Hearing Acuity Research Articles

K-complexes are a sensitive marker of noise-related sensory processing during sleep: a pilot study.

The primary aim of this study was to examine dose-response relationships between sound pressure levels (SPLs) and K-complex occurrence probability for wind farm and road traffic noise. A secondary aim was to compare K-complex dose-responses to manually scored electroencephalography arousals and awakenings. Twenty-five participants underwent polysomnography recordings and noise exposure during sleep in a laboratory. Wind farm and road traffic noise recordings of 20-sec duration were played in random order at 6 SPLs between 33 and 48 dBA during established N2 or deeper sleep. Noise periods were separated with periods of 23 dBA background noise. K-complexes were scored using a validated algorithm. K-complex occurrence probability was compared between noise types controlling for noise SPL, subjective noise sensitivity, and measured hearing acuity. Noise-induced K-complexes were observed in N2 sleep at SPLs as low as 33 dBA (Odds ratio, 33 dBA vs 23 dBA, mean (95% confidence interval); 1.75 (1.16, 2.66)) and increased with SPL. EEG arousals and awakenings were only associated with noise above 39 dBA in N2 sleep. K-complexes were 2 times more likely to occur in response to noise than EEG arousals or awakenings. Subjective noise sensitivity and hearing acuity were associated with the K-complex occurrence, but not arousal or awakening. Noise type did not detectably influence K-complexes, EEG arousals, or awakening responses. These findings support that K-complexes are a sensitive marker of sensory processing of environmental noise during sleep and that increased hearing acuity and decreased self-reported noise sensitivity increase K-complex probability.

A 4-year follow-up study of hearing acuity in a large population-based cohort of children and adolescents.

ObjectivesTo describe the prevalence of hearing loss among 13 year old adolescents, and to examine the change in prevalence between ages 9 and 13 years.MethodsThis study was embedded within Generation R, a population‐based prospective cohort study from fetal life onwards in the Netherlands. Pure‐tone thresholds were obtained at 0.5 to 8 kHz, and tympanometry was performed. Sensorineural hearing loss (SNHL) was defined as a low‐frequency and/or high‐frequency pure‐tone average of more than 15 dB HL in one of both ears. Audiometric signs suggestive of noise‐induced hearing loss (NIHL) included the presence of a notch and/or high‐frequency hearing loss. The study was conducted from April 2012 to October 2015, and April 2016 to September 2019.ResultsA total of 4572 adolescents with a mean age of 13 years and 7 months (SD, 5 months) were included, of whom 2334 (51.0%) were girls. Within the cohort, 6.4% (95% CI, 5.7%‐7.2%) were estimated to have SNHL, and 12.4% (95% CI, 11.5%‐13.4%) met the criteria of NIHL. In total, 3675 participants were included in the longitudinal analysis. The prevalence of SNHL decreased from 8.0% to 5.3% between ages 9 and 13 years (P < .001). The prevalence of NIHL increased from 9.8% to 11.7% (P = .004), due to an increase in number of participants with a notch.ConclusionsThe prevalence of SNHL significantly decreased by 2.7% (95% CI, 1.6%‐3.9%) between ages 9 and 13 years, probably due to a change in alertness during assessment at the age of 13 years. Other possible explanations include the presence of selection bias or a decline in prevalence of conductive hearing loss. The number of participants with audiometric signs suggestive of NIHL increased by 1.9% (95% CI, 0.5%‐3.3%).Level of EvidenceLevel 3.

The roles of cognitive abilities and hearing acuity in older adults’ recognition of words taken from fast and spectrally reduced speech

AbstractPrevious literature has identified several cognitive abilities as predictors of individual differences in speech perception. Working memory was chief among them, but effects have also been found for processing speed. Most research has been conducted on speech in noise, but fast and unclear articulation also makes listening challenging, particularly for older listeners. As a first step toward specifying the cognitive mechanisms underlying spoken word recognition, we set up this study to determine which factors explain unique variation in word identification accuracy in fast speech, and the extent to which this was affected by further degradation of the speech signal. To that end, 105 older adults were tested on identification accuracy of fast words in unaltered and degraded conditions in which the speech stimuli were low-pass filtered. They were also tested on processing speed, memory, vocabulary knowledge, and hearing sensitivity. A structural equation analysis showed that only memory and hearing sensitivity explained unique variance in word recognition in both listening conditions. Working memory was more strongly associated with performance in the unfiltered than in the filtered condition. These results suggest that memory skills, rather than speed, facilitate the mapping of single words onto stored lexical representations, particularly in conditions of medium difficulty.

