Hearing Thresholds Research Articles

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.

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.

The effect of different degrees of Eustachian tube dysfunction on hearing threshold in patients with acquired primary middle ear cholesteatoma after balloon eustachian tuboplasty

Objective:To investigate the changes in hearing threshold of the acquired primary cholesteatoma of the middle ear with different degrees of eustachian tube dysfunction after balloon eustachian tuboplasty. Methods:This retrospective study included forty cases with middle ear cholesteatoma and eustachian tube dysfunction who underwent open mastoidectomy + tympanoplasty + balloon eustachian tuboplasty were enrolled. All patients were admitted from November 2020 to April 2022. The preoperative eustachian tube score of 0-2 were defined as the lower group, and the scores of 3-5 were defined as the higher group. Pure tone audiometry was measured preoperatively and 1, 3, 6 and 12 months postoperatively. The average value of bone conduction threshold and air conduction threshold of 250-4 000 Hz were calculated, and the air-bone gap was calculated simultaneously. SPSS 25.0 was used for statistical analysis. P<0.05 was considered statistically significant. Results:In the lower group, the air conduction threshold and air-bone gap at 3 months postoperatively were significantly decreased in comparison with those preoperatively（P<0.05），as was the air-bone gap at 6 months postoperatively（P<0.05）. In the higher group, the air conduction threshold and air-bone gap were significantly decreased at 3, 6 and 12 months postoperatively（P<0.05）. Conclusion:The air conduction threshold and air-bone gap of patients with the acquired primary cholesteatoma of the middle ear and eustachian tube dysfunction were significantly decreased after eustachian tube balloon dilatation. Hearing improvement lasted longer in patients with slight eustachian tube dysfunction.

Association Between Noise-Induced Hearing Loss and Vestibular Dysfunction in Workers Chronically Exposed to Occupational Noise

Background: Despite the understanding of the association between noise exposure and noise-induced hearing loss (NIHL), the effects of noise on vestibular function are less well understood and neglected. Aim: The aim of this study was to investigate the function of the vestibular system in workers with NIHL. Materials and Methods: Thirty male textile workers with symmetrical NIHL (49.3 ± 4.5 dB at 4 kHz) and thirty healthy male textile office staff with normal hearing were included in this study. Pure tone audiometry using air conduction and bone conduction was used to determine hearing thresholds. The videonystagmography battery test, including the oculomotor test, caloric test, and video head impulse test (vHIT), was used for the evaluation of vestibular system function. Results: There was no difference in saccadic tracking, smooth pursuit tracking, and optokinetic nystagmus between the two groups. It was found that the abnormal vHIT was significantly higher in workers with NIHL (40%) than in the control group (3.3%). In addition, the abnormal caloric test was significantly higher in workers with NIHL (33.3%) than in the control group (0%). The association between the hearing thresholds of 3, 4, 6, and 8 kHz and vestibular dysfunction was significant. Conclusion: This study provides evidence of the simultaneous occurrence of NIHL and vestibular dysfunction. In other words, the results support the role of noise as a risk factor for the development of vestibular dysfunction in textile workers.

Intelligibility of Natively and Nonnatively Produced English Speech Presented in Noise to a Large Cohort of United States Service Members.

A corpus of English matrix sentences produced by 60 native and nonnative speakers of English was developed as part of a multinational coalition task group. This corpus was tested on a large cohort of U.S. Service members in order to examine the effects of talker nativeness, listener nativeness, masker type, and hearing sensitivity on speech recognition performance in this population. A total of 1,939 U.S. Service members (ages 18-68 years) completed this closed-set listening task, including 430 women and 110 nonnative English speakers. Stimuli were produced by native and nonnative speakers of English and were presented in speech-shaped noise and multitalker babble. Keyword recognition accuracy and response times were analyzed. General(ized) linear mixed-effects regression models found that, on the whole, speech recognition performance was lower for listeners who identified as nonnative speakers of English and when listening to speech produced by nonnative speakers of English. Talker and listener effects were more pronounced when listening in a babble masker than in a speech-shaped noise masker. Response times varied as a function of recognition score, with longest response times found for intermediate levels of performance. This study found additive effects of talker and listener nonnativeness when listening to speech in background noise. These effects were present in both accuracy and response time measures. No multiplicative effects of talker and listener language background were found. There was little evidence of a negative interaction between talker nonnativeness and hearing impairment, suggesting that these factors may have redundant effects on speech recognition. https://doi.org/10.23641/asha.26060191.

