High Frequency Sensorineural Hearing Loss Research Articles

How can the routine use of face masks by medical professionals affect hearing-impaired patients’ perception of speech? A case–control study

BackgroundFacemasks are routinely used among healthcare providers, especially after the COVID-19 pandemic. However, they negatively impact speech perception. Our study investigated how speech perception using the word discrimination score (WDS) was affected by wearing surgical and KN95 masks while dealing with hearing-impaired healthcare recipients.MethodThis case–control study included 60 participants [15 with normal hearing and 45 with varied degrees of sensorineural hearing loss (SNHL)], for whom word discrimination scores (WDS) were evaluated under various mask conditions.ResultsOn applying repeated measures of two-way analysis of variance (RM two-way ANOVA), there was statistically significant interaction (p = 0.0018), meaning that the level by which the mask affects the WDS depends on the underlying hearing level. Both main factors showed a statistically significant effect (p < 0.0001). Surgical masks had a lesser impact on speech discrimination compared to KN 95.ConclusionsIt was concluded that KN95 severely impacted the WDS among all groups relative to surgical mask and the no-mask condition. Although the high-frequency SNHL (HF-SNHL) group had mild hearing loss in the pure tone audiometry (PTA) average, they showed lower WDS relative to the mild to moderate flat SNHL (MM-SNHL). Moderately severe to severe SNHL expressed the worst values. As a result, the surgical mask is recommended over the KN95 mask since it provides better speech discrimination while giving adequate protection. These findings should be taken into consideration as they will have an impact on communication, especially in situations like hospitals where the patients must understand the instructors and healthcare providers very well.

Prospective Observational Study of Evaluating Cisplatin-Induced Ototoxicity in Patients

Abstract Introduction Platinum-based chemotherapeutic agents cisplatin and carboplatin are two of the most widely used drugs in cancer today. They display wide range of adverse reactions; among them, ototoxicity is an important cumulative toxicity that more commonly observed with cisplatin. At a later stage, it can affect speech of individual and lead to communication problem with decreased cognitive function and depression in cancer survivors. Periodic monitoring of hearing loss with pure-tone audiometry (PTA) provides early evidence of ototoxicity which may decrease debilitating effect of the same in a patient. Objective The primary objective of this study was to assess cisplatin-induced ototoxicity. We also investigated its severity, reversibility, and other modifying risk factors. Materials and Methods We conducted a prospective observational descriptive type of epidemiological study. The study was conducted over 80 randomly selected cancer patients (for estimation of sample size, the following formula was used n = [Zα 2 PQ] / d 2), who were starting with their first cycle of cisplatin from August 2018 to July 2020. This study was conducted at tertiary cancer care center in western Gujarat which caters patients from all over India. We performed PTA in all randomized patients at baseline and periodically. We classified hearing loss according to the World Health Organization (WHO) criteria. Results A total of 30% (n = 24) patients developed cisplatin-induced ototoxicity according to WHO criteria at end of 3 months after starting the first cycle of cisplatin. It was sensory neuronal, affecting both the ears equally, and was seen predominantly at high frequency. We observed hearing loss at 3 months to be significantly more common in the 301 to 400 mg/m2 cumulative dose group (47%), as compared with the other two groups (0–200 mg/m2 and 201–300 mg/m2; p &lt; 0.05). It showed dose dependency with cisplatin. In the multivariate step-wise regression model, baseline hearing loss (odds ratio [OR] = 17.71, 95% confidence interval [CI]: 6.57–118.91, p &lt; 0.05) and cumulative cisplatin dose of more than 300 mg/m2 were significantly associated with hearing loss at 3 months (OR = 6.62, 95% CI: 2.33–18.74, p &lt; 0.05). Conclusion Cisplatin-induced ototoxicity manifests as a bilateral high frequency sensorineural hearing loss. Cumulative dose of cisplatin is an important predictor of development of ototoxicity. Baseline and periodic audiometric monitoring could detect ototoxicity early which leads to possible limitation on the severity of ototoxicity.

The Onset-Offset N1-P2 Cortical Auditory Evoked Response in Individuals With High-Frequency Sensorineural Hearing Loss: Responses to High- and Low-Frequency Narrowband Noise.

