Average Hearing Loss Research Articles

Ocena skuteczności leczenia pacjentów z szumami usznymi za pomocą krioterapii ogólnoustrojowej

The aim of the study was evaluation of effectiveness of whole-body cryotherapy in patients with tinnitus. The research was carried out in 120 patients (aged 20-68) with tinnitus, divided into two groups: I--80 patients treated by cryotherapy and II--40 patients non treated. There were: 73 women and 47 men. Among patients of I group: 39 reported bilateral tinnitus, 20 reported right tinnitus, 15 reported left tinnitus and 6 reported tinnitus in head. Duration of the ailment took from 1 month to 23 years. The methods included: taking a history, otolaryngological physical examination, audiometry establishing level of tinnitus, medical consultation, X-ray examination of chest and cervical spine and CT of head. After examinations and additional consultations the patients were qualified for cryotherapy unless there were some contraindications. The patients underwent 10 procedures in two cycles with the weekend break. They were in cryochamber in temperature of -110 degrees C for 3 minutes. After cryotherapy they used kinesitherapy for 45 minutes. Intensity and troublesomeness of tinnitus was evaluated using self-assessment chart (point scale 0-100) and audiometry establishing level of tinnitus before and after treatment. The results indicates complete elimination of tinnitus in 4 patients, decrease in their intensity in 47 patients, maintenance of the ailment on the same level in 13 people and slightly increase of tinnitus in 16 patients. In audiometry we could observe in I group changes in frequency of tinnitus in 138 ears and changes in intensity of tinnitus in 91 ears. After treatment decrease of average hearing loss and average hearing damage were observed. Treatment of tinnitus may be effective by using whole-body cryotherapy.

Canal atresia: “Surgery or implantable hearing devices? The expert's question is revisited”

(1) Evaluate hearing results in patients managed with external auditory canal reconstruction; (2) compare results to the expectations from treatment with surgical; placement of an osteo-integrated bone-conduction device (BAHA system); (3) assess complications of both interventions; (4) evaluate the medical cost-effectiveness of each avenue of management at 2005 rates for billings based upon relative value units (RVUs). (1) Retrospective chart review for 36 ears in 29 pediatric patients who underwent surgical canal reconstruction at a tertiary-care pediatric hospital in a major urban center with assessment of management techniques and surgical and audiologic outcomes. (2) Retrospective chart review of six pediatric patients who underwent BAHA placement in a major urban center with assessment of management techniques and surgical and audiologic outcomes. (3) Cost reassessment at 2005 billings rates based upon RVUs for canal reconstruction versus BAHA system and comparative analysis. (1) The average post-operative hearing loss in the right ear was 34.3 dB left ear was 31.6 dB. The average gain per ear was 17.3 dB. (2) Twenty-seven (93%) of EAC reconstruction patients required some form of amplification post-operatively. (3) Data available for three of the BAHA patients reflected the predicted average gain in dB (predicted 34.3 dB, observed 31.8 dB). (4) Early complications of canal reconstruction included removal of the packing by the patient, post-operative bleeding and post-operative hematoma. (5) Late complications included recurrent canal stenosis, recurrent otitis externa, canal prolapse and canal cholesteatoma. (6) Uncomplicated external auditory canal reconstruction cost $51,505.98 or $2909.94/dB of hearing gain based upon billings fro RVUs. (7) Uncomplicated two-staged BAHA system placement cost $42,448.85 or $1237.57/dB of hearing gain based upon billings for RVUs. (8) Uncomplicated single-staged BAHA system placement cost $28,341.00 or $826.27/dB of hearing gain based upon billings for RVUs. Study results indicate that even with significant investments in EAC reconstruction, most patients still required some form of amplification. There are also significant risks of early and late complications from the reconstructive procedure. Studies indicate and our results support that the osteo-integrated bone-conduction device (BAHA system) can achieve truly acceptable hearing (<or=15 dB) in school-aged children with normal bone curves, and it can match the bone-curves for children with sensorineural hearing loss. The two-staged BAHA system placement may be provided at almost one-third the cost to the medical system, on a decibel-for-decibel basis. The single-stage BAHA system placement yields even greater cost savings at just over one-quarter of the cost of surgical EAC reconstruction on a decibel-for-decibel basis. Additionally, there are fewer complications and fewer follow-up visits for the care of the implant system. This is an added value to the parents and patient for the savings in opportunity costs related to the lost time at work and school for office visits and peri-operative care. Overall, it appears that osteo-integrated bone-conduction devices may provide a higher quality of outcome for patients while resulting in significant economic savings.

