Hearing In Noise Test Scores Research Articles

Validation of the Norwegian Version of the Speech, Spatial and Qualities of Hearing Scale (SSQ)

Introduction: The main objective of the study was to validate the Norwegian translation of the Speech, Spatial and Qualities of Hearing Scale (SSQ) and investigate the SSQ disability profiles in a cochlear implant (CI) user population. Methods: The study involved 152 adult CI users. The mean age at implantation was 55 (standard deviation [SD] = 16), and the mean CI experience was 5 years (SD = 4.8). The cohort was split into three groups depending on the hearing modality: bilateral CIs (BCIs), a unilateral CI (UCI), and bimodal (CI plus contralateral hearing aid; HCI). The SSQ disability profiles of each group were compared with those observed in similar studies using the English version and other translations of the SSQ. Standard values, internal consistency, sensitivity, and floor and ceiling effects were investigated, and the missing-response rates to specific questions were calculated. Relationships to speech perception were measured using monosyllabic word scores and the Norwegian Hearing in Noise Test scores. Results: In the BCI group, the average scores were around 5.0 for the speech and spatial sections and 7.0 for the qualities section (SD ∼2). The average scores of the UCI and HCI groups were about one point lower than those of the BCI group. The SSQ disability profiles were comparable to the profiles in similar studies. The slopes of the linear regression lines measuring the relationships between the SSQ speech and monosyllabic word scores were 0.8 per 10% increase in the monosyllabic word score for the BCI group (explaining 35% of the variation) and 0.4 for the UCI and HCI groups (explaining 22–23% of the variation). Conclusion: The Norwegian version of the SSQ measures hearing disability similar to the original English version, and the internal consistency is good. Differences in the recipients’ pre-implantation variables could explain some variations we observed in the SSQ responses, and such predictors should be investigated. Data aggregation will be possible using the SSQ as a routine clinical assessment in global CI populations. Moreover, pre-implantation variables should be systematically registered so that they can be used in mixed-effects models.

Longitudinal Auditory Benefit for Elderly Patients After Cochlear Implant for Bilateral Hearing Loss, Including Those Meeting Expanded Centers for Medicare & Medicaid Services Criteria.

To examine the effect of patient age on longitudinal speech understanding outcomes after cochlear implantation (CI) in bilateral hearing loss. Retrospective cohort study. Tertiary academic center. One thousand one hundred five adult patients with bilateral hearing loss receiving a unilateral CI between 1987 and 2022InterventionsNone. Postoperative speech recognition outcomes, including AzBio sentences, consonant-nucleus-consonant word, and Hearing in Noise Test in quiet were analyzed at short-term (<2 yr), medium-term (2-8 y), and long-term (>8 yr) term postoperative intervals. Eighty-six very elderly (>80 yr), 409 elderly (65-80 yr), and 709 nonelderly (18-65 yr) patients were included. Short-term postoperative AzBio scores demonstrated similar magnitude of improvement relative to preoperative scores in the very elderly (47.6, 95% confidence interval [CI], 28.9-66.4), elderly (49.0; 95% CI, 39.2-58.8), and nonelderly (47.9; 95% CI, 35.4-60.4). Scores for those older than 80 years remained stable after 2 years after implant, but in those 80 years or younger, scores continued to improve for up to 8 years (elderly: 6.2 [95% CI, 1.5-12.4]; nonelderly: 9.9 [95% CI, 2.1-17.7]) after implantation. Similar patterns were observed for consonant-nucleus-consonant word scores. Across all age cohorts, patients with preoperative Hearing in Noise Test scores between 40 and 60% had similar scores to those with preoperative scores of less than 40%, at short-term (82.4, 78.9; 95% CI, -23.1 to 10.0), medium-term (77.2, 83.9; 95% CI, -15.4 to 8.2), or long-term (73.4, 71.2; 95% CI, -18.2 to 12.2) follow-up. Patients older than 80 years gain significant and sustained auditory benefit after CI, including those meeting expanded Centers for Medicare & Medicaid Service criteria for implantation. Patients younger than 80 years demonstrated continued improvement over longer periods than older patients, suggesting a role of central plasticity in mediating CI outcomes as a function of age.

Predicting Aided Outcome With Aided Word Recognition Scores Measured With Linear Amplification at Above-conversational Levels.

