Ear Hearing Loss Research Articles

Severe Vestibular Dysfunction Following Unilateral Cochlear Implant: A Case Report and Management Approach

Abstract Cochlear implantation (CI) is a highly effective treatment for severe-to-profound hearing loss, but it can result in postoperative vestibular dysfunction, including vertigo and imbalance. This case report describes a 22-year-old female who developed severe vertigo and imbalance following right ear CI surgery. Audiological assessment confirmed normal hearing in the left ear and profound sensorineural hearing loss in the right ear. Vestibular tests revealed significant dysfunction, including left-beating spontaneous nystagmus, vestibular hypofunction, and abnormal saccular function in the implanted ear. This case underscores the prevalence of vestibular complications post-CI, reported in up to 75% of recipients. Comprehensive preoperative vestibular assessment is essential for identifying potential risks and guiding surgical decisions, such as choosing between unilateral and bilateral implantation. Early identification and management of vestibular issues can improve outcomes and quality of life for CI patients.

Sudden Hearing Loss as the Initial Manifestation of Chronic Myeloid Leukemia

Sudden hearing loss rarely presents as an initial manifestation of a hematologic disorder, although it can result from various factors. A 48-year-old male had sudden hearing loss in both ears. The pure tone audiometry and audiometry brainstem response revealed profound hearing loss in both ears. Further examination indicated an elevated leukocyte count, and a temporal bone magnetic resonance image suggested potential bleeding in the cochlear and labyrinth of both ears. Upon consultation with hematologic oncology, chronic myeloid leukemia was diagnosed. Hearing loss in leukemia patients is attributed to leukemic infiltration, hemorrhage, infection, and hyperviscosity. Following treatment using tyrosine kinase inhibitor for chronic myeloid leukemia, the leukocyte count was normalized. However, on the 90th day of treatment, both profound hearing loss persisted. We suspect that the cause of sudden hearing loss may be related to hemorrhage in both cochlear and labyrinth. Accurate diagnosis and treatment are essential for preventing complications.

Overview of the ASCO 2024 data on head and neck surgery

At the 2024 international cancer congress of the American Society of Clinical Oncology (ASCO), studies on immuno-oncological therapeutic approaches for head and neck cancers once again took center stage. Following the trend of recent years, neoadjuvant immunotherapy has now reached acentral role, and purely surgical studies have become increasingly scarce. This review article summarizes abstracts presented at the 2024 ASCO Annual Meeting that focus on surgical therapy or in which surgery was asignificant component of the study protocol. As part of the combination therapies, study results on neoadjuvant treatment strategies are also presented. Additionally, promising new developments are discussed, including the treatment of laryngeal papillomatosis, new considerations on the necessary extent of neck dissection, follow-up care for human papillomavirus (HPV)-positive head and neck squamous cell carcinoma (HNSCC), and the prevention of platinum-induced inner ear hearing loss.

Prevalence of and Risk Factors for Hearing Impairment in Craniofacial Microsomia

BackgroundWhile ear anomalies and hearing impairment are common in patients with craniofacial microsomia (CFM), their prevalence, characteristics, and relationship to speech-language development remain unclear. PurposeThis study analyzed the prevalence and risk factors for hearing impairment in patients with CFM. Study Design, Setting, SampleThis retrospective cohort study included patients with unilateral or bilateral CFM from a single center between January 1980 and July 2023 who had evidence of a hearing assessment at <18 years. Exclusion criteria were inconclusive CFM diagnosis by clinical examination and/or radiographs or incomplete medical records. Predictor VariablesThe predictor variables included presence or absence of cleft lip and/or palate, laterality of CFM, and external ear and mandibular anomaly scores measured using the Orbit, Mandible, Ear, Nerve, and Soft Tissue (OMENS) and Pruzansky-Kaban classifications. Main Outcome VariablesPrimary outcome variable was hearing impairment, measured through air and bone conduction audiometry and categorized by type, severity, and side. Secondary outcome variable was speech-language delay, evaluated through assessments of expressive and receptive language skills, vocabulary, speech intelligibility, general articulation, and phonological speech. CovariatesThe covariates included sex and age at first hearing assessment. AnalysesLogistic regression models were used to analyze the effect of predictors on outcomes. P-value <0.05 was considered significant. ResultsThe sample included 213 patients (61.5% male). Hearing assessments were performed at a mean age of 4.6 ± 4.8 years. Hearing impairment was found in 183 (85.9%) and was predominantly conductive (n=130, 91.5%). Of subjects with hearing impairment, 158 (86.3%) had external ear anomalies (P<0.001). In patients with unilateral CFM, 38 (21.8%) had bilateral hearing loss and 9 (5.2%) had contralateral-only hearing loss. Both M3 and E3 scores were associated with the presence and severity of hearing loss (P=0.01 and P<0.001, respectively). There was no significant association between hearing impairment and speech-language development (P>0.05). Conclusion and RelevanceAlthough the severity of mandibular and external ear anomalies was significantly associated with the prevalence and severity of hearing loss, clinicians should remain alert for concomitant or isolated contralateral hearing loss, given the high prevalence of hearing loss in ears without ipsilateral facial involvement or external abnormalities.

