Audiometric Testing Research Articles

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.

Early Audiometric Intervention in Bacterial Meningitis: Cochlear Implantation in a 10-Week-Old Child.

Sensorineural hearing loss is a well-known complication of Streptococcus pneumoniae meningitis. Given the propensity for fibrosis and ossification of the cochlea in bacterial meningitis, implantation must be performed in a timely fashion because a delayed attempt at implantation can frustrate obtaining an optimal technical result or lead to an inability to implant. Obtaining optimal audiometric outcomes is reliant on early hearing screening in patients with streptococcal meningitis. In the absence of standardized protocols, audiometric testing is often overlooked or delayed in the workup and management of meningitis. Our institution implemented a meningitis protocol with a particular focus on timing of audiometric testing in patients with meningitis. We present a patient diagnosed with streptococcal meningitis in the first week of life. Early hearing screening allowed the diagnosis of profound unilateral sensorineural hearing loss and subsequent cochlear implantation at 10 weeks of age, the youngest described in the medical literature. Despite early implantation, there was cochlear fibrosis at the time of implantation. Fortunately, the majority of electrodes were implanted to achieve a serviceable hearing outcome. Serial magnetic resonance imaging scans were obtained because of her contralateral ventriculoperitoneal shunt that allowed unique visualization of the progression of cochlear fibrosis over time. This case demonstrates the importance of including audiometric testing in a standardized meningitis protocol to diagnose hearing loss in a timely and accurate way and to achieve optimal long-term hearing outcomes.

Prevalence and Factors Associated With Occupational Noise-Induced Hearing Loss Among Palm Oil Mill Workers in Selangor, Malaysia.

Introduction Occupational noise-induced hearing loss (NIHL) continues to be a significant public health issue globally, with Malaysia being no exception. In Malaysia, the majority of NIHL cases are reported from the manufacturing sector, with Selangor among the states with the highest number of confirmed cases. This study aimed to assess the prevalence of and factors associated with occupational NIHL among palm oil mill workers in Selangor, Malaysia. Methods A cross-sectional study was conducted to analyze the data from the data collection form, noise risk assessment reports, and audiometric test results done between 2021 and 2022 with a comparable baseline audiometric test. Results A total of 143 participants from three palm oil mills joined this study. The prevalence of NIHL was 42.7% (n = 61). Following the logistic regression model, NIHL was significantly associated with a duration of employment of 10 years and above, a history of occupational noise exposure at the previous workplace, and the use of personal hearing protectors at the current workplace with an adjusted OR of 2.41 (95% CI (1.14, 5.07)), 5.89 (95% CI (2.38, 14.53)), and 0.36 (95% CI (0.16, 0.83)), respectively. Conclusion The prevalence of NIHL among the study participants was high, and the associated factors are modifiable factors that can be prevented with a comprehensive hearing conservation program in the palm oil mills.

Development of a National Ménière's Disease Registry: A Feasibility Study.

Ménière's disease is a disabling condition causing vertigo and hearing loss yet remains incompletely understood. Registry studies have the potential to answer important questions about phenotypes and natural history of clinical conditions. The aim of this study was to explore the feasibility of a patient-centered national Ménière's disease registry. This was an observational study carried out at 4 state-funded hospitals and 4 independent clinics, within 3 distinct urban and rural regions within the UK. Adults with Ménière's disease were eligible to participate. A range of patient reported data, questionnaire data and clinical data (audiometric, radiological, and specialist balance testing data) was inputted into a bespoke database. The study recruited 411 participants. The majority of participants chose online recruitment (73%) and 27% chose via paper-based methods for participation. A small majority (57%) of participants were female. 96% of participants were of white ethnicity. Data completeness from online or postal data collection was similar. Around 20% of participants had audiological evidence of bilateral Ménière's disease. This feasibility study has successfully piloted methods for recruitment of hundreds of participants diagnosed with Ménière's disease. Participants actively contributed their data to a robust and extensive data collection platform. The positive outcomes from this initial feasibility study are anticipated to serve as a foundation for the future expansion of the registry. This expansion holds the potential to address a broad spectrum of request, encompassing all aspects of the nature of Ménière's disease.

Factors to Describe the Outcome Characteristics of a CI Recipient.