Leveraging human–mouse studies to advance the genetics of hearing impairment in Africa

AbstractMouse models are used extensively to understand human pathobiology and mechanistic functions of disease‐associated loci. However, in this review, we investigate the potential of using genetic mouse models to identify genetic markers that can disrupt hearing thresholds in mice and then target the hearing‐enriched orthologues and loci in humans. Currently, little is known about the real prevalence of genes that cause hearing impairment (HI) in Africa. Pre‐screening mouse cell lines to identify orthologues of interest has the potential to improve the genetic diagnosis for HI in Africa to a significant percentage, for example, 10–20%. Furthermore, the functionality of a candidate gene derived from mouse screening with heterogeneous genetic backgrounds and multi‐omic approaches can shed light on the molecular, genetic heterogeneity and plausible mode of inheritance of a gene in hearing‐impaired individuals especially in the absence of large families to investigate.

A retrospective study on hearing outcomes of infants of COVID-19 mothers pre-vaccination era

Background: A COVID-19 infection can result in a variety of symptoms. Findings must be carefully reviewed because there is still a dispute over the potential involvement of the audiovestibular system. Moreover, there is debate over the intrauterine transfer of COVID-19 infection from mother to fetus in pregnant people. There are not many investigations on the audiovestibular symptomatology of infants exposed to COVID-19 during pregnancy. Aims and Objectives: This study looks at any potential links between the COVID-19 gestational infection and the start of hearing impairment in babies. The verification of hearing’s engagement in COVID-19 allows for the planning of the time and methods for children’s audiological evaluations. Materials and Methods: Newborns had audiological examination and screening for hearing loss. The automatic transient evoked otoacoustic emissions (OAEs) test is used to evaluate newborns for hearing impairments before they are released from the hospital. By employing the COVID-19 case history, otoscopy, acoustic immittance test, transient evoked OAEs test, and mother, pregnancy, and perinatal case histories, an audiological examination is conducted on children under 3 months of age, with 2 weeks, 1 month and 3 months of age follow-up. Results: The research comprised 100 children. Of these infants, 90% were part of the neonatal hearing screening initiative. Due to isolation protocols, the remaining 10 neonates did not undergo hearing screening; instead, a direct audiological examination was performed on them. Out of the 90 newborns that were tested, only 11 had a bilateral REFER test result, but the audiological examination revealed a normal hearing threshold. Conclusion: There is no data in this study that a mother’s COVID-19 infection results in hearing loss in newborn.

The effects of extended-wear hearing aids on the localization accuracy of listeners with normal audiometric thresholds.

Extended-wear hearing aids (EWHAs) are small broadband analog amplification devices placed deeply enough in the ear canal to preserve most of the cues in the head-related transfer function. However, little is known about how EWHAs affect localization accuracy for normal hearing threshold (NHT) listeners. In this study, eight NHT participants were fitted with EWHAs and localized broadband sounds of different durations (250 ms and 4 s) and stimulus intensities (40, 50, 60, 70, and 80 dBA) in a spherical speaker array. When the EWHAs were in the active mode, localization accuracy was only slightly degraded relative to open-ear performance. However, when the EWHAs were turned off, localization performance was substantially degraded even at the highest stimulus intensities. An electro-acoustical evaluation of the EWHAs showed minimal effects of dynamic range compression on the signals and good preservation of the signal pattern for vertical polar sound localization. Between-study comparisons suggest that EWHA active mode localization accuracy is favorable compared to conventional active earplugs, and EWHA passive mode localization accuracy is comparable to conventional passive earplugs. These results suggest that the deep-insertion analog design of the EWHA is generally better at preserving localization accuracy of NHT listeners than conventional earplug devices.

