Extended High-frequency Research Articles

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.

Detection and Grading of Early-Stage Cochlear Damage in Land Hunters by Comparison of Extended High-Frequency Audiograms with Conventional High-Frequency Audiograms.

Background and ObjectivesFirearms used by hunters produce intermittent loud noises. These sounds, which are above the safe limits set by the World Health Organization, can cause cochlear damage. Detection of cochlear damage at an early stage, before clinical complaints appear, will enable serious treatment measures.Subjects and MethodsA total of 105 male hunters without hearing complaints and 45 controls who were not exposed to loud noise were compared and investigated. Extended high-frequency audiograms and conventional audiograms were used to compare the groups.ResultsThe problem detection rates of conventional high-frequency audiometry, extended high-frequency audiometry, and both tests together were 59.1, 78.1, and 82.9%, respectively. There was no statistical difference between audiometric values at the extended high-frequency and at the acoustic notch at 4 kHz. When the extended high-frequency audiogram was grouped, values at the frequencies of 16, 14, and 12 kHz were affected before that at the acoustic notch at 4 kHz.ConclusionsThe results of our study indicate that hearing at extended high frequencies was affected before that at conventional high frequencies in individuals exposed to intermittent loud sounds. The first affected extended high frequencies were 16, 14, and 12 kHz. Although there was no statistically significant relationship between values at the notch and at extended high frequencies, the presence of a notch at 4 kHz, provided that 8 kHz is normal, may indicate a later stage of damage.

Extended high-frequency bone conduction audiometry Calibration of bone conductor transducers in the conventional and extended high-frequency range

Objective To monitor ototoxicity, air conduction (AC) extended high frequency (EHF) thresholds can be measured up to 16 kHz. However, conductive hearing loss might influence these results. This is unfortunate because the EHF thresholds are important to follow the impact of ototoxic medication during therapy. Therefore a suitable bone conduction (BC) transducer and norm values for EHF BC measurements are needed. Design In this study three different BC transducers were used: the B71 (Radioear), the KH70 (Präcitronic), and the KLH96 (Westra). Hearing thresholds were measured from 0.125 to 16 kHz using AC transducers (Telephonics TDH39, Sennheiser HDA200), and BC thresholds from 0.25 to 8 kHz with the B71, and from 0.25 to 16 kHz with the KLH96 and KH70. Study sample 60 ears of 30 normal hearing subjects were measured. Results The KLH96 showed the highest output for the high frequencies, and distortion measurements were similar to the KH70. The results show that EHF measurements are possible using the KLH96 and KH70 bone conductors. Conclusion EHF BC measurements are reliable when using the KLH96 and KH70 bone conductors. The extended force sensitivity of the used artificial mastoid should be determined for a proper EHF BC calibration.

Ototoxicity After Cisplatin-Based Chemotherapy: Factors Associated With Discrepancies Between Patient-Reported Outcomes and Audiometric Assessments.