Ramsay Hunt's Syndrome in Pediatric Age

AbstractThe Ramsay Hunt's syndrome (RHS), caused by the reactivation of the varicella-zoster virus (VZV), is an infrequent cause of peripheral facial palsy in the pediatric patients. A 16-year-old adolescent boy presented with headache, right earache, and signs of lower motor neuron type facial palsy. He was medicated with deflazacort. Four days later, he developed blurry vision in the right eye, gait imbalance, and vesicular lesions in the right ear with decreased ipsilateral hearing acuity. A diagnosis of RHS was considered. Cerebrospinal fluid (CSF) analysis showed pleocytosis, as well as VZV DNA. Magnetic resonance imaging of the brain identified abnormal uptake of gadolinium contrast in the right seventh cranial nerve, reinforcing the diagnosis. The patient was treated with acyclovir (14 days) and prednisone, with progressive clinical improvement. We emphasize the importance of recognizing this syndrome in patients with facial palsy, since the early antiviral treatment significantly improves the prognosis.

Dual impairments in visual and hearing acuity and age-related cognitive decline in older adults from the Rancho Bernardo Study of Healthy Aging.

We examined the associations between dual impairments in visual and hearing acuity and aging-related cognitive decline. This was a longitudinal study of adults who had visual and hearing acuity and cognitive function assessed in 1992-1996 and were followed for up to 24years (mean = 7.3years), with up to five additional cognitive assessments. Visual impairment was defined as vision worse than 20/40, hearing impairment as pure-tone average thresholds >25dB. Associations were tested using linear mixed-effects regressions. Of 1,383 participants, 293 had visual impairment, 990 had a hearing impairment and 251 had both deficits. In fully adjusted models, low visual acuity was associated with poorer Mini-Mental State Examination (MMSE; β = -0.29) and Trail-Making Test Part B (Trails B; β = 13.22) performance, and with faster declines in MMSE (β = -0.12) and Trails B (β = 1.84). The combination of low visual and low hearing acuity was associated with poorer MMSE (β = -0.44) and Trails B (β = 11.20) scores, and with faster declines in MMSE (β = -0.19), Trails B (β = 3.50), and Verbal Fluency Test (VFT; β = -0.14) performance. Associations were similar in men and women. Impairments in both vision and hearing are associated with a more rapid decline in cognitive function with aging.

Listener characteristics differentially affect self-reported and physiological measures of effort associated with two challenging listening conditions

Listeners vary in their ability to understand speech in adverse conditions. Differences in both cognitive and linguistic capacities play a role, but increasing evidence suggests that such factors may contribute differentially depending on the listening challenge. Here, we used multilevel modeling to evaluate contributions of individual differences in age, hearing thresholds, vocabulary, selective attention, working memory capacity, personality traits, and noise sensitivity to variability in measures of comprehension and listening effort in two listening conditions. A total of 35 participants completed a battery of cognitive and linguistic tests as well as a spoken story comprehension task using (1) native-accented English speech masked by speech-shaped noise and (2) nonnative accented English speech without masking. Masker levels were adjusted individually to ensure each participant would show (close to) equivalent word recognition performance across the two conditions. Dependent measures included comprehension tests results, self-rated effort, and electrodermal, cardiovascular, and facial electromyographic measures associated with listening effort. Results showed varied patterns of responsivity across different dependent measures as well as across listening conditions. In particular, results suggested that working memory capacity may play a greater role in the comprehension of nonnative accented speech than noise-masked speech, while hearing acuity and personality may have a stronger influence on physiological responses affected by demands of understanding speech in noise. Furthermore, electrodermal measures may be more strongly affected by affective response to noise-related interference while cardiovascular responses may be more strongly affected by demands on working memory and lexical access.

