High Frequency Pure Tone Audiometry Research Articles

High-Frequency Hearing Loss Is Associated With Anxiety and Brain Structural Plasticity in Older Adults.

Age-related hearing loss (ARHL) is a kind of symmetrical and slow sensorineural hearing loss, which is a common condition in older adults. The characteristic of ARHL is hearing loss beginning in the high-frequency region and spreading toward low-frequency with age. Previous studies have linked it to anxiety, suggesting that brain structure may be involved in compensatory plasticity after partial hearing deprivation. However, the neural mechanisms of underlying ARHL-related anxiety remain unclear. The purpose of this cross-sectional study was to explore the interactions among high-frequency hearing loss and anxiety as well as brain structure in older adults. Sixty-seven ARHL patients and 68 normal hearing (NH) controls participated in this study, and the inclusion criterion of ARHL group was four-frequency (0.5, 1, 2, and 4 kHz) pure tone average (PTA) > 25 decibels hearing level of the better hearing ear. All participants performed three-dimensional T1-weighted magnetic resonance imaging (MRI), pure tone audiometry tests, anxiety and depression scales. Our results found gray matter volume (GMV) decreased in 20 brain regions in the ARHL group compared with the NH group, and a positive correlation existed between high-frequency pure tone audiometry (H-PT) and anxiety scores in the ARHL group. Among 20 brain regions, we also found the GMVs of the middle cingulate cortex (MCC), and the hippocampal/parahippocampal (H-P) regions were associated with H-PT and anxiety scores in all participants separately. However, the depressive symptoms indicated no relationship with hearing assessment or GMVs. Our findings revealed that the crucial role of MCC and H-P in a link of anxiety and hearing loss in older adults.

ZABURZENIA ŚLIMAKOWE U PACJENTÓW Z BIELACTWEM

BackgroundVitiligo is a common chronic disease of pigmentation, which may be accompanied by audiological abnormalities.Material and methodsThe aim of this study was to assess vitiligo patients in terms of hearing thresholds using conventional pure tone audiometry (0.25 to 8 kHz), high frequency pure tone audiometry (10 and 12.5 kHz), as well as Transient Evoked Otoacoustic Emissions (TEOAEs). We correlated the audiometric findings with vitiligo duration and severity. The study included 75 subjects with a mean age of 29.7 ± 8.6 years. There were 50 vitiligo patients and 25 age and gender matched healthy controls who had never had any audiological condition or exposed to excessive noise.ResultsOnly 24% of vitiligo patients had high frequency sensorineural hearing loss (SNHL) using conventional audiometry and the majority (76%) had bilaterally normal hearing. The majority (90%) of vitiligo patients had SNHL in extended high frequency audiometry. There was a statistically significant difference between the cases and controls regarding TEOAE SNR at 5 kHz, and nearly half of the normal hearers had an abnormal TEOAE. Vitiligo patients were found to have subclinical inner ear dysfunction compared with the controls. There was a statistically significant correlation between PTA and age of the patients but not with vitiligo duration or severity.ConclusionsThe audiometric findings of the vitiligo group and the statistically significant differences from the control group suggest a subclinical involvement of the cochlea, probably related to the vitiligo condition, but not affected by vitiligo duration or severity. We therefore recommend the use of extended high frequency audiometry and otoacoustic emission tests for early detection of inner ear involvement in vitiligo.

Auditory dysfunction in patients with Huntington’s disease

ObjectiveHuntington’s disease (HD) is an autosomal, dominantly inherited, neurodegenerative disease. The main clinical features are motor impairment, progressive cognitive deterioration and behavioral changes. The aim of our study was to find out whether patients with HD suffer from disorders of the auditory system. MethodsA group of 17 genetically verified patients (11 males, 6 females) with various stages of HD (examined by UHDRS – motor part and total functional capacity, MMSE for cognitive functions) underwent an audiological examination (high frequency pure tone audiometry, otoacoustic emissions, speech audiometry, speech audiometry in babble noise, auditory brainstem responses). Additionally, 5 patients underwent a more extensive audiological examination, focused on central auditory processing. The results were compared with a group of age-matched healthy volunteers. ResultsOur results show that HD patients have physiologic hearing thresholds, otoacoustic emissions and auditory brainstem responses; however, they display a significant decrease in speech understanding, especially under demanding conditions (speech in noise) compared to age-matched controls. Additional auditory tests also show deficits in sound source localization, based on temporal and intensity cues. We also observed a statistically significant correlation between the perception of speech in noise, and motoric and cognitive functions. However, a correlation between genetic predisposition (number of triplets) and function of inner ear was not found. ConclusionsWe conclude that HD negatively influences the function of the central part of the auditory system at cortical and subcortical levels, altering predominantly speech processing and sound source lateralization. SignificanceWe have thoroughly characterized auditory pathology in patients with HD that suggests involvement of central auditory and cognitive areas.

