Clinical Audiometer Research Articles

Transducer Variability in Speech-in-Noise Testing: Considerations Related to Stimulus Bandwidth.

Clinical audiologists typically assume that headphones and insert phones will produce comparable results when they are used to conduct speech-in-noise or other audiological tests; however, this may not always be the case. Here, we show that there are significant differences in the scores that previous studies have reported for headphone and insert-phone transducers on the Words-in-Noise (WIN) Test, and discuss the possibility that the variations in high-frequency output that are allowable under the speech source specifications of American National Standards Institute S3.6 might be contributing to transducer-dependent differences in performance for the WIN and other tests that are presented through the auxiliary input channels of clinical audiometers. A literature review was conducted to identify articles that reported WIN Test results for both listeners with normal hearing and with hearing impairment and specified the type of transducer (insert or TDH-50) used for the data collection. Among the 19 included studies, participants with normal hearing using inserts exhibited systematically worse WIN Test scores compared to those using TDH-50 headphones, while participants with hearing loss showed comparable average scores across transducer types. The results highlight the importance of considering transducer type when interpreting WIN Test outcomes, particularly when comparing to normative scores obtained from individuals with normal hearing. Although further research is needed to elucidate the underlying mechanisms driving differences in test performance across transducer types, these findings underscore the need for standardized test administration protocols and careful documentation of transducer type when administering speech-in-noise tests for clinical or research applications.

A large-scale screening identified in USH2A gene the P3272L founder pathogenic variant explaining familial Usher syndrome in Sardinia, Italy

BackgroundUsher syndrome (USH) encompasses a group of disorders characterized by congenital sensorineural hearing loss (SNHL) and retinitis pigmentosa (RP). We described the clinical findings, natural history, and molecular analyses of USH patients identified during a large-scale screening to identify quantitative traits related to ocular disorders in the SardiNIA project cohort.MethodsWe identified 3 USH-affected families out of a cohort of 6,148 healthy subjects. 9 subjects presented a pathological phenotype, with SNHL and RP. All patients and their family members underwent a complete ophthalmic examination including best-corrected visual acuity, slit-lamp biomicroscopy, fundoscopy, fundus autofluorescence, spectral-domain optical coherence tomography, and electrophysiological testing. Audiological evaluation was performed with a clinical audiometer. Genotyping was performed using several arrays integrated with whole genome sequence data providing approximately 22 million markers equally distributed for each subject analyzed. Molecular diagnostics focused on analysis of the following candidate genes: MYO7A, USH1C, CDH23, PCDH15, USH1G, CIB2, USH2A, GPR98, DFNB31, CLRN1, and PDZD7.ResultsA single missense causal variant in USH2A gene was identified in homozygous status in all patients and in heterozygous status in unaffected parents. The presence of multiple homozygous patients with the same phenotypic severity of the syndromic form suggests that the Sardinian USH phenotype is the result of a founder effect on a specific pathogenic variant related haplotype. The frequency of heterozygotes in general Sardinian population is 1.89. Additionally, to provide new insights into the structure of usherin and the pathological mechanisms caused by small pathogenic in-frame variants, like p.Pro3272Leu, molecular dynamics simulations of native and mutant protein–protein and protein–ligand complexes were performed that predicted a destabilization of the protein with a decrease in the free energy change.ConclusionsOur results suggest that our approach is effective for the genetic diagnosis of USH. Based on the heterozygous frequency, targeted screening of this variant in the general population and in families at risk or with familial USH can be suggested. This can lead to more accurate molecular diagnosis, better genetic counseling, and improved molecular epidemiology data that are critical for future intervention plans.Trial registrationWe did not perform any health-related interventions for the participants.

