Auditory Brainstem Response Testing Research Articles

Hearing loss and impaired short-term memory in an Alzheimer's disease mouse model of amyloid-beta pathology

Current evidence supports the link between hearing loss and Alzheimer's disease (AD). However, few studies report the hearing status of AD mice compared to wild-type mice. This study aimed to compare hearing thresholds and short-term memory (STM) performance of an AD (APPNL-G-F) mouse model of amyloid-beta (Aꞵ) pathology with C57BL/6 J and CBA/CaJ mice across age. The auditory brainstem response (ABR) test, using click and five tone-burst (TB) stimuli, was recorded at 2, 4, 6, 9, and 12 months. The novel object recognition (NOR) test, a measure of STM, was conducted at 6 and 12 months. While hearing thresholds were almost preserved in CBA/CaJ mice, they were not recorded at high frequencies with age in C57BL/6 J and AD mice, leading to island hearing (severe to profound hearing loss) at 9 and 12 months. AD mice showed increased hearing thresholds in TB8 and TB16 kHz at 6 and 9 months compared to C57BL/6 J mice. NOR findings were evidence of impaired STM in both C57BL/6 J and AD mice relative to CBA/CaJ mice, and a relationship was found between hearing thresholds and NOR measures in three groups. The findings were in support of the link between the degree of hearing loss and impaired STM.

Apoptotic vesicles resist oxidative damage in noise-induced hearing loss through activation of FOXO3a-SOD2 pathway

BackgroundMesenchymal stem cell (MSC) transplantation is a promising therapeutic approach for noise-induced hearing loss (NIHL). As the indispensable role of apoptosis in MSC transplantation was raised, the benefits of MSC-derived apoptotic vesicles (apoVs) in several disease models have been proved. However, whether apoVs benefit in NIHL have not been studied yet.MethodsFemale CBA/J mice and HEI-OC1 cells were used in this study. Flow cytometry, nanoparticle tracking analysis (NTA) and transmission electron microscopy (TEM) were used to characterize apoVs. Proteomic analysis was used to identify function proteins in apoVs. Immunofluorescence was used to reveal distribution pattern. Auditory brainstem response (ABR) test was used to measure the effect of apoVs treatment. DCFH-DA staining and MitoSOX staining were used to indicate oxidative damage. Western-blot and qRT-PCR were used to study the signaling pathways.ResultsWe found that apoVs can be endocytosed by hair cells through systemic administration. Importantly, apoVs administration effectively attenuated NIHL and reduced hair cell loss by resisting oxidative damage in vivo. Further, apoVs application activated forkhead box o3 (FOXO3a)—mitochondrial superoxide dismutase 2(SOD2) pathway, which may relate to signal transduction and activators of transcription 3 (STAT3) in apoVs.ConclusionsThese findings uncovered the role of apoVs in preventing NIHL and resisting oxidative damage, indicating that apoVs is a promising way for inner ear delivery and a prospective cell-free therapy for NIHL.

Predicting Behavioral Threshold at 6 and 8 kHz for Children and Adults Based on the Auditory Brainstem Response.

Common clinical application of auditory brainstem response (ABR) testing is limited to 0.25-4 kHz. Prior research has demonstrated associations between ABR and behavioral thresholds for tone burst stimuli > 4 kHz in adults, but there are no comparable data for children. The ability to predict behavioral thresholds > 4 kHz clinically based on the ABR would provide valuable audiologic information for individuals who are unable to provide behavioral thresholds. This study included children with hearing loss and children with normal hearing to determine the association between ABR and behavioral thresholds at 6 and 8 kHz. ABR and behavioral thresholds were obtained for children ages 4.7-16.7 years (M = 10.5, SD = 3.4) with sensorineural hearing loss (n = 24) or normal hearing sensitivity (n = 16) and for adults ages 18.4-54.4 years (M = 32.7, SD = 10.4) with sensorineural hearing loss (n = 13) or normal hearing sensitivity (n = 11). Thresholds obtained for 6 and 8 kHz using ABR and conventional audiometry were compared. Differences between ABR and behavioral thresholds averaged 5-6 dB for both children and adults for both test frequencies, with differences of ≤ 20 dB in all instances. Linear mixed modeling for data from participants with hearing loss suggested that ABR threshold is a good predictor of behavioral threshold at 6 and 8 kHz for both children and adults. Test specificity was 100%; no participants with behavioral thresholds ≤ 20 dB HL had ABR thresholds > 25 dB nHL. Initial evidence suggests that ABR testing at 6 and 8 kHz is reliable for estimating behavioral threshold in listeners with hearing loss and accurately identifies normal hearing sensitivity. The results of this study contribute to efforts to improve outcomes for vulnerable populations by reducing barriers to clinical implementation of ABR testing at > 4 kHz.

