Incidence Of Hearing Loss Research Articles

Modeling the Risk of Hearing Loss From Radiation Therapy in Childhood Cancer Survivors: A PENTEC Comprehensive Review

The Pediatric Normal Tissue Effects in the Clinic (PENTEC) hearing loss (HL) task force reviewed investigations on cochlear radiation dose-response relationships and risk factors for developing HL. Evidence-based dose-response data are quantified to guide treatment planning. A systematic review of the literature was performed to correlate HL with cochlear dosimetry. HL was considered present if a threshold exceeded 20 dB at any frequency. Radiation dose, ototoxic chemotherapy exposure, hearing profile including frequency spectra, interval to HL, and age at radiation therapy (RT) were analyzed. Literature was systematically reviewed from 1970 to 2021. This resulted in 739 abstracts; 19 met inclusion for meta-analysis, and 4 included data amenable to statistical modeling. These 4 studies included 457 cochleas at risk in patients treated with RT without chemotherapy, and 398 cochlea treated with chemotherapy. The incidence and severity of cochlear HL from RT exposure alone is related to dose and age. Risk of HL was <5% in cochlea receiving a mean dose ≤35 Gy but increased to 30% at 50 Gy. HL risk ranged from 25% to 40% in children under the age of 5 years at diagnosis, declining to 10% in older children for any radiation dose. Probability of similar severe HL occurred at doses 18.3 Gy higher for children <3 versus >3 years of age. High-frequency HL was most common, with average onset occurring 3.6 years (range, 0.4-13.2 years) after RT. Exposure to platinum-based chemotherapies added to the rates of HL at a given cochlear dose level, with 300 mg/m2 shifting the dose response by 7 Gy. In children treated with RT alone, risk of HL was low for cochlear dose <35 Gy and rose when dose exceeded 35 Gy without clear RT dose dependence. High-frequency HL was most prevalent, but all frequencies were affected. Children younger than 5 years were at highest risk of developing HL, although independent effects of dose and age were not fully elucidated. Future reports with more granular data are needed to better delineate time to onset of HL and the effects of chemoradiotherapy.

Neonatal hearing screening - does failure in TEOAE screening matter when the AABR test is passed?

PurposeNewborns who fail the transient evoked otoacoustic emissions (TEOAE) but pass the automatic auditory brainstem response (AABR) in universal newborn hearing screening (UNHS), frequently have no further diagnostic test or follow-up. The present study aimed to investigate whether hearing loss might be missed by ignoring neonatal TEOAE failure in the presence of normal AABR.MethodsA retrospective analysis was conducted in newborns presenting between 2017 and 2021 to a tertiary referral centre due to failure in the initial UNHS. The main focus was on infants who failed TEOAE tests, but passed AABR screening. The clinical characteristics and audiometric outcomes were analysed and compared with those of other neonates.ResultsAmong 1,095 referred newborns, 253 (23%) failed TEOAE despite passing AABR screening. Of the 253 affected infants, 154 returned for follow-up. At 1-year follow-up, 46 (28%) achieved normal audiometric results. 32 (21%) infants had permanent hearing loss (HL) confirmed by diagnostic ABR, 58 (38%) infants had HL solely due to middle ear effusion (MEE), and for 18 (12%) infants HL was suspected without further differentiation. The majority of permanent HL was mild (78% mild vs. 13% moderate vs. 9% profound). The rate of spontaneous MEE clearance was rather low (29%) leading to early surgical intervention in 36 children. The profile of the risk factors for hearing impairment was similar to that of newborns with failure in both, TEOAE and AABR; however, there was a stronger association between the presence of risk factors and the incidence of HL (relative risk 1.55 vs. 1.06; odds ratio 3.61 vs. 1.80).ConclusionIn newborns, the discordance between a “refer” in TEOAE and a “pass” in AABR screening is associated with a substantial prevalence of hearing impairment at follow-up, especially in the presence of risk factors.

