Minimal Hearing Loss Research Articles

Measuring and modeling Gaussian noise disruption across frequency, level, and hearing status

Recent work suggested that older listeners with minimal hearing loss exhibit more forward masking for a highly fluctuating Gaussian noise (GN) masker relative to a low-fluctuation noise (LFN) masker. This threshold difference (GN–LFN) is referred to as GN disruption and was previously attributed to time-varying cochlear gain resulting from feedback control by the medial olivocochlear (MOC) system. However, thus far, masker conditions have been limited to 80 dB SPL at 4 kHz. The current study aims to challenge the hypothesis that the physiological basis of GN disruption is the MOC system using behavioral measures and computational models across multiple target and masker frequencies (0.5, 1, 2, and 4 kHz), masker levels (80-, 65-, and 50-dB SPL), masker-signal delays (25- and 75-ms), participant age ranges (18–30 and 60–75), and hearing statuses (normal hearing, sensorineural hearing loss). Additionally, speech recognition using IEEE sentences will be measured with GN and LFN maskers. Although testing will not be completed until 2025, preliminary data from 20 younger participants with normal hearing suggest that GN disruption is greater for higher than lower masker and probe frequencies, that GN disruption is similar across masker levels, and that refinements to the computational model are needed to more accurately predict GN disruption.

Comparative Analysis of Methods of Audiological Screening of the Adult Population: Global and Kazakhstani Experience

Hearing impairment is currently recognized as the most prevalent sensory impairment and one of the leading causes of disability worldwide. It is estimated that one in five people on Earth has at least minimal hearing loss, and more than 5% of the population has disabling hearing loss. There are many methods for screening detection of hearing impairment, and the most common ones are mobile applications, recognition of whispered speech, a portable audiometer, questionnaires, the speech intelligibility test in noise, and others. Nevertheless, the “gold standard” for hearing testing has been and remains the method of pure-tone threshold audiometry. The purpose of this review is to study the currently available literature, analyze ongoing research in the field of audiological screening of adults, study the cost-effectiveness of ongoing screening activities, study the situation in Kazakhstan, and the possibility of using these screening methods in Kazakhstan. We selected 25 full-text articles that met the following criteria: the 2018-2023 time interval, adult population, screening methods, effectiveness, and article language (English, Russian, Kazakh). Conclusions. Despite a sufficient number of hearing screening methods, their sufficient reliability, sensitivity, and specificity, and their obvious cost-effectiveness in comparison with the costs of rehabilitation of hearing impairments, none of the hearing assessment methods are included in the National Screening Program for examining adult population in any country in the world. In Kazakhstan, a screening test of hearing function using a one-question survey, the HHIA/HHIE questionnaire, a study of whispered speech at the primary health care level, and also the use of a mobile version of a hearing test as a hearing self-diagnosis are applicabl

Evaluation of Hearing Performance in Patients with Oral Submucous Fibrosis in Relation to Different Grades.

OSMF is now recognized worldwide as an Indian disease. Blanching and rigidity of the oral mucosa, impaired mobility of the soft palate and tongue, difficulty opening the mouth, burning sensation, lack of gustatory sensation, and mild deafness due to Eustachian tube dysfunction. Soft palatal muscles often affect Eustachian tube function. Rama Dental College Hospital and research center Kanpur conducted a cross-sectional study. 60 OSMF patients were randomly selected for this study. Visible light was used for a detailed case history and clinical examination. OSMF was diagnosed by difficulty opening the mouth, blanched oral mucosa, and palpable fibrous bands. Burning, salivation, tongue protrusion, habits, and malignant changes were also diagnostic. ENT specialists used pure tone audiometry to examine the ear (PTA). Out of 60 patients 59 were males and 1 female. The participants who took part in this study ranged in age from 18 to 65. Pure tone audiometry of 120 years, 84 (70%) revealed normal hearing, 10 (8.33%) revealed minimal hearing loss, 14 (11.67%) revealed mild hearing loss and 12 (10%) revealed moderate hearing loss. In order to improve the success rate of treatment, the protocol for managing OSMF patients should therefore include ENT consultation and hearing impairment treatment.

Study of the Effect of Minimal Sensorineural Hearing Loss on the Central Auditory Processing in Children: A Pilot Study.

Hearing loss is a main cause of poor auditory, academic, and social performance especially in children. This study aimed to find out the relationship between minimal hearing loss (sensorineural or conductive) and the central auditory processing disorders in children. A cross-sectional study was conducted to compare the probability of having central auditory processing disorder in 159 children diagnosed with minimal sensorineural hearing loss and hearing loss caused by otitis media with effusion aged (6-7years old) in 4 primary schools in Damascus Syria, and 155 children with normal hearing of the same age group using the children's auditory performance scale (C.H.A.P.S). A remarkable statistical difference was found between the two groups with higher scores of C.H.A.P.S scale in the minimal hearing loss group (P value = 0.000 < 0.05). The difference involved all the sub-scales of the C.H.A.P.S scale, which indicates that minimal hearing loss in children can be considered as one important predisposing factor for central auditory processing disorders.