Behavioral and functional assessment of mice inner ear after chronic exposure to an ultrahigh B0 field of 11.7 T or 17.2 T.

Assess short-term and long-term effects of chronic exposure to an ultrahigh static magnetic (B0 ) field on mice inner ear in the context of MR safety of human scanning at 11.7 T. Mice were chronically exposed to a B0 field of 11.7 T or 17.2 T during ten 2-h exposure sessions evenly distributed over a period of 5 weeks, resulting in a total of 20 h of exposure per mouse. During exposure sessions, mice were anesthetized and positioned either parallel or antiparallel to B0 . Before, during, and 2 weeks after the magnetic-field exposure period, mice performed behavioral tests (balance beam, rotarod, and swim tests) to evaluate their short-term and long-term motor coordination and balance. An auditory brainstem response (ABR) test was finally performed to assess the functional integrity of mice cochlea, 2 weeks after the last exposure. After awaking from anesthesia following B0 exposures at 11.7 Tor 17.2 T, mice displayed a transient (<5 min) rotating behavior. The behavioral tests did not show any difference between the exposed and the control mice at any time point. Determination of ABR thresholds did not reveal an impairment of cochlea hair cells resulting from chronic B0 exposure. Despite the transient disturbance of mice vestibular system observed immediately after B0 exposure, no short-term nor long-term alteration was detected with behavioral and ABR tests.

Amelioration of Sensorineural Hearing Loss through Regulation of Trpv1, Cacna1h, and Ngf Gene Expression by a Combination of Cuscutae Semen and Rehmanniae Radix Preparata

Sensorineural hearing loss (SNHL) is a common condition that results from the loss of function of hair cells, which are responsible for converting sound into electrical signals within the cochlea and auditory nerve. Despite the prevalence of SNHL, a universally effective treatment has yet to be approved. To address this absence, the present study aimed to investigate the potential therapeutic effects of TS, a combination of Cuscutae Semen and Rehmanniae Radix Preparata. To this end, both in vitro and in vivo experiments were performed to evaluate the efficacy of TS with respect to SNHL. The results showed that TS was able to protect against ototoxic neomycin-induced damage in both HEI-OC1 cells and otic hair cells in zebrafish. Furthermore, in images obtained using scanning electron microscopy (SEM), an increase in the number of kinocilia, which was prompted by the TS treatment, was observed in the zebrafish larvae. In a noise-induced hearing loss (NIHL) mouse model, TS improved hearing thresholds as determined by the auditory brainstem response (ABR) test. Additionally, TS was found to regulate several genes related to hearing loss, including Trpv1, Cacna1h, and Ngf, as determined by quantitative real-time polymerase chain reaction (RT-PCR) analysis. In conclusion, the findings of this study suggest that TS holds promise as a potential treatment for sensorineural hearing loss. Further research is necessary to confirm these results and evaluate the safety and efficacy of TS in a clinical setting.

Abstract 5062: Small molecule superoxide dismutase mimetic avasopasem manganese for the mitigation of cisplatin induced ototoxicity

