Mild Hearing Loss Research Articles

The Impact of Slight to Mild Hearing Loss on Academic Performance and Behavior of 9-15-Year-Olds.

To examine the impact of slight to mild hearing loss in children by studying its association with academic performance and behavioral problems. This study was embedded within a prospective birth cohort in Rotterdam, the Netherlands. Participants underwent audiometric and behavioral evaluations between ages 9-11 (April 2012-October 2015) and 13-15 (May 2017-September 2019). At 13-15, a multiple linear regression was conducted to explore the relationship between hearing acuity and both academic and behavioral outcomes. A cross-lagged analysis using data from ages 9 to 11 investigated bidirectional associations between hearing loss and behavioral problems. The cross-sectional part of the study involved 4688 participants at the age of 13-15 years. The relative risk for children with slight to mild hearing loss of being placed in a lower educational level compared with the highest level was 1.52 (95% confidence interval (CI) [1.14, 2.02]). Among boys, elevated high-frequency pure-tone average (HPTA) was associated with a higher total problem score (per 1 dB HPTA: β = 0.01; 95% CI [0.00, 0.02]). For girls, elevated low-frequency pure-tone average (LPTA) was associated with a higher attention problem score (per 1 dB LPTA: β = 0.02; 95% CI [0.01, 0.02]). Cross-lagged effects showed that participants with increased pure-tone averages in low frequencies at 9-11 years had more social problems at ages 13-15 years (Z-score difference: 0.01; 95% CI [0.01, 0.02]). Elevated hearing thresholds in slight to mild hearing loss were linked to poorer academic performance and increased behavioral problems. 2 (prospective cohort study) Laryngoscope, 2024.

Factors Influencing the Time to Treatment of Patients with Idiopathic Sudden Sensorineural Hearing Loss.

Objective: To identify the factors that influence the time to treatment (TT) in patients with idiopathic sudden sensorineural hearing loss (ISSNHL). Method: This study included a total of 324 patients with ISSNHL, who were treated at our department between September 2021 and May 2024. Basic information and audiological indicators of patients were collected, and their relationship with the TT was analyzed. Results: The patients were classified into long-term (TT >7 days, n = 75) and short-term groups (TT ≤7 days, n = 249). A significant difference was observed in sex, type of hearing loss, pretreatment hearing threshold, average improved hearing threshold, linear distance, and effective rate between the 2 groups. Conclusion: The average pretreatment hearing threshold and linear distance are related to the TT, and both of them are independent influencing factors. Patients with mild hearing loss and long linear distance from hospital may have a longer TT.

Polygenic Risk Scores and Hearing Loss Phenotypes in Children

Monogenic causes of childhood hearing loss are well established, as are polygenic risk contributions to age-related hearing loss. However, an untested possibility is that polygenic risk scores (PRS) also contribute to childhood hearing loss of all severities, alongside environmental and/or monogenic causes. To examine the association between a PRS for adult hearing loss and childhood hearing loss phenotypes. This cross-sectional study used a unique population-based dataset spanning normal hearing to profound loss, combining 2 contemporaneous population cohorts in Australia. This included the Child Health CheckPoint, a national population-based cross-sectional study nested within the Longitudinal Study of Australian Children, and the Victorian Childhood Hearing Longitudinal Databank (VicCHILD), a statewide population-based longitudinal data bank open to every child with congenital hearing loss in Victoria, Australia. The analysis took place from March to August 2023. Genotype data were generated from saliva- or blood-derived DNA using global single-nucleotide variations arrays. Based on genotype data, PRS was computed using published UK Biobank genome-wide association study results for self-reported hearing difficulty in individuals aged 40 to 69 years. Hearing outcomes were classified by laterality (bilateral, unilateral), severity (mild, moderate, severe or worse) and types (sensorineural, conductive, mixed, auditory neuropathy, atresia). Analyses included multinominal logistic regressions of PRS with hearing outcomes. Overall, 1488 CheckPoint study children (49.8% boys, aged 11-12 years) and 527 VicCHILD study children (55.2% boys, aged 0-13 years) with hearing and genotype data were included. A 1-SD increment in PRS was associated with higher odds of mild (odds ratio [OR], 1.3; 95% CI, 1.0-1.6), moderate (OR, 5.1; 95% CI, 3.2-8.1), and severe or worse (OR, 5.3; 95% CI, 3.9-7.3) unilateral hearing loss compared with normal hearing. Similarly, the PRS was associated with increased odds of mild, moderate, and severe or worse bilateral hearing loss (per-SD ORs, 3.9-6.6) and all hearing loss types (per-SD ORs, 8.5-10.6). In this cross-sectional study, a PRS initially developed for adult hearing difficulty was associated with wide-ranging childhood hearing loss phenotypes, partly explaining hearing phenotype variations despite shared genetic and environmental factors (eg, preterm birth). Large-scale studies with objectively defined hearing phenotypes are crucial for refining PRS and predicting high-risk children.

