High Frequency Audiometry Research Articles

Monitorización de la ototoxicidad por cisplatino.

Introduction and objective: The ototoxic damage goes unnoticed to disabling levels, being justified to apply control for its early detection procedures, make it possible to a therapeutic change and if necessary, a speech and auditory rehabilitation. The objective of this study will consist to present Protocol we did at the Hospital Clínico Universitario de Valladolid for the follow-up of the patients treated with cisplatin. Method: Ototoxicity monitoring means serially collect hearing thresholds. It is identified on a visit if hearing has worsened in some ear. The comparison allows to detect the change and indicate if it is significant or not in relation to some criteria. We will also evaluate the occurrence of vestibular damage. As auditory monitoring procedures, we will use high frequency audiometry and acoustic oto-emissions. Results: After giving informed consent and a brief medical history we started with baseline assessment of hearing, prior to treatment, continuing with periodic reviews before each cycle. If any change is detected it is reported to the physician and the patient. To grade the ototoxicity, we apply the Brock and Chang criteria. We maintain post-treatment control. Discussion and conclusion: The incidence of ototoxicity of cisplatin is unknown in our country and it is not possible to predict which patients will experience. The increase in the survival rate for cancer involves improving comorbidity, which in the case of its early ototoxicity supposed to find the best solutions to restore the quality of life of patient’s detection.

Audiological and electrophysiological alterations in HIV-infected individuals subjected or not to antiretroviral therapy.

IntroductionThe Human Immunodeficiency Virus (HIV) and infections related to it can affect multiple sites in the hearing system. The use of High Activity Anti-Retroviral Therapy (HAART) can cause side effects such as ototoxicity. Thus, no consistent patterns of hearing impairment in adults with Human Immunodeficiency Virus / Acquired Immune Deficiency Syndrome have been established, and the problems that affect the hearing system of this population warrant further research.ObjectivesThis study aimed to compare the audiological and electrophysiological data of Human Immunodeficiency Virus-positive patients with and without Acquired Immune Deficiency Syndrome, who were receiving High Activity Anti-Retroviral Therapy, to healthy individuals.MethodsIt was a cross-sectional study conducted with 71 subjects (30–48 years old), divided into groups: Research Group I: 16 Human Immunodeficiency Virus-positive individuals without Acquired Immunodeficiency Syndrome (not receiving antiretroviral treatment); Research Group II: 25 Human Immunodeficiency Virus-positive individuals with Acquired Immunodeficiency Syndrome (receiving antiretroviral treatment); Control Group: 30 healthy subjects. All individuals were tested by pure-tone air conduction thresholds at 0.25–8 kHz, extended high frequencies at 9–20 kHz, electrophysiological tests (Auditory Brainstem Response, Middle Latency Responses, Cognitive Potential).ResultsResearch Group I and Research Group II had higher hearing thresholds in both conventional and high frequency audiometry when compared to the control group, prolonged latency of waves I, III, V and interpeak I–V in Auditory Brainstem Response and prolonged latency of P300 Cognitive Potential. Regarding Middle Latency Responses, there was a decrease in the amplitude of the Pa wave of Research Group II compared to the Research Group I.ConclusionsBoth groups with Human Immunodeficiency Virus had higher hearing thresholds when compared to healthy individuals (group exposed to antiretroviral treatment showed the worst hearing threshold) and seemed to have lower neuroelectric transmission speed along the auditory pathway in the brainstem, subcortical and cortical regions.

High Frequency Audiometry and its importance for the hearing loss early diagnosis

High Frequency Audiometry (9000 до 20000 Hz) is available and can be useful for early diagnosis of hearing impairments and their management and therapy, besides the conventional one (125 до 8000 Hz). The use of high frequency audiometry (HFA) is particularly important for early detection of hearing deviations connected with noise exposure, ototoxic drug treatment, unclear hearing dysfunction – noisy environment speech misunderstanding. The authors present different patient cases with hearing loss etiology, revealed by high frequency audiometry testing, with or without hearing loss diagnosed by conventional audiomerty (125 – 8000 Hz). Based on the published referent threshold values for high frequency audiometry, age divided into groups, we evaluate the obtained results and HFA changes in different hearing disorders – tinnitus, noisy environment speech misunderstanding, hearing loss. That group includes etiologically patients with acute acoustic trauma, noisy occupational environment, treated by chemotherapy, and patients with normal hearing without hearing disorders. The aim of our study is to identify the importance of high frequency audiometry deviations, for the early diagnosis of hearing disorders.

