Frequency Hearing Loss Research Articles

Diabetes and long duration leading to speech-, low/mid-, and high- frequency hearing loss: current evidence from the China National Health Survey 2023.

To examine the effect of diabetes, duration of diabetes, and blood glucose on speech-, low/mid-, and high-frequency hearing loss. In this cross-sectional study, 2821 participants aged 20-87years in the China National Health Survey were included.Diabetes was defined as valid fasting blood glucose (FBG) of ≥ 7.0mmol/L, a self-reported history of diabetes or the use of anti-diabetic medications. Speech-(500, 1000, 2000, and 4000Hz), low/mid- (500, 1000 and 2000Hz), and high-frequency (4000, 6000, and 8000Hz) hearing loss was defined as pure tone average of responding frequencies > 20dB HL in the better ear, respectively. In fully adjusted models, for speech-, low/mid-, and high-frequency hearing loss, compared with no diabetes, those with diabetes (OR[95%CI]: 1.44 [1.12, 1.86], 1.23 [0.94, 1.61], and 1.75 [1.28, 2.41], respectively) and with diabetes for > 5years duration (OR[95%CI]: 1.63 [1.09, 2.42], and 1.63 [1.12, 2.36], 2.15 [1.25, 3.70], respectively) were at higher risk. High FBG level was associated with a higher risk of speech-, low/ mid-, and high-frequency hearing loss. And there were stronger associations between HL and diabetes, longer duration and higher in "healthier population" (no hypertension, no dyslipidemia and younger age). Diabetes, longer duration, and higher FBG level were independently associated with hearing loss for speech-, low/mid- and high-frequency hearing loss, particularly in higher frequency and "healthier population". Paying more attention to hearing loss in those populations could lower the burden of hearing loss.

Combined genetic polymorphisms of the GSTT1 and NRF2 genes increase susceptibility to cisplatin-induced ototoxicity: A preliminary study

ObjectiveThe genotype-phenotype relationship in cisplatin-induced ototoxicity remains unclear. By assessing early shifts in distortion product otoacoustic emission (DPOAE) levels after initial cisplatin administration, we aimed to discriminate patients’ susceptibility to cisplatin-induced ototoxicity and elucidate their genetic background. Study DesignA prospective cross-sectional study. SettingTertiary referral hospital in Japan. PatientsTwenty-six patients with head and neck cancer were undergoing chemoradiotherapy with three cycles of 100 mg/m2 cisplatin. InterventionsRepetitive pure-tone audiometry and DPOAE measurements, and blood sampling for DNA extraction were performed. Patients were grouped into early ototoxicity presence or absence based on whether DPOAE level shifts exceeded the corresponding reference limits of the 21-day test interval. Main Outcome MeasuresHearing thresholds after each cisplatin cycle, severity of other adverse events, and polymorphisms in cisplatin-induced ototoxicity-associated genes were compared. ResultsEarly ototoxicity was present in 14 and absent in 12 patients. Ototoxicity presence on DPOAEs was associated with greater progression of hearing loss in frequencies ≥2 kHz throughout therapy and with higher ototoxicity grades compared with ototoxicity absence. Ototoxicity was further associated with grade ≥2 nausea. Ototoxicity presence was genetically associated with the GSTT1 null genotype and G-allele of NFE2L2 rs6721961, whereas ototoxicity absence was associated with the GSTM1 null genotype. Dose-dependent progression of hearing loss was the greatest in the combined genotype pattern of GSTT1 null and the T/G or G/G variants of rs6721961. ConclusionEarly DPOAE changes reflected genetic vulnerability to cisplatin-induced ototoxicity. Hereditary insufficiency of the antioxidant defense system causes severe cisplatin-induced hearing loss and nausea.

Novel WFS1 mutations in patients with low-to-middle frequency hearing loss.

