Hearing Loss In Patients Research Articles

Effect of diabetes mellitus on sensorineural hearing loss patients in a tertiary healthcare centre

In patients with diabetes mellitus, by the time hearing loss is detected using conventional tuning for ktests, damage has already affected the sensorineural component, which will affect the hearing component of the patient and hence affect the quality of life. Therefore by using audiometry early detection of hearing loss in people affected with Type 2 Diabetes mellitus scan be done. It will help us to take early steps to make the patients affected by diabetes aware of the deafness and to take early measures for prevention and further progression of deafness.

HEARING LOSS IN PATIENTS WITH COVID-19

Objective
 Worldwide, scientists continue to follow-up on patients
 recovered from COVID-19 and have published the
 long-term persistent symptoms and permanent
 damage observed in various tissues. The present
 study aimed to evaluate hearing loss in patients
 with COVID-19 on the basis of pure tone averages
 measured using pure tone audiometry.
 Material and Method
 In this retrospective data analysis study, pure
 tone averages of non-hospitalised patients with
 COVID-19 were compared over 1 year before and
 after contracting COVID-19. Continuous variables
 were presented as mean ± Standard deviation
 (SD) and categorical variables were presented as
 number (n) and percentage (%). All data showed
 normal distribution. Therefore, paired t-test, a type of
 parametric test, was used to identify the significant
 differences between the measurements.
 Results
 The pure tone threshold values of patients increased
 significantly after COVID-19 (p0.001 for all) based on
 puretone averages measured in the bones and airways
 of theleftandrightears. Olderadults (41–64 yearsold)
 had a greater difference in puretone averages of the
 left ear airway before and after COVID-19 (p=0.040)
 than younger adults (18–40 yearsold).
 Conclusion
 COVID-19 affects both ears' bones and airways,
 causing varying degrees of hearing loss at different
 frequencies. Hearing loss tests should be included
 in COVID-19 complications research, and clinicians
 should be given advice on how to avoid hearing loss.

Diagnostic and predictive values of serum metabolic profiles in sudden sensorineural hearing loss patients.

Sudden sensorineural hearing loss (SSNHL) is an otologic emergency, and metabolic disturbance is involved in its pathogenesis. This study recruited 20 SSNHL patients and 20 healthy controls (HCs) and collected their serum samples. Serum metabolites were detected by liquid chromatography-mass spectrometry, and metabolic profiles were analyzed. All patients were followed up for 3 months and categorized into recovery and non-recovery groups. The distinctive metabolites were assessed between two groups, and their predictive values for hearing recovery were evaluated. Analysis results revealed that SSNHL patients exhibited significantly characteristic metabolite signatures compared to HCs. The top 10 differential metabolites were further analyzed, and most of them showed potential diagnostic values based on receiver operator characteristic (ROC) curves. Finally, 14 SSNHL patients were divided into the recovery group, and six patients were included in the non-recovery group. Twelve distinctive metabolites were observed between the two groups, and ROC curves demonstrated that N4-acetylcytidine, p-phenylenediamine, sphingosine, glycero-3-phosphocholine, and nonadecanoic acid presented good predictabilities in the hearing recovery. Multivariate analysis results demonstrated that serum N4-Acetylcytidine, sphingosine and nonadecanoic acid levels were associated with hearing recovery in SSNHL patients. Our results identified that SSNHL patients exhibited distinctive serum metabolomics signatures, and several serum biomarkers were proved to be potential in predicting hearing recovery. The discriminative metabolites might contribute to illustrating the mechanisms of SSNHL and provide possible clues for its treatments.

Profiling hearing aid users through big data explainable artificial intelligence techniques.