Prevalence of Noise Induced Hearing Loss among the Textile Workers

Background: Noise remains a common environmental pollutant in industrial workplaces and has been a constant issue since the industrial revolution. Occupational hearing loss is the dominant cause of preventable sensorineural hearing loss in adults. The degree of NIHL is determined by intensity, duration of exposure, spectral characteristics of the noise, and individual susceptibility Methods: This cross-sectional study was carried out among theNassa Taipei Textile Mills Ltd. and Nassa Taipei Spinners Ltd in kachpur,Narayangonj.200 Textile workers aged from 18 to 50 years were recruited in this study. Study subjects were interviewed by trained data collector through a structured questionnaire. Environmental sound intensity level in various departments were measured using a sound level meter (Quest sound level meter, Oconomowoc WISCONSIN. Model no: 2400). Pure Tone Audiometry was done by pure tone clinical audiometer (KAMPLEX Audiometer, Model no: AC 30; Calibrated by P.C. Werth Limited in October 2004) with a frequency range of 125Hz to 8000Hzand sound intensity levels of between -10dB to 120dB was used to test each ear of the subject separately. Data was analyzed using Statistical Package for Social Sciences (SPSS) program version 26. Results: Out of 200 Textile workers whose were recruited in this study, 138(69%) were males and predominant age group was 18 to 27 years (54.5%). The prevalence of NIHL was found to be 14.5%. The most common age group was 28 to 37 years and positive association (p<.05) between hearing loss and long working hours. Non-user of PPD had little bit higher among the workers who developed hearing loss. Conclusion: The prevalence of NIHL was higher in textile industry workers. This suggests the need to provide protective gear to workers in stations generating loud noise. The prevalence was higher in male, those who experienced prolong exposure and not to used PPD. Bangladesh J Otorhinolaryngology 2023; 29(2): 89-95

Description of a new low-cost and open-source audiometer and its validation with normal-hearing listeners: The Aupiometer.

Hearing loss is a major public health problem. In 2050, it could affect 2.5 billion people. It has therefore become necessary to prevent and diagnose them as early and as widely as possible. However, the costs of clinical equipment dedicated to the functional exploration of hearing remain high and hamper their distribution, while the technologies used are relatively basic. For example, the gold-standard pure-tone audiometry (PTA) essentially consists of emitting pure sounds. In addition, clinical audiometers are generally limited to PTA or few audiological tests, while hearing loss induce multiple functional deficits. Here, we present the Aupiometer, a low-cost audiometer implemented on a modular open-source system based on Raspberry Pi, and which integrates the entire technical framework necessary to carry out audiological measurements. Several hearing tests are already implemented (e.g. PTA, speech audiometry, questionnaires), while the clinical validity of the Aupiometer was verified on a panel of participants (N = 16) for an automated test of standard and extended high-frequency PTA, from 0.125 to 16 kHz, in comparison with a clinical audiometer. For this comparison between the two devices and over this wide frequency range, the difference is evaluated as less than ±10 dB for a 90% confidence interval, of the same order of magnitude as on test-retest differences on a single device. The interest of this device also extends to academic research as it should encourage the prototyping of innovative hearing tests by the community, in order to better understand the diversity of hearing problems in the population.

Online Simulation Education for Audiometry Training.

The purpose of this clinical focus article was to describe a new online simulation program for pure-tone audiometry. Fictional but realistic patient profiles and testing environments were created to teach students about hearing screening protocols and pure-tone audiology. The diversity of the demographics of the United States is represented throughout the program. The web app was created using HTML/JS/CSS with a Flask server backend and MySQL database. The program allows students to learn the process of conducting a hearing screening and measuring audiometric thresholds using a web-based virtual clinical audiometer. The virtual audiometer includes standard audiometer features and allows for instruction based on standard guidelines. The diversity of the patients within the simulation program allows for discussions of diversity to be woven throughout the curriculum. The new simulation program is designed for use as a clinical training tool enabling undergraduate and graduate students to actively participate in hearing screening testing and pure-tone audiometry using any web browser. The program is also designed with the intent to improve pedagogical outcomes at the undergraduate and graduate level for communication sciences and disorders education for pure-tone audiometry by providing instructors with content that focuses on the diversity that is represented in the demographics of the United States.

Development and Pilot Testing of Smartphone-Based Hearing Test Application.

Background: Identifying and treating hearing loss can help improve communication skills, which often leads to improved quality of life. Many people do not seek medical treatment and, therefore, go undiagnosed for an extended period before realizing they have hearing loss. This study presents a self-administered, low-cost, smartphone-based hearing test application (HearTest) to quantify the pure-tone hearing thresholds of a user. The HearTest application can be used with commercially available smartphone devices and an earphone with the mentioned specification. Methods: Air-conduction-based pure-tone audiometry for the smartphone application was designed and implemented to detect hearing thresholds using a traditional “10 dB down and 5 dB up” approach. Employed smartphone-earphone combination was calibrated with respect to a GSI-61 audiometer and insert earphone ER-3A to maintain clinical standards with the help of subjective testing on 20 normal-hearing (NH) participants. Results: Further subjective testing on 14 participants with NH and retesting on five participants showed that HearTest achieves high-accuracy audiogram within clinically acceptable limits (≤10 dB HL mean difference) when compared with the reference clinical audiometer. Hardware challenges and limitations in air-conduction-based hearing tests through smartphones and ways to improve their accuracy and reliability are discussed. Conclusion: The proposed smartphone application provides a simple, affordable, and reliable means for people to learn more about their hearing health without needing access to a formal clinical facility.

