Mild Hearing Loss Research Articles

Prevalence and pattern of sensorineural hearing loss among children and adolescents with sickle cell disease in a tertiary health facility, Northwest Nigeria

Sickle Cell Disease (SCD) can result in painful vascular occlusion crises, anoxia, and ischemia, which can occasionally cause damage to tissues and organs, including the auditory system, particularly the blood-rich cochlea. Despite being underreported, Sensorineural Hearing Loss (SNHL) is a well-known consequence of SCD globally. The study’s objective was to determine the prevalence and pattern of hearing loss in children and adolescents aged 5 to 16 years old with SCD who were in steady state and were seen at the hematology and pediatric outpatient clinics at Ahmadu Bello University Teaching Hospital (ABUTH), Zaria, Nigeria. A prospective hospital-based case-control study was conducted with 125 children with SCD in steady state, aged 5 to 16, who were enrolled in the hematology clinic at the Ahmadu Bello University Teaching Hospital in Zaria, Nigeria, and 125 ‘age- and sex-matched healthy controls, who were selected from the ABUTH’s pediatric outpatient clinics. An organized questionnaire was used to collect fundamental data on the sociodemographic characteristics and medical history of the participants and controls. In a sound-treated booth, the participant’s hearing was evaluated using tympanometry and pure tone audiometry. Overall, 68 (54.4%) and 57 (45.6%) out of the 125 assessed participants were male and female, respectively, with a male-to-female ratio of 1.2:1 and the mean age 10.17±3.55 years. Due to age-sex matching, the subject’s age and sex distributions match those of the controls. Children with SCD experienced bilateral SNHL ≥25 dB in 32/125 (25.6%) cases (21 males;11 females). The control group, which had a HbAA phenotype that was normal, did not exhibit any hearing loss. 21/32 (65.6%) of the participants had mild (26-40 dB) hearing loss, and SNHL occurred more frequently in males (21/32 (65.6%) than in females (11/32 (34.4%). In comparison to 3(9.4%) HbSC and 1(3.1%) HbSS+F, SNHL was more common in individuals with 28(87.5%) HbSS phenotypes. While diverse frequencies were impacted in the affected participants, there was no consistency in the frequency pattern of hearing loss. The current study showed that SNHL is a frequent complication in children and adolescents with SCD. About 25% of children and adolescents with SCD experienced SNHL, which disproportionately affected males. Frequent audiometry should be carried out to check the children’s hearing levels and identify any early hearing losses so that interventions can be made to perhaps prevent associated speech and language issues that might cause educational challenges.

Association Between Hearing Level and Mental Health and Quality of Life in Adults Aged >40 Years.

In this study, we investigated the effects of hearing loss on mental health and quality of life (QoL) using survey data in adults aged >40 years. Subjects and. We obtained data from 10,921 individuals who responded to the fifth Korean National Health and Nutrition Examination Survey. Primary outcomes were measured using questionnaires that recorded stress perception, depressive mood, and suicidal ideation to evaluate mental health and motor ability, self-management, activities of daily living, pain or discomfort, and anxiety or depression to evaluate QoL. On multivariate analysis, suicidal ideation was more prevalent among older adults with hearing loss than in older adults without hearing loss. Motor ability was lower in individuals with hearing loss of >20 dB than in older adults with normal hearing. Categorization of the EuroQol-5 Dimension (EQ-5D) health state into upper and lower groups showed that the EQ-5D values were lower in the moderate-tosevere hearing loss group than in the mild hearing loss group. Among adults aged >40 years, those with hearing loss experienced more suicidal ideation, had lower motor ability, and lower overall QoL compared with these variables in older adults with normal hearing. Additionally, QoL scores were low in individuals with poor hearing.