Abstract Introduction: Avasopasem manganese (GC4419) is a selective superoxide dismutase mimetic which has recently completed a Phase 3 clinical trial (NCT03689712) demonstrating a significant reduction in the severity of oral mucositis in patients receiving standard cisplatin and radiotherapy for head and neck squamous cell carcinoma (HNSCC). Up to 66% of HNSCC patients experience ototoxicity from platinum-based chemotherapy, resulting in tinnitus and hearing loss. The analysis of clinical trial data also revealed that patients treated with GC4419 in addition to cisplatin (cis) and radiotherapy reported less tinnitus than those treated with standard therapy alone. The generation of reactive oxygen species has long been recognized as an important contributor to cis-induced hearing loss; therefore, we hypothesize that administration of GC4419 with cisplatin can prevent ototoxicity by scavenging superoxide. Results: Organotypic cultures using postnatal day 2 or 3 mouse cochlea were treated with cis 4 µM and 0.5, 2, or 4 µM GC4419 for 24 hours. The explants were then stained for anti-myosin-VIIa. Hair cells were counted, and it was determined that 4 µM cis was sufficient to cause a decrease in hair cell numbers and GC4419 dose as low as 2 µM protected against this biological endpoint. To assess the effects of GC4419 on hearing loss in vivo, CBA/CaJ mice were treated as follows: 5 mice (1 female, 4 males) received 3 mg/kg cis IP, 4 mice (2 males and 2 females) received vehicle, 3 mice (2 females, 1 males) received 10 mg/kg IP GC4419, and 5 mice (2 females, 3 males) were treated with GC4419 10 minutes prior to cisplatin injection. Cis and GC4419 were administered for four consecutive days followed by two days of GC4419. The animals were allowed 8 recovery days, with Normosol SQ and high calorie food administered, prior to a second repetition of the treatment cycle. This protocol for cis dosing was found to be lethal in three mice in the cisplatin only group. Auditory brainstem response testing was performed before and after treatment, revealing elevated hearing thresholds in cis treated mice but not in mice treated with GC4419 and cis. Additionally, the cis treatment group experienced greater weight loss than the mice treated with GC4419 and cis Separately, in an H1299 tumor xenograft model in nu/nu mice, GC4419 5 mg/kg IP BID over 14 days was shown not to interfere with, and in fact somewhat increased, the tumor growth delay with cis 5 mg/kg IP QW x 3. Conclusion: These results support the hypothesis that treatment with the SOD mimetic GC4419 can reduce cis induced ototoxicity by scavenging superoxide and justify further studies to determine if this mechanism based approach can be implemented in cancer therapy. (Supported by a sponsored research agreement between the University of Iowa and Galera Therapeutics, Inc.) Citation Format: Keegan A. Christensen, Osama Tarabichi, Sei Sho, Hidaly Hernández, Bryce Hunger, Melissa A. Fath, Jeffery Keene, Robert Beardsley, Marlan Hansen, Douglas R. Spitz. Small molecule superoxide dismutase mimetic avasopasem manganese for the mitigation of cisplatin induced ototoxicity. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 5062.

Audiology for the Neurosurgeon

Many conditions that neurosurgeons manage are associated with audiologic symptoms. Unilateral hearing loss and tinnitus, poor suprathreshold speech understanding, and dizziness are hallmarks of retrocochlear lesions. Understanding the difference between air and bone conduction thresholds and the importance of speech discrimination helps differentiate types of hearing loss and their neurological importance. Acoustic reflex, otoacoustic emissions, and auditory brainstem response testing are objective measures used to determine function of the auditory structures. Accurate interpretation of these results can aid neurosurgeons in making differential diagnoses and determining surgical approaches. Cooperation among neurosurgeons, otolaryngologists, and audiologists ensures abnormal auditory symptoms are assessed correctly.

Is intrauterine exposure to COVID-19 infection a risk factor for infant hearing loss?

PurposeTo determine whether exposure to intrauterine COVID-19 infection causes congenital or late-onset hearing loss in infants. Material and methodThe hearing screening results of infants born in a tertiary hospital between March 2020 and April 2022 with and without a history of intrauterine exposure to COVID-19 infection (36 infants each) were retrospectively analyzed within one month after birth in all infants and additionally at six months after intrauterine COVID-19 infection exposure in the study group. The automated auditory brainstem response (AABR) test was used for the hearing evaluation. ResultsThe polymerase chain reaction test was negative in study group exposed to intrauterine COVID-19 infection. The number of infants admitted to the intensive care unit (ICU), and the length of ICU stay were significantly higher in this group (p < 0.01). Six infants (16.6 %) in the study group failed the first AABR test bilaterally, but five of these infants passed the second AABR test. A bilateral severe sensorineural hearing loss was detected in one infant (2.77 %). All the infants in the study group underwent the AABR test again at six months, and all infants, except this infant, passed the test. In the control group, five infants (13.88 %) failed the first AABR test bilaterally, but they all passed the second test. ConclusionsExposure to COVID-19 infection in the intrauterine period does not cause congenital or late-onset hearing loss (within six months) in infants; therefore, gestational COVID-19 infection is not a risk factor for infant hearing loss.

