Mean Pure Tone Average Research Articles

Prevalence of hearing loss in pseudohypoparathyroidism

BackgroundThe main clinical features of pseudohypoparathyroidism (PHP)/inactivating parathyroid hormone/parathyroid hormone-related protein signaling disorders (iPPSD), including parathyroid hormone (PTH) resistance, brachydactyly and short stature, develop during middle and late childhood. Very few studies have addressed hearing loss in PHP/iPPSD patients, and these studies have yielded widely divergent conclusions. The aim of our study was to assess hearing and determine the predictive factors of hearing loss in patients with PHP/iPPSD.MethodsOur retrospective cohort study was conducted between March 2019 and May 2020 in the Otolaryngology Department and the calcium phosphate reference center for rare diseases in Bicêtre Paris-Saclay Hospital, France. We retrospectively collected data from patients with PHP/iPPSDs (age, sex, genetic mutations, height, body mass index (BMI), PTH resistance, presence or absence of ectopic ossifications and brachydactyly). All patients underwent auditory investigations, including tonal and vocal audiometry. The primary outcome was the pure tone average (PTA). The PTA was compared with the norm according to the International Organization for Standardization. Hearing loss was defined as a PTA ≥ 20 db.ResultsThe median age of the patients was 15.6 years [9.5, 28.5]. Thirty-six patients were diagnosed with iPPSD2, and eight were diagnosed with iPPSD3. Twenty-six of them (59%) were female. Hearing impairment was confirmed in 17 patients (39%). The mean PTA and the mean SRT of the deaf ears were 40 ± 26 db and 31 ± 14 db. The mean difference in the PTA between the patients and the normal controls was 11.4 db (p = 0.00002). Short stature and the presence of ectopic ossifications were two significant predictive factors of hearing loss (p = 0.009 and p = 0.03, respectively). Sex, BMI, PTH resistance, mutation category and brachydactyly were not associated with an increased risk of hearing loss (p = 0.19, p = 0.41, p = 0.13, p = 0.50, p = 0.19, respectively).ConclusionOur study confirmed the frequency of hearing loss in patients with PHP/iPPSD disease (prevalence = 39%). A diagnosis of PHP/iPPSD should trigger auditory investigations and follow-up, especially when short stature and/or ectopic ossifications are present.

Long-Term Follow-Up After Translabyrinthine IAC Tumor Removal With Simultaneous Cochlear Implantation.

To evaluate the long-term hearing outcome after translabyrinthine resection of tumors within the internal auditory canal (IAC) with simultaneous cochlear implantation (CI). Prospective study. Tertiary referral center. Thirty-seven patients with tumors of the IAC undergoing translabyrinthine tumor surgery as a first-line therapy. Intraoperatively, electrically evoked auditory brainstem response audiometry (eABR) was performed in all patients to assess cochlear nerve (CN) integrity. In case of preserved CN function after tumor removal, CI was subsequently performed. Postoperatively, patients were regularly followed up to evaluate pure-tone hearing as well as speech recognition with a monosyllabic word comprehension test. Postoperative hearing thresholds and word recognition scores. Of 37 included patients, 22 (59.46%) had positive eABR responses after tumor removal. Twenty-one of these underwent simultaneous CI directly after tumor surgery and were followed-up for 24.24 ± 19.83 months after surgery. Hearing of these patients significantly improved from 73.87 ± 21.40 dB preoperatively to a mean pure-tone average of 41.56 ± 18.87 dB 1 year (p = 0.0008) and 34.58 ± 2.92 dB 3 years after surgery (p = 0.0157). Speech recognition significantly recovered from 13.33 ± 25.41% to 58.93 ± 27.61% 1 year (p = 0.0012) and 51.67 ± 28.58% 3 years postoperatively (p = 0.0164). Regardless of tumor histopathology, CI is an effective option to restore patients' hearing after translabyrinthine tumor surgery. After CI, patients hearing can be restored over a long-term period of a minimum of 3 years post-surgery. Furthermore, eABR proves to be a practical tool to evaluate CN function and screen for patients eligible for CI.

