Higher Risk Of Hearing Loss Research Articles

New classification and approaches to the treatment of schwannomatosis

Schwannomatoses is a new classification unit for all the hereditary diseases caused by chromosome 22 damage followed by multiple benign neoplasms of the peripheral and central nervous system. Schwannomatosis occurs as a result of damage to different genes: NF2, SMARCB1, LZRT1, loss of heterozygosity of the long arm of chromosome 22. Nevertheless, clinical manifestations are similar. Molecular diagnostics not only confirms the diagnosis, but also predicts the course of disease. Thus, the most severe clinical manifestations are observed in patients with violation of semantic sequences and reading frame shift in exons 2-13 of the NF2 gene. A more favorable course with less number of tumors is observed in patients with somatic mosaicism. Stereotactic irradiation and surgery are the main treatment options for schwannomatosis. However, there is evidence of effective targeted therapy with bevacizumab (inhibitor of vascular endothelial growth factor). Bevacizumab is used in patients with bilateral vestibular schwannomas and high risk of hearing loss, as well as for intramedullary tumor growth control.

Risk Factors for Hearing Loss in High-Risk Neonates at a Tertiary Care Centre in Central India: A Prospective Observational Study

Introduction: Hearing impairment and deafness are global issues that affect 5% of the world’s population, with nearly 34 million children requiring rehabilitation to address their hearing loss (HL). An approximately 10-20 fold higher incidence of audiological risk factors has been noted in Neonatal Intensive Care Units (NICUs), which translates that 2-5% of all newborns in NICUs may be affected. Early diagnosis of HL and intervention can be advantageous from the timely fitting of hearing aids or cochlear implants. Aim: The aim of this study was to evaluate the risk factors for HL in NICUs and Special Neonatal Care Units (SNCUs) at a tertiary care hospital in Central India. Materials and Methods: This prospective, observational, single-centre study was conducted from October 2019 to September 2021 in the Department of Paediatrics at Indira Gandhi Government Medical College and Hospital, Nagpur, Maharashtra, India. A total of 319 neonates at high risk for HL, discharged from NICUs and SNCUs, were included in the study. The association between risk factors like prematurity, low birth weight (LBW), Toxoplasmosis, Rubella, Cytomegalovirus, Herpes Simplex (TORCH) infections, neonatal asphyxia, neonatal sepsis, meningitis, exchange transfusion, assisted ventilation, and HL were studied. The chi-square test was used to assess the association between SNHL and risk factors. Results: The incidence of Sensorineural Hearing Loss (SNHL) was 3.76%. Neonatal asphyxia (p-value <0.01), exchange transfusion (p-value <0.001), TORCH infections (p-value < 0.001), meningitis (p-value <0.001), and assisted ventilation (p-value <0.001) were found to be significant risk factors associated with SNHL. Conclusion: Based on the assessment of risk factors, it was concluded that neonates should undergo hearing screening tests within the first month of life, and a diagnosis should be made by three months of age. This allows specialists to initiate treatment and intervention by six months of age, helping children with impaired hearing avoid the harmful consequences of semantic deprivation.

Hearing loss after exposure to vincristine and platinum-based chemotherapy among childhood cancer survivors

