Bilateral Hearing Threshold Research Articles

Risk patterns associated with transient hearing impairment and permanent hearing loss in infants born very preterm: A retrospective study.

To determine the risk patterns associated with transient hearing impairment (THI) and permanent hearing loss (PHL) of infants born very preterm who failed hearing screenings. We enrolled 646 infants (347 males, 299 females) born at no more than 30 weeks' gestation between 2006 and 2020 who received auditory brainstem response screening at term-equivalent age. Audiological examinations of infants who failed the screening revealed THI, when hearing normalized, or PHL, defined as a persistent unilateral or bilateral hearing threshold above20 dB. Principal component analysis (PCA) was used to characterize risk patterns. Among the 646 infants, 584 (90.4%) had normal hearing, 42 (6.5%) had THI, and 20 (3.1%) had PHL. Compared with the group with normal hearing, the THI and PHL groups had significantly higher rates of neurodevelopmental impairment at 24 months corrected age. PCA of risk patterns showed the THI group and especially the PHL group had more severe haemodynamic and respiratory instability. Moreover, severe intraventricular haemorrhage (IVH) was also a risk for PHL. Propensity score matching revealed an association of haemodynamic and respiratory instability with PHL. In infants born preterm, the severity and duration of haemodynamic and respiratory instability are risk patterns for both THI and PHL; severe IVH is an additional risk for PHL. Neurodevelopmental delay was more common in infants born preterm who failed hearing screening. Principal component analysis revealed the risk patterns associated with hearing impairment. Haemodynamic-respiratory instability was associated with transient and permanent hearing impairment outcomes. Severe haemodynamic-respiratory instability and intraventricular haemorrhage was associated with permanent hearing loss.

Retinopathy of Prematurity and Hearing Impairment in Infants Born with Very-Low-Birth-Weight: Analysis of a Korean Neonatal Network Database.

Background: To investigate hearing impairment and its association with retinopathy of prematurity (ROP) among children born with very low birth weight (VLBW, birth weight < 1500 g). Methods: This prospective registry study included 7940 VLBW infants who underwent both ophthalmic (ROP) and hearing screening at the 70 participating centers of the Korean Neonatal Network. Hearing screening was performed using auditory brainstem response and/or automated otoacoustic emission testing. Hearing impairment, defined as a unilateral or bilateral hearing threshold of ≥40 dB on the auditory brainstem response threshold (ABR-T) test, was evaluated and compared between children with and without ROP at the corrected ages of 18 months and 3 years. Results: The frequency of infants who did not undergo hearing screening at near-term ages was higher in the ROP group than in the no-ROP group (18.2% vs. 12.0%, p < 0.001), and the prevalence of hearing impairment at 18 months was higher in the ROP group than in the no-ROP group (3.5% vs. 2.2%, p = 0.043). The prevalence of deafness was higher in children with ROP than those without ROP (0.4% vs. 0.1%, p = 0.049). There were significant differences in hearing impairment among the stages of ROP (p < 0.001). However, multivariate analyses and propensity score matching showed no significant association between ROP and hearing impairment at 18 months and 3 years after adjusting for prematurity-related variables (all p > 0.05). Conclusions: Among infants born with VLBW, hearing impairment was more common in those with ROP than in those without ROP at 18 months of age. However, there was no significant independent association between hearing impairment and ROP.

Is the posterior cingulate cortex an on-off switch for tinnitus?: A comparison between hearing loss subjects with and without tinnitus

As the human brain works in a Bayesian manner to minimize uncertainty toward external stimuli, the deafferented brain may generate tinnitus in an attempt to fill in missing auditory information, e.g. due to hearing loss. However, not everybody with hearing loss develops tinnitus. Understanding the differences between people with hearing loss who develop tinnitus versus those who do not offers a unique opportunity to unravel critical brain areas involved in the generation of a phantom sound. In this study, we compared resting-state quantitative electroencephalography between hearing loss patients with (HL-T) and without tinnitus (HL-NT) to identify cortical oscillatory signatures that may reveal prerequisites for the selective development of tinnitus in subjects with hearing loss. We enrolled 65 subjects with HL-NT and 65 subjects with HL-T whose tinnitus handicap inventory scores were <16 (grade 1) to minimize the bias induced by distress-induced cortical activity changes. Subjects in the HL-T and HL-NT groups were matched in terms of the bilateral hearing threshold (0.25–8 kHz) using nearest neighbor method. Compared to the HL-NT group, the HL-T group showed significantly higher activity in the right parahippocampus for the beta 1 frequency band, in the left inferior parietal lobule (IPL) for the beta 2 frequency band, and in the right IPL for the beta 3- and gamma frequency bands. Functional connectivity analyses revealed that the HL-T group had significantly higher connectivity than the HL-NT group between both parahippocampal gyri and the right IPL for the delta frequency band, and between the left posterior cingulate cortex (PCC) and right IPL for the beta 2 frequency band. These results suggest that tinnitus may be perceived only if auditory memory stored in the parahippocampus is actively linked to the IPL-based “circuit breaker” system and the circuit breaker signal is connected to the PCC-based default mode network (DMN). Thus, when the circuit breaker system regards tinnitus secondary to peripheral deafferentation as a salient event and then the DMN regards tinnitus as a norm, subjects with hearing loss may consciously perceive tinnitus. The results of this study further refine the recently proposed Bayesian model and decipher the neurobiological mechanism of the selective development of tinnitus in subjects with hearing loss.