Many hearing aid (HA) users receive limited benefit from amplification, especially when trying to understand speech in noise, and they often report hearing-related residual activity limitations. Current HA fitting strategies are typically based on pure-tone hearing thresholds only, even though suprathreshold factors have been linked to aided outcomes. Furthermore, clinical measures of speech perception such as word recognition scores (WRSs) are performed without frequency-specific amplification, likely resulting in suboptimal speech audibility and thus inaccurate estimates of suprathreshold hearing abilities. Corresponding measures with frequency-specific amplification ("aided") would likely improve such estimates and enable more accurate aided outcome prediction. Here, we investigated potential links between either unaided WRSs or aided WRSs measured at several above-conversational levels and two established HA outcome measures: The Hearing-In-Noise Test (HINT) and the International Outcome Inventory for Hearing Aids (IOI-HA). Thirty-seven older individuals with bilateral hearing impairments participated. Two conditions were tested: unaided and aided, with all stimuli presented over headphones. In the unaided condition, the most comfortable level (MCL) for the presented speech stimuli, WRS at MCL+10 dB as well as uncomfortable levels (UCLs) for narrowband noise stimuli were measured. In the aided condition, all stimuli were individually amplified according to the "National Acoustic Laboratories-Revised, Profound" fitting rule. Aided WRSs were then measured using an Interacoustics Affinity system at three above-conversational levels, allowing for the maximum aided WRS as well as the presence of "rollover" in the performance-intensity function to be estimated. Multivariate data analyses were performed to examine the relations between the HINT (measured using a simulated HA with the NAL-RP amplification) or IOI-HA scores (for the participants' own HAs) and various potential predictors (age, pure-tone average hearing loss, unaided WRS, aided WRS, rollover presence [ROp], and UCL). Aided WRSs predicted the HINT scores better than any other predictor and were also the only significant predictor of the IOI-HA scores. In addition, UCL and ROp in the aided WRSs were significant predictors of the HINT scores and competed for variance in the statistical models. Neither age nor pure-tone average hearing loss could predict the two aided outcomes. Aided WRSs can predict HA outcome more effectively than unaided WRSs, age or pure-tone audiometry and could be relatively easily implemented in clinical settings. More research is necessary to better understand the relations between ROp, UCL and speech recognition at above-conversational levels.

Pupillometry as a Measure of Listening Effort in Patients with Bone-Anchored Hearing Systems

The goal of this study is to assess speech comprehension and listening effort by means of pupillometry, in patients with bone-anchored hearing system (BAHS). The study was performed prospectively in a group of 21 hearing-impaired adults, unilaterally implanted with BAHS Ponto. Listening effort was compared in patients wearing two sound processors (Oticon Medical AB, Askim, Sweden): Ponto 3 SuperPower (P3SP) and Ponto Pro (PP). Every patient was invited to two visits, separated by a 3-month break. The first session was to establish the noise level needed to obtain 95% correct sentence recall in the hearing in noise test (HINT), when speech is presented at 70 dB SPL. During the second session, pupillometry, with the use of the above-mentioned conditions, was performed. The mean HINT scores obtained during the second visit were 96.3% for PP and 97.7% for P3SP (p = 0.9863). In pupillometry, no significant differences were found for average PPD (peak pupil dilation; p = 0.3247), average peak pupil dilation timing (p = 0.527) and for pupil dilation growth curves with both processors. The findings of this study suggest that BAHS users allocate similar listening effort with PP and P3SP when processing speech-in-noise at a sound pressure level not saturating Ponto Pro and at a fixed performance level of 95%. This finding applies to the patients who meet the qualification criteria for bone conduction devices and have BC in situ threshold average below 45 dB HL.

Cochlear Implantation Improves Both Speech Perception and Patient-Reported Outcomes: A Prospective Follow-Up Study of Treatment Benefits among Adult Cochlear Implant Recipients.

