dB Hearing Level Research Articles

Universal Newborn Hearing Screening and Postnatal Hearing Loss

The goal of this study was to determine the percentage of children who have a postnatal permanent childhood hearing impairment (PCHI) and the percentage thereof who have risk indicators for a postnatal hearing loss. Data were drawn retrospectively from the clinical charts of children who had bilateral PCHI (>40 dB hearing level, better ear, unaided) and had undergone universal newborn hearing screening (UNHS) between 1995 and 2000 in various Austrian hospitals. A hearing loss was recognized as postnatal when a child passed UNHS but was later found to have a hearing impairment. The presence of risk indicators, as suggested by the Year 2000 Statement of the American Joint Committee on Infant Hearing (JCIH), was assessed by reviewing the children's clinical charts. Of a total of 105 children with bilateral PCHI, 23 (22%) showed postnatal impairment. After correction of this number for underascertainment, postnatal impairment was estimated to account for 25% of all bilateral PCHI at age 9 years. Risk indicators were found in 17 children but did not fully correspond to those proposed by the JCIH. The risk factors found were a family history of hearing loss (3 children), meningitis (2), craniofacial malformation (2), persistent pulmonary hypertension (1), congenital cytomegaly infection (1), extracorporeal membrane oxygenation (1), recurrent otitis media with effusion (1), and, in addition to the JCIH list, ototoxic therapy (5), and birth before 33rd gestational week (2) (1 child had a combination of the last 2). Six children showed no risk indicators for the postnatal hearing loss. Our findings suggest that approximately 25% of bilateral childhood hearing loss is postnatal, which supports the leading role of UNHS in detecting PCHI. Provisions for also identifying postnatal cases nevertheless are justified. Because in some of these children no risk indicators are detectable and in others the hearing deterioration starts after age 3 years, audiologic monitoring of at-risk children up to this age may not be sufficient. Additional methods, such as hearing screening at nursery schools or schools, are recommended.

Hearing impairment and cardiovascular disease risk factors in the Georgia Older Americans Nutrition Program

Hearing impairment is the third most common chronic health condition in older adults and is associated with impaired physical, emotional, and social function. Some researchers have suggested that cardiovascular risk factors are related to hearing impairment (Gates et al., 1993; Rosen & Olin, 1965). Therefore, we investigated these possible relationships in 147 older adults at senior centers. More than 70% had hearing impairment, defined as air conduction pure-tone average (1, 2, and 4 kHz) threshold greater than 25 dB hearing level in the worse ear. In a series of logistic regression analyses controlled for age, gender, and race, participants with hearing impairment had non-significant trends for lower mean HDL cholesterol levels (53 mg/dl vs. 61 mg/dl, p=0.08), higher prevalence of HDL cholesterol < 40 mg/dl (20% vs. 11%, p=0.47) and total cholesterol/HDL cholesterol ratio >3.5 (67% vs. 53%, p=0.32), greater ratio of total cholesterol/HDL cholesterol (4.1 vs. 3.7, p=0.43), and higher mean triglycerides (182 mg/dl vs. 158 mg/dl, p=0.25). In this sample, CVD risk factors were not generally associated with hearing impairment, perhaps because of the relatively small sample size, the advanced age of the participants, and the severity of their hearing loss. Funding: USDA-NRICGP #2000-01327, HATCH GA-AES #GEO00916.

Race and Sex Differences in Age‐Related Hearing Loss: The Health, Aging and Body Composition Study

