Ear Health Research Articles

The Implementation of the K-Medoid Clustering for Grouping Hearing Loss Function on Excessive Smartphone Use

During the current pandemic, smartphones have become a means of learning for all students in Indonesia, including high school students. Students use smartphones to send assignments, learn via video calls, and conduct online exams. The prolonged use of smartphones, from the beginning of learning hours in the morning to study hours in the evening, has a terrible impact on the ear health of high school students in Padang. Excessive smartphone use caused a decrease in the student's hearing function. Therefore, this study aims to group the audiometry results of high school students in Padang who have a hearing loss function. The audiogram result is only performed as the result of a frequency test of the subject's hearing in both the left and right ear. Conventionally, an otolaryngologist concluded the final decision of hearing loss ability. This research proposed an automatic classification of audiometry results using machine learning methods. The K-Medoids clustering was selected to classify the audiometry data in this research. Of 210 audiometry data, 91 data is confirmed by an otolaryngologist as valid data. By using the K-Medoids clustering, 93 data is classified into Normal hearing, Mild Hearing loss, and Moderate Hearing loss. The proposed model successfully grouped the audiometry data into three categories. The confusion matrix is applied to measure the model performance, which has 28,3% accuracy, 64,3% precision, and 21,4% recall.

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Polyphenols in Inner Ear Neurobiology, Health and Disease: From Bench to Clinics.

There is substantial experimental and clinical interest in providing effective ways to both prevent and slow the onset of hearing loss. Auditory hair cells, which occur along the basilar membrane of the cochlea, often lose functionality due to age-related biological alterations, as well as from exposure to high decibel sounds affecting a diminished/damaged auditory sensitivity. Hearing loss is also seen to take place due to neuronal degeneration before or following hair cell destruction/loss. A strategy is necessary to protect hair cells and XIII cranial/auditory nerve cells prior to injury and throughout aging. Within this context, it was proposed that cochlea neural stem cells may be protected from such aging and environmental/noise insults via the ingestion of protective dietary supplements. Of particular importance is that these studies typically display a hormetic-like biphasic dose-response pattern that prevents the occurrence of auditory cell damage induced by various model chemical toxins, such as cisplatin. Likewise, the hormetic dose-response also enhances the occurrence of cochlear neural cell viability, proliferation, and differentiation. These findings are particularly important since they confirmed a strong dose dependency of the significant beneficial effects (which is biphasic), whilst having a low-dose beneficial response, whereas extensive exposures may become ineffective and/or potentially harmful. According to hormesis, phytochemicals including polyphenols exhibit biphasic dose-response effects activating low-dose antioxidant signaling pathways, resulting in the upregulation of vitagenes, a group of genes involved in preserving cellular homeostasis during stressful conditions. Modulation of the vitagene network through polyphenols increases cellular resilience mechanisms, thus impacting neurological disorder pathophysiology. Here, we aimed to explore polyphenols targeting the NF-E2-related factor 2 (Nrf2) pathway to neuroprotective and therapeutic strategies that can potentially reduce oxidative stress and inflammation, thus preventing auditory hair cell and XIII cranial/auditory nerve cell degeneration. Furthermore, we explored techniques to enhance their bioavailability and efficacy.

An evaluation of the quality of ear health services for Aboriginal children living in remote Australia: a cascade of care analysis