The influence of occupational noise exposure on blood pressure and hearing loss among female workers of childbearing age

ObjectivesWomen exposed to occupational noise experience adverse pregnancy outcomes. Therefore, we initiated a large, population-based, cross-sectional study to further investigate the effects of occupational noise on hearing and blood pressure among female workers of childbearing age.Study design and settingA total of 6981 childbearing-aged female workers were selected for this cross-sectional study. Basic characteristics of participants were analyzed by comparing the exposed and control groups. Logistic regression models were employed to calculate the odds ratios (ORs) and 95% confidences intervals (CIs) for the associations of occupational noise with levels of hearing loss and blood pressure. The associations were further explored through stratification by age and duration of noise exposure.ResultsCompared with participants not exposed to occupational noise, increasing years of occupational noise exposure were independently associated with an elevated risk of hypertension after adjustment of age, industry classification, enterprise size and economic type. Compared to participants not exposed to occupational noise, only the prevalence of bilateral hearing loss was significantly higher after adjustments for age, industry classification, enterprise size and economic type. Compared with those with normal hearing, the ORs and 95% CIs were 1.97 (0.95–4.07), 2.22 (1.05–4.68) and 1.29 (1.06–1.57) for bilateral, unilateral and any ear hearing loss, respectively.ConclusionsOccupational noise exposure is positively associated with both hypertension and bilateral hearing loss among female workers of childbearing age. Those exposed to occupational noise show an increased risk of hypertension after adjusting for potential confounders.

Alzheimer's Disease-Related Analytes Amyloid-β and Tau in Perilymph: Correlation With Patient Age and Cognitive Score.

To describe the collection methods for perilymph fluid biopsy during cochlear implantation, detect levels of amyloid β 42 and 40 (Aβ42 and Aβ40), and total tau (tTau) analytes with a high-precision assay, to compare these levels with patient age and Montreal Cognitive Assessment (MoCA) scores, and explore potential mechanisms and relationships with otic pathology. Prospective study. Tertiary referral center. Perilymph was collected from 25 patients using polyimide tubing to avoid amyloid adherence to glass, and analyzed with a single-molecule array advanced digital enzyme-linked immunosorbent assay platform for Aβ40, Aβ42, and tTau. Cognition was assessed by MoCA. Perilymph volumes ranged from ∼1 to 13 µL, with analyte concentrations spanning 2.67 to 1088.26 pg/mL. All samples had detectable levels of tTau, Aβ40, and Aβ42, with a significant positive correlation between Aβ42 and Aβ40 levels. Levels of Aβ42, Aβ40, and tTau were positively correlated with age, while MoCA scores were inversely correlated with age. tTau and Aβ42/Aβ40-ratios were significantly correlated with MoCA scores. Alzheimer's disease-associated peptides Aβ42, Aβ40, and tau analytes are detectable in human perilymph at levels approximately 10-fold lower than those found in cerebrospinal fluid (CSF). These species increase with age and correlate with cognitive impairment indicators, suggesting their potential utility as biomarkers for cognitive impairment in patients undergoing cochlear implantation. Future research should investigate the origin of these analytes in the perilymph and their potential links to inner ear pathologies and hearing loss, as well as their relationships to CSF and plasma levels in individuals.

Parent-Reported Ease of Listening in Preschool-Aged Children With Bilateral and Unilateral Hearing Loss.