To provide new information on factors associated with discrepancies between patient-reported and audiometrically defined hearing loss (HL) in adult-onset cancer survivors after cisplatin-based chemotherapy (CBCT) and to comprehensively investigate risk factors associated with audiometrically defined HL. A total of 1410 testicular cancer survivors (TCS) ≥6 months post-CBCT underwent comprehensive audiometric assessments (0.25 to 12 kHz) and completed questionnaires. HL severity was defined using American Speech-Language-Hearing Association criteria. Multivariable multinomial regression identified factors associated with discrepancies between patient-reported and audiometrically defined HL and multivariable ordinal regression evaluated factors associated with the latter. Overall, 34.8% of TCS self-reported HL. Among TCS without tinnitus, those with audiometrically defined HL at only extended high frequencies (EHFs) (10 to 12 kHz) (17.8%) or at both EHFs and standard frequencies (0.25 to 8 kHz) (23.4%) were significantly more likely to self-report HL than those with no audiometrically defined HL (8.1%) [odds ratio (OR) = 2.48; 95% confidence interval (CI), 1.31 to 4.68; and OR = 3.49; 95% CI, 1.89 to 6.44, respectively]. Older age (OR = 1.09; 95% CI, 1.07 to 1.11, p < 0.0001), absence of prior noise exposure (OR = 1.40; 95% CI, 1.06 to 1.84, p = 0.02), mixed/conductive HL (OR = 2.01; 95% CI, 1.34 to 3.02, p = 0.0007), no hearing aid use (OR = 5.64; 95% CI, 1.84 to 17.32, p = 0.003), and lower education (OR = 2.12; 95% CI, 1.23 to 3.67, p = 0.007 for high school or less education versus postgraduate education) were associated with greater underestimation of audiometrically defined HL severity, while tinnitus was associated with greater overestimation (OR = 4.65; 95% CI, 2.64 to 8.20 for a little tinnitus, OR = 5.87; 95% CI, 2.65 to 13.04 for quite a bit tinnitus, and OR = 10.57; 95% CI, 4.91 to 22.79 for very much tinnitus p < 0.0001). Older age (OR = 1.13; 95% CI, 1.12 to 1.15, p < 0.0001), cumulative cisplatin dose (>300 mg/m2, OR = 1.47; 95% CI, 1.21 to 1.80, p = 0.0001), and hypertension (OR = 1.80; 95% CI, 1.28 to 2.52, p = 0.0007) were associated with greater American Speech-Language-Hearing Association-defined HL severity, whereas postgraduate education (OR = 0.58; 95% CI, 0.40 to 0.85, p = 0.005) was associated with less severe HL. Discrepancies between patient-reported and audiometrically defined HL after CBCT are due to several factors. For survivors who self-report HL but have normal audiometric findings at standard frequencies, referral to an audiologist for additional testing and inclusion of EHFs in audiometric assessments should be considered.

Personal Audio Systems Unsafe At Any Sound

Personal Audio Systems Unsafe At Any Sound

Study on audiometer calibration at the extended high-frequency range 8–16 kHz

Audiometry is a branch of acoustical measurements that concentrated on testing the devices related to hearing and used in medical part such as audiometer. It is substantial to calibrate the audiometer to assure the measurement traceability and to safe human health. So, it is considered as a major claim. The importance of calibration comes from the request for advanced instrument to test accurately the hearing loss for human, especially for those people who might be at risk due to noise. The conventional audiometry covered from 125 to 8 kHz, while the extended high-frequency (EHF) audiometry above 8 up to 20 kHz, the last-mentioned type may be useful in early diagnosis of hearing loss. The audiometer calibration performed using ear simulator, standard or working microphone, sound level meter, and frequency analyzer according to IEC60645-1. The physical parameters such as sound pressure level, frequency and distortion may be affected by environmental conditions such as temperature change. The gained results observed that the measured value of all the tests performed was affected by temperature variation. There were deviations observed from each performed test’s nominal values in the calibration process as the temperature varies from 16 to 40°C. So, this is a detailed study for the significance, method, and uncertainty estimation for audiometer calibration covering the EHF ranges within the temperature from 16 to 40°C.

Effects of extended high frequency bandwidth in osseointegrated bone conduction device users

High-frequency hearing above 5000 Hz improves the detection and discrimination of high frequency phonemes. Improved access to high-frequency hearing may be particularly advantageous in unilaterally deafened listeners who experience reduced access to high frequency speech cues on their impaired side and decreased speech perception abilities in competing noise. This study aimed to investigate the effects of extended high-frequency bandwidth on speech perception in unilaterally deafened osseointegrated bone conduction hearing device recipients. To study the effect of extended high-frequency bandwidth, participants underwent aided testing in narrow bandwidth and extended high-frquency bandwidth BCD listening conditions. Aided word and phoneme recognition in quiet was assessed at soft and conversational speech levels with the better ear plugged. Aided thresholds and Ling 6 phoneme sounds were also assessed in quiet with the better ear plugged. Speech perception in noise was assessed at ± 90° and co-located at 0° using the adaptive Hearing in Noise Test. Findings demonstrate a significant improvement in speech perception outcomes when listening with extended high-frequency bandwidth. Extended high-frequency bandwidth significantly improved word and phoneme recognition for soft and average conversational speech. The largest effects were observed for voiceless phonemes. Results suggest use of bone conduction devices with extended high-frequency bandwidth result in improved hearing outcomes when compared with narrow bandwidth bone conduction devices.