Low-Dose Aspirin and Progression of Age-Related Hearing Loss

Age-related hearing loss is common in an aging population, affecting communication and contributing to a worsened quality of life. It occurs as a result of cochlear degeneration and may be further exacerbated by inflammation and microvascular changes, as observed in animal models. To compare the effect of daily low-dose aspirin vs placebo on the progression of age-related hearing loss in healthy older adults. A prespecified secondary analysis was conducted of the Aspirin in Reducing Events in the Elderly (ASPREE) randomized clinical trial. Participants were 279 healthy community-dwelling individuals living in Australia who were aged 70 years or older and free of overt cardiovascular diseases, dementia, and life-limiting illnesses. Participants were recruited between January 1, 2010, and December 31, 2014, and followed up over 3 years. Statistical analysis was completed from June to December 2023. A 100-mg daily dose of enteric-coated aspirin or matching placebo. Hearing measures were air conduction audiometry and binaural speech perception in noise. Assessments were conducted at baseline, 18 months, and 3 years. The change from baseline hearing measures were analyzed using an intention to treat approach. Aspirin and placebo were compared using mixed linear regression models adjusting for age, sex, diabetes, and smoking. Of 279 participants, 154 (55%) were male, and the median age at baseline was 73.1 years (IQR, 71.5-76.2 years). A total of 98 of 138 participants (71%) in the aspirin group and 94 of 141 participants (67%) in the placebo group reported experiencing hearing loss at baseline. Compared with placebo, aspirin did not affect the changes in mean (SD) 4-frequency average hearing threshold from baseline to year 3 (aspirin: baseline, 27.8 [13.3] dB; year 3, 30.7 [13.7] dB; difference, 3.3 [3.9] dB; placebo: baseline, 27.5 [12.6] dB; year 3, 30.9 [13.8] dB; difference, 3.0 [4.8] dB; P = .55) nor any other tested frequencies. An increase in air conduction threshold indicates a deterioration in hearing. Similarly, for the mean (SD) speech reception threshold, there was no significant difference observed between the aspirin and placebo group at the year 3 follow-up assessment (aspirin: baseline, -9.9 [3.8] dB; year 3, -9.1 [3.8] dB; difference, 0.9 [2.9] dB; placebo: baseline, -10.5 [7.1] dB; year 3, -9.6 [4.1] dB; difference, 0.9 [5.9] dB; P = .86). The findings were consistent across sex, age groups, diabetic and smoking status. In this secondary analysis of the ASPREE randomized clinical trial, low-dose aspirin did not affect the progression of age-related hearing loss. More investigation is warranted on whether a longer follow-up or the use of a more powerful anti-inflammatory agent might prove beneficial. anzctr.org.au Identifier: ACTRN12614000496617.

Preliminary investigation of endoscopic surgery for tympanic membrane perforation: Regenerative treatment compared with conventional surgery

PurposeTo compare surgical outcomes of regenerative treatment (RT) including basic fibroblast growth factor (bFGF) (Group-R) with the conventional method (Group-C) for patients with tympanic membrane perforation (TMP), both of whom underwent transcanal endoscopic ear surgery. MethodsThe study population of Group-R included 61 ears of 59 patients treated with RT-TMP in which TMP edges were disrupted mechanically and a gelatin sponge immersed in bFGF was inserted into the TMP. Fibrin glue was then dripped over the sponge. Group-C consisted of 13 patients who underwent conventional surgery before adopting the RT-TMP. Patients' characteristics and outcomes including TMP closure rates, and change in hearing level were evaluated three or more weeks after the surgery. ResultsThe baseline characteristics including size of TMP were not significantly different between the two groups. Although Group-R had significantly shorter operating time than Group-C, the complete TMP closure rates were 69 % (9/13) and 85 % (52/61), respectively. Air-conduction hearing thresholds showed significant improvements, and analysis of variance showed that Group-R achieved significant interactions other than at 8 kHz, implying better improvement in cases with TMP closure. The air-bone gaps also improved at all frequencies in both groups. Specifically, at 4 kHz, there was a trend showing better improvement in Group-R. ConclusionRT-TMP had a high TMP closure rate and good hearing improvement, with no significant differences compared with those of conventional surgery. This new therapy is simple and safe, and requires less operating time, and it could help improve the quality of life of patients with TMP.

Auditory brainstem response audiometry in tauopathy mouse model of human Alzheimer's disease.

Alzheimer's disease (AD) is a progressive neurodegenerative disorder in which changes in hearing sensitivity precede cognitive decline. Despite a well-known link between dementia and hearing loss, few AD model mouse lines have hearing characterized. We screened for hearing loss using auditory brainstem responses (ABR) in young (3-4 months) and aging (9-10 months) mice with a P301S tauopathy (PS19 mice). Compared to wild types, aging PS19 mice did not show accelerated hearing loss but did show latency differences in centrally generated ABR waveform components. These results suggest that tauopathy causes mild central auditory dysfunction in the absence of overt hearing loss.

Outcome measures of brainwave entrainment using delta wave stimulation in individuals with tinnitus having normal hearing sensitivity.

