Audiological Tests Research Articles

Audiometry and doping control in competitive deaf sport

In the past forty years both the participating countries and the participants at the Summer Deaflympics Games have increased by 2.5-fold. Furthermore, there are approximately fifty European or World sports events organized for the hearing impaired. The aim of the paper was to discuss the procedures and requirements related to doping control in deaf people’s competitive sport in the context of the rising number of sports events and the participating athletes.For the sake of the fair play spirit of the dynamically developing deaf sports, The International Committee of Sports for the Deaf (ICSD) introduced rules governing the participation of hard-of-hearing athletes in sports events. Healthy individuals with a hearing loss of at least 55 dB are allowed. Thus, audiometric examination constitutes the first doping control criterion. Since 2004, ICSD has been cooperating with the World Anti-Doping Agency. The second criterion is, therefore, blood and urine sample control for prohibited substances. The 23rd Summer Deaflympics in 2017 involved 2858 athletes. Overall, 842 (29.5%) participants were randomly subjected to an audiological test; 9 competitors from different countries were disqualified because of non-compliance with the ICSD standards. A total of 300 randomly selected athletes underwent doping control for prohibited substances; 1 was disqualified. The world literature lacks scientific reports on deaf sports, including doping control.

Impact of Early Treatment With High-Dose Intravenous Immunoglobulin on Incidence of Kawasaki Disease Complications in Iranian Children.

Objective: Kawasaki disease (KD) occurs in five-year-old or younger children. This study aimed to evaluate the impact of high-dose intravenous immunoglobulin plus acetylsalicylic acid therapy on the prevention and treatment of coronary artery lesions and to evaluate the impact of high-dose acetylsalicylic acid (ASA) on the hearing of the patients. Materials and methods: In this retrospective cohort study, 31 patients with KD were followed from January 2012 to December 2015. The clinical, para-clinical, color Doppler echocardiogram and audiometry results were evaluated. Results: Overall, seven cases (22.6%) developed coronary artery aneurysm (CAA) in the acute phase of the disease, of whom only two still had CAA at the end of the treatment (6%). One of the five children with CAA recovery had a delay in the onset of treatment and one of two patients with persistent CAA at the end of treatment was admitted within the first 10 days. There was no evidence-based abnormal liver biochemical test. None of the patients developed sensorineural hearing loss (SNHL) on audiometry tests conducted before and after treatment. Conclusion: Recovery of coronary artery lesions was 71.43% after 28 days of the onset of treatment. The distribution of coronary artery aneurysm was not different in terms of the time of the treatment initiation (P-Value = 0.371). None of the children had a sensorineural hearing loss (SNHL) 48 hours and 4 weeks after treatment.

The effects of dyslipidemia on noise-induced hearing loss in petrochemical workers in the Southwest of Iran.

Research has shown that the decrease in the inner diameter of vessels caused by hyperlipidemia lowers the capacity for blood oxygen delivery to the cochlea. This leads to impaired cochlear metabolism and causes hearing problems. The effects of dyslipidemia on noise-induced hearing loss in workers were examined. This descriptive cross-sectional study was performed on 692 male employees in a petrochemical industry in the southwest of Iran exposed to 85 dB noise. Clinical audiometry and blood sample tests were used to evaluate the hearing and prevalence indices of dyslipidemia (cholesterol, triglyceride, HDL and LDL). The data were analyzed using SPSS software version 25 (p = 0.05). The results showed that the prevalence of dyslipidemia was 24.5% with abnormal relative triglyceride frequency of 49.5%, HDL of 28%, LDL of 33%, and total blood cholesterol level of 37.8%. There was no significant relationship between NIHL and dyslipidemia (p > 0.09). However, the major NIHL drops at different frequencies were in the individuals with dyslipidemia. The parameters age and dyslipidemia increased NIHL odds ratio (95% C.I.) by 1.130 (1.160-1.100) and 1.618 (2.418-1.082) respectively. The rate of hearing loss in individuals with dyslipidemia increases at different frequencies and it leads to an increase of the OR of NIHL in individuals with dyslipidemia. We can control dyslipidemia and its effective factors. The NIHL is more common in people exposed to noise.

Construction and Evaluation of a High-Frequency Hearing Loss Screening Tool for Community Residents.

