Degree Of Hearing Loss Research Articles

Cortical Auditory Evoked Potential Testing in Children With Auditory Neuropathy Spectrum Disorder.

In the present report, we reviewed the role of cortical auditory evoked potentials (CAEPs) as an objective measure during the evaluation and management process in children with auditory neuropathy spectrum disorder (ANSD). We reviewed the results of CAEP recordings in 66 patients with ANSD aged between 2 months and 12 years and assessed the relationship between their characteristics (prevalence, morphology, latencies, and amplitudes) and various clinical features, including the mode of medical management. Overall, the CAEPs were present in 85.2% of the ears tested. Factors such as prematurity, medical complexity, neuronal issues, or presence of syndromes did not have an effect on the presence or absence of CAEPs. CAEP latencies were significantly shorter in ears with cochlear nerve deficiency than in ears with a normal caliber nerve. Three different patterns of CAEP responses were observed in patients with bilateral ANSD and present cochlear nerves: (a) responses with normal morphology and presence of both P1-P2complex and N2 components, (b) responses with abnormal morphology and presence of the N2 component but undefined P1-P2complex peak, and (c) entirely absent responses. None of the patients with normal, mild, or moderate degree of hearing loss had a complete absence of CAEP responses. No significant differences were uncovered when comparing the latencies across unaided and aided children and children who later received cochlear implants. The CAEP protocol used in our ANSD program did inform about the presence or absence of central auditory stimulation. Absent responses typically fit into an overall picture of complete auditory deprivation and all of these children were ultimately offered cochlear implants after failing to develop oral language. Present responses, on the other hand, were acknowledged as a sign of some degree of auditory stimulation but always interpreted with caution given that prognostic implications remain unclear.

Electrophysiological Changes Associated with the Progression of Noise-Induced Hearing Loss.

The aim of this study is to evaluate the clinical characteristics and electrophysiological changes in patients with different degrees of noise-induced hearing loss compared with those of normal controls to elucidate the progression of auditory neural damage attributed to noise exposure. A retrospective cohort study was conducted through a review of the medical records for the patients who presented to a tertiary referral center. Sixty-nine participants were included in the study: 29 had noise-induced hearing loss, and 40 were healthy controls. All the participants underwent electrophysiological tests and pure-tone audiometry. Nine patients showed mild hearing loss (mild hearing loss group), while the others showed worse than moderate hearing loss on puretone audiometry (severe hearing loss group). Significantly reduced wave I and V amplitudes of auditory brainstem response were present in both mild and severe hearing loss groups compared to the control group (P -lt; .001 and P=.002, respectively), without significant differences between the mild and severe hearing loss groups. In the multivariate analysis, auditory brainstem response wave V amplitude was negatively associated with auditory brainstem response wave I-V inter-peak latency delay (B=-0.48, P=.02). The results of the present study confirm the similarity in the electrophysiological characteristics between the mild and severe hearing loss groups. Thus, widespread disruption in the auditory neural conduction could have been established in the early period when the patient developed mild hearing loss following noise exposure.

Effect of internal and external chaotic stimuli on synchronization of piezoelectric auditory neurons in coupled time-delay systems.

Hearing impairment is considered to be related to the damage of hair cells or synaptic terminals, which will cause varying degrees of hearing loss. Numerous studies have shown that cochlear implants can balance this damage. The human ear receives external acoustic signals mostly under complex conditions, and its biophysical mechanisms have important significance for reference in the design of cochlear implants. However, the relevant biophysical mechanisms have not yet been fully determined. Using the characteristics of special acoustoelectric conversion in piezoelectric ceramics, this paper integrates them into the traditional FitzHugh-Nagumo neuron circuit and proposes a comprehensive model with coupled auditory neurons. The model comprehensively considers the effects of synaptic coupling between neurons, information transmission delay, external noise stimulation, and internal chaotic current stimulation on the synchronization of membrane potential signals of two auditory neurons. The experimental results show that coupling strength, delay size, noise intensity, and chaotic current intensity all have a certain regulatory effect on synchronization stability. In particular, when auditory neurons are in a chaotic state, their impact on synchronization stability is sensitive. Numerical results provide a reference for exploring the biophysical mechanisms of auditory neurons. At the same time, we are committed to providing assistance in using sensors to monitor signals and repair hearing impairments.