To determine the prevalence of and risk factors for hearing loss in a sample of 2,052 older adults (aged 73-84; 46.9% male, 37.3% black) enrolled in the Health, Aging and Body Composition (Health ABC) Study. Cross-sectional analysis of a longitudinal cohort study. Pittsburgh, Pennsylvania, and Memphis, Tennessee, areas. Random sample of Medicare beneficiary subjects enrolled in the Health ABC program from 1997 to 1998. They included 2,052 individuals: 660 white men (32.2%), 631 white women (30.8%), 310 black men (15.1%), and 451 black women (22.0%). Participants ranged in age from 73 to 84, with a mean age of 77.5. Hearing sensitivity was measured using pure-tone threshold testing. Hearing loss was defined based on two averages of hearing thresholds: 500, 1,000, and 2,000 Hz greater than 25-decibel (dB) hearing level (HL) (hearing loss); and 2,000, 4,000, and 8,000 Hz greater than 40-dB HL (high-frequency hearing loss). Potential hearing loss correlates, including demographics, medical history, ototoxic medication use, occupational noise exposure, and lifestyle factors, were collected via questionnaire. The prevalence of hearing loss was 59.9%; the prevalence of high-frequency hearing loss was 76.9%. Hearing loss was most common in white men, followed by white women, black men, and black women. Older age, white race, diabetes mellitus, cerebrovascular disease, smoking, poorer cognitive status, occupational noise exposure, and ear surgery were associated with hearing loss after multivariable adjustment. Race- and sex-specific risk factors included higher blood pressure and occupational noise exposure (white men), poorer cognitive status and smoking (black women), and low total hip bone mineral density (black men). Possible protective factors included salicylate use (overall sample, black men) and moderate alcohol intake (black women). Hearing loss was extremely common in this population. Because many of the identified hearing loss risk factors are modifiable, some of the burden associated with hearing loss in older people should be preventable.

Protective Effect of Isoflurane Anesthesia on Noise‐Induced Hearing Loss in Mice

To examine the protective effect of general anesthesia with isoflurane against noise-induced hearing loss in mice. Animal study using noise stimulation and measurement of hearing in BALB/c mice. Mice were exposed to 122 dB peak equivalent sound pressure level click noise for 3 hours per day for 3 consecutive days with or without anesthesia using isoflurane. Hearing levels were measured and hair cell survival ratio was observed. In mice without anesthesia, hearing threshold increased after noise stimulation (73.7 dB hearing level [HL]) and persisted for at least 1 month. However, in mice exposed to noise under anesthesia, hearing loss was less severe (44.1 dB HL) and had recovered more (26.5 dB HL) by one month. Histological examination showed hair cell survival was higher in anesthetized compared to non-anesthetized mice. These data indicate isoflurane general anesthesia protects against noise-induced hearing loss and tissue damage in mice.

Mastoid and Epitympanic Obliteration in Canal Wall Up Mastoidectomy for Prevention of Retraction Pocket

To evaluate the surgical outcome in patients who have undergone mastoid and epitympanic obliteration technique. : Retrospective review. Tertiary care referral center. The study group included 151 patients with cholesteatoma who underwent mastoid and epitympanic obliteration technique. This technique was applied to cases who had a strong chance of recurrent retraction pocket and cholesteatoma formation, including those patients with an adhesive drum indicating poor eustachian tube function (n = 52) and patients with a destructive scutum (n = 68). Thirty-one patients had both an adhesive drum and a destructive scutum. The connection between the mastoid cavity and the middle ear was blocked by obliterating the epitympanum and antrum with bone pate and the remaining mastoid cavity with abdominal fat. The postoperative drum state, the incidence of retraction pocket formation and cholesteatoma recurrence, the surgical complications of obliteration, and the hearing outcome. In 114 of 151 patients (75.4%), the middle ear was well healed and well aerated. The retraction pocket formation or cholesteatoma recurrence did not develop in any subject. Postauricular skin depression was the most common complication of this technique (n = 31 [20.5%]). In three patients (2.0%), the bone pate used for obliteration was infected. Of the 56 cases who underwent a staged operation to regain their hearing, 37 resulted in a postoperative air-bone gap less than 20 dB hearing level. Mastoid and epitympanic obliteration is an effective option for preventing a retraction pocket and cholesteatoma recurrence in patients with a poorly functioning eustachian tube or a defective scutum, while preserving the same advantage of the canal wall up technique.