Background: In cochlear implant (CI) treatment, there is a large variability in outcome. The aim of our study was to identify the independent audiometric measures that are most directly relevant for describing this variability in outcome characteristics of CI recipients. An extended audiometric test battery was used with selected adult patients in order to characterize the full range of CI outcomes. Methods: CI users were recruited for this study on the basis of their postoperative results and divided into three groups: low (1st quartile), moderate (medium decentile), and high hearing performance (4th quartile). Speech recognition was measured in quiet by using (i) monosyllabic words (40-80 dB SPL), (ii) speech reception threshold (SRT) for numbers, and (iii) the German matrix test in noise. In order to reconstruct demanding everyday listening situations in the clinic, the temporal characteristics of the background noise and the spatial arrangements of the signal sources were varied for tests in noise. In addition, a survey was conducted using the Speech, Spatial, and Qualities (SSQ) questionnaire and the Listening Effort (LE) questionnaire. Results: Fifteen subjects per group were examined (total N = 45), who did not differ significantly in terms of age, time after CI surgery, or CI use behavior. The groups differed mainly in the results of speech audiometry. For speech recognition, significant differences were found between the three groups for the monosyllabic tests in quiet and for the sentences in stationary (S0°N0°) and fluctuating (S0°NCI) noise. Word comprehension and sentence comprehension in quiet were both strongly correlated with the SRT in noise. This observation was also confirmed by a factor analysis. No significant differences were found between the three groups for the SSQ questionnaire and the LE questionnaire results. The results of the factor analysis indicate that speech recognition in noise provides information highly comparable to information from speech intelligibility in quiet. Conclusions: The factor analysis highlighted three components describing the postoperative outcome of CI patients. These were (i) the audiometrically measured supra-threshold speech recognition and (ii) near-threshold audibility, as well as (iii) the subjective assessment of the relationship to real life as determined by the questionnaires. These parameters appear well suited to setting up a framework for a test battery to assess CI outcomes.

Client Oriented Scale of Improvement in First-Time and Experienced Hearing Aid Users: An Analysis of Five Predetermined Predictability Categories through Audiometric and Speech Testing.

Objectives: The aim of our investigation was to explore the relationship between unaided pure-tone and speech audiometry and self-reported aided performance measured according to five predetermined COSI categories among first-time hearing aid users and experienced hearing aid users. Methods: Data from 286 patients were retrospectively evaluated. We divided the sample into first-time hearing aid users (G1) and experienced hearing aid users (G2). The correlation between unaided tonal and speech audiometry and five preliminary selected client-oriented scale of improvement (COSI) categories was studied. Results: A greater percentage of hearing aid users aged >80 years and a higher prevalence of severe-to-profound hearing loss in G2 group were observed (p < 0.05). For the total cohort, a mean hearing threshold of 60.37 ± 18.77 db HL emerged in the right ear, and 59.97 ± 18.76 db HL was detected in the left ear (p > 0.05). A significant statistical difference was observed in the group of first-time hearing aid users for the "Television/Radio at normal volume" item, where patients with a lower speech intellection threshold (SIT) were associated with higher COSI scores (p = 0.019). Studying the relationship between the speech reception threshold (SRT) and the COSI item "conversation with 1 or 2 in noise" evidenced worse speech audiometry in patients who scored ≤2 among experienced hearing aid users (p = 0.00012); a higher mean 4-8 kHz frequencies threshold for the better ear was found within the G2 group among those who scored ≤2 in the COSI item "conversation with 1 or 2 in quiet" (p = 0.043). Conclusions: Our study confirms a poor correlation between unaided tonal and speech audiometry and self-reported patient assessment. Although we included only five COSI categories in this study, it is clear that unaided audiometric tests may drive the choice of proper hearing rehabilitation, but their value in predicting the benefit of hearing aids remains limited.