BackgroundThe role of vincristine as a contributing risk factor for hearing loss among childhood cancer survivors (CCS) treated with platinum-based chemotherapy has not been fully elucidated. We examined the association of vincristine with hearing loss in a national cohort of CCS.MethodsWe included CCS registered in the Swiss Childhood Cancer Registry diagnosed at age ≤ 18 years and treated with platinum-based chemotherapy between 1990 and 2014. Audiogram and treatment data were extracted from medical records for all participants in our retrospective cohort study. We identified CCS exposed to vincristine and calculated the total cumulative dose. We defined clinically relevant hearing loss as grade ≥ 2 using the International Society of Pediatric Oncology (SIOP) Boston Ototoxicity Scale at latest follow-up.ResultsOur study population included 270 CCS (43% female; median age at cancer diagnosis 6.8 years; interquartile range [IQR]: 2.1–11.7 years) with median age at audiogram 13.5 years (IQR: 9.3–17.0 years). Vincristine exposure was associated with an increased risk of hearing loss in the multivariable logistic regression analysis (odds ratio [OR] 4.8; 95% confidence interval [CI]: 1.8–12.9). We found no evidence of dose-response relationship (OR 1.0; 95% CI: 0.97–1.04) or effect modification from vincristine from other ototoxic treatments, such as type of platinum agent, cranial radiotherapy, and hematopoietic stem cell transplantation.ConclusionVincristine is associated with a higher risk of hearing loss in CCS treated with platinum-based chemotherapy. We suggest future studies investigate the underlying mechanism and causality among CCS without exposure to other ototoxic cancer treatments.

Fumante passivo e perda auditiva em pré-escolares e escolares: estudo caso-controle.

INTRODUCTION: Nonsmoking individuals who live with indoor smokers are included among those at higher risk of hearing loss, as the inner ear is sensitive to systemic changes, especially vascular ones. OBJECTIVE: To investigate whether there is an association between passive smoking and hearing loss in preschoolers and school-aged children. METHOD: retrospective, descriptive, case control study, comprising 76 children between 2 and 10 years of age, who underwent audiometric assessment between January 2016 and December 2018. The included children were divided into two groups: passively exposed to tobacco and not exposed to tobacco. The association between exposure or not to tobacco and type of hearing loss was evaluated using Fishers exact test, and the odds ratio of hearing loss in exposed children was calculated. RESULTS: Children exposed to smoking had fourfold odds of hearing loss compared to their non-exposed peers (OR 4.2, 95%CI 1.584 to 11.138). A significant association was also observed between exposure to smoking and sensorineural hearing loss (OR 5.60, 95%CI 1.783 to 17.591, p=0.002). No association was found between severity of exposure and intensity of hearing loss. CONCLUSION: This study suggest that sensorineural hearing loss occurs more frequently in children exposed to smoking then in their age-matched peers not so exposed. However, we cannot state conclusively whether there is an association between passive smoke exposure and conductive hearing loss, nor between the degree of hearing loss and the level of exposure to nicotine as assessed by the Fagerström test.

Fumante passivo e perda auditiva em préescolares e escolares: estudo caso-controle

ABSTRACT Introduction: Nonsmoking individuals who live with indoor smokers are included among those at higher risk of hearing loss, as the inner ear is sensitive to systemic changes, especially vascular ones. Objective: To investigate whether there is an association between passive smoking and hearing loss in preschoolers and school-aged children. Method: retrospective, descriptive, case control study, comprising 76 children between 2 and 10 years of age, who underwent audiometric assessment between January 2016 and December 2018. The included children were divided into two groups: passively exposed to tobacco and not exposed to tobacco. The association between exposure or not to tobacco and type of hearing loss was evaluated using Fishers exact test, and the odds ratio of hearing loss in exposed children was calculated. Results: Children exposed to smoking had fourfold odds of hearing loss compared to their non-exposed peers (OR 4.2, 95%CI 1.584 to 11.138). A significant association was also observed between exposure to smoking and sensorineural hearing loss (OR 5.60, 95%CI 1.783 to 17.591, p=0.002). No association was found between severity of exposure and intensity of hearing loss. Conclusion: This study suggest that sensorineural hearing loss occurs more frequently in children exposed to smoking then in their age-matched peers not so exposed. However, we cannot state conclusively whether there is an association between passive smoke exposure and conductive hearing loss, nor between the degree of hearing loss and the level of exposure to nicotine as assessed by the Fagerström test.

Frailty and hearing loss: From association to causation.