A novel approach to initial hearing assessment

Objective: justifying the possibility of using frequency-based hearing research via the web application ‘Automated System for Initial Hearing Assessment’. Materials and methods. The study was carried out at the Department of Otorhinolaryngology of the Samara State Medical University clinics in October 2019. It involved 91 patients 17 to 73 years old (average age 48±14.6 years). All study participants were divided into two age groups: Group I 17-59 years old), and Group II (over 60 years old). Patients were required to undergo two hearing assessment tests: using the Interacoustics AC-40 clinical audiometer and using our web application ‘Automated System for Initial Hearing Assessment’ (patent No. 2019664671). Results. The maximum difference in average hearing thresholds between pure-tone threshold audiometry and the web application in Group I was 3.3 dB at a frequency of 2 kHz on the right and 3.2 dB at frequencies of 2 and 4 kHz on the left; in Group II, it constituted 4.7 and 3.5 dB at 1 and 2 kHz, on the right, correspondingly, and 7.2 dB at 4 kHz on the left. The presented data were evaluated using the Cohen’s kappa coefficient, which confirmed high level of agreement between the results obtained using the clinical audiometer vs. our original web application. Conclusion. Based on the obtained results, a conclusion was made about the possibility of using the original web application for the initial hearing express assessment in general practice in conditions of limited availability of audiological care.

The Relationship between Psychoacoustic and Electrophysiological Assessments of Temporal Resolution.

Temporal resolution is essential to speech acoustic perception. However, it may alter in individuals with auditory disorders, impairing the development of spoken and written language. The envelope of speech signals contains amplitude modulation (AM) that has critical information. Any problem reducing the listener's sensitivity to these amplitude variations (auditory temporal acuity) is likely to cause speech comprehension problems. The modulation detection threshold (MDT) test is a measure for evaluating temporal resolution. However, this test cannot be used for patients with poor cooperation; therefore, objective evaluation of MDT is essential. The main aim of this study is to find the association between the auditory steady-state response (ASSR) and psychoacoustic measurement of MDT at different intensity levels and to assess the amplitude and phase of ASSR as a function of modulation depth. This was a correlational research. Eighteen individuals (nine males and nine females) with normal hearing sensitivity, aged between 18 and 23 years, participated in this study. ASSR was recorded at fixed AM rates and variable AM depths for carrier frequencies of 1,000 and 2,000 Hz with varying intensities. The least AM depth, efficient to evoke an ASSR response, was interpreted as the physiological detection threshold of AM. The ASSR amplitude and phase, as a function of AM depth, were also evaluated at an intensity level of 60 dB hearing level (HL) with modulation rates of 40 and 100 Hz. Moreover, the Natus instrument (Biologic Systems) was used for the electrophysiological measurements. An AC40 clinical audiometer (Intra-acoustic, Denmark) was also used for the psychoacoustic measurement of MDT in a similar setting to ASSR, using the two-alternative forced choice method. Pearson's correlation test and linear regression model and paired t-test were used for statistical analyses. A significant positive correlation was found between psychoacoustic and electrophysiological measurements at a carrier frequency of 1000 Hz, with a modulation rate of 40 Hz at intensity levels of 60 dB HL (r = 0.63, p = 0.004), 50 dB HL (r = 0.52, p = 0.02). A significant positive correlation was also found at a carrier frequency of 2000 Hz, with a modulation rate of 47 Hz at 60 dB HL (r = 0.55, p = 0.01) and 50 dB HL (r = 0.67, p = 0.002) and a modulation rate of 97 Hz at 60 dB HL (r = 0.65, p = 0.003). Moreover, a significant association was found between the modulation depth and ASSR amplitude and phase increment at carrier frequencies of 1,000 and 2000 Hz, with modulation rates of 40 and 100 Hz. There was a significant correlation between ASSR and behavioral measurement of MDT, even at low intensities with low modulation rates of 40 and 47 Hz. The ASSR amplitude and phase increment was a function of modulation depth increase. The findings of this study can be used as a basis for evaluating the relationship between two approaches in the clinical population.