Evidence from school-aged children suggests that the ease with which children listen varies with the presence of hearing loss and the acoustic environment despite the use of devices like hearing aids. However, little is known about the ease of listening in preschool-aged children with hearing loss-an age at which rapid learning occurs and increased listening difficulty or effort may diminish the required capacity to learn new skills. To this end, the objectives of the present study were to (i) assess parent-reported aided ease of listening as a function of hearing loss configuration (hearing loss in one versus both ears) and device configuration among children with hearing loss in one ear (unilateral hearing loss), and (ii) investigate factors that influence children's ease of listening. Parents of 83 children with normal hearing, 54 aided children with bilateral hearing loss (hearing loss in both ears), and 139 children with unilateral hearing loss participated in the study. Of the 139 children with unilateral loss, 72 were unaided, 54 were aided with a device on the ear with hearing loss (direct aiding) and 13 were aided with a device that routed signals to the contralateral normal hearing ear (indirect aiding). Mean age of children was 40.2 months (1 SD = 2.5; range: 36 to 51). Parents completed the two subscales of the Parents' Evaluation of Aural/Oral Performance of Children+ (PEACH+) questionnaire, namely functional listening and ease of listening. Individual percent scores were computed for quiet and noisy situations. Linear mixed-effects models were used to assess the effect of hearing loss configuration and device configuration in children with unilateral hearing loss. Multiple regression was used to assess factors that influenced ease of listening. Factors included hearing thresholds, age at first device fit, consistency in device use, condition (quiet/noise), presence of developmental disabilities, and functional listening abilities. Children with direct aiding for their hearing loss, either unilateral or bilateral, had similarly lower functional listening skills and ease of listening than their normal hearing peers. Unaided children with unilateral hearing loss had lower functional listening skills and ease of listening than their normal hearing peers in noise but not in quiet. All aided children with unilateral hearing loss, irrespective of direct or indirect aiding had lower functional listening skills and ease of listening relative to normal hearing children in both quiet and noise. Furthermore, relative to unaided children with unilateral hearing loss, those with indirect aiding had lower functional listening and ease of listening. Regression analyses revealed functional listening as a significant predictor of ease of listening in all children with hearing loss. In addition, worse degrees of hearing loss and presence of noise reduced ease of listening in unaided children with unilateral hearing loss. Bilateral hearing loss is associated with poorer-than-typical ease of listening in preschoolers even when aided. The impact of unilateral hearing loss on ease of listening is similar to that observed in children with bilateral hearing loss, despite good hearing in one ear and aiding. Given increased difficulties experienced by children with unilateral loss, with or without a device, additional strategies to facilitate communication abilities in noise should be a priority.

Evaluation of otoacoustic emissions and brainstem auditory evoked potential in infants with birth asphyxia

Background: Recent technological evolutions allow for the identification of hearing level (HL) in infants soon after birth. The goal of early hearing detection and intervention is to maximize linguistic and communication skills and literacy development for children who are deaf or hard of hearing. Infants whose HL has been confirmed before 6 months of age must be provided early intervention. Aims and Objectives: The aim of the study was to observe the changes in the otoacoustic emissions (OAE) and brainstem auditory evoked potential (BAEP) in infants with birth asphyxia (BA). Materials and Methods: The present study was a case–control study. A total of 50 cases of infants with BA and 50 normal-term infants were part of the study after obtaining informed consent as per the ICMR guidelines. A through clinical examination and otoscopy examination were done to rule out any conductive hearing loss. Then, OAE and BAEP were recorded to estimate the hearing loss and hearing threshold of infants. Results: BAEP waveform I, III, and V absolute latencies were significantly prolonged among BA infants than normal infants. The interpeak latency (IPL) of the right ear III-V was significantly increased in BA infants. However, III-V and I-V latencies though prolonged in BA infants, they are not statistically significant. No significant interaural difference was noted in absolute and IPLs of both BA and normal infants. No significant relationship existed between the mode of delivery and the degree of hearing loss in both ears. Significant association was observed between the degree of hearing loss and severity of BA (hypoxic-ischemic encephalopathy) in both ears. Conclusion: BAEP recording in BA infants is useful to identify the hearing impairment at the earliest. The implication of this research work will help in early detection of hearing impairment, so that speech and language developmental delay in the child can be prevented.