Evaluation of oral isotretinoin effects on hearing system in patients with acne vulgaris: Reversible or not?

Systemic isotretinoin is commonly used for severe acne treatment. It has many side effects, one of these is about hearing system, which has rarely been reported, also previous studies reported contradictory results about systemic isotretinoin and its association with hearing system. In this study, we aimed to investigate whether systemic isotretinoin affected on the hearing system or not. The study included 32 acne vulgaris patients (64 ears) who treated with oral isotretinoin 0.5 mg/kg body weight for at least 4 months and audiometric tests including pure-tone, speech, bilateral acoustic reflexes, and tympanometric measurements were performed at baseline, in the first week, in the first month, and third month of treatment, and sixth month after treatment. Audiometric tests were performed for right and left ears separately. A significant difference was found in the pure-tone thresholds (before treatment, first week, first month, third month of treatment, and sixth month after treatment) for the both ears at 8000 Hz (P < .001) and a significant decrease in the sixth month post-treatment pure-tone thresholds compared to pre-treatment thresholds at 8000 Hz. Additionally, a statistically significant increase was observed in serum LDL and triglyceride levels in the third month of treatment and a significant decrease at the sixth month after treatment (P < .001). Systemic isotretinoin caused bilateral hearing threshold changes in acne patients during the therapy but the changes improved after discontinuation. Therefore, our findings may provide safety using for dermatologists about hearing effects of isotretinoin, which is quite effective on severe acne.

Oral Retinoidlerin İşitme Düzeyi Üzerine Olan Etkileri: Prospektif Bir Klinik Çalışma

Objective: The main purpose of this study was to analyse the effects of oral isotretinoin and acitretin, on hearing functions detected by serial odiometric examinations. Material and Methods: A total of thirty patients with moderate acne vulgaris and other thirty patients diagnosed as psoriasis vulgaris with a PASI score between 30-50% were included in this study. Isotretinoin and acitretin were prescribed for acne vulgaris and psoriasis vulgaris, respectively. The hearing of patients were tested with pure tone odiometric examination before, at the first and third months of the treatment in the remaining 55 patients (110 ears). The differences between the mean values of pretreatment and posttreatment pure tone hearing thresholds at 500, 1000, 2000, 4000, 8000 and 10000 Hz frequencies were evaluated for each group. Results: No significant difference was detected between the mean values of the pretreatment and posttreatment pure tone hearing thresholds of acitretin group (p>0.05); while in the isotretinoin group, a significant difference was detected between the pretreatment and posttreatment values at 500 Hz frequencies at first and third months of the treatment which was progressively decreasing (p<0.05).Conclusion: It can be concluded that, according to the results of our study, acitretin has no significant effect on hearing systems, while isotretinoin may lead to bilateral hearing threshold changes in a period of three months.

Assessment of auditory function and lipid levels in patients receiving oral isotretinoin (13-cis retinoid) therapy for acne vulgaris.

IntroductionIsotretinoin (13-cis retinoid) is a synthetic retinoid. It was approved by the FDA in 1982 for use of oral isotretinoin in severe acne. It is also used in moderate-severe acne that does not respond to conventional treatments. Isotretinoin is the only available drug that affects all stages of acne pathogenesis.AimTo prospectively investigate whether there is an effect of isotretinoin therapy on auditory function and, if so, to demonstrate its association with simultaneous blood lipid levels.Material and methodsThirty patients (60 ears) with acne vulgaris, who received 0.5 mg/kg of isotretinoin therapy, were included in the study. Distortion product otoacoustic emissions (DPOAEs) and pure tone audiometry tests were performed to evaluate auditory function at the beginning of the procedure and the 6th month of treatment. In addition, aspartate aminotransferase (AST), alanine aminotransferase (ALT), total cholesterol, triglyceride, high-density lipoproteins (HDL) and low-density lipoproteins (LDL) cholesterol levels were recorded.ResultsThere was no statistically significant difference between pre-treatment and post-treatment mean pure tone audiometry threshold and DPOAE values; however, the increase in total blood cholesterol, triglyceride and LDL levels and the decrease in HDL levels were statistically significant.ConclusionsAccording to our study findings, isotretinoin did not cause worsening of the bilateral hearing threshold, but increased blood lipid levels. There is no need for follow-up auditory functions in routine practice during therapy, but blood lipid levels should be monitored.