Association between hearing loss and gout based on National Health and Nutrition Examination Survey and Mendelian randomization analysis

Hearing loss(HL) represents a significant public health concern. This study aimed to determine the association between hearing loss and gout and to elucidate the underlying causative mechanisms. Data for this study were obtained from the National Health and Nutrition Examination Survey (NHANES) and Mendelian randomization (MR) basic databases. Initially, baseline characteristics of individuals with and without gout were compared. A nonlinear relationship between pure tone audiometry (PTA) values and gout prevalence was confirmed through restricted cubic spline (RCS) curve analysis. Subsequently, hearing loss was categorized into different levels based on PTA values, and multiple logistic regression analysis was employed to calculate the impact of varying degrees of hearing loss on the risk of gout. Finally, MR analysis was conducted to further elucidate the causal relationship between hearing loss and gout. A total of 3,258 individuals were included in this study, with a gout prevalence of 3.7%. Significant differences were observed between the gout group and the non-gout group in variables such as age, gender, blood uric acid level, BMI, hypertension, and diabetes. RCS curve analysis revealed a significant nonlinear relationship between PTA values and gout risk, particularly when PTA values exceed a specific threshold, where the curve flattens. Based on different levels of hearing loss derived from PTA values, multiple logistic regression analysis demonstrated that mild and moderate hearing loss significantly increased the risk of gout, remaining statistically significant after adjusting for covariates (odds ratio (OR) = 2.10–3.48, P < 0.05). MR analysis further confirmed the causal relationship between hearing loss and gout. Inverse variance weighting (IVW) was employed as the primary method, revealing that both individuals with hearing difficulties (OR = 0.98, 95% confidence interval (CI) 0.96–0.999, P = 0.012) and those without hearing impairment (OR = 1.02, 95% CI 1.01–1.04, P = 0.012) exhibited a significant causal relationship with gout. Goodness-of-fit tests and sensitivity analyses were used to verify the reliability of the results. Hearing loss has a significant causal relationship with an increased risk of gout, providing a new perspective for the prevention and management of gout. Focused attention and prompt treatment of hearing loss, particularly mild and moderate hearing loss, may significantly reduce the risk of developing gout.

Sensory and affective dimensions in loudness perception: Insights from young adults

Traditional psychoacoustic measures often lack accuracy in diagnosing hyperacusis and other sound tolerance disorders, possibly due to their reliance on artificial stimuli and unidimensional scales. The aim of this study was to assess loudness across sensory and affective dimensions using natural sounds, drawing on pain research wherein intensity and unpleasantness are assessed separately. We hypothesized that similar distinctions apply to loudness perception. A total of 102 young adults with normal to mild hearing loss rated 32 sound stimuli (pleasant, unpleasant, neutral, and artificial) at 10 intensities (40 to 100 dBA) on sensory and affective scales. They also completed the Hyperacusis Questionnaire, the Noise Sensitivity Scale, and the Hospital Anxiety and Depression Scale. Mixed linear models indicated both correlations and dissociations between scales that varied according to intensity and valence. Louder stimuli were rated as more unpleasant, but only at high intensities. On the sensory scale, sounds were perceived as louder with increasing intensity; however, at low to moderate intensities, pleasant and neutral sounds were rated as louder, whereas at higher intensities, artificial and unpleasant stimuli were rated as louder. On the affective scale, the perception of unpleasantness also increased with intensity, but less steeply. At high intensities, artificial stimuli were rated similarly to unpleasant stimuli. Noise sensitivity scores predicted louder and more unpleasant ratings, whereas depression scores were associated with softer and less pleasant perceptions. This study highlights the need for multidimensional approaches in audiology and suggests that the integration of sensory and affective scales with natural stimuli may improve the diagnosis and treatment of sound tolerance disorders.