Debilitating hearing loss (HL) affects ~6% of the human population. Only 20% of the people in need of a hearing assistive device will eventually seek and acquire one. The number of people that are satisfied with their Hearing Aids (HAids) and continue using them in the long term is even lower. Understanding the personal, behavioral, environmental, or other factors that correlate with the optimal HAid fitting and with users' experience of HAids is a significant step in improving patient satisfaction and quality of life, while reducing societal and financial burden. In SMART BEAR we are addressing this need by making use of the capacity of modern HAids to provide dynamic logging of their operation and by combining this information with a big amount of information about the medical, environmental, and social context of each HAid user. We are studying hearing rehabilitation through a 12-month continuous monitoring of HL patients, collecting data, such as participants' demographics, audiometric and medical data, their cognitive and mental status, their habits, and preferences, through a set of medical devices and wearables, as well as through face-to-face and remote clinical assessments and fitting/fine-tuning sessions. Descriptive, AI-based analysis and assessment of the relationships between heterogeneous data and HL-related parameters will help clinical researchers to better understand the overall health profiles of HL patients, and to identify patterns or relations that may be proven essential for future clinical trials. In addition, the future state and behavioral (e.g., HAids Satisfiability and HAids usage) of the patients will be predicted with time-dependent machine learning models to assist the clinical researchers to decide on the nature of the interventions. Explainable Artificial Intelligence (XAI) techniques will be leveraged to better understand the factors that play a significant role in the success of a hearing rehabilitation program, constructing patient profiles. This paper is a conceptual one aiming to describe the upcoming data collection process and proposed framework for providing a comprehensive profile for patients with HL in the context of EU-funded SMART BEAR project. Such patient profiles can be invaluable in HL treatment as they can help to identify the characteristics making patients more prone to drop out and stop using their HAids, using their HAids sufficiently long during the day, and being more satisfied by their HAids experience. They can also help decrease the number of needed remote sessions with their Audiologist for counseling, and/or HAids fine tuning, or the number of manual changes of HAids program (as indication of poor sound quality and bad adaptation of HAids configuration to patients' real needs and daily challenges), leading to reduced healthcare cost.

Intrinsic Network Changes in Bilateral Tinnitus Patients with Cognitive Impairment: A Resting-State Functional MRI Study

Previous studies have found a link between tinnitus and cognitive impairment, even leading to dementia. However, the mechanisms underlying this association are not clear. The purpose of this study was to explore intrinsic network changes in tinnitus and hearing loss patients with cognitive disorders. We included 17 individuals with bilateral idiopathic tinnitus, hearing loss, and cognitive impairment (PA) and 21 healthy controls. We identified resting-state networks (RSNs) and measured intra-network functional connectivity (FC) values via independent component analysis (ICA). We also evaluated correlations between RSNs and clinical characteristics. Compared with the healthy controls, the PA group showed decreased connectivity within the ventral attention network, dorsal attention network (DAN), visual network, left frontoparietal network, right frontoparietal network, sensorimotor network, and increased connectivity within the executive control network. MoCA (Montreal Cognitive Assessment) scores were negatively correlated with the FC values for left calcarine within the DAN. We identified abnormal intrinsic connectivity in several brain networks, mainly involving cognitive control, vision, sensorimotor function, and the cerebellum, in tinnitus patients with cognitive impairment. It may be possible to use the FC strength of the left calcarine within the DAN as an imaging marker to predict cognitive impairment in tinnitus patients.

Related factors to the coping style of patients with sudden sensorineural hearing loss.

Coping style can affect the patient's physical and mental health management. Therefore this study aimed to identify factors related to the coping style of young and middle-aged sudden sensorineural hearing loss (SSNHL) patients to provide reference for clinical nursing practice. A cross-sectional study was conducted on young and middle-aged SSNHL patients hospitalized in the otolaryngology departments of four hospitals in Suzhou City, China. A paper-based self-administered questionnaire investigated the patient's coping style and related factors. Multiple linear stepwise regression analysed the effective related factors in patients' coping styles. Among 872 patients, 866 completed the survey, with an average age of 37.27y. Factors related to the coping style of these patients included gender, chronic diseases, history of trauma, social support and type D personality (p<0.05). Female patients adopt more negative coping styles than male patients. Patients with chronic diseases or a history of trauma had more positive coping styles. Higher social support scores were related to improvements in coping style. Patients with type D personality were more likely to adopt negative coping styles. This study suggests that psychological assessment of patients, chronic diseases, history of trauma, social support and type D personality may benefit the understanding of these patients' coping styles and, as a consequence, may improve their stress management.