BackgroundIn the Northern Territory (NT) the prevalence of otitis media (OM) in young Aboriginal children living in remote communities has persisted at around 90% over the last few decades. OM-associated hearing loss can cause developmental delay and adversely impact life course trajectories. This study examined the 5-year trends in OM prevalence and quality of ear health services in remote NT communities.MethodsA retrospective analysis was performed on de-identified clinical data for 50 remote clinics managed by the NT Government. We report a 6-monthly cascade analysis of the proportions of children 0–16 years of age receiving local guideline recommendations for surveillance, OM treatment and follow-up at selected milestones between 2014 and 2018.ResultsBetween 6,326 and 6,557 individual children were included in the 6-monthly analyses. On average, 57% (95%CI: 56–59%) of eligible children had received one or more ear examination in each 6-monthly period. Of those examined, 36% (95%CI: 33–40%) were diagnosed with some type of OM, of whom 90% had OM requiring either immediate treatment or scheduled follow-up according to local guidelines. Outcomes of treatment and follow-up were recorded in 24% and 23% of cases, respectively. Significant decreasing temporal trends were found in the proportion diagnosed with any OM across each age group. Overall, this proportion decreased by 40% over the five years (from 43 to 26%).ConclusionsThis cascade of care analysis found that ear health surveillance and compliance with otitis media guidelines for treatment and follow-up were both low. Further research is required to identify effective strategies that improve ear health services in remote settings.

Routine ear health and hearing checks for Aboriginal and Torres Strait Islander children aged under 6years attending primary care: a national consensus statement.

This consensus statement provides new recommendations for primary care assessment of ear health and hearing status of young Aboriginal and Torres Strait Islander children who are not known to have, or are not being actively managed for, ear health and hearing problems. Any child identified with otitis media should be actively managed. This national consensus statement extends existing treatment and management guidelines. MAIN RECOMMENDATIONS: Undertake checks at least 6-monthly, commencing at 6 months until 4 years of age, then at 5 years. Undertake checks more frequently in high risk settings for children under 2 years, when acceptable to families, or in response to parent/carer concerns. Ask parents/carers about concerns, signs, and symptoms; check children's listening and communication skills; and assess middle ear appearance and mobility. Otoacoustic emissions testing is suggested when equipment is available, primary health practitioners have capability and confidence to use the equipment, and there is local preference for its use. Video otoscopy is suggested for health promotion purposes, and/or for sharing images with other health practitioners. Audiometry should be done as per existing guidelines: when there are parent/carer concerns, signs of persistent/recurrent otitis media, or when listening and communication development is not yet on track. CHANGES IN MANAGEMENT AS A RESULT OF THIS STATEMENT: Key practice changes include routine use of tympanometry, and listening and communication skills checklists. Implementation will require access to equipment and training; clear information on immediate, practical actions for families; timely pathways to referral services; and a change management process that shifts perception and tolerance of otitis media and its impacts and raises expectations that Aboriginal and Torres Strait Islander children can have healthy ears and hearing.

Ear health and hearing in urban Aboriginal children

ObjectiveEvaluate ear health and hearing among urban Aboriginal children and quantify relationships with child, family and social factors. MethodsBaseline questionnaire and ear health examinations from 1430 children with diagnoses (0.5-18 years) attending Aboriginal Health Services enrolled in SEARCH. Ear health outcomes were Otitis Media (OM), and hearing loss (three-frequency average hearing loss >20dB) diagnosed using pneumatic otoscopy, tympanometry, and audiometry. ResultsHalf the children 0.5-3 years had OM (51.5%, 136/264). One third 0.5-18 years (30.4%; 435/1430) had OM, including 1.8% (26/1430) with perforation (0.8% chronic suppurative OM, 0.6% dry perforation and 0.4% acute OM with perforation). One quarter 0.5-18 years (25.7%; 279/1087) had hearing loss; 12.4% unilateral, 13.2% bilateral (70.6% with bilateral loss had concurrent OM). OM was associated with: younger age (0.5-<3 years versus 6-18 years) age-sex-site; adjusted prevalence ratio (aPR)=2.64, 95%, 2.18-3.19); attending childcare/preschool (aPR=1.24, 95%CI, 1.04-1.49); foster care (aPR=1.40, 95%CI, 1.10-1.79); previous ear infection/s (aPR=1.68, 95%CI, 1.42-1.98); and ≥2 people/bedroom (aPR=1.66, 95%CI, 1.24-2.21). Hearing impairment was associated with younger age (0.5-<6 years vs. ≥6 years aPR=1.89, 95%CI, 1.40-2.55) and previous ear infection (aPR=1.87, 95%CI, 1.31-2.68). ConclusionsHalf the urban Aboriginal children in this cohort had OM and two-thirds with hearing impairment had OM. Implications for Public HealthFindings highlight importance of early detection and support for ear health, particularly in pre-school-aged children with risk factors.