White noise use among children undergoing sound field audiometry: A preliminary study

ObjectiveTo describe the prevalence of routine white noise exposure in children who undergo sound field audiometry. MethodsA retrospective cohort study was conducted at a pediatric otolaryngology clinic affiliated with an academic tertiary care hospital. The medical records of children who underwent sound field audiometry were reviewed and data was collected regarding demographics and audiogram results. The group was divided into two cohorts based on routine exposure to white noise. Children exposed to white noise were tested with warble tones, while those not exposed were tested with narrow-band noise. Results127 patients underwent sound field audiometry testing, of which 96 (75.6%) were reported by their parents to use white noise for sleep. The mean age at time of testing was 1.6 years (95% Confidence Interval [CI] 1.5–1.7). 104 (81.9%) children were able to respond to at least four of the sound field thresholds, and there was no significant difference between the children exposed to white noise and those who were not (P = 0.459). Mean pure tone average (PTA) was 26.2 dB (95% CI 25.2–27.2) and mean speech reception threshold (SRT) was 19.2 dB (95% CI 18.2–20.2). The sound field response rate, PTA, and SRT were similar between these two groups. ConclusionsThe routine use of white noise therapy was extremely common in this pediatric population. The use of warble tones as the audiometric stimuli for children exposed to white noise resulted in similar testing success compared to the use of narrow-band noise in children not exposed to white noise.

National Cohort Data Suggests an Association Between Serious Mental Illness and Audiometric Hearing Loss.

To explore whether there is an association between serious mental illness (SMI) and hearing loss (HL) among USHispanic adults. Cross-sectional epidemiological study (Hispanic Community Health Study), including multicentered USvolunteers. Multivariable linear regressions were conducted to study the association between SMI and HL. Adjustments were made for potential confounders including age, sex, education, vascular disease (hypertension or diabetes mellitus), and cognition. SMI was defined by (1) antipsychotic medication classification and (2) the use of at least 1 antipsychotic medication specifically used to treat SMI in clinical psychiatric practice. HL was measured by pure tone audiometry. A total of 7581 subjects had complete data. The mean age was 55.2 years (SD = 7.5 years) and the mean pure tone average in the better ear was 16.8 dB (SD = 10.7 dB). A total of 194 (2.6%) subjects were taking a HCHS-defined antipsychotic and 98 (1.3%) were taking at least 1 antipsychotic specifically used to treat SMI. On multivariable regression, use of HCHS's classified antipsychotics was associated with 3.75 dB worse hearing (95% confidence interval [CI] = 2.36-5.13, P < .001) and use of antipsychotics specific for SMI was associated with 4.49 dB worse hearing (95% CI = 2.56-6.43, P < .001) compared to those not using antipsychotics. SMI, as defined by either the use of HCHS-defined antipsychotics or the use of antipsychotic medication specific for SMI, is associated with worse hearing, controlling for potential confounders. Whether SMI contributes to HL, antipsychotic medication (through ototoxicity) contributes to HL, or whether HL contributes to SMI is unknown and warrants further investigation.

Factors related to the surgical outcomes of type I tympanoplasty for tympanic membrane perforation in children

Background Factors related to surgical outcomes of type I tympanoplasty for tympanic membrane (TM) perforation in children are controversial. Objectives To investigate factors related to anatomical results of type I tympanoplasty for TM perforation 1 year after surgery. Material and methods We examined 68 ears. Anatomical results were determined based on the presence or absence of re-perforation, atelectasis, and otitis media with effusion. We retrospectively analyzed factors based on age (≤8 and >8 years), cause and size of TM perforation (<50% and ≥50%), history of asthma and cleft palate, and size of mastoid air cell system in bilateral ears before tympanoplasty. Audiological prognosis was evaluated in ears with anatomical success 1 year after surgery. Results Anatomical success was achieved in 80.9% (55/68) of the ears. No significant differences were observed between these factors and anatomical results. All children with cleft palate had anatomical success. Mean pure-tone average (0.5–4 kHz) was 16.25 dB HL for ears with both TM perforations <50% and ≥50%. Conclusion and significance We observed no significant relationship between factors considered and surgical outcomes. However, audiological prognosis was favorable for anatomical success regardless of TM perforation size. Accordingly, type I tympanoplasty is considered useful for TM perforation in children.

Spontaneous shrinkage of sporadic vestibular schwannomas: a clinical and radiological analysis.