Cochlear implantation is considered the best treatment option for patients with severe-to-profound sensorineural hearing loss for whom conventional hearing aids are insufficient. We used a repeated measures longitudinal approach to evaluate speech recognition and patient-reported outcomes after cochlear implantation in an unbiased cohort of Danish adult patients in a prospective cohort study. We assessed 39 recipients before and two times after implantation using a battery of tests that included Dantale I, the Danish Hearing in Noise Test, the Nijmegen Cochlear Implant Questionnaire, and the Speech, Spatial, and Qualities of Hearing Scale. The study group improved significantly on all outcome measures following implantation. On average, Dantale I scores improved by 29 percentage points and Hearing in Noise Test scores improved by 22 percentage points. Most notably, the average Dantale score improved from 26 to 70% in the CI in quiet condition and from 12 to 42% in the cochlear implantation in noise condition when tested monaurally. Dantale demonstrated a significant positive correlation with Nijmegen Cochlear Implant Questionnaire and Speech, Spatial, and Qualities of Hearing Scale scores, while Hearing in Noise Test had no significant correlation with the patient-reported outcome measures. Patients improved significantly at 4 months and marginally improved further at 14 months, indicating that they were approaching a plateau. Our study’s use of audiometric and patient-reported outcome measures provides evidence of the treatment benefits of cochlear implantation in adults, which may help physicians advise patients on treatment decisions and align treatment benefit expectations, as well as serve as a foundation for the development of new cochlear implantation selection criteria.

Right-Ear Advantage for Unaided and Aided Speech Perception in Noise in Older Adults

Objective: To investigate whether the magnitude of the right-ear advantage (REA) for speech perception in noise decreased in aided conditions as compared with unaided conditions in older adults bilaterally fitted with hearing aids. A secondary aim was to determine the effect of audibility on the right- and left-ear processing for speech stimuli in both aided and unaided conditions.Methods: Forty-two older adult, bilateral hearing-aid users were selected. Pure-tone audiometry and the hearing-in-noise test (HINT) were carried out and real-ear insertion gain (REIG) was measured in all participants. All HINT stimuli were delivered via loudspeakers in the free field in both aided and unaided conditions.Results: Right-ear scores for HINT were significantly better than the left ear in both unaided and aided conditions. No significant differences in the magnitude of the REA between the unaided HINT and aided HINT scores were found. Regression models showed that audibility explained 47% and 53% of the variance in unaided HINT scores in the right and left ears, respectively. For the aided HINT scores, age and audibility explained 46% of the variability for the left-ear scores, while for the right ear, the only remaining significant variable in the model was REIG, which explained 12% of the right-ear HINT scores.Conclusion: Right-ear processing is significantly more efficient for speech stimuli in both unaided and aided conditions in older adults. Audibility affected unaided speech perception in right and left ears similarly however this was not the case in the aided condition. Audibility was associated with aided speech perception in noise in the left ear only.

Cochlear Implant Performance in Adult Patients with Absent Intraoperative Electrically Evoked Compound Action Potentials.

To describe cochlear implant performance outcomes in adult patients in whom no intraoperative electrically evoked compound action potential (ECAP) responses were able to be obtained despite intracochlear electrode placement. Retrospective case review. Academic tertiary center. Patients 18 years of age and older undergoing cochlear implantation between May 2010 and September 2018 with absent ECAP measurements intraoperatively with intracochlear electrode positioning were identified. Patient performance on sentence recognition testing using the Hearing in Noise Test (HINT) and AzBio at 6 to 12 months postoperatively was compared to preimplantation scores. Additional collected data included patient demographics, etiology of hearing loss, and preoperative pure-tone average (PTA) and word recognition scores (WRSs). Intraoperative ECAP measurements were unable to be obtained in 15 cochlear implants performed on 14 patients out of 383 cochlear implant cases. Of the patients with absent ECAP measures, the mean ± SD age was 61.7 ± 15.7 years. Causes of hearing loss included congenital hearing loss, meningitis, autoimmune inner ear disease, otosclerosis, presbycusis, and Ménière's disease. The average preoperative PTA was 103.5 ± 17.0 dB. Twelve implanted ears had a WRS of 0% and 9 had a HINT score of 0% prior to surgery. The mean HINT score at 6 to 12 months postimplantation was 57.8% ± 37.8% and had improved by 42.6% ± 35.6% compared to the mean preimplantation HINT score (95% confidence interval, 22.0%-63.1%, P = .001, paired Student t test). There is a wide range of cochlear implant performance in patients with absent intraoperative ECAP measures ranging from sound awareness to HINT scores of 100%.