Otoacoustic emissions recorded in people with chronic migraine

Migraine, a moderate to severe chronic headache occurring on one or both sides, is a common disease affects young people. Although hearing loss in subjects with migraine is not rare, the correlation of migraine with hearing loss is not clear. In this study, we examined hearing loss in young migraine subjects to determine if migraine may be a factor in causing cochlear dysfunction. Seven college students with migraine and three age matched subjects without history of migraine were assessed using extended high frequency audiometry and distortion product otoacoustic emissions (DPOAEs). There was no significant difference in regular audiometry threshold between the migraine group and the control group. However, high frequency audiometry (9–16 kHz) showed thresholds at 25 dB nHL or higher in six out of twenty ears in the migraine group. The amplitude of DPOAEs were reduced for more than 10 dB in the migraine group in comparison with the control group. These data suggest that migraine may affect cochlear dysfunction evidenced by the reduced amplitude of DPOAE and high frequency pure-tone audiometry.

Dokładność diagnostyki z zastosowaniem wysokoczęstotliwościowej emisji otoakustycznej produktów zniekształceń nieliniowych w badaniach przesiewowych u dzieci w wieku szkolnym z zespołem Downa

BackgroundIt has been suggested that children with Down syndrome (DS) may display high frequency hearing loss much earlier than those in the general population. The purpose of this study was to investigate the diagnostic accuracy of high-frequency distortion-product otoacoustic emissions (HFDPOAEs) as a screening technique for schoolchildren with DS.Material and MethodsExactly 25 children with DS (15 males, 10 females, mean age =9.7 years, SD=2.6) were sampled from six special education schools. HFDPOAE results were compared to the reference test results – high-frequency pure tone audiometry (HFPTA) at 8 and 10 kHz.ResultsTest performance was found to reach adequate levels (≥0.7) of accuracy for HFDPOAE SNR at 8 kHz and 10 kHz. The hit rate at 8 kHz was average, but moderately high at 10 kHz. True negative rates and positive posterior probabilities for the HFDPOAE test were high, and false alarm rates were acceptably low. However, the false negative rate was average at 8 kHz and negative posterior probabilities were moderately high at both frequencies. Efficiency index values were high indicating that a large proportion of HFDPOAE results were correct when compared with HFPTA results.ConclusionsInitial findings support the potential future use of HFDPOAE for screening children with DS for high-frequency hearing loss.

Comparison of the effectiveness of monitoring Cisplatin-induced ototoxicity with extended high-frequency pure-tone audiometry or distortion-product otoacoustic emission.

Background and ObjectivesTo compare the effectiveness of monitoring cisplatin-induced ototoxicity in adult patients using extended high-frequency pure-tone audiometry (EHF-PTA) or distortion-product otoacoustic emission (DP-OAE) and to evaluate the concurrence of ototoxicity and nephrotoxicity in cisplatin-treated patients.Subjects and MethodsEHF-PTA was measured at frequencies of 0.25, 0.5, 1, 2, 3, 4, 6, 8, 9, 11.2, 12.5, 14, 16, 18, and 20 kHz and DP-OAE at frequencies of 0.5, 0.75, 1, 1.5, 2, 3, 4, 6, and 8 kHz in cisplatin-treated patients (n=10). Baseline evaluations were made immediately before chemotherapy and additional tests were performed before each of six cycles of cisplatin treatment. Laboratory tests to monitor nephrotoxicity were included before every cycle of chemotherapy.ResultsFour of 10 patients showed threshold changes on EHF-PTA. Five of 10 patients showed reductions in DP-OAE, but one was a false-positive result. The results of EHF-PTA and DP-OAE were consistent in two patients. Only one patient displayed nephrotoxicity on laboratory tests after the third cycle.ConclusionsIn our study, the incidence rate of cisplatin-induced ototoxicity was 40% with EHF-PTA or DP-OAE. Although both EHF-PTA and DP-OAE showed the same sensitivity in detecting ototoxicity, they did not produce the same results in all patients. These two hearing tests could be used to complement one another. Clinicians should use both tests simultaneously in every cycle of chemotherapy to ensure the detection of ototoxicity.

