing loss, 20.8% [95%CI: 14.5-29.0%] reported social avoidance due to hearing loss and 7.2% [95%CI: 4.3-11.8] reported symptoms suggestive of MDD. Multivariable regression demonstrated self-reported onset of hearing loss between ages 6-19 years (OR:2.49 [95%CI: 1.52-4.10]) and 20-59 years (OR:1.95 [95%CI: 1.07-3.55]) was associated with higher avoidance of social interaction than reported onset at ≥70 years. Those with onset between 20-59 years (OR:4.28 [95%CI: 1.17-15.6]) and 60-69 years (OR:5.68 [95%CI: 1.85-17.5]) were more likely to report symptoms consistent with MDD than those with onset at ≥70. Multivariable regression did not demonstrate increased risk of avoiding social interactions or MDD due to hearing loss from noise exposure, ear infection, or ear disease versus aging alone. There was an association between earlier hearing loss onset with social avoidance and MDD. This suggests a need for research to investigate the impact of earlier diagnosis and intervention for hearing loss on psychosocial outcomes. 2b Laryngoscope, 134:5073-5079, 2024.

Guidance to investigate university students’ bodily responses and perceptual assessments in sound exposure experiments

Previous studies have shown that sound influences students both physiologically and perceptually. However, most of these studies focussed on the effects of sounds at group-level, ignoring individual differences. Therefore, we investigated which indicators can be used to identify differences in bodily responses and perceptual assessments of each individual when exposed to four different sounds. First, based on an audiometric test, the hearing acuity of 15 students (from five different profiles based on their acoustical preferences and needs) was measured. Then, two sound exposure experiments were conducted in the SenseLab: direct sound exposure using earbuds in a laboratory setting, and indirect sound exposure with speakers in a real room setting. During each experiment, the attention level (AL), mental relaxation level (MRL), heart rate (HR), and respiration rate (RR) were measured with wearable devices, and students made perceptual assessments of each condition. The percentage of change normalised the four bodily response measurements among students. Based on correlation analysis and t-tests, bodily responses, and perceptual assessments across experiments were compared, at group-level and individual-level. Six students, who suffered from mild hearing loss in low-frequency sounds, showed bodily responses such as increased HR during exposure to low-frequency sound conditions. Perceptual assessments of different sound types during both lab experiments substantiated the acoustical preferences of the students from the five profiles. Bodily responses showed no strong nor significant correlations with perceptual assessments during the direct sound exposure experiments. Differences in bodily responses and perceptual assessments between the two experiments and between group-level and individual-level were observed in AL. It is concluded that hearing acuity and type of sound (sound frequencies) are key indicators for identifying differences in bodily responses (such as HR and RR) and perceptual assessment. For future research, it is crucial to consider incorporating audiometric tests, bodily responses such as HR and RR, and perceptual assessments in this type of investigations.

COMPARATIVE EFFICACY OF SLICED TRAGAL CARTILAGE VERSUS TEMPORALIS FASCIA IN TYMPANOPLASTY: A STUDY ON HEARING IMPROVEMENT AND GRAFT UPTAKE

Objective: Chronic suppurative otitis media (CSOM) often necessitates surgical intervention, with tympanoplasty being a key procedure to restore hearing. The choice of graft material-sliced tragal cartilage versus temporalis fascia remains controversial due to potential differences in acoustic transmission and graft resilience. Methods: This prospective cohort study included 48 patients with CSOM, randomly assigned to receive either tragal cartilage or temporalis fascia grafts. Outcomes measured were hearing improvement and graft uptake, assessed through audiometric testing and otoscopic evaluations. Results: Both groups showed significant improvements in hearing postoperatively, with no statistically significant difference in hearing gain (P=0.3064). Graft uptake rates were comparable, with a non-significant lower reperforation rate in the cartilage group (P=0.551). Conclusion: The study supports the use of either sliced tragal cartilage or temporalis fascia as effective materials for tympanoplasty, offering substantial hearing improvement and reliable graft uptake.

Management of Prenatal Expanded Genetic Carrier Screening Results for Autosomal Recessive Sensorineural Hearing Loss.