This study aimed to determine whether onset-offset N1-P2 auditory evoked responses differ in amplitude, latency, and offset-to-onset trough-to-peak N1-P2 amplitude ratios (OOAR) between normal hearing (NH) sensitivity and moderate high-frequency sensorineural hearing loss (HFSNHL) groups when stimuli target regions of peripheral hearing sensitivity where the groups are in the normal range (i.e., 500 Hz) versus where they differ regarding presence of hearing loss (i.e., 4000 Hz). Onset-offset N1-P2 auditory evoked responses were measured from 10 participants with normal hearing sensitivity and seven participants with moderate HFSNHL using 500-Hz and 4000-Hz narrowband noise (NBN) stimuli. Stimuli were 2000 ms with 40-ms rise-fall times presented at 50 dB SL referenced to stimulus behavioral thresholds. Amplitudes and latencies were analyzed for N1 and P2 onset and offset components via repeated measures analysis of variance (ANOVA). OOARs were compared between groups using one-way ANOVA and across stimuli per group using paired samples t tests. Despite dB SPL stimulus presentation differences between groups, there were no significant differences in individual/absolute amplitude and latency waveform components between groups for either stimulus. Derived comparative calculations of OOAR for 4000-Hz NBN were significantly larger (p < .025; NH: .39; HFSNHL: .62) for the group with HFSNHL than the group with NH sensitivity; 500-Hz NBN OOAR did not reach significance. OOARs revealed no significant difference between stimuli for the group with normal hearing sensitivity, with .38 OOAR for both stimuli (p = .961). OOAR comparisons for the HFSNHL group across stimuli were significant (p = .012), with the 4000-Hz NBN OOAR being nearly double the size of the 500-Hz NBN OOAR. OOARs may provide insight to the balance of excitatory and inhibitory neural firing in the central auditory nervous system (CANS). Larger OOARs may be a biomarker of reduced CANS inhibition, perhaps indicative of a homeostatic central auditory gain mechanism.

English

BACKGROUND Radiotherapy is a very well-known treatment modality for head and neck cancers besides surgery. The cochlea and its neuroepithelium are sensitive to ionizing radiation and resultant damage as it remains in the field of irradiation, the chemotherapy also has a similar effect leading to sensorineural hearing loss (SNHL). To minimize the adverse effects of hearing the advent of technology like intensitymodulated radiotherapy (IMRT) using smaller doses of radiation is now available with good control of the disease. The intended concomitant uses of chemotherapeutic agent cisplatin for increasing the sensitivity of radiation may induce ototoxicity. Both of these modalities result in a pronounced effect on highfrequency sensorineural hearing loss. We wanted to determine and compare sensorineural hearing loss amongst cases of head and neck cancer treated by radiotherapy, chemotherapy either alone or in a combination of both. METHODS All clinically diagnosed patients of head and neck cancer requiring treatment using radiotherapy or chemotherapy alone or in combination having a normal hearing on pure tone audiometry (PTA) were enrolled in the study. All enrolled cases were divided into three groups namely A, B and C based on treatment received like radiotherapy, chemotherapy and combination respectively and their effect on hearing was compared. Hearing acuity was assessed by doing PTA before and after completion of treatment and at 6 months follow up in every case. RESULTS In groups A, B and C SNHL was noted at higher frequencies of 4 kHz and 8 kHz during 1st as well as final follow up. Hearing loss was found maximum in group C receiving combination treatment compared to the other two groups receiving in isolation. Hearing loss was the least in Group - A cases that received radiotherapy using the IMRT technique. CONCLUSIONS The possibility of SNHL is increased in cases receiving a combination of radio and chemotherapy (94 %). Extra care of shielding the cochlea is essentially required during treatment with high doses (&gt; 60Gy) using conformal radiotherapy to limit the resultant radiotherapy-induced SNHL. Radiation-induced SNHL in the IMRT technique was the least (28 %) in the group - A cases and hence should be employed in every case. Future searches for cases of head and neck malignancy the newer effective combination of chemotherapeutic drug and radiation obviating the ototoxicity needs to be continued. KEY WORDS Cisplatin, Radiotherapy, Intensity - Modulated, Audiometry, Pure - Tone, Ototoxicity, Hearing Loss, Sensorineural

Hearing Function in Adults with Rheumatoid Arthritis: A Scoping Review for Preventive Audiology Planning.