GCT-18. GERMINOMAS OF THE CENTRAL NERVOUS SYSTEM (CNS): 20 YEARS EXPERIENCE WITH WHOLE VENTRICULAR IRRADIATION (WVI) AT FONDAZIONE IRCCS ISTITUTO NAZIONALE DEI TUMORI, MILAN

Abstract BACKGROUND Intracranial germ cell tumors account for 1-3% of pediatric CNS tumors, with germinomas constituting up to 65%, their prognosis being favourable compared to the non-germinomatous counterpart. METHODS After an unsuccessful experience with focal irradiation, from 2001 to 2021 we treated 68 patients (51 males/17 females, median age at diagnosis 16 years) with 4 PEB cycles (cisplatin 25 mg/sqm days 1-4, etoposide125 mg/sqm days 1-4, bleomycin 18 mg/sqm day 2, cycles every 21 days) followed by whole ventricular irradiation (WVI) 30,6 Gy/36Gy if CR/PR-SD. Patients with metastatic disease received craniospinal irradiation only (CSI 24 Gy+16Gy TB-tumor bed/WVI). RESULTS Fifty-nine patients had localized disease: 23 pineal, 22 suprasellar, 13 bifocal, 1 in the basal ganglia and 9 were metastatic. Suprasellar localization was associated with longer diagnostic delay. Five, 10 and 20 years OS and EFS were 100%, 97.5%, 97.5% and 95.3%, 92.8%.92.8% respectively. There was no statistical difference according to age at diagnosis, site and metastatic/bifocal disease. During follow-up 13/59 patients (22%) revealed moderate (2)/slight (11) impairment of the pulmonary function at spirometry assessment. Audiometric tests were available for 59 patients: 42 were normal (71%), 11 had a slight deficit, 4 moderate and 2 severe. Neurocognitive homogeneous evaluations were available only for 9 patients, so no clear correlation can be done, except observing the lowest scores in the patient with basal ganglia involvement. New endocrine deficits appeared in 9 patients after the treatment. CONCLUSIONS WVI tailored on response to chemotherapy proved effective in curing children CNS germinoma. Cisplatin and bleomycin-containing regimens induce high-response rates with known but in our experience limited sides effects. New collaborative protocols will investigate the reduction of the doses of irradiation and the use of less toxic drugs in order to achieve the same cure rates with less side effects.

Immigrant Status Disparities in Hearing Health Care Use in the United States.

To determine whether immigrant status is associated with likelihood of audiogram and hearing aid use among US adults with hearing loss. Cross-sectional study. Nationally representative data from 2009 to 2010, 2011 to 2012, 2015 to 2016, and 2017 to 2020 National Health and Nutrition Examination Survey (NHANES) cycles. This cross-sectional study of 4 merged cycles of NHANES included 12,455 adults with subjective (self-reported) or objective (audiometric) hearing loss. Sequentially adjusted logistic regressions were used to assess the association of immigration status with likelihood of having undergone audiogram among those with objective and self-reported hearing loss, and with likelihood of hearing aid use among candidates with objective hearing loss. Immigrants were less likely to have received an audiogram among subjects with subjective (odds ratio [OR]: 0.81, 95% confidence interval [CI]: 0.75-0.87), and objective (OR: 0.76, 95% CI: 0.72-0.81) hearing loss, compared to nonimmigrants. The association persisted for those with subjective (OR: 0.88, 95% CI: 0.81-0.96), and objective (OR: 0.87, 95% CI: 0.80-0.96) hearing loss after adjusting for sociodemographic factors, comorbidities, insurance, and hearing quality, but disappeared in both groups after adjusting for English proficiency. Immigrants were less likely to use hearing aids (OR: 0.90, 95% CI: 0.87-0.93). However, this association disappeared (OR: 0.98, 95% CI: 0.93-1.04) in the adjusted model. Immigrant status is a significant barrier to hearing health care and is associated with lower rates of audiometric testing and hearing aid use among individuals with hearing loss.

Comparing Approaches for Repair of Superior Semicircular Canal Dehiscence.