Ear disease, hearing loss, and cognitive outcomes in high school children who were previous participants in a randomized placebo controlled trial of an 11 valent conjugate pneumococcal vaccine administered in infancy

The WHO estimates that close to 1.7 billion people worldwide have hearing loss; 34 million of whom are children, with 90% residing in low- and middle-income countries. While the effects of ear disease and hearing loss on language, academic, and behavioral development are established, there is remarkably little data on intellectual and other cognitive differences. Here we report results from an extension of a randomized controlled vaccination trial originally carried out between 2000 and 2004. Primary caregivers completed demographic and household questionnaires. Beginning in 2016, children were followed up for a hearing and ear disease evaluation. Participants also completed extensive cognitive testing, which included the domains of IQ, language, attention and processing speed, visual and visuospatial skills, and learning and memory. The association between ear disease and hearing loss and each of the cognitive outcomes was examined using multivariate linear regression models. We followed up 8926 children ages 14-19 years old. Children with hearing loss or ear disease had lower socioeconomic status compared to children without. However, even after controlling for a high number of covariates, all levels of ear disease or hearing loss were associated with clinically relevant reductions across all cognitive domains, though effect sizes were small. Even mild ear disease or hearing loss was associated with a-0.15 (95% CI:-0.20,-0.11) and a-0.23 (95% CI:-0.32,-0.14) standard deviation reduction, respectively, in IQ. The effects of ear disease and hearing loss were additive as children with both had the lowest cognitive scores. Untreated ear disease and hearing loss exert measurable effects on cognition that are able to be detected into the teenage years. Early identification of hearing loss and chronic ear disease may have lifelong benefits. Individuals with ear disease and/or hearing loss may require supports and services in addition to those related to speech and language therapy. The Bill and Melinda Gates Foundation OPP1142570.

The effect of high-dose Levothyroxine on hearing in patients operated for thyroid cancer.

The aim of this study is to investigate the relationship between the use of high doses of levothyroxine (L-T4) and hearing loss in patients who have undergone surgery for thyroid cancer. After total thyroidectomy for thyroid cancer, patients were divided into two groups according to L-T4 dose below 150µg and above 150µg. Demographic characteristics, postoperative duration, radioactive iodine treatment, bone densitometry scans with LDxa and FDxa, and right and left ear hearing levels were statistically compared in both groups. The study included 62 patients, 85.5% (n = 53) of whom were female, with a mean age of 48.8 ± 11.7 years. While 56.45% (n = 35) of the patients were taking L-T4 below 150µg 43.55% (n = 27) were taking L-T4 above 150µg. The mean postoperative duration of the participants was 4.1 ± 2.7 years, osteopenic 30.7% and osteoporotic 16.13% according to LDxa, osteopenic 29.0% and osteoporotic 1.6% according to FDxa. Hearing loss in both right and left ears was 41.9% and sensorineural hearing loss in both ears was 22.6%. Age, LDxa, FDxa, hearing loss in the right and left ear were found to be significantly different in the two groups above and below 150µg according to the dose of L-T4 used (p < 0.05). However, no differences were found according to sex, height, weight, body mass index, postoperative period, or radioactive iodine treatment (p > 0.05). Both osteopenia and osteoporosis, as well as hearing loss in both the right and left ear, were significantly higher in the group taking L-T4 150µg or more (p < 0.05). In our study, we found that patients taking 150µg or more of L-T4 daily were more osteopenic and osteoporotic and had more hearing loss in both ears.

Otitis media sequelae and hearing in adolescence after administration of an 11-valent conjugate pneumococcal vaccine in infancy: a prospective cohort study with long-term follow-up of the ARIVAC trial