Puerarin inhibits cisplatin-induced ototoxicity in mice through regulation of TRPV1-dependent calcium overload

Puerarin (PUE), a flavonoid derivative with vasodilatory effects found in the traditional Chinese medicine kudzu, has anti-sensorineural hearing loss properties. However, the mechanism of its protective effect against ototoxicity is not well understood. In this study, we used in vitro and in vivo methods to investigate the protective mechanism of puerarin against cisplatin (CDDP)-induced ototoxicity. We established an ototoxicity model of CDDP in BALB/c mice and assessed the degree of hearing loss and cochlear cell damage. We used bioinformatics analysis, molecular docking, histological analysis, and biochemical and molecular biology to detect the expression of relevant factors. Our results show that puerarin improved CDDP-induced hearing loss and reduced hair cell loss. It also blocked CDDP-induced activation of TRPV1 and inhibited activation of IP3R1 to prevent intracellular calcium overload. Additionally, puerarin blocked CDDP-stimulated p65 activation, reduced excessive ROS production, and alleviated cochlear cell apoptosis. Our study provides new evidence and potential targets for the protective effect of puerarin against drug-induced hearing loss. Puerarin ameliorates cisplatin-induced ototoxicity and blocks cellular apoptosis by inhibiting CDDP activated TRPV1/IP3R1/p65 pathway, blocking induction of calcium overload and excessive ROS expression.

The Monitoring Environmental noise in Coffee Production, CCT/NCBA Companies in Bidau Lesidere Villige, Dili District Dili City Timor Leste

Noise-induced hearing loss is hearing loss caused by exposure to quite loud noise over a long period of time and is usually caused by noise in the work environment, in this case the company environment. Working environment noise is a major problem in occupational health which is a standard of OSH in various companies, the relationship between excessive noise exposure and hearing loss has been known since ancient times. Various epidemiological studies of noise-induced hearing loss have explored the relationship or risk factors between work, exposure to noise levels and the degree of hearing loss. The purpose of this study was to determine and survey the noise of electronic machines on hearing loss. The research method used is a quantitative, observational method using a cross observational study design.

Hearing assessment in mobile phone users

Background: Mobile phones have become an indispensable part of today's modern world. But with various day-to-day benefits, mobile phones also bring detrimental effects on the health of users. Ear being the closest organ in contact with phones, faces maximum effect of electromagnetic waves generated by them. Chronic exposure to these waves and sounds can result in permanent hearing loss. Hence, the present study was done to assess the association between hearing loss and duration of mobile usage. Methods: This cross-sectional study was conducted on mobile phone users between the age group of 20 and 40 years in the Department of ENT, Rajindra Hospital, Patiala over 6 months (1 August 2022 to 31 January 2023). 600 volunteers were involved and divided into three groups based on the duration of mobile phone usage. Pure tone audiometry and DPOAE were used to assess the hearing loss in these subjects. Results: A variable degree of hearing loss was observed on PTA and DPOAE in all three groups with a significant association between hearing loss and the duration of mobile phone usage. A higher proportion of sensorineural hearing loss was observed in the group with mobile phone usage of more than 1 hour per day for a minimum of 4 years as compared to those who used them for <1 hour per day for a minimum of 4 years and control group (p=0.001) which was significant statistically. Conclusions: People using mobile phones for long hours are at higher risk of developing hearing loss, especially in the dominant ear.