Auditory brainstem responses to peaky speech using zero- versus chirp-phases

Auditory brainstem responses (ABR) are used to identify hearing loss across multiple frequency bands in young children. ABRs typically use brief tonebursts or chirps, but we recently created a “peaky” speech method that uses stories to evoke ABRs—an engaging stimulus that may facilitate testing in infants and toddlers who cannot nap, sit still, or participate in behavioral testing. This study aimed to determine which phase profile (zero versus chirp) of multiband peaky speech evokes the largest ABRs in the fastest recording time. Fifteen adults with normal hearing listened to an hour each of zero- and chirp-phase multiband peaky speech while 2-channel ABRs were recorded. Overall, ABR wave V amplitudes were larger for chirp- than zero-phase multiband peaky speech, especially for lower frequency responses, and took 30 versus &amp;gt;60 minutes for all responses in the 5 bands (0.5–8kHz) and both ears to reach a criterion signal-to-noise ratio. In summary, chirp-phase peaky speech provided larger—and thus, more effective and efficient—multiband ABRs than zero-phase peaky speech for ABR testing using continuous speech. Reducing testing time in half will be important for future application as an ABR hearing screener in toddlers using engaging stories. [Work funded by Hearing Health Foundation ERG.]

Analysis of the Latency of Auditory Brainstem Response Wave V in Infants According to Age, Hearing Threshold and Stimulus Intensity

Background and Objectives The latency of auditory brainstem response (ABR) wave V shifts depending on age, hearing threshold, and stimulus intensity. This study was performed to examine the latencies of ABR wave V in infants with normal hearing and sensorineural hearing loss.Subjects and Method The retrospective review of ABR of 318 infants (539 ears) was performed. The patients were divided into four groups according to age at the time of the ABR test (group A: 0-2 months, group B: 3-5 months, group C: 6-8 months, and group D: 9-11 months). The test was performed using click sound under sedation, with the stimulus intensity adjusted by 10 dB intervals. The latency of wave V was analyzed according to age, hearing threshold, and stimulus intensity.Results Normal hearing was detected in 320 ears (wave V threshold of 20 dBnHL or less) and sensorineural hearing loss was found in 219 ears. Wave V latencies decreased with increase in age and stimulus intensity in both normal hearing infants and hearing-impaired infants. The ears with higher thresholds showed longer latencies at the same stimulus intensity. The normative data of wave V latency of infants with varying hearing thresholds according to age and stimulus intensity could be determined.Conclusion The present study examined the latencies of ABR wave V of hearing-impaired and normal hearing infants according to age and stimulus intensity. The data will help audiologists to evaluate the hearing of infants who are referred for ABR test.

Newborn Hearing Screening Results in Patients with Enlarged Vestibular Aqueduct.

Enlarged vestibular aqueduct (EVA) is the most common anatomic abnormality contributing to permanent hearing loss (HL) in children. Although the association between EVA and HL is well-documented, the pass rate for the newborn hearing screening (NBHS) for patients with EVA-related HL is not. Our objective was to investigate the association between NBHS results and audiologic and clinical outcomes in a large cohort of pediatric patients with EVA. This was a retrospective chart review of patients seen in the Boston Children's Hospital (BCH) Department of Otolaryngology and Communication Enhancement with confirmed HL, known NBHS results, and confirmed EVA. Demographic, clinical, audiologic, and imaging data were collected from the medical record. Frequency-specific data points from pure-tone audiograms and/or automated auditory brainstem response tests were recorded, and four-frequency pure tone average was calculated using air conduction thresholds at 500, 1000, 2000, and 4000 Hz. Of the 183 patients included in the study, 84 (45.9%) passed their NBHS, whereas 99 (54.1%) did not pass. Compared with patients who did not pass, patients who passed were more likely to have unilateral EVA and unilateral HL, whereas they were less likely to undergo cochlear implantation and to have causative SLC26A4 variants. EVA-associated HL may be identified at birth or during childhood, with nearly half the patients in this cohort passing their NBHS. Our results provide prognostic information for patients with EVA who pass their NBHS and highlight the importance of regular hearing monitoring for children not initially suspected of having HL. 4 Laryngoscope, 133:2786-2791, 2023.

The Clinical Evaluation of a Modified Fmp in Infant Auditory Brainstem Response Tests.

