Extended High-frequency Audiometry Research Articles

Standard and Extend High-Frequency Audiometry in Sudden Sensorineural Hearing Loss: Impacts on Tinnitus and Mental Health.

To analyze the results of auditory assessment in standard (SA) and extended high-frequency (EHF) audiometry, associating the findings with sudden tinnitus and mental health of patients with unilateral sudden sensorineural hearing loss (SSNHL). Prospective, cohort study. Outpatient otology clinic in a tertiary care hospital. Patients experiencing unilateral SSNHL were evaluated with pure-tone audiometry performed at frequencies of 250 to16,000 Hz, tinnitus pitch and loudness matching tests, Tinnitus Handicap Inventory (THI), Analog and Visual Scale (AVS) for bothersome tinnitus, and the Hospital Anxiety and Depression Scale (HADS). Eighteen patients with unilateral SSNHL were assessed. After starting treatment, there was a significant improvement in the SA (71.1 dB to 50 dB; p < 0.001*) and EHF audiometry (64.5 dB to 54.4 dB; p < 0.001*) thresholds at 15 days, and this persisted at 30 days of follow-up. Significant improvements were seen for tinnitus in loudness, VAS, and THI and for mental health in the realms of anxiety and depression by HADS. Despite improvements in SA, persistent EHF hearing loss was accompanied by persistent tinnitus, but it was of diminished loudness. Despite improvement in pure-tone thresholds by SA, a subset of unilateral SSNHL patients did not experience hearing recovery in EHF thresholds and reported persistent tinnitus. We postulate that their diminished anxiety and better mental health may be related to both hearing improvement in standard audiometry and reduction in tinnitus loudness. This pilot prospective study investigates the utility of performing EHF audiometry to better understand outcomes in patients with SSNHL.

Relationship between hypertension/blood pressure and hearing sensitivity among drivers: A correlation analysis

BACKGROUND: One of the most common chronic diseases is hypertension. The majority of research has linked hearing loss to hypertension. However, the relationship between hypertension and hearing is still unknown. The primary goal of the study is to investigate the effect of hypertension on hearing and to find out the association between blood pressure levels and auditory health in auto-rickshaw drivers. MATERIALS AND METHODS: The study utilized 121 healthy professional auto-drivers between the age range of 25 and 55 years. Pure-tone audiometry (PTA) and extended high-frequency audiometry (EHFA) were used to determine the participants' hearing thresholds from 0.25 to 16 kHz. The cochlear hair cell functioning was evaluated using distortion-product otoacoustic emission (DPOAE) testing. Blood pressure (mmHg) measurements were categorized under hypertension stage (normal (120; &lt;80); elevated (120–129; &lt;80); hypertension – stage 1 (130–139; 80–89); hypertension – stage 2 (≥140; ≥90)). RESULTS: The mean age of the study participants was 42.17 ± 9.03 years. The mean systolic and diastolic BP of all the study participants were 138.24 ± 19.73 (105–216) mmHg and 87.69 ± 12.14 (60–134) mmHg, respectively. BP levels were normal for 17.4% (N = 21) of the study participants, 21.5% (N = 26) had elevated blood pressure, 21.5% (N = 26) of the population falls under stage 1 hypertension, and 39.7% (N = 48) had stage 2 hypertension. Our study discovered a significant difference between main group effects and no significant difference between group interaction effects. Hearing thresholds were significantly higher in hypertensive participants compared to non-hypertensive participants. However, there was no statistically significant relationship between the two variables hypertension and hearing loss. CONCLUSION: Implementing health promotion initiatives and raising awareness about hearing health could improve the quality of life for a high-risk occupational group of drivers.

The Importance of Extended High Frequencies in Hearing Evaluation of Pediatric Patients with Type 1 Diabetes.