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.

Prevention of Noise-Induced Hearing Loss Using Investigational Medicines for the Inner Ear: Previous Trial Outcomes Should Inform Future Trial Design.

Significance:Noise-induced hearing loss (NIHL) is an important public health issue resulting in decreased quality of life for affected individuals, and significant costs to employers and governmental agencies.Recent Advances:Advances in the mechanistic understanding of NIHL have prompted a growing number of proposed, in-progress, and completed clinical trials for possible protections against NIHL via antioxidants and other drug agents. Thirty-one clinical trials evaluating prevention of either temporary or permanent NIHL were identified and are reviewed.Critical Issues:This review revealed little consistency in the noise-exposed populations in which drugs are evaluated or the primary outcomes used to measure NIHL prevention. Changes in pure-tone thresholds were the most common primary outcomes; specific threshold metrics included both average hearing loss and incidence of significant hearing loss. Changes in otoacoustic emission (OAE) amplitude were relatively common secondary outcomes. Extended high-frequency (EHF) hearing and speech-in-noise perception are commonly adversely affected by noise exposure but are not consistently included in clinical trials assessing prevention of NIHL.Future Directions:Multiple criteria are available for monitoring NIHL, but the specific criterion to be used to define clinically significant otoprotection remains a topic of discussion. Audiogram-based primary outcome measures can be combined with secondary outcomes, including OAE amplitude, EHF hearing, speech-in-noise testing, tinnitus surveys, and patient-reported outcomes. Standardization of test protocols for the above primary and secondary outcomes, and associated reporting criterion for each, would facilitate clinical trial design and comparison of results across investigational drug agents. Antioxid. Redox Signal. 36, 1171–1202.

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.

Extended high frequency hearing loss in tinnitus-positive chronic suppurative otitis media patient.

ObjectivesTo determine the association between extended high frequency hearing loss and tinnitus in normal cochlear function based on a conventional audiometry chronic suppurative otitis media (CSOM) patient.Design and methodsA cross‐sectional study was conducted on 220 ears diagnosed as having CSOM with an equal number of tinnitus and without tinnitus groups. Only those with normal cochlear function based on conventional pure tone audiometry (250 Hz to 8 kHz) were included. They were further tested for hearing at extended high frequencies of up to 16 kHz. The severity of tinnitus was tested using a tinnitus questionnaire.ResultsThe prevalence of extended high frequency hearing loss in the normal cochlear function CSOM patients with tinnitus was 81.8% (95% CI 74.5%, 89.1%), whereas the prevalence in the tinnitus negative group was 30.0% (95% CI 21.3%, 38.7%). There was a significant association between extended high frequency hearing loss and tinnitus in CSOM patients (P < .001). The average thresholds were significantly higher in the tinnitus group at all extended high frequencies tested with an increasing trend of significance toward the higher frequencies. However, this study did not observe any association between the severity of tinnitus and extended high frequency hearing loss.ConclusionThe development of tinnitus among normal cochlear function CSOM patients indicates that the damage has occurred at a higher frequency level. However, the severity of tinnitus does not predict the degree of higher frequency hearing loss. Therefore, the presence of tinnitus warrants more aggressive monitoring and treatment to prevent sensorineural hearing loss from developing into the speech frequencies.Level of Evidence4.