The performance of a modified calculation of F statistic using multiple points (Fmp) in auditory brainstem response (ABR) tests in infants was evaluated. Using UK national guidelines, the ABR threshold was established on 50 infant ears at 4 kHz and 41 infant ears at 1 kHz. A specificity-based Fmp criterion for response presence was established from the distribution of no-response values. This criterion was then applied to determine the sensitivity of Fmp in detecting responses. A 97.5% true negative rate in no-response waveforms corresponded to an Fmp of 2.2. This criterion detected 85% of 4 kHz and 68% of 1 kHz responses at 10 dB above the ABR threshold but only 51% of 4 kHz and 32% of 1 kHz responses at the ABR threshold. Fmp has reasonable clinical utility at stimulus levels above the ABR threshold but is not an adequate replacement for strictly applied conventional waveform interpretation at the ABR threshold. A proposal is offered that should improve Fmp sensitivity.

Clinical Decision Making for Intraoperative Auditory Brainstem Response Testing in Children following Tympanostomy Tube Placement.

Intraoperative auditory brainstem response (ioABR) testing following tympanostomy tube (TT) placement may be biased due to temporary threshold shifts (TTS). The purpose of the study was to assess the evidence for TTS in children who have undergone ioABR using prolonged latencies of wave I (males > 1.95 ms, females > 1.88 ms) as a marker of a persisting air-bone gap. Eighty-three children underwent ioABR following surgical procedures at University Hospital Bonn, Germany. The primary outcome measure was the latency of wave I at 80-dB SPL. The total sample consisted of 66 males (79.5%) and 17 females (20.5%) with a mean (SD) age of 46.4 (26.6) months. Of 163 operated ears (83 children), 72 (44.2%) had no middle ear fluid, 19 (11.6%) serous fluid, and 72 (44.2%) mucoid fluid. The risk of having a prolonged latency of wave I at 80-dB SPL was OR 4.61 (95% CI 2.01-10.59; p < 0.001) in those with mucoid fluid as compared to those without mucoid fluid. Intraoperative ABR results should account for sex differences and be interpreted with caution and be verified. Ultimately, parents should be engaged in a preoperative discussion to decide if an ioABR should be postponed if mucoid fluid was found.

Neonatal hearing screening in Soba University Hospital, Khartoum, Sudan: a cross-sectional study

BackgroundHearing loss in children constitutes a serious obstacle to their optimal development; early detection of hearing disability is vital to improve the outcome of management; currently, in Sudan, there is no national neonatal hearing screening program. The aim of this study is to discuss the results of neonatal hearing screening among newborns admitted to neonatal intensive care unit (NICU) and well-baby nursery, at Soba University Hospital, Khartoum (Sudan), and to reflect the magnitude of risk factors for hearing impairment present in these two different groups of newborns.MethodsIn this hospital-based cross-sectional study, newborns who were admitted to the NICU or being observed in the well-baby nursery in the period from February 2014 to February 2019 were screened for hearing loss using automated otoacoustic emission (OAE) device after recording the risk factors for hearing loss according to the Joint Committee on Infant Hearing (JCIH) year 2007 position statement and after conducting a detailed ear and general physical examination. Newborns who failed this screening test were rescreened using the same device after 48 h, and if they failed again, they underwent confirmatory auditory brainstem response test when they are 6 months old.ResultsOne thousand one hundred twenty newborns were tested; 736 were NICU and 384 were well-baby nursery newborns. The prevalence of hearing impairment after confirmatory test was found to be 10.8 per 1000 in the NICU group and 5.2 per 1000 in the well-baby nursery group considering that the drop rate for the confirmatory test was 50% and 66% respectively which is very high and reflect the poor compliance to the program. The risk factors for hearing loss were more encountered in the NICU group compared to well-baby nursery group. Unmonitored ototoxic drug use was found to be very prevalent and need urgent reconsideration.ConclusionIn this study, the estimated prevalence of neonatal hearing impairment is alarming; risk factors are very evident especially in the NICU group; this reflect the urgent need for establishing an efficient national program for neonatal hearing screening and working to eliminate the preventable risk factors for neonatal hearing impairment in this developing country.