Early screening and detection of individuals at high risk of high-frequency hearing loss and identification of risk factors are critical to reduce the prevalence at community level. However, unlike those for individuals facing occupational auditory hazards, a limited number of hearing loss screening models have been developed for community residents. Therefore, this study used lasso regression with 10-fold cross-validation for feature selection and model construction on 38 questionnaire-based variables of 4010 subjects and applied the model to training and testing cohorts to obtain a risk score. The model achieved an area under the curve (AUC) of 0.844 in the model validation stage and individuals’ risk scores were subsequently stratified into low-, medium-, and high-risk categories. A total of 92.79% (1094/1179) of subjects in the high-risk category were confirmed to have hearing loss by audiometry test, which was 3.7 times higher than that in the low-risk group (25.18%, 457/1815). Half of the key indicators were related to modifiable contexts, and they were identified as significantly associated with the incident hearing loss. These results demonstrated that the developed model would be feasible to identify residents at high risk of hearing loss via regular community-level health examinations and detecting individualized risk factors, and eventually provide precision interventions.

Newborn Hearing Screening: Analysing the Effectiveness of Early Detection of Neonatal Hearing Loss in a Hospital in Greece.

IntroductionThe introduction of newborn hearing screening programs (NHSP) has drastically contributed to the early diagnosis of hearing loss (HL) in children, with the prospect of children developing speech as early as possible. This retrospective study aims to present and discuss the preliminary results of the NHSP at the University Hospital of Patras, Greece, highlighting the strengths and weaknesses of the program. The evaluation of the implementation of NHSP is important to confirm the effectiveness of the process and elaborate system failures.MaterialsThe study describes the results of previous data collected from the NHSP in the Rio hospital of Patra and analyzed the conditions of the sample collected. The random sample involved newborns born between November 2018 - December 2020 at the University Hospital in Patra, Greece, which was assessed using transient evoked otoacoustic emissions (TEOAEs). Testing was performed twice per week on Thursday and Friday with a random sample, specifically examining the babies in the hospital these days. From the 2014 newborns assessed, 1491 were healthy neonates, while the other 523 required hospitalization in the neonatal unit.ResultsIn total, there were 2014 live births; 1491 healthy neonates were screened with TEOAEs. Of them, 44 did not pass the first test. After retesting one month later, 31 passed the test, while the other 13 were referred to a hearing centre for further audiological testing with auditory brainstem response (ABR) tests. Two infants never showed up for the follow-up appointment. Of the remaining 11, six infants had normal hearing, three had otitis media with effusion or other conductive HL. The last two infants had HL. Specifically, one had bilateral sensorineural HL greater than 40db, and one had unilateral sensorineural HL greater than 40db.Risk factors were identified in 523 newborns admitted to the unit. The most common risk factors identified were the use of ototoxic drugs, low Apgar scores, and prematurity. Of all the newborns, 491 passed the test the first time, and the rest 32 infants came back 1-2 months after leaving the neonatal unit. All the babies who had failed in the first screening test appeared for the follow-up appointment for the second screening test. Of these, 24 babies passed the test, but eight did not. Of these, four were diagnosed with media otitis with effusion or other conductive HL. Sensorineural HL was identified in the last four babies using ABR tests. In detail, two had unilateral sensorineural HL greater than 40db, while two had bilateral sensorineural HL greater than 40db.ConclusionIn conclusion, we found that for the NHS programs to be effective, they must be implemented long-term and have monetary support. Early diagnosis and cochlear implantation are the keys to excellent outcomes. Cooperation between different specialties and a patient-centred approach will help physicians holistically face neonatal HL. Building trust between the parents and doctor is essential for the program's success and reducing the lost-to-follow-up rate. To run a successful program, trained staff, equipment, and financial support are required. However, the gold standards for the success of the program are proper implementation of the program, close follow-up, strict adherence to the guidelines in the neonatal intensive care unit (NICU), and the early detection and diagnosis of HL.