BackgroundObservational studies suggest that frailty is associated with hearing loss (HL) but with inconsistent results. This study aims to examine such association and to assess its causality.Materials and methodsThe cross-sectional data from the National Health and Nutrition Examination Survey (NHANES). Multivariate logistic regression models were used to assess the association between HL and frailty index (FI). Genetic variants associated with the FI and HL were obtained from a large genome-wide association study (GWAS) meta-analysis and UK Biobank GWAS. The inverse variance weighting (IVW) method was used to estimate causal effects. Sensitivity analyses were performed to further validate the robustness of results.ResultsIn this cross-sectional analysis, results support the possibility that frailty may be associated with a higher risk of developing HL, with self-reported [odds ratio (OR) = 2.813; 95% CI, 2.386, 3.317; p < 0.001], speech frequency HL (OR = 1.975; 95% CI, 1.679–2.323; p < 0.001), and high frequency HL (OR = 1.748; 95% CI, 1.459–2.094; p < 0.001). In the adjusted model, frail participants remained at high risk of HL. Mendelian randomization (MR) studies showed a bidirectional causal association between genetically predicted FI and risk of HL (FI for exposure: OR = 1.051; 95% CI, 1.020–1.083; p = 0.001; HL for exposure: OR = 1.527; 95% CI, 1.227–1.901; p < 0.001).ConclusionOur observational study found that inter-individual differences in frailty were associated with the risk of developing HL. Genetic evidence suggests a potential bidirectional causal association between FI and HL. Furthermore, the potential mechanisms of this association require investigation.

Hearing loss and its associated factors among metal workshop workers at Gondar city, Northwest Ethiopia.

IntroductionNoise-induced hearing loss is a permanent sensorineural deficiency, which is caused by exposure to excessive noise sound. Although noise-induced hearing loss due to industrialization is a main public health problem in Ethiopia, studies on the prevalence and associated factors of hearing loss are scarce.ObjectivesThis study aimed to assess the prevalence and associated factors of hearing loss among workers at a metal workshop in Gondar city, Northwest Ethiopia.MethodsA cross-sectional study was employed among 300 participants using a stratified sampling technique. Data were collected using an interviewer-administered questionnaire. Bivariable and multivariable logistic regressions were conducted. In the multivariable logistic regression model, adjusted odds ratios (AOR) with a 95% confidence interval (CI) and a p < 0.05 were computed to determine the level of significance.ResultsThe prevalence of hearing loss among metal workshop workers was 30.7% [95% CI: (25.7, 35.7)]. Age between 30 and 44 years [AOR = 2.9; 95% CI: 1.2, 7.1], age between 45 and 65 years [AOR = 3.8; 95% CI (1.5, 9.5)], cigarette smoking [AOR = 2.3; 95% CI: 1.2, 4.5], working area noise level >85 dB [AOR = 2.2; 95% CI: 1.1, 6.5], working experience of 6–10 years [AOR = 1.8; 95% CI: 1.4, 6.0], working experience >10 years [AOR = 3.5; 95% CI: 1.3, 4.3], and using ear protection devices [AOR = 0.3; 95% CI: 0.1, 0.6] were significantly associated with hearing loss.ConclusionThe prevalence of hearing loss was considerably high. This study revealed that advanced age, cigarette smoking, increased working area noise level, and working experiences were found to increase the odds of having hearing loss. Therefore, it is important to emphasize metal workshop workers that are at high risk of hearing loss and develop preventive strategies to reduce the burden of this problem. Besides, minimizing working area noise levels, proper utilization of ear protection devices, and creating awareness about the impact of hearing loss are recommended.