The natural history of sporadic vestibular schwannoma (VS) is unpredictable, as tumors may or may not grow and can even spontaneously regress. A spontaneous VS shrinkage MRI-based pattern has been proposed with either a scalloped tumor aspect in the cerebellopontine angle or the appearance of a CSF-filled space surrounding the intracanalicular (IC) tumor within an enlarged canal. The authors of this retrospective study aimed to describe the evolution of sporadic VSs with radiological signs of VS regression and to identify prognostic factors for tumor shrinkage. All MRI scans obtained during patient follow-up were reviewed for extracanalicular (EC) and IC size and tumor characteristics. Volumetric measurements were performed on the first and last MRI scans. Shrinkage was considered to have occurred if the tumor size had decreased by ≥ 2 mm in its largest diameter and/or if the volume had decreased by ≥ 20%. Audiometric data were also collected. Among 512 patients under observation for sporadic VSs, 66 (13%) had at least one radiological sign of VS regression and 31 of these (6% overall) had confirmed tumor shrinkage. The mean follow-up was 4 ± 2.5 years. One radiological sign was present on initial MRI in 58% of patients and appeared during the follow-up period in the remaining 42%. Two groups were identified: 31 patients (47%) demonstrated progressive tumor regression during follow-up, and tumors in 35 patients (53%) remained stable once signs of regression were identified (assuming a stabilized regression). The prognostic factors for VS regression were as follows: EC VS extension (p = 0.02), cystic lesion (p = 0.002), and central necrosis (p = 0.02). The mean pure-tone average (PTA) was 43 ± 26.2 dB at the time of diagnosis and 53 ± 28.3 dB at the last visit (p < 0.0001). Among patients with an observed tumor shrinkage, ∆PTA was lower if the inner ear signal on the high-resolution T2-weighted image had improved (-3 ± 8.9 dB, n = 11) than if the inner ear signal had not improved (-10 ± 6.9 dB, n = 20) (p = 0.02) between the initial and last MRI scans. Spontaneous shrinkage of sporadic VSs could be suspected based on two radiological aspects that are indicative of VSs in progressive or stabilized regression and is an additional argument for the conservative management of these tumors. During follow-up, recovery from a reduced to a normal cochlear fluid MRI signal is a good indicator for hearing preservation.

Hearing loss, gait and balance impairments and falls among individuals with sub-acute stroke: A comparative cross-sectional study

BackgroundThe impact of hearing loss in stroke is less explored. This study aimed to compare hearing loss in patients with sub-acute stroke with healthy controls and evaluate its association with gait and balance impairments and falls. MethodsThis study involved 78 ambulant sub-acute stroke patients and 78 age-sex-matched controls. Hearing loss was assessed with pure tone average, while gait and balance impairments were assessed with the Timed Up and Go test, Berg Balance Scale, Functional Gait Assessment and 10-m walk test (gait speed). Fall occurrence was evaluated by a self-report questionnaire. ResultsThe prevalence of hearing loss (pure tone average of >25 dB) was higher in stroke patients than in controls (64.1% vs. 35.9%; p < 0.001). The mean pure tone average of stroke patients showed a significant positive correlation with Timed Up and Go test (r = 0.357; p = 0.001) and fall occurrence (r = 0.253; p = 0.025), and a significant negative correlation with Berg Balance Scale (r = −0.299; p = 0.008) and Functional Gait Assessment (r = −0.452; p < 0.001). There was a non-significant negative correlation with gait speed (r = −0.166; p = 0.147). Multiple regression showed that mean pure tone average was associated with Timed Up and Go test (B = 0.096; 95%CI: 0.010, 0.183) and Functional Gait Assessment (B = −0.087; 95%CI: −0.157, −0.017), but not with gait speed (B = −0.003; 95%CI: −0.007, 0.001) and Berg Balance Scale (B = −0.058; 95%CI: −0.165, 0.049). ConclusionHearing loss is more prevalent among patients with sub-acute stroke compared with age-sex-matched controls. Hearing loss is also associated with gait and balance impairments and falls among sub-acute stroke patients. We recommend that hearing screening and rehabilitation be incorporated into post-stroke rehabilitation programmes as part of strategies to improve balance and gait and reduce or prevent falls.

Cochlear Implantation in Charcot-Marie-Tooth Patients: Speech Perception and Quality of Life.