Analysis of Early Biomarkers Associated With Noise-Induced Hearing Loss Among Shipyard Workers

It is important to determine what frequencies and auditory perceptual measures are the most sensitive early indicators of noise-induced hearing impairment. To examine whether hearing loss among shipyard workers increases more rapidly at extended high frequencies than at clinical frequencies and whether subtle auditory processing deficits are present in those with extensive noise exposure but little or no hearing loss. This cross-sectional study collected audiometric data (0.25-16 kHz), survey questionnaires, and noise exposure levels from 7890 shipyard workers in a Shanghai shipyard from 2015 to 2019. Worsening hearing loss was evaluated in the group with hearing loss. Speech processing and temporal processing were evaluated in 610 participants with noise exposure and clinically normal hearing to identify early biomarkers of noise-induced hearing impairment. Data analysis was conducted from November to December 2020. Linear regression was performed to model the increase in hearing loss as function of cumulative noise exposure and compared with a group who were monitored longitudinally for 4 years. Auditory processing tests included speech-in-noise tests, competing sentence tests, dichotic listening tests, and gap detection threshold tests and were compared with a control group without history of noise exposure. Of the 5539 participants (median [interquartile range (IQR)] age, 41.0 [34.0-47.0] years; 3861 [86.6%] men) included in the cross-sectional analysis, 4459 (80.5%) were hearing loss positive and 1080 (19.5%) were hearing loss negative. In younger participants (ie, ≤40 years), the maximum rate of increase in hearing loss was 0.40 (95% CI, 0.39-0.42) dB per A-weighted dB-year (dB/dBA-year) at 12.5 kHz, higher than the growth rates of 0.36 (95% CI, 0.35-0.36) dB/dBA-year at 4 kHz, 0.32 (95% CI, 0.31-0.33) dB/dBA-year at 10 kHz, 0.31 (95% CI, 0.30-0.31) dB/dBA-year at 6 kHz, 0.27 (95% CI, 0.26-0.27) dB/dBA-year at 3 kHz, and 0.27 (95% CI, 0.27-0.28) dB/dBA-year at 8 kHz. In the 4-year longitudinal analysis of hearing loss among 403 participants, the mean (SD) annual deterioration in hearing was 2.70 (2.98) dB/y at 12.5 kHz, almost twice as that observed at lower frequencies (eg, at 3kHz: 1.18 [2.15] dB/y). The auditory processing scores of participants with clinically normal hearing and a history of noise exposure were significantly lower than those of control participants (eg, median [IQR] score on speech-in-noise test, noise-exposed group 1 vs control group: 0.63 [0.55-0.66] vs 0.78 [0.76-0.80]; P < .001). These findings suggest that the increase in hearing loss among shipyard workers was more rapid at 12.5 kHz than at other frequencies; workers with clinically normal hearing but high cumulative noise exposure are likely to exhibit deficits in speech and temporal processing.

Hidden or subclinical cochleopathy in idiopathic subjective tinnitus: extended high frequency audiometry and otoacoustic emission

Introduction Tinnitus patients with apparently normal hearing represent a challenge to models of tinnitus generation which rely on compromised cochlear function. Although it is known that any cochlear changes even subclinical can cause tinnitus, our rational was to apply an objective measure that can aids in the quantification of these cochlear changes. Objective The of study was designed to evaluate possible hidden or subclinical cochlear dysfunction in idiopathic subjective tinnitus patients with normal hearing using extended high frequency audiometry and otoacoustic emissions. Methods Forty seven subjects enrolled in this study divided into control group (20 normal hearing adults without tinnitus) and a study group (27 normal hearing adult patients complaining of tinnitus). Extended high frequency (EHF) audiometry and otoacoustic emissions (OAEs) in addition to tinnitus matching study were done for all subjects. Study group further subdivided according to tinnitus pitch matching into low- and high-pitched tinnitus groups. Results The data of this study showed that patients with normal hearing sensitivity in the conventional frequency range (up to 8 kHz) and reporting tinnitus, present alterations of the auditory system in the affected side. This affection manifested as elevated EHF audiometry thresholds at 9000, 10,000, 11,200, 14,000 and 16,000 Hz. Most tinnitus patients had pitch matching frequency at high frequency range between (3000 and 8000 Hz). Transient evoked OAEs and distortion product OAEs amplitude was lower in tinnitus patients relative to controls. Conclusion The ultrahigh frequency hearing loss is not hidden – but – exists and awaits identification with appropriate testing.

Hearing loss after cisplatin-based chemotherapy: Patient-reported outcomes versus audiometric assessments.