Otoacoustic emissions value in patients with idiopathic sudden sensorineural hearing loss

ObjectivesThis study aimed to determine the prognostic value of otoacoustic emissions (OAEs) in idiopathic sudden sensorineural hearing loss patients. MethodsThe study included 30 subjects with unilateral idiopathic sudden sensorineural hearing loss (ISSNHL). Each patient was evaluated four times: at baseline and after one week, one month, and three months of treatment. During each visit, each patient was subjected to full audiological history, otoscopic examination, basic audiological evaluations, and transiently evoked and distortion product otoacoustic emission (TEOAEs & DEOAEs). ResultsThe hearing thresholds (frequency range 250–8000 Hz) and word recognition scores of patients with detectable TEOAEs and DPOAEs improved significantly, whereas no significant improvements were observed in those with no response. ConclusionHearing improvement is better in patients with detectable TEOAEs and DPOAEs. As a result, TEOAEs and DPOAEs are recommended as routine tests in all SSNHL patients to predict outcomes and monitor treatment as TEOAEs and DPOAEs reflect the cochlear OHCs activity.

Altered Amplitude of Low-Frequency Fluctuations and Degree Centrality in Patients with Acute Subjective Tinnitus: A Resting-State Functional Magnetic Resonance Imaging Study.

The difference in spontaneous brain activity between acute subjective tinnitus patients (with or without hearing loss) and control participants was explored using the amplitude of low-frequency fluctuations and degree centrality methods through resting-state functional magnetic resonance imaging. The study aimed to provide an objective basis for clinical diagnosis and pathogenesis of patients with acute subjective tinnitus. Fourteen acute subjective tinnitus (AST) patients with hearing loss (AST-HL), 6 AST patients with no hearing loss (AST-NHL), and 14 healthy controls (HCs) with age, sex, and education status matched were recruited for this study. Resting-state functional magnetic resonance imaging (fMRI) examinations were performed in a resting state and the amplitude of low-frequency fluctuations (ALFF) and degree centrality (DC) values of each group were acquired. Statistical analysis was performed to assess the ALFF and DC values of different brain areas of the participants (AST-HL and AST-NHL were compared with HCs, but AST-HL and AST-NHL were not). Patients with acute subjective tinnitus and hearing loss showed a significantly increased amplitude of low-frequency fluctuation values in the left middle temporal gyrus and bilateral frontal gyrus/marginal lobe/cingulate gyrus but a decreased amplitude of low-frequency fluctuations values in the bilateral superior temporal gyrus/anterior cerebellar lobe in comparison with healthy controls. The amplitude of low-frequency fluctuation values of patients with acute subjective tinnitus and hearing loss in the right posterior lobe of the cerebellum, bilateral temporal gyrus, bilateral lenticular nucleus, bilateral frontal gyrus, right inferior occipital gyrus, were higher, but were significantly lower in the bilateral anterior lobe of cerebellum/superior temporal gyrus and left posterior cerebellar lobe as compared with those of healthy controls. Degree centrality values in the healthy controls group were increased in the right superior marginal gyrus and decreased in the right thalamus in patients with acute subjective tinnitus and hearing loss, while patients with acute subjective tinnitus with no hearing loss presented significantly higher degree centrality values in the left frontal lobe and lower degree centrality values in the left center rear return. Aberrant amplitude of low-frequency fluctuations and values exist in various brain regions, indicating abnormal spontaneous brain activity in both acute subjective tinnitus and hearing loss and acute subjective tinnitus no hearing loss patients. The pathogenesis of acute subjective tinnitus may be related to abnormalities in both the auditory cortex and nonauditory cortex. These findings provide more evidence to help clarify the neuronal symptoms of acute subjective tinnitus patients.

DESIGN AND IMPLEMENTATION OF A PORTABLE AUTOMATED AUDIOMETER FOR HEARING CLASSIFICATION USING MACHINE LEARNING APPROACHES

Audiometric tests can identify the hearing loss at specific frequencies using the audiogram. The aim and objectives of the study were (i) to develop an automated audiometer for self-diagnosing the hearing ability of the patient; (ii) to extract the features from the acoustic signals and to classify the normal and profound hearing loss patients using different machine learning algorithms; (iii) to validate the hearing loss classification using six-frequency average (6-FA) method based on simple linear regression analysis and machine learning algorithms. The study is conducted among 150 patients, including 75 patients with normal hearing ability and 75 patients with profound hearing loss. The total population of 150 underwent audiometric test both in the soundproof audiometric room and in the normal field environment. Based on the patient response, the intensity and frequency are changed automatically, and the audiogram is plotted by the principle of Artificial Neural Network learning procedures. The overall accuracy produced by classification of normal and profound hearing loss patients using Support Vector Machine (SVM), k-Nearest Neighbor classifier, and Naïve Bayes classifier is 97%, 96%, and 95%, respectively. The results indicated that the SVM classifier outperforms the other two classifiers well. The preliminary audiometric test can be performed remotely and then consulted with an audiologist. Thus, the patient could operate the developed prototype independently and get a consultation from trained medical personnel.