A study of otoacoustic emission and brainstem evoked response audiometry as audiological assessment modalities for early detection of hearing loss in children

Background: Aim of the research was to study the incidence of hearing loss in high risk children up to 5 years age and determine the common etiological factors associated with it. Methods: Total 140 neonates falling under the norms of inclusion criteria and the children brought by parents with suspicion of having impaired hearing were subjected to thorough history taking and clinical examination followed by audiological examination in the form of otoacoustic emission (OAE) and brainstem evoked response audiometry (BERA). Those showing REFER or FAIL were subjected to BERA. Results were documented accordingly and analysed for identifying the common risk factors and degree of hearing loss. Results: Maximum number of subjects with hearing loss were in the age group of 25-36 months age. Most common risk factor found was Consanguinity and most common postnatal risk factor was found to be hyperbilirubinemia. When compared to BERA, sensitivity of DPOAE was 97.59%, and the specificity was 92.98%. Conclusions: Universal hearing screening of neonates at birth in the form of DPOAE and followed by BERA can reduce the average age of diagnosis of hearing loss and therefore, can provide an opportunity to initiate an appropriate rehabilitative program.

Incidence of Hearing Loss in Corpus Callosum Agenesis.

Congenital corpus callosum agenesis (CCA) is one of the congenital anomalies in newborns, which usually presents with syndromic features. It can be asymptomatic or have variable neurological deficits. Some studies demonstrated that hearing loss can occur in patients with CCA; however, the exact prevalence remains unclear. Therefore, we aimed to investigate the prevalence of hearing loss in CCA using data from newborn hearing screening in a single tertiary referral center. A total of 126 patients with CCA combined with hearing loss diagnosed at our hospital from November 2005 to November 2022 were retrospectively included in our study. All patients had at least one screening or diagnostic auditory brainstem response result. Brain ultrasonography and magnetic resonance imaging were used to diagnose CCA. Among 126 patients, 93 had automated auditory brainstem response within a month from birth. Of the 93 patients, 20 (21.5%) had a "refer" result in the screening tests in at least one ear. The final incidence of hearing loss in patients with CCA was 16.1%. We observed no hearing loss in 22 patients with isolated CCA. Patients with CCA have a higher incidence of hearing loss. However, this is likely related to the concurrent condition of patients. CCA seems not to be a risk factor for hearing loss.

Incidence of cisplatin-induced ototoxicity in adult cancer patients based on audiometric confirmation of patient self-report

IntroductionRobust clinically relevant epidemiological and audiological data are needed to prepare for future clinical trials aiming at preventing cisplatin-induced ototoxicity in this suffering cancer population. We assessed the incidence, severity, and potential risk factors of symptomatic cisplatin-induced hearing loss in a large cohort of adults.MethodsRetrospective cohort study at a tertiary care university hospital. The study group included consecutive patients over 18 years old treated with cisplatin-based chemotherapy without concomitant inner ear radiotherapy or other ototoxic medication. Every participant underwent baseline pretreatment audiometry and was asked for audiological symptoms (tinnitus or subjective hearing loss) during the treatment. If symptomatic, comparative standard audiometry (0.125 to 8 kHz) was performed. Hearing loss was defined by a threshold shift ≥15 dB HL in at least one of the tested frequencies.ResultsA total of 401 cancer patients (59% males) with a mean age of 56 years (range 18-80) were included. Eighty-one patients (20%) developed symptomatic hearing loss, predominantly affecting the high frequencies from 4 to 8 kHz. Among them, 49 (60%) experienced simultaneous new-onset tinnitus. None of the analyzed potential risk factors (age, sex, smoking, hypertension, diabetes, dyslipidemia, chemotherapeutic regimen, and cumulative cisplatin dose) was statistically correlated with hearing loss.DiscussionAt least 1 out of 5 patients treated with cisplatin developed audiological symptoms associated with audiometric hearing loss within the 0.125 to 8 kHz range, for which new-onset tinnitus is a sensitive symptom. Not all audiological symptoms are accompanied by audiometric change. No predisposing factor could be identified. Standardized audiological monitoring before and during cisplatin-based chemotherapy allows quantitative assessment of early audiometric signs of ototoxicity, offering to optimize anticancer therapy while minimizing morbidity in a multidisciplinary setting.