Rheumatoid arthritis (RA) is a disease which affects the joints and bones of individuals diagnosed with this condition. Little remains known about the possible impact of this disease on hearing function, particularly thepossibilities of preventive audiology in low-and-middle-income countries (LMICs). The study aimed to review published evidence on hearing function in adults with RA. A scoping review of literature from January 2010 to August 2020 was conducted using Sage, ScienceDirect, PubMed, Scopus, Medline, ProQuest and Google Scholar. Studies published in English which reported on the audiological function in adult individuals with RA were included in the review. From 832 initial title records, 18 articles were included into the final scoping review. A qualitative analysis of the reviewed evidence revealed four themes: (1) hearing loss occurs-causality still unclear; (2) nature, degree and configuration of the hearing loss varies; (3) systematic and standardized assessment battery required; and (4) sensitive and specific measures for early detection needed. The occurrence of hearing loss in this population ranges between 21.3 and 66.6%, and this increased where advanced sensitive measures such as ultrahigh frequency and otoacoustic emission (OAEs) measures were included in the test battery. Many audiological tests were used in the studies in order to identify the presence and type of hearing loss in these individuals, with basic audiometry testing being the most commonly used. The most prevalent type of hearing loss was found to be a high frequency sensorineural hearing loss (SNHL), with mixed (MHL) and conductive hearing losses (CHL) being present in some of the individuals. Causal links between RA and hearing loss remains unclear. Although there are limited studies which have reported on the audiological function in the population with RA, the studies which have been reviewed seem to establish an association between RA and the presence of hearing loss. The published high prevalence of hearing loss in this population, when compared to healthy control groups raises implications for well-designed studies that utilize sensitive audiologicdiagnostic measures, with clear inclusion and exclusion criteria to ensure more accurate causal links establishment between RA and hearing loss in this population.

Temporal Bone Pathology Secondary to Head Trauma-A Human Temporal Bone Study.

We hypothesize that following head trauma there is a difference in temporal bone (TB) pathology in cases with and without skull fracture. Although conductive, sensorineural, mixed hearing loss, and TB pathology following head trauma have been reported, to our knowledge, there are no studies that have compared the pathology of the TB in cases with and without skull fracture. We analyzed 34 TBs from donors who had a history of head trauma (20 with skull fracture and 14 without fracture), and 25 age-matched controls without clinical or histological evidence of otologic disorders. We documented the presence and location of TB fracture, ossicular injury, and cochlear hemorrhage and evaluated the loss of spiral ganglion cells and sensory hair cells, damage to the stria vascularis, and the presence of endolymphatic hydrops. We found a significant loss of outer hair cells in the upper basal, lower, and upper middle turns of the cochlea (p = 0.009, =0.019, =0.040, respectively), a significant loss of spiral ganglion cells (p = 0.023), and cochlear hemorrhage predominantly in the basal turns secondary to head trauma. Interestingly, these findings were significantly observed in TBs from donors with a history of head trauma without skull fracture. The greatest damage was to the cochlear basal turn. Our findings suggest that head trauma may result in tonotopic high frequency sensorineural hearing loss. TBs from donors with skull fracture have less pathologic changes than those without.

The Onset-Offset N1-P2 Auditory Evoked Response in Individuals With High-Frequency Sensorineural Hearing Loss: Responses to Broadband Noise.