Brain stem auditory evoked potential response in neonates after recovery from hyperbilirubinemia: A neurophysiological approach to screening neuronal hearing loss

Objectives: Neonatal hyperbilirubinemia leads to neurological damages including encephalopathy and hearing loss. This study aimed to screen and evaluate the hearing loss in neonates after recovery from hyperbilirubinemia using the Brainstem evoked response audiometry (BERA) test. Materials and Methods: This cross-sectional comparative study was conducted in Physiology Department at Chitwan Medical College, Nepal. It included 20 age and sex-matched neonates recently recovered from hyperbilirubinemia and 20 normal healthy controls. The external acoustic canals of subjects were checked for any blockage or collapse before BERA testing. The BERA recordings were performed after the neonate’s natural sleep following a standard lab protocol explained by Taylor’s Evoked Potential in Clinical Testing. Results: The BERA wave latencies were delayed with a higher number of case group neonates I (IL-75%, IR-80%), III (IIIL-70%, III R-80%), and V (VL-80%, VR-85%) than those of controls. The percentage of neonates with delayed interwave latencies was comparable between groups. The neonate’s hearing sensitivity assessed using the grades of hearing impairment by WHO revealed slight (threshold of hearing left ear [THL]-25% and threshold of hearing right ear [THR]-30%) and moderate (THL-40% and THR-35%) grades among cases whereas no impairment (THL-60% and THR-55%) in controls. The hearing thresholds were more in cases. Conclusion: The auditory pathway is highly sensitive to elevated serum bilirubin. BERA detects even a minute degree of hearing damage seen after complete treatment of hyperbilirubinemia. Therefore, BERA is a helpful tool in the early screening of hearing impairment in neonates. This improves prognosis by early management so that the neurosensory systems develop to their full extent and one can enjoy a normal social life.

Investigation of the Interaction between Hearing Function and Comorbidities in Adults Living with Human Immunodeficiency Virus.

Adults living with the human immunodeficiency virus (HIV) have a high prevalence of co-existing comorbidities. While research indicates that adults living with HIV are at risk of developing hearing impairment, limited research exists on the interaction between hearing function and comorbidities in this population. The objective of this study was to determine and compare the hearing function of a group of adults living with HIV and comorbidities and those without comorbidities. A sample of 132 adults living with HIV underwent a basic audiological test battery to assess their hearing function. Participants with comorbidities were 1.23 times more likely to develop hearing loss, with crude odds of 1.236 (95%CI 0.5467 to 2.795), while those with three comorbidities were 2.52 times more likely to develop hearing loss. Participants with hypertension were 93% more likely to develop hearing loss when compared to nonhypertensive participants (OR = 1.928; 95%CI: 0.7856 to 4.7345). There was only a marginal association between hypercholesterolemia and sensorineural hearing loss (SNHL), with no association between other comorbidities and the type of hearing loss. The current findings raise a need for prioritizing patients with comorbidities in audiological assessment and monitoring in resource-constrained contexts, where capacity versus demand challenges might prevent the provision of audiological services to all adults living with HIV. These findings also highlight the importance of preventive care in this population with regard to the burden of the disease, as it may lead to worse ear and hearing outcomes for affected individuals.

Experience with an Affective Robot Assistant for Children with Hearing Disabilities.

This study presents an assistive robotic system enhanced with emotion recognition capabilities for children with hearing disabilities. The system is designed and developed for the audiometry tests and rehabilitation of children in a clinical setting and includes a social humanoid robot (Pepper), an interactive interface, gamified audiometry tests, sensory setup and a machine/deep learning based emotion recognition module. Three scenarios involving conventional setup, tablet setup and setup with the robot+tablet are evaluated with 16 children having cochlear implant or hearing aid. Several machine learning techniques and deep learning models are used for the classification of the three test setups and for the classification of the emotions (pleasant, neutral, unpleasant) of children using the recorded physiological signals by E4 wristband. The results show that the collected signals during the tests can be separated successfully and the positive and negative emotions of children can be better distinguished when they interact with the robot than in the other two setups. In addition, the children’s objective and subjective evaluations as well as their impressions about the robot and its emotional behaviors are analyzed and discussed extensively.

Evaluation of hematological parameters of patients with profound unilateral and mild to profound bilateral sensorineural hearing loss

OBJECTIVE: This study aimed to investigate whether changes in blood cells have an effect on sensorineural hearing loss (SNHL) and compare the hematological parameters of profound unilateral and mild to profound bilateral SNHL patients and the normal population. METHODS: This retrospective study included 100 SNHL patients (81 males, 19 females; mean age: 37.8±16.8 years; range, 18 to 83 years) and 32 healthy volunteers (22 males, 10 females; mean age: 32.8±5.7 years; range 22 to 46 years) between January 2018 and February 2019. Patients who underwent pure tone audiometry and auditory brainstem response (ABR) tests for any reason and were found to have SNHL with no accompanying disease, and those that are non-smokers and without medication were included. Hematological parameters were evaluated in all three groups. RESULTS: Of the 100 SNHL patients, 59 had bilateral and 41 had profound unilateral SNHL. Among the evaluated hematological parameters, the difference in red blood cell count, hematocrit, hemoglobin, platelet distribution width, and neutrophil to lymphocyte ratio (NLR) between the groups was statistically significant (p<0.001). CONCLUSION: Erythrocyte values were high in patients with profound unilateral SNHL, whereas platelet-related values [platelet count, PDW, and platelet to lymphocyte ratio) were higher in patients with bilateral SNHL. In addition, the NLR was found to be high in these patient groups. These findings may provide a treatment target, particularly for profound unilateral SNHL, and may shed light on further studies on SNHL.