Evaluation of the Austrian Newborn Hearing Screening Program

Universal Neonatal Hearing Screening (UNHS) has been gradually implemented since the mid-nineties in Austrian maternity wards and neonatal intensive care units. This study evaluated the effect of UNHS on reducing age at identification as well as age of intervention for children with congenital and perinatal sensorineural hearing impairment. This was a retrospective analysis of clinical data of 394 Austrian children diagnosed with an at least mild degree (> 20 dB hearing level) of permanent sensorineural hearing loss. Age at identification and age at intervention were compared between children who underwent UNHS ('with UNHS') and those who did not undergo UNHS ('without UNHS'). The median of age of identification was 37.6 months in children without UNHS, and 3.9 months in children with UNHS. By six months of age, 69% of hearing-impaired children who underwent UNHS, were identified but only 6% of those without UNHS. At one year, the corresponding percentages are 80% and 12%, respectively. In children without UNHS, the degree of hearing loss was the most predictive factor of age at identification (median of age at diagnosis for profound hearing loss: 15 months; severe: 26 months; moderate: 52 months; mild: 73 months). In children with UNHS, age of identification was unrelated to degree of hearing loss (medians between 3.7 and 4.4 months). In the majority of children intervention began within one month after diagnosis, regardless of whether or not the child was identified by UNHS. UNHS greatly increases the proportion of children whose hearing impairment is diagnosed before six months of age. However, in some 20% of children, hearing impairment was diagnosed later than one year of age, despite having failed the screening. Additionally, data from this study suggest that about 15% of childhood hearing losses manifest themselves after the hearing screening period. Efforts are thus required for the early detection of these children as well.

Grommets in otitis media with effusion: an individual patient data meta-analysis

Aims: To identify subgroups of children with otitis media with effusion (OME) that might benefit more than others from treatment with ventilation tubes. Methods: An individual patient data (IPD) meta-analysis...

Protective Effect of Isoflurane on Noise-induced Hearing Loss in Mice

Background: It is well known that the loud noise exposure can lead to noise-induced hearing loss (NIHL). Drilling during mastoid surgery may result in NIHL. The noise level produced by drilling of the mastoid bone can exceed 125 dB HL (hearing level); therefore, mastoid surgery itself is associated with a lower incidence of NIHL than expected. The aim of this study was to analyze the effects of isoflurane on NIHL and hair cell morphological changes. Methods: BALB/c mice were divided into 2 groups; a control group (n = 20) and an isoflurane group (n = 20). The mice of both groups were exposed to 120 dB SPL (sound pressure level) broadband white noise for 3 hours per day, for 3 consecutive days. The mice in the isoflurane group were anesthetized with isoflurane while exposed to the noise. The auditory brainstem response (ABR) thresholds were determined 1 day before and after the noise-exposure and then again after 7 days. Both cochlea were removed and stained using fluorescent isothiocyanate (FITC) phalloidin. Results: 1 day prior to noise-exposure, the ABR thresholds were those of a normal hearing level in both the control and isoflurane groups. In the control group, the mean hearing threshold was 78.0 2.6 dB HL after 1 day of noise-exposure and 81.5 3.4 dB HL after 1 week; in the isoflurane group, the mean hearing threshold was 49 11.7 dB HL after 1 day and 30.5 9.3 dB HL after 1 week. The hearing thresholds after noise exposure in the control were significantly higher than those in the isoflurane group (P ＜ 0.05). Conclusions: The occurrence of NIHL decreased and the hair cell damage suppressed in the mice exposed to intense noise while anesthetized by isoflurane.

Increased Amplitudes of Distortion Product Otoacoustic Emissions in Patients with Unilateral Acoustic Neuroma

We present a case series of 4 patients with a unilateral acoustic neuroma and increased amplitudes of the distortion products of otoacoustic emissions (DPOAEs) at the low- and middle- frequency bandwidth on the involved side compared to the uninvolved side despite a 28-dB hearing level (HL) worse (compared to the uninvolved side) pure-tone hearing threshold average for standard audiometric frequencies between 1 and 6 kHz at the involved side. In 3 of these patients, 2 with an inferior vestibular nerve origin of the acoustic neuroma and one in whom the nerve of origin could not be unequivocally defined, the tumor was extending extrameatally. One patient had a purely intrameatal acoustic neuroma of superior vestibular nerve origin. Moreover, notable was the presence of the DPOAEs in all of the involved ears despite elevated pure-tone hearing thresholds (pure- tone averages for the standard audiometric frequencies between 1 and 6 kHz ranging between 36 and 62 dB HL).