Application of narrow-band CE-Chirp NB ASSR in hearing threshold assessment of hearing-impaired children

Objective:To investigate the application value of NB CE-Chirp ASSR in the assessment of hearing threshold in children with hearing impairment. Methods:The hearing test results of 44 children with sensorineural hearing loss（88 ears） diagnosed in Shanghai Children's Hospital from January 2023 to December 2023 were retrospectively studied, including 19 ears in mild hearing loss group, 26 ears in moderate group, 20 ears in severe group and 23 ears in extremely severe group. Correlations between auditory brainstem response（ABR） thresholds, pure tone audiometry（PTA） thresholds and NB CE-Chirp ASSR response thresholds in different hearing loss groups were analyzed. Results:The threshold difference between ABR and NB CE-Chirp ASSR（2 000-4 000 Hz） was between 0.50-4.08 dB in different degrees of hearing loss group. There was a significant correlation between NB CE-Chirp ASSR and ABR response threshold in each group（P<0.001）, and the correlation coefficients of mild, severe and extremely severe groups were all greater than 0.8, showing a strong correlation. The average threshold difference between PTA and NB CE-Chirp ASSR in each group was between 1.88-3.91 dB. The correlation coefficients were all greater than 0.8, showing a strong correlation. The difference between PTA and NB CE-Chirp ASSR response threshold at 500, 1 000, 2 000 and 4 000 Hz in each groupwas between 0.25-3.84 dB. With the increase of frequency, the correlation coefficient between PTA and NB CE-Chirp ASSR response threshold showed an upward trend. The frequency with the highest coefficient was 4 000 Hz, and the r values were all greater than 0.9, followed by 2 000 Hz, and the correlation coefficient was relatively low at 500 Hz. In the extremely severe group, each frequency coefficient was greater than 0.7, showing a strong correlation. Conclusion:NB CE-Chirp ASSR has good frequency specificity and can reliably assess hearing thresholds in hearing-impaired children.

Follow-Up of Neonatal Hearing Screening in the Risk Factor Group for Hearing Loss: Results from a Tertiary Medical Center

Introduction: Universal newborn hearing screening has been successfully implemented in many places around the world, and it is recommended that cases with risk factors for hearing loss be followed-up regardless of hearing screening results. However, there is a need for clarity regarding the recommended rate of follow-up and which tests should be performed. The aim of this study was to assess the audiologic follow-up program for the group with risk factors. Method: Our retrospective study involved children of various ages with a risk factor for hearing loss who passed the initial neonatal hearing test but were later diagnosed with hearing loss. Out of 113,708 children born at Hadassah University Medical Center during the years 2013–2021, 6763 were at risk of hearing loss, and their follow-up audiologic test results were studied. Results: Audiologic testing including ABR, OAE, tympanometry and behavioral audiometry was performed in 1534 of 6763 (23%) of the risk factor group that returned to the hospital. In total, 73 children (4.7%) were diagnosed with hearing loss, 54 of whom failed the initial screening and 19 who had passed it. Further examination of the children that passed the initial screening and were later diagnosed with a hearing loss revealed that four cases had been missed in screening (one familial mild hearing loss, one familial progressive loss, one premature infant with a high tone loss, and one NICU graduate with CNS involvement). Another nine cases had late-onset hearing loss (three meningitis, five CMV, and one with a mitochondrial disease). An additional six cases were diagnosed late, and the age of onset of the hearing loss was unknown (two intubated, two with hydrocephalus, one with Cerebral Palsy, and one with general developmental delay). Conclusions: These results reveal the importance of implementing a refined protocol for monitoring hearing in the high-risk group of children that pass neonatal hearing screening with respect to which hearing tests should be conducted, at what age, and the duration of follow-up. Also, barriers to follow-up must be dealt with, and parents should be more involved in the monitoring process.