Approaches to Treat Sensorineural Hearing Loss by Hair-Cell Regeneration: The Current State of Therapeutic Developments and Their Potential Impact on Audiological Clinical Practice.

Sensorineural hearing loss (SNHL) is typically a permanent and often progressive condition that is commonly attributed to sensory cell loss. All vertebrates except mammals can regenerate lost sensory cells. Thus, SNHL is currently only treated with hearing aids or cochlear implants. There has been extensive research to understand how regeneration occurs in nonmammals, how hair cells form during development, and what limits regeneration in maturing mammals. These studies motivated efforts to identify therapeutic interventions to regenerate hair cells as a treatment for hearing loss, with a focus on targeting supporting cells to form new sensory hair cells. The approaches include gene therapy and small molecule delivery to the inner ear. At the time of this publication, early-stage clinical trials have been conducted to test targets that have shown evidence of regenerating sensory hair cells in preclinical models. As these potential treatments move closer to a clinical reality, it will be important to understand which therapeutic option is most appropriate for a given population. It is also important to consider which audiological tests should be administered to identify hearing improvement while considering the pharmacokinetics and mechanism of a given approach. Some impacts on audiological practice could include implementing less common audiological measures as standard procedure. As devices are not capable of repairing the damaged underlying biology, hair-cell regeneration treatments could allow patients to benefit more from their devices, move from a cochlear implant candidate to a hearing aid candidate, or move a subject to not needing an assistive device. Here, we describe the background, current state, and future implications of hair-cell regeneration research.

Effects of demographic, audiologic, and hearing-aid-related variables on the outcomes of using hearing aids.

To examine the influence of demographic, audiologic, and hearing-aid (HA)-related variables on HA outcomes. In total, 235 adults with hearing loss (HL) who used HAs for at least 3months were included in the study, and completed audiologic tests and the Chinese version of the International Outcome Inventory for Hearing Aids (IOI-HA). Spearman correlation analysis and Wilcoxon test were conducted to identify factors related to IOI-HA overall and subscales scores. Stepwise multiple linear regression analysis was subsequently performed to determine the influence of factors on HA outcomes. Age, daily use time, HA price, pure tone average (PTA) threshold, word recognition score (WRS), fitting (bilateral or unilateral), and HA style were associated with IOI-HA overall and subscales scores. However, only WRS, daily HA use time, HA price, and age entered the final regression model and were factors determining HA outcomes. HA outcome is a multi-dimensional construct. In this study, WRS had the greatest influence on HA outcomes and seemed to be a primary predictor. Thus, HA owners with a higher WRS before HA fitting may indicate better satisfaction. Daily use time, HA price, and patient age also made significant contributions to HA outcomes and should be considered in clinical practice to facilitate auditory rehabilitation.

Can prestin level be a biomarker for determining sensorineural hearing loss?

ObjectiveTo determine prestin levels in patients with sensorineural hearing loss and to assess whether the prestin level could be a determining factor in predicting sensorineural hearing loss. Material and methodsThe study was carried out with patients that presented to the Department of Otorhinolaryngology of Fırat University. Patients were divided into four groups of 30 subjects. Group 1: individuals aged ≥55 years with no hearing loss (control group); Group 2: individuals aged 20 to 55 years with no hearing loss (control group); Group 3: individuals aged 20 to 55 years with sensorineural hearing loss; Group 4: individuals aged ≥55 years with presbycusis.Following an audiometry examination, 5 cc blood was taken from all patients to assess serum prestin levels. ResultsPrestin levels were 445.32 pg/mL in Group 1; 452.79 pg/mL in Group 2; 123.64 pg/mL in Group 3; and 79.54 pg/mL in Group 4. No difference was found between the serum prestin levels of the younger patients with hearing loss (Group 3)] and of the patients with presbycusis (Group 4) (p=0.084). No difference was found between the serum prestin levels of the younger (Group 1) and the older (Group 2) patients with presbycusis (p=0.399). Significant differences (with higher levels in the control groups) were found in between the prestin levels of between Group 3 (the younger patients with sensorineural hearing loss) and Group 2 (younger controls), and between Group 4 (older patients with presbycusis) and Group 1 (older controls) (p<0.001 and p <0.001, respectively). ConclusionSerum prestin levels can be used as biomarkers for assessing patients with presbycusis and sensorineural hearing loss. They can also be used together with audiometry tests to predict the patient's potential level of hearing loss.