There is a limited understanding of the impact of cochlear implantation (CI) in patients with Charcot-Marie-Tooth disease (CMT), given the scarcity of reported cases. We aim to evaluate the audiological outcomes and quality of life (QoL) after CI in CMT. Multi-institutional, university-affiliated, tertiary-referral centers, retrospective chart review.Our cohort includes 5 patients with CMT. Patients' charts were reviewed for demographic characteristics, operation notes, and pre- and post-implantation audiology evaluation. Patients completed the Cochlear Implant Quality of Life-10 (CIQOL-10) Global questionnaire. Pre-implantation, the mean pure tone average was 84.1 ± 7.2 dB, and the mean word recognition score was 2.4% in the implanted ear. AzBio sentence test was performed in quiet, revealing a mean of 4 ± 1.4% in the implanted ear. Post-implantation, PTA results were all within the mild hearing loss range (mean 33.0 ± 5.9 dB). Post-CI, AZ-Bio test results were 5%, 65%, and 74% (for 3 patients), and HINT scores were 55% and 58% (for 2 patients). The mean score of the CIQOL-10 questionnaire was 42.7 ± 10.47 (range 1-100). Patients were most satisfied with their ability to listen to the television or radio, have conversations in a quiet environment, and feel comfortable being themselves. To the best of our knowledge, this is the most extensive series of CI in CMT-associated sensorineural hearing loss and auditory neuropathy. Our cohort suggests that CI is a safe and reliable method for hearing rehabilitation that can achieve good speech performance and improve QoL in CMT patients.

Comparison of hearing performance in patients with borderline indication for active middle ear or cochlear implants: clinical outcomes to guide preoperative counseling and decision making

PurposeThe aim of the presented study was to compare the audiological benefit achieved in cochlear implant (CI) patients who, in principle, could still have been treated with an active middle ear implant (AMEI) with a group of AMEI users.MethodsResults of 20 CI patients with a pure-tone average (PTA) of 70 dB HL prior to surgery were compared with a group of 12 subjects treated with a Vibrant Soundbridge (VSB). Pre-surgical comparison included PTA for air conduction and bone conduction, maximum speech recognition score for monosyllabic words (WRSmax), and aided monosyllabic word recognition at 65 dB SPL. One year after surgery, aided monosyllabic speech recognition score at 65 dB SPL was compared.ResultsMean PTA for air conduction in the VSB group was significantly lower than in the CI group (4.8 dB, Z = − 2.011, p < 0.05). Mean PTA for bone conduction in the VSB group was also significantly lower than in the CI group (23.4 dB, Z = − 4.673, p < 0.001). WRSmax in the VSB group was significantly better than in the CI group (40.7%, Z = − 3.705, p < 0.001). One year after treatment, there was no significant difference in aided speech perception in quiet between both subject groups.ConclusionComparison of the two methods showed equivalent results for both treatments in subjects with a borderline indication. Not only pure-tone audiometry results but, particularly, speech perception scores pre-surgery should be taken into account in preoperative counseling.

Neuroimaging Characteristics of Hearing Loss in the Mayo Clinic Study of Aging.

To investigate the association between standard pure tone and speech audiometry with neuroimaging characteristics reflective of aging and dementia in older adults. Prospective population-based study. Single tertiary care referral center. Participants from the Mayo Clinic Study of aging 60 years old or older with normal cognition or mild cognitive impairment, baseline neuroimaging, and a behavioral audiogram associated with neuroimaging were eligible for study. Imaging modalities included structural MRI (sMRI) and fluid-attenuated inversion recovery MRI (FLAIR-MRI; N = 605), diffusion tensor imaging MRI (DTI-MRI; N = 444), and fluorodeoxyglucose-positron emission tomography (FDG-PET; N = 413). Multivariable logistic and linear regression models were used to evaluate associations with neuroimaging outcomes. Mean (SD) pure tone average (PTA) was 33 (15) dB HL and mean (SD) word recognition score (WRS) was 91% (14). There were no significant associations between audiometric performance and cortical thinning assessed by sMRI. Each 10-dB increase in PTA was associated with increased likelihood of abnormal white-matter hyperintensity (WMH) from FLAIR-MRI (odds ratio 1.26, P = .02). From DTI-MRI, participants with <100% WRSs had significantly lower fractional anisotropy in the genu of the corpus callosum (parameter estimate [PE] -0.012, P = .008) compared to those with perfect WRSs. From FDG-PET, each 10% decrease in WRSs was associated with decreased uptake in the anterior cingulate cortex (PE -0.013, P = .001). Poorer audiometric performance was not significantly associated with cortical thinning but was associated with white matter damage relevant to cerebrovascular disease (increased abnormal WMH, decreased corpus callosum diffusion). These neuroimaging results suggest a pathophysiologic link between hearing loss and cerebrovascular disease.