Hearing loss (HL) is the most common sensorineural disorder in human. It is estimated that genetic factors contribute to over 50% of prelingual hearing loss. Most of dominant HHL patients manifest postlingual progressive hearing loss that mainly affect high frequencies. However, mutations in a few dominant HL genes, such as WFS1, TECTA and DIAPH1, cause distinct audiogram that primarily affects the low and middle frequencies. We recruited twelve independent HL families with worse low or middle frequency audiograms. Each proband of these families was excluded for pathogenic mutations in GJB2, SLC26A4, and MT-RNR1 genes. Mutation screening was performed by whole exome sequencing. Next, candidate variants were validated in each family by sanger sequencing. Six heterozygous WFS1 variants were identified in six families, including three novel mutations (c.2519T>G, p.F840C; c.2048T>G, p.M683R and c.2419A>C, p.S807R) and three previously reported variants (c.2005T>C, p.Y669H; c.2590G>A, p.E864K and c.G2389A, p.D797N). All the novel mutations were absent in 100 ethnically matched controls and were predicted to be deleterious by multiple algorithms. We identified three novel and three previously reported WFS1 mutations in six unrelated Chinese families. Our findings enriched the genotype-phenotype spectrum of WFS1 related NSHL. Additional genotype-phenotype correlation study will clarify the detailed phenotypic range caused by WFS1 mutations.

Study of aged central auditory function using the auditory middle latency response

ObjectiveInvestigate the auditory function of the elderly using the middle latency potentials. MethodologyGroup 1 (G1): 20 healthy individuals of both genders, older than 60 years, without hearing loss. Group 2 (G2): 20 healthy individuals of both sexes, older than 60 years, with hearing loss in frequencies from 4 to 8 kHz. Potential recording was performed with unilateral and bilateral stimulation and the Binaural Interaction Component was calculated. ResultsNa latency in C3A1 was greater in the stimulation of the right ear in G2 and the amplitude of Na-Pa was greater in the stimulation of the right ear and recording in C3A1 in G1. The latency of the Pa component was higher in the stimulation of the right ear recorded in C4A2. The Pb component in G2 by bilateral stimulation and recorded in C4A2 had higher latency. The first and second negative and positive peaks presented greater amplitude in G1. In C3A1, the 1st negative peak was more negative in G1 and the 2nd positive peak showed greater amplitude in C4A2 in both groups. ConclusionThe transmission of auditory information to the primary auditory cortex is impaired with aging, especially in unilateral stimulation, reinforced by losses in elderly people with peripheral hearing loss, such as in the binaural interaction at the cortical and subcortical levels. Thus, the AMLR has shown to be a sensitive examination to investigate neuroauditory disorders in the elderly, especially related to high-frequency hearing loss and primary auditory cortex dysfunctions caused by the aging process.

Screening detects clinically significant hearing loss in patients with GU malignancies.

e18624 Background: Four in 10 people aged 60-69 have hearing loss in frequencies that mediate speech comprehension. Untreated losses undermine medication adherence, increase risk for accidental injury, and generate higher total healthcare expenditures. Genitourinary (GU) malignancies are most frequently diagnosed in people over 60, and these patients are commonly exposed to ototoxic treatments like platinum-based chemotherapy. We hypothesized that a significant number of GU patients would fail hearing screenings at levels reflecting clinically significant hearing loss. Methods: This is a prospective, two-cohort pilot study conducted at Tulane Medical Center. Consecutive patients with active GU malignancies who did not use hearing aids were enrolled in cohort A. The primary objective of cohort A (screening) was to determine the prevalence of hearing loss among GU patients. Cohort B (interventional) will investigate the efficacy of a non-custom amplifier in improving communication for patients with hearing loss. The hearing screening consisted of a 9-item Self-Assessment of Communication (SAC) and a 25 decibel (dB) pure tone hearing screening at 1 kHz, 2 kHz, 4 kHz via an Earscan3 portable audiometer with headphones in a quiet exam room. The primary endpoint was the proportion of patients who failed the hearing screening (missed ≥ 2/6 tones). The SAC generates a global handicap score (none, slight, mild-to-moderate, severe). Surveys identifying any amount of handicap were considered positive. Patients who failed screenings were offered referrals to audiology. Here, we present results from cohort A. Results: From 8/21 to 1/22, 66 patients were invited to participate. Nine patients screen-failed (n = 8 hearing aids; n = 1 uninterested). Cohort A enrolled 57 patients [median age 68 (33-86); 91% men; 60% prostate, 24% kidney and 14% bladder cancer]. Most patients (82%) had evidence of metastatic disease and 12%, 19%, 36%, 21% of patients were receiving chemotherapy, immunotherapy, hormonal therapy, and no active therapy, respectively. Twenty (35%) patients had prior exposure to neurotoxic chemotherapy. Forty patients (70%) met the primary endpoint. Compared to the pure tone screening, the SAC had a specificity of 94%, and a sensitivity of 40%. The SAC asks patients for a situation where they want to hear better; 61% of patients who volunteered a scenario (17/28) identified a complex listening environment like an outpatient encounter. A minority of patients (n = 3) accepted audiology referrals after failing screenings. Cohort B is actively enrolling. Conclusions: Clinically significant hearing loss was prevalent among patients with GU malignancies. Patients reported struggling in listening situations with auditory demands like outpatient encounters but were unable to self-identify losses and did not pursue audiology referrals after failed screenings. Interventional studies addressing this unmet need are warranted.