Purpose Clinical use of electrophysiologic measures has been limited to use of brief stimuli to evoke responses. While brief stimuli elicit onset responses in individuals with normal hearing and normal central auditory nervous system (CANS) function, responses represent the integrity of a fraction of the mainly excitatory central auditory neurons. Longer stimuli could provide information regarding excitatory and inhibitory CANS function. Our goal was to measure the onset-offset N1-P2 auditory evoked response in subjects with normal hearing and subjects with moderate high-frequency sensorineural hearing loss (HFSNHL) to determine whether the response can be measured in individuals with moderate HFSNHL and, if so, whether waveform components differ between participant groups. Method Waveforms were obtained from 10 participants with normal hearing and seven participants with HFSNHL aged 40-67 years using 2,000-ms broadband noise stimuli with 40-ms rise-fall times presented at 50 dB SL referenced to stimulus threshold. Amplitudes and latencies were analyzed via repeated-measures analysis of variance (ANOVA). N1 and P2 onset latencies were compared to offset counterparts via repeated-measures ANOVA after subtracting 2,000 ms from the offset latencies to account for stimulus duration. Offset-to-onset trough-to-peak amplitude ratios between groups were compared using a one-way ANOVA. Results Responses were evoked from all participants. There were no differences between participant groups for the waveform components measured. Response × Participant Group interactions were not significant. Offset N1-P2 latencies were significantly shorter than onset counterparts after adjusting for stimulus duration (normal hearing: 43 ms shorter; HFSNHL: 47 ms shorter). Conclusions Onset-offset N1-P2 responses were resistant to moderate HFSNHL. It is likely that the onset was elicited by the presentation of a sound in silence and the offset by the change in stimulus envelope from plateau to fall, suggesting an excitatory onset response and an inhibitory-influenced offset response. Results indicated this protocol can be used to investigate CANS function in individuals with moderate HFSNHL. Supplemental Material https://doi.org/10.23641/asha.14669007.

Auditory and speech development in a 3-year-old boy with auditory neuropathy spectrum disorder

Background: Auditory neuropathy spectrum disorder (ANSD) in the auditory neural pathway can affect the auditory and speech development of children. Since the symptoms and complications of this disorder are similar in different children, hearing management and rehabilitation can help with better development of speech/ language and hearing perception in children with ANSD. The Case: In this study, the case was a one-yearold boy with ANSD and mild to moderate highfrequency sensorineural hearing loss. He first underwent various audiological examinations. Then, an aural rehabilitation program containing different auditory information and games was provided to him, his family, and caregiver at their home and in the rehabilitation center. Conclusion: Although auditory neuropathy/ dissynchrony in the auditory neural pathway has negative effect on the auditory and speech development, but the children with ANSD can use different inputs for language comprehension and acquisition if they receive effective education, especially auditory training at an earlier age. Keywords: Auditory neuropathy spectrum disorder; speech perception; auditory training

A Prospective Study of Audiological Manifestations in Patients of Allergic Rhinitis.

Allergic rhinitis is a type-I hypersensitivity reaction of the nasal mucosa, primarily mediated by immunoglobulin E (IgE) with complex etiological factors.Allergic rhinitis may involve the inner ear. The scientific basis for this is poorly understood. However, the inner ear has been found to demonstrate both cellular and humoral immunity, and the seat of immuno-activity appears to reside in the endolymphatic sac and duct. To assess the audiological profile of patients with allergic rhinitis. 100 Study group patients and 50 control group subjects underwent detailed audiological assessment. Present study revealed high frequency sensorineural hearing loss with prolongation of Wave I and shortened wave I-III and Wave I-V interpeak latencies on ABR and abnormal DPOAE findings, compared with controls which indicate inner ear involvement (cochlear pathology). Individuals with allergic rhinitis are more prone to hearing abnormalities which can be detected even before any symptoms of hearing impairment are present. However, the exact pathophysiology of inner ear damage in patients of airway allergy is poorly understood and therefore, additional studies in this area are required with a larger sample population to assess the benefits of hearing assessment in patients of allergic rhinitis for early detection of hearing loss.

Influence of sensorineural hearing loss on familiar speaker recognition: A forensic perspective on ageing

The main goal of this research was to discover the influence of high frequency sensorineural hearing loss on familiar speaker recognition during earwitnessing line-ups. The secondary objectives were to estimate the influence of familiarity with voices of the suspects on performance in the auditory speaker recognition test, and to correlate the results with forensically important factors such as a confidence scale from the line-up markings. The recordings from the line-up sessions were low-pass filtered to ensure an equal degree of signal distortion for all subjects and imitate the moderate, severe and profound hearing loss conditions. The results show that the correlation between mimicked hearing impairment and ability to identify a familiar speaker is statistically significant. It was observed that higher degree of signal distortion caused lower accuracy of recognition. Interestingly, it was reported that higher levels of familiarity and exposure to speakers’ voices had a negative effect on speaker identification.

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.

Sensorineural Hearing Loss After Surgery to Treat Chronic Otitis Media.