Association between speech perception in noise and electrophysiological measures: an exploratory study of possible techniques to evaluate cochlear synaptopathy in humans

Objective: The primary aim of this study was to investigate whether scores for a speech-in-noise test were associated with the results of two electrophysiological techniques mainly targeting low spontaneous rate, high-threshold auditory fibres.Design: Cross-sectional study. Participants were evaluated with the hearing-in-noise test (HINT), along with the Auditory Brainstem Response (ABR) with and without ipsilateral noise. The wave V/I amplitude ratio for the ABR without ipsilateral noise and ABR wave V latency shift in the presence of ipsilateral noise were obtained.Study sample: Twenty adults aged between 20 and 34 years (10 females) who did not report occupational exposure to noise were selected. All participants presented with normal hearing thresholds (0.250–8 kHz) and the presence of distortion product otoacoustic emissions, bilaterally.Results: A significant association between the wave V/I amplitude ratio for the left ear and the HINT scores for the left ear was found.Conclusions: Based on the results of this study, in normal-hearing listeners, the wave V/I ratio is associated with speech-in-noise performance, specifically in the left ear. This non-invasive procedure has the potential to be used in clinical populations who present with speech-in-noise difficulties despite having normal audiograms.

Association of Speech Processor Technology and Speech Recognition Outcomes in Adult Cochlear Implant Users.

Determine association of advancements in speech processor technology with improvements in speech recognition outcomes. Retrospective cohort. Tertiary referral center. Adult unilateral cochlear implant (CI) recipients. Increasing novelty of speech processor defined by year of market availability. Consonant-Nucleus-Consonant (CNC) and Hearing in Noise Test (HINT) in quiet. From 1991 to 2016, 1,111 CNC scores and 1,121 HINT scores were collected from 351 patients who had complete data. Mean post-implantation CNC score was 53.8% and increased with more recent era of implantation (p < 0.001, analysis of variance [ANOVA]). Median HINT score was 87.0% and did not significantly vary with implantation era (p = 0.06, ANOVA). Multivariable generalized linear models were fitted to estimate the effect of speech processor novelty on CNC and HINT scores, each accounting for clustering of scores within patients and characteristics known to influence speech recognition outcomes. Each 5-year increment in speech processor novelty was independently associated with an increase in CNC score by 2.85% (95% confidence limits [CL] 0.26, 5.44%) and was not associated with change in HINT scores (p = 0.30). Newer speech processors are associated with improved CNC scores independent of the year of device implantation and expanding candidacy criteria. The lack of association with HINT scores can be attributed to a ceiling effect, suggesting that HINT in quiet may not be an informative test of speech recognition in the modern CI recipient. The implications of these findings with respect to appropriate interval of speech processor upgrades are discussed.

The Impact of Comorbidities in the Aging Population on Cochlear Implant Outcomes.

Cochlear implants have been used for many years for bilateral profound hearing loss. General longevity has continued to increase and, therefore, the age at which cochlear implants are placed has concomitantly increased. Our purpose is to determine whether outcomes and complications are significantly different in the elderly. Retrospective, clinical review. Tertiary referral center, primarily ambulatory setting. One hundred and one patients with moderate-to-profound hearing loss who ranged in age from 18 to 89 years. Subjects were divided into younger (<69, n = 51) and older (>70, n = 50) groups for analysis. All patients received either a unilateral or bilateral multichannel cochlear implant. The change in hearing in noise testing and AZBio testing between pre and postimplantation was evaluated in each group. Primary outcome measures include preimplant and postimplant hearing in noise test (HINT) and/or AZBio speech perception testing. Preimplant HINT/AZBio was compared with postimplant HINT/AZBio for each patient and between the two groups. In addition, we reviewed the comorbidities between the two groups as well as complication rates between less than 70 and more than 70 group. Both the younger and the older group demonstrated a significant improvement in postimplant HINT and/or AZBio scores. No statistically significant difference was noted in precochlear implant HINT/AZBio testing (p = 0.65/p = 0.48) between the two groups or the postimplant HINT/AZBio testing (p = 0.19/p = 0.22) between the two groups. Although, more than 70 yo group had significantly more comorbidities, the complication rates between the groups were insignificant. There was no shown association of specific comorbidities to complications between the two groups. Both older and younger patients can receive a significant improvement in speech perception with cochlear implantation. Older patients tend to have more comorbidities compared with the younger patients, however, the complication rates are not higher in this population.