Potenciales evocados auditivos en pacientes que rechazan o no la amplificacion binaural

Se realizó un estudio descriptivo comparativo para determinar las diferencias significativas de los Potenciales Evocados Auditivos de Latencia Corta que podría, a través del análisis de diversas variables, determinar la razón por la cual los pacientes mayores de 65 años, con pérdida auditiva neurosensorial promedio hasta 70 – 80 dB rechazan la amplificación binaural en el Instituto Para Niños Ciegos y Sordos en la ciudad de Cali, en el 2005. Se tomó una muestra intencional de 40 pacientes con adaptación binaural de mínimo tres meses, de los cuales 20 rechazaban los audífonos y 20 no. El estudio permitió detectar que en los resultados de la latencia de las Onda I, III y V, las latencias interpicos I – III , III – V, I – V y la diferencia interaural de la onda V, utilizando un estímulo click, variando la velocidad del estímulo de 11 p/seg y 77 p/seg, y la polaridad del estímulo en Rarefacción y Condensación en cada uno de los oídos presentaron valores que no se desvían de lo normal, para la población objeto de estudio; igualmente esto sucedió en la funcionalidad auditiva en los dos grupos de pacientes en diferentes situaciones diarias presentadas en el cuestionario HHIE modificado. El estudio mostró que no existen diferencias significativas entre los dos grupos de estudio, lo cual se comprobó utilizando la prueba U de Mann-Whitney, es decir que la prueba electrofisiológica del BERA, no aporta información que permita determinar si un paciente mayor de 65 años con pérdida auditiva neurosensorial entre 70 y 80 dB se adaptará a la amplificación binaural.

Can self assessment of communication predict hearing loss?

A total of 120 subjects with hearing loss (75 men, 45 women), within the age range 18-70 years (mean, 38 years), and 15 normal subjects were administered a modified Hindi adaptation of the 'self assessment of communication' hearing loss inventory. The study aimed to determine whether there was any correlation between subjects' average pure tone thresholds and their inventory scores. Data was analysed using the Pearson coefficient of correlation and regression analysis. A negative correlation was obtained stating that the greater the hearing loss, the lower the inventory score. An equation could also be derived for the bilateral symmetrical sensorineural hearing loss group and the bilateral symmetrical conductive hearing loss group to enable calculation of patients' average hearing loss from their inventory scores, in the absence of an audiogram. This could aid rehabilitation in cases with either type of hearing loss (in which no medical intervention was required) when pure tone audiometry is not possible.

Long‐Term Follow‐up of Hearing Loss in Children and Young Adults With Enlarged Vestibular Aqueducts: Relationship to Radiologic Findings and Pendred Syndrome Diagnosis

To describe the long-term audiologic findings in pediatric patients with enlarged vestibular aqueducts (EVAs). The relationship between the hearing loss (HL) and the dimensions of the EVA, enlarged endolymphatic duct (EED), or enlarged endolymphatic sac (EES) was also investigated. The influence of a Pendred syndrome (PS) diagnosis on the audiologic phenotype was also examined. Retrospective analysis of case notes and imaging records, including measurement of the dimensions of the EVA, EED, and EES. Tertiary referral center. Twenty-seven patients (21 female, 6 male) had an EVA in at least one ear. Eighty-five percent had bilateral enlargements. Median age at onset of follow-up was 5.0 years, and median follow-up was 9.7 years. Hearing thresholds at the start and end of follow-up, rate of progression of HL, history of sudden drops in hearing. : All ears with an EVA had HL. Average HL at the start and end of follow-up was severe. Thirty-seven percent of patients had progressive HL, and 33% reported sudden drops in hearing. Progression was significantly associated with a history of sudden drops. PS patients had worse hearing at the end of follow-up as compared with nonsyndromic patients. There was no evidence of a relationship between the dimensions of the EVA, EED, or EES and the severity or progression of HL. Patients with EVAs should be advised to avoid known trigger factors for sudden drops in hearing (e.g., minor head trauma). A diagnosis of PS may be associated with a worse audiologic prognosis.

