Hearing Threshold Levels Research Articles

Hypothesis testing for detecting outlier evaluators.

In epidemiological studies, the measurements of disease outcomes are carried out by different evaluators. In this paper, we propose a two-stage procedure for detecting outlier evaluators. In the first stage, a regression model is fitted to obtain the evaluators' effects. Outlier evaluators have different effects than normal evaluators. In the second stage, stepwise hypothesis tests are performed to detect outlier evaluators. The true positive rate and true negative rate of the proposed procedure are assessed in a simulation study. We apply the proposed method to detect potential outlier audiologists among the audiologists who measured hearing threshold levels of the participants in the Audiology Assessment Arm of the Conservation of Hearing Study, which is an epidemiological study for examining risk factors of hearing loss.

Research on the prognosis and efficacy criteria of sudden sensorineural hearing loss

Sudden sensorineural hearing loss is a common and frequently-occurring disease. Looking at the efficacy evaluation of the diagnosis and treatment of sudden sensorineural hearing loss at home and abroad, each country has its own characteristics in the indicators and criteria of the treatment efficacy evaluation, and the common indicators of efficacy evaluation include: average pure-tone hearing threshold, the absolute value of hearing improvement of impaired frequency, the percentage of average pure-tone hearing threshold increase, speech discrimination score, speech recognition threshold, etc. The evaluation criteria mostly take the efficacy grade or the improvement level of average hearing threshold as the criterion of effective treatment, and the lack of unified standards is not conducive to the homogenization of global research related to sudden sensorineural hearing loss. In order to provide reference for the clinical evaluation of sudden sensorineural hearing loss in China, this study systematically reviewed the clinical practice guidelines and the evaluation indexes and criteria of clinical efficacy in high quality clinical multicenter studies of the disease in many countries.

Stimulation conditions leading to electrical vestibular co-stimulation in cochlear implant users.

The study objective was to investigate the influence of electrical stimulus properties on cervical and ocular vestibular-evoked myogenic potentials to electrical stimulation by cochlear implants (e-cVEMPs, e-oVEMPs). E-VEMPs were recorded in adult Nucleus cochlear implant (CI) patients using electric pulse trains (4 biphasic pulses at 1000 Hz burst rate). Ground path and stimulation electrodes were varied between monopolar stimulation at basal electrode contact E3 (MP1 + 2 E3), monopolar stimulation at apical electrode contact E20 (MP1 + 2 E20), and bipolar transmodiolar stimulation between E3 and E14 (BP E3-E14). The electric pulse train was further varied to 2 pulses at 1000 Hz, 2 pulses at 500 Hz, and a single pulse, in patients with present e-VEMP responses. VEMPs to bone-conducted vibration (BCV) were recorded as reference in all participants. Measurements were conducted in 30 ears of 27 participants (mean age 49.3 years, SD 12.7 years). E-VEMPs were present in 13 ears (43%). 5 of the 13 cases showed e-VEMPs but no BCV evoked VEMPs. Response numbers increased with increasing stimulation levels. The highest response rate of 40% was obtained for MP1 + 2 E3 stimulation. Stimulus variation did not affect response numbers. E-VEMP amplitudes were comparable to BCV-stimulated VEMPs. Latencies were up to 3.1 ms shorter for electric stimulation. Some patients showed e-VEMP thresholds close to or below the electric hearing threshold level. The occurrence of e-VEMPs is dependent on current path and stimulation level. Vestibular co-stimulation by the CI is more likely in patients with high stimulation levels and for monopolar stimulation of basal electrode contacts. 4.

Effect of exposure to recreational noise on hearing threshold levels in medical students

Introduction: Noise exposure may cause a kind of sensorineural hearing loss. Noise-induced hearing loss is known as an occupational disease, but the effect of exposure to recreational noise is not completely understood. This study aimed to assess the impact of exposure to recreational noise on hearing status. Materials and Methods: This was a cross-sectional study of 304 medical students. The participants were randomly selected from medical students in years 4 to 6 and were divided into two groups regarding their exposure to recreational noise. Conventional audiometry was done for all participants, and hearing thresholds at different frequencies were compared between two groups. Data were analyzed using SPSS (ver. 20) using Kolmogorov-Smirnov, Mann-Whitney U, and chi-square tests. Results: The mean age of the participants was 23.18±3.14 years. In total, 74.7% of participants were exposed to recreational noise. The mean duration of noise exposure was 4.67±2.91 years. The most frequent exposure was to music via a headphone or hands-free (27.3%). All hearing thresholds in both groups were within the normal range and there was no significant difference between the two groups regarding hearing thresholds. Conclusion: The results of the present study showed that any exposure type of recreational noise (music, eulogy, or lecture) in the young population did not affect hearing thresholds.