Differential weighting of temporal envelope cues from the low-frequency region for Mandarin sentence recognition in noise

BackgroundTemporal envelope cues are conveyed by cochlear implants (CIs) to hearing loss patients to restore hearing. Although CIs could enable users to communicate in clear listening environments, noisy environments still pose a problem. To improve speech-processing strategies used in Chinese CIs, we explored the relative contributions made by the temporal envelope in various frequency regions, as relevant to Mandarin sentence recognition in noise.MethodsOriginal speech material from the Mandarin version of the Hearing in Noise Test (MHINT) was mixed with speech-shaped noise (SSN), sinusoidally amplitude-modulated speech-shaped noise (SAM SSN), and sinusoidally amplitude-modulated (SAM) white noise (4 Hz) at a + 5 dB signal-to-noise ratio, respectively. Envelope information of the noise-corrupted speech material was extracted from 30 contiguous bands that were allocated to five frequency regions. The intelligibility of the noise-corrupted speech material (temporal cues from one or two regions were removed) was measured to estimate the relative weights of temporal envelope cues from the five frequency regions.ResultsIn SSN, the mean weights of Regions 1–5 were 0.34, 0.19, 0.20, 0.16, and 0.11, respectively; in SAM SSN, the mean weights of Regions 1–5 were 0.34, 0.17, 0.24, 0.14, and 0.11, respectively; and in SAM white noise, the mean weights of Regions 1–5 were 0.46, 0.24, 0.22, 0.06, and 0.02, respectively.ConclusionsThe results suggest that the temporal envelope in the low-frequency region transmits the greatest amount of information in terms of Mandarin sentence recognition for three types of noise, which differed from the perception strategy employed in clear listening environments.

Prognostic values of LDH and Hematological factors in Patients with Sudden Hearing Loss

Objective: In our study, we aimed to evaluate the relationship between Lactate Dehydrogenase and hematological parameters, neutrophil, Neutrophil lymphocyte ratio, platelet lymphocyte ratio, and mean platelet volume serum levels in patients with Sudden sensorineural hearing loss prognosis. Methods: 60 patients were hospitalized and treated for Sudden Hearing Loss at Dicle University Hospital Ear Nose Throat Clinic between May 2013 and April 2020, and 60 healthy individuals without any health problems were included in the study. Pretreatment peripheral blood was drawn from all subjects, followed by routine blood cell analysis. The absolute numbers of neutrophils, lymphocytes, and platelets in peripheral blood were obtained, and the Neutrophil lymphocyte ratio, platelet lymphocyte ratio, and mean platelet volume of each case were calculated. Results: A total of 120 participants, including 60 Sudden sensorineural hearing loss patients case group and 60 healthy individuals in the control group, were included in the study. The median age of the case group was 46.0 (29.0-55.0), and the control group was 48.0 (33.5-58.5), and no statistically significant difference was found between the groups in terms of age (p = 0.191). The median Lactate Dehydrogenase, Neutrophil, and Neutrophil lymphocyte ratio of the case group was significantly higher than the control group (p &lt;0.05). There was no significant difference between the groups in terms of thrombocyte, mean platelet volume, lymphocyte, platelet lymphocyte ratio, body mass index, and gender (p&gt; 0.05). Conclusion: We think that the increase in Lactate Dehydrogenase level may be a poor prognostic factor in patients with sudden hearing loss that does not improve. In addition, we believe that the increase in neutrophil count and Neutrophil lymphocyte ratio is quite significant but cannot be considered a poor prognostic factor.

Intrinsic network changes associated with cognitive impairment in patients with hearing loss and tinnitus: a resting-state functional magnetic resonance imaging study.