Inherent envelope fluctuations in forward masking: Effects of age and hearing loss.

Forward masking is generally greater for Gaussian noise (GN) than for low-fluctuation noise maskers, i.e., GN disruption. Because the minimal hearing loss that is associated with older age may affect GN disruption differently than more significant hearing loss, the current study explored the contribution of minimal hearing loss associated with older age to GN disruption. GN disruption was measured using three masker-signal delays (25, 75, and 150 ms) for three adult groups: younger participants with normal hearing (NH), older participants with minimal hearing loss, and older participants with sensorineural hearing loss. The role of underlying mechanisms was tested using a computational model for midbrain neurons. The primary result suggests that older listeners with mild threshold elevations that typically occur with age may be more susceptible to the deleterious effects of masker envelope fluctuations than younger listeners with NH. Results from the computational model indicate that there may be a larger influence of efferent feedback and saturation of inner hair cells on forward masking and GN disruption than previously considered.

Desempenho auditivo de indivíduos com perda auditiva mínima em experiências complexas e realistas de comunicação

ABSTRACT Purpose To analyze hearing performance and expectations regarding the use of hearing aids (HA) by participants with minimal hearing loss. Methods This research is a primary, observational, longitudinal and prospective study. Two questionnaires, the Speech Spatial Qualities Questionnaire (SSQ) and the Expected Consequences of Hearing Aid Ownership (ECHO), were used, respectively, to verify hearing performance in complex listening situations and expectations regarding the use of HA. The convenience sample consisted of adults aged 53 to 72. Results SSQ showed that, for hearing performance, greater difficulties were observed in unfavorable situations such as speech and speech-in-noise, followed by greater ease in locating the sound source and in the quality and naturalness of the sound. ECHO showed that, for the expectations regarding the use of the HA, the variables with significant correlation values were age x general expectation with HA and age x HA's positive aspects. No statistically significant association existed between performance scores in complex listening situations and the analyzed variables. Conclusion Minimal hearing loss can negatively influence everyday communicative situations, and the expectation of individuals with minimal hearing loss regarding the use of HA was shown to be high. In addition, the hearing performance of individuals in this study did not show correlations with the age, gender and education level of the sample.

Peripheral Auditory Nerve Impairment in a Mouse Model of Syndromic Autism.

Dysfunction of the peripheral auditory nerve (AN) contributes to dynamic changes throughout the central auditory system, resulting in abnormal auditory processing, including hypersensitivity. Altered sound sensitivity is frequently observed in autism spectrum disorder (ASD), suggesting that AN deficits and changes in auditory information processing may contribute to ASD-associated symptoms, including social communication deficits and hyperacusis. The MEF2C transcription factor is associated with risk for several neurodevelopmental disorders, and mutations or deletions of MEF2C produce a haploinsufficiency syndrome characterized by ASD, language, and cognitive deficits. A mouse model of this syndromic ASD (Mef2c-Het) recapitulates many of the MEF2C haploinsufficiency syndrome-linked behaviors, including communication deficits. We show here that Mef2c-Het mice of both sexes exhibit functional impairment of the peripheral AN and a modest reduction in hearing sensitivity. We find that MEF2C is expressed during development in multiple AN and cochlear cell types; and in Mef2c-Het mice, we observe multiple cellular and molecular alterations associated with the AN, including abnormal myelination, neuronal degeneration, neuronal mitochondria dysfunction, and increased macrophage activation and cochlear inflammation. These results reveal the importance of MEF2C function in inner ear development and function and the engagement of immune cells and other non-neuronal cells, which suggests that microglia/macrophages and other non-neuronal cells might contribute, directly or indirectly, to AN dysfunction and ASD-related phenotypes. Finally, our study establishes a comprehensive approach for characterizing AN function at the physiological, cellular, and molecular levels in mice, which can be applied to animal models with a wide range of human auditory processing impairments.SIGNIFICANCE STATEMENT This is the first report of peripheral auditory nerve (AN) impairment in a mouse model of human MEF2C haploinsufficiency syndrome that has well-characterized ASD-related behaviors, including communication deficits, hyperactivity, repetitive behavior, and social deficits. We identify multiple underlying cellular, subcellular, and molecular abnormalities that may contribute to peripheral AN impairment. Our findings also highlight the important roles of immune cells (e.g., cochlear macrophages) and other non-neuronal elements (e.g., glial cells and cells in the stria vascularis) in auditory impairment in ASD. The methodological significance of the study is the establishment of a comprehensive approach for evaluating peripheral AN function and impact of peripheral AN deficits with minimal hearing loss.