Association between occupational noise-induced hearing loss and genotoxicity among textile factory workers

Background/aimHearing loss caused by exposure to noise is still among the most prevalent health risks for industrial workers. This study aims to evaluate the relationship between Shebien El-kom textile factory workers’ occupational noise exposure, genotoxicity, and noise-induced hearing loss.MethodsThis cross-sectional case–control study was performed in a textile industry in Shebin Elkom, Egypt. The participants of this work were 36 exposed male workers from the spinning section of the textile factory and 36 subjects as the control male group from administrative staff in the same factory, in the age range of 25–45 years. A pure-tone audiometer and portable sound level meter were utilized for the measurement of hearing threshold and noise level, respectively. Genotoxicity was assessed using the Comet assay technique.ResultsThere was no significant difference between both groups regarding age and the mean duration of work was 18.94 ± 4.88 for exposed workers. The average level of noise was 95–105 dB (A). The exposed workers’ mean hearing thresholds for the left and right ears at frequencies between 2000 and 8000 Hz were substantially greater than those of the control group (P < 0.05). In the exposed workers, there was not a marked variation between the hearing thresholds of the left and right ears (p > 0.05). The exposed workers’ percentage of DNA damage was substantially greater than that of the control group (p < 0.001). Among exposed workers, a positive correlation between DNA damage, the degree of hearing loss, and the duration of time exposed to noise was demonstrated.ConclusionThe majority of exposed workers suffered from occupational noise-induced hearing loss. A positive correlation was found between the percentage of DNA damage, duration of exposure to noise, and hearing threshold in exposed workers.

Hearing and Hearing Loss Progression in Patients with GJB2 Gene Mutations: A Long-Term Follow-Up.

We aimed to investigate whether the degree of hearing loss with GJB2 mutations could be predicted by distinguishing between truncating and non-truncating mutations and whether the genotype could predict the hearing loss level. Additionally, we examined the progression of hearing loss in individuals monitored for over 2 years for an average of 6.9 years. The proportion of truncating mutations was higher in patients with profound and severe hearing loss, but it was not accurate enough to predict the degree of hearing loss. Via genotype analysis, mutations of the p.Arg143Trp variants were associated with profound hearing loss, while mutations of the p.Leu79Cysfs*3 allele exhibited a wide range of hearing loss, suggesting that specific genotypes can predict the hearing loss level. Notably, there were only three cases of progression in four ears, all of which involved the p.Leu79Cysfs*3 mutation. Over the long-term follow-up, 4000 Hz was significant, and there was a trend of progression at 250 Hz, suggesting that close monitoring at these frequencies during follow-up may be crucial to confirm progression. The progression of hearing loss was observed in moderate or severe hearing loss cases at the time of the initial diagnosis, emphasizing that children with this level of hearing loss need regular follow-ups.

Occupational Noise-Induced Hearing Loss in the City of Mosul: A Cross-sectional Study

Introduction: This study aimed to investigate the distribution of demographic characteristics and the prevalence of hearing loss among workers. Methods: The study sample consisted of 160 participants, and various demographic variables were examined. Data regarding age, gender, work experience, work hours, work nature, and work type were collected and analyzed. The degrees of hearing loss in the bilateral, left, and right ears were assessed, and the prevalence of hearing loss among different work types was examined. Audiograms were utilized to assess the degrees of hearing loss. The limitations of this study include a small sample size, and the cross-sectional design preventing causal relationships. Results: The majority of participants were male, and the age distribution showed a higher representation in the 30-49 years age range. The degrees of hearing loss were predominantly intermediate in the bilateral, left, and right ears. Military personnel had the highest prevalence of hearing loss, followed by builders, drivers, carpenters, and bakers. The logistic regression analysis indicated limited predictive power for age, diabetes mellitus (DM), years in the job, and years in the current job. However, the absence of formal training emerged as a significant factor associated with an increased likelihood of potential hearing loss. Conclusion: The findings highlight the importance of considering demographic characteristics and occupational factors in assessing the prevalence of hearing loss among workers. The results emphasize the need for occupational training programs and increased awareness of hearing protection measures in the workplace to mitigate the risk of hearing loss.