Drilling a vent often fails to give relief from occlusion

Drilling a vent often fails to give relief from occlusion

Predictive validity of a retrospective measure of noise exposure

Aims: To investigate the validity of measures of noise exposure derived retrospectively for a cohort of nuclear energy workers for the period 1950–98, by investigating their ability to predict hearing...

The oral referential communication skills of hearing-impaired children

AbstractThis paper focuses on the oral referential communication skills of hearing-impaired (HI) children. A task based on that used with language impaired children by Leinonen and Letts (1997) was used to assess the speaking and listening skills of 20 HI children (mean age=10;2 years; mean better ear average hearing loss=88.85 dBHL). Their performance was then compared to that of a group of younger normally hearing (NH) children (mean age=6;9 years). The findings were suggestive of a developmental lag in speaking and listening skills in some of the HI group. In addition, significant negative correlations were found between measures of listener performance and scores on the Test for Reception of Grammar (Bishop, 1989), which suggested that the detection and evaluation stages of Ackerman's (1983) model of message disambiguation might be related to linguistic competence. Differential performances within the HI group, and between the HI and NH groups, and the utility of the referential communication task for...

The oral referential communication skills of hearing-impaired children

This paper focuses on the oral referential communication skills of hearing-impaired (HI) children. A task based on that used with language impaired children by Leinonen and Letts (1997) was used to assess the speaking and listening skills of 20 HI children (mean age=10;2 years; mean better ear average hearing loss=88.85 dBHL). Their performance was then compared to that of a group of younger normally hearing (NH) children (mean age=6;9 years). The findings were suggestive of a developmental lag in speaking and listening skills in some of the HI group. In addition, significant negative correlations were found between measures of listener performance and scores on the Test for Reception of Grammar (Bishop, 1989), which suggested that the detection and evaluation stages of Ackerman's (1983) model of message disambiguation might be related to linguistic competence. Differential performances within the HI group, and between the HI and NH groups, and the utility of the referential communication task for teachers, clinicians and researchers are discussed.

Vibration induced hearing loss in guinea pig cochlea: expression of TNF-α and VEGF

Transcranial vibration was applied for seven animals at a frequency of 250 Hz for 15 min, and five animals were used as normal controls to investigate cellular and molecular mechanism linked to vibration-induced hearing loss in animal model. Compound action potential (CAP) thresholds were measured by round window niche electrode. The expression of tumour necrosis factor alpha (TNF-α) and its receptors (TNF R1, TNF R2), vascular endothelium growth factor (VEGF) and its receptors (VEGF R1, VEGF R2) were analysed by immunohistochemistry. Transcranial vibration caused expression of TNF-α, TNF R1 and TNF R2 in the cochlea and the expression of TNF R2 was stronger than that of TNF R1. Vibration also induced VEGF and VEGF R2 expression in the cochlea. The average immediate hearing loss was 62 dB and after three days still 48 dB. It is concluded that transcranial vibration as during temporal bone drilling produces cochlear shear stress that is connected with up-regulation of TNF-α and its receptors. Also VEGF and VEGF R2 are up-regulated. These responses may be linked to both the damage and repair process of the cochlea.

Stapes fixation in children

The audiometric results after stapes surgery in children with isolated stapes footplate fixation were reason enough to analyze intraoperative findings and surgical procedures. A total of 438 stapes surgeries were performed in the years 1985-2000, and a retrospective analysis was made of the anamnestic data, intraoperative findings and audiometric data from 12 children with isolated fixation of the stapes footplate. The average age of the children when operated was 10.2 years (the youngest was 7 and the eldest 13). A loss of hearing had set in 5 years earlier. Taking the anamnestic data and the intraoperative into account, otosclerosis was found in 5 children. One child had a narrow oval window niche, in a further six children a congenital fixation of the stapes footplate was evident. Only 58% (n=7) of the 12 children operated showed acceptable postoperative hearing results. The best hearing results were found in children with juvenile otosclerosis. In three of six children with congenital stapes fixation, a worsening of both bone and air conduction was evident. The average conductive hearing loss was 30 dB at 1, 2 and 4 kHz. When explorative tympanotomy is indicated, a thin-layer CT scan of the temporal bone should be made to assess the risk of a liquor pressure labyrinth developing.