Microplastic polyethylene induced inner ear dysfunction in murine model

While the hazardous effects of microplastics (MPs) are increasingly reported, it remains uncertain if MPs induce inner ear dysfunction. Nonetheless, prevalence of inner ear dysfunction was observed across all age groups. In this study, we investigated whether MP polyethylene affect inner ear function in a murine model. To detect hearing loss and balance defect after polyethylene (PE) exposure, we evaluated hearing threshold levels, assessed cerebral glucose metabolism, conducted transcriptome analysis, and performed behavioral studies. C57BL/6 J mice (5-week-old) were grouped into control (n = 10) and PE-fed groups (n = 10). Mice were orally administered 100 ppm/100 μL (equivalent to 10 μg) of PE every day for 4 months. We identified the accumulation of PE in the cochlea and vestibular region. The fragmented PE in inner ear was 3.00 ± 0.38 µm in size; the administered PE concentration was 1.14 ± 1.06 mg/g. Fourier transform infrared spectrometry confirmed that the properties of the MP were identical with those of PE fed to the mice. Transcriptomic analysis showed up-regulation of PER1, NR4A3 and CEBPB at the PE exposed inner ear tissue and it was confirmed using qRT-PCR, western blotting, and immunofluorescence staining. We observed abnormalities in balance related behavior assessment in the PE group. Exposure to PE increased the hearing thresholds and decreased glucose metabolism in the bilateral lateral entorhinal cortex, right primary auditory cortex, and right secondary auditory cortex. We can conclude that PE exposure induced inner ear dysfunction such as hearing loss and balance disorder.

Hearing Threshold Levels among Clothes Convection Industry Workers in Klaten, Central Java, Indonesia

Introduction: Noise-induced hearing loss is a condition that develops gradually and often goes unnoticed due to the absence of observable symptoms. Noise-induced hearing loss is usually detected after effects on hearing ability, difficulty understanding speech, and communication disorders. This study aims to determine the prevalence of hearing threshold decline in workers in the clothes convection industry in Klaten, Central Java, Indonesia. Methods: A cross-sectional study, with 21 respondents, was conducted from April to June 2023. Data were collected through interviews, measurement of noise levels in the workplace, otoscopic and audiometric examinations, and research questionnaires. Results: Most study respondents were female (85.7%) and workers who had worked for 11-20 years (66.7%). The main results showed that the prevalence of decreasing hearing threshold among workers in this study was 33.3%. Conclusion: The prevalence of hearing threshold decline was correlated with length of work and use of ear protection equipment.

Efficacy and Hemorheology of Ginkgo biloba Extract (EGb 761) in the Treatment of Sudden Sensorineural Hearing Loss: A Retrospective Study.

This study aimed to analyze the therapeutic effect of Ginkgo biloba extract (EGb 761) on sudden sensorineural hearing loss (SSNHL) and its influence on hemorheology. The clinical data of patients diagnosed with SSNHL and admitted to the Wendeng Hospital of Traditional Chinese Orthopedics and Traumatology of Shandong Province from May 2020 to May 2023 were retrospectively analyzed. Based on different clinical treatment protocols, patients were divided into a control group (treated with routine treatment) and an administration group (treated with routine treatment + EGb 761). Both groups underwent drug treatment for 10 days. Subsequently, the hearing threshold, hemorheological parameters (blood high shear viscosity, blood low shear viscosity, plasma viscosity, and platelet aggregation rate) and inflammatory factors and serum levels (C-reactive protein, interleukin-6, tumor necrosis factor-α and soluble vascular cell adhesion molecule-1) of these groups were compared. This study comprised 120 patients, with 66 cases in the control group and 54 cases in the administration group. Following treatment, the total effective rate of the administration group was significantly higher than that of the control group (90.74% vs. 72.73%) (P-value < 0.05). The hearing threshold, hemorheological parameters, inflammatory factors, and serum levels were significantly lower in the administration group than in the control group (P-value < 0.05). Compared with routine treatment, joint EGb 761 in the SSNHL treatment may improve the hearing threshold and hemorheological indexes of patients, inhibit the inflammatory response, and promote the recovery of hearing function. Moreover, no serious adverse reactions are observed, indicating adequate safety.