Sensorineural hearing loss among hypertensive patients attending cardiac institute in Tanzania: A cross-sectional study

INTRODUCTION Hypertension is among non-communicable diseases worldwide and it has been associated with sensorineural hearing loss. Almost 1.39 billion people (1 out of 4 adults) have hypertension and this figure is expected to increase. In Sub-Saharan Africa, hypertension is the leading cause of death and disability. Hypertension is associated with sensorineural hearing loss by compromising the blood supply in the cochlea. MATERIALS AND METHODS An assessment of the proportion and patterns of sensorineural hearing loss among hypertensive patients was conducted. 191 patients aged 18 years and above were recruited. History and physical examination including blood pressure, and otoscopy were done. Pure tone audiometry (PTA) was conducted. RESULTS Patients aged from 36 to 88 years with a mean age of 60 years and a standard deviation of 10. The patients aged between 61–76 years accounted for 85 (44.5%), whereas 29–44 and &gt; 76 years accounted for 12 (6.3%) each. The female-to-male ratio was 1:1. Sensorineural hearing loss was detected in 144 (75.4%), commonly above 76 years of age which was 11 (91.7%. Mild sensorineural hearing loss was the most common degree revealed. There was no relationship between the degree of sensorineural hearing loss and the grades of hypertension (p-value of 0.113). No relationship between the duration of hypertension with the severity of hearing loss, p-value =0.369. CONCLUSION The prevalence of sensorineural hearing loss among hypertensive patients was 75.4%. The bilateral and mild degree was the commonest presentation. Increasing age was found to be associated with increased hearing loss. The duration and grade of hypertension were not related to the severity of hearing loss.

Impact of age-related hearing loss on decompensation of left DLPFC during speech perception in noise: a combined EEG-fNIRS study.

Understanding speech-in-noise is a significant challenge for individuals with age-related hearing loss (ARHL). Evidence suggests that increased activity in the frontal cortex compensates for impaired speech perception in healthy aging older adults. However, whether older adults with ARHL still show preserved compensatory function and the specific neural regulatory mechanisms underlying such compensation remains largely unclear. Here, by utilizing a synchronized EEG-fNIRS test, we investigated the neural oscillatory characteristics of the theta band and synchronous hemodynamic changes in the frontal cortex during a speech recognition task in noise. The study included healthy older adults (n = 26, aged 65.4 ± 2.8), those with mild hearing loss (n = 26, aged 66.3 ± 3.8), and those with moderate to severe hearing loss (n = 26, aged 67.5 ± 3.7). Results showed that, relative to healthy older adults, older adults with ARHL exhibited lower activation and weakened theta band neural oscillations in the left dorsolateral prefrontal cortex (DLPFC) under noisy conditions, and this decreased activity correlated with high-frequency hearing loss. Meanwhile, we found that the connectivity of the frontoparietal network was significantly reduced, which might depress the top-down articulatory prediction function affecting speech recognition performance in ARHL older adults. The results suggested that healthy aging older adults might exhibit compensatory attentional resource recruitment through a top-down auditory-motor integration mechanism. In comparison, older adults with ARHL reflected decompensation of the left DLPFC involving the frontoparietal integration network during speech recognition tasks in noise.

The p. S178L mutation in Tbc1d24 disrupts endosome-mediated synaptic vesicle trafficking of cochlear hair cells and leads to hearing impairment in mice.

The ribbon synapses of cochlear inner hair cells (IHCs) employ efficient vesicle resupply to enable fast and sustained release rates. However, the molecular mechanisms of these physiological activities remain unelucidated. Previous studies showed that the RAB-specific GTPase-activating protein TBC1D24 controls the endosomal trafficking of the synaptic vesicles (SVs) in Drosophila and mammalian neurons, and mutations in TBC1D24 may lead to non-syndromic hearing loss or hearing loss associated with the DOORS syndrome in humans. In this study, we generated a knock-in mouse model for the p. S178L mutation in TBC1D24, which leads to autosomal dominant non-syndromic hearing loss (DFNA65). The p.S178L mutant mice show mild hearing loss and progressively declined wave I amplitude of the auditory brainstem responses. Despite the normal gross and cellular morphology of the cochlea, transmission electron microscopy reveals accumulation of endosome-like vacuoles and a lower-than-normal number of SVs directly associated with the ribbons in the IHCs. Consistently, patch clamp of the IHCs shows reduced exocytosis under prolonged stimulus. ARF6, a TBC1D24-interacting protein also involved in endosomal membrane trafficking, was underexpressed in the cochleae of the mutant mouse and has weakened in vitro interaction with the p.S178L mutant TBC1D24. Our results suggest an important role of TBC1D24 in maintaining endosomal-mediated vesicle recycling and sustained exocytosis of hair cell ribbon synapses.