Pneumococcal conjugate vaccines (PCVs) have been shown in randomised controlled trials and epidemiological studies to prevent acute otitis media caused by vaccine serotype pneumococci, although their role in preventing complications of acute otitis media is less clear. We hypothesised that the 11-valent PCV would reduce the long-term sequelae of acute otitis media, including moderate-to-severe ear disease and hearing loss. This prospective cohort study, referred to as 11PCV study, included follow-up after 16-20 years of children previously enrolled in 2000-04, at age 6 weeks to 6 months, in the randomised, placebo-controlled, ARIVAC trial of 11-valent PCV for the prevention of radiographical pneumonia. The ARIVAC trial and this 11PCV study were conducted at six study centres in Bohol, Philippines. Ear disease was classified using video-otoscopy review and observations derived from the ear exam. The final classification of the worst ear disease was mild (ie, acute otitis media, otitis media with effusion, healed perforation, or tympanosclerosis), moderate (ie, dry perforation or adhesive otitis media), or severe (chronic suppurative otitis media). Hearing loss was assessed following a standard schema and classified according to the worst ear as mild (>15 to 30 dB puretone average) or moderate-to-profound (>30 dB pure tone average). We calculated the relative and absolute risk reduction in the primary outcome of moderate-to-severe ear disease and the secondary outcomes of mild or moderate-to-profound hearing loss in adolescents who previously received the 11-valent PCV compared with those who received placebo during infancy in ARIVAC. Of the 15 593 children assessed for eligibility in ARIVAC, 12 194 were randomly assigned and 8926 were alive and could be located for enrolment in this 11PCV study between Sept 19, 2016, and Dec 13, 2019. 8321 (4188 in the vaccine group and 4133 in the placebo group) completed follow-up of the 11PCV study by March 30, 2020, and had sufficient data to classify ear disease and be included in the primary outcome analysis. The primary outcome of the absolute risk reduction in moderate-to-severe ear disease in the vaccine group (310 [7·4%] of 4188) versus those in the placebo group (356 [8·6%] of 4133) was 1·2% (95% CI 0·0-2·4; p=0·046) and the relative risk reduction was 14·1% (0·0 to 26·0). There were no differences in secondary outcomes of mild hearing loss or moderate-to-profound hearing loss between the vaccine and placebo groups. The absolute risk reduction for moderate-to-severe ear disease in adolescence of 1·2% (12 per 1000 children) was almost three times higher than the 0·45% reduction (4·5 per 1000 children) in radiographical pneumonia in the first 2 years of life shown in ARIVAC. Administration of 11-valent PCV in infancy was associated with absolute and relative risk reductions in the sequelae of acute otitis media 16-20 years after the original ARIVAC trial. Bill & Melinda Gates Foundation.

Sst- and Vip-Cre mouse lines without age-related hearing loss.

GABAergic interneurons, including somatostatin (SST) and vasoactive intestinal peptide (VIP) positive cells, play a crucial role in cortical circuit processing. Cre recombinase-mediated manipulation of these interneurons is facilitated by commercially available knock-in mouse strains such as Sst-IRES-Cre (Sst-Cre) and Vip-IRES-Cre (Vip-Cre). However, these strains are troublesome for hearing research because they are only available on the C57BL/6 genetic background, which suffer from early onset age-related hearing loss (AHL) due to a mutation of the Cdh23 gene. To overcome this limitation, we backcrossed Sst-Cre and Vip-Cre mice to CBA mice to create normal-hearing offspring with the desired Cre transgenes. We confirmed that in these "CBA Cre" lines, Cre drives appropriate expression of Cre-dependent genes, by crossing CBA Cre mice to Ai14 reporter mice. To assess the hearing capabilities of the CBA Cre mice, we measured auditory brainstem responses (ABRs) using clicks and tones. CBA Cre mice showed significantly lower ABR thresholds compared to C57 control mice at 3, 6, 9, and 12 months. In conclusion, our study successfully generated Sst-Cre and Vip-Cre mouse lines on the CBA background that will be valuable tools for investigating the roles of SST and VIP positive interneurons without the confounding effects of age-related hearing loss.

Evaluating the Correlation of Fasting Blood Sugar, Glycated Hemoglobin with the Hearing Loss

Background and objectives: Hearing loss is one of the most prevalent disabilities. Factors that can be controlled are linked to hearing loss. Diabetes, which can potentially lead to hearing loss during cases of high blood sugar levels, appears to be a contributing factor to hearing loss. This study aimed to determine the relationship between fasting blood sugar (FBS) and glycated hemoglobin (HbA1c) with hearing loss. Method: This was a cross-sectional study conducted on two groups: the study sample consisting of patients with both diabetes and hearing loss, and the control sample comprising non-diabetic individuals with hearing loss. The study was carried out at the Sabratha Residential Clinic, Surman Clinic Al-Kubra, and Surman General Hospital between April 12, 2022, and October 25, 2023. During this period, a questionnaire was prepared, and a "Pure Tone Audiometry" hearing test was performed in the planning room to assess the hearing status of participants in both the study and control groups. Results: The study involved 80 participants, of whom 44 (55%) were male and 36 (45%) were female, aged 25-65 years. Compared to the control group, the study group had significantly higher fasting blood sugar (FBS: 202.13 ± 48.13 vs. 81.38 ± 9.50, p&lt;0.001) and glycated hemoglobin (HbA1c: 9.48 ± 2.1 vs. 4.25 ± 0.59, p&lt;0.001) levels, The study group exhibited greater hearing impairment in the left ear (56.90 ± 22.94 vs. 44.40 ± 28.13, p=0.031), but the difference in right ear hearing loss was not statistically significant (53.33 ± 24.47 vs. 44.025 ± 28.41, p=0.121). HbA1c (r=0.239, p=0.027) and FBS (r=0.216, p=0.033) both showed significant positive correlations with hearing loss. Conclusion: This study found that type 2 diabetes mellitus adversely affects hearing, with sensorineural hearing loss positively correlating with HbA1c and FBS levels. These findings indicate that poor glycemic control is associated with an increased risk of hearing impairment in this patient population.