Stem Cell-Based Therapies for Auditory Hair Cell Regeneration in the Treatment of Hearing Loss.

The incidence and prevalence of hearing loss is increasing globally at an accelerated pace. Hair cells represent the sensory receptors of auditory and vestibular systems. Hair cell absence, loss or degeneration due to congenital diseases, trauma, toxicity, infection or advancing age, results in disabling hearing loss. Regenerative medicine approaches consisting in stem cell-based hair cell rescue or regeneration, gene therapy, as well as cell and tissue engineering are expected to dramatically improve the therapeutic arsenal available for addressing hearing loss. Current strategies that are using different stem cell types to rescue or to induce hair cell proliferation and regeneration are presented. Gene and cell therapy methods that modulates transdifferentiation of surrounding cell types into hair cells are presented, together with their specific advantages and limitations. Several modalities for improving therapeutic targeting to the inner ear such as nanoparticle-mediated cell and gene delivery are introduced. Further steps in building more relevant high-throughput models for testing novel drugs and advanced therapies are proposed as a modality to accelerate translation to clinical settings.

Incidence of hearing loss in neonates at a secondary care hospital in North India—a pilot UNHS study

BackgroundTo evaluate the incidence of hearing loss in neonates in our secondary care hospital under pilot UNHS programme. To assess association between various risk factors and neonatal hearing loss.MethodsProspective, observational cohort study was done in a secondary level hospital in North India after ethical approval, for 1 year. Inclusion criteria are as follows: neonates born in hospital during study period, consenting to testing. Exclusion criteria are as follows: sick neonates, non-consenting parents. Neonates underwent TEOAE at 48 h of birth; those failing retested at 1 month. Neonates failing 2nd stage are tested after 3 months using BERA. Neonates were evaluated for the presence of maternal/neonatal high-risk factors.ResultsOut of 506 neonates, 143 passed 1st OAE screening, 363 were refer, and referral rate is 71.7%. A total of 341/345 neonates passed 2nd stage; 4 were diagnosed with hearing loss on BERA at 3 months. (18 neonates lost to follow-up, excluded from final cohort.) Overall incidence of hearing loss was 0.82%, 1.08% for males and 0.44% for females (p = 0.87, NS). One-hundred nine neonates were high risk (prematurity, 36; consanguinity, 4; caesarean section for relevant indications, 68; craniofacial abnormalities, 1). Incidence of hearing loss for high-risk group was 1.83% and 0.53% for well-born neonates (p = 0.19, NS).ConclusionIncidence of hearing loss in our district in North India is as follows: 8.2 per 1000 live births for well neonates, 18.3 per 1000 live births for high-risk neonates, and respective overall national incidence rates were 1.59 to 8.8 per 1000 and 7 to 49 per 1000. UNHS programmes must be implemented in all hospitals; protocol may be varied according to local population profile and resources available.

Differentiating Meniere's Disease and Vestibular Migraine: Insights from Gadolinium-Enhanced Magnetic Resonance Imaging and Clinical Features.

To explore the predictive factors between Meniere's disease (MD) and vestibular migraine (VM) by Gadolinium-enhanced Magnetic resonance imaging (MRI) of the inner ear and Clinical Features. Eighty-seven patients (50 MD and 37 VM) underwent intratympanic injection of gadolinium and MRI was performed 24 h later. All patients underwent pure tone audiometry and caloric tests. In the MD group, 46 (92%) of 50 patients developed endolymphatic hydrops, although only 2 (5.4%) in the vestibular migraine (VM) group had positive results groups (p < 0.001). The incidence of migraine was 14% in the MD group and 67.7% in the VM group (p < 0.001). Multivariate logistic regression of the two groups of patients indicated that the greater the sum of the maximum slow phase velocity (SPV) of the ipsilateral ear, the higher the risk of VM occurrence (p = 0.009). The incidence of carsickness was positively correlated with the incidence of VM (p < 0.001) and asymmetric hearing loss (AHL) was negatively correlated with the diagnosis of VM (p = 0.045). Gadolinium-enhanced MRI of the inner ear is helpful for the differential diagnosis of VM and MD. Carsickness, decreased AHL, and increased Sum of the maximum SPV in the ipsilateral side (SSPVI) may act as diagnostic predictors of VM. 3 Laryngoscope, 134:426-432, 2024.