A humanized murine model, demonstrating dominant progressive hearing loss caused by a novel KCNQ4 mutation (p.G228D) from a large Chinese family.

The pathogenic variants in KCNQ4 cause DFNA2 nonsyndromic hearing loss. However, the understanding of genotype-phenotype correlations between KCNQ4 and hearing is limited. Here, we identified a novel KCNQ4 mutation p.G228D from a Chinese family, including heterozygotes characterized by high-frequency hearing loss that is progressive across all frequencies and homozygotes with more severe hearing loss. We constructed a novel murine model with humanized homologous Kcnq4 mutation. The heterozygotes had mid-frequency and high-frequency hearing loss at 4 weeks, and moved toward all frequencies hearing loss at 12 weeks, while the homozygotes had severe-to-profound hearing loss at 8 weeks. The degeneration of outer hair cells (OHCs) was observed from basal to apical turn of cochlea. The reduced K+ currents and depolarized resting potentials were revealed in OHCs. Remarkably, we observed the loss of inner hair cells (IHCs) in the region corresponding to the frequency above 32 kHz at 8-12 weeks. The results suggest the degeneration of OHCs and IHCs may contribute to high-frequency hearing loss in DFNA2 over time. Our findings broaden the variants of KCNQ4 and provide a novel mouse model of progressive hearing loss, which contributes to an understanding of pathogenic mechanism and eventually treatment of DFNA2 progressive hearing loss.

Association of Hearing Loss With Total and Specific Cause Mortality Among US Adults: A Prospective Cohort Study

Background: Hearing loss has become an increasingly prevalent disability and has greatly increased the global burden of diseases. However, evidences on the associations between hearing loss and total and cause-specific mortality are limited. Thus, we aimed to investigate the associations of hearing loss with total and cause-specific mortality among US adults. Methods: 11,732 individuals derived from the National Health and Nutrition Examination Survey (NHANES) 1999-2012 were included in this study. Data of death was extracted from the NHANES Public-Use Linked Mortality File through December 31, 2015. Cox proportional hazards models were used to explore the associations between hearing loss and total or cause-specific mortality. A meta-analysis was conducted to summarize the epidemiological evidences on the association of hearing loss with total mortality. Findings: A total of 1,253 deaths occurred with a median follow-up of 12.15 years. Significant positive dose-response relationship between hearing loss in speech frequency and total mortality was observed, and the HRs and 95% CIs were 1.16 (0.91, 1.47), 1.54 (1.19, 2.00) and 1.85 (1.36, 2.50), respectively for mild, moderate and severe speech-frequency hearing loss (SFHL) with a Ptrend of 0.0003. In addition, moderate (HR: 1.90, 95%CI: 1.20-3.00) and greater (3.50, 1.38-8.86) SFHL significantly elevated risk of heart diseases mortality. With regard to the frequency, hearing thresholds of >25 dB at 500, 1000, or 2000 Hz were significantly associated with elevated mortality from all causes (1.40, 1.17-1.68; 1.44, 1.20-1.73; and 1.33, 1.10-1.62, respectively) and heart diseases (1.89, 1.08-3.34; 1.95, 1.21-3.16; and 1.89, 1.16-3.09, respectively). The meta-analysis further revealed the positive association between hearing loss and total mortality (pooled HR: 1.33, 95%CI: 1.11-1.60). Interpretation: Hearing loss is associated with increased risks of total mortality and heart diseases mortality, especially for hearing loss at speech frequency. Funding Statement: National Natural Science Foundation of China (81903291). Declaration of Interests: The authors declare no competing interests. Ethics Approval Statement: The NHANES protocol was approved by the NCHS Ethics Review Board and written informed consent was obtained from all participants.