Assessment of Cochlear Function Among Hypertensive Patients in Bauchi: A Cross-Sectional Cohort Study

Background: Hypertension is an important public-health problem, and it has been identified as the leading cause of morbidity and mortality due to the high incidence of end-organ damages. Unlike other complications of hypertension, cochlear dysfunction in hypertensive patients is a hidden and progressive damage that remains undetected (subclinical) for a long time. The aim of this study was to assess the prevalence of subclinical hearing impairment, as well as the type and degree of hearing loss among hypertensive patients in our environment. Methods: This was a cross-sectional cohort study conducted among adults diagnosed with hypertension previously. Ethical clearance and informed consent were obtained. Previous history of related exposure event (hypertension) and outcome (hearing loss) was assessed. Each participant was then subjected to c-PTA and EHA tests, and findings were analyzed. Results: One hundred and ninety (190) hypertensive patients were enrolled, among which 107 (56.3%) were females and 83 (43.7%) males. Hypertension was more common in the age group of 51-60 years (26.8%) and 61-70 years (30.5%). The overall prevalence of hearing loss was 41.6%, of which 18.4% had subclinical hearing impairment. The most common type of hearing loss was sensorineural 68 (86.1%), found to be in varying degrees of 33.8%, 26.5%, 23.5%, and 16.2% for mild, moderate, severe, and profound hearing loss, respectively. Conclusion: The overall prevalence of hearing loss among hypertensive patients was 41.6%, with a significant proportion (18.4%) having subclinical hearing loss, which is not noticed by the patients. Therefore, routine pure tone audiometric hearing screening for all hypertensives is recommended to enable early detection and treatment of this hearing loss.

6976 Early-Onset Paget's Disease- A Unique Presentation In A Young Female With Elevated Alkaline Phosphatase And Low Back Pain

Abstract Disclosure: F. El Sayed: None. Background Paget disease of bone is an age-related disorder characterized by abnormal growth in certain bones, leading to changes in size and shape. Commonly affecting the skull, spine, pelvis, and long bones, it is more prevalent in men, those over 55, with a family history, and of European ancestry. The prevalence of Paget's disease of bone is approximately 2-3% in individuals over 55 in the United States and Europe, with higher rates in those of European descent. Symptoms, such as pain and deformities, may arise from the condition itself or complications like arthritis. While Paget disease can cause visible abnormalities and fractures in affected bones, most individuals remain asymptomatic. Diagnosis often involves blood tests measuring alkaline phosphatase levels, bone scans, and x-rays. Case Presentation We present the case of a 34-year-old woman who sought evaluation due to persistently elevated alkaline phosphatase (ALP) levels in the thousands. The abnormality was discovered during routine blood work conducted during her pregnancy in 2020, and subsequent investigation revealed a chronic elevation for over three years. The patient reported chronic lower back pain but denied other neurological symptoms. Quantification of ALP Bone showed elevated levels at 629, with normal aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels, as well as within-range calcium and gamma-glutamyl transferase (GGT). A whole-body bone scan revealed marked radio tracer uptake in the calvarium, raising concerns for Paget's disease. The patient received a one-time infusion of Zoledronic acid (5 mg), leading to a significant decrease in ALP levels to 182 after three months. Subsequent examination by an Ear, Nose, and Throat (ENT) specialist unveiled bilateral extra bone deposition and mild hearing loss in the right ear, adding a unique dimension to the patient's presentation. This case highlights the importance of a comprehensive approach to diagnose and manage Paget's disease, even in younger individuals with atypical symptoms. Discussion and conclusion Paget's disease presenting in young adults with back pain can be a diagnostic challenge due to its atypical occurrence in this age group. Although back pain is a common symptom, the underlying cause might not immediately be linked to Paget's disease, which typically affects older individuals. However, when encountering persistent back pain in young adults, especially when accompanied by elevated alkaline phosphatase levels, clinicians should consider Paget's disease as a potential differential diagnosis. Further investigation, including imaging studies and bone scans, becomes crucial to confirm the presence of Paget's disease and initiate appropriate management strategies to mitigate its impact on the patient's health and quality of life. Presentation: 6/2/2024

Unilateral Sensorineural Hearing Loss in Congenital Cytomegalovirus Retrospective Observational Study.