Cochleotoxicity monitoring protocol

IntroductionCochlear damage is frequent in long-term aminoglycosides therapy or chemotherapeutic treatments with platinum-based agents. Despite its prevalence, it is currently underestimated and underdiagnosed. A monitoring protocol is vital to the early detection of cochleotoxicity and its implementation is widely encouraged in every hospital unit. Our aim was to elaborate a cochleotoxicity monitoring protocol for patients treated with platinum compounds or aminoglycosides antibiotics. MethodsPubMed® database was searched using terms relevant to drug cochleotoxicity in order to identify the most adequate protocol. Several articles and guidelines influenced our decision. ResultsThere is no consensus on a universal monitoring protocol. Its formulation and application rely heavily on available resources and personnel. High-frequency audiometry and otoacoustic emissions play an important role on early detection of cochleotoxicity caused by aminoglycoside antibiotics and platinum compounds. ConclusionA cochleotoxicity monitoring protocol consisting on an initial evaluation, treatment follow-up and post-treatment evaluation is proposed.

Benefits of Extended High-Frequency Audiometry for Everyone

Benefits of Extended High-Frequency Audiometry for Everyone

Alterations in Evoked Otoacoustic Emissions by the Use of Meglumine Antimoniate in American Tegumentary Leishmaniasis Patients

IntroductionTegumentary Leishmaniasis (TL) is a neglected, non-contagious, infectious disease, caused by different protozoa species of the Leishmania genus that affects skin and mucous membranes. Meglumine Antimoniate (MA), the first drug of choice for TL treatment in Brazil, has already been associated with cochlear toxicity, which is defined as damages of the cochlea caused by exposure to chemical substances, resulting in reversible or irreversible hearing loss. Auditory monitoring for cochlear toxicity aims at the early detection of auditory disorders, enabling, when possible, hearing to be preserved or an early auditory rehabilitation. Although otoacoustic emissions (OAEs) are used in this monitoring, there is no consensus on the criteria that define cochlear toxicity by this examination. The objective of this study was to describe the characteristics of the OAEs in cochlear toxicity monitoring in TL patients using MA.MethodsProspective and longitudinal study of auditory monitoring of 35 patients with parasitological diagnosis of TL, with liminal tonal audiometry, high frequency audiometry, immitanciometry, distortion product evoked otoacoustic emissions (DPEOAEs) and transient evoked otoacoustic emissions (TEOAEs) before treatment, at the end of treatment, one month after the end of treatment and two months after the end of treatment.Results80% male, with median age of 44 years (IIQ: 22–59). In the pre-treatment evaluation: 11.4% complained of hearing loss and 20% of tinnitus, 48.6% presented auditory alterations in liminal tonal audiometry (LTA, 65.2% in high frequency audiometry (HFA), 26.6% in DPEOAE and 51.4% in TEOAE. No association was verified between genre and alterations in the EOAE examinations. We observed that patients that presented disorders in DPEOAE examinations were 17 years older than those without alterations and that patients that showed disorders in TEOAEO examinations were 34 years older than those without disorders. The presence of alterations in DPEOAE and TEOAE before beginning treatment was associated with each other and with the presence of alterations in LTA and HFA, and only DPEOAE was associated with hearing loss. We observed a significantly higher number of alterations of DPEOAE at the end of treatment than during pre-treatment and values of the ratio signal/noise significantly smaller at the end of treatment than during pre-treatment in the frequencies of 2 kHz (difference of 1.7dB; p = 0.016) and 4 kHz (difference of 2.45dB; p = 0.016) in DPEOAE and in the range 1.75/2.5 kHz in TEOAE (difference of 2.9dB; p = 0.039).ConclusionThe ototoxic signals observed in our study using EOAE indicated that both, DPEOAE and TEOAE are adequate and sensitive techniques for clinical monitoring of ototoxicity by MA. Their application is very simple, and their results help the physician to take the most adequate steps for each patient, thus avoiding permanent hearing damage.