Study of Mastoid Antral Changes in Tubotympanic Chronic Supportive Otitis Media

Background: Study of mastoid antrum findings in tubotympanic chronic suppurative otitis media Objectives: To study mastoid antrum findings in tubotympanic CSOM and to determine predictors for performing antrostomy. Methodology: 71 patients with tubotympanic CSQM were selected from OPD and IPD. All patients were subjected to investigations like X—ray mastoid (Schuller’s View), pure tone audiometry and Otoendoscopy. All patients were subjected to mastoid exploration (cortical mastoidectomy or antrostomy) with tympanoplasty. Pre-Operative findings on basis of history, examination and investigations were noted along with intra-operative findings of middle ear and mastoid antrum. Findings were tabulated and statistical tests were applied to determine significant predictors. Results: Mastoid antrum was found to be diseased in 21 patients with pathological findings like mucopus, granulations etc. Recurrent URTI, mastoid pneumatization pattern, pre operative middle ear mucosal status on otoendoscopy, degree of hearing loss and ossicular status were significantly associated with diseased antrum (P-value&lt;0.05). Conclusion: Disease can be found in mastoid antrum in tubotympanic CSOM. Mastoid exploration in form of antrostomy should be done in all cases where certain predictors are present. The predictors for performing antrostomy in tubotympanic disease are presence of recurrent URTI on history, sclerotic mastoid on x—ray mastoid (Schuller’s View), unhealthy middle ear mucosa on otoendoscopy, moderate and moderately severe hearing loss on pure tone audiometry and intra-operative ossicular necrosis and immobility.

Pre-Operative Predictors of Ossicular Status in Chronic Supportive Otitis Media

Introduction: Chronic suppurative otitis media is associated with ossicular necrosis. Both safe and unsafe CSOM have incidence of ossicular necrosis. This study will provide the much-needed insight, into the factors which can act as significant predictors for the intra operative ossicular status, and help in better preparing the patient before the surgery and need for ossiculoplasty. Furthermore, narrowing down to the most significant ly related predictors, it may also be»possib1eto reduce the financial burden on the patient, something which is of prime importance in a resource limited country like ours. Objectives: pre-operative predictors of intra operative ossicular status in chronic suppurative otitis media and effect of duration of disease on hearing threshold and ossicular-status. Material and methods: A descriptive observational study was done in a Tertiary care referral center. A total number of 124 patients with the clinical diagnosis of CSOM were selected from outpatient department and admitted. All patients were subjected to otoendoscopy, X-raymastt), 1d (Schiller’s view) and pure tone audiometry. All patients underwent tympanomastoidectomy. Preoperative findings on the basis of history, examination and investigations were noted along with findings of intraoperative ossicular status. Findings were tabulated and statistical test were applied to determine significant preoperative predictors of iv intraoperative ossicular status. Results: Intraoperative ossicular necrosis was seen in a total number of 43 patients. On; univariate analysis, blood-stained discharge (P&lt;0.0001), purulent consistency of ear discharge (0&lt;0.0()01), associated symptoms of vertigo (p=0.0047), otalgia (p=0.0019), size(p=0.0042) and f site(p=0.004l), severity of hearing loss (p=0.004), sclerotic mastoid air cell (p=0.0001) had significant association with ossicular necrosis. The duration of disease and hearing threshold did not have statistically significant association (p=0.227). Conclusion: Ossicular necrosis is best indicated by the presence blood-stained and purulent discharge, vertigo, otalgia, total perforation, severe degree of hearing loss and sclerosed mastoid. Incus was the most common necrosed ossicle followed by malleus followed by stapes, Duration of disease did not have a significant connotation with hearing threshold.

Clinicopathological Study of Salivary Gland Tumors in Tertiary Care Teaching Hospital