Depth of Cochlear Implant Array Within the Cochlea and Performance Outcome.

To evaluate whether the depth of cochlear implant array within the cochlea affects performance outcomes 1 year following cochlear implantation. A retrospective case review of 120 patients who were implanted with the Advanced Bionics HiFocus 1J. Post-implantation plain-radiographs were retrospectively reviewed, and the depth of insertion was measured in degrees from the round window to the electrode tip. Correlation between the depth of insertion and 1-year post-activation Hearing in Noise Test (HINT) scores was analyzed. Intrascala position was not assessed. Depth of electrode insertion ranged from 180° to 720°, and HINT scores ranged from 0% to 100%. A Mann-Whitney U test demonstrated significantly improved 1-year post-activation HINT scores in patients with an insertion depth of 360° or more in comparison with patients with insertion depth of less than 360° (81% vs 61%, P = .048). Patients with 13 to 15 contacts within cochlear turns performed as well as patients with full insertion of all 16 contacts, while patients with only 12 contacts performed poorly. Insertion depth of the AB HiFocus 1J electrode of less than 360° is associated with reduced 1-year post-activation HINT scores when compared with deeper insertions. Partial insertion of 13 active contacts or more led to similar results as full insertion.

Cochlear implantation in elderly patients: stability of outcome over time.

Cochlear implantation is the standard of care for treating severe to profound hearing loss in all age groups. There is limited data on long-term results in elderly implantees and the effect of ageing on outcomes. This study compared the stability of cochlear implantation outcome in elderly and younger patients. A retrospective chart review of cochlear implant patients with a minimum follow up of five years was conducted. The study included 87 patients with a mean follow up of 6.8 years. Of these, 22 patients were older than 70 years at the time of implantation. Hearing in Noise Test scores at one year after implantation were worse in the elderly: 85.3 (aged under 61 years), 80.5 (61-70 years) and 73.6 (aged over 70 years; p = 0.039). The respective scores at the last follow up were 84.8, 85.1 and 76.5 (p = 0.054). Most patients had a stable outcome during follow up. Of the elderly patients, 13.6 per cent improved and none had a reduction in score of more than 20 per cent. Similar to younger patients, elderly patients had improved Short Form 36 Health Survey scores during follow up. Cochlear implantation improves both audiometric outcome and quality of life in elderly patients. These benefits are stable over time.

What is the role of preoperative imaging for cochlear implants in adults with postlingual deafness?

What is the role of preoperative imaging for cochlear implants in adults with postlingual deafness?

Can a Remotely Delivered Auditory Training Program Improve Speech-in-Noise Understanding?

The aims of this study were to determine if a remotely delivered, Internet-based auditory training (AT) program improved speech-in-noise understanding and if the number of hours spent engaged in the program influenced postintervention speech-in-noise understanding. Twenty-nine first-time hearing aid users were randomized into an AT group (hearing aids + 3 week remotely delivered, Internet-based auditory training program) or a control group (hearing aids alone). The Hearing in Noise Test (Nilsson, Soli, & Sullivan, 1994) and the Words-in-Noise test (Wilson, 2003) were administered to both groups at baseline + 1 week and immediately at the completion of the 3 weeks of auditory training. Speech-in-noise understanding improved for both groups at the completion of the study; however, there was not a statistically significant difference in postintervention improvement between the AT and control groups. Although the number of hours the participants engaged in the AT program was far fewer than prescribed, time on task influenced the postintervention Words-in-Noise but not Hearing in Noise Test scores. Although remotely delivered, Internet-based AT programs represent an attractive alternative to resource-intensive, clinic-based interventions, their demonstrated efficacy continues to remain a challenge due in part to issues associated with compliance.

Cochlear implantation in older adults.