Hearing outcomes in preterm infants with confirmed hearing loss

ObjectivesPremature infants are at high risk for hearing loss (HL). The aim of the present study is to assess the frequency of preterm infants affected by HL who experience hearing improvement over months and evaluate possible factors associated with hearing changes. MethodsThis retrospective study was conducted in a third-level referral audiologic center.Preterm infants with a confirmed diagnosis of sensorineural HL within the first 3 months of life were reassessed at 18 months corrected age using the click-evoked auditory brainstem response between January 1, 2012, and June 30, 2020. The frequency of hearing improvement and associations between possible risk factors and hearing changes were evaluated. ResultsA total of 138 preterm infants (71 male and 67 female; mean gestational age: 30+2 weeks) were assessed. The percentages of hearing improvement and hearing threshold normalization were 58.7% (81/138) and 35.5% (49/138), respectively. We observed a higher frequency of hearing improvement among preterm infants who had received exclusive breastfeeding or mixed feeding compared with those who had received exclusive infant formula (80% versus 29.3%, P < 0.001). ConclusionThis study confirms the importance of performing a long audiological follow-up and postponing the indication for cochlear implantation in children with a history of preterm birth.Because of the expression of mesenchymal stem cells and high total antioxidant capacity, breast milk might play a protective role in the auditory system of preterm infants. These findings could have important implications for clinical practice, positively impacting the long-term hearing outcomes of preterm infants.

A Systematic Review of the Auditory and Vestibular Effects of Chloroquine and Hydroxychloroquine

Introduction: chloroquine and hydroxychloroquine are antimalarial drugs that, although normally well tolerated, have side effects, such as gastrointestinal intolerance, retinopathy and arrhythmias. There are reports of sensorineural hearing loss, tinnitus and vertigo related to the two drugs. However, the ototoxic potential of these medications is routinely not researched. With the significant increase in the use of these drugs in the face of the COVID-19 pandemic, the study of their ototoxic effects becomes even more important. Objective: to evaluate the ototoxic potential of chloroquine and hydroxychloroquine through a systematic review of the articles available in the literature. Method: a search for articles published until April 2020 was carried out in the PubMed, Web of Science, SciELO and Lilacs databases, with descriptors registered in MeSH. Articles that associated the use of chloroquine or hydroxychloroquine with auditory and / or vestibular effects were included. Result: the search resulted in 161 articles, of which 18 met the inclusion criteria. Of these, 16 demonstrated ototoxic effects of chloroquine and / or hydroxychloroquine. Chloroquine was considered the second main drug involved in ototoxicity in 2 studies. A 5-fold higher risk of hearing loss has also been reported in neonates whose mothers used chloroquine during pregnancy. Conclusion: studies have shown that chloroquine and hydroxychloroquine have ototoxic action, which may initially go unnoticed if there is no active investigation. The significant increase in the use of chloroquine and hydroxychloroquine in the face of the COVID-19 pandemic may represent an escalation in ototoxicity, which should not be neglected.

Otitis Media and Its Association With Hearing Loss in Chinese Adults: A Population Based Study of 4 Provinces in China.

ObjectiveOtitis media is a recognized cause of significant hearing loss, particularly in developing countries. This study aimed to investigate the relationship between otitis media and hearing loss in Chinese adults aged 18 years and older.MethodsThe survey was based on WHO Ear and Hearing Disorders Survey Protocol and 36,783 adults at the ages between 18 years and above were selected in this study. Trained local examiners performed pure tone audiometry to screen people with hearing loss, and those who were screened positively for hearing loss were referred to audiologists to make final diagnosis. All participants underwent clinical ENT check-up and otoscopic examination by doctors trained in ENT. Each participant was assigned a single middle ear diagnosis. Diagnoses were assigned as per the WHO classification of ear and hearing disorders.ResultsLogistic regressions showed that higher prevalence of hearing loss was found in participants with otitis media, with an unadjusted odds ratio of 5.67 (95%CI: 4.66, 6.90). The next two models (Model 2–3) had slight impact on ORs. The interaction of residency and otitis media was statistically significant (OR = 1.70, 95%CI = 1.15, 2.53); otitis media patients in rural areas had higher risk of hearing loss. However, this interaction became not significant in 65 years old and above participants.ConclusionsOtitis media was associated with the risk of hearing loss. Compared with urban patients with otitis media, rural patients have the higher risk of hearing loss. Action to reduce the risk of hearing loss in otitis media will require attention to rural-urban disparities.