Background: The study “Preoperative predictors of ossicular status in chronic suppurative otitis media” was undertaken in Swami Rama Himalayan University, Dehradun. A total number of 124 patients who underwent “tympanomastoidcetomy” for CSOM were evaluated to correlate the preoperative predictors with intraoperative ossicular status. Materials and Methods: This study was carried out for 12 months period in the Department of Otorhinolaryngology at Himalayan Institute of Medical Sciences, SRHU, Swami Ram Nagar, Dehradun. Subjects were recruited from Inpatient Department planned for surgery. Each of the patients selected for the study was subjected to a detailed history and complete ear, nose and throat examination. Site and size of perforation, status of attic, middle ear mucosa status, presence of myringosclerosis, tympanosclerosis, granulations and cholesteatoma were noted in each patient. Degree and type of hearing loss was evaluated via pure tone audiometry. Results: Most of the patients belonged to the age group of less than 40 years, with maximum patients falling in the age group of 21-30 years i.e.,39 (31.45%) patients. The average age of patients was 29.39±10.79 years. Female predominance was seen with male to female ratio being 1:1.33. More cases were from rural areas comprising of 81 (65.3%) cases while 43 (34.6%) resided in urban areas. Ear discharge was the most common presenting complaint seen in 109 cases (87.90%) followed by hearing loss which was present in 100 cases (80.64%). Unilateral ear discharge present in 89 (81.65%) and 20 (18.34%) had bilateral ear discharge. Conclusion: Blood-stained discharge was present in 40 (36.66%) patients out of which 28 (70%) patients had ossicular necrosis. On assessing the amount of ear discharge, highest number of patients had scanty discharge i.e., in 75 (68.80%), out of which 30 (40%) patients had ossicular necrosis. Mucopurulent discharge was seen in highest number of patients i.e., in 68 (62.38%) out of which 30 (44.1%) had ossicular necrosis. Associated symptoms of vertigo were present in 28 patients (22.5%) out of which 16 patients (57.1%) had ossicles necrosed. On findings of otoscopy and otoendoscopy, perforation in pars tensa was seen in 82 patients (66.12%) out of which ossicular necrosis was present in 14 patients (17%). Highest incidence of ossicular necrosis was seen in 4 (4.83%) patients who had perforation involving both pars tensa and pars flaccida.

71 Profiles of Parent Ratings on the Behavior Assessment System for Children-Third Edition in Children with Autism Spectrum Disorder who are Deaf and Hard of Hearing

Objective:Standardized assessment measures can provide data to inform a diagnosis of Autism Spectrum Disorder (ASD). Most measures assessing ASD characteristics rely on some degree of behavioral response to sound (e.g., responding to name, demonstrating listening response), and are often not appropriate for use with children who are Deaf and Hard of Hearing (DHH), especially with individuals who use signed languages. Few studies have reported on the Behavioral Assessment System for Children, Third Edition (BASC-3) for DHH children, and we aim to describe BASC-3 profiles in children with ASD who are DHH.Participants and Methods:Participants include eight DHH patients diagnosed with ASD through interdisciplinary team evaluations by developmental-behavioral pediatricians, speech-language pathologists, and neuropsychologists with expertise in DHH child development. Demographics include a mean age of 6.17 years, and 62.5% were Male. Self-reported racial distribution was 75% White, 12.5% Black and 12.5% declined to answer. Average Area Deprivation Index (marker of socioeconomic status) was 32.13%tile. As a part of the evaluation, parents rated their children using the BASC-3. Languages include spoken English (75%) and American Sign Language (25%). Relevant co-occurringneurodevelopmental/psychological diagnoses include Global Developmental Delay (n=1), Moderate Intellectual Disability (n=1), and Depression (n=1). Types of hearing loss include sensorineural (75%), conductive (12.5%), and mixed (12.5%). Three participants had different degrees of bilateral hearing loss in each ear: mild sloping-severe, moderate rising-mild (n=1), profound, moderate rising-normal level (n=1), and profound, moderate (n=1). Four participants had the same level of hearing loss in both ears: moderate-moderately severe (n=1), moderately severe-severe (n=1), severe-profound (n=1), and profound (n=1). One child had a unilateral moderate hearing loss. Technology utilized: unilateral hearing aid (n=2), bilateral hearing aids (n=2), unilateral cochlear implant (n=1), bilateral cochlear implants (n=2), and bimodal technology (n=1). BASC-3 scales of interest in this study were the developmental social disorders scale (DSD), Autism probability index (AUI), clinical scales, and adaptive scales. BASC-3 scores were standardized using General Combined norms and means were plotted.Results:BASC-3 mean scores on clinical scales were elevated (T&gt;60) on Atypicality (M=71), Hyperactivity (M=63), Withdrawal (M=63), and Attention Problems (M=65) in children with ASD who are DHH in this sample. BASC-3 mean scores on adaptive scales were below threshold (T&lt;40) on Social Skills (M=37), Functional Communication (M=39), and overall Adaptive Skills (M=39). DSD scores were in the at-risk (T&gt;60&lt;70) range for 2 out of 8 cases and clinically significant (T&gt;70) for 5 out of 8 cases.The AUI was clinically significant for 2 out of the 3 cases within the age range for reporting AUI data.Conclusions:In this preliminary sample of DHH children with a confirmed diagnosis of ASD by comprehensive specialized interdisciplinary clinical evaluations, parent ratings on the BASC-3 were consistent with what is known about BASC-3 profiles in hearing children diagnosed with ASD. Our findings suggest it may be helpful to review the DSD, AUI, clinical scales, and adaptive skills scales profiles when assessing DHH children at risk for ASD. Further research, including a larger sample size and assessment of language differences among participants, is necessary.