Ear health and quality of life in pet rabbits of differing ear conformations: A UK survey of owner-reported signalment risk factors and effects on rabbit welfare and behaviour.

The impacts of ear disease on animal welfare and behaviour are little documented. Ear disease may be common in rabbits, but difficult to recognise, and lop-ears have previously been indicated as a risk factor for ear disease. We aimed to better understand the range of ear conditions in pet rabbits, signalment risk factors, and impacts on welfare and behaviour. Through an online questionnaire, we investigated owner-reported signalment, veterinary diagnosis of ear conditions, impaired hearing, and ear pain for UK pet rabbits. Relationships between ear condition measures and ear conformation, quality of life, and behaviour were analysed using logistic regression. Of 551 valid responses, 28.5% of rabbits reportedly had experienced ear conditions; 21.2% diagnosed or mentioned by vets, with otitis and excess cerumen most common. Approximately 25% of lop-eared rabbits had ear conditions indicated by a vet versus 10% of erect-eared rabbits. Lop-eared, half-lop, and older rabbits were most at risk (P<0.050). Rabbits reported as showing ear pain responses had reduced owner-reported quality of life compared with other rabbits (P<0.050). Rabbits with ear problems were less likely to be responsive to relevant sounds, and performed binky behaviour (joy jumps) less frequently, than rabbits without such issues. Understanding prevalence and risk factors for ear conditions is critical to improving welfare standards across this widely owned pet species. The findings suggest that improved recognition and treatment of ear conditions, and avoiding breeding from rabbits with early signs, or a family history, of ear disease are necessary to help combat this animal welfare issue.

Otitis media and its associated risk factors: An investigation into patients’ knowledge, attitudes, practices, and information sources at a hospital setting

Abstract Background: Otitis media (OM) is a substantial healthcare issue globally, including in India. Despite its widespread occurrence, there has been only one prior investigation into the knowledge, attitude, practices, and sources of information (KAPS), as well as information sources regarding OM among patients in India, and this study dates back to 2009. This article unveils the findings of a recent KAPS study conducted among patients residing in Navi Mumbai, Maharashtra, India. Objectives: The primary goal of this study was to evaluate the KAPS regarding OM and its associated risk factors, with a specific focus on individuals diagnosed with this ailment. Settings and Design: This research was conducted in the Ear, Nose, and Throat (ENT) Outpatient Department (OPD) of MGM Medical College and Hospital, Navi Mumbai, Maharashtra, India. A cross-sectional study, the KAPS study, was conducted on 91 patients diagnosed with OM. Materials and Methods: This study used a cross-sectional methodology to assess KAPS. The research included 91 patients diagnosed with OM receiving care at the ENT-OPD of MGM Medical College and Hospital, Navi Mumbai, Maharashtra, India. Statistical Analysis: Descriptive statistics were used, and data normality was evaluated. Independent T-tests and analysis of variance methods were employed to compare means, followed by post hoc analysis using the Bonferroni test. Pearson coefficient test was utilized to estimate correlations, and associations were examined using the Chi-square test. Results: Most participants (47.3%) exhibited a low level of knowledge, with an average Knowledge score of 11.98 ± 4.64 out of a possible 23. The mean Attitude score was 5.37 ± 1.37 out of seven. Regarding Attitude scores, there were significant differences in educational level (P = 0.003) and socioeconomic status (P = 0.0001). The mean Practice score was 0.51 ± 0.6 out of a maximum score of three. There was a significant correlation between Knowledge and Attitude scores (P &lt; 0.0001). Only 17.6% of the participants reported receiving any education on ear health. Conclusion: Most patients in the study demonstrated a lack of comprehensive knowledge. While a positive attitude was common among the majority, the average Practice score remained relatively modest. This research underscores the significance of community education initiatives focused on OM to boost awareness and reduce the burden of this condition.