Hearing Loss in Older People With Schizophrenia: Audiologic Characteristics and Association With Psychosocial Functioning

The severity and impact of hearing deficits among adults with schizophrenia spectrum disorders may become increasingly relevant with advancing age. This study evaluated hearing ability and associated psychosocial functioning among older adults aged 50-70. Cross-sectional analysis. Four outpatient psychiatry clinics in New York City. Individuals aged 50-70 years with diagnoses of schizophrenia or schizoaffective disorder. Unaided pure tone air conduction audiometry conducted using a portable audiometry system determined the pure tone average (PTA) hearing threshold across four frequencies: 500, 1k, 2k, and 4k Hz. Better ear PTA defined the hearing threshold. Audiometry data retrieved from the U.S. National Health and Nutrition Examination Survey aided interpretation of sample hearing loss rates. Standard measures evaluated psychiatric symptoms, perceived impact of hearing impairment, loneliness, and quality of life. Among audiometry completers (N = 40), 35% (n = 14) demonstrated subclinical hearing loss (16-25 dB) and 35% (n = 14) had mild or worse hearing loss (≥26 dB). Rates were higher than expected based on age-based population data. Those who perceived hearing handicap rated it moderate (12.2%) or severe (7.3%); those who perceived tinnitus rated the impact as mild to moderate (12.2%) or catastrophic (2.4%). Neither psychiatric symptoms nor interviewer-rated quality of life was associated with hearing ability. Greater loneliness was significantly correlated with worse audiologic performance (r = 0.475, p <0.01) and greater perceived hearing handicap (r = 0.480, p <0.01). Identifying the need for hearing loss treatment among aging adults with schizophrenia spectrum disorders is important given the potential implications for social functioning, cognitive, and mental health.

App-Based Hearing Screenings in Preschool Children With Different Types of Headphones: Diagnostic Study.

Hearing disability in preschool children can delay or impact oral communication and social skills. Provision of hearing screening tests by standard audiometry in low- to middle-income countries is problematic due to a lack of pediatric audiologists, standard hearing equipment, and standard soundproof rooms. Therefore, an innovative hearing screening tool that is easily accessible and inexpensive such as a mobile app should be considered. Headphones have been a crucial part of hearing screenings. Audiometric headphones, which serve as the reference standard, have been used in most studies. However, since audiometric headphones are not accessible in rural areas, we hypothesized that generic headphones can also be used in hearing screenings. This study aimed to determine the sensitivity, specificity, κ coefficiency, and time consumption of the PASS-Pro (Preschool Audiometry Screening System-Pro) app when using TDH39 headphones, Beyerdynamic DT 770 PRO headphones, and generic earmuff headphones compared to standard conditioned play audiometry. We recruited preschool children aged 4 to 5 years to participate in this study. The children received 3 PASS-Pro screening tests using different types of headphones in a quiet room and 1 standard conditioned play audiometry in a soundproof room. All tests were administered in random order. The agreement coefficient, sensitivity, specificity, and mean test duration were determined. A total of 44 children participated in this study. For mild hearing loss screening, the κ coefficients between standard conditioned play audiometry and the PASS-Pro app using TDH39 headphones, Beyerdynamic DT 770 PRO headphones, and generic earmuff headphones were 0.195, 0.290, and 0.261 (P=.02, P=.002, and P=.004), respectively. The sensitivity for all headphones was 50% and the specificity was more than 88%. For moderate hearing loss screening, the κ coefficients were 0.206, 0.272, and 0.235 (all Ps=.001), respectively. The sensitivity for all headphones was 100% and the specificity was more than 92%. There were no statistical differences in sensitivity and specificity between the reference headphone (TDH39), Beyerdynamic DT 770 PRO headphone, and generic earmuff headphones (all Ps >.05). The PASS-Pro app used significantly less time to carry out hearing tests than conditioned play audiometry (P<.001). The PASS-Pro app, used with generic headphones, is effective for conducting hearing screening tests in preschool children with high sensitivity and specificity.

RBC Exchange Transfusion As an Adjunct Therapy to Control Iron Overload in Patients with Transfusion-Dependent Thalassemia