We investigated the incidence of sensorineural hearing loss (SNHL) after chronic otitis media (COM) surgery and determined the associated factors. Data were collected via retrospective medical chart review. Of the 192 patients, 82 underwent tympanoplasty, 26 underwent canal wall up mastoidectomy with tympanoplasty, and 84 underwent canal wall down mastoidectomy with tympanoplasty. After surgery, the average air conduction (AC) hearing threshold improved significantly, from 125 to 1000 Hz, but the average high-frequency AC and bone conduction (BC) hearing thresholds deteriorated significantly. In 21 (11%) cases, the BC hearing threshold worsened by more than 15 dB at 4000 Hz. When we compared these 21 cases to patients in whom hearing was preserved, the former group was found to be significantly younger and had a higher frequency of cholesteatomatous otitis media. However, when comparing the severity of inflammation in patients with temporal bone computed tomography, there was no significant difference between the 2 groups. High-frequency SNHL may develop after surgery to treat COM, especially in young patients with cholesteatoma.

Hearing impairment in patients of hypothyroidism in sub Himalayan region

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; The objective of the study was to assess the hearing impairment in patients of hypothyroidism.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; A prospective clinical study has done at a referral centre included 33 diagnosed patients of hypothyroidism in the age group of 15 to 65 years, fulfilling the inclusion and exclusion criteria who attended the outpatient department. The diagnosis of hypothyroidism was confirmed by thyroid function tests i.e., serum T3, T4 and TSH levels while hearing assessment was done using tuning fork tests, pure tone audiometry, impedance audiometry and otoacoustic emissions. Hearing impairment was measured in decibels of hearing loss, or dB HL and graded as mild, moderate, moderately severe, severe, or profound. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Percutaneous transluminal angioplasty showed 42.7% of the patients had high frequency sensorineural type of hearing loss. The air bone gap was not significant. On tympanometry, all the patients had type A graph and distortion product otoacoustic emissionss in all patients were pass.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Acquired hypothyroidism affects primarily high frequency hearing thresholds causing high frequency sensorineural hearing loss, with little or no effect on lower frequencies.&lt;/p&gt;

Hearing Assessment in Patients of Allergic Rhinitis: A Study on 200 Subjects.

Allergic rhinitis (AR) is a type I hypersensitivity reaction of the nasal mucosa, primarily mediated by IgE, with a complex etiology, determined by genetic and environmental interactions. Several mechanisms by which AR affect middle ear and cause conductive hearing loss have been well described. There is paucity of data regarding involvement of inner ear in AR patients leading to sensorineural hearing loss. However, endolymphatic sac and outer hair cells have been hypothesized to be the seat of immunoreactivity. To study the audiological profile in AR and effect of AR on inner ear functions. 100 cases of AR patients (55 males, 45 females, mean age group 21-30years) and 100 controls (65 males, 35 females, mean age group 41-50years) were enrolled in study. All underwent thorough clinical ear, nose and throat examination, diagnostic nasal endoscopy and otoendoscopy, followed by audiological assessment including pure tone audiometry, tympanometry and oto-acoustic emission test. Hearing results of both the groups were compared and analysed statistically. Thirty two patients among case group had sensorineural hearing loss, pronounced at 4000 and 8000Hz frequencies. 18 patients showed conductive hearing loss in the form of type B or type C tympanogram. 32 patients of AR patients showed unusual oto-acoustic emission test. We found higher prevalence of high frequency sensorineural hearing loss in pure tone audiometry and abnormal OAEs in patients having upper airway allergy. The likely seat of damage appears to be the inner ear as evidenced by recordings of OAE in allergic patients.

Audiological manifestations in patients of upper airway allergy

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; The pathophysiology of involvement of inner ear in patients of upper airway allergy is poorly understood. The endolymphatic sac may be the likely seat of involvement in these patients as it can process antigens and produce its own local immune response. The aim of study was to assess the audiological profile of these patients.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; 53 patients of upper airway allergy (33 females and 20 males with mean age 25.77 years) and 20 control subjects (9 females and 11 males with mean age of 35.65 years) underwent haematological and audiological assessment. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; The study group had sensorineural hearing loss at 4000 and 8000 Hz frequencies. Abnormal distortion product otoacoustic emissions (DPOAEs) were noted in the study group as compared with the controls. On auditory brain stem response testing, no statistically significant difference was noted in the absolute latencies of waves I, III and V between study and control groups. Also no statistically significant difference was noted in the wave I-III and wave I-V inter peak latencies between the two groups.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; We found higher prevalence of high frequency sensorineural hearing loss and abnormalities of DPOAEs in patients having upper airway allergy. The likely seat of damage appears to be the inner ear as evidenced by abnormalities of DPOAEs. However the exact pathophysiology of inner ear damage in patients of upper airway allergy is poorly understood and needs further research.&lt;/p&gt;

Eustachian tube balloon dilation in treatment of equalization problems of freediving spearfishermen.