The current study aimed to evaluate the efficacy of delta frequency binaural beats stimulation in treatment of individuals with tinnitus having normal hearing sensitivity. Twenty-four individuals who reported bothersome tinnitus in the presence of clinically normal hearing were grouped into two (I and II). The group was provided with delta frequency binaural beats and II was provided with white noise stimulation (both of 20min duration) for 30days. Post 30days, the re-assessment of tinnitus handicap, depression, anxiety, and quality of life parameters were performed and compared with that of pre-treatment scores. A considerable reduction of tinnitus handicap scores, depression and anxiety levels were observed for both the groups, except for the quality-of-life parameters. However, few of the participants showed limited or negligible improvement post-treatment. On comparison of reduction of scores observed across the groups, there was a higher reduction of scores observed for group I when compared to group II. The current study was an initial attempt to study the efficacy of binaural beats in treatment of individuals with tinnitus having normal hearing. Apart from a few individuals, the delta wave stimulation acted as a helpful tool in improving tinnitus borne distress symptoms in such patients with normal hearing.The results of the present study put forward the scope of adapting binaural beats stimulation for the treatment of individuals presenting with tinnitus having normal hearing sensitivity. This technique could be adopted into clinical practice after extensive research involving an extended treatment duration on a larger population.

Tranylcypromine upregulates Sestrin 2 expression to ameliorate NLRP3-related noise-induced hearing loss.

JOURNAL/nrgr/04.03/01300535-202505000-00030/figure1/v/2024-07-28T173839Z/r/image-tiff Noise-induced hearing loss is the primary non-genetic factor contributing to auditory dysfunction. However, there are currently no effective pharmacological interventions for patients with noise-induced hearing loss. Here, we present evidence suggesting that the lysine-specific demethylase 1 inhibitor-tranylcypromine is an otoprotective agent that could be used to treat noise-induced hearing loss, and elucidate its underlying regulatory mechanisms. We established a mouse model of permanent threshold shift hearing loss by exposing the mice to white broadband noise at a sound pressure level of 120 dB for 4 hours. We found that tranylcypromine treatment led to the upregulation of Sestrin2 (SESN2) and activation of the autophagy markers light chain 3B and lysosome-associated membrane glycoprotein 1 in the cochleae of mice treated with tranylcypromine. The noise exposure group treated with tranylcypromine showed significantly lower average auditory brainstem response hearing thresholds at click, 4, 8, and 16 kHz frequencies compared with the noise exposure group treated with saline. These findings indicate that tranylcypromine treatment resulted in increased SESN2, light chain 3B, and lysosome-associated membrane glycoprotein 1 expression after noise exposure, leading to a reduction in levels of 4-hydroxynonenal and cleaved caspase-3, thereby reducing noise-induced hair cell loss. Additionally, immunoblot analysis demonstrated that treatment with tranylcypromine upregulated SESN2 expression via the autophagy pathway. Tranylcypromine treatment also reduced the production of NOD-like receptor family pyrin domain-containing 3 (NLRP3) production. In conclusion, our results showed that tranylcypromine treatment ameliorated cochlear inflammation by promoting the expression of SESN2, which induced autophagy, thereby restricting NLRP3-related inflammasome signaling, alleviating cochlear hair cell loss, and protecting hearing function. These findings suggest that inhibiting lysine-specific demethylase 1 is a potential therapeutic strategy for preventing hair cell loss and noise-induced hearing loss.

Therapeutic efficacy of methylprednisolone sodium succinate via diverse administration routes for mid- to high-frequency sudden sensorineural hearing loss

BACKGROUND Sudden sensorineural hearing loss (SSNHL), characterized by a rapid and unexplained loss of hearing, particularly at moderate to high frequencies, presents a significant clinical challenge. The therapeutic use of methylprednisolone sodium succinate (MPSS) via different administration routes, in combination with conventional medications, remains a topic of interest. AIM To compare the therapeutic efficacy of MPSS administered via different routes in combination with conventional drugs for the treatment of mid- to high-frequency SSNHL. METHODS The medical records of 109 patients with mid- to high-frequency SSNHL were analyzed. The patients were divided into three groups based on the route of administration: Group A [intratympanic (IT) injection of MPSS combined with mecobalamin and Ginkgo biloba leaf extract injection], Group B (intravenous injection of MPSS combined with mecobalamin and Ginkgo biloba leaf extract injection), and Group C (single IT injection of MPSS). The intervention effects were compared and analyzed. RESULTS The posttreatment auditory thresholds in Group A (21.23 ± 3 .34) were significantly lower than those in Groups B (28.52 ± 3.36) and C (30.23 ± 4.21; P &lt; 0.05). Group A also exhibited a significantly greater speech recognition rate (92.23 ± 5.34) than Groups B and C. The disappearance time of tinnitus, time to hearing recovery, and disappearance time of vertigo in Group A were significantly shorter than those in Groups B and C (P &lt; 0.05). The total effective rate in Group A (97.56%) was significantly greater than that in Groups B and C (77.14% and 78.79%, χ 2 = 7.898, P = 0.019). Moreover, the incidence of adverse reactions in Groups A and C was significantly lower than that in Group B (4.88%, 3.03% vs 2.57%, χ 2 = 11.443, P = 0.003), and the recurrence rate in Group A was significantly lower than that in Groups B and C (2.44% vs 20.00% vs 21.21%, χ 2 = 7.120, P = 0.028). CONCLUSION IT injection of MPSS combined with conventional treatment demonstrates superior efficacy and safety compared to systemic administration via intravenous infusion and a single IT injection of MPSS. This approach effectively improves patients' hearing and reduces the risk of disease recurrence.