Utilizing True Wireless Stereo Earbuds in Automated Pure-Tone Audiometry.

True wireless stereo (TWS) earbuds have become popular and widespread in recent years, and numerous automated pure-tone audiometer applications have been developed for portable devices. However, most of these applications require specifically designed earphones to which the public may not have access. Therefore, the present study investigates the accuracy of automated pure-tone audiometry based on TWS earbuds (Honor FlyPods). The procedure for developing an automated pure-tone audiometer is reported. Calibration of the TWS earbuds was accomplished by electroacoustic measurements and establishing corrected reference equivalent threshold sound pressure levels. The developed audiometer was then compared with a clinical audiometer using 20 hearing-impaired participants. The average signed and absolute deviations between hearing thresholds measured using the two audiometers were 3.1 dB and 6.7 dB, respectively. The overall accuracy rate in determining the presence/absence of hearing loss was 81%. The results show that the proposed procedure for an automated air-conduction audiometer based on TWS earbuds is feasible, and the system gives accurate hearing level estimation using the reported calibration framework.

Evaluation of the cochlear implantation users rehabilitation results using psychoacoustic methods

To investigate the correlation of the speech intelligibility in quiet with frequency resolving power (FRP) of hearing using a ripple-spectrum phase reversion test (RSPRT) in CI users. The study includes 30 CI users, three of them after bilateral CI, aged from 13 to 63 years with CI usage experience from 1 year to 16 years. 19 patients used CI systems manufactured by Cochlear Ltd. (Australia), 11 patients used CI systems manufactured by Advanced Bionics (Switzerland). All subjects underwent a number of studies including pure tone audiometry (TPA), speech audiometry in quiet using a multi-syllable speech material on a two-channel clinical audiometer AC-40 (Interacoustics A/S, Denmark); PC with recorded phonetic material from which the signal was reproduced, acoustic speaker SP90 (Interacoustics A/S, Denmark), for FRP estimation - RSPRT test in a free sound field, which was installed on the PC and also reproduced through SP 90 speakers (Interacoustics A/S, Denmark) were used. According to TPA results in a free sound field, the sound perception thresholds in all subjects corresponded to the mild degree sensorineural hearing loss. The sound perception threshold in the free sound field in the range from 500 Hz to 4 kHz was within the range of 25-30 dB nHL. The percentage of speech intelligibility in quiet in the free sound field ranged from 5 to 100%. During the FRP study of patients using RSPRT test, the following results were obtained: the average value of RSPRT test results at the frequency of 1 kHz was 1.94 RPO; for 2 kHz - 2.3 RPO; for 4 kHz - 2.2. The significant correlation between the speech intelligibility in quiet and frequency resolution of hearing was obtained at 1 and 4 kHz. The highest correlation coefficient was detected at 1 kHz - r=0.57 (p=0.0005), while at 4 kHz it was lower - r=0.46 (p=0.009), and at 2 kHz - at the boundary of the significance: r=0.34 (p=0.051). As a result of the study, it was found that there is a correlation between speech intelligibility in quiet and FRP of hearing, which makes it possible to recommend the use of RSPRT in assessing the auditory rehabilitation of patients after CI.

Performing examination on «MA-52 clinical audiometer» — device for speech audiometry

The article presents description and results of the examination with application of «Clinical audiometer MA-52» device.

CLINICAL AND AUDIOLOGICAL VALUES IN THE EARLY DIAGNOSIS OF HEARING IMPAIRMENTS AND RISK GROUPS AMONG SHIP REPAIR WORKERS

Introduction: The hazardous effect of industrial noise exposure on ship repair workers has been highlighted in a number of studies. However, no data are currently available for studying the effect of noise exposure on the auditory system and general health of ship repair workers. The aim: The study is focused on the early diagnosis of hearing impairments and identifying risk groups among the workers. Materials and methods: It was examined two groups of workers of approximately the same age and length of employment. The Group 1 included workers from the Azov Shiprepair Yard (Mariupol city, Ukraine) who were exposed to workplace noise impact of less than 80 dBA threshold level, the workplace noise level in the Group 2 was above 80 dBA. Audiometric testing was conducted in a sound-treated room using the MA 31 clinical audiometer (Germany). Results: Our findings indicate that all the noise-exposed groups of ship repair workers should be conducted audiometric testing. The hearing levels at the audiometric test frequencies of 4, 6 and 8 kHz, as well as differential thresholds at the audiometric test frequencies of 4 kHz by the Luscher-Zwislocki method should be taken into account. Such complaints as increased annoyance, sleep disorder, tinnitus aurium, hypertension should be considered as most hazardous. Conclusions: We recommend that the ship repair workers undergo routine medical check-ups and systematic prophylactic observation. All these preventive measures will contribute to the early detection of hearing impairments, thereby timely preventing the development and progression of occupational sensorineural hearing loss.