Cochlear implants allow individuals with severe to profound hearing loss access to sound and spoken language. The number of older adults in the United States who are potential candidates for cochlear implantation (CI) is approximately 150,000 and will continue to increase with the aging of the population. Should CI be routinely recommended for these older adults, and do these individuals benefit from CI? We reviewed our 12-year experience with CI in adults aged ≥60 years (n = 445) at Johns Hopkins Medical Institutions to investigate the impact of CI on speech understanding and to identify factors associated with speech performance. Complete data on speech outcomes at baseline and 1 year post-CI were available for 83 individuals. Our results demonstrate that CI in adults aged ≥60 years consistently improved speech understanding scores, with a mean increase of 60.0% (SD 24.1) on HINT (Hearing in Noise Test) sentences in quiet. The magnitude of the gain in speech scores was negatively associated with age at implantation, such that for every increasing year of age at CI the gain in speech scores was 1.3 percentage points less (95% confidence interval [95% CI], 0.6-1.9) after adjusting for age at hearing loss onset. Conversely, individuals with higher pre-CI speech scores (HINT scores between 40% and 60%) had significantly greater post-CI speech scores by a mean of 10.0 percentage points (95% CI, 0.4-19.6) than those with lower pre-CI speech scores (HINT <40%) after adjusting for age at CI and age at hearing loss onset. These results suggest that older adult CI candidates who are younger at implantation and with higher preoperative speech scores obtain the highest speech understanding scores after CI, with possible implications for current United States Medicare policy. Finally, we provide an extended discussion of the epidemiology and impact of hearing loss in older adults. Future research of CI in older adults should expand beyond simple speech outcomes to take into account the broad cognitive, social, and physical functioning outcomes that are likely detrimentally affected by hearing loss and may be mitigated by CI.

A neural basis of speech-in-noise perception in older adults.

We investigated a neural basis of speech-in-noise perception in older adults. Hearing loss, the third most common chronic condition in older adults, is most often manifested by difficulty understanding speech in background noise. This trouble with understanding speech in noise, which occurs even in individuals who have normal-hearing thresholds, may arise, in part, from age-related declines in central auditory processing of the temporal and spectral components of speech. We hypothesized that older adults with poorer speech-in-noise (SIN) perception demonstrate impairments in the subcortical representation of speech. In all participants (28 adults, age 60-73 yr), average hearing thresholds calculated from 500 to 4000 Hz were ≤ 25 dB HL. The participants were evaluated behaviorally with the Hearing in Noise Test (HINT) and neurophysiologically using speech-evoked auditory brainstem responses recorded in quiet and in background noise. The participants were divided based on their HINT scores into top and bottom performing groups that were matched for audiometric thresholds and intelligent quotient. We compared brainstem responses in the two groups, specifically, the average spectral magnitudes of the neural response and the degree to which background noise affected response morphology. In the quiet condition, the bottom SIN group had reduced neural representation of the fundamental frequency of the speech stimulus and an overall reduction in response magnitude. In the noise condition, the bottom SIN group demonstrated greater disruption in noise, reflecting reduction in neural synchrony. The role of brainstem timing is particularly evident in the strong relationship between SIN perception and quiet-to-noise response correlations. All physiologic measures correlated with SIN perception. Adults in the bottom SIN group differed from the audiometrically matched top SIN group in how speech was neurally encoded. The strength of subcortical encoding of the fundamental frequency appears to be a factor in successful speech-in-noise perception in older adults. Given the limitations of amplification, our results suggest the need for inclusion of auditory training to strengthen central auditory processing in older adults with SIN perception difficulties.

Efficacy and Safety of an In-the-Mouth Bone Conduction Device for Single-Sided Deafness

To determine the efficacy, benefit, and safety of a new in-the-mouth bone conduction device (SoundBite Hearing System) for single-sided deafness (SSD). A multicenter, controlled, nonrandomized prospective unblinded study of SSD patients wearing the device. Ambulatory care centers typical of those where SSD patients are diagnosed and treated. Adults (ages >18 and <80 yr) with acquired, permanent SSD (N=28) and no current use of any SSD device. Continual daily wear of the new device over a 30-day trial period. The Hearing in Noise Test (HINT), the Abbreviated Profile of Hearing Aid Benefit (APHAB), comprehensive pretrial and posttrial medical, audiologic, and dental examinations and an SSD questionnaire. The Hearing in Noise Test scores improved an average of -2.5 dB after 30 days, compared with wearing no device (p<0.001). The Abbreviated Profile of Hearing Aid Benefit scores improved (p<0.05) for all subjects for the Global and Background Noise subscales and for all but 1 subject for the Reverberation and Ease of Communication subscales. There were no medical, audiologic, or dental complications. The SoundBite system is safe and effective and provides substantial benefit for SSD patients with continual daily use over a 30-day period.

