High-frequency Pure-tone Average Research Articles

Early detection of sensorineural hearing loss in Muckle-Wells-syndrome.

BackgroundMuckle-Wells-syndrome (MWS) is an autoinflammatory disease characterized by systemic and organ-specific inflammation due to excessive interleukin (IL)-1 release. Inner ear inflammation results in irreversible sensorineural hearing loss, if untreated. Early recognition and therapy may prevent deafness. The aims of the study were to characterize the spectrum of hearing loss, optimize the otologic assessment for early disease and determine responsiveness to anti-IL-1-therapy regarding hearing.MethodsA single center prospective cohort study of children and adults with MWS was performed. Standardized clinical, laboratory and otologic assessments including standard pure tone audiometry, additional high tone thresholds, vestibular organ testing, tinnitus evaluation and functional disability classes were determined serially. Pure-tone-average models were developed and evaluated. Risk factors for hearing loss and the impact of anti-IL-1 treatment were determined.ResultsA total of 23 patients with genetically confirmed MWS were included, of whom 63 % were females; 52 % were children. At baseline all patients had active MWS; 91 % reported clinically impaired hearing with 74 % having an abnormal standard assessment (0.5–4 kHz). In contrast, high frequency pure tone averages (HF-PTA) were abnormal in all symptomatic patients including those with early hearing loss (sensitivity 100 %). Females were at highest risk for hearing loss even after adjustment for age (p = 0.008). Treatment with IL-1 blockade resulted in improved or stable hearing in 91 % of patients.ConclusionsEarly inner ear inflammation in MWS primarily affects the high frequencies, beyond the range of standard otologic assessment tools. The HF-PTA is a sensitive tool to detect imminent hearing loss and monitor treatment response.Electronic supplementary materialThe online version of this article (doi:10.1186/s12969-015-0041-9) contains supplementary material, which is available to authorized users.

Evaluation of the effects of nonlinear frequency compression on speech recognition and sound quality for adults with mild to moderate hearing loss

Objective: While potentially improving audibility for listeners with considerable high frequency hearing loss, the effects of implementing nonlinear frequency compression (NFC) for listeners with moderate high frequency hearing loss are unclear. The purpose of this study was to investigate the effects of activating NFC for listeners who are not traditionally considered candidates for this technology. Design: Participants wore study hearing aids with NFC activated for a 3–4 week trial period. After the trial period, they were tested with NFC and with conventional processing on measures of consonant discrimination threshold in quiet, consonant recognition in quiet, sentence recognition in noise, and acceptableness of sound quality of speech and music. Study sample: Seventeen adult listeners with symmetrical, mild to moderate sensorineural hearing loss participated. Better ear, high frequency pure-tone averages (4, 6, and 8 kHz) were 60 dB HL or better. Results: Activating NFC resulted in lower (better) thresholds for discrimination of /s/, whose spectral center was 9 kHz. There were no other significant effects of NFC compared to conventional processing. Conclusion: These data suggest that the benefits, and detriments, of activating NFC may be limited for this population.

Audiometric thresholds among a Canadian sample of 10 to 17 year old students

A total of 237 students, 10 to 17 years of age, from 14 schools underwent hearing evaluations. Otoscopic examination, tympanometry and air-conduction pure tone audiometry was conducted at low (0.5, 1, 2 kHz) and high (4 and 8 kHz) frequencies. In all schools, hearing thresholds were measured with headphones in a portable audiometric booth. Socio-demographic information from students and their parents were collected using questionnaires. Overall, the prevalence of any hearing loss greater than 15 dB was 22.3% for low or high frequency pure tone averages. Self-reported symptoms of hearing loss, such as tinnitus, difficulty following a conversation with background noise, and having to turn up the TV/radio more than in the past, were associated with audiometric thresholds, most notably at 4 kHz. These study findings are among the first to provide a detailed characterization of hearing status in a sample of youth in a Canadian demographic.

Effects of packing on the postoperative hearing after middle ear surgery

Conclusion. The changes of hearing by packing after middle ear surgery should be anticipated and carefully interpreted. Objectives. To evaluate the amount and patterns of hearing loss resulting from packing in middle ear cavity (MEC) and external auditory canal (EAC) after middle ear surgery. Method. We obtained pure tone thresholds by bone (BC) and air conduction (AC) up to 12 weeks after middle ear surgery in 17 patients who had minimal middle ear pathology. To observe the effects of packing only in the EAC as in cases of explorative tympanotomy or stapes surgery, BC and AC threshold were obtained after packing only in the EAC in 18 volunteers. The changes of BC and AC thresholds in terms of pure tone average (PTA) and high frequency PTA were analyzed. Results. PTA by AC increased significantly by a maximal value of 38.7 dB at the second postoperative day, by 35.0 dB at 1 week after middle ear surgery. PTA by BC also increased maximally at the second postoperative day by 4.8 dB. The elevation of BC threshold at high frequencies (2, 3, 4 kHz) was more pronounced. Packing of EAC without MEC packing resulted in elevation of AC threshold by 43.0 dB, with similar patterns of BC threshold changes as MEC and EAC packing.

A prospective study of hearing changes after beginning zidovudine or didanosine in HIV-1 treatment-naïve people

BackgroundWhile hearing loss in HIV-infected people after beginning nucleoside reverse transcriptase inhibitors (NRTIs) has been reported, there have been no prospective studies that measured hearing changes longitudinally in treatment-naïve HIV-infected subjects following initiation of regimens containing NRTIs. The goal of this study was to conduct a prospective assessment of the contribution of zidovudine (ZDV) and didanosine (ddI) to hearing lossMethods/designA prospective observational pilot study to determine whether ZDV or ddI, alone or in combination, are associated with sensorineural hearing loss in HIV-infected persons. Changes in hearing levels at all frequencies and in low and high frequency pure tone averages were measured at baseline, 16, and 32 weeks after initiating antiretroviral therapy.DiscussionTreatment with ZDV and ddI did not result in loss of hearing, even after taking into account noise exposure, immune status and age. The results of this prospective pilot study do not support the notion that treatment with nucleoside antiretrovirals damages hearing.