A KCNQ4 c.546C>G Genetic Variant Associated with Late Onset Non-Syndromic Hearing Loss in a Taiwanese Population.

Clinical presentation is heterogeneous for autosomal dominant nonsyndromic hearing loss (ADNSHL). Variants of KCNQ4 gene is a common genetic factor of ADNSHL. Few studies have investigated the association between hearing impairment and the variant c.546C>G of KCNQ4. Here, we investigated the phenotype and clinical manifestations of the KCNQ4 variant. Study subjects were selected from the participants of the Taiwan Precision Medicine Initiative. In total, we enrolled 12 individuals with KCNQ4 c.546C>G carriers and 107 non-carriers, and performed pure tone audiometry (PTA) test and phenome-wide association (PheWAS) analysis for the patients. We found that c.546C>G variant was related to an increased risk of hearing loss. All patients with c.546C>G variant were aged >65 years and had sensorineural and high frequency hearing loss. Of these patients, a third (66.7%) showed moderate and progressive hearing loss, 41.7% complained of tinnitus and 16.7% complained of vertigo. Additionally, we found a significant association between KCNQ4 c.546C>G variant, aortic aneurysm, fracture of lower limb and polyneuropathy in diabetes. KCNQ4 c.546C>G is likely a potentially pathogenic variant of ADNSHL in the elderly population. Genetic counseling, annual audiogram and early assistive listening device intervention are highly recommended to prevent profound hearing impairment in this patient group.

English

BACKGROUND Dentists are liable to loss of hearing during dental treatment due to noise exposure. A study was carried out to determine whether or not dental professionals from the Department of Periodontics, Conservative Dentistry and Endodontics and Prosthodontics ought to cause hearing decrement with the aid of using continual excessive frequency sounds created by dental equipments. METHODS This study involved 38 dentists from the specialities of Periodontics, Conservative Dentistry and Endodontics, and Prosthodontics who were subjected to noise during operating for 6 hours per day and 38 medical professionals who were matched served as a control group. Three audiometric examinations included an otoscopic exam; tympanometry and pure tone audiometry were performed by the participants. RESULTS According to the data, 15.8 % of dentists and 2.6 % of the control group suffered from loss of hearing. In the pure tone audiometry test, there was no substantial difference between the two groups; however, the qualitative analysis showed that the dentists' group had a greater percentage of hearing loss than their control counterparts. In the pure tone audiometry test, there was a statistically significant difference between the specialists from periodontics, conservative dentistry and endodontics, and prosthodontics (P = 0.005). CONCLUSIONS Noise from dental clinics has been shown to cause hearing problems, with the left ear being affected when compared to that of the right; again, these problems aren't serious. Dentists were common among noise-induced hearing impairment and periodontic specialists than conservative dentistry and endodontics, and prosthodontic specialists than the control group. KEY WORDS Dental Professionals, Long Term Exposure, Noise-Induced Hearing Loss, Pure Tone Audiometry.

Magnetic resonance imaging: Role on diagnosing all types of endolymphatic hydrops