5016 Background: Although pure-tone audiometry is the gold standard to evaluate hearing loss (HL), patient-reported outcomes are practically more time and cost effective. However, no data exist on factors associated with discrepancies between patient-reported and audiometrically-defined HL in adult-onset cancer survivors after cisplatin-based chemotherapy (CBCT); and few comprehensive assessments of factors associated with audiometrically-defined HL have been conducted. Methods: A total of 1,410 testicular cancer survivors (TCS) ≥6 months post-CBCT completed comprehensive audiometric assessments (0.25-12 kHz) and detailed questionnaires of sociodemographic, clinical, and health behaviors. Audiometrically-defined HL severity was defined using American Speech-Language-Hearing Association (ASHA) criteria. Multivariable multinomial logistic regression identified factors associated with discrepancies (overestimation and underestimation vs. concordance), between patient-reported and audiometrically-defined HL and multivariable ordinal logistic regression evaluated factors associated with the HL severity. Results: Overall, 34.8% of TCS self-reported HL, while 77.8% had audiometrically-defined HL. Among TCS without tinnitus, those with audiometrically-defined HL at only extended high frequencies (EHFs) (10-12 kHz) (17.8%) or at both EHFs and standard frequencies (0.25-8 kHz) (23.4%) were significantly more likely to self-report HL than those with no audiometrically-defined HL (8.1%) (OR = 2.48; 95%CI, 1.31-4.68 and OR = 3.49; 95%CL,1.89-6.44, respectively). Older age (OR = 1.09; P&lt; 0.0001), absence of prior noise exposure (OR = 1.40; P= 0.02), and mixed/conductive HL (OR = 2.01; P= 0.0007) were associated with greater underestimation of audiometrically-defined HL severity. Hearing aid use (OR = 0.18; P= 0.003) and higher education ( P= 0.004) were associated with less underestimation of audiometrically-defined HL severity, while tinnitus was associated with greater overestimation ( P&lt; 0.0001). Older age (OR = 1.13; P&lt; 0.0001), cumulative cisplatin dose ( &gt; 300 mg/m2, OR = 1.47; P= 0.0001), and hypertension (OR = 1.80; P= 0.0007) were associated with greater ASHA-defined HL severity, whereas post-graduate education (OR = 0.58; P= 0.005) was associated with less severe HL. Conclusions: Discrepancies between patient-reported and audiometrically-defined HL after CBCT are associated with several factors including age, education, tinnitus, prior noise exposure, use of hearing aids, and conductive HL. Understanding these factors will help clinicians to better interpret self-reported HL as a surrogate for audiometric assessments. For survivors who self-report HL, but have normal audiometric findings at standard frequencies, referral to an audiologist for additional testing and inclusion of EHFs in audiometric assessments, should be considered.

Extended high-frequency hearing and head orientation cues benefit children during speech-in-speech recognition

While the audible frequency range for humans spans approximately 20 Hz to 20 kHz, children display enhanced sensitivity relative to adults when detecting extended high frequencies (frequencies above 8 kHz; EHFs), as indicated by better pure tone thresholds. The impact that this increased hearing sensitivity to EHFs may have on children's speech recognition has not been established. One context in which EHF hearing may be particularly important for children is when recognizing speech in the presence of competing talkers. In the present study, we examined the extent to which school-age children (ages 5-17 years) with normal hearing were able to benefit from EHF cues when recognizing sentences in a two-talker speech masker. Two filtering conditions were tested: all stimuli were either full band or were low-pass filtered at 8 kHz to remove EHFs. Given that EHF energy emission in speech is highly dependent on head orientation of the talker (i.e., radiation becomes more directional with increasing frequency), two masker head angle conditions were tested: both co-located maskers were facing 45°, or both were facing 60° relative to the listener. The results demonstrated that regardless of age, children performed better when EHFs were present. In addition, a small change in masker head orientation also impacted performance, with better recognition at 60° compared to 45°. These findings suggest that EHF energy in the speech signal above 8 kHz is beneficial for children in complex listening situations. The magnitude of benefit from EHF cues and talker head orientation cues did not differ between children and adults. Therefore, while EHFs were beneficial for children as young as 5 years of age, children's generally better EHF hearing relative to adults did not provide any additional benefit.