Study: Osteoporosis Linked to Higher Risk of Hearing Loss in Women

Study: Osteoporosis Linked to Higher Risk of Hearing Loss in Women

Predictors of hearing functional outcome following surgery for cerebellopontine angle meningioma.

Cerebellopontine angle (CPA) meningiomas can affect hearing function and require expeditious treatment to prevent permanent hearing loss. The authors sought to determine the factors associated with functional hearing outcome in CPA meningioma patients treated with surgery and/or radiation therapy in the form of either stereotactic radiosurgery or stereotactic radiation therapy. Consecutive patients with CPA meningiomas who had presented at our hospital from 2008 to 2018 were identified through retrospective chart review. Hearing function (as defined by pure tone average (PTA) and speech discrimination score (SDS) on Audiogram) was assessed before and after surgery for CPA meningioma. Audiograms with PTA > 50dB and SDS < 69% were defined as poor hearing functional outcome. Multivariable Cox Proportional Hazards Regression Model was used to assess the associations between pre-operative hearing functional assessment and post-operative hearing functional outcomes. The study cohort included 31 patients (80.6% females, with a mean age of 61.3 ± 15.2years) with a median clinical follow-up of 5months (range: 1week-98months). The mean pre-operative PTA and SDS were 23.8 ± 11.2dB and 64.4 ± 22.2% respectively. At the last visit, there was significant hearing recovery, with an improvement of 29.7 ± 18.0dB (p < 0.001) and 87.6 ± 17.8% (p < 0.001) in PTA and SDS respectively. After adjusting for age, gender, tumor volume, location, and tumor classification, Multivariable Cox Proportional Hazards Regression Model was conducted which revealed that patients undergoing surgery through retro sigmoid approach [Hazards Ratio (HR): 32.1, 95% Confidence Interval (CI): 2.11-491.0, p = 0.01] and gross total resection (GTR) (HR: 2.99, 95% CI: 1.09-9.32, p = 0.05) had significantly higher risk of poor hearing functional outcome compared to petrosal approach and near/subtotal resection. Moreover, patients with poor preoperative hearing had 85% higher chance of poor hearing functional outcome postoperatively (HR: 0.15, 95%CI: 0.03-0.59, p = 0.007). Postoperative improvement in hearing is a reasonable expectation following surgery for CPA meningioma. Preoperative hearing, surgical approach and extent of surgical resection are predictive factors of postoperative hearing function outcome and can therefore aid in identification of patients at higher risk of hearing loss.

Construction and Evaluation of a High-Frequency Hearing Loss Screening Tool for Community Residents.

Early screening and detection of individuals at high risk of high-frequency hearing loss and identification of risk factors are critical to reduce the prevalence at community level. However, unlike those for individuals facing occupational auditory hazards, a limited number of hearing loss screening models have been developed for community residents. Therefore, this study used lasso regression with 10-fold cross-validation for feature selection and model construction on 38 questionnaire-based variables of 4010 subjects and applied the model to training and testing cohorts to obtain a risk score. The model achieved an area under the curve (AUC) of 0.844 in the model validation stage and individuals’ risk scores were subsequently stratified into low-, medium-, and high-risk categories. A total of 92.79% (1094/1179) of subjects in the high-risk category were confirmed to have hearing loss by audiometry test, which was 3.7 times higher than that in the low-risk group (25.18%, 457/1815). Half of the key indicators were related to modifiable contexts, and they were identified as significantly associated with the incident hearing loss. These results demonstrated that the developed model would be feasible to identify residents at high risk of hearing loss via regular community-level health examinations and detecting individualized risk factors, and eventually provide precision interventions.

Predictive Modeling and Risk Stratification of Patients With Enlarged Vestibular Aqueduct.