Hearing loss and extent of labyrinthine injury in pseudomonas otitis media

Problem: Semicircular canal transection (SCT), in the presence of chronic suppurative otitis media (OM), usually leads to permanent, profound sensorineural hearing loss (SNHL). Models have suggested that pseudomonas or its toxins may be responsible, but SCT, in the presence of pseudomonas OM in the guinea pig, usually does not result in profound SNHL. The purpose of this study was to determine if the severity of SNHL, due to SCT in OM, is a function of the extent of the labyrinthine injury. Methods: Pseudomonas OM was induced bilaterally in pigmented guinea pigs. Two to four days later, SCT was performed in one ear on the horizontal canal, the superior canal, or both the horizontal and the superior canals. Auditory-evoked brainstem responses were measured both before and after SCT. Results: Pseudomonas OM was induced bilaterally in all animals. Elevation of click thresholds was found in almost all SCT ears of all 3 groups; however, there were no significant differences between groups. When comparing the SCT ear to the contralateral, internal control ear, average hearing losses in the horizontal, superior, and horizontal and superior labyrinthine ablation groups were 23, 27, and 24 dB (± 4.1, 4.0, and 4.2 dB), respectively. Conclusion: SCT in the presence of pseudomonas OM causes significant hearing loss in a guinea pig model. Significance: Sensorineural hearing loss secondary to semicircular canal transection may not correlate directly with the extent of vestibular labyrinthine injury. Support: None reported.

Changing characteristics of first-time hearing aid applicants in The Netherlands in the past decade

This study assessed changes in the characteristics of firsttime hearing aid applicants in the past decade. Age, gender, date, type and ear of first hearing aid and audiometry were determined for a sample of 705 firsttime hearing aid applicants. Thirteen cohorts resulted, according to the year of first visit to the dispenser. Differences in age, hearing loss, gender and type and ear of first hearing aid between cohorts were analysed. The mean age of first-time hearing aid users increased from 59.52 years in 1987 to 71.84 years in 1999. The mean pure-tone average hearing loss in the better ear (1, 2 and 4 kHz) decreased from 69.06 dB in 1987 to 51.86 dB in 1999. Relatively more males than females were fitted with hearing aids. Our conclusions are that people are being fitted with hearing aids at older ages and with smaller degrees of hearing loss.

Help-seeking Behaviour of Hearing-impaired Persons Aged ≥ 55 Years; Effect of Complaints, Significant Others and Hearing Aid Image

Objective - To determine factors influencing help-seeking behaviour in hearing-impaired persons aged ≥ 55 years.Materials and Methods - The study comprised 1,419 persons (480 females, 939 males) aged ≥ 55 years who participated voluntarily in a driving test. Pure-tone audiometry was performed in all subjects. Participants without a hearing aid with an average hearing loss of ≥ 30dB in the better ear for the frequencies 0.5, 1.2 and 4kHz were asked how they perceived their hearing by means of a structured questionnaire. The questionnaire provided insight into why some hearing-impaired people seek help from a general practitioner (GP) and others do not. Four factors were examined.Results - A total of 483/1,419 (34%) participants tested had a hearing loss exceeding 30 dB. Fewer than half of these had visited their GP with complaints of hearing impairment. Of those who had not sought help from a GP, 57% nethertheless judged their hearing as poor. Social pressure exerted by significant others was less in the non-consulters froup. Hearing aid image did not differ significantly between the two groups.Conclusion - The help-seeking behaviour of hearing-impaired elderly people is related to the degree of hearing disability and the social pressure exerted by significant others as well as the willingness to try hearing aids.

Effects of sensorineural hearing loss on cortical event-related potential and behavioral measures of speech-sound processing.