Hearing Loss among Children Visiting Department of Otolaryngology and HNS of a Tertiary Care Centre.

Hearing loss is defined as the partial or total reduction in auditory acuity. Hearing loss can cause detrimental effects on speech, language, developmental, educational, and cognitive outcomes in children. This study aimed to find out the prevalence of hearing loss among children visiting the Department of Otolaryngology and HNS of a tertiary care centre. A descriptive cross-sectional study was conducted among children visiting the Department of Otolaryngology and HNS between 1 January 2022 and 31 December 2022 after obtaining ethical approval. All the patients who underwent pure tone evaluation were included in the study. A convenience sampling technique was used. The point estimate was calculated at a 95% Confidence Interval. Among 3051 children, 328 (10.75%) (9.65-11.85, 95% Confidence Interval) had hearing loss. Among children with hearing loss, 170 (51.83%) of children were female. The mean age of children with hearing loss was 13.31±3.39 years. The mean pure tone average among 452 ears with hearing loss was 44.60±17.71 dB. The commonest degree of hearing loss was mild hearing loss 266 (58.85%), and the commonest type was conductive hearing loss 310 (68.58%). Among children with hearing loss, 124 (37.80%) had bilateral hearing loss. The prevalence of hearing loss among children visiting the Department of Otolaryngology and HNS was found to be lower than similar studies done in similar settings. audiology; audiometry; hearing loss; outpatients; prevalence.

Novel Pathogenic Variants in the Gene Encoding Stereocilin (STRC) Causing Non-Syndromic Moderate Hearing Loss in Spanish and Argentinean Subjects.

Non-syndromic hearing impairment (NSHI) is a very heterogeneous genetic condition, involving over 130 genes. Mutations in GJB2, encoding connexin-26, are a major cause of NSHI (the DFNB1 type), but few other genes have significant epidemiological contributions. Mutations in the STRC gene result in the DFNB16 type of autosomal recessive NSHI, a common cause of moderate hearing loss. STRC is located in a tandem duplicated region that includes the STRCP1 pseudogene, and so it is prone to rearrangements causing structural variations. Firstly, we screened a cohort of 122 Spanish familial cases of non-DFNB1 NSHI with at least two affected siblings and unaffected parents, and with different degrees of hearing loss (mild to profound). Secondly, we screened a cohort of 64 Spanish sporadic non-DFNB1 cases, and a cohort of 35 Argentinean non-DFNB1 cases, all of them with moderate hearing loss. Amplification of marker D15S784, massively parallel DNA sequencing, multiplex ligation-dependent probe amplification and long-range gene-specific PCR followed by Sanger sequencing were used to search and confirm single-nucleotide variants (SNVs) and deletions involving STRC. Causative variants were found in 13 Spanish familial cases (10.7%), 5 Spanish simplex cases (7.8%) and 2 Argentinean cases (5.7%). In all, 34 deleted alleles and 6 SNVs, 5 of which are novel. All affected subjects had moderate hearing impairment. Our results further support this strong genotype-phenotype correlation and highlight the significant contribution of STRC mutations to moderate NSHI in the Spanish population.

Genotypic and Allelic Frequencies of GJB2 Variants and Features of Hearing Phenotypes in the Chinese Population of the Dongfeng-Tongji Cohort.