This study utilized the recently advanced technique in MR imaging to establish its role on diagnosing all types of endolymphatic hydrops (EH). Twenty-two patients (26 ears) with clinical EH were admitted due to acute hearing loss and/or vertiginous attack. Each patient underwent an inner ear test battery comprising audiometry, cervical and ocular vestibular-evoked myogenic potential tests, and caloric test, followed by MR imaging for confirmation. Of the 22 clinical EH patients, 12 patients were referred to primary EH (Meniere's disease), 8 patients were secondary EH (including delayed EH in 5), and 2 patients were EH of embryopathic origin. MR imaging of 26 affected ears demonstrated EH in the cochlea only for 14 ears, in the utricle and saccule only for 1 ear, and in all three endorgans for 3 ears, accounting for a sensitivity of 69% (18/26). The 8 affected ears showing negative MR images were EH patients with hearing recovery 1, just after vertiginous attack 3, and chronic low-tone hearing loss 4. In contrast, 3 out of 18 unaffected ears demonstrated asymptomatic EH in the cochlea, representing a specificity of 83% (15/18). The sensitivity and specificity of MR imaging for confirming all types of EH were 69% and 83%, respectively. Although diagnostic criteria can identify primary and delayed EH, MR imaging may provide a supplementary tool for diagnosing secondary, embryopathic, or asymptomatic EH, if patients are not with hearing recovery, chronic low-tone hearing loss, or just after vertiginous attack.

Auditory manifestations in HIV-infected children at a state hospital in South Africa

Objective To determine the prevalence and risk factors for developing ear disease and hearing loss (HL) in children living with HIV/AIDS (CLWHA). Methods This was a cross-sectional survey where participants underwent an otoscopic examination and an otoacoustic emissions screening (<6-years-old) or smartphone-based pure tone audiometry (>6-years-old) test. Prevalence data were analyzed using descriptive statistics while multivariate logistic regression identified the risk factors for developing ear disease/HL. Results Forty-one participants aged 3–12-years-old (22 males and 19 females) took part in this study. Twenty participants (48.7%) presented with ear disease including otitis media (n = 9, 22%), cerumen impaction (n = 10, 23%), and tympanic membrane perforation (n = 1, 2.4%). HL was observed in 13 participants (32%). Lower CD4 count, longer duration of HIV infection, shorter duration on ART treatment, and concomitant tuberculosis (TB) infection were (p < .05) all associated with ear diseases. Conclusion A high prevalence of ear disease and HL was found in CLWHA, which indicated the need for ear and hearing screening to be incorporated into 3-monthly consultations with CLWHA; to enable early detection and intervention and prevent the associated negative impacts. A multidisciplinary team approach to the management of CLWHA, specifically the inclusion of audiologists, and the use of mHealth in resource-constrained settings is highly recommended.

Validation of a Personalized Hearing Screening Mobile Health Application for Persons with Moderate Hearing Impairment.

Hearing impairment is a frequent human sensory impairment. It was estimated that over 50% of those aged >75 years experience hearing impairment in the United States. Several hearing impairment–related factors are detectable through screening; thus, further deterioration can be avoided. Early identification of hearing impairment is the key to effective management. However, hearing screening resources are scarce or inaccessible, underlining the importance of developing user-friendly mobile health care systems for universal hearing screening. Mobile health (mHealth) applications (apps) act as platforms for personalized hearing screening to evaluate an individual’s risk of developing hearing impairment. We aimed to evaluate and compare the accuracy of smartphone-based air conduction and bone conduction audiometry self-tests with that of standard air conduction and bone conduction pure-tone audiometry tests. Moreover, we evaluated the use of smartphone-based air conduction and bone conduction audiometry self-tests in conductive hearing loss diagnosis. We recruited 103 patients (206 ears) from an otology clinic. All patients were aged ≥20 years. Patients who were diagnosed with active otorrhea was excluded. Moderate hearing impairment was defined as hearing loss with mean hearing thresholds >40 dB. All patients underwent four hearing tests performed by a board-certified audiologist: a smartphone-based air conduction audiometry self-test, smartphone-based bone conduction audiometry self-test, standard air-conduction pure-tone audiometry, and standard bone conduction pure-tone audiometry. We compared and analyzed the results of the smartphone-based air conduction and bone conduction audiometry self-tests with those of the standard air conduction and bone conduction pure-tone audiometry tests. The sensitivity of the smartphone-based air conduction audiometry self-test was 0.80 (95% confidence interval CI = 0.71–0.88) and its specificity was 0.84 (95% CI = 0.76–0.90), respectively. The sensitivity of the smartphone-based bone conduction audiometry self-test was 0.64 (95% CI = 0.53–0.75) and its specificity was 0.71 (95% CI = 0.62–0.78). Among all the ears, 24 were diagnosed with conductive hearing loss. The smartphone-based audiometry self-tests correctly diagnosed conductive hearing loss in 17 of those ears. The personalized smartphone-based audiometry self-tests correctly diagnosed hearing loss with high sensitivity and high specificity, and they can be a reliable screening test to rule out moderate hearing impairment among the population. It provided patients with moderate hearing impairment with personalized strategies for symptomatic control and facilitated individual case management for medical practitioners.