Selective hyperfamiliarity for voices

An 84-year-old man manifested false recognition/misidentification of unfamiliar person after cardiogenic cerebral infarction. He had good visual and hearing acuity, no hemianopsia, unilateral spatial neglect and visual object agnosia. However, he was unable to remember faces of his rehabilitation therapists, and repeatedly misidentified other patients’ visitors and therapists as his family members and friends, without recognizing his mistakes. General cognitive function was preserved with Hasegawa dementia score-revised (HDS-R) 25/30 (cut-off score 20). In terms of recognition of faces, tasks not requiring recognition of facial identity, such as interpreting facial emotions, and gender and age assessment, were relatively preserved, but recognition of family members and celebrities was severely impaired, and matching unfamiliar faces was slightly impaired. Semantic information of family and friends was retained. Although his symptoms resembled associative prosopagnosia, they differed from general associative prosopagnosia in having phonagnosia. MRI lesions were localized in the frontal and temporal lobes including the right anterior temporal lobe, and not in the right occipital and temporal lobes considered to the lesion site of multimodal people recognition disorders manifesting inability of utilization of visual (face) and auditory (voice) cues for person identification. In addition to the facial cognitive impairment, impaired exploratory (monitoring) function of the frontal lobe on the temporal lobe may also contribute to the false recognition/misidentification of this case.

Van Buchem Disease: First Case Report from the Indian Subcontinent with an Early Presentation

AbstractVan Buchem disease is a rare autosomal recessive genetic disorder that causes a compromised inhibitory feedback mechanism resulting in increased bone formation and overgrowth of the skeleton leading to a variety of neurological symptoms. It has been reported in less than 50 patients most of which were in western Europe. We report the first case of this condition from the Indian subcontinent with an early presentation. This patient presented with a global delay in attaining the developmental milestones and progressive reduction in visual acuity and loss of hearing. He had dysmorphic facies, multiple cranial nerve palsies, and severe visual and auditory deficits. Imaging revealed sclerosing bone dysplasia. This case illustrates the clinical and imaging findings of this rare condition.

&lt;br/&gt; RELAÇÃO ENTRE A MOBILIDADE FUNCIONAL E A ACUIDADE AUDITIVA E VISUAL EM PESSOAS IDOSAS &lt;br/&gt;

Introduction: Functional mobility is associated with the ability to perform activities of daily living, essential for maintaining the autonomy of the elderly. Decreased hearing acuity leads to decreased participation in the community, the ability to detect the origin of sounds and become more exposed to the environment. Changes in vision have been associated with physical disability and functional disability. Vision accounts to the information from the outside world, essential for interactions with others and the environment. Methods: A cross-sectional, non-experimental correlational study was conducted with individuals aged 55-96 years. Hearing acuity was assessed using the Hearing Test-Pure Tone application, visual acuity through the Snellen Scale and functional mobility was assessed using the Timed Up and Go. The data collected were processed using the SPSS pro-gram. Results: The correlation between TUG values and the ear with better hearing acuity was obtained a moderate positive correlation (r=0.394), statistically significant. There is also a moderate negative correlation (r=-0.412) between the TUG values and better visual acuity, statistically significant. Conclusion: The present study concluded that people with impaired hearing or visual acuity present a decrease in their functional mobility. Keywords: Aging; Hearing; Physical Functional Performance; Vision Ocular.

ANALYSIS OF EFFECTIVENESS OF SPECIALIZED OTOLARYNGOLOGICAL CARE TO CHILDREN OF METROPOLIS AS EXEMPLIFIED BY THE CITY OF KHARKIV

The availability of medical resources to provide an otolaryngological care to children in the metropolis as exemplified by the city of Kharkiv was comparatively analyzed. The indices of medical service density as well as the available otolaryngological beds of the city residents have been established to be stable and on the background of reducing their number in Ukraine by the end of 2017 exceed the latter except reducing thechildren's otolaryngological beds by 19.4 %. The revealed excess in an average number of bed occupancy, its turnover and reduction of the duration of inpatient treatment indicates an active use of the hospital bed capacity. It has been statistically proven that on the background of sufficient medical resources there are decreased as follows: the number of patients' visits to otolaryngologists in polyclinics of the Ministry of Health of Ukraine; relative index of the number of children who left the hospital due to diseases of the ear and mastoid process, coverage of the Kharkiv children aged 0−14 years with reduced hearing acuity with preventive examinations. The Kharkiv region is shown to occupy the first ranking place among the regions of Ukraine in terms of the disability level due to diseases of the ear and mastoid process. It was found that in the structure of primary disability the children aged 3 to 6 years and those with deafness were mainly determined. The described dynamics of indices has been more clearly traced since 2014. The above data indicate the existing shortcomings when treating the upper respiratory tract, ear and mastoid process diseases, mainly due to imperfect interaction of otolaryngological care service elements for children, inefficiency of typical medical routes. All this determines the relevance of developing an effective functional model of specialized otolaryngological care for children in the metropolis based on determining and monitoring of indices of simulated pathology quality treatment, training of doctors at all levels of care providing. Key words: efficiency of specialized otolaryngological care, children of the metropolis, analysis of medical resources, disability.