Background Patients with transfusion-dependent thalassemia (TDT) require red blood cell (RBC) transfusions as frequently as every 2-4 weeks to maintain a pre-transfusion hemoglobin of 9.0-10.5 g/dL for patients without cardiac complications. Chronic RBC transfusions increase body iron stores leading to iron deposition in liver, pancreatic, and cardiac tissues. Deferoxamine, deferiprone, and deferasirox are the iron chelators currently licensed for clinical use to manage iron overload in TDT patients with side effects ranging from nausea to nephrotoxicity and hearing loss. RBC exchange transfusion (RBCX), particularly in conjunction with isovolumic hemodilution, has been utilized for patients with sickle cell disease as a means of stabilizing iron overload. The 2015 ASFA Red Blood Cell Exchange consensus supports RBCX to reduce or prevent iron overload in sickle cell disease. Review of literature shows that RBCX can be beneficial as an acute intervention for patients with TDT and pulmonary hypertension however there is a paucity of literature documenting chronic RBCX use in TDT patients with iron overload. Case series This series presents five patients with TDT who were transitioned from chronic simple RBC transfusions to chronic RBCX after developing treatment-refractory iron overload as evidenced by serum ferritin elevation. Patients were treated on a transfusion schedule with a pre-transfusion goal hemoglobin of 9.5g/dL or higher and interval 4-6 weeks. Patient A is a 14 year-old male who developed significant iron overload (peak ferritin of 7077) on deferasirox 20 mg/kg/day and MRI T2 imaging suggestive of iron deposition. After transition to RBCX, ferritin decreased significantly with a post-RBCX mean of 1382. Blood utilization was 4200 ml three months pre-RBCX and 5625 ml three months post-RBCX. Patient B is a 23 year-old male with a peak ferritin of 1310 prior to RBCX on 23 mg/kg/day of deferasirox complicated by mild hearing loss. Serum ferritin has shown stabilization, with a mean post-RBCX ferritin of 880. Blood utilization was 2400 ml three months pre-RBCX and 8100 ml three months post-RBCX. Patient C is a 17 year-old male with a peak ferritin of 1400 with deferasirox management complicated by acute renal injury. Mean serum ferritin of 633 post-RBCX. Blood utilization was 1200 ml three months pre-RBCX and 5200 ml three months post-RBCX. Patient D is a 17 year-old male managed on 23 mg/kg/day of deferasirox with a peak ferritin of 3060 on pre-RBCX. The patient transitioned to chronic RBCX with mean serum ferritin of 1073. Blood utilization was 1800 ml three months pre-RBCX and 7700 ml three months post-RBCX. Patient E is a 17 year-old male with peak ferritin of 3404 despite 20 mg/kg/day of deferasirox prior to chronic RBCX. Mean serum ferritin after transition to RBCX was found to be 1282. Blood utilization was 1500 ml three months pre-RBCX and 4900 ml three months post-RBCX. All 5 patients have tolerated RBC exchange procedures without complications. Serum ferritin levels pre- and post-RBC exchange were trended pre- and post- RBCX (Figure 1). Serum ferritins were averaged together for each patient to obtain an equal number of time points considered prior to and after starting RBCX therapy. Descriptive statistics (Table 1) were used to summarize average ferritin levels for the patient group. A Wilcoxon signed-rank test was performed to assess the median difference in ferritin level from pre-RBCX to post-RBCX. All analyses were conducted in SAS version 9.4. P &amp;lt;0.05 is considered statistically significant. Median pre-RBCX ferritin level for the study group is 2489.3 (Inter-quartile range (IQR): 1190.0, 2659.0). The median post-RBCX ferritin level for the series is 1329.3 (IQR: 941.0, 1711.0). After subtracting the post-RBCX ferritin level from the pre-RBCX ferritin level, the median change for the group is 457 (IQR: 249.0, 1160.0) (p=0.06). Conclusion This case series documents the successful clinical application of chronic RBCX in TDT patients as a means of stabilizing serum ferritin levels over time. Mean ferritin levels were significantly lower, clinically, after transitioning from chronic simple RBC transfusion to RBCX (Table 1), though analysis is limited due to cohort size. Blood utilization increased after transitioning to RBCX. Next steps in evaluating our practice for the patient group will be to evaluate iron deposition status with MRI T2* imaging.

Association between sensation, perception, negative socio-psychological factors and cognitive impairment