Avaliação audiológica de pacientes com doença falciforme

Objetivos: Os objetivos deste estudo foram avaliar a prevalência de perda auditiva em pacientes diagnosticados com doença falciforme (DF) acompanhados no Ambulatório de Hematologia do Conjunto Hospitalar de Sorocaba e correlacionar os achados com o tipo de hemoglobinopatia. Métodos: Neste estudo, foram incluídos 19 pacientes com diagnóstico de DF, sendo 68% da forma homozigota da hemoglobina S (SS); 16% do tipo hemoglobinopatia SC; e 16%, S-β-talassemia. Em cada paciente, foram realizados anamnese direcionada, exame físico otorrinolaringológico e avaliação audiológica com audiometria tonal, vocal e imitanciometria. Do total da amostra, 37% apresentou alguma alteração na audiometria tonal e a média dos limiares mostrou tendência a ser maior nas altas frequências. Resultados: Na amostra, foram encontrados um paciente (5%) com perda auditiva de grau leve a moderado bilateralmente e seis pacientes (32%) com limiares >25 dB em frequências de 250, 6.000 ou 8.000 Hz em um ou ambos os ouvidos. Não foi observada alteração do Índice de Reconhecimento de Fala (IRF) em nenhum paciente e a imitanciometria mostrou-se com curva Tipo A em 100% dos ouvidos avaliados. A relação do tipo de hemoglobinopatia e a presença ou não de perda auditiva não foram significantes. Conclusão: Assim como descrito na literatura, observou-se, neste estudo, a presença de perda auditiva neurossensorial, principalmente em altas frequências, nos pacientes com DF avaliados. Portanto, conclui-se que é de extrema importância o monitoramento audiológico desses pacientes.

Is cochlear synapse loss an origin of low-frequency hearing loss associated with endolymphatic hydrops?

There is a strong association between endolymphatic hydrops and low-frequency hearing loss, but the origin of the hearing loss remains unknown. A reduction in the number of cochlear afferent synapses between inner hair cells and auditory nerve fibres may be the origin of the low-frequency hearing loss, but this hypothesis has not been directly tested in humans or animals. In humans, measurements of hearing loss and postmortem temporal-bone based measurements of endolymphatic hydrops are generally separated by large amounts of time. In animals, there has not been a good objective, physiologic, and minimally invasive measurement of low-frequency hearing. We overcame this obstacle with the combined use of a reliable surgical approach to ablate the endolymphatic sac in guinea pigs and create endolymphatic hydrops, the Auditory Nerve Overlapped Waveform to measure low-frequency hearing loss (≤ 1 kHz), and immunohistofluorescence-based confocal microscopy to count cochlear synapses. Results showed low- and mid-(1–4 kHz) frequency hearing loss at all postoperative days, 1, 4, and 30. There was no statistically significant loss of cochlear synapses, and there was no correlation between synapse loss and hearing function. We conclude that cochlear afferent synaptic loss is not the origin of the low-frequency hearing loss in the early days following endolymphatic sac ablation. Understanding what is, and is not, the origin of a hearing loss can help guide preventative and therapeutic development.

The importance of high-frequency hearing in a medico-legal context

People whose hearing is damaged by exposure to intense sounds, typically in noisy factories or during military service, often claim compensation. The most common complaint of such people is difficulty in understanding speech when background sounds are present. However, because direct measures of the intelligibility if speech in noise were perceived to be unreliable, compensation has traditionally been based on the audiogram. Exposure to intense sounds usually has its greatest effects on audiometric thresholds at 4, 6, and 8 kHz. However, in several countries, including the USA and the UK, compensation for occupational noise-induced hearing loss is usually calculated using the average of audiometric thresholds for selected frequencies up to 3 kHz, based on the implicit assumption that hearing loss for frequencies above 3 kHz has no material adverse consequences. In fact, several studies show that frequencies above 3 kHz are important for the perception of speech in background sounds and for sound localisation, especially for resolving front-back confusions. It is concluded that audiometric thresholds at 4 kHz and perhaps 6 kHz should be taken into account when assessing hearing in a medico-legal context. In addition, direct measures of the ability to understand speech in noise should be obtained.