To investigate systematically the effects of sensorineural hearing loss on cortical event-related potentials (ERPs) N1, MMN, N2 and P3 and their associated behavioral measures (d' sensitivity and reaction time) to the speech sounds /ba/ and /da/ presented at 65 and 80 dB ppe SPL. Cortical ERPs were recorded to /ba/ and /da/ speech stimuli presented at 65 and 80 dB ppe SPL from 20 normal-hearing adults and 20 adults who are hearing impaired. The degree of sensorineural impairments at 1000 to 2000 Hz ranged from mild losses (defined as 25 to 49 dB HL) to severe/profound losses (75 to 120 dB HL). The speech stimuli were presented in an oddball paradigm and the cortical ERPs were recorded in both active and passive listening conditions for each stimulus intensity. Both ERP amplitudes and behavioral discrimination (d') scores were lower for listeners with sensorineural hearing loss than for those with normal hearing. However, these differences in response strength were evident only for those listeners whose average hearing loss at 1000 to 2000 Hz exceeded 60 dB HL for the lower intensity stimuli and exceeded 75 dB HL for the higher intensity stimuli. In contrast, prolongations in the ERP and behavioral latencies, relative to responses from normal-hearing subjects, began with even mild (25 to 49 dB HL) threshold elevations. The amplitude and latency response changes that occurred with sensorineural hearing loss were significantly greater for the later ERP peaks (N2/P3) and behavioral discrimination measures (d' and RT) in comparison with earlier (N1, MMN) responses. The results indicate that latency measures are more sensitive indicators of the early effects of decreased audibility than are response strength (amplitude, d' or percent correct) measures. Sensorineural hearing loss has a greater impact on higher level or "nonsensory" cortical processing in comparison with lower level or "sensory" cortical processing. Possible physiologic mechanisms within the cortex that may be responsible for these response changes are presented. Lastly, the possible clinical significance of these ERP and behavioral findings is discussed.

Evoked otoacoustic emissions in patients with Ménière's disease.

This study investigated whether otoacoustic emissions (OAEs) in patients with Ménière's disease show abnormal properties. Patients with Ménière's disease experience vertigo, tinnitus, and hearing loss. OAEs are sounds generated in the inner ear, and their presence is associated with normal hearing. Click-evoked OAEs and distortion product OAEs were measured in 100 patients with Ménière's disease. The incidence of the emissions in affected ears (56%) was lower than in unaffected (i.e., contralateral) ears (85%). The mean emission amplitude in affected ears was also significantly lower (2.6 dB), and the mean amplitude in unaffected ears was lower than in normal-hearing ears (5.3 dB). These differences were likely caused by the hearing loss involved. Further, ears with OAEs clearly showed smaller hearing losses than ears without OAEs (24-dB difference). The average hearing loss showed correlations with the emission amplitudes, although this correlation was not very strong; when plotted against the smallest hearing loss, a certain upper boundary for the emission amplitude was present. Also, the amplitude of click-evoked OAEs showed a considerable correlation with the largest of the three distortion product OAEs. OAEs in patients with Ménière's disease differed from those in normal-hearing ears but did not differ from those in non-Ménière's ears with equivalent hearing loss. This was best observed by comparing emission amplitude with smallest hearing loss instead of mean hearing loss.

Cartilagem tragal com pericondrio em timpanoplastias

Introdução: os enxertos de cartilagem começaram a ser usados por Jansen em 1963 que sugeriu que teriam sua indicação em casos mais avançados por ser mais rígido resistindo melhor à reabsorções e retrações. Em 1998 Eavey descreve o uso de cartilagem tragal com pericôndrio bilateral e a sua colocação sem incisões no meato acústico externo. Forma de estudo: clínico prospectivo randomizado. material e método: Foram estudados 100 pacientes portadores de seqüelas de otites médias crônicas, com perfurações da membrana timpânica com rebordo e submetidos a timpanoplastias com cartilagem tragal e pericôndrio. As dimensões das perfurações foram em média 40% da área da membrana timpânica. Na avaliação auditiva observamos média pré-operatória de perda condutiva de 28.3 dB e pós-operatória de 9.8 dB. Resultados: O fechamento da perfuração foi total em 95.0% dos casos. Conclusão: Estudando os resultados concluímos que o método é de fácil realização, com poucas complicações, bons resultados auditivos e ótimos resultados anatômicos. Sendo uma ótima opção para o otologista na resolução das seqüelas das otites crônicas.

Three-dimensional Fourier transformation constructive interference in steady state magnetic resonance imaging of the inner ear in patients with unilateral and bilateral Menière's disease.