BackgroundEvidence has suggested that sensation and socio-psychological factors may be associated with cognitive impairment separately in older adults. However, the association between those risk factors and cognitive impairment is still unknown. ObjectiveTo investigate the association between sensation, perception, negative socio-psychological factors, and cognitive impairment in institutionalized older adults. MethodsFrom two public aged care facilities, 215 participants were investigated. The Mini-mental State Examination was applied to assess cognitive function. The sensory function was bifurcated into auditory and somatosensory realms which were evaluated using pure tone audiometry and Nottingham Sensory Assessment, respectively. Albert's test, left and right resolution, and visuospatial distribution were used to evaluate perception. Depression and social isolation were selected as negative socio-psychological factors and were evaluated by the Geriatric Depression Scale and the Lubben Social Network Scale. The multivariate analysis was performed utilizing binary logistic regression. ResultsParticipants with moderately severe or severe hearing loss exhibited significant cognitive impairment compared to those with mild hearing loss. It was observed that perceptual dysfunction and depression were independently related to cognitive impairment. However, there was no significant association between somatosensory function, social isolation, and cognitive impairment in the institutionalized older adults. ConclusionMore profound hearing loss, abnormal perception, and depression are associated with cognitive impairment in older adults. Subsequent research endeavors should delve into the causal mechanisms underpinning these associations and explore whether combined interventions have the potential to postpone the onset of cognitive impairment.

Hearing Loss among Children Visiting Department of Otolaryngology and HNS of a Tertiary Care Centre.

Hearing loss is defined as the partial or total reduction in auditory acuity. Hearing loss can cause detrimental effects on speech, language, developmental, educational, and cognitive outcomes in children. This study aimed to find out the prevalence of hearing loss among children visiting the Department of Otolaryngology and HNS of a tertiary care centre. A descriptive cross-sectional study was conducted among children visiting the Department of Otolaryngology and HNS between 1 January 2022 and 31 December 2022 after obtaining ethical approval. All the patients who underwent pure tone evaluation were included in the study. A convenience sampling technique was used. The point estimate was calculated at a 95% Confidence Interval. Among 3051 children, 328 (10.75%) (9.65-11.85, 95% Confidence Interval) had hearing loss. Among children with hearing loss, 170 (51.83%) of children were female. The mean age of children with hearing loss was 13.31±3.39 years. The mean pure tone average among 452 ears with hearing loss was 44.60±17.71 dB. The commonest degree of hearing loss was mild hearing loss 266 (58.85%), and the commonest type was conductive hearing loss 310 (68.58%). Among children with hearing loss, 124 (37.80%) had bilateral hearing loss. The prevalence of hearing loss among children visiting the Department of Otolaryngology and HNS was found to be lower than similar studies done in similar settings. audiology; audiometry; hearing loss; outpatients; prevalence.

Facultys Awareness to the Situation of Students with Mild Hearing Loss in a Single School in a Large City in China

Plenty of research has shown that noisy environment has significant impact on childrens speech recognition, especially on children with different degrees of hearing impairment. Modifications on the construction of classroom and improvement in study environment help assist children with MHL to perceive more information in class. Several research studies assessing environment of classrooms in normal schools which are for normal children and children with hearing loss in China have found that traffic noise, speech shape masking, babble noise and other typical noises around school sites impose negative impact on Chinese speech intelligibility of children in elementary school. By analyzing the result of a designed questionnaire, this research focused on the facultys awareness to the situation of students with mild hearing loss in a single school in Wuhan, a large city in China in order to find possible measurements that can be taken by the faculty to improve the learning experience of students with hearing loss at school.

Hippocampal atrophy is associated with hearing loss in cognitively normal adults.

A growing body of evidence suggests that age-related hearing loss (HL) is associated with morphological changes of the cerebral cortex, but the results have been drawn from a small amount of data in most studies. The aim of this study is to investigate the correlation between HL and gray matter volume (GMV) in a large number of subjects, strictly controlling for an extensive set of possible biases. Medical records of 576 subjects who underwent pure tone audiometry, brain magnetic resonance imaging (MRI), and the Korean Mini-Mental State Exam (K-MMSE) were reviewed. Among them, subjects with normal cognitive function and free of central nervous system disorders or coronary artery disease were included. Outliers were excluded after a sample homogeneity check. In the end, 405 subjects were enrolled. Pure tone hearing thresholds were determined at 0.5, 1, 2, and 4 kHz in the better ear. Enrolled subjects were divided into 3 groups according to pure tone average: normal hearing (NH), mild HL (MHL), and moderate-to-severe HL (MSHL) groups. Using voxel-based morphometry, we evaluated GMV changes that may be associated with HL. Sex, age, total intracranial volume, type of MRI scanner, education level, K-MMSE score, smoking status, and presence of hypertension, diabetes mellitus and dyslipidemia were used as covariates. A statistically significant negative correlation between the hearing thresholds and GMV of the hippocampus was elucidated. Additionally, in group comparisons, the left hippocampal GMV of the MSHL group was significantly smaller than that of the NH and MHL groups. Based on the negative correlation between hearing thresholds and hippocampal GMV in cognitively normal old adults, the current study indicates that peripheral deafferentation could be a potential contributing factor to hippocampal atrophy.