Conservative management versus ventilation tube insertion in children with otitis media with effusion accompanying cleft palate

Background and Aim: Otitis media with effusion (OME) usually affects ∼92–97% of children experiencing cleft palate during their first year. The wide incidence of OME in cleft palate has largely been owing to dysfunction of the Eustachian tube. The aim of this study is to evaluate and compare the outcome of ventilation tube insertion versus conservative management in patients with cleft palate complaining of hearing affection. Patients and methods: This is a prospective cohort study carried out in the Department of Otorhinolaryngology at Luxor International Hospital at Luxor in the period from May 2019 to May 2020. A total of 20 children with cleft palate having OME were chosen. Overall, 10 patients were subjected to ventilation tube insertion after repair, and 10 patients were subjected to conservative management. Complete investigations were done including tympanometry and hearing assessment by audiometry or Auditory Brain stem Response Test (ABR). All cases were followed up by tympanometry before and after repair and after 3 months of repair. Results: According to our study, there was a statistically significance relationship between hearing improvement and ventilation tube insertion after 3 months of repair measured by tympanometry, where 60% of the patients transformed to type B tympanometry but only 40% still had type A tympanogram (P=0.006). There was a statistically significance relationship between hearing improvement and ventilation tube insertion after 3 months of repair measured by audiogram, where it was better in group B, where mean±SD was 26±12.6 (P=0.007). Conclusion: Equated with conservative management, Ventilation tube insertion (VTI) is beneficial to hearing recovery. There is a belief that the early VTI at the time of palatoplasty surgery is beneficial; however, there is insignificant evidence indicating the best timing for VTI.

Photoacoustic Stimulation in Auditory Brainstem Response Test in Salicylate Induced Tinnitus

Photoacoustic Stimulation in Auditory Brainstem Response Test in Salicylate Induced Tinnitus

The Multifaceted Clinical Characteristics of Congenital Cytomegalovirus Infection: From Pregnancy to Long-Term Outcomes.

The aim of this study was to capture multifaceted clinical characteristics of congenital cytomegalovirus (CMV) infection from diagnosis to treatment using a multidisciplinary approach including obstetrics, pediatrics, pathology, and otorhinolaryngology-head and neck surgery. This is a retrospective study including 30 consecutive cases of congenital CMV infection that were diagnosed at a single tertiary hospital located in Seoul, Korea from January 2009 to December 2020. Congenital CMV infection was defined as a positive result by polymerase chain reaction from urine, saliva or cerebrospinal fluid or positive CMV IgM from neonatal blood sampled within 3 weeks after birth. All cases were analyzed with respect to whole clinical characteristics from diagnosis to treatment of congenital CMV by a multidisciplinary approach including prenatal sonographic findings, maternal immune status regarding CMV infection, detailed placental pathology, neonatal clinical manifestation, auditory brainstem response test, and antiviral treatment (ganciclovir or valganciclovir). Long-term outcomes including developmental delay and hearing loss were also investigated. The total number of births during the study period in our institution was 19,385, with the prevalence of congenital infection estimated to be 0.15%. Among 30 cases of congenital CMV, the median gestational age at delivery was 32.2 weeks [range, 22.6-40.0] and 66.7% of these infants were delivered preterm at less than 37 weeks. Suspected fetal growth restriction was the most common prenatal ultrasound finding (50%) followed by ventriculomegaly (17.9%) and abnormal placenta (17.9%), defined as thick placenta with calcification. No abnormal findings on ultrasound examination were observed in one-third of births. Maternal CMV serology tests were conducted in only 8 cases, and one case each of positive and equivocal IgM were found. The most common placental pathologic findings were chronic villitis (66.7%) and calcification (63.0%), whereas viral inclusions were identified in only 22.2%. The most common neonatal manifestations were jaundice (58.6%) followed by elevation of aspartate aminotransferase (55.2%) and thrombocytopenia (51.7%). After excluding cases for which long-term outcomes were unavailable due to death (n = 4) or subsequent follow up loss (n = 3), developmental delay was confirmed in 43.5% of infants (10/23), and hearing loss was confirmed in 42.9% (9/21) during the follow-up period. In our cohort, 56.7% (17/30) of neonates were treated for congenital CMV with ganciclovir or valganciclovir. Our data show that prenatal findings including maternal serologic tests and ultrasound have limited ability to detect congenital CMV in Korea. Given that CMV is associated with high rates of developmental delay and hearing loss in infants, there is an urgent need to develop specific strategies for the definite diagnosis of congenital CMV infection during the perinatal period by a multidisciplinary approach to decrease the risks of neurologic impairment and hearing loss through early antiviral treatment.

Results and patient satisfaction from an early access infant hearing detection clinic.