This study aimed to describe the distribution of the genotype and allele frequencies of GJB2 variants in the Chinese population of the Dongfeng Tongji cohort and to analyze the features of the hearing phenotype. We used data from 9910 participants in the Dongfeng Tongji cohort in 2013 and selected nine GJB2 variants. Pure tone audiometry was employed to measure hearing. Differences in genotype and allele frequencies were analyzed via chi-squared test or Fisher's exact test. Of the 9910 participants, 5742 had hearing loss. The genotype frequency of the GJB2 variant c.109G>A was statistically significantly distributed between the normal and impaired hearing groups, but not for the variant c.235delC. A higher frequency of the c.109G>A homozygous genotype was found in the hearing loss group (0.5%) than in the normal hearing group (0.1%). Patients with c.109G>A and c.235delC homozygous mutations exhibited varying degrees of hearing loss, mainly presenting sloping and flat audiogram shapes. A significant difference was found in the genotype frequency of the GJB2 variant c.109G>A between the case and control groups, but not in that of the variant c.235delC. Different degrees of hearing loss and various audiogram shapes were observed in patients with c.109G>A and c.235delC homozygous mutations.

The construction and validation of prognostic prediction model for sudden sensorineural hearing loss in middle-aged and elderly people

ObjectiveIdiopathic sudden sensorineural hearing loss (ISSNHL), as an otologic emergency, is commonly encountered and its prevalence has been climbing every year recently. To our knowledge, the prognosis of middle-aged and elderly patients is worse than that of young patients. Previous researches mainly focused on the adult population, which was considered as prognostic models who performed hearing recovery in ISSNHL. However, few studies regarding the middle-aged and elderly population who are regarded as prognostic models have been reported. Therefore, we aim to construct and validate a nomogram-based prognostic prediction model, which can provide a reference for the prognostic assessment in the middle-aged and elderly patients with ISSNHL. MethodA total of 371 middle-aged and elderly ISSNHL patients who were admitted to the Department of Otolaryngology-Head and Neck Surgery, Yanbian Hospital, Yanbian University, from April 2018 to April 2023 were enrolled in the study. All subjects were randomly divided into two groups including training group (n = 263) and validation group (n = 108). Lasso regression and multi-factor logistic regression were jointly utilized to screen out prognosis-related independent risk factors and establish a nomogram-based risk prediction model. The accuracy and clinical application value of the model were evaluated by combining the Bootstrapping method and k-fold cross-validation, plotting the receiver operating characteristic (ROC) curve, calculating the area under the ROC curve (AUC), plotting the decision curve analysis (DCA), and the calibrating curve. ResultWe used the method of lasso regression combined with multivariate logistic regression and finally screened out eight predictors (including age, number of affected ears, degree of hearing loss, type of hearing curve, duration of disease, presence of vertigo, diabetes, and lacunar cerebral infarction) that were included into the nomogram. The C-index were 0.823 [95% CI (0.725, 0.921)] and 0.851 [95% CI (0.701, 1.000)], and the AUC values were 0.812 and 0.823 for the training and validation groups, respectively. The calibration curve for the validation group was approximately conformed to that for the modeling group, indicating favorable model calibration. The DCA results revealed the modeling group (3%-86%) and the validation group (2%-92%) showed significant net clinical benefit under the majority of thresholds. ConclusionThis study developed and validated a nomogram-based prognostic prediction model which based on the eight independent risk factors mentioned above. The predictors are conveniently accessible and may assist clinicians in formulating individualized treatment strategies.

How can the routine use of face masks by medical professionals affect hearing-impaired patients’ perception of speech? A case–control study