Effect of mastoid drilling on hearing of the contralateral ear

This study aimed to: understand the effect that high intensity noise associated with drilling (during otological surgery) has on hearing in the contralateral ear; determine the nature of hearing loss, if any, by establishing whether it is temporary or persistent; and examine the association between hearing loss and various drill parameters. A prospective clinical study was carried out at a tertiary centre. Thirty patients with unilateral cholesteatoma and normal contralateral hearing were included. Patients were evaluated pre-operatively and for five days following surgery using high frequency pure tone audiometry, and low and high frequency transient evoked and distortion product otoacoustic emission testing. The findings revealed statistically significant changes in distortion product otoacoustic emissions at high frequencies (p = 0.016), and in transient evoked otoacoustic emissions at both low and high frequencies (p = 0.035 and 0.021, respectively). There was a higher statistical association between otoacoustic emission changes and cutting burrs compared with diamond burrs. Drilling during mastoid surgery poses a threat to hearing in the contralateral ear due to noise and vibration conducted transcranially.

Audiological findings in pediatric perineal allergic rhinitis (house dust mite allergy) patients

Allergic rhinitis is the type 1 hypersensitivity reaction of the nasal mucosa and its primary mediator is Ig E. It is most frequently observed in children and adolescents. Our purpose in this study is to investigate the impact of allergy on hearing functions in children with perineal allergic rhinitis (house dust mite allergy). 50 perineal allergic rhinitis (house dust mite allergy) patients (33 male, 17 female patients, aged between 6 and 15, average age 10.4) and 20 control patients (12 male, 8 female, aged between 6 and 15, average age 11.2) underwent high frequency pure tone audiometry, acoustic reflex, otacoustic emission (OAE) and auditory brainstem potentials to assess their auditory functions. No statistically significant difference was detected between the study group and the control group with respect to their hearing thresholds (250-16,000Hz). No statistically significant difference was detected as a result of the comparison between the study group and control group in terms of their signal-noise ratios at Distortion Product OAE in all frequencies (996-8,004Hz). No statistically significant difference was detected between the study group and the control group in terms of the 1st, 3rd and 5th wave latencies and 1-3, 3-5 and 1-5 inter-peak values. This study is the first study where the audiological functions of the pediatric perineal allergic rhinitis (house dust mite allergy) patients were assessed. No significant difference was detected between the group of pediatric perineal allergic rhinitis (house dust mite allergy) patients and the control group with respect to their audiological functions.

High-Frequency Pure-Tone Audiometry in Children: A Test–Retest Reliability Study Relative to Ototoxic Criteria