Outcomes and Management of Infants Who Refer Newborn Hearing Screening.

With the implementation of Universal Newborn Hearing Screening, early diagnosis and referral has been expedited. Many patients who refer screening pass subsequent testing with otoacoustic emissions (OAE) or auditory brainstem response (ABR). The objective of our study was to identify the incidence and etiology of hearing loss in infants who refer initial testing in an urban, tertiary care pediatric otolaryngology practice. We performed a chart review of infants who were evaluated after referring newborn hearing screening from 2017 to 2021. Data collected included birth history, hospital screening results, subsequent audiology and otolaryngology visit findings, final hearing diagnoses, interventions, and outcomes. Of the 450 patients, 83.8% (n = 377) had normal hearing bilaterally after repeat testing (OAE and/or ABR). Thirty five patients were diagnosed with otitis media with effusion (OME) (7.8%) and 17 patients (3.8%) were diagnosed with sensorineural hearing loss. Twenty seven patients (6.0%) were diagnosed with obstructing cerumen/vernix, many times in addition to another diagnosis. Of the 17 patients with sensorineural hearing loss, 2 had genetic syndromes and 2 had congenital cytomegalovirus. Sensorineural hearing loss was significantly associated with the presence of a deafness syndrome (P = .004) and in-utero infections (P = .04). About 11 (2.4%) underwent myringotomy with tube placement, 5 (1.1%) were fitted with hearing aids, 2 (0.4%) were referred for hearing aids, 4 (0.9%) had both myringotomy with tube placement and hearing aids, 1 child had a soft band/Bone Anchored Hearing Aid (BAHA) (0.2%), and 1 child (0.2%) had a cochlear implant. Our incidence of sensorineural hearing loss was 3.8% (95% CI 2.0, 5.5), compared to rates of 0.44 to 68% in the published literature. Most patients had normal hearing, usually identified after only 1 repeat test. OME requiring myringotomy tube insertion was the most common pathology requiring intervention. Close observation for resolution and intervention, if warranted, is critical to prevent sequelae.

A Comparative Analysis of the Vestibulocochlear Function in Patients with Isolated Semicircular Canal Hypofunction Using a Video Head Impulse Test

Objectives: The objective of this study was to analyze vestibulocochlear function results in patients identified with isolated semicircular canal (SCC) hypofunction using the video head impulse test (vHIT).Methods: A retrospective review was conducted on the clinical records of 123 patients diagnosed with isolated SCC hypofunction based on vHIT results. Among these patients, 72 had isolated posterior SCC (PSCC) hypofunction, 25 had isolated lateral SCC (LSCC) hypofunction, and 26 had isolated anterior SCC (ASCC) hypofunction. Descriptive analyses were performed on various vestibulocochlear tests including pure tone audiometry, sinusoidal harmonic acceleration (SHA), spontaneous nystagmus (SN), head-shaking nystagmus (HSN), caloric testing, and cervical vestibular evoked myogenic potential, with results analyzed separately for each SCC hypofunction group.Results: The study found that 66.0% of the evaluated patients exhibited abnormal results in at least one vestibulocochlear function test. PSCC hypofunction patients showed a significantly higher incidence of hearing loss compared to ASCC and LSCC hypofunction patients. LSCC hypofunction patients exhibited higher rates of corrective saccade, phase asymmetry of SHA, and SN abnormalities compared to other SCC hypofunction patients. Additionally, the rates of corrective saccade and phase asymmetry of SHA were also higher in LSCC hypofunction patients. ASCC hypofunction patients demonstrated significantly higher rates of normal corrective saccade, phase lead of SHA, and SN.Conclusions: The analysis of this study suggests that even in cases where vHIT indicates isolated SCC hypofunction, additional vestibulocochlear function tests should be conducted to identify any associated vestibulocochlear dysfunctions. This highlights the importance of comprehensive evaluation to accurately diagnose and manage patients with SCC hypofunction.