19 Auditory and Cognitive Function in Adults Living With and Without HIV

Objective:Hearing consists of peripheral components (outer and middle ear, cochlea) and the central auditory system (cochlear nuclei to the auditory cortex). Speech perception relies on peripheral hearing abilities (i.e., pure-tone thresholds) and central auditory processing (CAP) and cognitive functioning. Specifically, working memory, executive function, attention, and verbal functioning allow for speech understanding. As a result, CAP deficits are also influenced by peripheral hearing sensitivity and cognitive functioning. Assessing CAP deficits can be difficult because of these complex interactions. Prior work has shown persons living with HIV (PWH) are at higher risk for sensorineural hearing loss compared to persons living without HIV (PWOH) after adjusting for age, sex, and noise exposure. Further, HIV is a risk factor for cognitive impairment, one example being Alzheimer's disease (AD) and its precursor, Mild Cognitive Impairment (MCI), with auditory dysfunction occurring in earlier stages of AD. Therefore, the purpose of this study was to evaluate: 1) the peripheral hearing sensitivity and CAP in PWH and PWOH; and 2) the association between cognitive function measures and CAP in PWH and PWOH.Participants and Methods:Participants included 59 PWH (39 men and 20 women, mean age=66.7 years [SD=4.4 years]) and 27 PWOH (13 men and 14 women, mean age=71.9 years [SD=7.1 years]). Participants completed a standard neuropsychological battery assessing the domains of learning, recall, executive function, working memory, verbal fluency, processing speed and motor. Raw scores were transformed to demographically corrected, domain T-scores. Cognitive function was normal for 39 (66.1%) PWH and 16 (59.3%) PWOH while 43 (72.9%) PWH and 17 (63.0%) PWOH were determined to have MCI. Participants with dementia were excluded. Participants also completed a hearing assessment, a portion of which consisted of pure-tone thresholds, peripheral hearing measure, and dichotic digits testing (DDT), a CAP measure. Pure-tone air-conduction thresholds were obtained at octave frequencies from 0.25 through 8 kHz, including 3 and 6 kHz. A pure-tone average (PTA) was calculated from 0.5, 1, 2, and 4 kHz thresholds for each ear. The DDT involves the presentation of numbers from 1 to 10, excluding 7, in which two different digits are presented to one ear while two other digits are simultaneously presented to the opposite ear. The outcome of DDT is percent correct.Results:PWH had slightly lower (i.e., better) mean PTAs in both ears compared to PWOH, but this was not statistically significant. Conversely, PWH had lower percent correct DDT results compared to PWOH, but this difference was also not statistically significant. Participants with impairment in verbal fluency, executive functioning, and working memory had significantly worse DDT results by approximately 10%, but only for right ear data.Conclusions:PWH in our sample had better hearing than PWOH, which can be explained by PWH having a lower mean age. PWH had poorer DDT results, however, indicative of CAP deficits rather than peripheral hearing problems. Poor right ear DDT was associated with impairments specifically in frontal-based cognitive processes with an executive component.

Functional and anatomical outcomes following cartilage myringoplasty

Background: Myringoplasty using cartilage graft is being popular in recent years because of its better graft uptake and optimal hearing outcome. Thickness plays an important role in achieving optimal hearing outcome and although studies have shown 0.5 mm thickness to give better hearing results, concrete studies are lacking. Methods: A prospective study was conducted in the department of otorhinolaryngology at a tertiary-referral-hospital in North-Karnataka; India between January-December 2019, on 25 patients of chronic otitis media; mucosal inactive or quiescent with conductive hearing loss and intact ossicular chain who underwent cartilage myringoplasty using conchal cartilage of 0.5 mm thickness. Follow-up was done at 3, 4½ and 6 months postoperatively to assess graft uptake. Hearing assessment was performed at the end of 6 months postoperative period with pure-tone audiometry. Results: The preoperative mean pure tone average was 33.64±9.42 dB which improved to 22.56±7.41 dB at 6 months. At 3 months and 4½ months, there were 21casess (84%) of complete graft uptake, 3 cases of partial graft uptake (12%) and one case of total graft rejection (4%). Whereas, at 6 months postoperative period complete graft uptake was seen in 22 cases (88%) with 1 case of total rejection (4%) and 2 cases of partial uptake (8%). Conclusions: Cartilage myringoplasty using 0.5 mm thickness conchal cartilage offers good hearing outcome in addition to significant graft uptake. As the conchal cartilage can be easily harvested from the site of incision for the surgery it can be an important primary alternative to temporalis fascia.