Effect of External Ear Deformity on Hearing in Wrestlers.

Cauliflower ear in wrestlers can lead to hearing impairment. This study primarily aims to assess the hearing of wrestlers with bilateral cauliflower ears and determine their external ear canal (EEC) resonance frequencies. Our second aim is to evaluate their hearing quality, speech, and spatial perception. This study included 28 male wrestlers aged 18-35 years with bilateral cauliflower ears, as well as 27 male participants in the control group with no wrestling history. The participants' hearing thresholds were determined across the frequency range of 125-16000 Hz for air-conduction and 500-4000 Hz for bone conduction. EEC resonance frequencies were measured. Additionally, all participants completed the Turkish version of the Speech, Spatial, and Qualities of Hearing Scale (SSQ) questionnaire. Wrestlers with cauliflower ears exhibited significantly higher hearing thresholds, particularly at frequencies above 4000 Hz (p < .05). Analysis of EEC resonance showed a shift to higher frequencies in the second resonance peak of the right ear (p < .001) and the first resonance peak of the left ear (p = .045). SSQ scores revealed that wrestlers had higher spatial perception (p = .046), hearing quality (p = .004), and general scores (p = .042) in comparison to the control group. Blunt traumas in wrestlers, leading to cauliflower ear, can result in hearing loss. Moreover, deformities in the external ear affect the resonance frequencies of the EEC. Therefore, it is crucial to advocate for the use of ear protection equipment among wrestlers. When fitting hearing aids, attention should be given to changes in the EEC resonance frequency.

Word-in-noise perception test in children

Background The word-in-noise discrimination test evaluates the phonological aspect of speech based on the detection of the vowels. While word-in-noise perception (WINP) test is one of the speech perception exams and evaluates the ability to understand the meaning of words by discovering the consonants.Until now, all word-in-noise tests have assessed speech discrimination performance, and for the first time, the normal values of the WINP test for adults have been determined. Since the normal values of WINP scores in children have not been reported, our research aimed to determine the normal values of the WINP test in children aged 5 to 13 years.In this cross-sectional study, 120 Persian speaking Iranain children with normal hearing thresholds were evaluated from the beginning to the end of spring 2023. We divided them into 4 age groups (A = 5–7 < years, B = 7–9 < years, C = 9–11 < years, D = 11–13 < years). The evaluations included general audiology tests and WINP tests using homtonic-monosyllabic words (HMWs) at a signal-to-noise ratio of 5 dB.ResultsSignificant difference was observed between the mean scores of the WINP test in age group A (54%) compared to age group B (66%), (Pv = 0.04). Also, the differences between the mean scores of age group A compared to age groups C (70%) and D (69%) were significant (Pv = 0.01, Pv = 0.03).ConclusionsThis article presented the norm values of WINP test scores for Persian speaking Iranian children aged 5 to 13 years. The norm values of WINP test scores in the age group of 5–7 years were lower than in the age groups of 7–13 years. The biggest change in the performance of speech perception in noise was observed in the age range of 7–9 years.

Audiological Profile of a Rare Case with 1kHz Notch Audiogram.