Comparison of two cortical measures of binaural hearing acuity

Objective Multiple studies have demonstrated binaural hearing deficits in the aging and those with hearing loss. Consequently, there is great interest in developing efficient clinical tests of binaural hearing acuity to improve diagnostic assessments and to assist clinicians when fitting binaural hearing aids and/or cochlear implants. Design Two cortical measures of interaural phase difference sensitivity, the acoustic change complex (ACC) and interaural phase modulation following response (IPM-FR), were compared on three metrics using five different stimulus interaural phase differences (IPDs; 0°, ±22.5°, ±45°, ±67.5° and ±90°). These metrics were scalp topography, time-to-detect, and input–output characteristics. Study sample Ten young, normal-hearing listeners. Results Scalp topography qualitatively differed between ACC and IPM-FR. The IPM-FR demonstrated better time-to-detect performance on smaller (±22.5° and ±45°) but not larger (67.5°, and ±90°) IPDs. Input–output characteristics of each response were similar. Conclusions The IPM-FR may be a faster and more efficient tool for assessing neural sensitivity to subtle IPD changes. However, the ACC may be useful for research or clinical questions concerned with the topographic representation of binaural cues.

ИССЛЕДОВАНИЕ УРОВНЯ СЛУХА У РАЗНОВОЗРАСТНЫХ ГРУПП ЛЮДЕЙ

Background: to research the level of hearing sensitivity among people of different age groups with normal hearing ability or with hearing impairment.&#x0D; Methods: the results of hearing test of people of different age groups and those of sociological survey are presented here.&#x0D; Result: 66% of examined have no anomalies of hearing ability, 16% of examined showed results, ranging from 75 to 85 percent of normal, hearing level of 18% of examined is ranged from 60 to 70 percent of normal.&#x0D; Conclusion: hearing impairment is caused by enhanced level of sound pressure, loss of hearing acuity is caused by ageing.

Diagnostic Assessment of Progressive Fluctuating Sensorineural Hearing Loss in Children

Deterioration of auditory thresholds in young children is directly associated with negative impact on language development. Early detection of the cause of sensorineural hearing loss eases proper intervention and signalizes valuable prognostic data. Nowadays, the etiology of pediatric hearing loss has been modified, attributable to progresses in gene testing and adequate management of birth infections. This paper updates well known risk factors for progression along with fluctuation of hearing acuity involving health hazard indicators, auditory, laboratory and clinical manifestations of such young patients. This review takes into consideration the most well-known risk indicators associated with an increased likelihood of progressive hearing loss (including but not limited to neonatal intensive care unit admission, family history of hearing loss, various syndromes, prenatal and postnatal infections etc.). Prompt post neonatal monitoring of hearing, leading to early hearing loss identification, is crucial to optimize management and therefore appropriate intervention.

Використання інноваційних комп’ютерних технологій у забезпеченні моніторингу здоров’я дітей та підлітків в умовах школи

Introduction. The current achievements of modern science are the use of specialized automated systems and applications in various fields of medicine. In the current context of health care reform, the burden on health workers who provide medical care to school-age children is growing. The purpose of the work. With the declining level of children’s health, the system of optimizing the monitoring of children’s health and their physical development is becoming an urgent issue. Results. The proposed program is based on MS Access, VBA programming language. Designed for a comprehensive automatic assessment of physical development of students on the basis of anthropometric and physiometric indicators, functional capabilities of the body and the data of medical examination. The program provides the possibility of longitudinal observation (accumulation of data) on the health and physical development of students of an educational institution or classroom during the entire period of study of students. The result of the program is the formation of reports that describe the results of medical examinations to determine the proportion of students, physical or sexual development, visual or hearing acuity which meets or does not meet the normative age. Also, students who need further counseling from specialists in various fields are identified. Conclusions. The use of the proposed software will help to improve the organization of medical care by increasing the effectiveness of health monitoring and optimizing the work of health care workers or educational institutions. Key words: Medical examinations; Database; Software packages; Children’s health.

Модель функціональної системи адаптивного керування навчальним процесом студента у системах е-навчання

Introduction. The current achievements of modern science are the use of specialized automated systems and applications in various fields of medicine. In the current context of health care reform, the burden on health workers who provide medical care to school-age children is growing. The purpose of the work. With the declining level of children’s health, the system of optimizing the monitoring of children’s health and their physical development is becoming an urgent issue. Results. The proposed program is based on MS Access, VBA programming language. Designed for a comprehensive automatic assessment of physical development of students on the basis of anthropometric and physiometric indicators, functional capabilities of the body and the data of medical examination. The program provides the possibility of longitudinal observation (accumulation of data) on the health and physical development of students of an educational institution or classroom during the entire period of study of students. The result of the program is the formation of reports that describe the results of medical examinations to determine the proportion of students, physical or sexual development, visual or hearing acuity which meets or does not meet the normative age. Also, students who need further counseling from specialists in various fields are identified. Conclusions. The use of the proposed software will help to improve the organization of medical care by increasing the effectiveness of health monitoring and optimizing the work of health care workers or educational institutions. Key words: Medical examinations; Database; Software packages; Children’s health.

What am I measuring? Disentangling cognitive status from sensory impairment

AbstractBackgroundSensory impairment in hearing or vision affects 55% of older adults aged 60+. Some studies have shown sensory impairment is associated with impaired cognitive test performance, however tests rely to varying degrees on hearing, vision, or both. We hypothesized that scores for cognitive tests whose administration or instructions depend on vision (e.g., Trail Making) or hearing (e.g., word‐list learning) are biased among those with vision or hearing impairment, respectively, after controlling for underlying cognitive performance.MethodWe leveraged cross‐sectional data from a comprehensive neuropsychological battery on N=658 men and women from the Baltimore Longitudinal Study of Aging (BLSA) and N=1,008 participants from the Atherosclerosis Risk in Communities study (EyeDOC ancillary study), all of whom had objective diagnostic hearing and vision assessed. We used item response theory methods to test for differential item functioning (DIF) by hearing (PTA&gt;25 db in 4 speech frequencies) and visual acuity (20/40) impairment.ResultThe BLSA sample was 55.7% female and 66.3% white. The EyeDoc sample had a higher proportion of women (63.4%) but fewer white participants (54.3%). Overall, we found more evidence of DIF in the EyeDoc study, a sample with lower cognitive performance and a higher number of comorbidities, as compared to the BLSA. No DIF by visual impairment was observed in BLSA, but in EyeDoc we observed DIF by visual impairment for the Delayed Word Recall Task such that the task was harder for those with visual impairment. A larger number of tests showed DIF by hearing impairment in both BLSA and EyeDoc, including the Delayed Word Recall Task in EyeDoc and the Digit Symbol Substitution Task in BLSA.ConclusionWe identified DIF by hearing impairment for tests that do not rely on hearing and DIF by vision impairment for tests that do not rely on vision. Based on these findings, if bias is found in cognitive tests independent of characteristics of the test administration or instructions, cognitive load may be playing a larger role than previously acknowledged. Future investigation is warranted to determine how sensory impairment impacts completion of cognitive testing, as this study was limited to participants who successfully completed cognitive testing.