Cisplatin-induced ototoxicity in patients receiving concurrent chemoradiation in carcinoma cervix

Background: Weekly cisplatin at 40mg/m2 is the most common regimen followed in our institution. However, patients receiving cisplatin can experience high-frequency hearing loss due to its expansive toxicity profile, a side effect known as ototoxicity. The dearth of information on the extent and severity of cisplatin-associated ototoxicity prevents implementing a context-specific audiological monitoring program. The study aimed to determine the extent and severity of cisplatin ototoxicity in patients receiving concurrent chemoradiation in carcinoma cervix. Methods: Otoscopic examinations and audiological investigations were undertaken at regular intervals in patients undergoing concurrent chemoradiation for carcinoma cervix with single-agent cisplatin in the Department of Radiation Oncology, with the aid of the Department of ENT. All the audiological investigations were provided free of cost. Sixty-six patients who met the inclusion criteria were sent for audiological evaluation before the start of chemotherapy, immediately after chemotherapy completion and after one month following chemotherapy. Results: The study found that cisplatin was associated with high frequency, predominantly bilateral sensorineural hearing loss. Among 66 patients, seven patients (11%) developed cisplatin-induced hearing loss. However, most of the patients developed mild and minimal hearing loss. Conclusion: The study concluded that patients receiving concurrent chemoradiation for carcinoma cervix with cisplatin developed predominantly bilateral, high-frequency sensorineural hearing loss. However, most patients developed minimal or mild hearing loss.

Minimal hearing loss in children: effect on speech in noise perception

Minimal hearing loss in children: effect on speech in noise perception

Evaluation of Hearing Status and Eustachian Tube Function in Oral Submucous Fibrosis: A Cross Sectional Study

Introduction Oral Submucous Fibrosis (OSMF) in severe cases involves palatal and paratubal muscles of Eustachian tube leading to Eustachian tube dysfunction and hearing disabilities. This study aims to evaluate to evaluate hearing status and Eustachian tube function in patients of Oral Submucous Fibrosis and to correlate them with various groups of the disease. Materials and Methods A Cross Sectional study was carried out in a Tertiary Care Hospital on diagnosed patients of OSMF. Patients with hearing loss due to other middle ear pathologies or previous ear surgeries were excluded. Patients were classified into various Groups depending on the severityof the disease. They were subjected to Pure Tone Audiometry and Impedance Audiometry. Results obtained were statistically analysed. Results A total of 121 patients (242 ears) were included in the study. On Pure Tone Audiometry, minimal hearing loss was found in 20(8.26%) ears while mild and moderate hearing loss was seen in 26(10.74%) and 28(11.58%) ears respectively. On tympanometry, Type B and Type C tympanograms(abnormal) were seen in 36(14.88) and 26(10.74%) ears, respectively. On Eustachian Tube Function Test, out of 242 ears, 67 ears (27.68%) showed Eustachian tube dysfunction. On using Pearson’s chi square test, significant association was found between degree of hearing loss, type of tympanograms and eustachian tube function with various groups of OSMF (p value &lt; 0.05). Conclusion OSMF may affect hearing efficiency and Eustachian tube function as the disease progresses.

Acceptability of the Wulira app in assessing occupational hearing loss among workers in a steel and iron manufacturing industry.

Industrial workers are at a high risk of acquiring noise induced hearing loss, yet there is minimal hearing loss screening of such groups of people. Pure Tone Audiometry (PTA), the gold standard for hearing loss screening, is expensive, and not readily available at health sites. Mobile audiometry can bridge this gap. However, there is limited knowledge on its acceptability in low-income countries like Uganda. We aimed to assess the acceptability of using the Wulira App, a validated mobile phone app, in assessing hearing loss among industrial workers in Kampala. We carried out a qualitative study in a steel and iron manufacturing industry in Kampala, in April 2021. Four Focus group discussions (FGDs) with 8 participants per FGD, and 12 In-depth Interviews (IDI), were conducted on the industrial workers. The industrial workers were first tested for hearing loss, then enrolled for the FGDs and IDI. A semi-structured interview guide was used. Audio recordings were transcribed verbatim. Themes were derived using thematic content analysis, borrowing from Sekhon's model of Acceptability of Health Interventions. Industrial workers found the Wulira App user friendly, cheap, time saving, and an effective hearing loss assessment tool. However, barriers such as lack of smart phones, difficulty in navigating the app, and fear of getting bad news hindered the App's acceptability, as a hearing assessment tool. Hearing loss assessment using Wulira App was acceptable to the industry workers. There is need of informing industrial workers on the essence of carrying out regular hearing loss screening, such that barriers like fear of getting screened are overcome.

Situation Analysis of Ear and Hearing Care Program in Islamic Republic of Iran: System's Challenges and Proper Interventions.

Background: More than 6.8% of the world's population suffer from disabling hearing impairment. Hearing impairment can cause lifelong or even life-threatening problems and has a significant impact on the health and quality of life. This study aimed to analyze the current situation of the ear and hearing care (EHC) in the frame of Iran health system. Methods: This situation analysis was performed over a 5-year period (2013-2017) using the Strengths, Weaknesses, Opportunities, and Threats analysis method. First, after formation of the steering committee, all relevant published and unpublished articles and reports were reviewed and analyzed. In the next step, focused group discussion sessions (FGDs) were held with the participation of the experts, stakeholders, and Steering Committee members. Through the scissor-and-sort technique, the relevant data were highlighted and main categories evolved. