Hearing Examination Research Articles

Prevalence and Risk Factors of Hearing Loss in Children in Mumbai, India

Introduction: Hearing loss (GP) is a significant public health problem in India, especially in children. In Mumbai, the prevalence of GP among children is not yet known with certainty. This study aims to determine the prevalence and risk factors of GP in children in Mumbai. Methods: This research was conducted cross-sectionally involving 500 children aged 5-15 years in Mumbai. Data was collected through interviews and hearing examinations. Risk factors analyzed included age, gender, socioeconomic status, noise exposure, and history of ear infections. Results: The prevalence of GP among children in Mumbai is 12%. Risk factors significantly associated with GP were age, noise exposure, and history of ear infections. Conclusion: The prevalence of GP among children in Mumbai is quite high. The main risk factors for GP are age, noise exposure, and history of ear infections. Efforts to prevent GP in children in Mumbai need to focus on controlling noise exposure and treating ear infections early.

Vertigo and dizziness in child: a clinical analysis in 120 cases

Objective: To investigate the disease composition, clinical features, diagnosis, and treatment characteristics of vertigo in children. Methods: A total of 120 children with vertigo diagnosed and treated in the Department of Otorhinolaryngology, Children's Hospital, Capital Institute of Pediatrics in Beijing from February 2018 to February 2022 were retrospectively analyzed to explore the clinical characteristics of common peripheral vertigo in children and to summarize the experience of diagnosis and treatment. Results: The etiological composition of 120 cases of vertigo in children are as follows: 63 (52.5%) cases of vestibular migraine of childhood (VMC), 19 (15.8%) of recurrent vertigo of childhood (RVC), 11 (9.2%) of probable vestibular migraine of childhood (PVMC), 10 (8.3%) of secretory otitis media (SOM), 6 (5.0%) of persistent postural-perceptual dizziness (PPPD), 4 (3.3%) of benign paroxysmal positional vertigo (BPPV), 2 (1.7%) of vestibular neuritis (VN), 2 (1.7%) of Meniere's disease (MD), 2 (1.7%) of inner ear malformation (IEM), and 1 (0.8%) of vestibular paroxysmal syndrome (VP).The major cause of vertigo in children of different ages was different. SOM was the most important cause in preschool children, followed by RVC and VMC; VMC was the most important cause in school-age children, followed by RVC; and MD and BPPV were exclusive found in adolescents. The incidence rate of PPPD was higher in adolescents than in preschool and school-age children. Children with vertigo had good prognosis in general. Conclusions: VMC, RVC and SOM are the most common causes in vertigo in children, and their proportion was different in different aged children. Transforming abstract feelings into specific information is the skill required for collecting medical history of children with vertigo. Considering the age and cooperation of children, appropriate hearing and vestibular examination techniques are recommended. We should pay more attention to the mental health of children with vertigo and their parents.

Advances in the diagnosis and management of acute vertigo.

Patients presenting to the emergency department with acute vertigo pose a diagnostic challenge. While 'benign' peripheral vestibulopathy is the most common cause, the possibility of a posterior circulation stroke is paradoxically the most feared and missed diagnosis in the emergency department. This review will attempt to cover the significant advances in the ability to diagnose acute vertigo that have occurred in the last two decades. The review discusses the role of neurological examinations, imaging and specific oculomotor examinations. The review then discusses the relative attributes of the Head Impulse-Nystagmus-Test of Skew plus hearing ('HINTS+') examination, the timing, triggers and targeted bedside eye examinations ('TiTrATE'), the associated symptoms, timing and triggers, examination signs and testing ('ATTEST') algorithm, and the spontaneous nystagmus, direction, head impulse testing and standing ('STANDING') algorithm. The most recent technological advancements in video-oculography guided care are discussed, as well as other potential advances for clinicians to look out for.

Further characterization of ARSK-related mucopolysaccharidosis type 10.

Mucopolysaccharidosis type 10 is caused by biallelic variants in ARSK, which encodes for a lysosomal sulfatase. To date, seven patients with a mild phenotype resembling spondyloepiphyseal dysplasia or multiple epiphyseal dysplasia have been described. In this report, we present two novel ARSK variants and report clinical and radiological findings of three patients. The patients' initial complaints were hip or knee pain and a waddling gait. All patients showed normal intelligence, normal hearing and eye examinations, and none had organomegaly. While typical dysostosis multiplex findings were not observed, mild platyspondyly with anterior beaking of some vertebral bodies, irregular vertebral endplates, wide ribs, inferior tapering of the ilea with a poorly developed acetabulum, irregularity of the central part of the femoral head, delayed ossification of the carpals were noted. Remarkably, all patients showed metaphyseal striation of the long bones, a crucial diagnostic clue to identify ARSK-related MPS type 10. Interestingly, vertebral involvement regressed during follow-up. On the other hand, hip dysplasia progressed in all patients. In conclusion, this study provides valuable long-term results on a recently discovered form of MPS.

Unilateral Retinopathy in a Preterm Infant With 4q Duplication: Description and Management.

A 33-5/7, 1570 g dichorionic diamniotic twin presented with cryptorchidism, failed hearing examination (both ears), poor feeding, profound hypoglycemia, coagulopathy, conjugated hyper-bilirubinemia, hydronephrosis, and hypotension. Microarray sent with results of whole genome SNP microgray analysis detected an interstitial duplication of the chromosomal segment 4q35 1q35.2. On this basis, telemedicine screening was performed to evaluate for ocular abnormalities in association with abnormal gene testing. Unilateral advanced retinopathy was noted affecting the right eye, with mature vascularization in the left eye. This infant was managed in concordance with retinopathy of prematurity guidelines, despite not making screening criteria. Off-label intravitreal bevacizumab injection (0.625 mg in 0.025 mL) resulted in full vascular maturation assessed by fluorescein angiography 6 months later. This represents the first description and management of retinopathy in 4q duplication syndrome. [Ophthalmic Surg Lasers Imaging Retina 2024;55:228-230.].

Evaluation of Digits-in-Noise Test and Hearing Handicap Inventory for Adults Screening in Patients with Occupational Noise-Induced Hearing Loss

Objective: To explore the clinical evaluation role of the Digits-in-Noise (DIN) test and Hearing Handicap Inventory for Adults Screening (HHIA-S) for patients with occupational noise-induced hearing loss and to observe and analyze their application values. Methods: Fifty patients with suspected occupational noise-induced hearing loss were randomly selected from the Department of Otolaryngology at the hospital as the research target. The collection period for the research cases spanned from January 2022 to November 2023, and all patients had a history of noise exposure. The DIN test and HHIA-S were used for hearing examinations, with clinical, comprehensive diagnosis serving as the gold standard to study their diagnostic performance. Results: The compliance rate of the DIN test was 88.00%, the HHIA-S’s compliance rate was 80.00%, and the combined compliance rate was 94.00%. The compliance rate of the DIN test and the combined compliance rates of the patients were statistically significant compared to the clinical gold standard data (P < 0.05), while there was no difference between the compliance rate of the HHIA-S and the gold standard (P > 0.05). The data shows that the sensitivity of the combined diagnosis is significantly higher than the sensitivity data of the DIN test and HHIA-S examination alone (P < 0.05). Its specificity is 100.00%, and the accuracy data of the joint diagnosis in the degree were higher than those of the DIN test alone (P > 0.05) and the HHIA-S alone (P < 0.05). Conclusion: For patients with occupational noise-induced hearing loss, the joint evaluation of the DIN test and HHIA-S can significantly improve their diagnostic value with high sensitivity and accuracy.

Hearing Loss, Hearing Aid Use, and Risk of Dementia in Older Adults

Hearing loss has been suggested as a risk factor for dementia, but there is still a need for high-quality research to better understand the association between these 2 conditions and the underlying causal mechanisms and treatment benefits using larger cohorts and detailed data. To investigate the association between hearing loss and incident dementia, as well as how hearing aid use contributes to this association. This population-based cohort study was conducted in Southern Denmark between January 2003 and December 2017 and included all residents 50 years and older. We excluded all persons with dementia before baseline as well as those who did not live in the region 5 years before baseline, with incomplete address history, or who had missing covariate information. Individual hearing status based on the Hearing Examinations in Southern Denmark database, which contains data on all pure-tone audiometry examinations performed at public hearing rehabilitation clinics in Southern Denmark. Incident cases of dementia and Alzheimer disease as identified from national registries. The study population comprised 573 088 persons (298 006 women [52%]; mean [SD] age, 60.8 [11.3] years) with 23 023 cases of dementia and mean (SD) follow-up of 8.6 (4.3) years. Having a hearing loss was associated with an increased risk of dementia, with an adjusted hazard ratio (HR) of 1.07 (95% CI, 1.04-1.11) compared with having no hearing loss. Severe hearing loss in the better and worse ear was associated with a higher dementia risk, with an HR of 1.20 (95% CI, 1.09-1.32) and 1.13 (95% CI, 1.06-1.20), respectively, compared with having no hearing loss in the corresponding ear. Compared with people without hearing loss, the risk of dementia was higher among people with hearing loss who were not using hearing aids than those who had hearing loss and were using hearing aids, with HRs of 1.20 (95% CI, 1.13-1.27) and 1.06 (95% CI, 1.01-1.10), respectively. The results of this cohort study suggest that hearing loss was associated with increased dementia risk, especially among people not using hearing aids, suggesting that hearing aids might prevent or delay the onset and progression of dementia. The risk estimates were lower than in previous studies, highlighting the need for more high-quality longitudinal studies.

Long-term auditory monitoring in children with Alport syndrome based on different degrees of renal injury

Objective:To investigate long-term auditory changes and characteristics of Alport syndrome（AS） patients with different degrees of renal injury. Methods:Retrospectively analyzing clinical data of patients diagnosed AS from January 2007 to September 2022, including renal pathology, genetic detection and hearing examination. A long-term follow-up focusing on hearing and renal function was conducted. Results:This study included 70 AS patients, of which 33（25 males, 8 females, aged 3.4-27.8 years） were followed up, resulting in a loss rate of 52.9%.The follow-up period ranged from 1.1to 15.8 years, with 16 patients followed-up for over 10 years. During the follow-up, 10 patients presenting with hearing abnormalities at the time of diagnosis of AS had progressive hearing loss, and 3 patients with new hearing abnormalities were followed up, which appeared at 5-6 years of disease course. All of which were sensorineural deafness. While only 3 patients with hearing abnormalities among 13 patients received hearing aid intervention. Of these patients,7 developed end-stage renal disease（ESRD）, predominantly males （6/7）. The rate of long-term hearing loss was significantly different between ESRD group and non-ESRD group（P=0.013）. There was no correlation between the progression of renal disease and long-term hearing level（P>0.05）. kidney biopsies from 28 patients revealed varying degrees of podocyte lesion and uneven thickness of basement membrane. The severity of podocyte lesion was correlated with the rate of long-term hearing loss（P=0.048）, and there was no correlation with the severity of hearing loss（P>0.05）. Among 11 cases, theCOL4A5mutationwas most common （8 out of 11）, but there was no significant correlation between the mutation type and hearing phenotype（P>0.05）. Conclusion:AS patients exhibit progressive hearing loss with significant heterogeneity over the long-term.. THearing loss is more likely to occur 5-6 years into the disease course. Hearing abnormalities are closely related to renal disease status, kidney tissue pathology, and gene mutations, emphasizing the need for vigilant long-term hearing follow-up and early intervention.

PENGARUH PAPARAN KEBISINGAN WEAVING MACHINE TERHADAP RESIKO TERJADINYA HEARING IMPAREMENT PADA KARYAWAN PT. KECUBUNG MOJOGEDANG

Noise-induced hearing loss is a sensorineural type of hearing loss caused by exposure to loud enough noise over a long period of time. Hearing loss due to noise has an impact on life. The diagnosis of noise-induced hearing loss was obtained from a hearing examination, pure tone audiometry and audiometric examination results. The impact of noise-induced hearing loss is in several aspects, namely functional, social and emotional aspects, as well as economic aspects. This study aims to determine the effect of the duration of exposure to weaving machine noise on the risk of hearing imparement on employees of PT. Kecubung Mojogedang. This research is a quantitative research using a cross sectional design. The sampling technique is Total Sampling. The sample used was 40 people. The data collected will be analyzed by univariate and bivariate, the data analysis technique in this study uses the contingency coefficient test. The results of the bivariate analysis using the Contingency C coefficient test obtained a value of 0.367 with a significance (p) of 0.013. The significance value (p) is smaller than = 0.05, meaning that Ho is rejected and Ha is accepted, which means that there is an effect of the duration of noise exposure with the risk of hearing loss in employees who work at PT. Kecubung Mojogedang

SELF-REPORTED AND OBJECTIVE ASSESSMENT OF HEARING HANDICAP AND COGNITIVE CHALLENGES IN AGE-RELATED HEARING LOSS

Abstract Age-related hearing loss (ARHL) is a common condition in older adults, with most reporting challenges in recognizing speech-in-noise (SiN). Growing evidence also indicates cognitive alterations in this population. Concomitant examination of hearing and cognitive abilities using a combination of subjective and objective measures would be useful in characterizing the challenges faced by individuals with ARHL. We examined hearing abilities and cognitive functions in 15 individuals with bilateral mild-to-moderate untreated sensorineural ARHL (age: 70.4 ± 7.4 years, pure tone average: 31.0 ± 3.8 dB HL) and 15 age- and education-matched normal hearing controls (age: 65.7 ± 5.8 years, pure tone average: 15.4 ± 5.9 dB HL). We examined subjective ratings of hearing handicap (Hearing Handicap Inventory for Adults) and cognitive ability (Self-rating of Cognition in Everyday Activities), and objective measures of SiN (Quick Speech-In-Noise) and cognition (Montreal Cognitive Assessment [MoCA] and MoCA-memory index score [MoCA-MIS]). Our analysis revealed that individuals with ARHL self-reported a greater number of cognitive issues in everyday activities and had a higher hearing handicap score (p=.044) relative to controls. Additionally, the ARHL group performed significantly worse on SiN (p=.005) and cognitive screening (MoCA, p=.031; MoCA-MIS, p=.039). Taken together, these findings suggest that in addition to experiencing challenges with hearing abilities, individuals with mild-to-moderate ARHL also experience cognitive changes. Furthermore, these challenges are self-perceived as well as noticeable on objective testing. Our work points towards the consideration of self-report and objective assessment of cognition in geriatric hearing care, which can further inform the development of novel interventions.

Literature study: Superior semicircular canal syndrome (SSCS)

Superior Semicircular Canal Syndrome (SSCS) or Superior Canal Dehiscence Syndrome is a rare abnormality in the medical field in the form of balance disturbance or vertigo caused by loud noises or changes in pressure causing rupture of the roof of the superior semicircular canal. SSCS was first described by Lloyd Minor in 1998 after more than 70 years since Tullio and Hennebert discovered the Tullio phenomenon, a condition in which vertigo or nystagmus is triggered by loud noises, and the Hennebert phenomenon, a condition in which vertigo or nystagmus, is triggered by changes in pressure. The exact prevalence of superior semicircular canal syndrome is not known until now. Estimates of prevalence varied from 0.5–2% of cases in temporal bone studies, to 3–9% of cases in studies performed with CT scans. Cases of SSCS are more common in males than females. Clinical symptoms that appear in SSCS are caused by dehiscence so that patients will complain of autophonia, which the sound produced by their body sounds louder, hyperacusis, tinnitus, vertigo which is triggered by loud noises, and nystagmus. A Careful history, an examination of hearing and balance function, also high-resolution CT scan are needed to establish the diagnose of SSCS. Management can be done conservatively. If the complaints are severe, then operative options can be considered.

Sudden Sensorineural Hearing Loss Following Immunization With BNT162b2 or mRNA-1273: A Danish Population-Based Cohort Study.

To compare the occurrence of sudden sensorineural hearing loss following immunization with BNT162b2 (Comirnaty®; Pfizer BioNTech) or mRNA-1273 (Spikevax®; Moderna) to the occurrence among unvaccinated individuals. Cohort study. Nationwide Danish health care registers comprised all Danish residents living in Denmark on October 1, 2020, who were 18 years or older or turned 18 in 2021. We compared the occurrence of sudden sensorineural hearing loss following immunization with BNT162b2 (Comirnaty®; Pfizer BioNTech) or mRNA-1273 (Spikevax®; Moderna) (first, second, or third dose) against unvaccinated person time. Secondary outcomes were a first-ever hospital diagnosis of vestibular neuritis and a hearing examination, by an ear-nose-throat (ENT) specialist, followed by a prescription of moderate to high-dose prednisolone. BNT162b2 or mRNA-1273 vaccine was not associated with an increased risk of receiving a discharge diagnosis of sudden sensorineural hearing loss (adjusted hazard ratio [HR]: 0.99, confidence interval [CI]: 0.59-1.64) or vestibular neuritis (adjusted HR: 0.94, CI: 0.69-1.24). We found a slightly increased risk (adjusted HR: 1.40,CI, 1.08-1.81) of initiating moderate to high-dose oral prednisolone following a visit to an ENT specialist within 21 days from receiving a messenger RNA (mRNA)-based Covid-19 vaccine. Our findings do not suggest an increased risk of sudden sensorineural hearing loss or vestibular neuritis following mRNA-based COVID-19 vaccination. mRNA-Covid-19 vaccination may be associated with a small excess risk of a visit to an ENT specialist visit followed by a prescription of moderate to high doses of prednisolone.

Subjective and objective hearing loss among US adult cancer survivors: A national cross-sectional study.

e24059 Background: Approximately 13% of adults had some degree of hearing loss (HL), and the prevalence is higher among adults aged 65 and over (30.9%). Approximately 50-80% of the childhood, adolescent and young adult cancer survivor population report HL following treatment with high-dose platinum-based chemotherapy, head or brain radiotherapy. We aimed to 1) estimate the prevalence of subjective and objective hearing loss (HL) among cancer survivors and compare to the general population; 2) assess the performance of subjective HL questions in detecting HL by audiometry among cancer survivors. Methods: Adults aged 20-80 years old were selected from the National Health and Nutrition Examination Survey. The weighted prevalence of subjective HL (having troublesome hearing and tinnitus) and objective HL (speech-frequency HL and high-frequency HL) by audiometry test was calculated. Chi-square test and multi-adjusted logistic regression models were used to compare HL between cancer survivors and the general population. To evaluate the performance of subjective HL questions as a tool to screen for objective HL by audiometry, area under the curve (AUC) were estimated using age-and gender- adjusted logistic regression. Results: Compared to the general population, cancer survivors had a statistically significantly higher prevalence of troublesome hearing (aOR = 1.43; 95%CI:1.22-1.68), tinnitus (aOR = 1.28; 95%CI:1.08-1.53), speech-frequency HL (SFHL) (aOR = 1.44; 95%CI:1.20-1.73) and high-frequency HL (HFHL) (aOR = 1.74; 95%CI:1.45-2.09). The sensitivity and specificity of the combined subjective questions “whether having troublesome hearing and/or tinnitus” in detecting HL was shown in Table. The age- and gender- adjusted AUC for detecting SFHL and HFHL using combined questions was 0.88 and 0.90. Conclusions: Cancer survivors have a significantly higher prevalence of both subjective and objective HL, but a lack of hearing examination. Two subjective HL questions could accurately identify those have true HL and provide a simple and efficient screening tool for providers. Cancer survivors and their families should be educated and encouraged to discuss hearing concerns, and providers should facilitate raising awareness and provide early screening and timely referral when HL is identified.[Table: see text]

A SPEECH DELAY DUE TO EXPRESSIVE LANGUAGE DISORDER WITH NORMAL HEARING: CASE REPORT

A method is required in communication to provide information to one another, including the capacity to comprehend and create communications. Language is a mental analysis of communication that includes both receptive language (understanding) and expressive language (ability to convey feelings, information, thoughts and ideas). Language disorders can appear when speaking and language development does not occur in accordance with age milestone. Anamnesis, physical examination, and supporting examinations, including an audiometric examination, revealed normal findings. Auditory growth is closely related to brain development, with the brain developing significantly until the age of three years, affecting linguistic functions.
 Objective: To be able to find out how appropriate treatment should be for patients with language disorders with normal hearing examination results.
 Case Report: A child aged 2 years and 8 months was diagnosed with expressive language disorder, considering that his history, physical exams, and OAE, BERA, and ASSR tests were all normal.
 Method: PubMed, medline, other manual searches.
 Result: OAE, BERA, ASSR with normal hearing results according to the case in this patient.
 Conclusion: Expressive language disorder occurs when a child is unable to articulate or explain the substance of his opinions and ideas verbally according to his age, and OAE, BERA, and ASSR have all been tested with normal findings. This is necessary to prevent speech and language problems and to allow cognitive, social, and scholastic skills to function properly. To enhance communication and get an improved prognosis, speech treatment and child psychologist advice should be explored.

ANALISIS HUKUM TERHADAP SAH TIDAKNYA SEBUAH PENANGKAPAN, PENAHANAN DAN PENETAPAN TERSANGKA BERDASARKAN PUTUSAN PRAPERADILAN NO. 01 .Pid/ Pra/ 2022.PN Blg

The existence and presence of pretrial is not a separate judicial institution but only the granting of new powers and functions delegated to the District Court. Article 1 point 10 of the Criminal Procedure Code emphasizes that the court must examine and decide whether the arrest/detention is legal, whether the termination of the investigation/termination of prosecution is legal, requests for compensation/rehabilitation by the suspect or his family or his attorney whose case has not been submitted to the District Court. For the smooth running of pretrial duties and responsibilities, the Head of the District Court may have alternatives by taking into account workload factors and technical personnel for the sake of upholding the law and protecting Human Rights (HAM). Procedures for the pretrial hearing examination process are regulated in Chapter X Part I Article 79 to Article 83 of the Criminal Procedure Code. Pretrial examinations can fail, meaning that they are stopped before a decision is passed/terminated without a decision, namely by canceling the request and at the same time all matters relating to the case are withdrawn into the authority of the District Court to evaluate and decide it. This research is to find out benchmarks regarding the legality of the arrest, detention and determination of suspects and to find out the objectivity of the panel of judges of the District Court in examining and deciding on pretrial requests, the method in this study is Normative Juridical and Analytical Descriptive, research results of Detention Actions can only be carried out if the conditions the material and formal conditions for arrest are fulfilled, meaning that if an arrest is declared legally disabled, then the act of detention is automatically disabled, law enforcement is carried out in ways that violate the law, then the action is illegal and disgraceful, In Decision No: 1/Pid . Pre/ 2022/ PN Blg there was not the slightest bit of objectivity in the panel of judges in viewing cases with a balanced understanding of the law.

Relationship between tinnitus and olfactory dysfunction: audiovisual, olfactory, and medical examinations.

Sensory dysfunctions and cognitive impairments are related to each other. Although a relationship between tinnitus and subjective olfactory dysfunction has been reported, there have been no reports investigating the relationship between tinnitus and olfactory test results. To investigate the relationship between tinnitus and olfactory test results, we conducted sensory tests, including hearing and visual examinations. The subjects included 510 community-dwelling individuals (295 women and 215 men) who attended a health checkup in Yakumo, Japan. The age of the subjects ranged from 40 to 91 years (mean ± standard deviation, 63.8 ± 9.9 years). The participants completed a self-reported questionnaire on subjective tinnitus, olfactory function, and hearing function, as well as their lifestyle. The health checkup included smell, hearing, vision, and blood examinations. After adjusting for age and sex, the presence of tinnitus was significantly associated with subjective olfactory dysfunction, poor olfactory test results, hearing deterioration, vertigo, and headache. Additionally, high serum calcium levels and a low albumin/globulin ratio were significantly associated with low physical activity and nutrition. Women scored higher than men in olfactory and hearing examinations, but there was no gender difference in vision examinations. Subjective smell dysfunction and poor smell test results were significantly associated with tinnitus complaints. Hearing and vision were associated even after adjusting for age and sex. These findings suggest that evaluating the mutual relationships among sensory organs is important when evaluating the influence of sensory dysfunctions on cognitive function.

Pemeriksaan dan Edukasi Gangguan Pendengaran Pada Anak Panti Asuhan

Unhealthy ears may cause hearing loss. This issue may affect children to have difficulty communicating with others and decrease learning achievement at school. This community service activity aimed to give knowledge about hearing loss and conduct hearing examinations in orphanage children. This community service was held at the Aulia Al-Ikhlas Orphanage in Sungai Pagar Village, Kampar Kiri Hilir District, Kampar Regency, Riau. At the beginning of the activity, we provided counseling about hearing loss, followed by ear and hearing examinations using a tuning fork. Before and after the counseling, respondents filled out a questionnaire to assess knowledge about hearing loss. Twenty-four residents of the orphanage attended this activity. The questionnaires found that children's knowledge about hearing loss and ear health increased significantly after the counseling. The examination results found cerumen in 14 children, 4 with conductive hearing loss and 2 with sensory neural hearing loss. As a result, this community service activity can increase the knowledge of orphanage children about hearing loss and make their ears cleaner and healthier.

Diagnostic Accuracy of the Government of India Mother and Child Protection Card for Developmental Screening of Indian Children Aged 2–36 Months: A Hospital-based Mixed Method Study

Universal developmental screening is recommen-ded at 9, 18, 24 and 36 months. The Government of India Mother and Child Protection (MCP) card is an immunization record that is used to monitor child development, and identify children requiring further evaluation. To determine the diagnostic accuracy of the MCP card for developmental screening, and perform its item analysis. Mixed-method study (prospective study of diag-nostic accuracy and qualitative study). Mother-child dyads of children between 2-36 months of age were recruited from the outpatient department or wards of a tertiary level children's hospital from November, 2019 to October, 2021. Children with confirmed neurodevelopmental disorders/disability, and mothers with less than 6th standard education were excluded. Each mother was given a MCP card, and taught how to mark the items. This was followed by the researcher's evaluation (index tool). The reference tool was a comprehensive clinical assessment (CCA) by the researcher and an expert. The CCA included clinical examination of hearing, vision, and neuro-development; and psychometric assessment of development and adaptive function. Each mother underwent an in-depth inter-view. Overall and group wise psychometric properties of diagnostic accuracy were computed. The interview transcripts were analyzed thematically. The proportion of children with 'fail' and 'delay' by the evaluation of the researcher with the MCP card and the expert by the CCA, respectively. The study population included 213 children (40.4% females). Fifty-two (24.4%) children were identified as 'Fail' by the MCP card and 43 (20.2%) as 'delay' by the expert's CCA. The overall sensitivity and specificity was 83.7% (95% CI 69.3-93.2) and 90.6% (95% CI 85.2-94.5), respectively. Acceptable diagnostic accuracy was found in the age-group 7-9 months, 13-18 months, and 25-36 months. The MCP card may be used for developmental screening at 9, 18, and 36 months.

Cross-Sectional Study of Hearing Status in Primary Students in Mainstream and Special Schools

Background. The only way to prevent the negative outcomes of hearing loss in children (speech, mental, learning, socialization disorders) is early diagnosis of the pathology and rehabilitation onset. It can be provided by hearing screening programs for children of different ages, including school-age children. Hearing screening is not performed among school-age children in Russian Federation. Objective. The aim is to study the prevalence and structure of hearing disorders in students in mainstream and special (for children with visual impairments) schools to determine the strategy for implementing hearing screening of school-age children in Russian Federation. Methods. The study included children of two groups who had not previously been diagnosed with hearing disorders: group 1 — students of 1–4 grades of mainstream school, group 2 — students of 1–4 grades of special school (children with visual impairments) (St. Petersburg). The screening stage included otoscopy, tympanometry, otoacoustic emissions, pure tone audiometry. Children with any problems later underwent a complex hearing examination at Center of Pediatric Audiology (St Petersburg) to confirm the presence of hearing disorder and for disease differential diagnosis. The major indicator in this study is the percent (%) of children with confirmed hearing disorder in each group. The additional indicator is the proportion of various pathological conditions in hearing disorders’ structure (persistent disorders and hearing loss degree included). Study methods: otoscopy, tympanometry, pure tone audiometry, speech audiometry, otoacoustic emissions and auditory brainstem responses. Results. We have revealed abnormalities in 23% of 183 children from mainstream school. Hearing disorders were confirmed in 19.7% of children. Most children were diagnosed with temporary mild and moderate conductive hearing loss, whereas 3.9% were diagnosed with permanent (sensorineural) hearing loss. The total percent of children with confirmed hearing disorder was not significantly different in 148 children from special school. Therefore, they have 2.5 times more cases of permanent hearing loss and children with more severe hearing disorder. Conclusion. The obtained data confirm the hearing screening relevance in school-age children. Further studies are required to develop hearing screening protocol for school-age children considering the features of audiologic service and educational system in Russian Federation.

Development of an audiological assessment and diagnostic model for high occupational noise exposure.

To explore the diagnostic auditory indicators of high noise exposure and combine them into a diagnostic model of high noise exposure and possible development of hidden hearing loss (HHL). We recruited 101 young adult subjects and divided them according to noise exposure history into high-risk and low-risk groups. All subjects completed demographic characteristic collection (including age, noise exposure, self-reported hearing status, and headset use) and related hearing examination. The 8kHz (P = 0.039) and 10kHz (P = 0.005) distortion product otoacoustic emission amplitudes (DPOAE) (DPs) in the high-risk group were lower than those in the low-risk group. The amplitudes of the summating potential (SP) (P = 0.017) and action potential (AP) (P = 0.012) of the electrocochleography (ECochG) in the high-risk group were smaller than those in the low-risk group. The auditory brainstem response (ABR) wave III amplitude in the high-risk group was higher than that in the low-risk group. When SNR = -7.5dB (P = 0.030) and -5dB (P = 0.000), the high-risk group had a lower speech discrimination score than that of the low-risk group. The 10kHz DPOAE DP, ABR wave III amplitude and speech discrimination score under noise with SNR = -5dB were combined to construct a combination diagnostic indicator. The area under the ROC curve was 0.804 (95% CI 0.713-0.876), the sensitivity was 80.39%, and the specificity was 68.00%. We expect that high noise exposure can be detected early with this combined diagnostic indicator to prevent HHL or sensorineural hearing loss (SNHL). ChiCTR2200057989, 2022/3/25.