Expanded carrier screening (ECS) identified couples at-risk to have a baby with an autosomal recessive genetic condition. Several genes implicated in sensorineural hearing loss (SNHL) are included in prenatal or preconception genetics ECS testing. Early identification of SNHL risk may enable prognostication of hearing loss, early educational intervention, and minimization of unnecessary diagnostic testing. We sought to describe cases where ECS enabled early SNHL-risk identification. Retrospective chart review. Maternal-Fetal Care Center and Otolaryngology department at an academic tertiary hospital. Medical records of parent-infant dyads with positive ECS results for variants in autosomal recessive SNHL genes were reviewed. Data regarding genetic diagnostic testing, newborn hearing screening, time to HL diagnosis, audiological evaluation, and clinical consultations were compiled. Fifteen pregnant with positive ECS results for SNHL were referred for consultation with a pediatric otolaryngologist and genetic counselor. Generally, these couples were highly educated and adequately insured. 14 had pathogenic variants for GJB2 and 1 for USH2A. Four couples pursued prenatal genetic diagnosis via amniocentesis; 11 couples deferred genetic testing to the postnatal period or waited for initial hearing evaluation. Six babies inherited biallelic GJB2 mutations. Four were found to have SNHL on ABR by age 5 weeks and received follow-up management, 1 had a normal hearing evaluation despite being gene-positive, and 1 was lost to follow-up before hearing evaluation. Carrier screening and confirmatory prenatal or neonatal genetic testing provided considerable lead time for early audiometric testing and appropriate intervention services including hearing aid fitting.

Active piezoelectric bone conduction implant Osia® 2 - evaluation of surgery and one-year audiological and quality of life benefits.

To present the surgical outcomes and one-year audiological and quality of life results of implantation of the Osia®2 active piezoelectric bone conduction implant. Twenty adults with mixed and conductive hearing loss were implanted with the Osia® 2 system and followed up for at least one year. The surgical course, healing, and soft tissue condition were assessed. Audiometric tests included pure tone audiometry, speech audiometry and direct bone conduction measurements. Participants completed the APHAB and SSQ questionnaires. All surgeries were successful. No soft tissue problems were observed. Pure tone audiometry showed a mean functional gain of 47.4 ± 5.6 dB HL (p = 0.000089). The Polish Monosyllabic Word Test showed mean improvements for silent, medium and loud speech of 59.5 ± 1.8%, 46.5 ± 32.3% and 13.3 ± 20.9% in quiet and 38.5 ± 24.4%, 62.0 ± 9.1%, and 36.5 ± 34.4% in noise (all p < 0.05). The Polish Matrix Test indicated a mean SNR improvement of 8.78 ± 2.31 dB SPL (p = 0.000155). BC in situ measurements were significantly better post-implantation compared to preoperative levels with Baha®6Max on the Softband. APHAB scores showed significant improvements in global, ease of communication, background noise and reverberation scores (all p < 0.001). SSQ scores improved significantly in speech, spatial and quality subscales (all p < 0.000001). The Osia®2 implantation is an effective treatment for patients with mixed and conductive hearing loss. The surgery is relatively easy and safe, with no significant postoperative or magnet pressure-related complications. Osia®2 significantly improves speech understanding in noise and reduces communication problems.

Reference Speech-recognition curves for a German monosyllabic test in noise: effects of loudspeaker configuration and room acoustics

Objective Measurement of reference speech-recognition curves for a specific speech test in typical clinical testing environments and for different loudspeaker configurations. Design Speech-recognition scores were measured at four signal-to-noise ratios for five loudspeaker configurations in two anechoic rooms, and in four audiometric test rooms with low reverberation times. Study sample 240 young participants (aged 18–25 years) without hearing impairment participated in the measurements. Results Reference speech-recognition curves for speech and noise from the front (S0N0) were similar across rooms. Compared to S0N0, lower speech-recognition thresholds (SRTs) were observed for all other loudspeaker configurations in which speech and noise were spatially separated. This spatial release from masking was significantly reduced for the audiometric test rooms compared to the anechoic rooms. A binaural speech-intelligibility model was used to verify the influence of room acoustic properties and loudspeaker configuration on SRT. Conclusions Speech-recognition curves for spatially separated loudspeaker configurations depend on the room acoustic properties, even in audiometric test rooms with low reverberation times. This makes it more difficult to compare clinical measurements with reference speech-recognition curves, or even with data measured in a different test room. It is thus recommended to document the loudspeaker configuration and test room for each clinical measurement.