Bone Conduction as a Viable Alternative to Current Communications Systems in Fighter Cockpits.

Effective voice communication is essential when operating aircraft. Because of the loud operating environment in fighter cockpits, it has been a challenge to provide effective communication while simultaneously protecting the hearing sense. The objective of this study was to determine the feasibility of using bone conducting transducers (BCT) in place of legacy communications systems in fighter cockpits. A military flight helmet was modified and outfitted with BCT and air-conducting speakers. BCT were independently tested against air-conducting speakers using a clinical audiometer under three conditions: without earplugs, with earplugs, and with earplugs in the presence of 100-dB broad-spectrum noise. Three test subjects were given an audiological examination using tones of varying intensity ranging from 100 Hz to 8000 Hz. The lowest hearable intensity indicated by button press was recorded for each frequency. In the presence of 100-dB ambient noise, bone conducting transducers performed better than air-conducting speakers at all frequencies. Hearability of BCT by audiogram was, on average, 10-20% lower intensity (dB) than air-conducting speakers. Currently, USAF pilots wear two layers of hearing protection; i.e., the helmet's integrated earcup and some form of ear plug (e.g., foam earplug or custom-molded earbud). Our results suggest that bone conducting audio transducers may be better for layered hearing protection than air-conducting speakers when used with foam earplugs. Given the cost, complexity, and non-interoperability of custom-molded earphones, helmet-integrated bone conducting transducers and foam earplugs may be a better option for sustained airborne operations.Bradke BS, White Z, Poston J. Bone conduction as a viable alternative to current communications systems in fighter cockpits. Aerosp Med Hum Perform. 2018; 89(10):927-930.

Asymmetric Flankers in Comodulation Masking Release.

Background and ObjectivesDetection of auditory signals may be improved when maskers far from the frequency of the target signal are coherently amplitude-modulated. This improvement of signal detection is called comodulation masking release (CMR). In the CMR experiments, flankers have been usually arranged symmetrically. In practice, we will be confronted with a problem by using symmetric flankers due to the limited output of clinical audiometers, especially at high-frequency. We aimed to check whether flanker arrangement has any effect on the amount of CMR, especially when there is no flankers with a frequency higher than the signal.Subjects and MethodsEighteen normal hearing listeners ranging in age from 20 to 46 years old participated. Symmetric (2-2) and asymmetric (3-1 and 4-0) flankers were used and then the amount of CMR compared among them.ResultsOur results showed in the same numbers of flankers, there were no statistically CMR differences between symmetric and asymmetric arrangement. Also when we did not have a flanker at a frequency higher than the signal and all flankers were placed below the signal, there was no statistically difference with the symmetric arrangement.ConclusionsThe asymmetry of the flankers and also omitting the flankers with a frequency higher than the signal, have no effect on CMR results. We concluded that CMR can be considered by using clinical audiometer.

The Impact of Vitamin D Deficiency on Retinopathy and Hearing Loss among Type 2 Diabetic Patients.