To investigate patient-specific characteristics that independently predict for progressive hearing loss in patients with enlarged vestibular aqueduct (EVA). Utilize multivariable predictive models to identify subgroups of patients with significantly different progression risks. Retrospective analysis of patients evaluated at an academic tertiary care center. Cohort included 74 ears of patients with a diagnosis of EVA as defined by the Cincinnati criteria. Hearing trajectories were characterized, and a Kaplan-Meier estimator was utilized to determine progressive phenotype probabilities across the first 10 years after diagnosis. Cox proportional hazard regression was used to identify patient characteristics that independently altered this probability. Stratified risk groups were delineated from generated nomogram scores. Male gender was associated with a 4.53 hazard ratio for progressive hearing loss (95% confidence interval [CI], 2.53 to 12.59). Each millimeter increase in operculum size was independently associated with an 80.40% increase in expected hazard (95% CI, 40.18 to 120.62). Each dB increase in air pure tone average at time of diagnosis decreased expected hazard by 1.59% (95% CI, -3.02 to -0.17). The presence of incomplete partition type II was associated with a 2.44 hazard ratio (95% CI, 1.04 to 5.72). Risk groups stratified by median nomogram score evidenced the discriminative ability of our model with the progression probability in the high-risk group being six times higher at 1 year, nearly five times greater at 3 years, and three times greater at 9 years. EVA patient characteristics can be used to predict hearing loss probability with a high degree of accuracy (C-index of 0.79). This can help clinicians make more proactive management decisions by identifying patients at high risk for hearing loss. 4 Laryngoscope, 132:1439-1445, 2022.

Illegal Drug Use and Risk of Hearing Loss in the United States: A National Health and Nutrition Examination Survey.

The use of illegal drugs may be a risk factor of hearing loss. However, very few studies with large sample size have investigated the relationship between illegal drug use and hearing loss. Therefore, to evaluate the association between illegal drug use and hearing loss, this cross-sectional population-based study collected data from the US National Health and Nutrition Examination Survey 2011. The study included 1772 participants aged 20 to 59 years who underwent the Drug Use Questionnaire and Audiometry Examination. Of the 1772 participants in this study, 865 were men (48.8%) and 497 were illegal drug users. The mean (SD) age of the patients was 40.0 (11.4) years. After considering age, sex, and comorbidities, the participants who used illegal drugs were found to have higher risks of high-frequency hearing loss (adjusted odds ratio (OR), 1.69; 95% confidence interval (CI), 1.35–2.10) and overall hearing loss (adjusted OR, 1.69; 95% CI, 1.36–2.12) as compared with the nonusers. In the second analysis, the participants who used ≥ 2 types of illegal drugs were associated with higher risks of high-frequency hearing loss (adjusted OR, 1.57; 95% CI, 1.06–2.32) and overall hearing loss (adjusted OR, 1.60; 95% CI, 1.08–2.37). In the third analysis, cocaine use was associated with increased risks of high-frequency hearing loss (adjusted OR, 1.34; 95% CI, 1.01–1.77) and overall hearing loss (adjusted OR, 1.38; 95% CI, 1.04–1.82). The adjusted OR for overall hearing loss in the methamphetamine users was 1.54 (95% CI, 1.05–2.27) as compared with that in the nonusers. This study shows that illegal drug users might have a higher risk of overall hearing loss than nonusers. In addition, the analysis results demonstrated that the more kinds of illegal drugs used, the higher the risk of hearing loss. Further experimental and longitudinal research studies are required to confirm the causal relationship between illegal drug use and hearing loss.

Establishment of nomograms for the prediction of useful hearing loss in patients with neurofibromatosis type 2.