Cisplatin associated ototoxicity in patients receiving cancer chemotherapy in a tertiary care hospital

Background: Cisplatin-based treatment regimen has been a gold standard in the treatment of various solid tumors. Ototoxicity is a very serious adverse effect of cisplatin therapy in either high or low dose regimens. Cisplatin selectively damages the outer hair cells within the organ of Corti, spiral ganglion cells, and cells within the stria vascularis and produce hearing loss in higher frequencies. Aims and Objectives: The objective of the study is to estimate the extent and severity of ototoxicity in cancer patients receiving cisplatin based chemotherapy. Materials and Methods: All the patients irrespective of age and sex diagnosed with cancer and receiving cisplatin chemotherapy were included in the study. The otoscopic examination and puretone audiogram taken before each cycle of cisplatin therapy were recorded in the data collection form. The data collected were statistically analyzed using descriptive statistics and expressed in percentage. Results: Twenty-five patients were enrolled in the study and sequential audiogram was taken before each cycle of cisplatin therapy and post-treatment and it showed that there was a gradual increase in threshold of hearing in speech frequency and high frequency when compared to pre-treatment audiogram in both ear. The audiogram of speech frequency after treatment showed that 52% and 56% of patients had moderate hearing loss in the right and left ear, respectively. Conclusion: Early identification of ototoxicity by sequential monitoring of hearing loss might help in early rehabilitation of the cancer survivors thereby improving their quality of life.

Voluntary increase of acoustic middle ear impedances with simultaneous sound attenuation associated with mild hyperacusis (VIMH)

Background: Acoustic impedances, as measured with tympanometers, change with the pressure in the middle ears, or reflexively as a response to a range of stimuli. A few persons are able to influence their acoustic impedances voluntarily.Aims/objectives: To describe this phenomenon and its clinical consequences.Material and methods: Presentation of five case reports with measurements of the acoustic impedances, hearing thresholds, and otoacoustic emissions (TEOAE) in the relaxed state and while the change in acoustic impedance was invoked.Results: All five subjects were able to voluntarily increase the acoustic impedance of their ears for short periods of time. While the change was active, TEOAE levels decreased by 0.8–9.7 dB and a mild transient conductive hearing loss in the low frequencies occurred. Four out of the five subjects reported a mild hyperacusis when the voluntary change was not invoked and showed unusual features in their acoustically evoked reflex.Conclusions and significance: Subjects who can control their acoustic impedances voluntarily seem to have an increased prevalence of mild hyperacusis. Our results suggest interference of the voluntary control with the acoustic stapes reflex as a mechanism and we propose to name this phenomenon ‘Voluntary Impedance increase with Mild Hyperacusis’, or VIMH.

Optimizing maps for electric acoustic stimulation users

Objectives: To optimize patient’s maps in Electric Acoustic Stimulation (EAS) users based on the degree of post-operative aided hearing thresholds.Methods: Twenty-one adult EAS patients participated in this study. Patients were subdivided into three groups, based on their unaided hearing threshold: (1) electric complementary (EC, n = 6) patients with ≤30 dB HL at 125–500 Hz with severe to profound hearing loss at higher frequencies who only use electric stimulation, (2) EAS (n = 8) patients with 30–70 dB HL from 125 to 250 Hz and profound hearing loss in high frequencies who use combined EAS, and (3) Marginal-EAS (M-EAS, n = 7) patients with 70–95 dB HL at frequencies ≤250 Hz who use combined EAS. Sentence perception in noise, melodic contour identification, and subjective preference were measured using Full Overlap, Narrow Overlap, Gap, and Meet maps.Result: Of the 21 patients that participated, 12 subjects were classified as complete hearing preservation and 9 subjects were classified as partial hearing preservation. The highest performing maps in sentence-in-noise perception and melodic contour identification were Gap, Meet, and Full Overlap for the EC, EAS, and the M-EAS groups, respectively. These results are consistently across different test materials and align with subject preference as well.Conclusion: These results suggest that clinical fitting in EAS listening should be individually tailored. EAS performance can be enhanced by optimizing maps between acoustic and electric stimulation based on the degree of aided hearing thresholds.