Developing and validating a risk assessment method for noise-induced hearing loss in workers

Various risk factors can affect noise-induced hearing loss (NIHL) among employees. This research sought to establish and validate a risk assessment method for NIHL using these risk factors. This cross-sectional research was carried out with 220 workers from a steel manufacturing facility. At first, their demographic characteristics and information related to the studies’ items were gathered by the researcher-made questionnaire. In the next step, the noise exposure values of the participants were measured by the sound pressure level meter based on the ISO 9612 standard. Moreover, a pure tone audiometric test of bone and air conduction was used to measure hearing loss in people. Ultimately, a new index for risk assessment was created. Indirect effect coefficients of individual factors such as work experience, age, smoking, and effective diseases were 0.266, 0.227, 0.056, and 0.064, respectively. The coefficients of noise exposure items including occupational noise and leisure noise were obtained as 0.687 and 0.660. The personal protective equipment (PPE) items including use of PPE, noise reduction rating of PPE, and awareness of PPE were 0.194, 0.147, and 0.127, respectively. These coefficients were utilized to create a new index. The overall score of the index was divided into four categories using optimal cut-off values of 4.85, 6.84, and 7.59. According to the findings, the OHLRA methods were able to account for 74 percent of the hearing loss values. The results showed that the novel index for risk assessment had proper validity in the prediction of NIHL.

Evaluation of auditory system in vitiligo patients: A case-control study

BackgroundVitiligo is a common acquired pigmentary disorder characterized by well-defined areas of depigmentation due to loss of melanocytes. Vitiligo can affect melanocytes in the auditory system and potentially hearing. ObjectiveThe aim of this study was to investigate hearing changes in vitiligo patients. MethodsTwenty-six with vitiligo patients and 26 demographically matched healthy controls were included in this study. Audiological function was evaluated using pure tone audiometry (PTA), speech audiometry and tympanometry tests in all subjects. ResultsThe mean hearing threshold of the left ear at frequencies of 250 and 8000 Hz in vitiligo patients was significantly higher than the control group. Sensorineural hearing loss (SNHL) was seen in 14 (53.8 %) vitiligo patients and 5(19.2 %) control group (p < 0.05). Most affected patients (10/14; 71 %) had bilateral hearing loss especially in high frequency (8000 Hz). A significant association was identified between vitiligo and SNHL (OR 4.9; 95 % CI, 1.41–16.98, P = 0.01). There was a statistically significant correlation between hearing impairment and age in both groups. Gender, severity, activity and duration of vitiligo had no a significant effect on the results of audiometric tests. ConclusionThis study confirmed that the auditory system was affected in vitiligo patients. Vitiligo patients might be at a higher risk for auditory abnormalities at a younger age than control subjects. Auditory evaluation of vitiligo patients should be considered for early detection of hearing loss.

Unilateral versus bilateral stapes surgery: A comparative study on auditory outcome and quality of life

Otosclerosis is a well-known disease which mainly affects middle-aged female patients, causing conductive or mixed hearing loss. Diagnosis is essentially made through a complete audiometric battery testing, while treatment substantially relies on stapes surgery.In this study, we analyzed audiometric and Quality-of-Life data from 33 patients in order to refine the surgical indications (unilateral versus bilateral stapes surgery) and assess the best technique (stapedotomy versus partial stapedectomy) and timing of treatment. The original questionnaire OTOS, in the Italian language, was administered to all patients.In this study, most of the patients were female (18/33), with a mean age of 53 years old. Both surgical techniques appear to be effective with no significant difference in post-operative Air Bone Gap. OTOS questionnaire appeared to be effective in assessing quality of life in patients treated by stapes surgery. Post-operative QoL appeared to be similar in bilaterally and unilaterally operated patients, suggesting that a contralateral intervention after effective surgery should be undertaken only if expressly requested by the patient.