Compare outcomes for subjects who underwent middle cranial fossa (MCF) or transmastoid (TM) repair of superior semicircular canal dehiscence (SSCD). Retrospective cohort study. Quaternary-care, academic neurotology practice. Subjects who underwent MCF or TM repair of SSCD between December 1999 and April 2023 were identified. Main outcome measures included demographic data, length of surgery and hospital stay, clinical presentation, and audiometric testing. Ninety-three subjects (97 ears) who underwent surgery for SSCD met inclusion criteria: 58.8% (57) via MCF, 39.2% (38) via TM, and 2.0% (2) via TM + MCF. Median operative time was shorter for the TM (35) compared to the MCF (29) approach (118 vs 151 minutes, P < .001). Additionally, median hospital stays were shorter for TM (36) compared to the MCF (56) approach (15.3 vs 67.7 hours, P < .001). Overall, 92% (49/53) of MCF and 92% (33/36) of TM surgeries resulted in an improvement or resolution of one or more symptoms (P = .84). There was no significant preoperative to postoperative change in the median air conduction pure-tone average (PTA), air-bone gap, or word recognition score in both the MCF and TM groups (P > .05). Improvements of >10 dB in the pre- to postoperative absolute change in bone conduction PTA were noted in 3 subjects in the MCF group and 4 subjects in the TM group (P = .49). The TM approach for SSCD demonstrates shorter operative times and length of hospital stay. The TM and MCF approaches have comparable audiometric and clinical outcomes.

Prevalence and associated factors of noise-induced hearing loss among workers in Bishoftu Central Air Base of Ethiopia

Excessive occupational exposure to noise results in a well-recognized occupational hearing loss which is prevalent in many workplaces and now it is taken as a global problem. Therefore, this study aims to assess the prevalence of noise-induced hearing loss and associated factors among workers in the Bishoftu Central Air Base in Ethiopia. An institutional-based cross-sectional study was conducted among 260 central air base workers through face-to-face interviews, an environment noise survey, and an audiometric test for data collection. Data were entered by Epi-data version 3.1 and SPSS was used to analyze the data. Finally, a statistical analysis such as descriptive and binary logistic regression analysis was applied. A P-value < 0.05 at 95% CI was considered statistically significant. The overall prevalence of noise-induced hearing loss and hearing impairments was 24.6 and 30.9%, respectively. The highest prevalence of noise-induced hearing loss was recorded for workers who were exposed to noise levels greater than 90 dBA. Out of 132 workers exposed to the average noise level of 75 dB A, only 5% of workers were affected with noise-induced hearing loss, while 128 workers exposed to an average noise level equal to or greater than 90 dB A, 19.6% of workers were identified with noise-induced hearing loss. Regarding sex, around 21.9% of male workers were identified with noise-induced hearing loss. Workers who were exposed to a high noise level workplace previously or before the Central Air Base workplace were five times (AOR = 5.0, 95% CI 1.74–14.36) more likely affected by noise-induced hearing loss than those workers not previously exposed. Those workers who were exposed to greater or equal to 90dBA noise level were 4.98 times (AOR = 4.98, 95% CI 2.59–9.58) more likely to be exposed to noise-induced levels than those who were exposed to less than 90dBA noise level. Moreover, male air base workers were 3.5 times more likely exposed to hearing impairment than female workers (AOR = 3.5, 95% CI 1.01–12.0). This study identified that the prevalence of noise-induced hearing loss and hearing impairments was significantly high. So implementation of a hearing conservation program, giving noise education, and supplying adequate hearing protective devices (HPDs) are essentials.

Mitigation of Effect Modification by Psychological Status in Patients With Hearing Loss

Although patient-reported outcomes provide valuable insights, these subjective data may not align with objective test results. Hearing loss is a pervasive problem, such that concordance between subjective perceptions of hearing ability and objective audiogram assessments would be beneficial. To determine (1) whether psychological status is an effect modifier of the association between subjective patient reports of hearing ability and objective audiometry results, and (2) whether any effect modification observed in standard static questionnaires would be either mitigated or exacerbated by adaptive testing based on Item Response Theory analyses. This diagnostic study at a tertiary care center and community-based practice included consecutive adults who presented with queries related to hearing loss. Participants were recruited and enrolled and data analyses occurred from 2022 to 2024. Participants prospectively reported their hearing-specific abilities through either a standard static or adaptive version of the Inner Effectiveness of Auditory Rehabilitation (EAR) scale, alongside validated measures of their mental health and audiometry. Word recognition scores (WRS) and pure tone averages (PTA) were used to analyze audiometric testing. The association between subjective Inner EAR results and audiometry was evaluated. Stratified analyses were used to assess for effect modification by psychological status. The results of standard static and adaptive testing were compared. In this study of 395 patients (mean [range] age, 55.9 [18-89] years; 210 [53.2%] female), standard static Inner EAR mean scores were appropriately higher in patients with higher (better) WRS (50.7, 95% CI, 46.4-54.9), compared with patients with lower (worse) WRS (34.7, 95% CI, 24.3-45.1). However, among patients with worse mental health, there was no association between standard static Inner EAR scores and WRS. In contrast, adaptive Inner EAR mean scores were significantly higher for those with better WRS, regardless of mental health status. Thus, effect modification was observed in standard static assessments, whereas adaptive testing remained durably associated with audiometry, regardless of mental health. Psychological status was an effect modifier of the association between standard Inner EAR scale scores and audiometry, with a positive association observed only in those with better mental health. Adaptive testing scores, however, remained significantly associated with audiometry, even when mental status was worse. Adaptive testing may stabilize the association between subjective and objective hearing outcomes.