BackgroundHearing loss and tinnitus often occur concurrently and play a vital role in the development and progression of cognitive impairment (CI). However, the exact mechanism remains unclear. This study aimed to investigate the changes in intrinsic brain connectivity in patients with hearing loss and tinnitus accompanied by CI.MethodsA total of 24 hearing loss and tinnitus patients with CI, 23 hearing loss and tinnitus patients with cognitive normality (CN), and 20 healthy controls (HCs) underwent resting-state functional magnetic resonance imaging (rs-fMRI). Resting-state networks (RSNs) were identified and intrinsic functional connectivity (FC) values were measured using independent component analysis (ICA). FC values within the RSNs were measured and correlations between altered RSNs and clinical characteristics were evaluated using Pearson correlation analysis.ResultsNo significant difference was found in the disease duration or Tinnitus Handicap Inventory (THI) scores between the CI and CN groups. Eleven RSNs differed significantly among the 3 groups. Compared with the CN group, the CI group exhibited higher FC in the right supramarginal and left middle temporal gyri within the auditory network (AN), the left inferior parietal, but supramarginal and angular gyrus (IPL) gyrus within the right frontoparietal network (RFPN), the right middle occipital gyrus (R_MOG) and left superior frontal gyrus (L_SFG) within the dorsal attention network (DAN), the right middle frontal gyrus (R_MFG) within the executive control network (ECN), the right cuneus (R_cuneus) within the visual network (VN), and the left inferior frontal gyrus within the salience network (SAN), as well as lower FC in the right superior temporal gyrus (R_STG) within the AN and the left FPN (LFPN) and the right superior frontal gyrus (R_SFG) within the LFPN. Montreal Cognitive Assessment (MoCA) scores were negatively correlated with the FC values of the R_MFG and positively correlated with the FC values of the R_STG and R_SFG.ConclusionsAberrant intrinsic FC was observed in the R_MFG within the ECN, the R_STG within the AN, and the R_SFG within the LFPN in hearing loss and tinnitus patients, which may be a biomarker for the severity of CI in hearing loss and tinnitus patients.

Republication de : Incidence and duration of self-reported hearing loss and tinnitus in a cohort of COVID-19 patients with sudden chemosensory loss: A STROBE observational study

To investigate the self-reported audiological symptoms in a cohort of coronavirus disease 2019 (COVID-19) patients and monitor improvement or recovery. Following the STROBE guidelines for observational studies, a retrospective questionnaire concerning audio-vestibular symptoms was conducted in a cohort of Danish COVID-19 patients with self reported chemosensory loss. Data regarding demographics, symptoms onset, duration and remission was registered in a REDCap database. Of the 225 respondents with chemosensory loss, 59 (26.2%) reported concomitant hearing loss (10.7%) or tinnitus (16.4%). In a follow-up questionnaire focused on ear-symptoms, severity, and duration ( n = 31), 17 reported hearing loss and 21 reported tinnitus. Debut of hearing loss and tinnitus were on average 10 and 30 days respectively, after onset of initial symptoms. Among the hearing loss patients, only two patients experienced full recovery, whereas 15 had partial or no recovery after on average 266 days from COVID-19 symptom onset. Among the tinnitus patients, 7/21 had full recovery, while 14 had partial or no recovery after on average 259 days from COVID-19 symptom onset. In a large Danish cohort of COVID-19 patients, a significant proportion experienced concomitant audiological symptoms which seem long lasting and with negative impact on quality of life. This study warrants further investigation of the association between COVID-19 and audio-vestibular symptoms, and the need for rehabilitation among convalescents.

Frequency of Sensorineural Hearing Loss in Chronic Otitis Media

Objective: To identify the frequency of sensorineural hearing loss in chronic otitis media. Study Design: Cross-sectional study. Place and Duration of Study: Department of ENT, Bacha Khan Medical College, Mardan Medical Complex Mardan from 1st October 2019 to 30th September 2021. Methodology: One hundred patients with chronic suppurative otitis media clinical symptoms and diagnosis were included in the study. The age of the patients was between 11-50 years. A mean of 0.05 an average result of three recorded frequencies on an audiogram was calculated. With an increase in chronic suppurative otitis media duration the number of sensorineural hearing loss patients was determined. Results: The mean age was 36.3±6.6 years with 54% males and 46% females. The frequency of sensorineural hearing loss was reported as 51 (51%) of the otitis media disease patients were suffering from sensorineural hearing loss condition while the similar condition was not seen in the 49% of the chronic suppurative otitis media patients. Conclusion: A high frequency of sensorineural hearing loss was recorded in the chronic suppurative otitis media patients. Keywords: Sensorineural, Otitis media, Hearing loss

APSO Standards: Implementing Hearing Aid Needs Assessments and Measuring Related Outcomes.