Investigation and analysis of tinnitus in diabetic patients

Objective:To analyze the influencing factors of tinnitus in diabetic patients and the correlation between hearing loss and tinnitus.Method:Participants were patients with diabetes. Subjects were tested for hearing function and tinnitus symptoms by questionnaire and pure tone audiometry.Result:①112 patients (55 were men and 57 were women) were affected by tinnitus symptoms in 255 patients with diabetes，there were no significant differences between the number of male patients and female patients(P=0.278).②The incidence of tinnitus increased with age (≤30 year: 40%, 31-40 year :25%, 41-50 year: 27%, 51-60 year: 43%, >60 year: 55%),and there was significant differences in the number of patients among different age (P=0.001).③The incidence of tinnitus was no significant difference in diabetes patients with different educational level (P=0.648).④Totally 83 subjects who complained hearing impairment were tested for hearing loss by pure tone audiometry, while 113 (66%) of 172 subjects who insisted their hearing were normal had hearing loss. Of the subjects with normal hearing but tinnitus, 72% had hearing loss and 62% of patients without tinnitus actually had hearing loss.⑤There were statistically significant in patients with diabetes between the incidence of tinnitus and low/intermediate frequency hearing loss or high frequency hearing loss.Conclusion:The incidence of tinnitus symptoms is increased in patients with diabetes mellitus, which may be related to the age, the incidence of hearing loss,however, may be irrelevant to gender and educational level. Diabetic patients with tinnitus symptoms should be tested as soon as possible to achieve early intervention.

Cochlear implant assessment and candidacy for children with partial hearing

Children who have partial hearing (PH) in the low frequencies and profound sensorineural hearing loss in the high frequencies can present a challenge to cochlear implant (CI) teams in terms of referral, assessment, and candidacy. Neither clinical criteria nor optimal timing for implantation has been explored in the literature. Data from both the Hearing Implant Centres of Birmingham Children's Hospital and St Thomas’ Hospital indicate that it is clinically appropriate to implant children with PH; they perform better with CIs than with hearing aids, even if their hearing is not fully preserved. We have also found that children need early access to high frequency sound in order to reach their full potential.

The curative effect analysis between postauricular injection and systemic application of glucocorticoids in the treatment of sudden hearing loss

Objective To investigate the therapeutic effect of topical corticosteroids injection and systemic application in the treatment of sudden hearing loss. Methods Total of 58 patients with sudden hearing loss were randomly divided into two groups.The systemic application group:dexamethasone(DEX) was applied by intravenous injection in dose of 10mg×3d,followed by 5mg×4d.And the postauricular injection group: methylprednisolone sodium succinate of 40mg was injected into cortical bone of mastoid region every three days, until hearing back to normal,or 15 days.SPSS 13.0 software was used to analyze the data. Results The total effective rate of systemic application group was 67.7%,the total effective rate of postauricular injection group was 64.7%.There was no statistical difference between the two groups(χ2= 2.58,P= 0.316).The recovery rate in cases with postauricular injection group was significantly increased in comparison with the systemic application group,but no statistical difference between the two groups(t= 2.71,P= 0.062).Patients with hearing loss in low frequencies(250Hz,500 Hz),the recovery rate in cases with postauricular injection group was significantly increased in comparison with the systemic application group(t= 3.82,P= 0.031;t= 3.26,P= 0.042). Conclusion Postauricular topical injection and systemic application of glucocorticoids in the treatment of sudden hearing loss are all have good curative effect.Systemic application is selected by conventional treatment,and topical injection has a better effect in the hearing loss of low-middle frequencies. Key words: Hearing loss; Sudden; Glucocorticoids; Drug administration routes

Analyses prognostic factors relevant to sudden sensorineural hearing loss

To investigate the prognostic factors relevant to sudden sensorineural hearing loss. The internationally accepted standardized clinical research methods, unified design, and unified program were adopted to conduct the prospective clinical multi-center study. The sudden deafness patients between 18 to 65 years old, with the course of this disorder less than two weeks, and without any medical treatments were collected, and then, divided into four types according to the hearing curve: type A, acute sensorineural hearing loss in low tone frequencies; type B, acute sensorineural hearing loss in high tone frequencies; type C, acute sensorineural hearing loss in all frequencies; and type D, total deafness. The factors, in terms of age, gender, type of initial audiogram, time delay before the first visit, and severity of hearing loss, were included in the analyses. A total of 1 024 cases with single side sudden deafness were collected in the study from 33 hospitals in China from August 2007 to October 2011, inclusive of for 492 males (48.05%) and 532 females (51.95%). The average age was (41.2 ± 12.8) years old. There were 553 cases (54.00%) in left ear, and 471 cases (46.00%) in right ear. The curative effects of different types were shown as follows: the type in low tone frequencies had the highest rate of 90.73%, the type in all frequencies was 82.59%; the type of total deafness was 70.29%; and the type in high tone frequencies had the lowest rate of 65.96%. It had significant difference of the effective rate between different types (χ(2) = 231.58, P = 0.000). Age, time delay before first visit, and severity of initial hearing loss were significantly correlated with hearing improvement. Initial audiogram of SSNHL might predict hearing recovery. The young in age and a short time delay before starting treatment are positive prognostic factors for hearing recovery in SSNHL. The initial severity of hearing loss is negative prognostic factor of hearing recovery.