Correlation between Hearing Impairment and the Triglyceride Glucose Index in Middle-Aged Female Based on a Korean National Health and Nutrition Examination Survey

Background and Objectives: This study aimed to investigate the association between insulin resistance, as measured by the triglyceride–glucose index (TyG index), and hearing impairment in middle-aged women in Korea. Materials and Methods: This cross-sectional survey utilized data from the Korea National Health and Nutrition Examination Survey (KNHANES) IV (2007–2009), specifically from the period after July 21, 2009, when hearing test results became available, and from the KNHANES V (2010–2012). This study was conducted on 5416 women aged 40 to 69 who had completed both the health examination survey and audiometric tests, excluding those with missing data on menopausal status and the use of hormone replacement therapy. Results: In the study group, the prevalence of high-frequency hearing loss according to the TyG index was significantly higher in the mild hearing loss group (OR = 1.29; 95% CI: 1.12, 1.49, p &lt; 0.001) and the moderate hearing loss group (OR = 1.27; 95% CI: 1.09, 1.48, p = 0.002). Conversely, the prevalence of low-frequency hearing loss did not show a significant difference in either the mild hearing loss group (OR = 1.17; 95% CI: 0.99, 1.37, p = 0.065) and the moderate hearing loss group (OR = 1.13; 95% CI: 0.94, 1.35, p = 0.199) Conclusions: Since diabetes can induce hearing impairment in women, it is recommended that women with a high TyG index undergo early hearing tests

Cochlear Implantation for Single-Sided Deafness in Pediatric Patients: A Critical Assessment of Usage Rate.

To assess the usage rate of pediatric patients undergoing cochlear implantation (CI) for single-sided deafness (SSD). Retrospective cohort study. Tertiary care pediatric referral center. Pediatric patients who underwent CI for SSD. CI with requisite audiometric follow-up. Device use and audiometric testing. Sixty-six patients were implanted for SSD between 8/2015 and 7/2023 at a median age of 4.7 years (interquartile range, 1.7-7.7 yr). The cause of hearing loss was unknown in the majority of cases (28 patients, 42%), with cytomegalovirus being the most common known cause (17 patients, 26%). Hearing loss was prelingual in 38 patients (58%). Post-implantation, 12 patients (18%) were identified as lost to follow-up. For the remaining 54 patients, the median length of audiometric follow-up was 1.4 years (interquartile range, 0.9-2.2 yr). At last evaluation, only 10 of these 54 patients (19%) were designated as users (≥6 h per day), and 13 patients (24%) were designated as limited users (>2 but <6 h per day). Of patients capable of performing speech-in-noise testing (n = 13), 11 patients (85%) showed improvement on BKB-SIN SNR-50 testing with their implant on versus off with a mean improvement of 3 dB. Notably, 4 of these 11 patients (36%) were categorized as nonusers despite this benefit. Despite audiometric benefit from CI in the pediatric SSD population, usage rates over time remain markedly lower than anticipated at a high-volume, well-resourced tertiary care pediatric center. No influencing factors were identified, warranting critical assessment to ensure appropriate resource allocation.

Cross-sectional screening for inflammation in tinnitus with near-normal hearing

Tinnitus is the perception of sound without an external stimulus. Recently, inflammation has been implicated in the pathophysiology of tinnitus. In tinnitus animal models, cytokine levels are increased throughout the whole auditory pathway, and microglia and astrocytes are activated. However, only a few human studies on inflammation in tinnitus were conducted, which generally did not account for confounders such as hearing loss, anxiety and depression. The current study therefore aimed to evaluate the association between inflammation and tinnitus specifically in participants with (near-)normal hearing and without signs of anxiety or depression.In this cross-sectional study, fifty tinnitus participants and fifty healthy controls completed a tinnitus questionnaire and underwent audiometric testing. Complete blood count measures were determined in blood plasma, as well as cytokine concentrations by using the enzyme-linked immunosorbent assay (ELISA) technique.Platelet count and cytokine concentrations of IL-10 and IFN-γ were lower in participants with tinnitus compared to controls, and male sex, lower MCV, lower platelet count, and lower IL-10 and IFN-γ concentrations were significant predictors of tinnitus presence.The current study shows that inflammatory parameters are altered in tinnitus patients after exclusion of important confounders such as hearing loss, anxiety, depression, and inflammatory diseases.

A Study of Hearing Acuity and the Health of the External Auditory Canal Among Earphone Users in Central India.