Hearing and Auditory Working Memory in Women with Polycystic Ovarian Syndrome (PCOS)

Objectives: The present study assessed the hearing and auditory working memory in women with polycystic ovarian syndrome (PCOS). Study Design: Standard group comparison. Materials and Methods: A total of 20 female participants were included in the study and were divided into two groups. Group-1 included ten women diagnosed with PCOS, under ultrasound examination and hyperandrogenism was confirmed through hormonal analysis. Group-2 included ten healthy women, with no evidence of hyperandrogenism and normal menstrual cycles. Routine pure tone audiometry was done in the frequency range of 250 Hz to 8000 Hz and extended high frequency hearing thresholds from 9000 Hz to 16,000 Hz, was also obtained. Auditory working memory was assessed through digit span and digit sequencing tasks. Results: The results revealed that the extended high frequency audiometry threshold was significantly poorer for PCOS group compared to the normal group for 9000 Hz (F1, 34=9.444, p<0.05), 10000 Hz (F1, 34=6.120, p<0.05), 11200 Hz (F1, 34=9.211, p<0.05), 12500 Hz (F1, 34=12.651, p<0.05), 14000 Hz (F1, 34=41.342, p<0.05), 16000 Hz (F1, 34=12.230, p<0.05). Comparison across various auditory working memory tasks showed that the PCOS group performed significantly poorer on backward digit task (Z=-1.996, p<0.05), ascending digit task (Z=-1.989, p<0.05) and descending digit task (Z=-3.198, p<0.01). Conclusion: These findings suggest that the high frequency sensitivity and working memory is affected in subjects with PCOS compared to the normal group. The study highlights the importance of early identification of hearing loss in PCOS group and the importance of auditory working memory screening in women with PCOS.

Group-Wide, Prospective Study of Ototoxicity Assessment in Children Receiving Cisplatin Chemotherapy (ACCL05C1): A Report From the Children's Oncology Group.

Purpose Optimal assessment methods and criteria for reporting hearing outcomes in children who receive treatment with cisplatin are uncertain. The objectives of our study were to compare different ototoxicity classification systems, to evaluate the feasibility of including otoacoustic emissions and extended high frequency audiometry, and to evaluate a central review mechanism for audiologic results for cisplatin-treated children in the cooperative group setting. Patients and Methods Eligible participants were 1 to 30 years, with planned cisplatin-containing treatment. Hearing evaluations were conducted at baseline, before each cisplatin cycle, and at the end of therapy. Audiologic results were assessed and graded by the testing audiologist and by two central review audiologists using the American Speech-Language-Hearing Association Ototoxicity Criteria (ASHA), Common Terminology Criteria for Adverse Events, version 3.0 (CTCAE), and Brock Ototoxicity Grades (Brock). One central reviewer also used the International Society of Pediatric Oncology Ototoxicity Scale (SIOP). Results At the end of treatment, the prevalence of any degree of ototoxicity ranged from 40% to 56%, and severe ototoxicity ranged from 7% to 22%. Compared with CTCAE, SIOP detected significantly more ototoxicity ( P = .004), whereas Brock criteria detected significantly fewer patients with any or severe ototoxicity ( P < .001 for both). SIOP detected ototoxicity earlier than did the other scales. Agreement between the central reviewers and the institutional audiologist was almost perfect for ASHA and Brock, whereas the poorest agreement occurred with CTCAE. Conclusion The SIOP scale may be superior to ASHA, Brock, and CTCAE scales for classifying ototoxicity in pediatric patients who were treated with cisplatin. Future studies should evaluate inter-rater reliability of the SIOP scale.