Update on Bone-Anchored Hearing Aids in Pediatric Patients With Profound Unilateral Sensorineural Hearing Loss

To evaluate the use of bone-anchored hearing aids (Bahas) in children with single-sided deafness. Retrospective 3-year chart review. Arkansas Children's Hospital, Little Rock, pediatric hospital serving children from birth to 21 years of age. The study included 23 children (14 girls and 9 boys) with single-sided deafness (mean age, 12.6 years; age range, 6-19 years). Two-stage Baha surgery with 6-month osseointegration was performed on children 5 years and older at a single institution. The Baha processor was placed 2 weeks after the second-stage surgery. Results of the Hearing in Noise Test (HINT) and the Children's Home Inventory for Listening Difficulties (CHILD) questionnaires were compared before and after Baha activation in children with profound unilateral sensorineural hearing loss. Preimplant mean HINT scores at speech-noise ratios of 0, +5, and +10 dB were 42%, 76%, and 95%, respectively. Postimplant mean HINT scores improved to mean speech-noise ratios of 82%, 97%, and 99% at 0, 5, and 10 dB, respectively. The CHILD scores also improved from mean preimplant ratings of 4.49 and 4.60 for patients and parents, respectively, to postimplant ratings of 6.90 and 7.10. Both teenagers (n = 15) and children younger than 13 years (n = 7) demonstrated improved HINT and CHILD scores. The complication rate was 17%. Bone-anchored hearing aids are a durable treatment option that can achieve noticeable improvements in hearing in noise and in listening difficulties in children with profound unilateral sensorineural hearing loss.

Higher serum aldosterone correlates with lower hearing thresholds: A possible protective hormone against presbycusis

Aldosterone hormone is a mineralocorticoid secreted by adrenal gland cortex and controls serum sodium (Na +) and potassium (K +) levels. Aldosterone has a stimulatory effect on expression of sodium–potassium ATPase (Na, K-ATPase) and sodium–potassium–chloride cotransporter (NKCC) in cell membranes. In the present investigation, the relation between serum aldosterone levels and age-related hearing loss (presbycusis) and the correlation between these levels versus the degree of presbycusis in humans were examined. Serum aldosterone concentrations were compared between normal hearing and presbycusic groups. Pure-tone audiometry, transient evoked otoacoustic emissions (TEOAE), hearing in noise test (HINT) and gap detection were tested for each subject and compared to the serum aldosterone levels. A highly significant difference between groups in serum aldosterone concentrations was found ( p = 0.0003, t = 3.95, df = 45). Highly significant correlations between pure-tone thresholds in both right and left ears, and HINT scores versus serum aldosterone levels were also discovered. On the contrary, no significant correlations were seen in the case of TEOAEs and gap detection. We conclude that aldosterone hormone may have a protective effect on hearing in old age. This effect is more peripheral than central, appearing to affect inner hair cells more than outer hair cells.

Cochlear implantation in patients with osteogenesis imperfecta

Hearing loss has been shown to occur in 42% to 58% of patients with osteogenesis imperfecta (OI), with deafness arising in 25% to 60% of the patients. Implantation in patients with OI is relatively rare, with only 4 prior single case reports published in the English-language literature. The goal of this study was to evaluate the feasibility and functional outcome of cochlear implantation in 2 patients with OI tarda type I with profound sensorineural hearing loss. Case series. The implantations were performed in a tertiary academic referral center (Johns Hopkins University). Though promontory vascularity was encountered, full insertion of a normal cochlear implant array could be achieved in both cases. One-year postimplant scores demonstrated 20 to 40 dB hearing thresholds, Consonant-Nucleus-Consonant Test word scores of 54% and 70%, Consonant-Nucleus-Consonant Test phoneme scores of 75% and 83%, Hearing in Noise Test scores of 76% and 99%, and Central Institute of the Deaf Sentence Score sentence scores of 99% and 100%, for patients 1 and 2, respectively. Cochlear implantation in patients with OI is not only technically possible but the results are similar to implant outcomes for patients with sensorineural hearing loss from a variety of other causes. C.