Translation into Spanish and validation of the Tinnitus Functional Index (TFI)

ObjectiveThe objectives of this study were to translate into Spanish, cross-culturally adapt and validate the TFI. Materials and MethodsThe TFI questionnaire translated into Spanish (Sp-TFI) and cross-culturally adapted following the published guidelines on cross-cultural adaptation of health questionnaires was evaluated using two indicators. Its internal consistency was assessed with Cronbach’s α considering the Tinnitus Handicap Inventory (THI) as the gold standard. Further, its test-retest reliability was assessed with intraclass correlation coefficients (ICCs). ICCs were also calculated for the THI and visual analogue scales (VAS) for tinnitus tested and retested in all participants. ResultsThe mean age of the 18 participants was 45.77 (SD: 11.87) years; 12 were female (66.67 %) and 6 were male (33.33%). Half of the participants experienced tinnitus in their left ear and half in their right. The mean pure-tone average (PTA) in the affected ear was 29.34 (SD: 8.08) dB-HL. Regarding internal consistency and reliability of the Sp-TFI respectively, Cronbach’s α was 0.83 and the ICC type (2,1) was 1 (CI: 0.99–1). Among the variables studied, we found the following independent predictors had statistically significant effects on THI score: sex (p < 0.01), PTA (p = 0.03), overall Sp-TFI score (p = 0.02) and Sp-TFI SL, R and A subscale scores (p = 0.03, p = 0.03, and p < 0.01, respectively). ConclusionBased on the internal consistency and reliability results obtained in this study, the cross-culturally adapted Spanish version of the TFI (Sp-TFI) has been validated for use in Spain. Level of evidence2B: Individual cohort study/low-quality randomized control studies

Audiologic Consequences of Gunshot Wounds to the Temporal Bone Show No Relation to Concomitant Neurologic or Vascular Injuries.

To evaluate audiologic consequences of gunshot wounds (GSWs) to the temporal bone (TB), and to correlate hearing outcomes with neurologic and vascular injuries adjacent to the temporal bone. Retrospective case series. University-based level-one trauma center. Retrospective review of 35 patients surviving TB ballistic injury, 2012 to 2021. Main outcomes were audiologic results. Demographics, concomitant injuries, CT, and interventions were reviewed. Mean age was 30.7 years; 80% male. Seventeen patients (48.6%) underwent audiologic testing. Mean pure tone average (PTA) was 75 ± 35 dB, bone line average 41 ± 26 dB, and speech discrimination score (SDS) 60 ± 43%. Nineteen (54.3%) demonstrated facial nerve injury (FNI), who were more likely to show SNHL especially anacusis, though their mean PTA and SDS were not statistically different from those without (P = .30 and .47, respectively). Radiographic review of those with sensorineural loss (SNHL, 6/17) revealed otic capsule-disrupting fracture (n = 2), pneumolabyrinth (n = 2), intracranial hemorrhage (n = 3). Those with mixed loss (6/17) showed otic capsule-sparing fracture (n = 6), EAC injury (n = 5), ossicular discontinuity (n = 2), and intracranial hemorrhage (n = 4). Two with mastoid tip fractures alone had normal audiograms. Audiometric outcomes were not predicted by concomitant CSF leak, spinal injuries, vascular injuries, cranial neuropathies, or traumatic brain injury. All patterns of hearing loss-conductive, sensorineural, mixed and normal-may be seen following TB ballistic injuries. Trauma severe enough to disrupt the facial nerve is more likely to cause anacusis. However, all should be formally evaluated, since ballistic injuries complicated by neurologic or vascular damage do not necessarily correlate with worse audiologic outcomes, while patients with minimal fractures may demonstrate losses.

Early fitting in cochlear implant surgery: preliminary results.