Multi-center study on the treatment of sudden deafness accompanied with tinnitus

To investigate the clinical characteristics and the effects of different drug therapies in patients of sudden deafness accompanied with tinnitus. The international standardized clinical research methods, the unified design and program were used in the study. The patients of sudden deafness accompanied with tinnitus, aged between 18 to 65 years old, were recruited, whose duration was less than two weeks with no medication. The patients were divided into four types according to the hearing curve: type A was acute sensorineural hearing loss in low tone frequencies, type B was acute sensorineural hearing loss in high tone frequencies, type C was acute sensorineural hearing loss in all frequencies and type D was total deafness. Each type had four different treatment programs, based on the unified designed randomized table. A total of 1024 cases with single side sudden deafness were recruited in the study by 33 hospitals in China from August 2007 to October 2011. Among the 1024 cases, 922 cases were accompanied with tinnitus (90.04%). By classification of audiogram, among the 922 cases, 169 cases were type A (82.44%), 127 cases were type B (90.07%), 370 cases were type C (92.04%), and 256 cases were type D (92.75%). The tinnitus mostly was persistent and low tone tinnitus. The degree of the tinnitus was mostly 2-3 grade. The curative effects of different types were analyzed, type A had the highest rate of 96.18%, type C was 87.75%, type B was 81.51%, and type D had the lowest rate of 75.32%. Significant difference of curative rate between different types was detected (χ² = 125.33, P = 0.000). There had no significant difference between the four different treatment groups (all P > 0.05). In the cases with single side sudden deafness accompanied with tinnitus, the type in low tone frequencies has the best curative effect, followed by the type in all frequencies. The type in high tone frequencies and the total deafness type have poor curative results. The steroid plays a good effect in the treatment.

Evaluation of serum antioxidants in age-related hearing loss.

Age-related hearing loss (ARHL) has been linked to the shift in the pro-oxidant/antioxidant ratio. Our objectives were to assess serum levels of retinol and zinc among the elderly individuals and to correlate the levels with hearing threshold. Prospective study of apparently healthy individuals aged ≥60 years of age. Participants had complete clinical history, physical examination and pure tone average conducted. Blood samples were collected for determination of serum levels of retinol and zinc. Mann-Whitney U test was used to compare retinol and zinc values. Pearson's correlation test was used to determine the relationship between hearing threshold and serum levels of retinol and zinc. Among 126 elderly participants with mean age 67 ± 2.7 years; the mean pure tone average for air conduction was 29.3 ± 1.6 dBHL while the mean bone conduction was 36.5 ± 1.8 dBHL. The median values of serum retinol and zinc levels in the elderly participants who had hearing loss in the speech frequencies were 52 and 83.3 μg/L, respectively, while among participants with normal hearing threshold, values were 50 and 89.9 μg/L, respectively (p = 0.59 and 0.99, respectively). For the high frequencies, the median value of serum retinol and zinc levels among the elderly participants with normal hearing threshold was 70.3 and 99.9 μg/L, while among those with hearing loss, it was 46.9 and 83.2 μg/L, respectively (p = 0.000 and 0.005, respectively). Serum retinol and zinc levels were significantly lower among elderly with hearing loss involving the high frequencies. This is added evidence to extant literature on the possible role of antioxidants in the development of ARHL and suggests further study on the effect of antioxidants supplementation in the control of ARHL which is presently controversial and inconclusive.

Comparative Analyses between the Intensity of Hearing Loss in High Frequencies and Its Impact in Tinnitus-Related Quality of Life

Comparative Analyses between the Intensity of Hearing Loss in High Frequencies and Its Impact in Tinnitus-Related Quality of Life