Aim The current study was aiming to investigate the relation between vitamin D, retinopathy, and hearing loss among type 2 diabetes mellitus (T2DM) patients. Methods Cross-sectional study carried on 638 subjects aged between 20 and 60 years who visited the Endocrinology, Ophthalmology, and ENT Outpatient Clinics of the Medipol Hospital during the period from March 2016 to May 2017. Two audiometers Grason Stadler GSI 61 and Interacoustics AC40 Clinical audiometer were used to evaluate the hearing loss. Risk factors for diabetic retinopathy were evaluated, including age, sex, diabetes duration, glycated hemoglobin (HbA1c), hypertension, and lipid profiles. Results The mean age (± SD, in years) for retinopathy with hearing loss versus normal subjects was 47.7 ±10.2 versus 48.5±9.1. The associated risk factors were significantly higher in T2DM with hearing loss, hypertension (32.6% versus 15.7%), tinnitus (40.0% versus 18.0%), vertigo (59.7% versus 26.8%), and headache (54.9% versus 45.3%), than in normal hearing diabetes. There were statistically significant differences between hearing impairment versus normal hearing for vitamin D [19.40±9.71 ng/ml versus 22.67±9.28 ng/ml; p<0.001], calcium, magnesium, phosphorous, cholesterol, HDL-C, LDL-C, albumin, systolic blood pressure [131.70±9.25 Hg versus 127.73±11.98 Hg], diastolic blood pressure [82.20±8.60 mm Hg versus 79.80±8.20 mm Hg], and microalbuminuria. Multivariate logistic regression analysis revealed that variables such as vertigo, duration of DM, mobile/I pad phone, vitamin D deficiency, sleeping disturbance, headache, frequently TV watching, tinnitus, cigarette smokers, and hypertension were considered at higher risk as a predictors of retinopathy with hearing loss among diabetic patients. Conclusion Vitamin D deficiency is considered as a risk factor for diabetic retinopathy and hearing loss among diabetic patients. Meanwhile, hyperglycemia could be considered as a modifiable risk factor for diabetic retinopathy; tight glycemic control may be the most effective and important therapy for improving quality of life and substantially reducing the incidence of retinopathy and in T2DM patients.

F194. Cerebellar contributions to somatosensory induced neuroplasticity

Monitoring, processing and integration of sensory inputs by the cerebellar circuitry is important for learning and adaptation in order to anticipate sensory events. The aim of this transcranial magnetic stimulation (TMS) study is to investigate the cerebellar involvement in the formation of cortical plasticity in response of vibrotactile hand stimulation. Such somatosensory-induced plasticity within the sensorimotor area was demonstrated in our previous studies. However, the afferent signals to the sensorimotor area are gated by extrinsic vertical pathways such as the cerebello-thalamo-cortical pathway, which raise the assumption of possible influence from subcortical relays along this neuronal route. Examining this hypothesis is of potential importance for patients with cerebellar lesions. The activation of the cerebello-thalamo-cortical networks in response to vibrotactile hand stimulation was assessed using TMS and twin coil for conditioning stimulation of the ipsilateral cerebellum and test stimulation of the contralateral motor cortex. Motor evoked potentials (MEP) were recorded from the right first dorsal interosseus muscle. The cerebellocortical inhibition (CBI) was tested before and after hand stimulation at 25 Hz for 20 min (HANDSTIM) versus SHAM in 14 healthy subjects in within subject design. Additionally vibration threshold (using a bone conduction probe of a clinical audiometer) and motor performance (Pegboard test) were evaluated. Following HANDSTIM the normalized MEP amplitude was increased which shows reduced effect of CBI. The vibration threshold was decreased for 30 min while the Pegboard test motor performance remained unchanged. No effects were found in response to SHAM stimulation. The reduction of CBI in response to hand vibrotactile stimulation confirms the cerebellar involvement in mediating the sensory information to the cortex and will be compared in a follow-up study to patients with an infarct on the territory of the posterior inferior cerebellar artery. These patients often show sensorimotor/learning deficits, whereby the processes staying behind these effects are still not clarified.

Hearing Status of the Traffic Police with or without Use of Sound Protector in Dhaka Metropolitan City

Background: Sound protector is an essential tool to protect hearing.Objective: The purpose of the present study was to see the hearing status of traffic police with or without sound protector.Methodology: The cross-sectional study was conducted in the Department of Otolaryngology and Head Neck Surgery at Bangabandhu Sheikh Mujib Medical University, Dhaka from January 2003 to June 2004 for a period of one and half year. Traffic police who were working in the Dhaka metropolitan city at any age were included as study population. Hearing status was measured to all subjects. The traffic police at any age working in the Dhaka metropolitan city with the duration of service more than 5 years were included as study population. Otoscopic examination, tuning fork test and pure tone audiometry were performed by clinical audiometer (AC 33) with two channels, with TDH39 earphones among the entire study subject.Result: A total number of 100 traffic polices working in Dhaka metropolitan city were examined. Highest (56%) number of the respondents was in between 30 to 40 years of age group. The mean age with SD was 36.15 ±5.5. In this study 53.0% respondents found to have exposure of 6 to 10 years and 16.0% found to have exposure between 16 to 20 years. It was found that 26 traffic police used ear protector occasionally. Among them 7(26.9%) subjects had different degree of hearing loss. Nonusers had higher rate (23%) of hearing loss (p=0.685).Conclusion: In conclusion use of sound protector by traffic police is not significantly related with the hearing loss though this is clinically significant.Journal of Current and Advance Medical Research 2017;4(1):13-16

Temporomandibular Joint Disorders as a Cause of Aural Fullness.