Good test-retest reliability of high frequency (≥ 8 kHz) pure-tone audiometry (HFPTA) is essential to detect significant changes in hearing threshold caused by ototoxicity. While the test-retest reliability of HFPTA in adults has been extensively studied, such investigations in children are scant. This study aimed to evaluate the test-retest reliability of the HFPTA in normal-hearing children with particular reference to the criteria for ototoxicity. Participants were 125 children aged between 4 and 13 yr, with normal hearing in the 0.25 to 4 kHz range and normal tympanometric findings. The participants were divided into three age groups, 4 to 6 yr (16M; 16F); 7 to 9 yr (22M; 30F); and 10 to 13 yr (24M; 17F), for investigating possible age effects in the test-retest reliability of HFPTA. The instrumentation for the HFPTA procedure was an Interacoustics AC40 audiometer with Koss R/80 high-frequency headphones, calibrated to meet Australian standards. Hearing thresholds at 8, 9, 10, 11.2, 12.5, 14, and 16 kHz were measured in a sound-treated chamber using a modified Hughson-Westlake procedure with a 5 dB step size. Testing began with an ear and test frequency selected at random; the subsequent test frequencies were randomly selected. After acquisition of hearing threshold data at all frequencies, the other ear was tested using the same procedure. After the first HFPTA test, the headphones were removed and carefully replaced. A second HFPTA test was performed with the ear order reversed. The order of testing the ear for the next participant was reversed. Good test-retest reliability of HFPTA was achieved with no significant difference in mean HFPTA thresholds across test and retest conditions for all age groups. An age effect in the test-retest reliability of HFPTA was evident with the 4- to 6-yr-old, 7- to 9-yr-old, and 10- to 13-yr-old children demonstrating normal variability of thresholds (within ±10 dB) in 89.9%, 93.0%, and 97% of ears tested, respectively. When the variability of test-retest thresholds was assessed at each frequency, the 4 to 6 yr group showed significantly lower percentage of normal variability at 14 kHz. In identifying significant deterioration of hearing thresholds across test-retest conditions in relation to the ASHA (1994) ototoxicity criteria, the three age groups (youngest to oldest) demonstrated false-positive rates of 24.6%, 11%, and 7.6%, respectively. : Overall, this study demonstrated high test-retest reliability of HFPTA in all but the 4 to 6 yr group. With a false-positive rate of 24.6% for ototoxicity for the youngest group, it is recommended that the HFPTA should not be used alone in assessing the possibility of a genuine threshold shift for this age group. If possible, the HFPTA should be supplemented with an objective test of auditory function to confirm the diagnosis. For children aged 7 yr or older, the HFPTA test is promising as a useful tool to identify hearing impairment in the extended high-frequency range (>8 kHz). However, interpretation of HFPTA findings in serial testing for monitoring hearing in a child should be made with due attention being given to the frequency of the stimulus, age of the child, and the associated nonzero false-positive rates.

“High Frequency Presbycusis”–Is There an Earlier Onset?

The objective of this study is to determine whether presbycusis occurs much earlier than previously believed if the high frequency (above 8kHz) are included. Tertiary referral center (a teaching University). This is a cross-sectional observational study. Healthy adults from 20 to 49years of age who had essentially normal hearing were included into the study. They were subjected to high frequency pure tone audiometry (until 16kHz). Participants were grouped based on age ranges of 10years (e.g., 20-29, 30-39, and 40-49) and the presence of symmetrical high frequency sensor neural hearing loss were documented. There is a significant presence of symmetrical high frequency sensor neural hearing loss (not attributed to any known risk factors) as early as from the age group of 40 to 49years. Seven of 43 participants (16%) from age group of 20 to 29years and 12 of 24 participants (50%) from age group of 30 to 39years had significant high frequency hearing loss. High frequency hearing loss (high frequency Presbycusis) may occur much earlier than previously believed.

C048 Objective and subjective evaluation of Neurelec Saphyr® speech processor

Huntington’s disease (HD) is an autosomal, dominantly inherited, neurodegenerative disease. The main clinical features are motor impairment, progressive cognitive deterioration and behavioral changes. The aim of our study was to find out whether patients with HD suffer from disorders of the auditory system.A group of 17 genetically verified patients (11 males, 6 females) with various stages of HD (examined by UHDRS – motor part and total functional capacity, MMSE for cognitive functions) underwent an audiological examination (high frequency pure tone audiometry, otoacoustic emissions, speech audiometry, speech audiometry in babble noise, auditory brainstem responses). Additionally, 5 patients underwent a more extensive audiological examination, focused on central auditory processing. The results were compared with a group of age-matched healthy volunteers.Our results show that HD patients have physiologic hearing thresholds, otoacoustic emissions and auditory brainstem responses; however, they display a significant decrease in speech understanding, especially under demanding conditions (speech in noise) compared to age-matched controls. Additional auditory tests also show deficits in sound source localization, based on temporal and intensity cues. We also observed a statistically significant correlation between the perception of speech in noise, and motoric and cognitive functions. However, a correlation between genetic predisposition (number of triplets) and function of inner ear was not found.We conclude that HD negatively influences the function of the central part of the auditory system at cortical and subcortical levels, altering predominantly speech processing and sound source lateralization.We have thoroughly characterized auditory pathology in patients with HD that suggests involvement of central auditory and cognitive areas.