Type 1 diabetes (T1D), one of the most common childhood diseases worldwide, can cause hearing loss through its systemic effects. Diabetes-induced hearing loss is considered a progressive sensorineural hearing loss with a gradual onset typically occurring at high frequencies. We investigated extended high-frequency (EHF) hearing sensitivity in children with T1D who did not complain of hearing loss as an early marker for hearing loss at the standard/conventional frequency range of hearing. We evaluated 42 children (21 with T1D and 21 healthy controls) in a case-control design. Conventional and EHF (14,000, 16,000, and 18,000 Hz) audiometry were performed. The diabetes group underwent routine blood biochemistry and glycated hemoglobin (HbA1c) measurements. The data were analyzed by the Student t-test, Mann-Whitney U test, chi-square test, and logistic regression analysis. The mean hearing thresholds were significantly higher (p < 0.05) in the diabetes group than in controls at 500, 2,000, 4,000, and 8,000 Hz (all < 15 decibel hearing level [dB HL]). The number of ears with thresholds > 15 dB HL at 14,000-18,000 Hz but ≤ 15 dB HL at 500-4,000 Hz was significantly higher in the diabetes group than in the control group (p = 0.049). Children with diabetes showed normal hearing thresholds within the conventional audiometric frequency range; however, they presented higher hearing thresholds during EHF audiometry when they were compared with controls. Audiometry in these children should be performed using frequencies above 8,000 Hz combined with the conventional frequency range. EHF audiometry could be an effective method for identifying subclinical hearing loss in children with diabetes. Thus, diabetic children with an EHF mean hearing threshold above 15 dB HL should be monitored more closely in terms of blood glucose regulation to prevent diabetes-related hearing loss at the conventional frequency range.

A Comparison of the Digits-in-Noise Test and Extended High Frequency Response between Formally Trained Musicians and Non-Musicians

Background and Aim: Musical training has been hypothesised to result in enhanced Speech Perception in Noise (SPIN) abilities, but prolonged exposure to music  also  increases  the risk for Music-Induced Hearing Loss (MIHL). The Signal-to-Noise Ratios (SNR) and the Extended High Frequency (EHF) thresholds between formally trained musicians and non- musicians were compared to determine the effect of musical training on musicians’ SPIN and hearing abilities.&#x0D; Methods: This cross-sectional study included 40 musicians and 39 non-musicians 18–30 years, with mean age (SD) 22.43(2.71) years. EHF audiometry and the Digits-in-Noise (DIN) test were conducted via a smartphone.&#x0D; Results: Differences found between the two groups regarding the DIN test and EHF thresholds were statistically insignificant. Musicians displayed early signs of MIHL as the musicians reported significantly more (p=0.004) instances of tinnitus than non-musicians. A statistically significant correlation was found only for the non-musician group between the 12.5 kHz threshold left and the SNR obtained in the diotic listening condition (rs=-0.465; p=0.003).&#x0D; Conclusion: The results suggested that musicians did not display a significant advantage for SPIN and did not appear to have significantly poorer EHF hearing sensitivity. However, slight trends were noticeable in the musicians which gravitated more towards studies that found enhanced SPIN abilities and elevated EHF thresholds in the musician population. In the future, it may be useful to include additional speech tests (open-set) alongside the DIN test (closed-set). The present study suggests that EHF audiometry may be used for the early detection of MIHL.&#x0D; Keywords: Music; audiometry; hearing loss; noise-induced; pitch discrimination; sound localization

ASSESSMENT OF HIDDEN HEARING LOSS IN NOISE EXPOSED WORKERS

Aim:To evaluate hidden hearing loss (HHL) in industrial workers using the extended high frequency audiometry(EHFA) and ABR wave I amplitude during routine follow-up visits to the audiology clinic to identify and managehidden hearing loss as early as possible. Materials and Methods: This study is comprised of two groups: study group which consisted of 50 adultindustrial workersattending the audio-vestibular medicine clinic for their routine follow-up visits and control group which consisted of 20 adults with bilateral normal peripheral hearing in the frequency range of 250-8000 Hz, including 3 and 6 kHz without any history of occupational noise exposure. Both groups were age and sex-matched. Results: Results showed statistically significant differences between patient and control groups as regards thresholds of EHFA at 12 and 16 KHz. In addition, there was statistically significant reduction in ABR wave I amplitudes between the two groups. Conclusion: Combining extended high-frequency audiometry and ABR amplitude measurements as two methods for early detection of audibility declines upon exposure to noise as well as an early warning of hair cell damage and loss is advised.

Characteristics of Hearing Loss in Patients with Systemic Lupus Erythematosus.