The comprehensive audiological evaluation in young violinists: the medial olivocochlear system, high frequency thresholds, and the auditory figure ground test.

The aim of this study was to examine whether the medial olivocochlear hearing system functions, the high frequency hearing thresholds and speech discrimination in noise performance can guide us in assessing the risk of hearing loss among violinists. It is aimed to investigate possible hearing damage that is not reflected in pure tone hearing thresholds in violinists. The participants (n = 50) who have normal hearing and the ages of 18-30 were included in this study in two groups: violinists and controls who are unrelated to music. High frequency audiometer, auditory figure ground test (AFG) for speech discrimination in noise performance, Distortion Product Otoacoustic Emission (DPOAE) and contralateral suppression on DPOAE for medial olivocochlear system function tests were applied to all participants as well as routine audiological tests. The high frequency hearing thresholds were obtained higher in violinists compared to the controls. In violinists, the AFG test scores and the suppression amount at 1kHz were lower than the controls. In addition, DPOAE responses at 4-6kHz were obtained lower in violinists (p < 0.05). The reason for high frequency hearing loss, decreased DPOAE response amplitudes, and poor medial olivocochlear function in violinists can be explained by the long-term exposure to high-level noise caused by the violin, one of the closest musical instruments. Routine and comprehensive audiological follow-up is crucial for musicians.

Effectiveness of hearing protection apparatus in preventing noise induced vestibular loss

ABSTRACT Hearing protection apparatus (HPAs) are frequently used to prevent the detrimental effect of noise on the hearing system. However, it is not known exactly whether wearing HPAs in workers protects the vestibular system. This study aims to investigate the effectiveness of wearing HPAs in preventing vestibular loss caused by noise. Eighty-one workers exposed to chronic noise were divided into three groups according to their HPAs wearing status. Pure-tone audiometry test was used to evaluate the hearing. Caloric test and visual analogue scale were used to evaluate their vestibular systems. The pure-tone average of the workers who constantly wore HPAs was better than that of the other groups (p< 0.05). There was no difference between the groups in the vestibular tests (p > 0.05). This study demonstrated that HPAs do not protect the vestibular system but protect the hearing system in the inner ear from the harmful effects of noise

Familial Temperature-Sensitive Auditory Neuropathy: Distinctive Clinical Courses Caused by Variants of the OTOF Gene.

Objective: To investigate the clinical course and genetic etiology of familial temperature-sensitive auditory neuropathy (TSAN), which is a very rare subtype of auditory neuropathy (AN) that involves an elevation of hearing thresholds due to an increase in the core body temperature, and to evaluate the genotype–phenotype correlations in a family with TSAN.Methods: Six members of a non-consanguineous Chinese family, including four siblings complaining of communication difficulties when febrile, were enrolled in this study. The clinical and audiological profiles of the four siblings were fully evaluated during both febrile and afebrile episodes, and the genetic etiology of hearing loss (HL) was explored using next-generation sequencing (NGS) technology. Their parents, who had no complaints of fluctuating HL due to body temperature variation, were enrolled for the genetics portion only.Results: Audiological tests during the patients’ febrile episodes met the classical diagnostic criteria for AN, including mild HL, poor speech discrimination, preserved cochlear microphonics (CMs), and absent auditory brainstem responses (ABRs). Importantly, unlike the pattern observed in previously reported cases of TSAN, the ABRs and electrocochleography (ECochG) signals of our patients improved to normal during afebrile periods. Genetic analysis identified a compound heterozygous variant of the OTOF gene (which encodes the otoferlin protein), including one previously reported pathogenic variant, c.5098G > C (p.Glu1700Gln), and one novel variant, c.4882C > A (p.Pro1628Thr). Neither of the identified variants affected the C2 domains related to the main function of otoferlin. Both variants faithfully cosegregated with TSAN within the pedigree, suggesting that OTOF is the causative gene of the autosomal recessive trait segregation in this family.Conclusion: The presence of CMs with absent (or markedly abnormal) ABRs is a reliable criterion for diagnosing AN. The severity of the phenotype caused by dysfunctional neurotransmitter release in TSAN may reflect variants that alter the C2 domains of otoferlin. The observations from this study enrich the current understanding of the phenotype and genotype of TSAN and may lay a foundation for further research on its pathogenesis.