Transient evoked otoacoustic emissions in rock musicians

Objective: Our focus in this study was the assessment of transient evoked otoacoustic emissions (TEOAEs) in a large group of rock musicians. A further objective was to analyse tinnitus among rock musicians as related to TEOAEs. Design: The study was a cross-sectional survey of rock musicians selected at random. A control group was included at random for comparison. Study sample: We recruited 111 musicians and a control group of 40 non-musicians. Testing was conducted by using clinical examination, pure tone audiometry, TEOAEs and a questionnaire. Results: TEOAE SNR in the half-octave frequency band centred on 4 kHz was significantly lower bilaterally in musicians than controls. This effect was strongly predicted by age and pure-tone hearing threshold levels in the 3–6 kHz range. Bilateral hearing thresholds were significantly higher at 6 kHz in musicians. Twenty percent of the musicians had permanent tinnitus. There was no association between the TEOAE parameters and permanent tinnitus. Conclusions: Our results suggest an incipient hearing loss at 6 kHz in rock musicians. Loss of TEOAE SNR in the 4 kHz half-octave frequency band was observed, but it was related to higher mean 3–6 kHz hearing thresholds and age. A large proportion of rock musicians have permanent tinnitus.

Analysis of the Prevalence of and Factors Associated with Hearing Loss in Korean Adolescents

BackgroundHearing loss can lead to a number of disabilities, subsequently reducing the quality of life. In general, hearing thresholds of adolescents are better than adults and the elderly. However, occasionally, adolescents acquire hearing loss for a number of reasons. In this study, our goal was to estimate the prevalence of hearing loss in the Korean population and to investigate the factors related to hearing thresholds in adolescents.MethodsA cross-sectional study was conducted using data from the Korean National Health and Nutrition Examination Survey (KNHANES) between 2010 and 2012. We enrolled a total of 1,658 participants, ages 13 to 18 years. We investigated the prevalence of hearing loss and the factors associated with hearing thresholds at various frequencies (0.5, 1, 2, 3, 4, and 6 KHz).ResultsWeighted prevalence of unilateral and bilateral hearing loss in Korean adolescents was 2.2% and 0.4%, respectively. Weighted prevalence of hearing thresholds ≥ 20 dB at speech and high frequencies were 3.1% and 5.0%, respectively, for unilateral hearing loss and 0.7% and 1.9%, respectively, for bilateral. Age group, tympanometric data, and household income were significantly related to unilateral or bilateral hearing thresholds ≥ 20 dB at speech frequencies. Earphone use in noisy places was associated with bilateral hearing thresholds ≥ 20 dB at high frequencies.ConclusionsThe prevalence of hearing loss in Korean adolescents was 2.6% using the general standard threshold associated with hearing loss. However, the prevalence of hearing thresholds ≥ 20 dB for speech and high frequencies was much higher. The results from this study provide an estimate of hearing loss in adolescents and suggest the need for early detection and hearing preservation programs among adolescents.

Hearing Aid Use and Associated Factors in South Korea.

Despite the high prevalence of hearing impairment in the elderly, the rate of hearing aid use is still low. The objectives of this study were to report the nation-wide prevalence of hearing aid use in the Korean population and to determine the associated factors with hearing aid use utilizing a nationally representative data set.We obtained data from the 2010 to 2012 Korea National Health and Nutrition Examination Surveys, which were cross-sectional surveys of the civilian, noninstitutionalized population of the Republic of Korea at age ≥40 years (N = 12,709). A field survey team performed interviews as well as physical examinations. Hearing aid use was assessed using an interviewer-administered questionnaire and pure-tone audiometry was administered for all participants in a sound-attenuating booth. Prevalence of hearing aid acquisition and regular use were calculated in participants who reported perceived hearing loss and who have bilateral hearing thresholds exceeding the 40 dB hearing level. Multivariable analyses were used to examine the associated factors with hearing aid use.The prevalence of hearing aid acquisition and regular use was 17.4% and 12.6%, respectively, in South Korea. Increased hearing threshold (OR 1.05, 95% CI 1.03–1.07), severe perceived hearing loss (OR 10.73, 95% CI 4.52–25.46), annoying tinnitus (OR 3.30, 95% CI 1.61–6.74), balance problems (OR 0.39, 95% CI 0.18–0.86), and myopia (OR 0.30, 95% CI 0.12–0.76) were associated factors of regular use of hearing aids.The prevalence of hearing aid use in Korea is relatively low. Finding relevant factors of hearing aid use could provide further insight in setting up hearing-rehabilitation strategy for the elderly with significant hearing loss.