Idiopathic Sudden Sensorineural Hearing Loss, But Not Compatible With the Classical Definition.

The purpose of this study was to raise awareness for patients who did not meet the audiometric criteria of idiopathic sudden sensorineural hearing loss (SSNHL) but complained of acute hearing loss. Medical records of patients who were diagnosed with SSNHL from October 2021 to March 2023 were examined retrospectively. Among 223 patients with SSNHL, 40 cases with atypical SSNHL and fitting in the criteria were included in the study. The patients who were included in this study were the ones who were given one bolus dose of IV systemic steroid (250 mg methylprednisolone with a proton pump inhibitor) and betahistine 2x24 mg po for a month. Pure tone audiometry was performed during the initial visit, on the fifth day, and at the end of the one-month usage of betahistine tablets. Hearing levels on the 250, 500, 1,000, 2,000, 4,000, and 8,000 Hz of the affected ear were compared with those of the contralateral ear. Hearing improvement was calculated as the hearing gain (in decibels) on the control audiograms and the resolution of the patients' complaints. These patients were suffering from idiopathic SSNHL with minimal hearing impairment. A total of 36 of the cases had hearing recovery on the fifth-day audiogram, and the remaining four patients showed hearing improvement on the first-month audiogram. The changes between the initial and the control audiogram values were found to be statistically significant (p<0.001). Additionally, these patients showed distinctive characteristics, such as being younger than the classical SSNHL population, lacking systemic diseases (diabetes or hypertension), and having good unaffected hearing. Although there have been lots of studies to understand the pathophysiology, prognostic factors, and treatment options for SSNHL, atypical SSNHL patients have been underestimated and generally excluded from studies, and there have been a small number of studies on this issue. These patients might be accepted as having mild hearing loss. However, when the nerve injury is proven by audiograms, it is hard to decide what to do due to the lack of a treatment approach. This study is important as it focuses on atypical SSNHL cases. Further studies with larger group patients or prospective randomized-controlled group studies are needed to define these patients and decide how to treat this type of acute nerve dysfunction.

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

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

Recent advances in genetic etiology of non-syndromic deafness in children

Congenital auditory impairment is a prevalent anomaly observed in approximately 2–3 per 1,000 infants. The consequences associated with hearing loss among children encompass the decline of verbal communication, linguistic skills, educational progress, social integration, cognitive aptitude, and overall well-being. Approaches to reversing or preventing genetic hearing loss are limited. Patients with mild and moderate hearing loss can only use hearing aids, while those with severe hearing loss can only acquire speech and language through cochlear implants. Both environmental and genetic factors contribute to the occurrence of congenital hearing loss, and advancements in our understanding of the pathophysiology and molecular mechanisms underlying hearing loss, coupled with recent progress in genetic testing techniques, will facilitate the development of innovative approaches for treatment and screening. In this paper, the latest research progress in genetic etiology of non-syndromic deafness in children with the highest incidence is summarized in order to provide help for personalized diagnosis and treatment of deafness in children.