To investigate the clinical characteristics of hearing loss (HL) in patients with systemic lupus erythematosus (SLE) and its related factors. Ninety-one hospitalized SLE patients and thirty healthy controls were enrolled. All subjects completed pure tone audiometry (PTA), extended high frequency audiometry (EHFA) and distortion product otoacoustic emission (DPOAE) to assess hearing function. SLE patients were divided into two groups according to the presence or absence of HL, and the risk factors of HL were determined by multivariate logistic regression. The incidence of HL was 27.47% in SLE patients, significantly higher than in the control group (3.3%) and most cases were mild-to-moderate, bilateral and predominantly sensorineural. Compared with the control group, the hearing thresholds of SLE patients increased significantly in the middle and high frequencies starting from 2000 Hz. Even though the PTA test results were normal, the EHFA test results showed significant differences in hearing impairment between SLE patients and normal controls. For patients with abnormal PTA results, the signal-to-noise ratio (SNR) in DPOAE was markedly reduced, and the pass rate was also decreased. The Systemic Lupus International Collaborating Clinics Damage Index (SDI, OR 9.13) and secondary Sjögren's syndrome (sSS, OR 8.20) were identified as independent associated factors for HL, and there was no difference in PTA and EHFA at all frequencies between hydroxychloroquine users and non-users. HL is not rare in SLE patients, and EHFA can help identify early hearing impairment. Having a high SDI score and secondary Sjögren's syndrome may predict the presence of HL in SLE.

Extended High-Frequency Audiometry for Ototoxicity Monitoring: A Longitudinal Evaluation of Drug-Resistant Tuberculosis Treatment.

The aim of this study was to describe extended high-frequency (EHF) pure-tone audiometry monitoring of ototoxicity in a longitudinal treatment program for drug-resistant tuberculosis (DRTB). This was a retrospective record review of longitudinal conventional (0.25-8 kHz) and EHF (9-16 kHz) audiometry for ototoxicity monitoring of DRTB patients undergoing treatment at community-based clinics between 2013 and 2017. Data from 69 patients with an average age of 37.9 years (SD = 11.2, range: 16.0-63.8 years) were included. Patients were assessed by primary health care audiologists (87%) or community health workers (13%) using portable audiological equipment. The average length of time between initial and exit assessments was 84.6 days (SD = 74.2, range: 2-335 days). EHF ototoxicity of a mild or greater degree of hearing loss (> 25 dB HL in one or both ears across frequencies) was evident in 85.5% of patients' posttreatment, compared with 47.8% of patients across conventional frequencies. EHF audiometry demonstrated an ototoxic shift (American Speech-Language-Hearing Association criteria) in 56.5% of cases compared with 31.9% when only conventional audiometry was considered. Mean hearing deterioration for patients was significant across EHFs (9-16 kHz) bilaterally (p < .05). Absent EHF thresholds at the initial assessment, owing to maximum output limits, was a limitation that occurred most frequently at 16 kHz (17.4%, 24/138). EHF audiometry is most sensitive for the early detection of ototoxicity and should be included in monitoring programs. Clinical ototoxicity monitoring protocols should consider shortened assessment approaches that target frequencies most sensitive to ototoxicity, including EHFs. https://doi.org/10.23641/asha.21651242.

Extended high-frequency audiometric analyses of tinnitus patients exhibiting normal hearing on conventional pure-tone audiometry

Background While hearing loss is the greatest risk factor associated with developing tinnitus, some tinnitus patients exhibit no hearing loss on conventional pure-tone audiometry (PTA). Objectives This study was developed to assess whether tinnitus patients with normal hearing as measured via conventional PTA would exhibit differences from normal controls upon extended high-frequency (EHF) audiometric evaluation. Methods In total, 102 tinnitus patients were separated into unilateral and bilateral tinnitus groups. Age- and sex-matched controls without tinnitus were enrolled. Results No significant differences were observed when comparing EHF audiometry results in the 9–14 kHz range between controls and tinnitus patients, with only left-sided tinnitus ears exhibiting higher hearing thresholds than contralateral ears at 9, 10, and 14 kHz. Relative to normal controls, the hearing thresholds in the 2–8 kHz range for tinnitus ears were significantly increased. Conclusions and significance Relative to controls, tinnitus patients with normal hearing did not exhibit any significant hearing loss in the EHF range. Unexpectedly, tinnitus patients with normal hearing exhibited significant hidden hearing loss in the conventional frequency range rather than in the EHF range. For patients with normal hearing, it appears to be unnecessary to conduct EHF examinations to detect hearing loss in the EHF range.

Noise exposure and hearing status among employees using communication headsets.