Treatment for vestibular schwannoma (VS) in patients with neurofibromatosis type 2 (NF2) is extremely challenging due to the high risk of hearing loss. The aim of this study was to develop nomograms for the prediction of useful hearing loss in patients with NF2. The nomogram was based on a retrospective study of 111 NF2 patients who underwent resection of large VS (> 2cm) at Beijing Tiantan Hospital between 2011 and 2018. The utility of the proposed nomogram models was evaluated by receiver operating characteristic (ROC) curve, area under ROC curve (AUC), and calibration curve. The results were validated using a prospective cohort study on 33 patients consecutively enrolled at the same institution from 2019 to 2021. On multivariate analysis of the primary cohort, large tumour size (> 3cm) and long duration of symptoms (> 24months) were independent risk factors for preoperative useful hearing loss (AAO-HNS Class D) (P = 0.001 and P = 0.011, respectively), while large tumour size (> 3cm), poor hearing (Class C), and lobular growth were significantly related to postoperative useful hearing loss (P < 0.001, P = 0.031 and P = 0.033, respectively). Factors derived from multivariable analysis were all assembled into the nomogram. The calibration curve for probability of hearing loss showed good agreement between predictions by nomogram models and actual observation. The ROC curves showed good predictive accuracy of the nomogram models in both cohorts (AUC: 0.708 to 0.951). The proposed nomograms resulted in accurate predictions of hearing outcomes for patients with NF2.

Role of Otoacoustic Emission Test in Early Diagnosis of Hearing Impairment in Infants.

Hearing impairment is most common congenital dissorder and undiagnosed hearing loss can cause disorder in speech, language with delay in social and emotional developments. Early detection of Hearing Impairment in Infants and too access the relationship between selected risk factor and hearing loss. Neonates age upto 15days randomly selected from pediatric and obstetrics and gynaecology department, born during this period were screened by OAE before their discharge from the hospital and after stabilizing high risk neonates. Informed consent of neonates parent/guardian was obtained before babies were subjected to OAE. A total of 400 neonates were screened for hearing loss by otoacoustic emission. Out of that 18 (4.5%) neonates failed the test in initial screening and were asked for follow up screening. Two neonates were lost to follow up. Out of 16 neonates, 2 (12.5%) neonate failed the test on follow up screening by otoacoustic emission and was referred for BERA. Neonates were classified as low and high risk basis of risk factors present. Out of 76 neonates having high risk of hearing loss, 16 failed the test. Similarly out of 324 neonates with low risk of hearing loss, only one neonate failed the test. Chi square analysis has revealed highly significant results (p < 0.001). Late identification of hearing loss presents a significant public health concern. However, without screening, children with hearing loss are usually not identified until 2years of age, which results in significant delays in voice communication, language communication, social, cognitive, and emotional development. In contrast, early recognition, and intervention prior to 3months of historic period has a significant positive impact on development.

The correlation between fibroblast growth factor-23 and ESRD patients with hearing impairment.

BackgroundEnd-stage renal disease (ESRD) patients often experience hearing impairment, resulting in a high rate of disability and a decline in their quality of life. Fibroblast growth factor-23 (FGF23) is a diagnostic biomarker for chronic kidney disease (CKD) and a pathogenic contributor to CKD progression. However, the correlation between FGF23 level and CKD patients with hearing impairment remains elusive. This study aimed to investigate the relationship between the FGF23 and ESRD accompanied with hearing impairment.MethodsA total of 144 ESRD patients, who were admitted to the First Affiliated Hospital of Kunming Medical University from November to December 2020, were enrolled in this study. Firstly, 144 ESRD patients underwent pure-tone audiometry (PTA). Secondly, it was attempted to randomly select 20 ESRD patients with normal hearing, and 20 ESRD patients with hearing impairment (match ratio, 1:1). Age- and gender-matched healthy people (n = 20) were also recruited as controls group. The expression levels of FGF23 was detected by enzyme-linked immunosorbent assay (ELISA).ResultsThe results of pure-tone audiometry showed that the prevalence of hearing impairment in ESRD patients was 80.5%. Male ESRD patients were more likely to develop hearing impairment compared to female patients. The incidence rate of hearing impairment at a high frequency was significantly higher than that at a low frequency (P < 0.01). The serum levels of FGF23, phosphorus, and parathyroid hormone (PTH) in ESRD patients with hearing impairment significantly increased compared with those with normal hearing and healthy controls.ConclusionESRD patients had a higher risk of hearing loss, especially high-frequency hearing impairment. As FGF23 level increased, the risk of hearing loss was also elevated. The hearing impairment in ESRD patients was associated with the degree of kidney injury, and serum FGF23 level.