In this study, three-dimensional Fourier transformation constructive interference in steady state (3DFT-CISS) magnetic resonance imaging was used to quantify the distance between the vertical part of the posterior semicircular canal and the posterior fossa as a measure of the endolymphatic sac and duct in patients with Menière's disease. Differences in this distance between affected and unaffected ears, as well as differences between unilaterally and bilaterally affected patients, were studied and compared with a control group. Also, possible correlations between the measured distance and the duration and severity of symptoms, patient age, and average hearing loss were investigated in the group of patients with Menière's disease. Retrospective clinical study. Tertiary referral center (University Hospital) as part of a large, diagnostic research project on Menière's disease. Of the 111 patients with Menière's disease initially included, 90 patients underwent 3DFT-CISS MRI. Eighty-six of these patients were analyzed in this MRI study. Fifty-six patients had unilateral Menière's disease, and 30 patients had bilateral Menière's disease (116 affected and 56 unaffected ears). Sixty-two ears in patients without Menière's disease were studied as controls. The distance between the vertical part of the posterior semicircular canal and the posterior fossa was determined by 3DFT-CISS MRI. Contiguous axial 3DFT-CISS MRI slices of 0.7 to 1.0 mm were made by a radiologist according to a strict protocol. Measurements of the distance between the vertical part of the posterior semicircular canal and the posterior fossa were taken by two professionals-a radiologist and an otolaryngologist-using a ruler and the original scan. A significantly smaller distance (2.9 mm) between the vertical part of the posterior semicircular canal and the posterior fossa as visualized on MRI scans was found in the ears of patients with Menière's disease than in the ears of patients in the control group (3.8 mm, p < 0.001). In both uni- and bilaterally affected patients (n = 56 and n = 30, respectively), no significant difference between ears was found (p = 0.44 and p = 0.19, respectively). In bilaterally affected patients, however, this distance (3.2 mm) was significantly greater than the distance in unilaterally affected patients (2.7 mm, p = 0.004). There was no relationship between the MRI-visualized distance between the vertical part of the posterior semicircular canal and the posterior fossa and the duration of disease, average hearing loss, or severity of symptoms in uni- and bilaterally affected patients. The difference in MRI-visualized distances between the vertical part of the posterior semicircular canal and the posterior fossa of uni- and bilaterally affected patients strongly suggests that unilateral and bilateral hearing loss are two different entities in patients with Menière's disease. The size of the endolymphatic sac seems not to be the only factor in the pathogenesis of Menière's disease. That the MRI-visualized distance between the vertical part of the posterior semicircular canal and the posterior fossa does not have any relationship to the duration of the disease or to patient age indicates that this distance is a congenital feature.

Observations on the Relations among Occlusion Effect, Compliance, and Vent Size

In a clinical experiment, it was found that there is a high correlation between the compliance measured by tympanometry and the minimum size of the earmold vent, which just solves the client's occlusion problem related to his/her own voice when using a hearing aid. For ears with sensorineural hearing losses, compliance explained 59 percent of the variation in vent size, whereas the average low-frequency hearing loss explained as little as 0.3 percent. In a laboratory experiment, the objective occlusion effect measured with the participants' own voices showed a similar relationship with compliance. Whereas the former relationship between compliance and vent size may be explained by a simple model, the latter relationship turns out to be the opposite of what a first-order model predicts. Hence, compliance must be indicative of another aspect of the occlusion mechanism, which has a more profound influence on the observed occlusion effect than compliance itself.

Effects of Early Auditory Deprivation and Stimulation on Auditory Brainstem Responses in the Rat

The purpose of this study was to investigate the effect of auditory sound deprivation or stimulation on auditory brainstem responses (ABRs) during the maturation period of the rat auditory system. At postnatal day (PND) 21, 40 newborn Norway Brown male rats were categorized into 3 groups: (i) an auditory deprivation group in which a bilateral average conductive hearing loss of 27 dB was induced; (ii) an auditory activation group exposed to 65-90 dB sound pressure level; and (iii) a control group. ABR recordings were made on PND 84. In order to compare group differences in interpeak latency (IPL), sensation level (SL), defined as stimulus intensity above threshold, was used. IPL measurements and analysis were restricted to the 20-60 dB SL range. No differences were observed in the IPLs of peaks I-IV between the three groups. Small, but not statistically significant, differences in mean estimated IPLs of peaks I-IV were shown in the ranges >50 dB SL and <25 dB SL. Possible confounding factors explaining the apparent discrepancy between these results and those of other animal studies are reviewed.