Background and objective The pervasive use of earphones has raised concerns about its potential impact on hearing acuity and the health of the external auditory canal (EAC). This study aimed to investigate these effects in a sample of individuals in Central India to better understand the associated risks. Materials and methods This observational cross-sectional study was conducted in the Department of Otorhinolaryngology, Acharya Vinoba Bhave Rural Hospital, SawangiWardha. A total of 130 participants aged 15-35 years were divided into two groups: 65 earphone users and 65 non-earphone users. The data collection involved medical histories, clinical examinations, and audiometric testing, including pure-tone audiometry (PTA), impedance audiometry, and otoacoustic emissions (OAE). Participants completed a questionnaire on earphone usage, and EAC health was assessed via physical examinations and photographic documentation. Statistical analyses included descriptive and inferential statistics, with significance set at p<0.05. Results Among earphone users, 45 (69.23%) exhibited hearing loss compared to 11 (16.92%) in non-users (p<0.00001). Noise-canceling earphones were associated with fewer cases of hearing loss (6/45, 13.33%) than non-noise-canceling types (39/45, 86.67%) (p<0.00001). EAC issues were more prevalent in earphone users, with 39 (60%) showing normal conditions versus 52 (80%) in non-users. Impactions of wax, otomycosis, and otitis externa were observed more frequently among earphone users. Conclusions The study highlights a significant association between earphone use and increased risk of hearing loss and EAC issues. Noise-canceling earphones may offer some protective benefits. These findings underscore the need for raising awareness and implementing preventive measures to mitigate potential risks associated with prolonged earphone use.

The biphasic impact of apolipoprotein E ε4 allele on age-related hearing loss

Both the ε4 variant of the apolipoprotein E (APOE) gene and hearing loss are well-known risk factors for Alzheimer's disease. However, previous studies have produced inconsistent findings regarding the association between APOE genotypes and hearing levels, necessitating further investigation. The aim of this study was to investigate the relationship between APOE genotypes and hearing levels. This retrospective study analyzed clinical data from a clinical data warehouse of seven affiliated Catholic Medical Center hospitals. The study included 1,162 participants with records of APOE genotypes, audiometric tests, and cognitive function tests. In Generalized linear mixed model analysis, ε4 carriers exhibited lower pure tone audiometry thresholds with an estimate of -0.353 (SE = 0.126, p = 0.005). However, the interaction term for age and APOE ε4 had a coefficient of 0.577 (SE = 0.214 p = 0.006), suggesting that the APOE ε4 gene may accelerate hearing deterioration with age. Subgroup analysis based on an age cut-off of 75 revealed that ε4 carriers had better hearing at younger ages, but showed no significant difference at older ages. These results indicate that the ε4 allele may have a biphasic effect on hearing levels depending on age.

Sudden sensorineural hearing loss: audiological profile during the COVID-19 pandemic.

Sudden sensorineural hearing loss (SSNHL) is an otological emergency that requires prompt recognition and intervention to prevent devastating impacts on people's lives. During the COVID-19 pandemic, sensory deprivations have been reported in patients positive for SARS-CoV-2 virus, including deleterious effects on the auditory pathway. This study aims to describe the audiological profile of individuals with SSNHL during the COVID-19 pandemic and to correlate hearing recovery in subgroups of individuals with or without COVID-19. Prospective cohort including patients diagnosed with SSNHL evaluated in a tertiary care center between March 2020 and September 2022. Hearing loss was confirmed with pure-tone and speech audiometry, with Speech Recognition Threshold (SRT) and word recognition score (WRS). Audiometric testing was performed at the moment of diagnosis, then 7, 30 and 120 days after diagnosis. The average degree of hearing loss was assessed by calculating the 4-frequency pure tone average (4fPTA). The investigation of COVID-19 included RT-PCR technique for the SARS-CoV-2 virus and collection of information regarding disease severity. A statistical analysis was performed using an analysis of covariance (ANCOVA) model to compare the 4fPTA between the four groups (with and without a history of COVID-19, unilateral and bilateral cases) at the end of the follow-up period. Fifty-two patients with SSNHL were assessed, 40 (76.9%) with unilateral and 12 (23.1%) with bilateral hearing loss, totaling 64 ears included. Of those, 15 (28.8%) patients tested positive for SARS-CoV-2 and were symptomatic for COVID-19. Of all unilateral cases, 22.5% were seropositive and showed symptoms of COVID-19, a number that increased to 50% for bilateral cases. Comparing the COVID-19 positive groups, individuals with unilateral SSNHL went from 40 dB as their average 4fPTA at onset to 20 dB as their average 4fPTA after 120 days, whereas those with bilateral SSNHL went from an initial average of 60 dB to a final average of 66 dB. Although the 4fPTA value of individuals with unilateral SSNHL improved in 7 days, the mean values showed no significant difference between positive and negative groups. There was a higher incidence of bilateral simultaneous SSNHL in patients who had not been vaccinated against COVID-19 and who presented with symptoms of severe COVID-19. Infection with SARS-CoV-2 resulted in more severe SSNHL, in bilateral SSNHL, and in poorer recovery from SSNHL in bilateral cases. Bilateral SSNHL was seen more frequently in patients who had not received vaccination against COVID-19.