Focus on the effect of nursing care combined with cognitive intervention and functional training on negative emotion, compliance and quality of life in elderly patients with sudden deafness: A retrospective study.

To explore the effects of focused solution nursing combined with cognitive intervention combined with functional training on negative emotions, compliance and quality of life in elderly patients with sudden deafness. A total of 160 patients with sudden deafness in the elderly who were treated in our hospital from January 2019 to May 2021 were selected as the objects of this retrospective study. Based on different treatment approaches, subjects were divided into a control group and an observation group. Due to reasons such as the COVID-19 pandemic and transfers, 10 cases were lost to follow-up. In total, 75 cases were ultimately lost from both the control and observation groups. The control group implements cognitive intervention and functional training, and the observation group adopts focused solution nursing care on the basis of the control group. Observe and compare the effects of negative emotions, psychological distress, air conduction threshold level, compliance and quality of life of the 2 groups of patients. The air conduction hearing threshold level of the 2 groups of patients after nursing was lower than that before nursing and the observation group was lower than the control group. The positive coping scores of the 2 groups were significantly increased, and the negative coping scores were both significantly reduced and the observation group was in the 2 indicators. The degree of change was greater than that of the control group (P < .05). After nursing, the self-rating anxiety scale (SAS) and self-rating depression scale (SDS) of the observation group were lower than those of the control group (P < .05). The mental vitality score, social interaction score, emotional restriction score, and mental status of the observation group were significantly higher than those of the control group. The observation group's psychological compliance, activity compliance, dietary compliance, and treatment protocol compliance were significantly higher than those of the control group (P < .05). Adopting the focused solution model of nursing care can provide a better nursing recovery for elderly patients with sudden deafness, significantly improve the patient quality of life and anxiety and depression, improve patient compliance with treatment, and provide a certain reference for the nursing of elderly patients with sudden deafness.

Correlation of Grading and Number of Ear Subunits With Auditory Brainstem Response Findings in Children With Microtia.

The association between microtia severity and hearing function has been thoroughly investigated. This study examined the relationship between microtia grade, number of ear subunits (i.e., helix, antihelix, scapha, triangularis fossa, concha, lobule, tragus, and antitragus) with auditory brainstem response (ABR) findings in children with microtia. A retrospective chart review was employed in this study. We analyzed the ABR test results and photographs of 22 children with 30 microtia ears at Dr. Cipto Mangunkusumo National Hospital, Jakarta. The ABR test results were acquired using click (air conduction only) and 500-Hz tone burst stimuli (air- and bone-conduction). Ear photographs were overlaid with a template of a normal ear to determine the number of ear subunits present and the subsequent microtia grade. Number of ear subunits and ABR results were analyzed using the chi-square, Mann-Whitney U, and Spearman's correlation tests. ABR thresholds for click and 500-Hz tone bursts air-conduction were significantly poorer for ears with a subunit < 5 compared to ears with a subunit ≥ 5. No significant difference was observed in 500 Hz bone-conduction ABR thresholds between these groups. Correlation analysis showed a significant negative correlation between increased ear subunits and click ABR thresholds. No significant correlation was found between ear subunits and 500-Hz air- and bone-conduction ABR thresholds. A higher number of ear subunits are associated with a lower hearing threshold, as assessed using ABR with click stimuli. Therefore, the number of ear subunits and microtia grades can be used to examine the hearing level thresholds in infants and children with microtia. https://doi.org/10.23641/asha.25669440.