Prevalence of Hearing Loss among Noise Exposed Industrial Workers

Exposure to any type of noise has a potential risk. Higher the level of noise and longer duration of exposure, more the risk for hearing sensitivity and health as a whole. Occupational noise induced hearing loss (ONIHL) is a major cause of disability throughout the world. So this study was designed to know the prevalence of NIHL among the noise exposed industrial workers in Bangladesh. A prospective observational study of 377 People working at industrial environment in Jute mills at Faridpur region were studied between January 2021 to June 2021. Data collected from each respondent recorded on a predesigned data collection form. Pure tone audiometry was performed in both ears. Among 377 study population, 157(41.6%) subjects had hearing loss and 220 subjects (58.4%) had no loss. Among the workers with hearing loss, 98(62.4%) got hearing loss on both sides, 32(20.4%) on the right side and 27(17.2%) on the left side. Among them 83(52.9%) had mild hearing loss, 37(23.6%) had moderate hearing loss, 31(19.7%) had severe hearing loss and 6(3.8%) had profound hearing loss. The average duration of work in the industry was 6.94±5.64 years and majority (78.5%) had 8 hours working hour per day and 21.5% had more than 8 hours. The average sound intensity was 91.51±8.12 dB(A) with 10.9% exposed to &lt;_85 dB(A) and 89.1% to &gt;85 dB(A). This study shows Noise-induced hearing loss (NIHL)as highly prevalent among noise-exposed workers in Bangladesh. Age &gt;35 years, high noise level, exposure of more than 10 years, were significantly associated with increased risk of hearing loss. The local and national authority should focus on noise monitoring, engineering modifications of buildings and machinery, occupational safety policies, administrative controls, providing education on NIHL, periodic audiometric assessments and follow-up evaluation for hearing threshold shift. This study supported the elements for further research studies related to the employer compliance with occupational health and safety regulations to address awareness of their responsibility in minimizing hazards in workplaces.&#x0D; Bangabandhu Sheikh Mujib Med. Coll. J. 2022;1(1):90-95

THU454 Paget’s Disease Of Bone As An Atypical Cause Of Headaches

Abstract Disclosure: A.N. Delgado Nieves: None. C. Gomez Hernandez: None. R. Nassar: None. P.A. Goulden: None. Background: Worsening Paget’s disease of bone (PDB) typically manifests as pelvic or spine bone pain. Headache as a primary presenting symptom of PDB is uncommon. Case Presentation: A 54-year-old female with Paget’s disease on alendronate presented at our institution with progressively worsening headaches, frontal bossing, alkaline phosphatase (ALP) of 1,668 U/L, and serum C-telopeptide of 986 pg/mL, indicating active disease. Subsequently, a bone scan confirmed active PDB, and zoledronic acid injection was administered in clinic. When re-evaluated, repeat laboratory values showed an ALP of 191 U/L, serum C-telopeptide of 511 pg/mL, PTH of 103 pg/mL, and vitamin D of 25.6 ng/mL, consistent with improved yet persistently active disease. Likewise, the patient complained of ongoing headaches, dizziness, hearing loss, and jaw pain. An X-ray of the skull showed diffuse expansile mixed Paget's disease, predominantly sclerotic, involving the calvarium with some basilar invagination noted. Subsequent whole-body bone scan showed intensely increased uptake in the skull. Audiology evaluation revealed slight to mild sensorineural hearing loss in bilateral ears. A second dose of zoledronic acid infusion was administered, and the patient’s ALP and C-telopeptide decreased to normal levels. Conclusion: We describe a case of advanced Paget’s disease presenting with persistent headaches. Clinicians should identify Paget’s disease as an atypical cause of headaches to provide appropriate treatment and prevent complications of skull involvement such as hearing loss. Presentation: Thursday, June 15, 2023

Emotional behavioral outcomes of children with unilateral and mild hearing loss.

Deaf and hard-of hearing (DHH) children often experience emotional/behavioral difficulties. The impact of unilateral/mild hearing loss (HL) on children's emotion and behavior are unclear. We aimed to describe emotional/behavioral, health related quality-of-life (HRQoL) and parent psychological distress outcomes of school-age children with unilateral/mild HL, compared to children with moderate to profound HL, and in relation to population norms; and identify predictive factors of emotional/behavioral difficulties. Data of 339 DHH children, 5-12 years, enrolled in the Victorian Childhood Hearing Longitudinal Databank (VicCHILD), which include demographics, early development, medical/audiological characteristics and parent rated questionnaires of emotion/behavior, HRQoL and parental psychological distress collected at various stages of child's life were analyzed. We used Cohen's d to investigate the outcomes by measuring the mean score differences of both groups with published norms and logistic regression to analyze the factors predictive of emotional/behavioral difficulties. The proportion of children with unilateral/mild HL and moderate to profound HL who experienced emotional/behavioral difficulties was similar (18.3% vs. 20.6%), with hyperactivity and poor prosocial behavior reported as the predominant symptoms in both groups. Mean emotional/behavioral scores of both groups were comparable and substantially higher than normative population scores. This was also the case for HRQoL and levels of parent distress. Among children with unilateral/mild HL, additional health needs were the strongest predictive factor, demonstrating an approximately 1.7-fold increase in odds of emotional/behavioral difficulties (OR = 1.67; 95% CI 1.29-2.17, p < 0.001) with every additional health need. Early developmental concerns, other than communication milestone and attending mainstream schoolshowed weaker evidence of association. Children with unilateral/mild HL were just as likely as those with moderate to profound HL to experience more emotional/behavioral difficulties, poorer HRQoL and higher parental distress scores compared to population norms. Our findings justify the provision of early intervention, support and medical services for all DHH children to identify those at risk of poorer outcomes.