Transient otoacoustic emissions and audiogram fine structure in the extended high-frequency region

Objective Previous studies at conventional audiometric frequencies found associations between the ripple depth seen in audiogram fine structure (AFS) and amplitudes of both transient evoked otoacoustic emissions (TEOAEs) and overall hearing threshold levels (HTLs). These associations are explained by the cochlear mechanical theory of multiple coherent reflections of the travelling wave apically by reflections sites on the basilar membrane and basally by the stapes. Design The aim was to investigate whether a similar relationship is seen in the extended high-frequency (EHF) range from 8–16 kHz. Measurements from 8–16 kHz were obtained in normal-hearing subjects comprising EHF HTLs, EHF TEOAEs using a double evoked paradigm, and Bekesy audiometry to assess AFS ripple depth and spectral periodicity. Study Sample Twenty eight normal-hearing subjects participated. Results Results showed no significant correlation between AFS ripple depth and either frequency-averaged EHF HTLs or EHF TEOAE amplitudes. The amplitude of AFS ripple depth was also lower than that seen in the conventional frequency region and spectral periodicity in the ripple more difficult to discern. Conclusion The results suggest a weaker interference pattern between forward and reverse cochlear travelling waves in the most basal region compared to more apical regions, or a difference in cochlear mechanical properties.

The Immediate and Long-Term Impact of Military Aircraft Noise on Hearing: A Cross-Sectional Comparison of Fighter Pilots and Ground Staff

We examined the immediate and long-term impacts of military aircraft noise exposure on noise-induced hearing loss (NIHL) in fighter pilots and ground staff. We recruited 40 pilots, 40 ground staff, and 136 age-matched controls; all participants underwent hearing tests, including conventional pure-tone audiometry (PTA) (0.25–8.0 kHz), extended high-frequency (EHF) audiometry (9.0–18.0 kHz), and distortion-product otoacoustic emission (DPOAE) as a recent reference. A subsequent hearing test immediately after flight-mission noise exposure was requested. The results revealed higher recent hearing thresholds in pilots and ground staff than in controls. Threshold shifts at many octave band frequencies were also significantly elevated in ground staff. The grouped frequency threshold was significantly elevated in the 4–8 kHz high-frequency range. After a single flight-mission noise exposure, both ground staff and pilots showed decreased signal-to-noise ratios for DPOAE (1–8 kHz), whereas only ground staff showed significantly elevated left-ear hearing thresholds at 3, 11.2, and 12.5 kHz by conventional and EHF PTA. Fighter pilots and ground staff serve in hazardous noise-exposed environments that cause hearing damage and subsequent NIHL, but ground staff may be more vulnerable. A comprehensive hearing conservation program should be implemented to protect high-risk service members, and especially ground staff, from high-intensity noise exposure.

Detection of hearing loss in rheumatoid arthritis patients using extended high frequency audiometry: Is it related to disease activity and severity?

Aim of the workTo evaluate audiological characteristics in rheumatoid arthritis (RA) patients compared with controls using extended high frequency audiometry and analyze their correlations with RA activity and severity to identify patients at higher risk of hearing loss. Patients and methodsThe study was carried out on 95 RA patients and 100 controls. Every subject underwent pure tone audiometry (PTA) from 250 through 8000 Hz, speech audiometry and extended high frequency audiometry (EHFA) from 10,000 to 20000 Hz. Disease activity score (DAS28) and RA medical records-based index of severity (RARBIS) were assessed. ResultsPatients were 85 females and 10 males with age mean 46.5 ± 1.1 years and disease duration of 9.57 ± 0.61 years. The hearing thresholds (HT) of patients were significantly higher than those of controls at all PTA (p < 0.001) and EHFA frequencies (p < 0.001). Hearing loss (HL) was detected in 68.4% and 64.2% by using PTA, while EHFA revealed it in 100% and 97.9% of right and left ears of RA patients respectively. Hearing loss was bilateral, symmetrical and sensorineural in all cases. HT of EHFA significantly correlated with age (r = 0.63, p < 0.001), age at onset (r = 0.51, p < 0.001), disease duration (r = 0.3, p = 0.03), DAS28 (r = 0.31, p = 0.01) and RARBIS (r = 0.21, p = 0.03). ConclusionBilateral symmetrical sensorineural hearing loss (SNHL) is significantly more frequent in RA patients compared to control. EHFA is valuable test to detect HL in patients with RA. Older age, longer disease duration, higher disease activity and severity are important factors for the development of HL in RA.