Utilizing Artificial Neural Networks for Establishing Hearing-Loss Predicting Models Based on a Longitudinal Dataset and Their Implications for Managing the Hearing Conservation Program

BackgroundThough the artificial neural network (ANN) technique has been used to predict noise-induced hearing loss (NIHL), the established prediction models have primarily relied on cross-sectional datasets, and hence, they may not comprehensively capture the chronic nature of NIHL as a disease linked to long-term noise exposure among workers. MethodsA comprehensive dataset was utilized, encompassing eight-year longitudinal personal hearing threshold levels (HTLs) as well as information on seven personal variables and two environmental variables to establish NIHL predicting models through the ANN technique. Three subdatasets were extracted from the afirementioned comprehensive dataset to assess the advantages of the present study in NIHL predictions. ResultsThe dataset was gathered from 170 workers employed in a steel-making industry, with a median cumulative noise exposure and HTL of 88.40 dBA-year and 19.58 dB, respectively. Utilizing the longitudinal dataset demonstrated superior prediction capabilities compared to cross-sectional datasets. Incorporating the more comprehensive dataset led to improved NIHL predictions, particularly when considering variables such as noise pattern and use of personal protective equipment. Despite fluctuations observed in the measured HTLs, the ANN predicting models consistently revealed a discernible trend. ConclusionsA consistent correlation was observed between the measured HTLs and the results obtained from the predicting models. However, it is essential to exercise caution when utilizing the model-predicted NIHLs for individual workers due to inherent personal fluctuations in HTLs. Nonetheless, these ANN models can serve as a valuable reference for the industry in effectively managing its hearing conservation program.

Effects of Astragaloside IV on Hearing, Inflammatory Factors, and Intestinal Flora in Mice Exposed to Noise.

Long-term exposure to noise can cause irreversible hearing loss. Considering that there is no effective drug treatment, it is important to seek preventive treatment for noise-induced hearing loss (NIHL). Although astragaloside IV (AS-IV) protects against NIHL by reducing serum inflammatory factors, there is scarce information on the regulation of inflammatory factors by AS-IV to prevent NIHL. We investigated the hearing thresholds and relationship between the serum levels of inflammatory cytokines and intestinal microbiota of c57bl/6j mice exposed to noise (103 dB SPL 4 h·d-1) for 7 days, treated with or without AS-IV. Our results revealed a lower hearing threshold and lower serum levels of TNF-α, TNF-γ, IL-6, IL-1β, and IFN-γ in the mice treated with AS-IV. Additionally, AS-IV increased the abundance levels of the phylum Firmicutes, class Bacillus, order Lactobacillus, and family Lactobacillus (p < 0.05), and decreased those of the phylum Bacteroidetes and order Bacteroidales (p < 0.05). Lactobacillus and Bacilli negatively correlated with TNF-α, TNF-γ, and IL-1β; Erysipelotrichaceae negatively correlated with INF-γ; and Clostridiales positively correlated with IL-1β. In conclusion, AS-IV reduces the elevation of hearing thresholds in mice, preventing hearing loss in mice exposed to noise, and under the intervention of AS-IV, changes in the levels of inflammatory factors correlate with intestinal flora. We suggest that AS-IV improves intestinal flora and reduces inflammation levels in c57bl/6j mice exposed to noise.

Effect of noise and hand-transmitted vibration exposure on hearing and equilibrium under a simulated work environment with building tools.

Construction workers are exposed to hand-transmitted vibration (HTV) and/or noise caused by vibrating hand tools in the work environment. The present study aims to investigate the effects of exposure to HTV and/or noise on workers' hearing loss and body balance. Forty construction workers were exposed to HTV (10 m/s2 rms, 31.5 Hz) and/or typical construction noise (90 dBA) in three simulated experiment scenarios with the vibrating hand-held tool for 30 minutes over three days. The hearing loss from 1000 to 6000 Hz and the body balance were determined before and after each exposure scenario. Separate noise exposure at all frequencies except for 1000 Hz could significantly affect hearing threshold levels (p-value<0.05). Separate exposure to HTV cannot lead to a remarkable effect on hearing loss (p-value>0.05); however, it can synergistically increase the effect of noise on hearing loss. Also, the affected frequency range in concurrent exposure has been greater than in separate noise exposure. The separate effects of exposure to HTV and noise on the subjects' body balance were not statistically significant (p-value>0.05); however, these effects became significant in concurrent exposure (p-value<0.05). Based on the estimated effect sizes, noise could synergistically increase the observed effect of HTV on body balance. There is a synergistic interaction between HTV and noise on hearing loss and body balance. It seems necessary to pay attention to the risk evaluation of simultaneous exposure to noise and HTV when setting the occupational action limit values.