Eustachian tube balloon dilation is a minimally invasive surgical procedure used to treat Eustachian tube dysfunction which is not responsive to conventional therapies. In this cohort intervention series we report the results of balloon dilation in treating refractory equalization problems in 20 freediving spearfishermen; in 19 cases the problem was unilateral and in one case bilateral. All the patients had already received medical and insufflation therapy and four patients had also had nasal surgery. None of these treatments or procedures had achieved improvement. We used a 20 mm x 3 mm disposable balloon catheter inserted through a 70-degree guide catheter and inflated up to 12 ATM three times at three different depths of insertion within the Eustachian tube. Every inflation lasted 120 seconds. Fifteen out of 20 patients improved. Ten patients reported a complete resolution of equalization problems, five showed improvement with persistence of a slight equalization delay on the treated side. Five patients did not report any improvement. Two complications occurred: subcutaneous emphysema of the parotid region in one case; and a mild high frequency (4-8 KHz) sensorineural hearing loss in another patient. Balloon dilation of the Eustachian tube is an effective therapy in the treatment of equalization problems with a good success rate.

High-Frequency Sensorineural Hearing Loss Alters Cue-Weighting Strategies for Discriminating Stop Consonants in Noise.

There is increasing evidence that hearing-impaired (HI) individuals do not use the same listening strategies as normal-hearing (NH) individuals, even when wearing optimally fitted hearing aids. In this perspective, better characterization of individual perceptual strategies is an important step toward designing more effective speech-processing algorithms. Here, we describe two complementary approaches for (a) revealing the acoustic cues used by a participant in a /d/-/g/ categorization task in noise and (b) measuring the relative contributions of these cues to decision. These two approaches involve natural speech recordings altered by the addition of a “bump noise.” The bumps were narrowband bursts of noise localized on the spectrotemporal locations of the acoustic cues, allowing the experimenter to manipulate the consonant percept. The cue-weighting strategies were estimated for three groups of participants: 17 NH listeners, 18 HI listeners with high-frequency loss, and 15 HI listeners with flat loss. HI participants were provided with individual frequency-dependent amplification to compensate for their hearing loss. Although all listeners relied more heavily on the high-frequency cue than on the low-frequency cue, an important variability was observed in the individual weights, mostly explained by differences in internal noise. Individuals with high-frequency loss relied slightly less heavily on the high-frequency cue relative to the low-frequency cue, compared with NH individuals, suggesting a possible influence of supra-threshold deficits on cue-weighting strategies. Altogether, these results suggest a need for individually tailored speech-in-noise processing in hearing aids, if more effective speech discriminability in noise is to be achieved.

Occupational noise induced hearing loss among local industrial population in Kashmir: a lifestyle study

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; The purpose of this observational study was to evaluate the incidence of occupational noise induced hearing loss (ONIHL) among the local industrial population of Kashmir who are involved in occupations exposed to noise.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; This prospective observational study was conducted in the department of ENT&amp;amp;HNS of government medical college Srinagar and SMHS Hospital. Total of 508 patients were screened and 158 patients were found have ONIHL patients were included in this study. The study population was evaluated for any significant history and were subjected thorough ENT assessment which included history, clinical examination, Otoscopic examination and then a pure tone audiometry. All these patients were further evaluated with a questionnaire in addition to clinical examination. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Around 31% (158) participants were found to have occupational noise induced hearing loss. The highest incidence of hearing loss was found in 50-59 years age group, which was 0.61. The industrial distribution of occupational noise induced hearing loss (ONIHL) in the screened population in the community was found maximum among Bandsaws workers with ONIHL, contributing 30.37% to the total. ONIHL was found to be most common (64.28%) in individuals exposed to loud noise for maximum duration of time (&amp;gt;20 yrs), while it was least common (20.34%) in individuals exposed to loud noise for least duration of time (&amp;lt;5 yrs).&lt;/p&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Our study concluded that people who are exposed to noise more than 90db for more than 8 hours day working in local industries of Kashmir have high frequency sensorineural hearing loss.