Extended high frequency audiometry in users of personal listening devices

PurposeNoise exposure leads to high frequency hearing loss. Use of Personal Listening Devices may lead to decline in high frequency hearing sensitivity because of prolonged exposure to these devices at high volume. This study explores the changes in hearing thresholds by Extended High Frequency audiometry in users of personal listening devices. Material and methodA descriptive, hospital based observational study was performed with total 100 subjects in age group of 15–30years. Subjects were divided in two groups consisting of 30 subjects (Group A) with no history of Personal Listening Devices use and (Group B) having 70 subjects with history of use of Personal Listening Devices. Conventional pure tone audiometry with extended high frequency audiometry was performed in all the subjects. ResultSignificant differences in hearing thresholds of Personal Listening Device users were seen at high frequencies (3kHz, 4kHz and 6kHz) and extended high frequencies (9kHz, 10kHz, 11kHz, 13kHz, 14kHz, 15kHz and 16kHz) with p value <0.05. Elevated hearing thresholds were observed in personal listening devices users which were directly proportional to volume and duration of usage. ConclusionIn present study no significant changes were noted in hearing thresholds in PLD users before 5years of PLD use. However, hearing thresholds were significantly increased at 3kHz, 10kHz, 13kHz in PLD users having >5years usage at high volume. Thus, it can be reasonably concluded that extended high frequencies can be used for early detection of NIHL in PLD users.

Sound generator associated with the counseling in the treatment of tinnitus: evaluation of the effectiveness

IntroductionThe relations between the tinnitus and the hearing loss are due to the sensory deprivation caused by hearing loss, since this is followed by the functional and structural alteration of the auditory system as a whole. The cochlear lesions are accompanied by a reduction in the activity of the cochlear nerve, and the neural activity keeps increased in mainly all the central auditory nervous system to compensate this deficit. ObjectiveThis study aimed to verify the effectiveness of the sound generator (SG) associated with the counseling in the treatment of the tinnitus in individuals with and without hearing loss regarding the improvement of the nuisance through Tinnitus Handicap Inventory (THI) and Visual Analogue Scale (VAS). MethodsThe sample consisted of 30 individuals of both genders divided into two groups: Group 1 (G1) was comprised of 15 individuals with tinnitus and normal hearing, adapted to SG; Group 2 (G2) was comprised of 15 individuals with complaints of hearing acuity and tinnitus, adapted with SG and an individual hearing aid device (HA). Both groups underwent the following procedures: anamnesis and history of complaint, high frequency audiometry (HFA), imitanciometry, acuphenometry with the survey of psychoacoustic pitch and loudness thresholds and application of the tools THI and VAS. All of them were adapted with HA and Siemens SG and participated in a session of counseling. The individuals were assessed in three situations: initial assessment (before the adaptation of the HA and SG), monitoring and final assessment (6 months after adaptation). ResultsThe comparison of the tinnitus nuisance and handicap in the three stages of assessment showed a significant improvement for both groups. ConclusionThe use of the SG was similarly effective in the treatment of the tinnitus in individuals with and without hearing loss, causing an improvement of the nuisance and handicap.

Extended high frequency audiometry can diagnose sub-clinic involvement in a seemingly normal hearing systemic lupus erythematosus population

Conclusions: Sensorineural hearing loss must be considered within the clinical picture of systemic lupus erythematosus. The results confirm the usefulness of extended high-frequency audiometry in the audiologic testing of these patients, enabling the possibility of modifying or applying a preventive treatment for a possible hearing loss.Objectives: Hearing involvement is usually under-diagnosed with routine auditory examination. This study proposes the use of extended high-frequency audiometry to achieve a correct detection of a possible asymptomatic hypoacusis in early stages of the disease. The aim of this study is to analyze the hearing levels in extended high-frequencies in these patients and to correlate the hearing loss with the severity of the disease and the immunological parameters.Methods: A descriptive cross-sectional study was performed. Fifty-five patients with systemic lupus erythematosus were included in the study. The control group consisted of 71 patients paired by age and sex with the study population. Both a pure tone audiometry and an extended high-frequency audiometry (8–18 KHz) were performed.Results: In total, 70% were diagnosed with sensorineural hearing loss with extended high-frequency audiometry, overcoming the results obtained with pure tone audiometry (30.9%). Statistically significant correlations were found within the patients regarding sensorineural hearing loss related with age, disease activity and cryoglobulinemia.