Does social isolation mediate the association between hearing loss and cognition in adults? A systematic review and meta-analysis of longitudinal studies.

There has been extensive research on the relationship between hearing and cognitive impairment in older adults but little examination of the role of mediating factors. Social isolation is a potential mediator, occurring because of hearing loss, and contributing to accelerated cognitive decline. Previous systematic reviews on this topic area have not considered the temporal nature of hearing loss and cognitive impairment exclusively or examined potential mediators within a longitudinal study design. A systematic review was conducted. Electronic searches were performed in Web of Science, PubMed (Medline), Scopus, EMBASE, PsychInfo, and ProQuest (PsychArticles and ProQuest Dissertation and Theses) based on a search string of keywords relating to hearing loss, social isolation, and cognitive impairment/dementia in June 2023. Papers were critically appraised using the CASP checklists for cohort studies. Risk of bias in the selected studies was assessed using the Item Bank for Assessment of Risk of Bias and Precision for Observational Studies of Interventions or Exposures. Eleven of the 15 included studies provide evidence of a dose-dependent association between hearing threshold (40 dB HL or greater) and later cognitive impairment or incident dementia. Only one study included social isolation as a mediator, which was found to not be a significant contributing factor. The meta-analysis of 5 studies pooled hazard ratio for cognitive impairment due to hearing loss is 1.11 (95% CI: 1.06 to 1.15, p < 0.001). The pooled hazard ratio for incident dementia due to hearing loss was HR 1.21 (95% CI: 1.11 to 1.31, p = 0.002). The analysis of included studies indicate that hearing threshold level affects later cognitive status or dementia diagnosis. There is not enough evidence to determine the role of social isolation as a mediator. Future epidemiology studies need to measure different elements of social isolation and ensure that hearing and cognition are measured at multiple time points.

Trends in Distributions of Hearing Threshold Levels by Ages: A Comparison of the ISO 7029 and Newly Available Country-Specific Data.

Hearing thresholds provide essential information and references about the human auditory system. This study aimed to identify changing trends in distributions of hearing threshold levels across ages by comparing the International Organization for Standardization (ISO) 7029 and newly available data after publishing ISO 7029. To compare ISO 7029 and newly available hearing threshold data after publishing ISO 7029, four country-specific datasets that presented average hearing threshold levels under conditions similar to ISO 7029 were utilized. For frequencies between 125 Hz and 8,000 Hz, the deviations of hearing threshold values by ages from the hearing threshold of the youngest age group for each data point were utilized. For frequencies from 9,000 Hz to 12,500 Hz, the median threshold information was utilized. Hearing threshold data reported after publishing ISO 7029 from the four countries were mostly similar to the ISO 7029 data but tended to deviate in some age groups and sexes. As national hearing threshold trends change, the following ISO 7029 revision suggests the need to integrate hearing threshold data from different countries.

백색잡음 환경에서 귀덮개 사용이 변조이음향방사 신호대잡음비에 미치는 영향

Objective: Earmuff has been shown to attenuate noise and may be useful in boothless audiometry. This study aimed to determine the effect of earmuff use on the signal-to-noise ratio of distortion production otoacoustic emission (DPOAE) in a white noise environment.&#x0D; Method: Participants were 19 young, healthy men and women (38 ears) aged 22.45±1.31 years. The hearing threshold level in 1, 2, 3, and 4 ㎑ did not exceed 15 ㏈ HL. DPOAE was performed at four points per octave in the range 842 to 9,509 ㎐ based on f2. After obtaining the baseline (Base), white noise was presented at 10 ㏈ intervals from 40 to 70 ㏈ SPL. DPOAE was obtained without (WN) and with earmuff (Earmuff). The maximum permissible ambient noise level (MPANL) of the WN and Earmuff were compared (paired t-test). Signal-to-noise ratio (one-way repeated measures ANOVA) and PASS rate (Chi-square test) between WN, Earmuff and Base at the overall frequency, mid-frequency (mid-3-freq), and high-frequency (hi-3-freq) bands were analyzed.&#x0D; Results: There was a difference of 22.19 ㏈ in MPANL between Base and WN (p=.000). There was a significant difference in the SNR between Base and WN from 40 ㏈ SPL, and in PASS rate between Base and Earmuff from 60 SPL (p&lt;.005).&#x0D; Conclusion: In DPOAE, earmuff increase MPANL, which enables recording at up to 60 ㏈ SPL. The SNR in the high-frequency band is more preserved than in the lower, Therefore, it seems advantageous for early detection of cochlear microstructural changes due to noise or aging.