The objective of this study was to assess the hearing of employees using communication headsets with regard to their exposure to noise. The study group comprised 213 employees, including 21 workers of the furniture industry, 15 court transcribers and 177 call center operators, aged 19-55 years, working with headsets for a period of up to 25 years. All the participants underwent a standard puretone audiometry, extended high-frequency audiometry (EHFA) as well as transient-evoked otoacoustic emissions (TEOAEs) and distortion-product otoacoustic emissions (DPOAEs). Noise exposure from headsets was evaluated using the microphone in a real ear technique according to PN-EN ISO 11904-1:2008. Personal daily noise exposure levels ranged 57-96 dB and exceeded 85 dB only in 1.4% of the call center operators. Forty-two percent of the participants had bilateral normal hearing in the standard frequency range of 250-8000 Hz, and 33% in the extended highfrequency range of 9-16 kHz. It was found that DPOAEs were present bilaterally in 59% of the participants. Reproducibility of TEOAE at >70% and signal-to-noise ratio at >6 was exhibited by 42% and 17% of them, respectively. The 3 subgroups of workers differed in age, gender, noise exposure and type of headsets in use. However, after adjusting for age and gender, significant differences between these subgroups in terms of hearing were mostly visible in EHFA. A significant impact of age, gender, daily noise exposure level and current job tenure on hearing tests results was also noted among the call center operators and the transcribers. The most pronounced were the effects of age and gender, whereas the impact of the daily noise exposure level was less evident. It seems that EHFA is useful for recognizing early signs of noise-induced hearing loss among communication headset users. However, further studies are needed before any firm conclusions concerning the risk of hearing impairment due to the use of such devices can be drawn. Int J Occup Med Environ Health. 2022;35(5):585-614.

Early detection of cochlear hearing loss in rheumatoid arthritis patients: a cross-sectional study

BackgroundRheumatoid arthritis (RA) is an inflammatory autoimmune disorder that has cardinal articular and peri-articular symptoms. Extra-articular manifestations (EAMs) are also reported among RA patients. In the current study, we assessed hearing function in 50 RA patients. An extensive audiological assessment including pure tone audiometry (PTA), extended high-frequency audiometry (EHFA), tympanometry, and acoustic reflex in addition to the oto-acoustic emission (OAEs) were done.ResultsOur data demonstrates that among the 50 participants with median disease duration of 8 years, about 80% had normal hearing using PTA and EHFA. However, 46% of them had—interestingly—demonstrated absent OAEs, suggesting early stages of cochlear hearing loss.ConclusionWe conclude that rheumatoid arthritis can cause hearing impairment that can be early diagnosed by TEOAEs.

Extended high-frequency audiometry: hearing thresholds in adults

PurposeThis study aimed to determine hearing thresholds in an otologically normal population without occupational noise exposure aged 18 to 64 years using extended high-frequency audiometry (EHFA).MethodsIndividuals from the general population who have never had hearing problems and whose job was not associated with noise exposure were included in the study and classified by age into 5 categories: 18–24 and, further, by 10 years of age. Each of these groups was further divided according to gender. All subjects underwent tympanometry, conventional pure-tone audiometry within the 0.125–8 kHz range, and extended high-frequency audiometry within the 9–16 kHz range, performed according to the standards. The significance level for statistical testing was set at 5%.ResultsHere, we established hearing thresholds in an otologically healthy population within the extended high-frequency (EHF) range (9–16 kHz). We found the EHFA to be a highly sensitive method for early detection of hearing loss, with hearing thresholds decreasing as soon as 35 years of age. In males, the hearing thresholds grew with age more rapidly than in women. The ability to respond at EHF gradually decreased with age and increasing frequency.ConclusionOur results can help improve the knowledge of EHF hearing thresholds for individual sexes and age groups. So far, the standard 7029:2017 is not binding and, moreover, it only reaches up to the frequency of 12.5 kHz. EHFA is a highly sensitive method for the evaluation of hearing loss depending on age and sex.

Early hearing loss detection in gout using extended high frequency audiometry.

The study aimed to analyse the hearing levels of patients with gout using extended high frequencies (EHFs) audiometry. Thus, we aimed to reveal the early detectability of potential hearing losses. Comparative cross-sectional study. A single centre patient was diagnosed with gout disease. Two groups consisted of 32 patients with gout and 32 healthy volunteers. The primary outcome was hearing thresholds in pure tone (PT) audiometry and EHFs audiometry. Also, the association between audiometric results and haematological and biochemical parameters were evaluated. There was no significant difference between groups in terms of mean hearing thresholds in PT audiometry. But, at all frequencies above 4000 Hz (4000-18 000 Hz), the hearing thresholds were significantly higher in patients with gout. Also, the hearing thresholds above 8000 Hz were positively correlated with serum uric acid levels. Hearing thresholds at higher frequencies were positively correlated with haemoglobin levels and negatively correlated with high-density lipoprotein levels. To our knowledge, this is the first study in the literature demonstrating the high frequency of hearing loss in patients with gout using EHFs audiometry. We consider that using EHFs audiometry should have an important place in the early detection of potential hearing losses in gout patients.