Management of subjective tinnitus with conductive hearing loss through Ayurveda: An experience

Tinnitus (~Karnanada) is a type of perception of sound that people occasionally experience in the absence of an accompanying external sound. The noise can be intermittent or continuous and can vary in loudness. Tinnitus is frequently linked to hearing loss and impaired speech understanding in noisy settings. A 31-year-old female patient came to the outpatient department with complaints of annoying sounds in both ears, hearing impairment in the right ear, headache, and disturbed sleep for the past 3 years. The patient was examined using tuning fork test, pure-tone audiometry, and impedance audiometry, which led to a diagnosis of subjective tinnitus with conductive hearing loss in both ears. The difficulties faced by the patient in daily life due to tinnitus were assessed using the Tinnitus Handicap Inventory (THI) questionnaire and the THI score. The patient was treated with Nirgundyadi taila karnapurana (~instillation of medicated oil in the ear) along with Ashwagandhadi ghrita orally for 21 days. The patient showed relief in tinnitus along with an improvement in hearing loss. There was no recurrence during a follow-up period of 30 days. The treatment reveals that Ayurvedic interventions are effective in the management of tinnitus quite efficiently.

QOL-44. EARLY SEVERE HEARING LOSS IN CANADIAN CHILDREN WITH CENTRAL NERVOUS SYSTEM TUMORS: A POPULATION-BASED COHORT STUDY

Abstract BACKGROUND Severe treatment-related hearing loss (HL) is associated with devastating psychosocial/neurocognitive outcomes. Children with central nervous system (CNS) tumors are highly vulnerable to severe HL due to tumor location and treatment exposures. This is the first study to report national CNS tumor-specific rates and predictors of early severe HL. METHODS We conducted a retrospective, population-based cohort study of all children ≤15yrs at diagnosis with CNS tumors between 2001-2019 using the Cancer in Young People in Canada registry. The primary outcome was Common Terminology Criteria for Adverse Events grade 3/4 HL ≤5yrs following diagnosis. We determined prevalence and probabilities of early HL; predictors were determined using multivariable logistic regression models. RESULTS Among 3,201 children with CNS tumors, 5.1% experienced early HL. Children with medulloblastoma (N=570) and ATRT/other embryonal tumors (N=269) experienced disproportionate rates (16.1%, 15.2%, respectively); 85.4% (medulloblastoma) and 68.8% (ATRT/other embryonal) received cisplatin, 74.6% (medulloblastoma) and 52.1% (ATRT/other embryonal) were irradiated. In children with medulloblastoma, when controlling for follow-up, age &amp;lt;=5yrs at diagnosis [odds ratio (OR) 2.4, 1.5-3.8], radiation (OR 3.5, 1.6-7.6), and cisplatin (OR 20.4, 1.3-329.7) predicted early HL. In children with medulloblastoma post cisplatin, age ≤5yrs at diagnosis doubled the probability of early HL in both irradiated (29.8%, vs 15.3% if &amp;gt;5yrs at diagnosis) and non-irradiated patients (10.6% vs 4.8% if &amp;gt;5yrs at diagnosis). In children with ATRT/other embryonal, cisplatin (OR 28.2, 1.7-472.1) was the only predictor of early HL. CONCLUSIONS In the largest population-based study of early severe HL in children with CNS tumors, we report striking rates in children with embryonal tumors. Younger irradiated children had disproportionate probabilities of early HL, suggesting a novel additive interaction between age at diagnosis and radiation. Standardized otoprotection and research focusing on therapy de-escalation in young children with embryonal tumors are urgently needed.