Comorbidity in Congenital Hypothyroidism-A Nationwide, Population-based Cohort Study.

Patients with congenital hypothyroidism (CH) are affected more often than the general population by other chronic diseases and neurological difficulties. The aim of this nationwide population-based register study was to investigate the incidence of congenital malformations, comorbidities, and the use of prescribed drugs in patients with primary CH. The study cohort and matched controls were identified from national population-based registers in Finland. All diagnoses from birth until the end of 2018 were collected from the Care Register, and subject-specific prescription drug purchases were identified from The Prescription Register from birth until the end of 2017. Diagnoses of neonatal and chronic diseases were collected for 438 full-term patients and 835 controls (median follow-up time 11.6 years; range, 0-23 years). Newborns with CH were more often found to have neonatal jaundice (11.2% and 2.0%; P < .001), hypoglycemia (8.9% and 2.8%; P < .001), metabolic acidemia (3.2% and 1.1%; P = .007), and respiratory distress (3.9% and 1.3%; P < .003) as compared to their matched controls.Congenital malformations were diagnosed in 66 of 438 (15.1%) CH patients and in 62 of 835 (7.4%) controls (P < .001). The most commonly affected extrathyroidal systems were the circulatory and musculoskeletal systems. The cumulative incidence of hearing loss and specific developmental disorders was higher among CH patients than controls. The use of antidepressant and antipsychotic drugs was similar in CH patients and their controls. CH patients have more neonatal morbidity and congenital malformations than their matched controls. The cumulative incidence of neurological disorders is higher in CH patients. However, our results do not support the existence of severe psychiatric comorbidity.

Association of Glycemic Index Using HbA1c and Sensorineural Hearing Loss in Diabetes Mellitus Type 2 Patients: A Systematic Review and Meta-Analysis

ABSTRACT&#x0D; Objective: To systematically review the available evidence on the association of HBA1c levels and development of sensorineural hearing loss and to quantitatively analyze the available data on HBA1c levels in patients with type 2 diabetes mellitus and sensorineural hearing loss to determine an HbA1c level that may be associated with the risk of having sensorineural hearing loss.&#x0D; Methods:&#x0D; Design: Systematic Review and Meta-analysis Eligibility Criteria: Cross-sectional studies, or cohort studies which were limited to English language that investigated the correlation of glycemic index using HBA1c and sensorineural hearing loss among adult type 2 diabetic patients which were done from January 2010 to December 2021. Studies with no published outcome, incomplete data or that were ongoing as of August 1, 2022 were also excluded.&#x0D; Information Sources: MEDLINE (through PubMed), Cochrane Library, Scopus, Embase (through OVID@journal), Directory of Open Access Journals (DOAJ), Google Scholar and HERDIN Plus&#x0D; Risk of Bias: Risk of Bias was assessed using the Guidelines for Cochrane Collaboration Synthesis of Results: Results were presented using forest plots for representation.Results: A total of 8 studies were reviewed with 2,103 participants in all. Six articles compared hearing loss incidence between diabetic and non-diabetic patients. Overall, there were a total of 881 diabetic patients and 1222 non-diabetic patients. There was a significantly lower incidence of sensorineural hearing loss in non-diabetic patients with a risk ratio of 1.89, 95% CI [1.65, 2.16]. Three articles compared the HbA1c levels of diabetic patients with or without sensorineural hearing loss. Diabetic patients without sensorineural hearing loss had significantly lower HbA1c levels compared to those with sensorineural hearing loss with mean difference of 1.04, 95%CI [0.82, 1.25].Conclusion: In conclusion, this meta-analysis showed a higher prevalence rate of sensorineural hearing loss among patients with diabetes mellitus compared to non-diabetic patients. Moreover, poor glycemic control among diabetic patients with a glycemic index based on HbA1c of more than 8.3 (6.97-9.6) is associated with sensorineural hearing loss.