Unilateral Cochlear Delivery of Virally Mediated Gene Therapy Demonstrates Bilateral Expression in VGLUT3 Knockout Mice

Objectives: (1) Examine whether unilateral round window membrane injection of adeno-associated virus-1 carrying vesicular glutamate transporter-3 (AAV1-VGLUT3) in congenitally deaf VGLUT3 knockout (KO) mice results in bilateral VGLUT3 expression. (2) Quantify hearing recovery in ipsilateral versus contralateral cochleae following VGLUT3 rescue. Methods: Five wild-type (WT) and 7 VGLUT3 rescued KO mice were used; 2 VGLUT3 KO mice served as deaf controls. Postnatal-day 1 (P1)-P3 VGLUT3 KO mice to be rescued underwent left-ear fixed-volume round window injection of AAV1-VGLUT3. On P21-28, auditory brainstem responses (ABRs) were performed to determine bilateral hearing thresholds. Immunofluorescence was used to count inner hair cells (IHCs) expressing VGLUT3. Results: The 2 VGLUT3 KO mice were completely deaf and showed no IHC expression of VGLUT3. Rescued mice demonstrated VGLUT3 IHC expression in the injected side (85.8 ± 4.6% relative to WT) that was greater than the contralateral side (31.1 ± 22.7% relative to WT; P = .03). ABR thresholds were 33.1 (±2.7) dB ipsilaterally and 46.0 (±14.1) dB contralaterally ( P = .03). Conclusions: The cochlea represents an attractive target for gene therapy due to its bony compartmentalization, but the extent of transfection outside the cochlea has yet to be fully studied. Our study suggests that hearing restoration and IHC transfection occurs bilaterally after unilateral injection, although contralateral changes are significantly less. This supports a model of extracochlear viral spread via cerebrospinal fluid and perilymph, and has important potential implications for future implementation of cochlear gene therapy. This preliminary study provides the basis for a larger, future project examining cochlear and brain expression following VGLUT3 rescue.

The effects of oral isotretinoin (13-Cis retinoic acid) on the inner ear: A prospective clinical study

The purpose of this study was to investigate the effect of oral isotretinoin, a drug used in the treatment of acne vulgaris, on hearing function determined by serial audiology examinations. Forty patients with acne vulgaris were included in this study. Nine patients were excluded from the study because of inconsistent follow-up. The hearing of each participant was tested with pure tone audiometry and transient evoked autoacoustic emissions before and two and four weeks after treatment with isotretinoin (0.3-0.6 mg/kg/day) in the remaining 31 patients (62 ears). The differences between the mean values of the pre-treatment and post-treatment pure tone hearing thresholds at 1000, 2000, 4000 and 6000 Hz frequencies were statistically significant (p < 0.05), but there was no significant difference between the pre-treatment and post-treatment values at 250 and 500 Hz frequencies (p > 0.05). The difference between the pre-treatment and post-treatment signal-noise ratio values of the transient evoked autoacoustic emissions was not significantly different (p > 0.05). Our results suggest that the use of isotretinoin may cause bilateral hearing threshold changes. Further animal and human studies are required to investigate and characterize isotretinoin-induced neurophysiological alterations in hearing.