Neuroprotective Effects of Brain-Derived Neurotrophic Factor (BDNF) on Hearing in Experimental Pneumococcal Meningitis

Bacterial meningitis is still one of the most common causes of acquired profound sensorineural deafness in children despite antibiotic treatment. We investigated the neuroprotective effects of brain-derived neurotrophic factor on hearing function in experimental bacterial meningitis. We implanted stainless steel tubes into both cerebral ventricles of Sprague-Dawley rats aged 21 days. Bacterial meningitis was induced by inoculating a strain of serotype III Streptococcus pneumoniae into the cisterna magna. Six micrograms per day of brain-derived neurotrophic factor (groups 1 and 3) or albumin (groups 2 and 4) was injected into the cerebral ventricles 24 hours after or before infection, respectively, for a duration of 7 days. Additionally, all rats received antibiotic subcutaneous treatment starting 24 hours after infection for 7 days. Brainstem auditory evoked potentials were recorded 24 hours before and 24 hours after infection and after 7 days of treatment with brain-derived neurotrophic factor or placebo and antibiotics, respectively, to determine hearing threshold. Our results showed that the hearing thresholds of animals in each group increased significantly 24 hours after infection compared with the results recorded 24 hours before infection (P < .01). After 7 days of treatment with brain-derived neurotrophic factor, brainstem auditory evoked potential responses recurred in 16 ears when stimulated at 75 dB hearing level in groups 1 and 3. Their hearing thresholds significantly decreased compared with the control group 2 (P < .05) and group 4 (P < .01). However, 13 of 14 ears absent brainstem auditory evoked potential responses could still not be identified at 75 dB hearing level in control groups 2 and 4. The improvement of the hearing thresholds in group 3 (treated before infection) was greater than that of group 1 (treated after infection) (P < .05), but there was no significant difference found between the control groups before and after infection (P > .05). Our study supports the hypothesis that the administration of exogenous brain-derived neurotrophic factor can be effective in preventing or treating hearing loss following bacterial meningitis.

Audio-vestibular disturbances in Behcet’s patients: report of 62 cases

This study was carried out to determine the characteristics and incidence of hearing loss and vestibular disturbance in Behcet’s syndrome with a large number of patients. Sixty-two patients with Behcet’s syndrome were included in this study, 34 men and 28 women whose mean age was 33.7 (15–60). Sixty-two healthy normal control subjects (38 male and 24 female) were included. Patient and control groups were questioned about any history of audio-vestibular disturbance and underwent physical and ENT examination and the following audiologic tests: pure tone audiometric test (0.25, 0.5, 1, 2, 4, and 6 kHz), tympanogram, speech discrimination, short increment sensitivity index, tone-decay test, auditory brainstem response. Vestibular system was evaluated by videonistagmogram and caloric test. Cranial and brainstem magnetic resonance imagine (MRI) of patients who have vestibular disturbances were practiced to examine the central nervous system. Both the patient and the control groups were tested with the HLA-B51 antigen. Pure tone audiogram showed sensory-neural hearing loss (⩾25 dB hearing level in at least two frequencies) in 20 of the 62 (32%) Behcet’s patients while the control group were normal. There was a hearing loss involving high frequencies in the audiograms of Behcet’s patients with hearing disturbances. The recruitment investigation tests and auditory brain stem response confirmed cochlear involvement in all 20 patients. Caloric stimulation tests revealed a normal vestibular function in all patient and control group. In electronystagmography, 21 (34%) patients had hypometric or hypermetric saccades and smooth pursuit tests showing that 4 (6%) patients had pathological changes while the control group was normal. HLA-B51 antigen was found positive in 15 of 20 Behcet’s patient with hearing loss. Conclusion: (1) The hearing and vestibular disturbances in Behcet’s syndrome is more prevalent than previously recognized; (2) Hearing loss in high frequencies in Behcet’s patients is an indicator of cochlear involvement in this disease; (3) There is a higher prevalence of central vestibular syndrome in Behcet’s patients than it was thought before; (4) HLA-B51 antigen may be able to be a prognostic factor for sensorineural hearing loss in Behcet’s patients.