O01 LISTEN TO YOUR HEART AND MIND: A FEASIBILITY STUDY ON COMBINED SCREENING OF RAISED BLOOD PRESSURE, ATRIAL FIBRILLATION, COGNITIVE IMPAIRMENT AND HEARING LOSS

Background and Objective. Detection rates of hypertension continues to be suboptimal worldwide. The risk of hypertension increases substantially in older adults aged ≥65 years, a group also at increased risk of atrial fibrillation (AF), cognitive decline and hearing loss—all factors associated with hypertension. This pilot study aimed to 1) implement a combined screening strategy for these health conditions, and 2) assess feasibility and acceptability of the combined screening. Methods. Adults aged ≥65 years without a prior diagnosis of cognitive impairment and dementia were invited to attend a combined screening appointment through advertisements posted in university and community group newsletters and noticeboards. Participants underwent blood pressure (BP) and AF screening using an oscillometric BP monitor with AF detection (Microlife WatchBP Office 2G), cognitive assessment (General Practitioner Assessment of Cognition, GPCOG), and audiometric testing. A subset of participants was invited to participate in a post-study process evaluation interview. Results. Of the 35 participants (age 73±6 years, 51% females), 26 (74%) had hypertension (on antihypertensive medication: n=20; measured: n=6; unaware: n=2; uncontrolled: n=4). Possible AF was detected in two participants and seven had possible cognitive decline (GPCOG score &lt;9). Hearing loss was detected in 13 participants. Interviews (n=16, 50% females) revealed that combined screening was acceptable and feasible as participants felt it was “convenient”, “saves time”, “a brilliant idea”, and that “… conditions are related and therefore appropriate to be together”. Most participants were already aware of their hypertension status, thus screening did not result in increased hypertension awareness except for one with uncontrolled hypertension who proceeded to purchase a home BP monitor. One participant with detected AF visited a cardiologist and confirmed non-AF arrhythmia. All interviewees found the appointment duration (approximately 60-75 minutes) was not too long nor too taxing. Conclusions. Combined screening in older adults with increased cardiovascular risk is feasible and acceptable and should be considered for future screening programs in older adults.

Sound Metric Proximity Hearing App

Globally, hearing impairment affects over 466 million people, creating barriers to accessing audiometric testing and timely diagnosis. Conventional methods often prove challenging to access, especially for people with limited resources or any other disadvantages. The proposed innovative "Sound Metric Proximity Hearing App" aims to revolutionize auditory health through mobile technology. Utilizing advanced techniques such as frequency-specific sound generation, individual ear sound production, and obstacle detection, the app provides comprehensive hearing tests through a user-friendly platform. The application is developed using React Native for the frontend and Django for the backend. It integrates seamlessly with mobile devices and databases, ensuring efficient and reliable performance. With simple result export and tools for early detection, the application enhances the accessibility and efficiency in hearing assessments. It bridges gaps in traditional testing methods, empowering users to proactively manage their auditory health. The "Sound Metric Proximity Hearing App" addresses the essential need for accessible, efficient hearing tests, making a positive impact on global auditory health. Through its innovative approach, the app aims to reduce the stigma associated with hearing loss and promote early intervention. By providing a convenient tool for educators, the app supports classroom management and improves learning environments. With its potential to reach unprivileged people and enhance awareness, the proposed sound metric application is devised to contribute significantly to global auditory health.