Audiologic Profile of Chronic Otitis Media with Effusion in Children

Background: Otitis media with effusion (OME), the most common ear disease in pediatrics, can lead to hearing loss (HL) and might have a significant impact on a child’s auditory and speech development. Objectives: This study was conducted to indicate the audiologic profile of children with chronic OME who were scheduled for tympanostomy tube placement. Methods: Otoscopy, pure-tone audiometry, and tympanometry assessments were carried out in 663 children (420 males and 243 females) who had a chronic OME diagnosis and were scheduled for ear surgery. They were selected consecutively at Imam Khomeini Hospital, Ahvaz, Iran. The paired sample t-test was conducted to compare mean hearing thresholds before and after ear surgery. Results: The most frequent age groups affected by OME were 12 - 36 months (33.48%) and 36-72 months (31.67%). The majority of children (60.03%) showed retracted tympanic membrane (TM), and the most common color of the TM was yellowish-brown, observed in 74.20% of cases. Before surgery, the majority of patients demonstrated mild conductive hearing loss (61.08%) and a Type B tympanogram (73.75%). The myringotomy site of 61.53% of children was anterior-inferior. Four hundred-eight children indicated serous secretion. The mean pure-tone average before surgery was significantly reduced after surgery (45.23 ± 23.25 vs. 27.83 ± 15.86 dB HL, P = 0.001). This improvement was about 18 and 17 dB in the right and left ears 2 months after surgery, respectively. The postoperative findings also indicated that in 487 children (73.45%), hearing thresholds returned to normal limits. Conclusions: It is essential to address chronic OME promptly to prevent potential long-term impacts on a child’s hearing, speech, and language. Treatment options, such as watchful waiting or surgical intervention, depending on the severity and duration of the condition, are effective procedures in this group of patients.

A Transparent Mask and Clear Speech Benefit Speech Intelligibility in Individuals With Hearing Loss.

The purpose of the study is to investigate the impacts of a surgical mask and a transparent mask on audio-only and audiovisual speech intelligibility in noise (i.e., 0 dB signal-to-noise ratio) in individuals with mild-to-profound hearing loss. The study also examined if individuals with hearing loss can benefit from using a transparent mask and clear speech for speech understanding in noise. Thirty-one individuals with hearing loss (from 22 to 74 years old) completed keyword identification tasks to measure face-masked speech intelligibility in noise. A mixed-effects logistic regression model was used to examine the effects of face masks (no mask, transparent mask, surgical mask), presentation modes (audio only, audiovisual), speaking styles (conversational, clear), noise type (speech-shaped noise [SSN], four-talker babble [4-T babble]), hearing groups (mild hearing loss [MHL], greater than MHL: GHL), and their interactions on binary accuracy of keyword identification. In the audio-only mode, the GHL group showed reduced speech intelligibility regardless of other factors, whereas the MHL group showed decreased speech intelligibility for the transparent mask more than for the surgical mask. The use of a transparent mask was advantageous for both hearing loss groups. Clear speech remediated the detrimental effects of face masks on speech intelligibility in noise. Both groups tended to perform better in SSN versus 4-T babble. The findings indicate that, when using face masks, either a transparent mask or a surgical mask negatively affects speech understanding in noise for individuals with hearing loss. Using a transparent mask and clear speech could be a potential solution to improve speech intelligibility in communication with face masks in noise.