A notch is defined as the frequency point at which hearing loss is greater than 15 dB when compared to one octave above and below. C3 dip or 1kHz notch is rarely seen and not much information is known about the clinical profile of such condition. The aim of this case report is to highlight the audiological profile of a case with 1kHz notch and discuss the possible causes for the same. Case A (16 yrs) was referred with a complaint of hearing loss and speech understanding difficulty specially at school. The teen had taken multiple medications for several health related issues like malaria, appendicitis and the understanding difficulty was evident during this period. Detailed audiological evaluation revealed a significant C3 dip in the right ear and normal hearing sensitivity in the left ear. Evidences from literature suggests strong correlation between drugs like Cefotetan, cefotaime, piperacillin, ampicillin (appendicitis treatment) and chloroquine (malaria) and hearing loss. Hence, we concluded that the possible cause of 1khz is ototoxic medication.

Efficacy and Mechanisms of Antioxidant Compounds and Combinations Thereof against Cisplatin-Induced Hearing Loss in a Rat Model.

Cisplatin is an election chemotherapeutic agent used for many cancer treatments. Its cytotoxicity against neoplastic cells is mirrored by that taking place in healthy cells and tissues, resulting in serious adverse events. A very frequent one is ototoxicity, causing hearing loss which may permanently affect quality of life after successful oncologic treatments. Exacerbated oxidative stress is a main cytotoxic mechanism of cisplatin, including ototoxicity. Previous reports have shown antioxidant protection against cisplatin ototoxicity, but there is a lack of comparative studies on the otoprotectant activity and mechanism of antioxidant formulations. Here, we show evidence that a cocktail of vitamins A, C, and E along with Mg++ (ACEMg), previously shown to protect against noise-induced hearing loss, reverses auditory threshold shifts, promotes outer hair cell survival, and attenuates oxidative stress in the cochlea after cisplatin treatment, thus protecting against extreme cisplatin ototoxicity in rats. The addition of 500 mg N-acetylcysteine (NAC), which, administered individually, also shows significant attenuation of cisplatin ototoxicity, to the ACEMg formulation results in functional degradation of ACEMg otoprotection. Mg++ administered alone, as MgSO4, also prevents cisplatin ototoxicity, but in combination with 500 mg NAC, otoprotection is also greatly degraded. Increasing the dose of NAC to 1000 mg also results in dramatic loss of otoprotection activity compared with 500 mg NAC. These findings support that single antioxidants or antioxidant combinations, particularly ACEMg in this experimental series, have significant otoprotection efficacy against cisplatin ototoxicity. However, an excess of combined antioxidants and/or elevated doses, above a yet-to-be-defined "antioxidation threshold", results in unrecoverable redox imbalance with loss of otoprotectant activity.

Automated hearing loss type classification based on pure tone audiometry data

Hearing problems are commonly diagnosed with the use of tonal audiometry, which measures a patient’s hearing threshold in both air and bone conduction at various frequencies. Results of audiometry tests, usually represented graphically in the form of an audiogram, need to be interpreted by a professional audiologist in order to determine the exact type of hearing loss and administer proper treatment. However, the small number of professionals in the field can severely delay proper diagnosis. The presented work proposes a neural network solution for classification of tonal audiometry data. The solution, based on the Bidirectional Long Short-Term Memory architecture, has been devised and evaluated for classifying audiometry results into four classes, representing normal hearing, conductive hearing loss, mixed hearing loss, and sensorineural hearing loss. The network was trained using 15,046 test results analysed and categorised by professional audiologists. The proposed model achieves 99.33% classification accuracy on datasets outside of training. In clinical application, the model allows general practitioners to independently classify tonal audiometry results for patient referral. In addition, the proposed solution provides audiologists and otolaryngologists with access to an AI decision support system that has the potential to reduce their burden, improve diagnostic accuracy, and minimise human error.

An Open-Source Deep Learning-Based GUI Toolbox For Automated Auditory Brainstem Response Analyses (ABRA).

In this paper, we introduce a new, open-source software developed in Python for analyzing Auditory Brainstem Response (ABR) waveforms. ABRs are a far-field recording of synchronous neural activity generated by the auditory fibers in the ear in response to sound, and used to study acoustic neural information traveling along the ascending auditory pathway. Common ABR data analysis practices are subject to human interpretation and are labor-intensive, requiring manual annotations and visual estimation of hearing thresholds. The proposed new Auditory Brainstem Response Analyzer (ABRA) software is designed to facilitate the analysis of ABRs by supporting batch data import/export, waveform visualization, and statistical analysis. Techniques implemented in this software include algorithmic peak finding, threshold estimation, latency estimation, time warping for curve alignment, and 3D plotting of ABR waveforms over stimulus frequencies and decibels. The excellent performance on a large dataset of ABR collected from three labs in the field of hearing research that use different experimental recording settings illustrates the efficacy, flexibility, and wide utility of ABRA.