Patterns of Teprotumumab-Induced Hearing Dysfunction: A Systematic Review.

Hearing loss has been reported after administration of the monoclonal antibody teprotumumab. The purpose of this study was to review available evidence regarding the patterns of teprotumumab-related ototoxicity. PubMed, EMBASE, and Cochrane Library. A systematic review was performed using standardized methodology. Studies were included if they included subjects who were prescribed teprotumumab. Exclusion criteria included non-English articles, abstracts, letters/commentaries, case reports, and reviews. Subjects without both pre- and posttreatment audiometric data were also excluded. Bias was assessed using the Mixed Methods Appraisal Tool. From an initial search of 76 articles, 7 studies reporting on 109 unique patients were included. Four studies were level 4 evidence, 1 study was level 3 evidence, and 2 studies were level 2 evidence. Mean age was 55 ± 14 years with a female predominance (64%). The most commonly reported symptoms were hearing loss (22%), followed by fullness (18%) and tinnitus (14%). In total, 41% of patients with available data met criteria for ototoxicity, all exhibiting shifts in the middle frequencies or higher. Fifteen (14%) patients underwent ultrahigh frequency audiometric testing and 8 (53%, 8/15) demonstrated shifts exclusively in this range. Ototoxicity may occur in patients treated with teprotumumab. Hearing loss occurs primarily in higher frequencies, and routine hearing screening with ultrahigh frequency testing may be warranted. The true incidence of ototoxicity with teprotumumab remains unknown, and more data is needed to elucidate underlying mechanisms and develop strategies to minimize risks.

Persistent postural perceptual dizziness (PPPD) in pediatric patients after COVID-19 infection

BackgroundPatients with long-COVID suffer from symptoms that continue or develop after a COVID-19 or SARS-CoV-2 infection and are present for four or more weeks after the initial infection. This case series describes a group of previously healthy adolescent patients with long-COVID who were seen in a pediatric vestibular clinic for evaluation of severe dizziness and were diagnosed with persistent postural-perceptual dizziness (PPPD). By presenting their symptoms, management and treatment effects, this study aims to provide a diagnostic and therapeutic framework for providers who encounter these patients. MethodsPatient records were reviewed for past medical history, symptoms, physical exam findings, results of audiometric and vestibular testing, dizziness handicap inventory for patient caregiver (DHI-pc) scores, and treatment recommendations. Parents of patients were contacted for a follow up survey to assess treatment adherence and outcomes including changes in symptoms and return to activity. ResultsA series of 9 adolescent patients were referred from a multidisciplinary long-COVID clinic and diagnosed with PPPD. Recommended treatment included vestibular physical therapy, selective serotonin reuptake inhibitor medication, and cognitive behavioral therapy. The majority of patients experienced an improvement in their symptoms, and all patients had improved activity levels and DHI-pc scores after treatment. ConclusionTo the best of our knowledge, no previous reports exist discussing PPPD in long-COVID patients. This case series provides insight into symptom evolution and treatment efficacy in this patient population.

Evaluation and diagnosis of pediatric patients with dizziness.

Children experiencing dizziness frequently go unevaluated or experience delays in correct diagnosis due to systemic and inherent barriers. While most causes of pediatric dizziness do not involve the peripheral vestibular system, otolaryngologists are frequently consulted for expert opinion. This study offers a broad overview of the leading causes of pediatric dizziness and imbalance to assist otolaryngologists with evaluating and managing this challenging population. Evaluation of children with dizziness should exclude serious central nervous system conditions. Approximately 70% of nonhazardous cases of pediatric dizziness are caused by migraine-related conditions, concussion, or functional disorders. Etiologies for peripheral vestibular dysfunction include inner ear malformations and vestibular disorders more commonly seen in adults. Audiometric and vestibular testing can provide helpful information, although correct diagnosis depends on a detailed history. Otolaryngologists should be familiar with the conditions that cause dizziness in children. While most underlying causes are outside their scope of practice, understanding possible etiologies can facilitate correct diagnosis and appropriate management.