Association between occupational noise-induced hearing loss and genotoxicity among textile factory workers

Background/aimHearing loss caused by exposure to noise is still among the most prevalent health risks for industrial workers. This study aims to evaluate the relationship between Shebien El-kom textile factory workers’ occupational noise exposure, genotoxicity, and noise-induced hearing loss.MethodsThis cross-sectional case–control study was performed in a textile industry in Shebin Elkom, Egypt. The participants of this work were 36 exposed male workers from the spinning section of the textile factory and 36 subjects as the control male group from administrative staff in the same factory, in the age range of 25–45 years. A pure-tone audiometer and portable sound level meter were utilized for the measurement of hearing threshold and noise level, respectively. Genotoxicity was assessed using the Comet assay technique.ResultsThere was no significant difference between both groups regarding age and the mean duration of work was 18.94 ± 4.88 for exposed workers. The average level of noise was 95–105 dB (A). The exposed workers’ mean hearing thresholds for the left and right ears at frequencies between 2000 and 8000 Hz were substantially greater than those of the control group (P < 0.05). In the exposed workers, there was not a marked variation between the hearing thresholds of the left and right ears (p > 0.05). The exposed workers’ percentage of DNA damage was substantially greater than that of the control group (p < 0.001). Among exposed workers, a positive correlation between DNA damage, the degree of hearing loss, and the duration of time exposed to noise was demonstrated.ConclusionThe majority of exposed workers suffered from occupational noise-induced hearing loss. A positive correlation was found between the percentage of DNA damage, duration of exposure to noise, and hearing threshold in exposed workers.

Test-retest reliability of the urban outdoor situated phoneme (SiP) test*

Objective To introduce the urban outdoor version of the Situated Phoneme (SiP) test and investigate its test-retest reliability. Design Phonemic discrimination scores in matched-spectrum real-world (MSRW) maskers from an urban outdoor environment were measured using a three-alternative forced choice test paradigm at different phoneme-to-noise ratios (PNR). Each measurement was repeated twice. Test-retest scores for the full 84-trial SiP-test, as well as for four types of contrasting phonemes, were analysed and compared to critical difference scores based on binomial confidence intervals. Study sample Seventy-two adult native speakers of Swedish (26–83 years) with symmetric hearing threshold levels ranging from normal hearing to severe sensorineural hearing loss. Results Test-retest scores did not differ significantly for the whole test, or for the subtests analysed. A lower amount of test-retest score difference than expected exceeded the bounds of the corresponding critical difference intervals. Conclusions The urban outdoor SiP-test has high test-retest reliability. This information can help audiologists to interpret test scores attained with the urban outdoor SiP-test.

Audiological characteristics of children with congenital unilateral hearing loss: insights into Age of reliable behavioural audiogram acquisition and change of hearing loss.