[Electrophysiological study of the cochlea in patients with unilateral acute tinnitus].

Objective:To analyze the objective test results of the pure-tone audiogram （PTA）, extended high-frequency audiometry （EHFA）, distortion product otoacoustic emission （DPOAE）, auditory brainstem response（ABR）, and electrocochleogram （ECochG） in patients with unilateral acute tinnitus, summarize their characteristics and explore their clinical application value in hidden hearing loss. Methods:PTA, DPOAE, ABR, and ECochG tests were performed in 33 patients with unilateral acute tinnitus as the chief complaint. The detection rate and response amplitude of each DPOAE frequency, incubation period, and interval of ABR waves and -SP/AP in ECochG were analyzed. Results:①The thresholds of PTA at 0.25-8 kHz in both ears were in the normal range （P>0.05）, and the thresholds of PTA at 9-16 kHz in affected ears were higher than those in healthy ears （P<0.001）; ②There was statistical significance in the detection rate and response amplitude of DPOAE at 3, 4, 6, 8 kHz between ears （P<0.05）; ③The incubation period of ABR Ⅰ wave in affected ears was （1.55±0.17） ms, that in the healthy ear was （1.50±0.14） ms, among them, the incubation period of ABR Ⅰ wave in the affected ear was longer than that in the healthy ear, and the difference was statistically significant （P<0.05）; ④In ECochG, there was no significant difference in -SP amplitude between ears （P>0.05）, but there was a significant difference in AP amplitude and -SP/AP amplitude between ears （P<0.05）. Conclusion:EHFA, DPOAE, ABR, and ECochG have clinical significance in evaluating cochlear function in tinnitus patients.

Hearing status of people occupationally exposed to ultrasonic noise.

The aim of the study was to evaluate the hearing status of operators of low-frequency ultrasonic devices compared to employees exposed to audible noise at a similar A-weighted sound pressure level (SPL) but without ultrasonic components. Standard pure-tone audiometry, extended high-frequency audiometry (EHFA), transient-evoked otoacoustic emissions (TEOAE), and distortion-product otoacoustic emissions (DPOAE), as well as questionnaire surveys were conducted among 148 subjects, aged 43.1±10.8 years, working as ultrasonic device operators for 18.7±10.6 years. Their exposure to noise within the ultrasonic and audible frequency range was also evaluated. The control group comprised 168 workers, adjusted according to gender, age (±2 years), tenure (±2 years), and the 8-hour daily noise exposure level (LEX,8h) of ±2 dB. The ultrasonic device operators and the control group were exposed to audible noise at LEX,8h of 80.8±3.9 dB and 79.1±3.4, respectively. The Polish maximum admissible intensity (MAI) values for audible noise were exceeded in 16.8% of the ultrasonic device operators, while 91.2% of them were exposed to ultrasonic noise at SPL>MAI values. There were no significant differences between the groups in terms of the hearing threshold levels (HTLs) up to 3 kHz, while the ultrasonic device operators exhibited significantly higher (worse) HTLs, as compared to the control group, in the range of 4-14 kHz. The results of the DPOAE and TEOAE testing also indicated worse hearing among the ultrasonic device operators. However, the differences between the groups were more pronounced in the case of EHFA and DPOAEs. The outcomes of all hearing tests consistently indicated worse hearing among the ultrasonic device operators as compared to the control group. Both EHFA and DPOAE seem to be useful tools for recognizing early signs of hearing loss among ultrasonic device operators. nt J Occup Med Environ Health. 2022;35(3):309-25.

Extended high-frequency audiometry in research and clinical practice.