Obesity and risk of hearing loss in the middle-aged and elderly: a national cohort of Chinese adults

BackgroundThe relationship between obesity and hearing loss among the middle-aged and older population remained unclear. Moreover, few studies have focused on the impact of gender on this association.MethodsThis cohort study extracted the data from the China Health and Retirement Longitudinal Study, a national survey of adults aged 45 years or over. Waist circumference was categorized into three groups: normal, pre-central obesity, and central obesity. We classified BMI into four categories: underweight, normal weight, overweight, and obese. The primary endpoint was the incidence of self-reported hearing loss.ResultsOf the 14,237 participants, 1972 incidents of hearing loss were identified during a median 6.9 years of follow-up. The cumulative incidence of hearing loss was 13.9% (95% CI 13.3% -14.4%). Our study showed that central obesity was significantly associated with hearing loss (HR 0.84, 95%CI 0.75–0.94), and this relationship was more prominent in males (HR 0.76, 95%CI 0.63–0.91). Among male participants, the underweight group was at the highest risk of hearing loss (HR 1.39, 95%CI 1.08–1.79). Compared with the normal weight group, the adjusted HR for hearing loss in the obese groups was 0.69 (95%CI 0.51–0.94) among men. Among female participants, only the overweight group had a lower risk of hearing loss than the normal weight group (HR 0.83, 95%CI 0.71–0.96).ConclusionsBeing overweight and obese were significantly associated with a decreased risk of hearing loss, whereas being underweight was associated with an increased risk of hearing loss.

Role of Cisplatin Dose Intensity and TPMT Variation in the Development of Hearing Loss in Children.

Cisplatin, widely used in the treatment of solid tumors, causes permanent hearing loss in more than 60% of treated children. Previous studies have implicated several clinical factors in the development of ototoxicity, including cumulative cisplatin dose. However, the role of cisplatin dose intensity in the development of hearing loss in children remains unclear. Pharmacogenetic studies have also identified genetic variants in TPMT that increase the risk of cisplatin-induced hearing loss. This study aims to determine whether cisplatin dose intensity contributes to the risk of hearing loss in children and whether genetic variations in TPMT further modifies the risk of cisplatin-induced hearing loss. The authors genotyped 371 cisplatin-treated children for the presence of any 3 TPMT -risk variants. Patients were categorized into high-, moderate-, and low-intensity cisplatin dosing groups according to the cisplatin dose administered per unit time. Kaplan-Meier curves were plotted to compare the cumulative incidence of hearing loss between the genotype and dose intensity groups. Patients receiving cisplatin at high dose intensity experienced significantly higher incidences of ototoxicity than those receiving cisplatin at low dose intensity ( P = 9 × 10 -7 ). Further stratification by TPMT genotype revealed that carriers of ≥1 TPMT variants receiving high-intensity cisplatin developed ototoxicity sooner and more often than their wild-type counterparts (93.8% vs. 56.6% at 12 months; P = 5 × 10 -5 ) and noncarriers receiving low-intensity cisplatin (21.2% at 12 months). Cisplatin dose intensity is strongly associated with ototoxicity development in children, and this risk is further increased by the presence of TPMT -risk alleles.