The aims of this study were to report the audiological characteristics of children with congenital unilateral hearing loss (UHL), examine the age at which the first reliable behavioural audiograms can be obtained, and investigate hearing changes from diagnosis at birth to the first reliable behavioural audiogram. This study included a sample of 91 children who were diagnosed with UHL via newborn hearing screening and had reliable behavioural audiograms before 7 years of age. Information about diagnosis, audiological characteristics and etiology were extracted from clinical reports. Regression analysis was used to explore the potential reasons influencing the age at which first reliable behavioural audiograms were obtained. Correlation and ANOVA analyses were conducted to examine changes in hearing at octave frequencies between 0.5 and 4 kHz. The proportions of hearing loss change, as well as the clinical characteristics of children with and without progressive hearing loss, were described according to two adopted definitions: Definition 1: criterion (1): a decrease in 10 dB or greater at two or more adjacent frequencies between 0.5 and 4 kHz, or criterion (2): a decrease in 15 dB or greater at one octave frequency in the same frequency range. Definition 2: a change of ≥20 dB in the average of pure-tone thresholds at 0.5, 1, and 2 kHz. The study revealed that 48 children (52.7% of the sample of 91 children) had their first reliable behavioural audiogram by 3 years of age. The mean age at the first reliable behavioural audiogram was 3.0 years (SD 1.4; IQR: 1.8, 4.1). We found a significant association between children's behaviour and the presence or absence of ongoing middle ear issues in relation to the delay in obtaining a reliable behavioural audiogram. When comparing the hearing thresholds at diagnosis with the first reliable behavioural audiogram across different frequencies, it was observed that the majority of children experienced deterioration rather than improvement in the initial impaired ear at each frequency. Notably, there were more instances of hearing changes (either deterioration or improvement), in the 500 Hz and 1,000 Hz frequency ranges compared to the 2,000 Hz and 4,000 Hz ranges. Seventy-eight percent (n = 71) of children had hearing deterioration between the diagnosis and the first behavioural audiogram at one or more frequencies between 0.5 and 4 kHz, with a high proportion of them (52 out of the 71, 73.2%) developing severe to profound hearing loss. When using the averaged three frequency thresholds (i.e., definition 2), only 26.4% of children (n = 24) in the sample were identified as having hearing deterioration. Applying definition 2 therefore underestimates the proportion of children that experienced hearing changes. The study also reported diverse characteristics of children with or without hearing deterioration. The finding that 78% of children diagnosed with UHL at birth had a decrease in hearing loss between the hearing levels at first diagnosis and their first behavioural audiogram highlights the importance of monitoring hearing threshold levels after diagnosis, so that appropriate intervention can be implemented in a timely manner. For clinical management, deterioration of 15 dB at one or more frequencies that does not recover warrants action.

Hearing thresholds for "otologically normal" adults from the National Health and Nutrition Examination Surveys 2011-12 and 2015-16.

Hearing threshold levels (HTLs) get worse with advancing age in adults. Publications of nationally representative data from U.S. adults have been confined to HTLs from unscreened individuals. ISO 7029:2017 provides equations for the hearing loss of adults of various ages. Equations were generated from a synthesis of international studies of HTLs for "otologically normal" or screened adults. No nationally representative data for screened U.S. adults were included in the ISO synthesis. This study investigated three different levels of screening rigor, referred to here as Screened, Screened+, and Screened++. Median HTLs are provided for Screened (N = 1545) and Screened++ (N = 795) groups from the National Health and Nutrition Examination Surveys for 2011-12 and 2015-16, the two most recent surveys of adults from 20 to 69 years of age with audiograms. Median HTLs from the Screened and Screened++ groups differed slightly between the sexes, were not affected by race/ethnicity, and increased substantially with age. For young adults, there were no differences in HTLs between screened (any level) and unscreened adults, but such differences in HTLs increased with advancing age, especially at higher frequencies. The default power-function model from ISO 7029:2017 did not provide a good description of the median age-associated HTLs from screened U.S. adults.

Does in vitro fertilization affect the hearing levels of women?

This study aimed to determine whether there is a relationship between changes in blood estrogen levels and hearing threshold levels in women undergoing in vitro fertilization (IVF). Sixty patients with normal otoscopic examination findings and scheduled for IVF treatment were included in the study. All patients underwent pure tone audiometry, tympanogram tests, and otoacoustic emission measurements (TEOAE) during IVF treatment, and estrogen levels were measured simultaneously. The patients were divided into three groups based on estrogen levels during IVF. The patients' audiological test results at the beginning and end of treatment (the 12th day) were compared between the groups. There was an increase in hearing levels on the 12th day of treatment compared to the beginning of treatment in all the study groups. This increase was significant between Group 1 and Group 2 and between Group 1 and Group 3 (p<0.05). The best hearing in audiometry was determined in the patients in Group 2. While a significant increase was observed in TEOAE (otoacoustic emission) measurements in Groups 1 and 2, a significant decrease was determined in Group 3 (p<0.05). Middle ear pressure and compliance measurements on the tympanogram tests were significantly lower in Group 3 compared to Groups 1 and 2 (p<0.05). During IVF treatment, as the estrogen level increases, it causes an increase in the level of hearing, but this increase does not continue after specific doses.