Edukasi dan Pemeriksaan Fisik Kesehatan Telinga pada Pekerja Usia Produktif

Educational activities and physical examinations regarding ear canal hygiene and tympanic membrane health have the aim of increasing public knowledge about the importance of maintaining ear hygiene and maintaining the integrity of the tympanic membrane. In this activity, counseling is given to the public to provide a correct understanding of cerumen, proper ear care, and signs of damage to the tympanic membrane. This community service activity was carried out on June 9, 2023 by involving 52 respondents. All respondents attended community counseling and physical examinations. On the results of the physical examination it was found that 3 (5.8%) respondents had a perforated tympanic membrane, and 6 (11.5%) respondents had prop cerumen. The results of this educational activity and physical examination are expected to increase public understanding of the importance of maintaining ear hygiene and maintaining the health of the tympanic membrane. With the right knowledge, it is hoped that people will be able to adopt healthy habits in caring for their own ears and take the necessary precautions to maintain optimal ear health.

Comparing outcomes of ultra-low-cost hearing aids to programmable, refurbished hearing aids for adults with high frequency hearing loss in Malawi: a feasibility study.

Access to ear and hearing health services are limited or non-existent in low-income countries, with less than 10% of the global production of hearing aids distributed to this population. The aim of this feasibility study was to compare the outcomes of an ultra-low-cost hearing aid (LoCHAid) to programmable, refurbished hearing aids for adults with high-frequency hearing loss, in Blantyre, Malawi. Sixteen adults with high frequency hearing loss, and no prior experience of hearing aids, took part in this study, nine were fitted with the LoCHAid and seven were fitted with refurbished, programmable hearing aids, for a one-month trial. Five standardized hearing qualities questionnaires were used to compare outcomes pre and post device fitting and between devices. Questionnaire scales were analysed using general linear models and inductive thematic analysis was used to evaluate qualitative data. Overall, there was no significant difference found between LoCHAid and refurbished hearing aids, and the two device types each showed a similar degree of improvement after fitting. Qualitative data analysis identified two key themes: Sound Quality and User experience. The results from this feasibility study are encouraging, but a comprehensive, larger clinical study is needed to draw firm conclusions about the LoCHAid's performance. This study has identified key improvement indicators required to enhance sound quality and user experience of the LoCHAid.

Ear disease and hearing loss: a descriptive study of Aboriginal children living in metropolitan South Australia

ObjectiveThis article aims to describe the rates of middle ear disease in Aboriginal children living in metropolitan Adelaide. MethodsData from the Under 8s Ear Health Program (population-based outreach screening) were analysed to identify rates of ear disease and the referral outcomes for children identified with ear conditions during screening. ResultsIn total, 1598 children participated in at least one screening between May 2013 and May 2017. Males and females were equally represented; 73.2% had one or more abnormal findings on otoscopy at the first screening visit, 42% had abnormal tympanometry, and 20% registered a “fail” on otoacoustic emission testing. The referral pathway for children with abnormal findings included referrals to their GP, Audiology, and Ear Nose Throat (ENT) Departments. Also, 35% (562/1598) of the children screened required referral either to a GP or Audiology, and 28% of those referred (158/562) or 9.8% (158/1598) of the total number of children screened required further ENT management. ConclusionsHigh rates of ear disease and hearing problems in urban Aboriginal children were detected in this study. Existing social, environmental, and clinical interventions need to be evaluated. Closer monitoring including data linkage may assist to better understand the effectiveness, timeliness, and challenges of public health interventions and follow-up clinical services to a population-based screening program. Implications for Public HealthAboriginal-led population-based outreach programs such as the Under 8s Ear Health Program augmented by seamless integration with education, allied health and tertiary health services should be prioritised for expansion and continued funding.