Cochlear implants are usually activated 3-5weeks after surgery; to date, no universal protocol exists regarding switch on and fitting of these devices. The aim of the study was to assess safety and functional results of activation and fitting of cochlear implant within 24h following surgery. In this retrospective case-control study, 15 adult patients who underwent cochlear implant surgery, for a total of 20 cochlear implant procedures were analyzed. In particular, clinical safety and feasibility were investigated by examinating patients at activation and at each follow-up. Values of electrodes' impedance and most comfortable loudness (MCL) were analyzed from the time of surgery to 12months after activation. Free-field pure tone average (PTA) was also recorded. No major or minor complications were reported and all patients could perform the early fitting. Activation modality influenced impedance values only in the short term but the differences were not statistically significant (p > 0.05). Mean MCL values in the early fitting group were lower than MCL of the late fitting in all follow-up sessions, and the difference was statistically significant (p < 0.05). The mean PTA was lower in the early fitting group but the difference was not statistically significant (p < 0.05). Early fitting of cochlear implants is safe, allows for an early rehabilitation and can have possible beneficial effects on stimulation levels and dynamic range.

Infliximab for the Treatment of Inflammatory Labyrinthitis: A Retrospective Cohort Study.

Inflammatory labyrinthitis is defined as a fluctuant vestibulo-cochlear syndrome associated with an impairment of the blood-labyrinthine barrier (BLB) on delayed FLAIR MRI sequences. Systemic and intratympanic corticosteroids are the gold standard treatment but their effect is frequently insufficient. The objective is here to determine whether infliximab could be of value in the treatment of bilateral inflammatory labyrinthitis. A retrospective monocentric study was conducted between January 2013 and December 2021. All patients included in the study were affected with a bilateral vestibulo-cochlear syndrome associated with bilateral blood-labyrinthine barrier impairment. Patients were administered infliximab at the dose of 5 mg/kg every 6 weeks for 6 months. Audiometry, MRI with delayed FLAIR sequences on the labyrinth, and corticosteroid doses still required were assessed both before and after treatment with infliximab was completed. Pure-tone average (PTA) was the primary outcome. The secondary outcomes were the speech recognition threshold (SRT), the Dizziness Handicap Inventory (DHI) score, and the corticosteroid (CS) dose. A total of nine patients including five men and four women were enrolled in the study. Thirteen ears were analyzed. After a 6-month period of treatment, the mean PTA (54 ± 24 db versus 66 ± 22 db; p = 0.027), SRT (54 ± 37 db versus 66 ± 32 db; p = 0.041) and DHI score (27 ± 15 versus 9 ± 2; p = 0.032) significantly improved. After the 6-month treatment period, the mean CS dose decreased from 38 ± 33 to 6 ± 5 mg/day (p = 0.003). We conclude that infliximab substantially improves the vestibulo-cochlear function in patients with bilateral inflammatory labyrinthitis and could be of value in corticosteroid-dependent cases.

Audiometric Outcomes After the Middle Cranial Fossa Repair of Superior Semicircular Canal Dehiscence.

To evaluate the audiometric outcomes after the middle cranial fossa approach (MCF) for superior canal dehiscence (SCD) repair. Retrospective review. Tertiary referral center. SCD cases presented to a single institution between 2012 and 2022. The MCF repair of SCD. Air conduction (AC) threshold (250-8,000 Hz), bone conduction threshold (BC) (250-4,000 Hz), and air bone gap (ABG) (250-4,000 Hz) at each frequency, pure tone average (PTA) (500, 1,000, 2,000, 3,000 Hz). Among 202 repairs, 57% were bilateral SCD disease and 9% had previous surgery on the affected ear. The approach significantly narrowed ABG at 250, 500, and 1,000 Hz. The narrowing of ABG was achieved by both decreased AC and increased BC at 250 Hz, but mediated primarily by increased BC at 500 Hz and 1,000 Hz. Among cases without previous ear surgery, mean PTA remained in the normal hearing range (mean: preop, 21 dB; postop, 24 dB) and clinically important hearing loss (PTA increased by ≥10 dB) after the approach was noted in 15% of cases. Among cases with previous ear surgery, mean PTA remained in the mild hearing loss range (mean: preop, 33 dB; postop, 35 dB) and clinically important hearing loss after the approach was noted in 5% of cases. This is the largest study to date examining the audiometric outcomes after the middle cranial fossa approach for SCD repair. Findings of this investigation support that the approach is effective and safe with long-term hearing preservation for most.

Auditory Function in the Pediatric HIV/AIDS Cohort Study Adolescent Master Protocol Up Young Adults: A Pilot Study.