The proportion of individuals who pose to benefit from the use of hearing aids is much smaller than those who adopt them. Likewise, many adults who try hearing devices abandon using them after a short period of time. Most factors related to hearing aid use are unrelated to a patient's hearing loss severity. Hearing loss treatment requires more than the provision of hearing aids as a sole intervention. Adoption rates could be improved through the implementation of evidence-based clinical protocols which maximize patients' success. Recently, the Audiology Practice Standards Organization (APSO) released evidence-based, formal standards of practice addressing hearing aid selection, fitting, and rehabilitation for adult and geriatric patients. Notably, the standards acknowledge the importance of an amplification needs assessment, including hearing aid outcomes measurement. In this brief narrative, we describe Standards 3 and 14 ( Needs Assessment and Hearing Aid Outcomes Measurement ) and offer an example of the clinical implementation of a comprehensive needs assessment and hearing aid outcomes measurement currently being used in a multisite, longitudinal clinical trial.

Etiology of hearing loss affects auditory skill development and vocabulary development in pediatric cochlear implantation cases

Background Cochlear implantation (CI) is an effective treatment for severe-to-profound hearing loss patients and is currently used as the standard therapeutic option worldwide. However, the outcomes of CI vary among patients. Aims/Objectives This study aimed to clarify the clinical features for each etiological group as well as the effects of etiology on CI outcomes. Materials and methods We collected clinical information for 308 pediatric cochlear implant cases, including the etiology, hearing thresholds, age at CI, early auditory skill development, total development, monosyllable perception, speech intelligibility and vocabulary development in school age, and compared them for each etiology group. Results Among the 308 CI children registered for this survey, the most common etiology of hearing loss was genetic causes. The genetic etiology group showed the most favorable development after CI followed by the unknown etiology group, syndromic hearing loss group, congenital CMV infection group, inner ear malformation group, and cochlear nerve deficiency group. Conclusions and significance Our results clearly indicated that the etiology of HL affects not only early auditory skill development, but also vocabulary development in school age. The results of the present study will aid in more appropriate CI outcome assessment and in more appropriate intervention or habilitation programs.

Automatic Speech Discrimination Assessment Methods Based on Event-Related Potentials (ERP).

Speech discrimination is used by audiologists in diagnosing and determining treatment for hearing loss patients. Usually, assessing speech discrimination requires subjective responses. Using electroencephalography (EEG), a method that is based on event-related potentials (ERPs), could provide objective speech discrimination. In this work we proposed a visual-ERP-based method to assess speech discrimination using pictures that represent word meaning. The proposed method was implemented with three strategies, each with different number of pictures and test sequences. Machine learning was adopted to classify between the task conditions based on features that were extracted from EEG signals. The results from the proposed method were compared to that of a similar visual-ERP-based method using letters and a method that is based on the auditory mismatch negativity (MMN) component. The P3 component and the late positive potential (LPP) component were observed in the two visual-ERP-based methods while MMN was observed during the MMN-based method. A total of two out of three strategies of the proposed method, along with the MMN-based method, achieved approximately 80% average classification accuracy by a combination of support vector machine (SVM) and common spatial pattern (CSP). Potentially, these methods could serve as a pre-screening tool to make speech discrimination assessment more accessible, particularly in areas with a shortage of audiologists.

PREDICTING THE SUBJECTIVE HEARING OUTCOME IN TYPE I TYMPANOPLASTY USING BELFAST 15/30DB RULE OF THUMB.