Sensory function, cognition, and brain structure in SCD, MCI, and AD: Initial findings from the COMPASS‐ND Study

AbstractBackgroundThere is a strong relationship between sensory and cognitive function in older adults and impairment in hearing, vision, and olfaction are each independently associated with dementia. However, these have rarely been examined together in persons with dementia, nor their concurrent relationship with cognitive function and brain structure. The Comprehensive Assessment of Neurodegeneration and Dementia (COMPASS‐ND) study is a large‐scale study of older Canadians who are living with, or are at risk for, dementia, including those with subjective cognitive decline (SCD), mild cognitive impairment (MCI), Alzheimer’s disease (AD), other causes of dementia, and normal controls. We collect clinical and cognitive data, structural brain imaging, and measures of sensory function.MethodComplete sensory, cognitive, and brain imaging data have been released on participants with study diagnoses of SCD (n=35; 74% women, mean age = 69.4 years; mean education = 16.6 years), MCI (n=79; 49% women, mean age = 73.5 years; mean education = 15.5 years), and AD (n=21; 10% women, mean age = 75.9 years; mean education = 15.5 years).Hearing function was assessed by pure tone screening at 25 and 40 dB and with a computerized speech in noise perception task. Vision function was assessed by measuring reading acuity and contrast sensitivity. Olfaction was assessed with a 16‐item olfactory recognition test.ResultControlling for age, sex, and education, cognitive performance measures decreased over the groups (SCI&gt;MCI&gt;AD), as expected. The groups differed in contrast sensitivity and olfaction, but not hearing (audiometric category, perceiving digits in noise) or visual reading acuity. Poorer olfaction was associated with poorer auditory episodic memory and lower hippocampal volume. Poorer hearing thresholds were associated with lower right hippocampal volume in SCD participants. Within MCI participants, poorer hearing was associated with a disruption in the relationship between auditory episodic memory and a number of variables, including visual episodic memory and lateralized hippocampal volume.ConclusionThese results illustrate a complex interplay between sensory‐cognitive‐brain measures in older adults with or at risk for dementia and suggest that sensory status has important implications for brain structure and clinical status.

Understanding ethnic inequalities in hearing health in the UK: a cross-sectional study of the link between language proficiency and performance on the Digit Triplet Test

IntroductionResearch using the UK Biobank data has shown ethnic inequalities in hearing health; however, the hearing test used may exhibit a disadvantage for non-native language speakers.ObjectivesTo validate the results of...

Aural rehabilitation programme for hearing impaired: a psychosocial intervention

Background: Hearing impairment i.e., reduced hearing acuity, has adverse effects on the physical, cognitive, emotional, behavioral, and social functions of an individual, resulting in passivity, social withdrawal, and negative impact on the quality of life (QOL). The present study aimed to determine whether participation in a counseling-based aural rehabilitation program and hearing aids would enhance the QOL of severely hearing-impaired by reducing their learned helplessness and social isolation.Methods: The study included 52 participants (35 males and 17 females) in the age range of 45-65 years having severe hearing loss with high perceived social isolation and learned helplessness and low quality of life. Scales used are Friendship scale for social isolation, LH scale for learned helplessness, and WHOQOL-Bref for quality of life. A paired t-test was applied to see the significant difference between pre and post scores.Results: Pre- and post-intervention analysis showed that learned helplessness and perceived social isolation was significantly reduced as a function of intervention with a substantially better quality of life.Conclusions: Aural rehabilitation program combined with hearing aids resulted in a better quality of life by reducing isolation and helplessness.

Evaluation of hearing acuity in patients with chronic renal failure by pure tone audiometry

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Hearing loss is common in patients with chronic renal failure. It is well known that chronic renal failure (CRF) causes different systemic and otorhinolaryngologic manifestations due to the accumulation of nitrogenous waste products. The aim of the study was to evaluate hearing threshold and the severity of hearing loss at different frequencies in patients of chronic renal failure (CRF), and to analyse the role of duration of disease on hearing threshold in patients of CRF.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; Fifty two patients of CRF were included in the study. Pure tone audiometry was done in all cases.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Majority of the patients were in 21 to 40 year age group (mean: out of 52 patients, 38 patients (73.07%) had sensorineural hearing loss and 14 patients (26.93%) had normal hearing. Majority of the patients with hearing loss had mild (44.73%) or moderate (42.11%) sensorineural hearing loss. On comparison of the mean hearing threshold Group II (duration of disease more than five years- 17 patients) showed a statistically significant difference (P&amp;lt;0.05) in mean hearing threshold at 250 Hz.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Hearing loss is present in majority of the patients of CRF. Most of the cases have mild to moderate sensorineural hearing loss. High frequency hearing loss in chronic renal failure is related to the duration of the disease, duration of haemodialysis’ and internal homeostasis, namely hyponatremia.&lt;/p&gt;