To collect and compare selected hearing measures in a pilot study of young adults with perinatally acquired HIV (YAPHIV) and those with perinatal HIV exposure who are uninfected young adults with PHEU (YAPHEU). Cross-sectional hearing measures in YAPHIV and YAPHEU enrolled in the Pediatric HIV/AIDS Cohort Study Adolescent Master Protocol (AMP) for Participants 18 Years of Age and Older (AMP Up). Pure-tone air conduction audiometry and distortion product otoacoustic emission (DPOAE) data were collected in 1 visit. A low-frequency pure-tone average (PTA) (LFPTA, at 0.25, 0.5, 1, and 2 kHz), a speech-frequency PTA (SFPTA, at 0.5, 1, 2, and 4 kHz), and a high-frequency PTA (HFPTA, at 3, 4, 6, and 8 kHz) were calculated. Hearing loss was defined as worse ear SFPTA of ≥20 dB HL. Separate linear regression models were fit for worse ear LFPTA, SFPTA, and HFPTA to assess associations with PHIV status. DPOAE signal-to-noise ratios (SNRs) were obtained at 3 frequencies in each ear. Forty-seven YAPHIV and 9 YAPHEU completed hearing testing. All adjusted mean PTAs were similar between YAPHIV and YAPHEU. Hearing loss occurred more in YAPHIV (7/47, 15.2%; 95% CI: 6.3%-28.9%), compared with YAPHEU (0/9, 0%). No associations were detected between HIV disease severity measures and worse ear SFPTA. DPOAE SNRs were similar between YAPHIV and YAPHEU. In this pilot study, peripheral hearing (ie, PTAs) and cochlear function (ie, DPOAEs) were similar between YAPHIV and YAPHEU. A larger study is warranted to confirm these findings.

Psychometrically Equivalent Fante Speech Recognition Threshold Materials by a Female Talker.

This study aimed to create and evaluate digitally recorded speech materials for speech recognition threshold (SRT) testing among children and adults in Fante. Fifty-one (51) familiar trisyllabic words were chosen from a list of 107 widely used trisyllabic Fante words. They were digitally captured and edited to create the same root mean square as a 1-kHz calibration tone. The study used a three-phase cross-sectional study method. Twenty native Fante speakers with normal hearing thresholds were selected at random for listener evaluation. For each of the words, the researchers used logistic regression to measure the slope, intercepts, and psychometric function slope at 50% and from 20% to 80%. In the study, the intensity of each word was modified digitally, so that the threshold at 50% of each word was equal to the mean pure-tone average (PTA) of the participants to increase the homogeneity of the thresholds of the selected words. A final list of 25 familiar homogenous words with the same tone patterns of slopes greater than 7%/dB was finally selected and recorded for speech audiometry in Fante. Psychometrically equivalent trisyllabic words in Fante were successfully developed and evaluated for SRT testing in Ghana. There is a need for the development of speech audiometry materials in other Ghanaian languages.

Translation into Spanish and validation of the Tinnitus Functional Index (TFI)

ObjectiveThe objectives of this study were to translate into Spanish, cross-culturally adapt and validate the TFI. Materials and MethodsThe TFI questionnaire translated into Spanish (Sp-TFI) and cross-culturally adapted following the published guidelines on cross-cultural adaptation of health questionnaires was evaluated using two indicators. Its internal consistency was assessed with Cronbach’s α considering the Tinnitus Handicap Inventory (THI) as the gold standard. Further, its test-retest reliability was assessed with intraclass correlation coefficients (ICCs). ICCs were also calculated for the THI and visual analogue scales (VAS) for tinnitus tested and retested in all participants. ResultsThe mean age of the 18 participants was 45.77 (SD: 11.87) years; 12 were female (66.67 %) and 6 were male (33.33%). Half of the participants experienced tinnitus in their left ear and half in their right. The mean pure-tone average (PTA) in the affected ear was 29.34 (SD: 8.08) dB-HL. Regarding internal consistency and reliability of the Sp-TFI respectively, Cronbach’s α was 0.83 and the ICC type (2,1) was 1 (CI: 0.99–1). Among the variables studied, we found the following independent predictors had statistically significant effects on THI score: sex (p < 0.01), PTA (p = 0.03), overall Sp-TFI score (p = 0.02) and Sp-TFI SL, R and A subscale scores (p = 0.03, p = 0.03, and p < 0.01, respectively). ConclusionBased on the internal consistency and reliability results obtained in this study, the cross-culturally adapted Spanish version of the TFI (Sp-TFI) has been validated for use in Spain. Level of evidence2B: Individual cohort study/low-quality randomized control studies