Noise exposure and hearing loss among the traffic policemen working at busy streets of Jalgaon urban centre

Traffic police have a high risk of hearing loss due to road traffic noise exposure. Here estimates are made of typical sound levels prevailing at the work place environment of traffic policemen and measures obtained of the hearing status of policemen The study focused on the traffic policemen working for 10–12 h daily in a noisy environment. Data on self-reported health status was collected by questionnaire and an audiometry used to determine hearing threshold at high and low frequencies. Eighty-four percent of the sample reported hearing loss and defined at least some difficulty in hearing by one or both ears. The prevalence of audiometric hearing impairment defined as a threshold average greater than 25 dB(A) hearing level was 80% for binaural low frequency average (250, 500 and 1000 Hz), 70% for binaural mid-frequency average (1000, 2000, 3000 and 4000 Hz) and 46% for binaural high frequency average (3000, 4000, 6000 and 8000 Hz) in the traffic policemen.

Serum Cotinine Level and Incident Hearing Loss

A growing body of literature suggests an association between cigarette smoking and hearing loss. To assess the relation between levels of serum cotinine, a biomarker of exposure to tobacco smoke, and incident hearing loss. A cross-sectional, incident, case-control study of participants selected from a population-based cohort. Testing was conducted at the Beaver Dam Community Hospital, Beaver Dam, Wis. A total of 197 participants with incident hearing loss and 394 control participants, aged 53 to 75 years, selected from the 2800 participants of the 5-year follow-up examination of the population-based Epidemiology of Hearing Loss Study, 1998-2000. Incident hearing loss. The incidence of hearing loss was defined as a pure-tone average of thresholds at 500, 1000, 2000, and 4000 Hz greater than 25-dB hearing level in either ear at follow-up among those without hearing loss at baseline. No significant associations were found between serum cotinine levels and incident hearing loss. These results were not consistent with a previous report, which found cross-sectional associations between prevalent hearing loss and current smoking and environmental tobacco smoke exposure in the home. Longer-term longitudinal studies of smoking and/or serum cotinine levels and the subsequent development of hearing loss may help clarify these associations.

Audiological Characteristics of Some Affected Members of a Dutch DFNA13/COL11A2 Family

Members of a Dutch DFNA13/COL11A2 family were evaluated with pure tone audiometry, stapedial reflexes, otoacoustic emissions, loudness scaling, difference limen for frequency, gap detection, and speech perception in quiet and noise. The tone audiometry showed a predominant loss for the low and middle frequencies, with only a few otoacoustic emissions at thresholds better than 25 dB hearing level. The stapedial reflexes appeared elevated, and loudness growth curves were shifted parallel to those for normal-hearing subjects, indicating a shift of the dynamic range toward higher presentation levels. The data for the difference limen for frequency, gap detection, and speech perception in noise fell within the (near-)normal range. Despite elevated thresholds, all suprathreshold functions showed fairly normal properties, suggesting an attenuation of signal energy in the cochlea with limited degradation of the cochlea's signal analyzing capabilities. The effect of DFNA13/COL11A2 may thus be characterized as a cochlear conductive loss.