The leading nonhereditary cause of childhood sensorineural hearing loss has been attributed to congenital cytomegalovirus (cCMV). Sensorineural hearing loss can be unilateral (UHL) or bilateral (BHL), and may be progressive. Our objective was to describe the characteristics, clinical nature and follow-up of ears in cCMV-associated UHL. This 16-year retrospective study was performed at Schneider's Medical Center, Israel. Data were collected from all cCMV infants with UHL at birth who were treated with antiviral treatment initiated within the first 4 weeks of life and had a follow-up period of at least 1 year. We enrolled 67 infants diagnosed with UHL at birth: 17 (25%) with mild hearing loss, 22 (33%) with moderate hearing loss and 28 (42%) with severe hearing loss. At the last follow-up visit, 7 (41%) ears in the mild hearing loss group improved to normal hearing, 8 (47%) ears exhibited no change and 2 (12%) ears deteriorated. In the moderate hearing loss group, 9 (41%) ears improved, 7 (32%) remained static and 6 (27%) deteriorated to the severe hearing loss group. One (4%) ear in the severe hearing loss group showed improvement. Of the 67 ears with normal hearing at birth, 4 (6%) ears deteriorated. This study assessed and elucidated the characteristics, clinical nature and long-term follow-up of both the affected and unaffected ears diagnosed with UHL due to cCMV. These data are crucial when medical and/or surgical interventions are considered.

A study of noise-induced annoyance and fatigue in open-plan offices: comparison between hearing-impaired and normal-hearing listeners

Several studies outline a future scenario of longer working lives and later retirement, meaning that there could be a large number of elderly workers in offices. Add to this the natural effect of hearing loss due to ageing (presbycusis; which usually presents after the 5th decade of life) and you have an open door to questions regarding the acoustic comfort of this group. In a first study, it was shown that the effect of intelligible speech on performance in a serial recall task is similar for listeners with normal hearing and presbycusis. The aim of this new experiment is to assess whether any differences might occur when people are involved in a more ecologically valid task (long exposure to noise - 3 h/condition - and similar tasks to those performed in open-plan offices). Given the validation of a hearing loss simulator in previous studies, this one will be used to reproduce the group of people with mild hearing loss (onset of presbycusis). Therefore, the same group of people (32 participants) with normal hearing will perform the experiment under two listening conditions, with and without the simulator. Each listening condition will have two noise conditions, irrelevant speech, each with a different intelligibility level.

Does Mild and Moderate Hearing Loss Affect Verbal Working Memory and Language Skills in Children?

Introduction: For a comprehensive approach in children with hearing loss (HL), some cognitive and language skills should also be considered, along with auditory skills. The main aim of this study was to evaluate the working memory and language skills in children with mild to moderate HL. Methods: Forty children with mild to moderate HL between the ages of 4 and 9 years were included in this study. The children with mild and moderate HL were evaluated in two groups. The Meaningless Word Repetition test, Test of Language Development-Primary test, and Meaningful Auditory Integration Scale were administered to assess working memory, language skills, and auditory perception, respectively. Also, the relationship between language and memory skills was evaluated. Results: The study found statistically significant correlations between language skills and working memory test scores. Additionally, statistically significant differences were found between children with mild and moderate HL in terms of language and memory skills (p < 0.001). Conclusion: The children with moderate HL demonstrated poorer performance compared to those with mild HL. Even if it is mild, the degree of HL affects children’s language and memory skills. It is emphasized that the relationship between language and working memory should be taken into consideration in auditory rehabilitation programs for these children.

Detection of mild sensory hearing loss using a joint reflection-distortion otoacoustic emission profile.