BackgroundFacemasks are routinely used among healthcare providers, especially after the COVID-19 pandemic. However, they negatively impact speech perception. Our study investigated how speech perception using the word discrimination score (WDS) was affected by wearing surgical and KN95 masks while dealing with hearing-impaired healthcare recipients.MethodThis case–control study included 60 participants [15 with normal hearing and 45 with varied degrees of sensorineural hearing loss (SNHL)], for whom word discrimination scores (WDS) were evaluated under various mask conditions.ResultsOn applying repeated measures of two-way analysis of variance (RM two-way ANOVA), there was statistically significant interaction (p = 0.0018), meaning that the level by which the mask affects the WDS depends on the underlying hearing level. Both main factors showed a statistically significant effect (p < 0.0001). Surgical masks had a lesser impact on speech discrimination compared to KN 95.ConclusionsIt was concluded that KN95 severely impacted the WDS among all groups relative to surgical mask and the no-mask condition. Although the high-frequency SNHL (HF-SNHL) group had mild hearing loss in the pure tone audiometry (PTA) average, they showed lower WDS relative to the mild to moderate flat SNHL (MM-SNHL). Moderately severe to severe SNHL expressed the worst values. As a result, the surgical mask is recommended over the KN95 mask since it provides better speech discrimination while giving adequate protection. These findings should be taken into consideration as they will have an impact on communication, especially in situations like hospitals where the patients must understand the instructors and healthcare providers very well.

Predicting Atrophy of the Cochlear Stria Vascularis from the Shape of the Threshold Audiogram.

Several lines of evidence have suggested that steeply sloping audiometric losses are caused by hair cell degeneration, while flat audiometric losses are caused by strial atrophy, but this concept has never been rigorously tested in human specimens. Here, we systematically compare audiograms and cochlear histopathology in 160 human cases from the archival collection of celloidin-embedded temporal bones at the Massachusetts Eye and Ear. The dataset included 106 cases from a prior study of normal-aging ears, and an additional 54 cases selected by combing the database for flat audiograms. Audiogram shapes were classified algorithmically into five groups according to the relation between flatness (i.e., SD of hearing levels across all frequencies) and low-frequency pure-tone average (i.e., mean at 0.25, 0.5, and 1.0 kHz). Outer and inner hair cell losses, neural degeneration, and strial atrophy were all quantified as a function of cochlear location in each case. Results showed that strial atrophy was worse in the apical than the basal half of the cochlea and was worse in females than in males. The degree of strial atrophy was uncorrelated with audiogram flatness. Apical atrophy was correlated with low-frequency thresholds and basal atrophy with high-frequency thresholds, and the former correlation was higher. However, a multivariable regression with all histopathological measures as predictors and audiometric thresholds as the outcome showed that strial atrophy was a significant predictor of threshold shift only in the low-frequency region, and, even there, the contribution of outer hair cell damage was larger.SIGNIFICANCE STATEMENT Cochlear pathology can only be assessed postmortem; thus, human cochlear histopathology is critical to our understanding of the mechanisms of hearing loss. Dogma holds that relative damage to sensory cells, which transduce mechanical vibration into electrical signals, versus the stria vascularis, the cellular battery that powers transduction, can be inferred by the shape of the audiogram, that is, down-sloping (hair cell damage) versus flat (strial atrophy). Here we quantified hair cell and strial atrophy in 160 human specimens to show that it is the degree of low-frequency hearing loss, rather than the audiogram slope, that predicts strial atrophy. Results are critical to the design of clinical trials for hearing-loss therapeutics, as current drugs target only hair cell, not strial, regeneration.

Opinions of hearing-impaired individuals about social media: A preliminary study

Objectives: The study examined the opinions of hearing-impaired individuals about the content on social media platforms, their social media usage tendencies, and their feelings, thoughts, and experiences during their use. Patients and Methods: Forty individuals aged 18 years and older who are native Turkish speakers diagnosed with hearing loss regardless of the type and degree of hearing loss participated in this cross-sectional survey study between November 1, 2021, and September 1, 2022. Individuals with advanced vision problems and illiterate individuals were excluded from the study. The questionnaire consisted of four sections: (i) demographic data and hearing loss characteristics; (ii) social media usage and purposes; (iii) opinions about the content on social media; and (iv) feelings, thoughts, and experiences about social media. Responses were evaluated on a 5-point Likert-type scale. Results: The most common purposes of using social media were doing research and getting information about hearing loss and the technologies they use. Of the participants, 45.5% stated that they do not prefer their devices to be seen in the photos they share on social media platforms and that they are undecided about the ease of use of existing social media platforms for the hearing impaired. Conclusion: It is important to determine what hearing-impaired individuals feel about hearing loss and technologies, both to guide hearing care professionals and health institutions in creating content on these issues and to improve these platforms.