OBJECTIVE: Both Otologists and patients mutually hope for an improvement in hearing and a functional benet from an ear surgery to correct unilateral conductive hearing loss that has been reported as the closure of air-bone gap or reduction in air conduction thresholds. While these provide a measure of technical success of the operation, they may not always translate into real life benet for the patient. This is because listening is a binaural task and benet to the patient is determined by numerous factors, of paramount importance is hearing in the non-operated ear. With the aim, to estimate patient benet in terms of subjective hearing gain after type I tympanoplasty, we reviewed the Belfast 15/30 dB rule of thumb. METHOD: A 100 cases of chronic otitis media with inactive mucosal disease having conductive hearing loss, who had undergone type I tympanoplasty were included. Hearing was assessed using pure tone audiogram with average of, .5, 1, 2 &amp; 4Hz and a detailed questionnaire regarding the subjective perception of hearing was obtained pre and 6 month post-operatively which was correlated with Belfast 15/30 dB rule of thumb. RESULT: The predictive value as per pure tone audiometry with Belfast 15/30 dB rule of thumb is 89% with a conclusion that the objective hearing improvement (88.1%) does not necessarily transform into patients' perception of hearing improvement (78.4%) CONCLUSION: Hearing is a binaural function and this should always be kept in mind while operating on unilateral/ asymmetric hearing loss patients as mere closure of air-bone gap or reduction in air conduction threshold might not conclude patients' perception of hearing gain. Belfast 15/30 dB rule of thumb has proved to be a valuable tool in predicting the subjective improvement of hearing

Analysis of the genotype\u2013phenotype correlation of MYO15A variants in Chinese non-syndromic hearing loss patients

BackgroundMutations in the MYO15A gene are a widely recognized cause of autosomal recessive non-syndromic sensorineural hearing loss (NSHL) globally. Here, we examined the role and the genotype–phenotype correlation of MYO15A variants in a cohort of Chinese NSHL cases.MethodsEighty-one cases with evidenced MYO15A variants from the 2263 Chinese NSHL cases, who underwent next-generation sequencing (NGS), were enrolled in the study. We investigated the association of MYO15A variants with the severity, progression and age of onset of hearing loss, as well as compared it to the previous reports in different nationalities. The cases were divided into groups according to the number of truncating variants: 2 truncating, 1 truncating and 1 non-truncating, 2 non-truncating variants, and compared the severity of HL among the groups.ResultsMYO15A accounted for 3.58% (81/2263) of all NSHL cases. We analyzed 81 MYO15A-related NSHL cases, 73 of whom were with congenital bilateral, symmetric or severe-to-profound hearing loss (HL), however, 2 of them had a postlingual, asymmetric, mild or moderate HL. There were 102 variants identified in all MYO15A structural domains, 76.47% (78/102) of whom were novel. The most common types of detected variants were missense (44/102, 43.14%), followed by frameshift (27/102, 26.47%), nonsense (14/102, 13.72%), splice site (10/102, 9.80%), in frame (4/102, 3.92%), non-coding (2/102, 1.96%) and synonymous (1/102, 0.98%). The most recurrent variant c.10245_10247delCTC was detected in 12 cases. We observed that the MYO15A variants, located in its N-terminal, motor and FERM domains, led to partial deafness with better residual hearing at low frequencies. There were 34 cases with biallelic truncating variants, 37 cases with monoallelic truncating variants, and 13 cases with biallelic non-truncating variants. The biallelic non-truncating variants group had the least number of cases (12/81), and most of them (10/12) were with profound NSHL.ConclusionsMYO15A is a major gene responsible for NSHL in China. Cases with MYO15A variants mostly showed early-onset, symmetric, severe-to-profound hearing loss. This study is by far the largest focused on the evaluation of the genotype–phenotype correlations among the variants in the MYO15A gene and its implication in the outcome of NSHL. The biallelic non-truncating MYO15A variants commonly caused profound HL, and the cases with one or two truncating MYO15A variants tended to increase the risk of HL. Nevertheless, further investigations are needed to clarify the causes for the variable severities and progression rates of hearing loss and the detected MYO15A variants in these cases.

Objective Audiological Test Procedures: Indications and Differential Diagnostics

Diagnostics of hearing loss comprises subjective and objective methods and is successfully applied since many decades. This article introduces into the methods of impedance audiometry, otoacoustic emissions, auditory evoked potentials and electrically evoked potentials and describes the respective methodologies. Using an exemplary case, in this article we guide through all stages of objective audiological diagnostics and introduce the scientific and technical background, the application and evaluation of the findings of the objective test procedures. An application pathway for objective audiometric diagnostic tools is also described, including newborn hearing screening, differential diagnostics of hearing loss, auditory neuropathy, sudden sensorineural hearing loss, vestibular schwannoma and pediatrics patients. Finally, the application to patients with active middle-ear implants and cochlear implants is described.