National recommendations in the United States specify that all infants with hearing impairment should be identified by 3 months of age. Infants who fail universal newborn hearing screening (UNHS) require follow up testing after hospital discharge. Follow up testing may be difficult to obtain in some communities within the ideal time frame. A rapid access multidisciplinary clinic was established for failed UNHS. The objective of this study is to report outcomes and patient satisfaction from an early access hearing detection clinic. Infants that failed UNHS were seen in the multidisciplinary clinic between 1/1/19 and 2/28/22. Patients underwent automated auditory brainstem response (ABR) and distortion product otoacoustic emissions testing and consulted with an otolaryngology nurse practitioner. Failed results were followed by diagnostic ABR. Surveys were administered at the beginning and end of the appointment. In total, 169 infants were seen at a mean age of 8.4 weeks (95%CI 7.5, 9.4). Repeat testing was abnormal in 38 (22.4%). Diagnostic ABR was performed at an average age of 13.7 weeks (n=34, 95% CI: 10.8, 16.6) and led to a diagnosis of hearing loss in 18 infants. Twenty-seven parents completed surveys at the initial visit. Anxiety level among patients with normal repeat testing (n=20) decreased from 1.9 to 1.2 (p=.002), while anxiety level among those with abnormal repeat testing (n=7) was not statistically different before and after (2.1 vs 2.7, p=.2). Satisfaction level was 3.7±0.7 (scored 1-4). All parents reported having a better understanding of their child's hearing problem after the visit. This novel nurse practitioner-led early hearing detection clinic enabled timely diagnosis of hearing loss and reassurance to families without hearing loss. Age at hearing loss diagnosis compares favorably to published cohorts.

Protective effects of nigella sativa oil against gentamicin-induced ototoxicity in rats: A dose-ranging study.

Aminoglycosides are relatively potent antibiotics used against some life-threatening infections but contribute to ototoxicity. Although the beneficial effects of high-dose nigella sativa oil (NSO) on ototoxicity in the form of intratympanic or oral use have been demonstrated, no variable-dose studies have been conducted on this subject. We aimed to investigate the potential protective effect of different doses of intraperitoneal (i.p.) NSO on Gentamicin (GM)-induced ototoxicity with auditory brainstem responses (ABR) testing. Thirty adult male Sprague-Dawley rats (300-400 gr) were used in this study. Rats were randomly divided into 5 groups, with six animals in each group: All the groups received GM (120mg/kg i.p) for ten days. Group 1: 0.9% saline solution (0.3ml/kg i.p.), Group 2: NSOL (low dose 0.1ml/kg i.p.), Group 3: NSOM (median dose 0.3ml/kg i.p.), Group 4: NSOH (high dose 3ml/kg i.p.), Group 5: NSOML (late onset median dose 0.3ml/kg i.p) were given for fifteen days. But death occurred in 3 rats in group 4 and they were excluded from the study. The pretreatment and posttreatment ABR testings were performed. The posttreatment ABR results were compared with the pretreatment values. A significant difference was found in group 1 (p:0,002), group 2 (p: 0,040), and group 4 (p: 0,027). When the posttreatment tests were compared with each other, there was a significant difference between groups 1 and 2 (p<0,001), groups 1 and 3 (p<0,001), and groups 1 and 5 (p<0,001). The administration of 0.1ml/kg and 3ml/kg dose of NSO does not prevent ototoxicity. The 0.3ml/kg dose of NSO effectively prevents GM-induced ototoxicity within both prophylactic and therapeutic use.

A prospective cohort study of sensorineural hearing loss associated with Kawasaki disease.

About 60 cases of sensorineural hearing loss (HL) have been reported in patients with Kawasaki disease (KD), but the current estimate of its prevalence is uncertain. The present study aimed to determine the prevalence and risk factors of sensorineural HL associated with KD. The present, prospective cohort study, conducted from May 2019 to May 2020, evaluated patients with a diagnosis of KD who received the initial therapy and underwent two auditory brainstem response (ABR) tests. HL was defined as a threshold of 40dB or more, and borderline hearing was defined as a threshold of 30dB. In total, 107 patients were enrolled, and 75 underwent two ABR tests. Thirty-one patients (30.0%) received prednisolone with their initial intravenous immune globulin and acetylsalicylic acid therapy. HL was present in only one patient who had congenital conductive HL. Five patients had borderline hearing but had normal hearing behavior. There was no significant difference between the patients with normal hearing and those with borderline hearing in terms of the clinical variables. In Japan, the prevalence of sensorineural HL after KD is not high. It may therefore be unnecessary to perform routine hearing tests for all patients with KD. Association between Kawasaki Disease and Sensorineural Hearing Loss. UMIN000037019 (the date of registration: June 11, 2019).