Programmatic Approach to Hearing Health in Low- and Middle-Income Countries

Programmatic Approach to Hearing Health in Low- and Middle-Income Countries

GATA2 at 10: Emergence of Genotype-Phenotye correlations

GATA2 mutations cause adult-onset bone-marrow failure characterized by cytopenias, infections and increased risk of leukemia. We reviewed hospital records and referrals from 232 GATA2 mutation positive individuals from 122 families to gather hematopoietic and syndromic features.Mutations were categorized by effect on GATA2 protein: missense after the 2nd Zinc-finger (C-term, n = 10); missense in the 2nd Zinc-Finger (2nd Zf, n = 104); mutations producing stable truncated protein (truncation, n = 26); null alleles (mRNA instability, large deletions, n = 42); or enhancer (n = 50). Median age at first symptom presentation for the cohort was 20 years.Kaplan-Meier analysis for symptom onset showed differences in age at presentation across truncation and null mutations (median 15 and 18 years, respectively), 2nd Zf (22 years) and enhancer mutations (45 years). A similar analysis of four recurrently mutated 2nd ZF amino acids revealed later symptom onset for R361 and R398 mutations (median 22 and 34 years, respectively) compared to R396 or T354 (16 and 19 years, respectively). Mixed-effect Cox regression analysis corrected for relatedness across patients and confirmed these findings.There was decreased penetrance in enhancer (27/50, 54% symptomatic) and 2nd Zf (85/104, 81.7%) compared to truncation (24/26, 92.3%) and null (39/40, 97.5%) mutation patients. Grouping mutations by median onset before (null, truncation, R396, T354) or after (R361, R398, enhancer) age 20 revealed significantly increased incidence of cytopenias, HPV, myelodysplastic syndrome and hearing loss among the early onset mutation group. Additionally, age of cytopenia or myelodysplasia syndrome diagnosis was significantly younger in the early onset group (P = 0.0019, P = 0.0012 respectively).Males had more monosomy 7 (11/92 males, 4/142 females, P < 0.0001). Nontuberculous mycobacterial infection was the presenting symptom in 14/92 males vs 7/142 females (P = 0.0188). Warts/anogenital HPV were common (93/234, 39.7%). Non-hematologic manifestations included hearing loss (46/232; 19.8%), lymphedema (30/232; 12.8%), and non-hematologic malignancies (46/232, 19.8%), the majority being HPV-related ano-genital cancers. Hematologic malignancy occurred in 26/234 patients (11%).This comprehensive analysis demonstrates that GATA2 mutation type, and specific mutations, affect penetrance and expression. Gender is an independent risk for specific infectious complications and cytogenetic abnormalities.

Audiometry-Confirmed Sudden Sensorineural Hearing Loss Incidence Among COVID-19 Patients and BNT162b2 Vaccine Recipients.

Cohen Michael, Ori B.Med.Sc; Tamir, Sharon Ovnat M.D.; O'Rourke, Norm Ph.D.; Marom, Tal M.D. Author Information

Sensorineural Hearing Loss Among COVID-19 Patients and BNT162b2 Vaccine Recipients: Comment.

To the Editor: We would like to share ideas on the publication “Audiometry-confirmed sudden sensorineural hearing loss incidence among COVID-19 patients and BNT162b2 vaccine recipients” (1). The incidence rates of sudden sensorineural hearing loss (SSNHL) during the 2019 COVID-19 epidemic and COVID-19 vaccine campaign were compared with pre–COVID-19 periods by Cohen Michael et al. (1). There were fewer SSNHL instances during the first COVID-19 months, according to Cohen Michael et al. (1). Although the SSNHL rate increased during the COVID-19 vaccination campaign, Cohen Michael et al. (1) noted that it was not greater for individuals who got the BNT162b2 vaccine. Whether or not the COVID-19 vaccination is related to the detected clinical problem is an intriguing subject. It could be difficult to come up with the answer. It may be challenging to pinpoint the precise clinical link, which is an important element to consider, because of a lack of clinical information on the physiological and immunological status of vaccine recipients before injection. Even when they are, comorbidities are rarely discussed in clinical reports. Establishing the specific therapeutic relationship may occasionally be challenging because of the lack of data on the health and immunological status of vaccine recipients before injection. It is possible that the patient's comorbidities made things worse. How concurrent medical conditions affect clinical outcomes is a key challenge (2). Genetics, last but not least, also has an effect (3). It is impossible to pinpoint the precise clinical association for any of the reports because of a lack of information. Rujittika Mungmunpuntipatip, Ph.D.Private Academic Consultant, Bangkok Thailand [email protected]Viroj Wiwanitkit, M.D.Joseph Ayobabalola University Ikeji-Arakeji, NigeriaDr. DY Patil Medical College–Dr. D. Y. Patil Vidyapeeth Pune, India