Effect of Smoking on Hearing Impairment

Background and objectives: Some clinical studies have suggested that cigarette smoking may be associated with hearing loss. The objective of this study is to evaluate the association between smoking and hearing loss and to characterize the type of hearing loss found in smokers. Methods: A hospital-based cross-sectional study conducted on 100 cases aged between 20-50 years, 70 cases were smokers and 30 were non-smokers. All the participants were examined by an Otoscope, a Tuning Fork, Tympanometry and Pure Tune air conduction and bone conduction Audiogram. Audiogram results were analyzed and hearing loss was defined as hearing threshold greater than 25 dB HL at one or more of frequencies (0.25,0.5, 1, 2,4 and 8 kHz). The type, severity and involved frequencies of hearing loss were analyzed based on the pure tone average. Results: The number of cases with hearing loss was 26 cases, 22 of them were smokers and 4 were non-smokers. Smoking significantly increased the risk of hearing loss (p value = 0.04). Smokers were 2.3 times more likely to have hearing impairment as non-smoker. High frequency sensorineural hearing loss was the predominant type among smokers and the severity ranged from mild to severe, mild loss was the most common. The severity of hearing loss was affected significantly by the intensity and the duration of smoking. Conclusions: Cigarette smoking affects the hearing ability after exclusions of most possible factors including noise exposure. It increases the risk of hearing impairment with increasing age in a dose related manner.

Open-Fit Domes and Children with Bilateral High-Frequency Sensorineural Hearing Loss: Benefits and Outcomes.

Open-fit domes (OFDs) coupled with behind-the-ear (BTE) hearing aids were designed for adult listeners with moderate-to-severe bilateral high-frequency hearing loss (BHFL) with little to no concurrent loss in the lower frequencies. Adult research shows that BHFL degrades sound localization accuracy (SLA) and that BTE hearing aids with conventional earmolds (CEs) make matters worse. In contrast, research has shown that OFDs enhance spatial hearing percepts in adults with BHFL. Although the benefits of OFDs have been studied in adults with BHFL, no published studies to date have investigated the use of OFDs in children with the same hearing loss configuration. This study seeks to use SLA measurements to assess efficacy of bilateral OFDs in children with BHFL. To measure SLA in children with BHFL to determine the extent to which hearing loss, age, duration of CE use, and OFDs affect localization accuracy. A within-participant experimental design using repeated measures was used to determine the effect of OFDs on localization accuracy in children with BHFL. A between-participant experimental design was used to compare localization accuracy between children with BHFL and age-matched controls with normal hearing (NH). Eighteen children with BHFL who used CE and 18 age-matched NH controls. Children in both groups were divided into two age groups: older children (10-16 yr) and younger children (6-9 yr). All testing was done in a sound-treated booth with a horizontal array of 15 loudspeakers (radius of 1 m). The stimulus was a spondee word, "baseball": the level averaged 60 dB SPL and randomly roved (±8 dB). Each child was asked to identify the location of a sound source. Localization error was calculated across the loudspeaker array for each listening condition. A significant interaction was found between immediate benefit from OFD and duration of CE usage. Longer CE usage was associated with degraded localization accuracy using OFDs. Regardless of chronological age, children who had used CEs for <6 yr showed immediate localization benefit using OFDs, whereas children who had used CEs for >6 yr showed immediate localization interference using OFDs. Development, however, may play a role in SLA in children with BHFL. When unaided, older children had significantly better localization acuity than younger children with BHFL. When compared to age-matched controls, children with BHFL of all ages showed greater localization error. Nearly all (94% [17/18]) children with BHFL spontaneously reported immediate own-voice improvement when using OFDs. OFDs can provide sound localization benefit to younger children with BHFL. However, immediate benefit from OFDs is reduced by prolonged use of CEs. Although developmental factors may play a role in improving localization abilities over time, children with BHFL will rarely equal that of peers without early use of minimally disruptive hearing aid technology. Also, the occlusion effect likely impacts children far more than currently thought.