Zebrafish models of sensorineural hearing loss

Sensorineural hearing loss negatively impacts over 450 million people worldwide. While we know that insults such as ototoxic drugs and noise damage sensory hair cells, our understanding of damage mechanisms is incomplete. Zebrafish are an exciting vertebrate model for research on fundamental mechanisms of hair cell damage. In addition to the inner ear, zebrafish have a lateral line system containing clusters of externally located hair cells. These hair cells are homologous to vertebrate inner ear hair cells and respond similarly to ototoxic damage. Our lab uses the lateral line system to determine the ototoxic potential of COVID-19 therapies; with over 900 medications currently in clinical trials, it is highly likely that a subset of those medications causes mild hearing loss that is not detected in clinical settings. In addition, while ototoxicity is a significant concern for patients exposed to these medications, acoustic damage and age-related hearing loss are far more prevalent in the general population. Our lab developed a zebrafish model of acoustic trauma and showed that noise exposure causes synaptic damage and hair cell loss in the larval lateral line analogous to the damage observed in the mammalian cochlea. Finally, we show that aged adult zebrafish lose both lateral line and inner ear hair cells similar to hair cell loss seen in aging mammals. Collectively, our research demonstrates that zebrafish are a tractable model to understand mechanisms of sensorineural hearing loss and to test therapeutic strategies.

Hearing loss is associated with decreased default-mode network connectivity in individuals with mild cognitive impairment

Mild cognitive impairment (MCI) and hearing loss (HL) have been separately associated with increased dementia risk. These highly co-occurring dementia risk factors are associated with aberrant functional brain connectivity. In individuals with HL aberrant functional connectivity has been associated with cognitive impairment. In individuals with MCI, aberrant brain connectivity has been associated with severity of cognitive impairment and conversion to dementia. Despite the high prevalence of HL in individuals with MCI, the relationship between the two is understudied, especially in the context of functional connectivity. Participantsinclude 94 older adults with MCI. Hearing measures include pure-tone hearing thresholds and speech-reception thresholds. In analyses with pure-tone hearing loss, participants were classified as having normal hearing (n = 60) or hearing loss (n = 34) based on a pure-tone screening protocol. We used independent component analyses on resting-state functional magnetic resonance imaging data to identify the default-mode network (DMN). Analysis of variance with covariate control was used to investigate DMN connectivity differences between the normally hearing individuals with MCI and individuals with MCI and pure-tone HL. A linear regression was used to investigate the relationship between speech-reception threshold and DMN connectivity in the whole sample.Compared to those with MCI and normal hearing, those with MCI and pure-tone HL had decreased connectivity between the DMN and the caudate and thalamus. There was no difference in DMN connectivity as a function of speech-reception threshold.Our findings indicate that in individuals with MCI, HL is associated with decreased connectivity between the DMN and regions important for sensory and cognitive processing. This suggests that the increased risk for cognitive decline and dementia in individuals with HL may be due to decreased DMN connectivity in individuals with HL.

Development of a smartphone-based Turkish digits in noise test

BackgroundPure-tone audiometry is the traditional gold standard for assessment and screening of hearing impairment, but it requires the use of calibrated devices and soundproof booth. Mobile apps can offer a good alternative to traditional methods in limited circumstances and in some emergency situations, especially when traditional methods are not available. The aim of the study was to develop an easily accessible mobile-based Turkish Digit in Noise Test screening test for the assessment of hearing.MethodsThe digits were read by a male speaker whose native language is Turkish. A mobile application was developed in accordance with the Android operating system. Twenty-five individuals with normal hearing, 25 individuals with bilateral mild sensorineural hearing loss, 25 with bilateral mild mixed hearing loss, and 25 with bilateral mild conductive hearing loss total of 100 participated in the study. All participants were between the ages of 18–60. The Turkish Digit in Noise Test mobile application was applied to the participants and the test scores were compared among the types of hearing loss.ResultsThe Turkish Digit in Noise Test scores of participants with bilateral mild sensorineural hearing loss (19.4 ± 5.39) and mixed hearing loss (22.96 ± 4.52) were lower than those of participants with normal hearing (39.68 ± 6.82) (p < .01). In addition, the results of participants with bilateral mild sensorineural hearing loss (19.4 ± 5.39) and mixed hearing loss (22.96 ± 4.52) were lower than those of participants with conductive hearing loss (36.88 ± 6.31) (p < .01).ConclusionAn easy and accessible Turkish Digit in Noise Test mobile application has been developed using which one can assess his/her hearing.