Measuring and analyzing both nonlinear-distortion and linear-reflection otoacoustic emissions (OAEs) combined creates what we have termed a "joint-OAE profile." Here, we test whether these two classes of emissions have different sensitivities to hearing loss and whether our joint-OAE profile can detect mild-moderate hearing loss better than conventional OAE protocols have. 2f1-f2 distortion-product OAEs and stimulus-frequency OAEs were evoked with rapidly sweeping tones in 300 normal and impaired ears. Metrics included OAE amplitude for fixed-level stimuli as well as slope and compression features derived from OAE input/output functions. Results show that mild-moderate hearing loss impacts distortion and reflection emissions differently. Clinical decision theory was applied using OAE metrics to classify all ears as either normal-hearing or hearing-impaired. Our best OAE classifiers achieved 90% or better hit rates (with false positive rates of 5%-10%) for mild hearing loss, across a nearly five-octave range. In summary, results suggest that distortion and reflection emissions have distinct sensitivities to hearing loss, which supports the use of a joint-OAE approach for diagnosis. Results also indicate that analyzing both reflection and distortion OAEs together to detect mild hearing loss produces outstanding accuracy across the frequency range, exceeding that achieved by conventional OAE protocols.

Hearing Loss, Hearing Aids, and Cognition.

Most observational studies examining the association between hearing loss (HL) and cognitive impairment used subjective measures of hearing and addressed only one dimension of cognition, and very few investigated the potential benefit of hearing aids (HAs). To evaluate objectively measured HL and several dimensions of cognition and estimate the association with HA use. A cross-sectional analysis of the CONSTANCES cohort study, which recruited participants from January 1, 2012, to December 31, 2020, was conducted. Participants were a representative sample of adults (age, 45-69 years) with audiometric data and cognitive evaluation from 21 preventive health centers in France. Data analysis was conducted from April 1 to September 15, 2023. The main exposure was HL, which was defined by a pure-tone average in the best ear higher than 20 dB hearing level for mild loss and 35 dB hearing level for disabling loss. Secondary exposure was self-reported HA use. Cognition was evaluated at study inclusion by a standardized battery of 5 cognitive tests conducted by trained neuropsychologists. A global cognitive score was computed from principal component analysis and global cognitive impairment was defined as having a score less than or equal to the 25th percentile of the distribution. The study population included 62 072 participants with audiometric data (mean [SD] age, 57.4 [7] years; 52% women). Overall, 38% (n = 23 768) had mild HL, 10% (n = 6012) had disabling HL, and 3% (n = 1668) were HA users. In multivariable analyses, mild HL (odds ratio [OR], 1.10; 95% CI, 1.05-1.15) and disabling HL (OR, 1.24; 95% CI, 1.16-1.33) were associated with greater global cognitive impairment. The odds of cognitive impairment did not differ significantly between all participants with HA use and participants with disabling HL without HAs (OR, 0.94; 95% CI, 0.83-1.07), except among participants with depression (OR, 0.62; 95% CI, 0.44-0.88). In this cohort study, an association between the severity of HL and global cognitive impairment was found. The use of HAs was not associated with significantly lower odds of cognitive impairment. The findings suggest that it may be useful to monitor cognitive function in middle-aged individuals with HL.

A Prospective Comparative Study of Impedance Audiometry Findings Preoperatively and Postoperatively in Cases of Conventional Adenoidectomy versus Microdebrider Assisted Adenoidectomy.