Translabyrinthine approach in acoustic neuroma surgery – case report

Introduction. Acoustic neuroma is a benign tumor that arises from the glial Schwann sheath junction of the vestibulocochlear nerve. It has an incidence of 1:100000 population. Despite the fact that this is a rare tumor, it accounts for approximately 6% of all intracranial tumors and 80% of tumors localized in cerebellopontine angle. Treatment of acoustic neuroma is represented by “Wait and Scan” monitoring, radiologic and surgical treatment. The latter remains the primary treatment for acoustic neuroma and consists of 3 main approaches: retrosigmoid approach, middle cranial fossa approach and translabyrinthine approach. Until now, in our country, acoustic neuroma surgery was done only by retrosigmoid approach. Case presentation. The first translabirinthine surgery for acoustic neuroma in our country was done on 09.12.2021 on a 60-year-old patient who, during preparation for cochlear implant surgery, was accidentally diagnosed with 3rd grade right acoustic neuroma, according to Koos classification. Patient had cophosis on the right ear and moderate hearing loss in the left ear. During the surgery, a gross total resection of the tumor was accomplished. The patient was discharged from the medical institution on 20.12.2021 in a satisfactory condition. Magnetic resonance imaging performed 3 months and 1 year after the surgery showed no complications or tumor remnants. Conclusion. The current report, which describes an accidental diagnosis of acoustic neuroma during preparation for a cochlear implantation surgery, resulted in acoustic neuroma surgery through the translabyrinthine approach. This serves as an eloquent example of why it is necessary to perform initially a magnetic resonance examination in cases of sensorineural hearing loss or tinnitus. The translabyrinthine approach in acoustic neuroma surgery allows for the removal of tumors of any size without affecting the brain, especially the cerebellum. In our case, where the patient had cophosis on the side of the tumor, this was the most appropriate surgical approach.

Knowledge and Practice of Amran University Students toward Ear and Hearing Health

The World Health Organization (WHO) has detected an urgent need for action to prevent and manage ear diseases and hearing loss. However, the first step is to identify the areas of knowledge deficiency within the population. The aim of the study was to evaluate knowledge of university students' community in managing and preventing ear disease and hearing loss. This was a cross-sectional study conducted during February 2023 at Amran University using an online ontological questionnaire. Data was retrieved and processed in Excel spreadsheet and analyzed using SPSS version 29. A total of 330 participants responded to the online questionnaire, of whom 84.5% were male, with a mean age of 21.43 ± 1.77. Among them, 15.8% reported previous ear problems, while 41.2% had relatives with ear or hearing problems. Exposure to loud noise was reported by 37.6%, and 52.2% reported listening to headphones loudly. The overall correct response rate to the statements was 73.2%, indicating a lack of certain important knowledge. The study results showed a need for official campaigns to educate the Yemeni population. Moreover, they indicated the necessity of conducting a survey on a much wider scale to aid in the development of appropriate health communication strategies and the promotion of ear and hearing health.

Cochlear implantation in pediatrics: Impact of newborn hearing screening on intervention time

ObjectivesThe newborn hearing screening (NHS) program was globally established for early hearing loss (HL) identification and intervention. Early intervention is essential to minimize or prevent the negative consequences of HL. In Saudi Arabia, the NHS was officially implemented in 2016. Currently, its impact on the timing of cochlear implantations (CIs) in Saudi Arabia remains unclear, and information on potential hospital-related delays affecting early implantation is lacking. Thus, this study aimed to evaluate the effect of implementing the NHS on age at CI in children with prelingual deafness in a CI center in Saudi Arabia, and to evaluate the hospital timing in the CI process. MethodsAll pediatric CI users who presented for the first time to the CI committee (CIC) at a tertiary center and received their implants between 2015 and 2022 were enrolled in this study. Date of birth (DOB), date of presentation to the CI committee (DOCIC), and date of CI surgery (DOCIS) were retrospectively reviewed. ResultsIn total, 304 CI children were included in the analysis. Approximately 55 % of the children (n = 167) were screened for HL through the NHS, whereas 45 % of the children (n = 137) were born before the launch of the NHS. Both age at the presentation to the CIC (i.e. difference between DOCIC and DOB) and age at implantation (i.e. difference between DOCIS and DOB) were significantly earlier in children who were screened for HL through the NHS than those who were not screened (P < 0.0001). The time difference between the DOCIC and DOCIS was not significantly different between the screened and unscreened children (P > 0.05). ConclusionThe implementation of the NHS in the tertiary center has a significant positive effect on age at presentation to the CIC and age at implantation, but not on the actual CI surgery. Further research is needed to reduce the hospital delays before the actual surgery in order to increase the likelihood of children receiving implantation early in their life.