Functional Impacts of Aminoglycoside Treatment on Speech Perception and Extended High-Frequency Hearing Loss in a Pediatric Cystic Fibrosis Cohort.

Purpose The purpose of this study is to better understand the prevalence of ototoxicity-related hearing loss and its functional impact on communication in a pediatric and young adult cohort with cystic fibrosis (CF) and individuals without CF (controls). Method We did an observational, cross-sectional investigation of hearing function in children, teens, and young adults with CF (n = 57, M = 15.0 years) who received intravenous aminoglycoside antibiotics and age- and gender-matched controls (n = 61, M = 14.6 years). Participants completed standard and extended high-frequency audiometry, middle ear measures, speech perception tests, and a hearing and balance questionnaire. Results Individuals with CF were 3-4 times more likely to report issues with hearing, balance, and tinnitus and performed significantly poorer on speech perception tasks compared to controls. A higher prevalence of hearing loss was observed in individuals with CF (57%) compared to controls (37%). CF and control groups had similar proportions of slight and mild hearing losses; however, individuals with CF were 7.6 times more likely to have moderate and greater degrees of hearing loss. Older participants displayed higher average extended high-frequency thresholds, with no effect of age on average standard frequency thresholds. Although middle ear dysfunction has not previously been reported to be more prevalent in CF, this study showed that 16% had conductive or mixed hearing loss and higher rates of previous otitis media and pressure equalization tube surgeries compared to controls. Conclusions Individuals with CF have a higher prevalence of conductive, mixed, and sensorineural hearing loss; poorer speech-in-noise performance; and higher rates of multiple symptoms associated with otologic disorders (tinnitus, hearing difficulty, dizziness, imbalance, and otitis media) compared to controls. Accordingly, children with CF should be asked about these symptoms and receive baseline hearing assessment(s) prior to treatment with potentially ototoxic medications and at regular intervals thereafter in order to provide otologic and audiologic treatment for hearing- and ear-related problems to improve communication functioning.

ZABURZENIA ŚLIMAKOWE U PACJENTÓW Z BIELACTWEM

BackgroundVitiligo is a common chronic disease of pigmentation, which may be accompanied by audiological abnormalities.Material and methodsThe aim of this study was to assess vitiligo patients in terms of hearing thresholds using conventional pure tone audiometry (0.25 to 8 kHz), high frequency pure tone audiometry (10 and 12.5 kHz), as well as Transient Evoked Otoacoustic Emissions (TEOAEs). We correlated the audiometric findings with vitiligo duration and severity. The study included 75 subjects with a mean age of 29.7 ± 8.6 years. There were 50 vitiligo patients and 25 age and gender matched healthy controls who had never had any audiological condition or exposed to excessive noise.ResultsOnly 24% of vitiligo patients had high frequency sensorineural hearing loss (SNHL) using conventional audiometry and the majority (76%) had bilaterally normal hearing. The majority (90%) of vitiligo patients had SNHL in extended high frequency audiometry. There was a statistically significant difference between the cases and controls regarding TEOAE SNR at 5 kHz, and nearly half of the normal hearers had an abnormal TEOAE. Vitiligo patients were found to have subclinical inner ear dysfunction compared with the controls. There was a statistically significant correlation between PTA and age of the patients but not with vitiligo duration or severity.ConclusionsThe audiometric findings of the vitiligo group and the statistically significant differences from the control group suggest a subclinical involvement of the cochlea, probably related to the vitiligo condition, but not affected by vitiligo duration or severity. We therefore recommend the use of extended high frequency audiometry and otoacoustic emission tests for early detection of inner ear involvement in vitiligo.