Assessing Loss to Follow-up After Newborn Hearing Screening in the Neonatal Intensive Care Unit: Sociodemographic Factors That Affect Completion of Initial Audiological Evaluation.

Neonatal intensive care unit (NICU) patients are at high risk for congenital hearing loss. Previous studies have found sociodemographic factors associated with loss to follow-up for newborn hearing screening, but none have specifically studied the NICU population. Our objective is to determine if demographics and socioeconomic status is associated with loss to follow-up in a newborn population with extended NICU stay. A retrospective cohort study was conducted on 443 NICU infants with extended NICU stay utilizing data extracted from infant and maternal medical records at an urban safety-net hospital. Younger maternal age (adjusted odds ratio [OR] 0.95, confidence interval [CI] 0.91 to 0.99), higher gravidity (adjusted OR 1.39, CI 1.12 to 1.72), and former smoking status (adjusted OR 2.57, CI 1.07-6.18) were identified as independent predictors of loss to follow-up for NHS after conducting a multivariable logistic regression. Demographic and socioeconomic variables, such as sex, parity, birth weight, mode of birth, highest level of maternal education, maternal race/ethnicity, zip code metrics, and maternal language were not found to be associated with loss to follow-up. Maternal age, gravidity, and smoking status are risk factors for loss to follow-up for NHS in newborns with extended NICU stay, a group at high risk for hearing loss. Our findings demonstrate that socioeconomic and demographic factors for loss to follow-up in the extended-stay NICU population are distinct from the well-baby population. Further investigation of these patients will allow prioritization of limited resources to subgroups within the extended-stay NICU population at risk for loss to follow-up for newborn hearing screening.

Osteoporosis, bisphosphonate use, and risk of moderate or worse hearing loss in women.

Osteoporosis and low bone density (LBD) may be associated with higher risk of hearing loss, but findings are inconsistent and longitudinal data are scarce. Bisphosphonates may influence risk, but the relation has not been studied in humans. We longitudinally investigated associations of osteoporosis and LBD, bisphosphonate use, vertebral fracture (VF), hip fracture (HF), and risk of self-reported moderate or worse hearing loss. Longitudinal cohort study. The Nurses' Health Study (NHS) (1982-2016) and Nurses' Health Study II (NHS II) (1995-2017). Participants included 60,821 NHS women, aged 36-61 years at baseline, and 83,078 NHS II women, aged 31-48 years at baseline (total n=143,899). Information on osteoporosis, LBD, bisphosphonate use, VF, HF, and hearing status was obtained from validated biennial questionnaires. In a subcohort (n=3749), objective hearing thresholds were obtained by audiometry. Multivariable-adjusted Cox proportional hazards models were used to examine independent associations between osteoporosis (NHS), osteoporosis/LBD (NHS II), and risk of hearing loss. The multivariable-adjusted relative risk (MVRR, 95% confidence interval) of moderate or worse hearing loss was higher among women with osteoporosis or LBD in both cohorts. In NHS, compared with women without osteoporosis, the MVRR was 1.14 (1.09, 1.19) among women with osteoporosis; in NHS II, the MVRR was 1.30 (1.21, 1.40) among women with osteoporosis/LBD. The magnitude of the elevated risk was similar among women who did and did not use bisphosphonates. VF was associated with higher risk (NHS: 1.31 [1.16, 1.49]; NHS II: 1.39 [1.13, 1.71]), but HF was not (NHS: 1.00 [0.86, 1.16];NHS II: 1.15 [0.75,1.74]). Among participants with audiometric measurements, compared with women without osteoporosis/LBD, the mean multivariable-adjusted hearing thresholds were higher (i.e., worse) among those with osteoporosis/LBD who used bisphosphonates. Osteoporosis and LBD may be important contributors to aging-related hearing loss. Among women with osteoporosis, the risk of hearing loss was not influenced by bisphosphonate use.