Prevalence of Ocular Morbidity and Associated Factors Among Hearing Impaired Children at Embangweni School of the Deaf in Mzimba District, Malawi.

To assess the prevalence of ocular morbidities and associated factors among hearing-impaired (HI) students at the Embangweni School for the Deaf in Mzimba, Malawi. This was an institutional cross-sectional study of HI students at Embangweni School for the Deaf. A series of optometric and audiometric tests was performed, and the results were exported to the Statistical Package for Social Science for statistical analysis (SPSS) version 25. Pearson's chi-square test was used to assess correlations and associations between variables. A P-value less significance was set at p < 0.05. A total of 147 children comprising of 76 (51.7%) males and 71 (48.3%) females participated in this study. The prevalence of ocular conditions and visual impairment was 39 (26.5%) and 2 (1.4%), respectively. The Prevalence of eye disease was significantly associated with male sex (p=0.02) and type of HI (p=0.031). Allergic conjunctivitis 36 (24.5%) was the most common ocular condition, followed by refractive error 28 (19%). The prevalence of ocular conditions among HI students was significant and associated with sex. Regular school vision screening of students with HI is highly advised to reduce the burden of visual impairment.

Investigating the Utility of a Compact Loudspeaker Array for Audiometric Testing.

This project addressed the uses of a loudspeaker array for audiometric measurements. It sought to evaluate a prototype compact array in terms of the reliability of test results across sound booths. A seven-loudspeaker array was developed to deliver sounds from -60° to +60° on an arc with a radius of 0.5 m. The system was equipped with a head position sensing system to maintain the listener's head near the optimal test position. Three array systems were distributed to each of the two test sites for within-subject assessments of booth equivalence on tests of sound localization, speech reception in noise, and threshold detection. A total of 36 subjects participated, 18 at each test site. Results showed excellent interbooth consistency on tests of sound localization using speech and noise signals, including conditions in which one or both ears were covered with a muff. Booth consistency was also excellent on sound field threshold measurements for detecting quasi-diffuse noise bands. Nonequivalence was observed in some cases of speech-in-noise tests, particularly with a small one-person booth. Acoustic analyses of in situ loudspeaker responses indicated that some of the nonequivalent comparisons on speech-in-noise tests could be traced to the effects of reflections. Overall, the results demonstrate the utility and reliability of a compact array for the assessment of localization ability, speech reception in noise, and sound field thresholds. However, the results indicate that researchers and clinicians should be aware of the reflection effects that can influence the results of sound field tests in which signal and noise levels from separate loudspeakers are critical.

Evaluation of Subjective Tinnitus Severity and Distortion Product Otoacoustic Emissions and Extended High-Frequency Audiometry.