Programmatic Approach to Hearing Health in Low- and Middle-Income Countries

Programmatic Approach to Hearing Health in Low- and Middle-Income Countries

The summating potential polarity encodes the ear health condition

The summating potential (SP), the DC potential which, along with the AC response, is produced when the hair cells convert the vibrational mechanical energy of sound into electrical signals, is the most enigmatic of the cochlear potentials because its polarity and function have remained elusive for more than seven decades. Despite the tremendous socioeconomic consequences of noise-induced hearing loss and the profound physiological importance of understanding how loud noise exposure impairs the hair cell receptor activation, the relationship between the SP and noise-induced hearing impairment remains poorly characterized. Here, I show that in normally hearing ears, the SP polarity is positive and its amplitude relative to the AC response grows exponentially across frequencies, and becomes negative and decreases exponentially across frequencies following noise-induced hearing injury. Since the SP is thought to be generated by K+ outflow down the gradient through the hair cell basolateral K+ channels, the SP polarity switch to negative values is consistent with a noise-induced shift in the operating point of the hair cells.

Pemeriksaan dan Edukasi Gangguan Pendengaran Pada Anak Panti Asuhan

Unhealthy ears may cause hearing loss. This issue may affect children to have difficulty communicating with others and decrease learning achievement at school. This community service activity aimed to give knowledge about hearing loss and conduct hearing examinations in orphanage children. This community service was held at the Aulia Al-Ikhlas Orphanage in Sungai Pagar Village, Kampar Kiri Hilir District, Kampar Regency, Riau. At the beginning of the activity, we provided counseling about hearing loss, followed by ear and hearing examinations using a tuning fork. Before and after the counseling, respondents filled out a questionnaire to assess knowledge about hearing loss. Twenty-four residents of the orphanage attended this activity. The questionnaires found that children's knowledge about hearing loss and ear health increased significantly after the counseling. The examination results found cerumen in 14 children, 4 with conductive hearing loss and 2 with sensory neural hearing loss. As a result, this community service activity can increase the knowledge of orphanage children about hearing loss and make their ears cleaner and healthier.

Morbidity Pattern Among Elderly in an Urban Area of Burla, Odisha.

Population aging is an inevitable demographic reality that is associated with improvements in the health and medical care system. With longevity and declining fertility rates, the population of older persons is growing faster than the general population globally. The elderly population is more prone to various kinds of morbidity due to decreasing immunity and the risk of advancing age. To describe the morbidity pattern of the elderly in an urban area of Burla. Community-based cross-sectional study was carried out for one year from 1st July 2021 to 30th June 2022. A total of 385 individuals aged 60 years and above residing in Burla were included in the study. Patient-wise data collection was done by a predesigned, pretested structured questionnaire. The chi-square test for categorical variables at a 95% confidence interval and significance set at 0.05 were used as measures of association in the analysis of factors associated with morbidity. The most common health problem involved was musculoskeletal (68.6%), followed by cardiovascular (57.1%), eye (47.3%), endocrine (25.2%), respiratory (21.3%), digestive (20.5%), skin (16.1%), ear (15.3%), general and unspecified health problems (30.7%), and urological (5.5%) and 4.5% had neurological problems. Elderly population has a high frequency of numerous morbidities, so it is important to educate the elderly population about prevalent age-related health issues as well as preventive care.

Examining relationships between parent-reported factors and recurring ear symptoms among Aboriginal and Torres Strait Islander children.