Noise-induced Hearing Loss among Non-Medical Workers in a Healthcare Institution

Introduction: The effects of prolonged and excessive noise exposure on healthcare workers have not been studied. This study aims to estimate the prevalence of hearing loss among such workers and correlate the degree of hearing loss with age, duration of exposure, and coexisting illnesses. Methods: A retrospective review of 117 clinical records was conducted on 179 employees working in areas of excessive noise in a tertiary care hospital. Correlations between categorical variables were made using the Chi-square and Fisher's exact tests, while an independent samples t-test was used to compare means for continuous variables. Binary logistic regression was used to quantify the strength of correlations through an odds ratio and 95% confidence interval. Results: A clinical evaluation was conducted to assess hearing loss on employees from various departments, including Boiler Section, Central Sterile Supply Department (CSSD), Laundry, Prosthetics and Orthotics Laboratory, and Dietary. The median age of the participants was 37 years. Out of the 116 participants who underwent by audiological tests, 63.8% had sensorineural hearing loss and 68.5% had absent otoacoustic emissions in at least one frequency. The incidence of hearing loss was found to increase with age (p = 0.037). A significant correlation was noted between hearing loss and the duration of noise exposure of more than 10 years (p = 0.0013). Considering all areas together, a significantly higher proportion of employees with hearing loss was observer (p = 0.044), with 69.5% in the CSSD. Conclusion: Noise-induced hearing loss is a prevalent occupational health hazard in healthcare settings. The risk of developing hearing loss increases with the duration of work in a noise-generating area.

Comparison of Hearing Thresholds among Patients on Treatment for Drug-Resistant Versus Drug-Susceptible Pulmonary Tuberculosis in A SubSaharan African Healthcare Setting

Background: Pulmonary tuberculosis is a debilitating infectious disease that affects all age groups and sadly, a leading cause of death in developing countries particularly in sub-Saharan Africa. One major challenge facing the global efforts against tuberculosis is drug-resistance, which necessitates the use of aminoglycoside-based second line drugs that are known to have ototoxic potentials. Hearing impairment can be a source of social distress, professional disability and in some cases, litigation. This research compared the pure tone audiometric patterns of patients on treatment for drug-resistant versus drug-susceptible pulmonary tuberculosis. The incidence of hearing loss between the groups was assessed. Patients and Method: The research was a prospective comparative study of all eligible newly diagnosed pulmonary tuberculosis patients admitted into the Pulmonology unit of Federal Medical Centre, Owerri, Nigeria. Pre-treatment (baseline) and monthly pure tone audiometry was done for each patient before and during treatment respectively. The patients were followed up and assessed for three months. Data collected was analyzed with Statistical Package for Social Sciences (SPSS) version 20.0 software for Windows. Statistical significance was set at p&lt; 0.05. Results: A total of 76 patients (38 in each group) completed the study. The M:F ratio was 1.53:1 and 1.24:1 for the drug resistant and drug susceptible groups respectively while the mean duration of presenting symptoms were 11.7 ± 7.8 and 7.4 ± 5.1 weeks for the groups respectively. The prevalence of baseline hearing impairment was 73.7% among both groups while by the third month it was 89.5% among the dug-resistant group and 78.9% among the drug-susceptible group implying a cumulative incidence of hearing loss of 15.8% and 5.3% respectively over three months. This difference was statistically significant. Conclusion: The incidence of hearing impairment among patients on treatment for drug-resistant pulmonary tuberculosis was approximately three-fold higher than their drug susceptible counterparts after three months of treatment; this was statistically significant.