The Role of Trace Elements in Tinnitus.

In this study, we aimed to investigate the role of three trace elements, namely, zinc, copper, and lead, in tinnitus by analyzing the serum level of copper and lead and both the serum and tissue level of zinc. Eighty patients, who applied to outpatient otolaryngology clinic with the complaints of having tinnitus, and 28 healthy volunteers were included. High-frequency audiometry was performed, and participants who had hearing loss according to the pure tone average were excluded; tinnitus frequency and loudness were determined and tinnitus reaction questionnaire scores were obtained from the patients. Of all the participants, serum zinc, copper, and lead values were measured; moreover, zinc levels were examined in hair samples. The levels of trace elements were compared between tinnitus and control groups. The level of copper was found to be significantly lower in the tinnitus group (p=0.02), but there was no significant difference between the groups in terms of the levels of zinc, neither in serum nor in hair, and lead in serum (p>0.05). The lack of trace elements, especially that of "zinc," have been doubted for the etiopathogenesis of tinnitus in the literature; however, we only found copper levels to be low in patients having tinnitus.

Does Vincristine affect Cochlear function in children with acute lymphoblastic leukaemia?

Context: Vincristine chemotherapy has dose dependent ototoxicity. Early detection of ototoxicity is better with otoacoustic emissions and high frequency audiometry than conventional pure tone audiometry. The study was done to see if vincristine treatment interferes with hearing sensitivity in children.Methods and Material: A prospective study was conducted on twenty-three children with acute lymphoblastic leukemia (ALL) on Multi Center Protocol (MCP 841).These were subjected to conventional audiometry, high frequency audiometry and distortion product otoacoustic emissions (DPOAEs) before starting chemotherapy. The follow up audiological evaluation after early intensive phase chemotherapy (approximately 6 months) was conducted in thirteen children, who received 12 doses of vincristine (1.4 mg/m2), cranial irradiation of 1800cGy (&gt;3 years) as per protocol and antibiotics as per clinical demands.Results: Baseline audiological evaluation was normal. Follow-up evaluation DPOAEs showed a declining tendency, however changes did not reach statistical significance. Differences in median hearing thresholds prior and post treatment in higher frequency audiometry were also minimal which was not statistically significant. Conventional audiometric thresholds were not altered.Conclusions: The reduction in the signal noise ratio of DPOAE, and reduced hearing sensitivity in high frequencies in post chemotherapy in comparison with baseline measures cannot be ignored though it has failed to reach the level of statistical significance. children on vincristine should have a pre chemotherapy and follow up audiological evaluation with DPOAE The results of the present study needs to be strengthened by including larger sample and long term follow up.Bangladesh J Medicine Jan 2016; 27(1) : 3-7

The application of extended high frequency audiometry in detecting the early hearing loss for thalassemia

Objective:To preliminarily explore the clinical significance of extended high frequency audiometry in evaluating the early hearing loss for thalassemia.Method:Pure tone audiometry(PTA) included conventional pure tone audiometry and extended high frequency audiometry were obtained on the pre and post-treatment day in 60(117 ears) patients from September in 2013 to October in 2014. Result:The averages of conventional pure tone audiometry for 117 cases were（15.72±11.62）dBHL on the pre-treatment day and（15.40±12.24）dBHL on the post-treatment day. There were no significant differences in PTA(P >0.05). But the hearing without detection rate was higher than before especially at 18 and 19 kHz. The differences of the hearing without detection rate between the pre-treatment and the post-treatment day were statistically significant(P <0.05).Conclusion:The extended high frequency may be more sensitive in evaluating the early hearing loss for thalassemia.