A New Electromagnetic Hearing Aid Using Lightweight Coils to Vibrate the Ossicles

As the first stage in the development of a noninvasive electromagnetic hearing aid, we made a new transducer that generates a high-excitation force to vibrate ossicles via the tympanic membrane. This transducer consists of a core, driving and induction coils, a rare-earth magnet, and a vibrator coil. We designed the core, the driving and induction coils, and the magnet so as to generate the greatest excitation force possible when installed in the external ear canal of humans. With regard to the vibrator coil, which was attached to the center of the tympanic membrane to vibrate the ossicles, we determined its optimal mass, position, and shape both by finite-element method (FEM) analysis and by experiments using an artificial middle ear. A prototype of the optimally designed transducer can generate an excitation force of more than 95 dB sound pressure level (SPL) in terms of sound pressure at frequencies between 0.1 and 10 kHz. This result indicates that the transducer developed in this study can be used to treat patients with a hearing loss up to 70 dB hearing level (HL).

Cochlear implants for children with significant residual hearing.

Previous research suggests that children with pure-tone averages of greater than 90 dB hearing level and/or open-set sentence perception of less than 30% may derive significant benefit from cochlear implantation. To evaluate postoperative speech perception benefit and bilateral-bimodal benefit for 16 children whose preimplant speech perception scores exceeded conservative candidacy guidelines. Preimplant and postimplant repeated-measure design. Sixteen child subjects who obtained 30% or greater on preimplant open-set sentence material, presented live voice audition alone, were selected for this study. Preimplant pure-tone averages ranged from 73 to 110 dB in the better aided ear. Preimplant and postimplant open-set word and sentence testing was completed in quiet and with competing background noise for separate ear and binaural conditions. Fourteen of 16 subjects had improved speech perception scores across all test materials after implantation. Group means were significantly higher for all test materials. Results in the bimodal-bilateral condition were significantly higher than implant alone for open-set word tests (scored for phonemes) and open-set sentences in quiet. The results of this study suggest that, with appropriate counseling and management, some children with significant residual hearing benefit from cochlear implantation, in particular improved speech understanding due to bimodal-bilateral hearing.

A Dutch family with hearing loss linked to the DFNA20/26 locus: longitudinal analysis of hearing impairment.

To perform linkage analysis and to outline hearing loss characteristics in a family exhibiting a nonsyndromic, autosomal dominant type of progressive sensorineural hearing loss. Genetic analysis was performed using microsatellite markers. Audiometric data were collected and analyzed longitudinally. Sigmoidal dose-response curves enabled us to perform nonlinear regression analysis per frequency and on phoneme recognition scores. Speech recognition scores were compared with those of DFNA2, DFNA5, DFNA9, and presbyacusis subjects. Affected family members of a Dutch family (W99-060). We revealed linkage of hearing loss to the DFNA20/26 locus (maximum logarithm of odds score, 3.1 at theta=0.04) and reduced the critical region from 12 to 9.5 centimorgans. Patients younger than 15 years already showed gently downsloping audiograms. At ages 15 to 20 and 25 to 40 years, hearing loss was profound at 8 kHz and 1 to 4 kHz, respectively. The 0.25- to 0.5-kHz thresholds showed more gradual progression by about 1.5 to 2 dB/y. From about age 40 years onward, hearing was residual. Hearing impairment took a more severe course than in a known DFNA20 family. Score recognition in DFNA20/26 subjects was better than in DFNA9 subjects at any pure-tone average (1-4 kHz) threshold. Compared with subjects having DFNA2 and DFNA5, speech recognition in those with DFNA20/26 scored better at threshold levels below 85 dB hearing level, but worse at levels above 90 dB. Compared with presbyacusis subjects, those with DFNA20/26 scored better in speech recognition at levels below 100 dB and worse at levels above 100 dB. Autosomal dominant hearing loss is linked to the DFNA20/26 locus in this Dutch family. The critical region is reduced from 12 to 9.5 centimorgans. Phenotypically, patients are more severely affected than those of a known DFNA20 family.