Audiometric testing in research and in clinical settings rarely considers frequencies above 8 kHz. However, the sensitivity of young healthy ears extends to 20 kHz, and there is increasing evidence that testing in the extended high-frequency (EHF) region, above 8 kHz, might provide valuable additional information. Basal (EHF) cochlear regions are especially sensitive to the effects of aging, disease, ototoxic drugs, and possibly noise exposure. Hence, EHF loss may be an early warning of damage, useful for diagnosis and for monitoring hearing health. In certain environments, speech perception may rely on EHF information, and there is evidence for an association between EHF loss and speech perception difficulties, although this may not be causal: EHF loss may instead be a marker for sub-clinical damage at lower frequencies. If there is a causal relation, then amplification in the EHF range may be beneficial if the technical difficulties can be overcome. EHF audiometry in the clinic presents with no particular difficulty, the biggest obstacle being lack of specialist equipment. Currently, EHF audiometry has limited but increasing clinical application. With the development of international guidelines and standards, it is likely that EHF testing will become widespread in future.

Early detection of noise-induced hearing loss.

BACKGROUNDNoise-induced hearing loss (NIHL) is the second most common acquired hearing loss following presbycusis. Exposure to recreational noise and minimal use of hearing protection increase the prevalence of NIHL in young females. NIHL is irreversible. Identifying minor hearing pathologies before they progress to hearing problems that affect daily life is crucial.AIMTo compare the advantages and disadvantages of extended high frequency (EHF) and otoacoustic emission and determine an indicator of hearing pathologies at the early sub-clinical stage. METHODSThis cross-sectional study was implemented in West China Hospital of Sichuan University from May to September 2019. A total of 86 participants, aged 18-22 years, were recruited to establish normative thresholds for EHF. Another 159 adults, aged 18-25 years with normal hearing (0.25-8 kHz ≤ 25 dBHL), were allocated to low noise and noise exposure groups. Distortion otoacoustic emission (DPOAE), transient evoked otoacoustic emissions (TEOAE), and EHF were assessed in the two groups to determine the superior technique for detecting early-stage noise-induced pathologies. The chi-square test was used to assess the noise and low noise exposure groups with respect to extended high-frequency audiometry (EHFA), DPOAE, and TEOAE. P ≤ 0.05 was considered statistically significant.RESULTSA total of 86 participants (66 females and 20 males) aged between 18 and 22 (average: 20.58 ± 1.13) years were recruited to establish normative thresholds for EHF. The normative thresholds for 9, 10, 11.2, 12.5, 14, 16, 18, and 20 kHz were 15, 10, 20, 15, 15, 20, 28, and 0 dBHL, respectively. A total of 201 participants were recruited and examined for eligibility. Among them, 159 adults aged between 18 and 25 years were eligible in this study. No statistical difference was detected between the noise exposure and the low noise exposure groups using EHFA, DPOAE, and TEOAE (P > 0.05) except in the right ear at 4 kHz using TEOAE (abnormal rate 20.4% vs 5.2%, respectively; P = 0.05).CONCLUSIONThese results showed TEOAE as the earliest indicator of minor pathology compared to DPOAE and EHFA. However, a multicenter controlled study or prospective study is essential to verify these results.

Systematic review and meta-analysis of extended high-frequency audiometry in tinnitus patients.

This study aimed to systematically evaluate the detection effect of extended high-frequency audiometry (EHFA) in tinnitus patients and provide a theoretical basis for the clinical diagnosis of tinnitus. We conducted a computer-based search for randomized controlled trial (RCT) literature on extended audiometry in tinnitus patients using the PubMed, Web of Science, China National Knowledge Infrastructure (CNKI), and Elsevier Science Direct databases. The search dates ranged from the database establishment date to February 2020. Risk of bias in the included literature was evaluated using the RCT bias risk assessment standard provided in the Handbook for Systematic Reviews for Interventions (version 5.0.2, 2008, Chapter 9). Finally, Review Manager 5.3 software was used to conduct a meta-analysis of the included literature. The retrieved literature was systematically screened. A total of 10 RCTs were included in the meta-analysis, which involved a total of 1,389 tinnitus patients. The results of the meta-analysis showed that at the frequencies of 14 kHz and 16 kHz, there was visible difference in detection rate of hearing threshold (DR-HT) between the 2 groups [odds ratio (OR) =0.21, 95 confidential interval (CI): 0.14-0.32, Z=7.29, P<0.00001] and (OR =0.14, 95% CI: 0.07-0.27, Z=5.96, P<0.00001) respectively. When the frequency was 18 kHz, there was a significant statistical difference in DR-HT between the 2 groups (OR =0.13, 95% CI: 0.07-0.24, Z=6.50, P<0.00001), and at 20 kHz, the statistically significant difference in DR-HT between the 2 groups was high (OR =0.17, 95% CI: 0.12-0.23, Z=10.38, P<0.00001). EHFA had a critical effect on tinnitus patients. The meta-analysis provided evidence for early hearing loss in tinnitus patients. EHFA played a crucial role in the clinical diagnosis of tinnitus patients.