Tinnitus is a multifactorial phenomenon with quality-of-life detriments for those affected by it. We aim to establish a relationship between subjective tinnitus severity with objective audiometric data in the extended high frequency (EHF) from 9 to 16 khz and with distortion product otoacoustic emissions (DPOAE). We hypothesize that severe subjective tinnitus as measured by the Tinnitus Handicap Inventory (THI) does not correlate with increased hearing thresholds in the EHF range. Prospective. Single Tertiary Care Center. Patients identified with tinnitus and normal hearing thresholds within standard frequency range (250-8000 Hz) were consented for participation. Those with underlying otologic disease, trauma, radiotherapy, or ototoxic drug use were excluded. The THI questionnaire was given to eligible patients and audiometric test results were collected. THI scores were categorized by severity groups. An n = 20 to 30 was determined to have an effect size of 0.7 with a significance level of P = .05. THI and audiometric data were collected for 38 patients and categorized into mild (n = 18, 47.4%), moderate (n = 8, 21.1%), slight (n = 7, 18.4%), and severe (n = 5, 13.2%) tinnitus severity groups. Mean THI score was 32.3 ± 19.6 with a statistically significant difference in scores by assigned THI severity group (P < .01). There were no significant differences or linear relationship among hearing thresholds in EHF range or DPOAE stratified by subjective tinnitus group (P = .49, r2 = 0.10) CONCLUSION: Subjective tinnitus severity is not predictive of audiometric outcomes. This finding can be used as a counseling tool to help tinnitus patients manage symptoms, expectations, and overall treatment outcomes.

Prevalence of hearing loss in patients with sickle cell disease in the southeast of Iran

Background: One of the complications of sickle cell disease (SCD) is hearing loss. The purpose of the present study is to determine the prevalence of hearing loss in SCD.&#x0D; Materials and Methods: This is a descriptive-analytical cross-sectional study conducted on 100 patients with SCD in 2019-2020. All the patients underwent otololaryngological examination and audiometric tests to assess their hearing status. The type and severity of hearing loss were determined, the demographic information of the patients was recorded, and the data were analyzed using the SPSS software version 21, a Chi-square test, and the Kruskal-Wallis test. The P-values of &lt; 0.05 were considered statistically significant.&#x0D; Results: The mean age of the patients was 17.6 ± 10.8 years. Of them, 60% were male. Hearing loss was diagnosed in 26 patients (26%), 16 of whom had sensorineural hearing loss (SNHL) and 10 had conductive hearing loss (CHL). In terms of the disease severity, 12, 10, 3 and 1 patients had mild, moderate, severe and profound hearing loss, respectively. The mean age of the patients with SNHL was significantly higher than the median age of the subjects with CHL (p-value = 0.043). Also, the patients with hearing loss had no statistically significant difference in terms of the variables of age, gender, unilateral or bilateral ear involvement and type of SCD (p-value = 0.069).&#x0D; Conclusion: This study revealed a hearing loss frequency of 26% among patients with SCD. Regular hearing assessment and timely treatment and rehabilitation measures are recommended for these patients.

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.

Test-retest reliability of remote home-based audiometry in differing ambient noise conditions

BackgroundHome-based remote audiometry has been emerging due to the increasing accessibility of mobile technology and the need for healthcare solutions that are available worldwide. However, the challenges presented by uncontrolled conditions, such as noisy environments, could compromise the reliability of the hearing assessment.MethodIn this study, we evaluate the reliability of the Jacoti Hearing Center (JHC) smartphone application in differing ambient noise environments. Hearing test data were synchronized from the JHC application to the Jacoti earCloud database (JEC). We collected, de-identified, and analyzed real-world, home-based audiometric test data spanning from 2015 to 2023, extracted from the JEC database. A set of exclusion criteria was defined to perform data cleaning, ensuring the removal of incomplete and unreliable data, as well as, data from users who had completed a large number of tests. The final dataset comprised 9,421 test and retest threshold pairs from 1,115 users. Hearing tests conducted under relatively quiet and noisy conditions were categorized based on threshold-to-noise ratio.ResultsThe test-retest reliability of the JHC application demonstrated an average absolute difference of 4.7 dB within the range from 20 to 75 dB, ranging from 3.7 dB to 6.2 dB across frequencies. A strong positive correlation of 0.85 was found between test and retest thresholds. Moreover, the pure tone average differences were within 5 dB for 84.6% of the audiograms. No clinically significant effects of ambient noise were observed on thresholds determined between 20 and 75 dB HL.ConclusionsOur results demonstrate that the JHC application can provide reliable audiometric data for hearing loss, even in non-ideal acoustic conditions. This highlights the potential of home-based audiometric assessment, reinforcing the idea that, with continuous noise monitoring and noise-aware control of the testing procedure, remote audiometry can be reliable.