The aim of the study was to evaluate and compare the efficacy of Endoscopic Adenoidectomy with Microdebrider over Conventional technique by Curettage using Impedance Audiometry findings. In this prospective, randomised, comparative study patients were divided into two groups to undergo one of the above adenoidectomy surgeries. Patients with symptoms of Adenoid hypertrophy after failed maximal medical therapy (12 weeks) were selected after due consideration of the inclusion and exclusion criteria. Baseline Impedance Audiometric assessment was done one week prior to surgery which was compared to Impedance Audiometric values 12 weeks post operatively in each group. This study enrolled 50 patients with adenoid hypertrophy, 25 patients of group A underwent Conventional adenoidectomy and the other 25 patients of group B underwent Endoscopic Adenoidectomy with Microdebrider. Significant difference in type of tympanogram before and after adenoidectomy was found in both the groups (p = 0.0008 in group A & p < 0.0001 in group B). In Group A Percentage of abnormal tympanograms becoming normal (Type A), 12 weeks after adenoidectomy was 80%. In Group B Percentage of abnormal tympanograms becoming normal (Type A), 12 weeks after adenoidectomy was 88%. A statistically significant improvement (p < 0.0001 in both the groups) in the percentage of ears with absent stapedial reflex was observed in both groups postoperatively, with no difference between the two groups suggestive of improvement in eustachian tube function. Association of Preoperatively & Postoperatively Eustachian tube function in each group undergoing adenoidectomy was statistically significant (p < 0.0001). Both forms of adenoidectomy are effective in managing adenoid hypertrophy with tubal dysfunction causing mild conductive hearing loss and prone for OME. However, the audiological and endoscopic evaluation seems to favor Endoscopic Adenoidectomy with microdebrider over conventional adenoidectomy, and it should be therefore considered in the therapeutic management of young patients with adenoidal disease.

Audiological Characterization of Individuals with Cornelia de Lange Syndrome.

Introduction Cornelia de Lange Syndrome (CdLS) is a genetic disorder in which individuals may present sensorineural and/or conductive hearing loss, and the results of behavioral auditory assessments are not accurate. Objective To characterize the audiological profile of individuals with CdLS through behavioral, electroacoustic, and electrophysiological audiological assessments. Methods The study included 13 individuals of both sexes, aged between 3 and 26 years, with diagnoses confirmed through genetic studies. The following procedures were performed: medical history survey, otoscopy (pure-tone audiometry [PTA], speech audiometry, and acoustic immittance measures), and auditory brainstem response (ABR). Results In total 62.50% of the participants who underwent PTA had abnormal results (all of which were mild), with a predominance of bilateral conductive hearing loss (60%). Regarding tympanometry, 76.93% had abnormal results, most frequently type B (85.72% on the right and 88.89% on the left ear). Acoustic reflexes showed results compatible with tympanometry changes. Changes in ABR latency values compatible with middle-ear impairment were found in 8 of them (66.66%) - 3 had bilateral (37.50%), and 5 had unilateral impairments (62.50%). Conclusion Mild hearing loss was identified in 62.5% of the individuals with CdLS who underwent the behavioral audiological assessment. In the acoustic immittance measures, 76.9% of the participants presented a tympanometry curve characteristic of middle-ear changes. Acoustic reflexes were absent in 84.6% of the subjects. In the ABR, no changes were identified in auditory pathway integrity. On the other hand, changes in the absolute latency values were found, which are characteristic of conductive hearing loss.

Correlation between Hearing Impairment and the Triglyceride Glucose Index in Middle-Aged Female Based on a Korean National Health and Nutrition Examination Survey

Background and Objectives: This study aimed to investigate the association between insulin resistance, as measured by the triglyceride–glucose index (TyG index), and hearing impairment in middle-aged women in Korea. Materials and Methods: This cross-sectional survey utilized data from the Korea National Health and Nutrition Examination Survey (KNHANES) IV (2007–2009), specifically from the period after July 21, 2009, when hearing test results became available, and from the KNHANES V (2010–2012). This study was conducted on 5416 women aged 40 to 69 who had completed both the health examination survey and audiometric tests, excluding those with missing data on menopausal status and the use of hormone replacement therapy. Results: In the study group, the prevalence of high-frequency hearing loss according to the TyG index was significantly higher in the mild hearing loss group (OR = 1.29; 95% CI: 1.12, 1.49, p &lt; 0.001) and the moderate hearing loss group (OR = 1.27; 95% CI: 1.09, 1.48, p = 0.002). Conversely, the prevalence of low-frequency hearing loss did not show a significant difference in either the mild hearing loss group (OR = 1.17; 95% CI: 0.99, 1.37, p = 0.065) and the moderate hearing loss group (OR = 1.13; 95% CI: 0.94, 1.35, p = 0.199) Conclusions: Since diabetes can induce hearing impairment in women, it is recommended that women with a high TyG index undergo early hearing tests