Hearing impairment in middle-aged patients with diabetes

ABSTRACTMost studies focus on elderly patients with type 2 diabetes mellitus (T2DM). There is little known about the hearing of middle-aged subjects with T2DM. The objective of this study is to evaluate hearing impairment in patients aged 40–50 years with T2DM using pure-tone audiometry and high-frequency audiometry. Forty patients with T2DM (19 males, 21 females) and 40 (20 males, 20 females) age and sex similar controls were included. All subjects completed clinical, laboratory and auditory assessments. Pure-tone audiometry auditory tests and high-frequency audiometry tests were performed in a soundproof room for each ear using the AC-40 audiometer from Interacoustics with a special earphone appropriate for high frequency. In the T2DM group, the duration of T2DM was between 5 and 15 years (7.7 ± 2.4 years). At all frequencies, the thresholds of the T2DM group were higher than the control group for both right and left ears and also significant. However, the thresholds at standard frequencies (125–8000 Hz) for both group's average were lower than 20 dB-HL and were considered to be normal, and at high frequencies (9000–16,000 Hz) the T2DM group's average thresholds were higher than 20 dB-HL and considered to be a hearing loss. A Spearman's correlation test was done between the duration of T2DM and hearing thresholds. There was a mild correlation between the duration of T2DM and hearing thresholds in all frequencies. In conclusion, patients with type 2 diabetes have a high prevalence of subclinical sensorineural hearing loss. High-frequency audiometry can be used in hearing assessment screening of diabetic patients.

An audiological profile of patients infected with multi-drug resistant tuberculosis at a district hospital in KwaZulu-Natal.

BackgroundThe increased incidence of multi-drug-resistant tuberculosis (MDR-TB) and the consequent use of aminoglycosides with their ototoxic potential necessitate a better understanding of the audiological pattern of infected patients.ObjectiveTo describe the occurrence and nature of hearing loss in patients with MDR-TB receiving aminoglycosides over a period of 6 months.MethodsBaseline and five consecutive monthly audiological assessments were conducted on 52 adults at a hospital in KwaZulu-Natal. A longitudinal descriptive study was implemented. A conventional audiological test battery, extended high frequency audiometry and otoacoustic emission testing were conducted. Data were analysed using SPSS version 19 statistical software package.ResultsDecreased hearing was the most common audiological symptom experienced. Bilateral sensorineural hearing loss was predominant. Ototoxic hearing loss was noted in 27 participants (52%) in 1 month post-treatment. Hearing loss progressed from mild to moderate at post-treatment one, to moderate to severe at post-treatment three and severe to profound at post-treatment five. Changes in hearing function were noted in 52 participants (100%) by post-treatment five. High and ultra-high frequencies were most affected. Speech discrimination scores deteriorated over time. The number of patients with absent distortion product otoacoustic emissions increased over treatment duration.ConclusionThe greatest effects were observed in the high frequencies before manifesting in the lower frequencies. This highlights the importance of inclusion of high frequency audiometry in the early detection of ototoxicity which can go undiagnosed with traditional audiometry. The high prevalence of hearing loss has implications for the provision of audiological service to this patient population.

Early detection of changes to hearing status attributed to treatment regimen with ototoxicity in the state of Qatar

Background Ototoxicity resulting from cisplatin chemotherapy constitutes a significant clinical problem and challenge. Therefore, an early and effective detection of hearing loss in pediatric oncology patients receiving ototoxic medication and early intervention are critical to help these patients in achieving these developmental milestones and improving their quality of life. Materials and methods This prospective, observational study was designed as an initial pilot study to collect and analyze data from January 2014 to January 2015 on a variety of parameters. All pediatric patients, aged less than 14 years, referred from the Pediatric Hematology/Oncology Clinic to the new Ototoxic Clinic were included in the study. Descriptive statistics were used to summarize the above data, and associations between two or more qualitative variables were assessed using the χ2-test or Fisher's exact test as appropriate. Results A total of 20 patients were included in the study. Diagnostic otoacoustic emission findings were found to be normal in 14 patients (80%); four patients (20%) had abnormal findings, and in two cases this test was not carried out. High-frequency audiometry test indicated that nine (52.9%) patients had normal findings, whereas five (29.4%) had abnormal results. High-frequency audiometry could not be carried out for six (30%) patients because of their ages. Hearing loss involving the speech frequencies affected only two patients (10%; 95% confidence interval 1.7–29.3); they were diagnosed to have β-thalassemia and retinoblastoma and are currently using xjade and cisplatin. Conclusion Early and effective identification of ototoxicity is vital in children receiving cancer treatments because of the impact acquired hearing loss has on social and educational outcomes in children. This study highlights the role of early detection of hearing loss in pediatric patient receiving ototoxic medication and of possible potential interventions to enhance their quality of life during and after treatment.