Sudden deafness and Lyme disease.

Otolaryngological manifestations are common in Lyme disease, affecting up to 75% of patients. One of these symptoms is sudden deafness. Hearing loss has been frequently described in Lyme disease; on the other hand, titers seropositive for, the causal agent of this disease, have been found in almost 20% of cases of sudden deafness. No consensual information exists on the outcome of Borrelia-seropositive patients or on the importance of determining Borrelia antibody titers. The present study aimed to determine the prevalence of seropositivity for Borrelia in sudden deafness, describing clinical characteristics and outcomes. This was a prospective observational study. Forty-seven consecutive patients with sudden deafness were enrolled in the study. Demographic data, the presence of tinnitus and vertigo, and low- and high-frequency pure-tone averages were recorded. The percentage of hearing recovery was determined. Data obtained from Borrelia-seropositive patients were described and compared with those from the seronegative group. Titers positive for antibodies were present in 21.3% of the cases. Seropositive and seronegative groups of patients were homogeneous concerning age, sex distribution, the presence of tinnitus and vertigo, and high- and low-frequency hearing thresholds. Hearing outcome was not significantly different between the groups of patients. No distinctive clinical characteristic was found between seropositive and seronegative subjects. The hearing outcome of treated Borrelia-seropositive patients was similar to that of the seronegative group.

Hearing development in classical orchestral musicians. A follow-up study.

Using pure tone audiometry in 1995, a hearing reassessment was made in 56 classical musicians who participated in Axelsson & Lindgren's study 16 years earlier, in 1979. This study focuses on hearing development in these classical orchestra musicians, active in Göteborg, Sweden. The aim of the study is to evaluate the risk of progressive hearing loss during work in a classical orchestra. Another aim is to study possible hearing differences in females and males and to compare the high frequency pure-tone average values found in the study with two normal materials. The main findings were that the male, compared to the female musicians, showed a tendency toward a more pronounced, although not significant, hearing reduction in the high frequency region and higher threshold distribution within the 90th percentile than the females. This was found most often in the left ear. The median audiogram for all females showed a notch configuration at 6 kHz, compared to the males who had a high-tone sloping configuration. When comparing high frequency pure-tone average (HFPTA) values with ISO 7029, the females are distributed around the ISO 7029 median and well within the 90th percentile. The average among the males was equal with the median. Comparison with Davis normal population "all the sample, overall occupational group" showed a more even distribution of the HFPTA values around the median for both females and males on both occasions. This follow-up study showed no extended negative progress of the pure-tone hearing threshold values in spite of an additional 16 years of musical noise exposure.

Hearing loss in community-dwelling older persons: national prevalence data and identification using simple questions.

To estimate the prevalence of hearing loss among community-dwelling older persons according to clinical criteria and to develop a brief self-report screening instrument to detect hearing loss. Survey. National probability sample of noninstitutionalized older persons. A total of 2506 persons aged 55 to 74 who participated in the National Health and Nutrition Examination Survey. Hearing loss as defined by Ventry and Weinstein (VW) criteria and by the High Frequency Pure-Tone Average (HFPTA) scale. Hearing loss by VW criteria was present in 14.2% and by HFPTA criteria in 35.1% of those surveyed. The prevalence increased with advancing age and was higher among men and those with less education. A logistic regression model identified six independent factors for hearing loss by VW criteria: age > or = 70 years (adjusted odds-ratio (AOR) 2.7, 95% confidence interval (95% CI) 1.6, 4.4), male gender (AOR 3.0, 95% CI 1.9, 4.8), < or = 12th grade education (AOR 3.8, 95% CI 1.8, 7.7), having seen a doctor for deafness or hearing loss (AOR 8.9, 95% CI 5.3, 14.9), unable to hear a whisper across a room (AOR 3.2, 95% CI 2.0, 5.1), and unable to hear a normal voice across a room (AOR 6.2, 95% CI 2.6, 14.9). A clinical scale based on the logistic model had 80% sensitivity and 80% specificity in predicting hearing loss using VW criteria and 59% sensitivity and 88% specificity in predicting hearing loss using HFPTA criteria. Hearing loss, as defined by two clinical criteria, is common and can be screened for accurately using simple questions that assess sociodemographic and hearing-related characteristics.

Methods for Screening for Hearing Loss in Older Adults

Two common screening tools for detecting hearing loss, the Hearing Handicap Inventory for the Elderly-Screening Version (HHIE-S) and Audioscope, are compared. One hundred eighty-five consecutive patients over age 60 at a primary care clinic received both screening tests followed by pure tone audiometry. Three criteria for hearing loss was considered: Speech Frequency Pure Tone Average > or = 25 dB; High Frequency Pure Tone Average > or = 25 dB; and Ventry and Weinstein's criteria of a 40 dB loss at 1.0 or 2.0 kHz. Ranges of respective operating characteristics for the Audioscope versus the HHIE-S were: sensitivities 0.64 to 0.96 versus 0.29 to 0.63; specificities 0.80 to 0.91 versus 0.75 to 0.93; and positive likelihood ratios 4.86 to 7.52 versus 2.42 to 4.27. Most patients preferred screening with the Audioscope (60%) over the HHIE-S (13%). The Audioscope is preferred by patients, and outperforms the HHIE-S using a variety of reference standard definitions.