High Frequency Pure Tone Audiometry (8–16 kHz) in Children: A Normative Study

Establishing normative high frequency pure tone audiometry (HFPTA) threshold data would assist in monitoring ototoxicity in the paediatric oncology population. The present study aimed to acquire HFPTA (8-16 kHz) data from normally hearing children in a common clinical setting. Participants were 129 normally hearing children (63 males and 66 females), aged between 4 and 13 years (mean = 8.4 years; SD = 2.2 years). HFPTA thresholds at 8, 9, 10, 11.2, 12.5, 14, and 16 kHz were measured using an Interacoustics AC40 audiometer with Koss R/80 high frequency headphones. The results from the normative HFPTA data showed that the mean threshold and standard deviation values increased with frequency. A significant age effect was found with the youngest age group showing poorer HFPTA thresholds than their older counterparts. This indicates that children aged 4 to 6 years require a separate set of norms from children aged 7 years and older.

Hearing Abilities at Ultra-High Frequency in Patients with Tinnitus

ObjectivesTo compare tinnitus patients who have normal hearing between 250 Hz and 8 kHz with normal controls with regard to the ability of each group to hear extended high-frequency pure tone thresholds.MethodsWe enrolled 18 tinnitus patients, each of whom had a threshold of HL <25 dB and threshold differences of <10 dB between ears at frequencies of 250 and 500 Hz and 1, 2, 4, and 8 kHz. We also enrolled age- and gender-matched normal volunteers (10 ears), for each patient. Extended high frequency pure tone audiometry was performed, and the mean hearing thresholds at 10, 12, 14, and 16 kHz of each tinnitus ear were compared with those of the 10 age- and sex-matched normal ears.ResultsOf the 18 patients with tinnitus, 12 had significantly increased hearing thresholds at more than one of the four high frequencies, compared with the normal group. When we assessed results according to frequency, we found that 8 patients had decreased hearing ability at 10 kHz, 10 at 12 kHz, 8 at 14 kHz, and 4 at 16 kHz.ConclusionSome patients with tinnitus who have normal hearing below 8 kHz have decreased hearing ability at extended high-frequencies. Thus, the proportion of patients with tinnitus who have normal hearing over the entire audible range is smaller than in previous reports.

Absence of Cochleotoxicity Measured by Standard and High-Frequency Pure Tone Audiometry in a Trial of Once- versus Three-Times-Daily Tobramycin in Cystic Fibrosis Patients

We undertook assessment of hearing in patients with cystic fibrosis who were taking part in a large randomized controlled trial of once- versus three-times-daily tobramycin for pulmonary exacerbations of cystic fibrosis (the TOPIC study). All patients were eligible to have standard pure tone audiometry performed across the frequency range of 0.25 to 8 kHz. High-frequency pure tone audiometry over 10 to 16 kHz was also performed with a subset of patients. Audiometry was undertaken at the start of tobramycin treatment, at the end of a 14-day course of treatment, and at follow-up 6 to 8 weeks later. We enrolled 244 patients, of whom 219 (125 children and 94 adults) completed treatment. Nineteen patients were excluded from analysis due to abnormal baseline audiometry. Complete pre- and posttreatment standard audiological data were obtained for 168/219 patients. We found no significant differences in hearing thresholds when they were assessed at the baseline, at the end of treatment, and at follow-up 6 to 8 weeks later were compared. In addition, no significant differences in hearing thresholds were detected between treatment regimens. Similar results were obtained for the subset of 63/168 patients who underwent high-frequency audiometry. We conclude that for a single 14-day course of tobramycin treatment in patients with cystic fibrosis with no preexisiting auditory deficit, no measurable effect on hearing was apparent with either once- or three-times-daily treatment. Estimation of the cumulative cochleotoxic risk in cystic fibrosis patients due to repeated aminoglycoside therapy, as evidenced by the patients excluded from this study due to hearing loss, also requires further characterization.