Investigating Hearing Function in Pediatric Patients with Renal Dysfunction: In Pursuit of Preventive Audiology Outcomes.

Chronic kidney is being increasingly recognized as a global health problem with effects that have implications for both mortality and morbidity; with hearing loss being one of the effects that has an impact on quality of life. This study aimed to describe hearing function in a group of children with chronic renal dysfunction receiving treatment in an academic hospital in Johannesburg, South Africa. One hundred children between the ages 5 and 18years (mean age 11.68) were included in the study. A cross-sectional, descriptive, quantitative research design was employed. All participants underwent a case history interview and an audiological examination which included otoscopy, immittance testing, pure tone audiometry including extended high frequency testing up to 16kHz as well as diagnostic distortion product otoacoustic emission testing. A medical record review was also done. Both descriptive and inferential statistics were used to analyze the collected data. Results revealed that there was a high prevalence of hearing loss in this group. The most common hearing loss was a low and high to ultrahigh frequency mild sensorineural hearing loss. No relationship between the severity of hearing loss and the severity of renal dysfunction, or the duration of renal dysfunction and the duration of treatment was found. However, a relationship between the severity of hearing loss and certain treatments was found. These were v hemodialysis and the use of ototoxic medication such as loop diuretics, tuberculosis medication, and antimalarial medication. Current findings highlight the importance of extended high frequency audiometry as well as diagnostic distortion product otoacoustic emission testing for early detection of hearing impairment, in pursuit of preventive audiology outcomes, in ototoxic monitoring in this population.

Identifying subclinical hearing problems

Noise exposure and aging can cause subclinical hearing problems that are not identified with conventional audiometry. Potential clinical assessments were studied that could identify subclinical hearing deterioration: (1) Electrocochleography (ECoG); (2) Middle Ear Muscle Reflex (MEMR); (3) Extended High Frequency (EHF) thresholds (10–16 kHz); and (4) word recognition in noise. Sixty-one young, normal-hearing people were recruited. Each completed the four auditory assessments and the Life-Time Exposure to Noise Solvents Questionnaire (LENS-Q). ECoG and MEMR measurements were measured as a function of sound level using clinical equipment. Word recognition in noise was measured with a diotic, closed-set, 12-alternative spondees-in-noise test. It was hypothesized that normal-hearing individuals reporting more noise exposure would have slower growth of the ECoG measures and MEMR magnitudes with increasing levels. Individuals reporting higher noise exposure with the LENS-Q had significantly reduced MEMR magnitudes and smaller slopes, supporting the hypothesis. Gender effects were observed. No significant effect of self-report noise-exposure was seen with ECoG AP growth functions or SP/AP ratios, though modest age effects were observed. EHF thresholds were the only significant predictor of word recognition in noise. The results suggest that word recognition in noise, EHF audiometry, and MEMR could indicate subclinical hearing problems.

Applications of extended high-frequency audiometry: a narrative review

Background and Aim: Hearing loss assessment is typically done using the conventional pure tone audiometry (125 Hz to 8000 Hz). Extended high-frequency audiometry (EHFA), which covers the frequency range of 9000 Hz to 20000 Hz, is a very useful tool for detecting early hearing loss before engaging middle and low frequencies. The involvement of these frequencies significantly affects hearing sensitivity. The purpose of the present study was to review the literature on the early diagnosis of hearing impairment using EHFA.&#x0D; Recent Findings: EHFA has been suggested as a low utilization tool in clinical evaluation. How­ever, in recent years, a great deal of information has been provided in this area. This evaluation has proven to be useful in a variety of areas, including ototoxicity, noise-exposed individuals, and users of personal music devices, hidden hear­ing loss (HHL), middle ear infections, rheuma­toid arthritis, and Sjogren’s syndrome.&#x0D; Conclusion: Given the importance and appli­cation of this clinical tool in the early detection of hearing loss and its use in conjunction with other evaluations, better care planning and pre­vention can be offered to patients in some areas.&#x0D; Keywords: Extended high-frequency audiometry; middle ear infections; hidden hearing loss; ototoxic medications; noise exposure; personal music player