High-frequency Audiometry Hearing on Monitoring of Individuals Exposed to Occupational Noise: A Systematic Review.

Introduction The literature reports on high-frequency audiometry as one of the exams used on hearing monitoring of individuals exposed to high sound pressure in their work environment, due to the method́s greater sensitivity in early identification of hearing loss caused by noise. The frequencies that compose the exam are generally between 9 KHz and 20KHz, depending on the equipment.Objective This study aims to perform a retrospective and secondary systematic revision of publications on high-frequency audiometry on hearing monitoring of individuals exposed to occupational noise.Data Synthesis This systematic revision followed the methodology proposed in the Cochrane Handbook, focusing on the question: “Is High-frequency Audiometry more sensitive than Conventional Audiometry in the screening of early hearing loss individuals exposed to occupational noise?” The search was based on PubMed data, Base, Web of Science (Capes), Biblioteca Virtual em Saúde (BVS), and in the references cited in identified and selected articles. The search resulted in 6059 articles in total. Of these, only six studies were compatible with the criteria proposed in this study.Conclusion The performed meta-analysis does not definitively answer the study's proposed question. It indicates that the 16 KHz high frequency audiometry (HFA) frequency is sensitive in early identification of hearing loss in the control group (medium difference (MD = 8.33)), as well as the 4 KHz frequency (CA), this one being a little less expressive (MD = 5.72). Thus, others studies are necessary to confirm the HFA importance for the early screening of hearing loss on individuals exposed to noise at the workplace.

Incidence of tinnitus in mp3 player users

Exposure to loud noise is one of the main causes of tinnitus. AimTo analyze the incidence of tinnitus in mp3 player users and non-users. Material and methodOne hundred subjects aged from 15 to 30 years were enrolled, 54 of them were regular mp3 player users and 46 were not. Patients with continuous tinnitus for at least 6 months completed the Tinnitus Handicap Inventory (THI) and were tested with high frequency audiometry and transient-evoked otoacoustic emissions (TAOE). Study designA cross-sectional cohort study. ResultsThe incidence of tinnitus in non-users was about 8%; in mp3 player users it was about 28 %, a statistically significant difference. Hearing thresholds at 8kHz were significantly higher in tinnitus patients that used mp3 portable players. TAOE were reduced at 2 kHz in the users group. No statistically significant difference was found in the THI scores between the two groups. ConclusionTinnitus was more frequent in teenagers and young adults who regularly listen to mp3 music in players. Moreover, the incidence of tinnitus among mp3 player users was associated with higher hearing thresholds at 8 kHz and lower TOAE at 2 kHz. Clinicaltrials.gov registration number: NCT 01187251

High-frequency audiometry in normal hearing military firemen exposed to noise

The study of high frequencies has proven its importance for detecting inner ear damage. In some cases, conventional frequencies are not sensitive enough to pick up early changes to the inner ear.AimTo analyze the results of threshold high frequency analysis of individuals exposed to noise with normal conventional audiometry.Materials and MethodsThis was a retrospective cross-sectional cohort study, in which we studied 47 firefighters of the Fire Department of Rio de Janeiro, based on Santos Dumont airport and 33 military men without noise exposure. They were broken down into two age groups: 30-39years and 40-49years. The high frequencies were studied immediately after conventional audiometry.ResultsThe results were most significant in the 40 to 49 years of age range, where the experimental group showed significantly higher threshold values than the control group 14000Hz (p = 0.008) and 16,000Hz (p = 0.0001).ConclusionsWe concluded that noise interfered with high frequency thresholds, where all the mean values found in the experimental group were higher than those in the control group. We suggest that these data reinforce the importance of studying high frequencies, even with normal conventional audiometry in the early detection of noise-induced hearing loss.