Aboriginal and Torres Strait Islander child ear health is complex and multiple. We examined relationships between parent-reported sociodemographic, child health, health service access factors and ear symptoms among Aboriginal and Torres Strait Islander children aged 3 to 7 years. The Longitudinal Study of Indigenous Children is a large child cohort study with annual parent-reported data collection. Generalised linear mixed model analyses examined Wave 1 (1309 children 0-5 years; 2008) predictors of being free of parent-reported ear symptoms in both Waves 2 and 3. A total of 1030 (78.7%) had no reported ear symptoms in either Wave 2 or 3. In the fully adjusted model, children who had been hospitalised in the past year (aOR = 2.16; 95% CI 1.19-3.93) and those with no ear symptoms (aOR = 2.94; 95% CI, 1.59-5.46) at Wave 1 had higher odds of no ear symptoms in both the subsequent waves. There were also relationships between parent main source of income-government pension or allowance as well as parents who reported no history of their own ear symptoms and higher odds of no ear symptoms in Waves 2 and 3 after partial adjustment for sociodemographic factors. These findings suggest relationships between different sociodemographic and health factors and parent-reported ear symptoms among Aboriginal and Torres Strait Islander children that warrant further investigation. So what? Children with parent-reported ear symptoms during the early years need holistic support to prevent future ear symptoms that impact health, social and educational life trajectories.

School Children's Health Screening at SDN Bangsal 1 with Puskesmas Pesantren 1 Kediri City

The guidance and development of School Health Business (UKS) in schools is carried out through three main programs (known as the UKS trias) which include health education, health services, and fostering a healthy school life environment. The health services in question include school children's health screening, otherwise known as health screening; health monitoring; and health education. The purpose of this community service is to conduct a health screening of school children at SDN Bangsal 1 Kediri City. The school health screening program will be held in February 2022, precisely at 08.00 – 12.00. The health tests carried out include eye health, ear health, skin health, teeth and reproductive health tests. An eye health test is conducted to determine whether the student suffers from color blindness, low vision, cataracts, or other diseases. A skin health test is done by checking whether there are red spots on the skin. In addition, health tests are also added to other body parts. This community service is carried out in collaboration with the Pesantren 1 Public Health Center, Kediri City. From the screening results, it was found that the health of the students of SDN Bangsal 1 Kediri City did not show any serious diseases, but some eye problems were found. The action taken by the school for students with health problems was to refer to the Pesantren 1 Public Health Center which is not far from the school, by bringing a referral letter given by the examining doctor at the health screening. The health screening program is one of the school's flagship programs. It is hoped that the students of SDN Bangsal 1 Kediri have more awareness to maintain health.

Ear Portal: An urban-based ear, nose, and throat, and audiology referral telehealth portal to improve access to specialist ear health services for children

Introduction Shortage of ear, nose, and throat specialists in public hospitals can result in delays in the detection and management of otitis media. This study introduced a new hospital-based telehealth service, named the Ear Portal, and investigated its role in improving access to specialist care. Methods The study included 87 children (aged 6 months to 6 years) referred to a tertiary children's hospital due to otitis media-related concerns. A specialist multidisciplinary team met fortnightly to review pre-recorded data and provide care plans. Results The service resulted in a median waiting time of 28 days to receive a diagnosis and care plan by the multidisciplinary team, compared to a mean waiting time of 450 days for a reference group receiving standard healthcare services. Most children (90.3%) received bilateral ear diagnosis. Normal findings were found in 43.9%. However, the majority required further ear, nose, and throat with or without audiology face-to-face follow-up due to a diagnosis of middle-ear disease, unknown hearing status, or concerns not related to ears. The mean time required for clinical assessments completion by research assistants and multidisciplinary team review was 37.6 and 5.1 min per participant, respectively. Discussion Children in the Ear Portal service received a diagnosis and care plan in a median of 28 days, which is within the clinically recommended timeframes. With sufficient clinical information, this service can provide faster access to specialist care than the standard healthcare pathway. The service can reduce the time required by the specialist to provide a diagnosis and care plan which may help increase the specialists’ capacity.

How can we ensure returning trainees have a positive impact on ear and hearing health?

How can we ensure returning trainees have a positive impact on ear and hearing health?

Improving the Level of Ear Health Literacy in Teenager: Policy Brief

Improving the Level of Ear Health Literacy in Teenager: Policy Brief