Quantitative analysis of the characteristics and influencing factors of hearing loss among workers exposed to noise in Tianjin

Objective: To analyze the characteristics of high-frequency average hearing loss in both ears of noise exposed workers in Tianjin in 2020, and quantitatively analyze the influencing factors of high-frequency hearing loss in both ears of workers. Methods: In March 2023, Collect and organize basic information about noise-hazardous enterprises and personal information of workers exposed to noise. Data from the Tianjin Occupational Disease and Health Hazard Factors Information Monitoring System from January 2020 to December 2020, and analyze the impact of basic information of employees, enterprise size, regional distribution, industry category, and economic type on the high-frequency average hearing loss of workers during work. Apply logistic regression to quantitatively analyze the influencing factors of abnormal high-frequency average hearing threshold of noise exposed workers. Results: The size, economic type, industry category, and regional distribution of enterprises, as well as the gender, age, length of service of workers, have an impact on the abnormal high-frequency average hearing threshold of noise exposed workers (χ(2)=733.56、3 497、27、1352.84、1197.62、2570.59、22.30、506.60, P<0.001) . Quantitative analysis using a logistic regression model showed that in the basic information of workers, noise exposed workers were male (OR=2.500, P<0.001) and aged 30-39, 40-49, and 50-59 years (OR=1.33, P<0.001; OR=1.68, P<0.001; OR=1.52, P< 0.001) , with a length of service of 4 to<10 years and≥10 years (OR=1.08, P<0.001; OR=1.615, P<0.001) being the influencing factors for high-frequency hearing loss in both ears of noise exposed workers; In terms of enterprise characteristics, medium-sized, small and micro enterprises (OR=1.12, P<0.001; OR=1.75, P<0.001; OR=2.09, P<0.001) , enterprises located in the fourth district around the city (OR=1.268, P<0.001) , and enterprises with economic types of collective economy, other economy, private economy, Hong Kong, Macao and Taiwan investment, shareholding system, and other industry economies (OR are all >1, P<0.001) are all factors affecting high-frequency hearing loss in noise exposed personnel. Conclusion: Noise is a common occupational hazard factor in Tianjin's enterprises, especially for workers in micro enterprises who face a high risk of hearing abnormalities. Therefore, enterprises need to strengthen the management and intervention of noise operations to prevent the occurrence of hearing loss in workers.

Demographic, Functional, and Risk Factors Characterization in Ecuadorian Mestizo Patients With Microtia: A Retrospective Study.

This paper compares demographic, morphological, functional, and risk factors between isolated and familial forms of microtia in Ecuadorian mestizo patients. The authors did an epidemiological, and retrospective study with 112 patients divided into isolated microtia (n = 91) and familial microtia (n = 21). Patients with syndromic microtia were not included. In isolated microtia, the mean age was 11.80 ± 16.9, and the most prevalent age group was from 5 to 9 years, with 45.0%; males were 58.2%, and 91.2% of patients were born in a city above 2500 meters about sea level. In familial microtia, the mean age was 15.57 ± 17.2. There were no statistically significant differences between the analyzed variables. In isolated microtia, 41.8% of patients had bilateral involvement, 40.7% had grade 1 microtia in the right ear (RE), and grade 1 in the left ear was 47.3%; external auditory canal atresia of RE was present in 62.6%, and in left ear in 31.6%. External auditory canal atresia sidedness was mostly unilateral in both groups. Most patients did not have tags or pits (78% and 81% in RE and 85.7% and 71.4%). Most patients had moderate hearing loss in both ears. The authors found an association between both microtia forms with external auditory canal atresia in RE; only 20% of patients had unilateral auricular tags or pits in both groups. The authors also found a high incidence (18.75%) of familial microtia, which suggests a distinct pathological genetic component than the more prevalent isolated cases. The authors found a high association of microtia cases from the Ecuadorian highlands above 2500 meters about sea level (over 90%). The presence of "social" intake of alcohol during pregnancy showed over twice the chance of having a child born with microtia.