ObjectivesTemporomandibular joint disorders (TMD) are often associated with aural manifestations. However, it is not clear whether aural fullness could be induced by TMD. The purpose was to investigate the TMD and effectiveness of TMD treatments in patients with mainly or exclusively aural fullness complaint.MethodsOne hundred and twelve patients, who had aural fullness as the main or sole complaint, presented to the Otolaryngology Department, PLA Army General Hospital, Beijing, China, between January 2010 and January 2015. Patients’ medical history indicated that they had previously been diagnosed and treated for otitis media or sensorineural hearing loss but without positive results. Patients were subjected to pure tone audiometry and acoustic immittance screening using GSI-61 clinical audiometer and GSI TympStar middle ear analyzer respectively. Patients were examined by questionnaire, X-ray and/or computed tomography scan of temporomandibular joint. TMD was categorized according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Patients were then treated for TMD.ResultsAll the patients showed normal eardrum and type A tympanogram. The patients of 60.7% (68/112) were classified as group I TMD disorders (muscle disorders), 34.8% (39/112) were group II (disc displacements), and 4.5% (5/112) were group III (arthralgia, osteoarthritis, and osteoarthrosis). Aural fullness was completely resolved or significantly improved in 67 and 34 patients respectively following treatments aimed at improving TMD, with a combined effectiveness of 90.2% (101/112). TMD treatments are especially effective (94.1%) in group I TMD.ConclusionTMD as a potential cause of aural fullness should be considered in otolaryngology practice.

Examination of Insert Ear Interaural Attenuation (IA)Values in Audiological Evaluations

The purpose of this study was to evaluate Interaural Attenuation (IA) in frequency base in the insert earphones that are used in audiological assessments. Thirty healthy subjects between 18-65 years of age (14 female and 16 male) participated in our study. Otoscopic examination was performed on all participants. Audiological evaluations were performed using the Interacoustics AC40 clinical audiometer and ER-3A insert earphones. IA value was calculated by subtracting good ear bone conduction hearing thresholds of the worst airway hearing threshold. In our measuring for 0.125-8.0 kHz frequency were performed in our audiometry device separately for each frequency. IA amount in the results we found in 1000 Hz and below frequencies about 75-110 dB range avarage is 89±5dB, in above 1000 Hz frequencies in 50-95 dB range and avarage it is changed to 69±5dB. According to the obtained findings the quantity of melting in the transition between the ears are increasing with the insert earphones. The insert earphone should be beside supraaural earphone that is routinely used in clinics. Difficult masking applications due to the increase in the value of IA can be easily done with insert earphones.

Software intelligent system for effective solutions for hearing impaired subjects

PurposeThe anatomy and physiology of the ear is complex in nature, which makes it a challenge for audiologists to prescribe solutions for varied hearing-impaired subjects. There is a need to increase the satisfaction level of hearing-aid users by adopting better strategies that involve modern technological advancements. AimTo design and develop a decision support Software Intelligent System (SIS) that performs audiological investigations to assess the degree of hearing loss and to suggest appropriate hearing-aid gain values. MethodsSIS is developed based on the study conducted in the Government General Hospital, Chennai, India, between 2013 and 2015. In the study period, audiological investigations were performed on 368 subjects, using the clinical audiometer (Inventis-Piano, Italy) and the SIS. Gain suggestions were recommended for hearing-aid users (Siemens Intuis life & Intuis-SP) using standard prescriptive procedures, alterations made by the audiologists, and by the SIS. It was developed with artificial neural network-based gain predictions. ResultsOf the tested subjects, 256 were identified as hearing-impaired. The calculated sensitivity, specificity and accuracy of the computerised audiometer incorporated in the SIS are 93%, 85% and 90% respectively. Furthermore, 86% of the hearing-impaired subjects were satisfied during their first hearing-aid trial with the gain recommendations from SIS. ConclusionThe findings suggest that the proposed SIS could be used to perform audiological screening tests and to recommend appropriate hearing-aid gain values to the hearing-impaired subjects. This could eventually be helpful for audiologists in the areas where routine mass audiological screening and fast hearing-aid solution is required.