Hyperbaric Oxygen in the Treatment of Sudden Hearing Loss

Treatment of idiopathic sudden hearing loss (SHL) is still a great problem for the physicians, due to the still unexplained etiopathogenesis of the disease. This retrospective study includes 115 patients with idiopathic SHL and compares two therapy regimens. Of the total number of patients, 51 had been primarily treated by hyperbaric oxygen (HBO) at 2.8 bar. The remaining 64 patients had been treated by pentoxifylline infusions in increasing and decreasing doses. Hearing thresholds were ascertained at the frequencies of 250, 500, 1,000, 2,000 and 4,000 Hz using pure-tone audiometry. The results after treatment showed a statistically significant improvement of hearing by 46.35 (SD ±18.58) dB hearing level (HL) in the group of patients treated with HBO, compared with an improvement of hearing by 21.48 dB HL (SD ±13.5) in the group of patients treated with pentoxifylline infusions (p < 0.001). Furthermore, hearing recovered to physiological values in 24 of 51 (47.1%) HBO-treated patients, compared to only 4 of 64 (6.2%) of the pentoxifylline-treated patients. Furthermore, after pentoxifylline treatment only 8/64 (12.5%) patients showed partial recovery, whereas after HBO therapy 21/51 (41.2%) patients improved up to a mild persistent hearing loss. This indicates strong evidence that HBO therapy is more effective in the treatment of idiopathic SHL than conventional rheological treatment. However, more prospective clinical trials should confirm the efficiency of HBO therapy and lead to its wider application.

Behçet’s disease and hearing loss

Objectives: The aim of this study was to determine the incidence and severity of hearing loss in different frequencies in Behçet’s patients in a Turkish population. Material and method: Sixty-three consecutive cases with Behçet’s syndrome and 63 sex- and age-matched healty subjects as control group were included in this study. A detailed history was taken, all patients underwent neuro-otolological, ophthalmologic and dermatologic examination. Audiometric pure-tone thresholds at 125–8000 Hz were obtained in all subjects in both groups. The results of the two groups were statistically evaluated by Chi-square, Student’s- t and McNemar tests. Results: In 35 patients (55%), a hearing loss equal or more than 30 dB hearing level was detected. 24 of 35 patients (68%) showed hearing loss in the higher frequencies (6 and 8 kHz). 12 of 35 patients (34%) showed hearing loss in speech frequencies (500–2000 Hz). No relationship could be found between hearing loss and other system involvements in Behçet’s group. Also there was no correlation between hearing loss and duration of the disease, but the mean age of Behçet’s patients with hearing loss was found to be significantly higher than the mean age of the patients without hearing loss. Conclusion: We suggest that presence of hearing loss in Behçet’s disease is prevalent and represents a fourth clinical symptom after oral, genital ulcers and skin lesions and especially there is a statistically significant hearing loss at high frequencies when compared with the speech frequencies.

The 5-year incidence and progression of hearing loss: the epidemiology of hearing loss study.

Hearing impairment affects many older adults, but the incidence is unknown. To determine the 5-year incidence and progression of hearing impairment. A longitudinal, population-based study of adults aged 48 to 92 years at baseline examination. Hearing sensitivity was measured twice, 5 years apart. Testing was conducted at the Beaver Dam Community Hospital, Beaver Dam, Wis. A total of 1636 participants without hearing loss and 1085 participants with hearing loss at the baseline examination in 1993-1995 were reexamined in 1998-2000. The examinations included otoscopy, screening tympanometry, and tone air- and bone-conduction audiometry. Incidence of hearing impairment was defined as a pure-tone average (PTA) of thresholds at 500, 1000, 2000, and 4000 Hz (PTA 0.5, 1, 2, and 4 kHz) greater than 25 dB HL (hearing level) in either ear at follow-up among those without hearing loss at baseline. Progression was defined as a change of more than 5 dB in the PTA 0.5, 1, 2, and 4 kHz among those with hearing loss at baseline. The 5-year incidence of hearing impairment was 21%. More than half of those with hearing loss at baseline experienced a decline in hearing. Age was an important risk factor for both incidence and progression. Male sex, occupation, and education were associated with the incidence of hearing loss after adjusting for age. Older adults have a high risk of developing hearing loss. Among those with hearing loss, most experience further declines in hearing sensitivity over time. These data indicate that hearing impairment is an important public health problem and underscore the need for appropriate hearing screening and treatment.