The Research of Hearing Loss in Polyester Fiber Workers

PP-29-174 Background/Aims: Noise problems received respect gradually in working places and one of high prevalent occupational diseases was noise hearing loss. If it proceeded precautions beforehand and carried out Hearing Conservation Program certainly, noise-induced hearing loss could be prevented. The cross-sectional study measured the noise in working places and compared by questionnaires. Methods: The study measured a polyester fiber factory and workers who were 89 exposed subjects and administrators were 38 nonexposed subjects. The working places were estimated using the environmental noise spectrum analysis (LD-824). The personal noise exposure level was estimated using noise-dosimeter and the pure tone audiometry by OSCILLA SM910. According to the gauge sequence surveyed it. Results: The result was that Leq = 89.4 ± 2.6 dB(A) was higher in working places by exposed group. It was more evident high than administrators nonexposed group, which Leq = 60.8 ± 5.6 dB(A). Bilateral hearing thresholds compared that result found left ears (37.0 ± 16.5 dB(A)) vs. right ears (36.8 ± 15.4 dB(A)) with a dip at 4 kHz. In a multivariate logistic model, the high frequency trisection odds ratio was 3.2 (95% confidence interval [CI]: = 1.3–7.8), 6–10 years Odds Ratio = 3.4 (95% CI: = 1.1–10.5), and over 11 years Odds Ratio = 3.9 (95% CI: = 1.4–10.6) by exposed group. To accompany increasing seniority, hearing loss was more serious. Conclusion: Personal noise levels were over occupational noise exposure standard 85 dB(A) by workers. In all, 77.5% workers used ear plugs but 22.5% did not use. The factory should notice workers who used ear plugs truly or not. The employer should avoid hearing loss to ensure health for workers.

Ruído e idade: análise da influência na audição em indivíduos com 50 - 70 anos

Age and exposure to noise are among the factors that may cause hearing loss in adults. Both of these factors are considered additives once their combined effects can cause damage to the hair cells of the organ of Corti. To verify whether the exposure to occupational noise is an important risk factor for hearing disorders in adults with ages between 50 to 70 years, besides the auditory deterioration caused by age. The audiograms of 71 men with ages ranging between 50 to 70 years were studied (cohort study), with the participants being divided in 2 groups (Group 1 with occupational exposure to noise and Group 2 without the exposure to noise) in order to compare their auditory profiles. The groups do not present significant differences regarding age (p = 0.321), with most of the participants with ages between 50 and 55 years (48); 14 subjects presented normal bilateral hearing thresholds and all of the others presented neurossensorial hearing loss. An association between noise and hearing disorders was found, with significant differences between the groups for auditory thresholds above 3000 Hz, with Group 1 presenting worse results (p < 0.05). The auditory thresholds of individuals with ages between 50 and 70 years are worse for the group that is exposed to noise. Noise is a higher risk factor than age when considering neurossensorial hearing losses.

Multiple work-related accidents: tracing the role of hearing status and noise exposure

Objectives:Our main purpose was to investigate any relationship between noise exposure levels in the workplace, degree of hearing loss (HL), and the relative risk of accident (OR of single or...

Kernikterus bei zwei Neugeborenen nach ambulanter Geburt - Kernicterus in Term Newborns After Outpatient Delivery: A Report of Two Cases -

We describe two term infants who developed severe jaundice with kernicterus due to hemolytic disease (anti-B and anti-c, respectively) after outpatient delivery. The total serum bilirubin levels were 38 and 39 mg/dL, respectively. The infants developed permanent deafness (bilateral hearing threshold above 80dB). The diagnosis was delayed because a finding of anti-c antibody was not recorded in the maternity pass and because a direct Coombs test was negative. Short hospital stays after delivery may increase the risk of missing severe hemolytic disease of the newborn, particularly if pediatric follow-up after discharge is not guaranteed.

Evaluation of the use of a questionnaire to detect hearing loss in babies in China

A questionnaire was used to screen hearing of 1020 babies 6–8 months in China. All babies failing the questionnaire and 10% of those who passed were tested using auditory brainstem audiometry (ABR). Babies with unilateral or bilateral hearing thresholds 30 dBnHL or more were investigated to determine the cause of the hearing impairment. Sixty-seven failing the questionnaire were tested and 23 were confirmed to have a hearing loss, 20 with bilateral hearing impairment. The causes were: 13 otitis media with effusion (OME), one hypoxia, one genetic and five unknown. One child with an OME related hearing loss passed the screen. The sensitivity of the questionnaire was estimated to be 70%, specificity 96%.

Monitoring of hearing during treatment of leukaemia with special reference to the use of amikacin.

Thirty-nine patients with leukaemia were followed audiometrically during treatment with broad-spectrum antibiotics. Amikacin was given during neutropenic febrile episodes. Five patients reported a deterioration of the hearing function after termination of amikacin treatment. Significant hearing threshold loss occurred in 20 patients (51%). The hearing threshold changes were small in general, except for two patients who exhibited bilateral hearing threshold changes in the frequency range 0.5-8 kHz. Using multiple linear regression analysis 22% of the changes in hearing thresholds was estimated to be related to old age, an increased trough concentration of amikacin and an impaired pretreatment hearing state. Factors found not to influence the hearing thresholds were maximum peak concentration of amikacin, cumulative duration of therapy, pretreatment renal dysfunction and concomitant use of vancomycin. It is concluded that administration of amikacin for repeated treatment courses is associated with a low incidence of serious changes in hearing function.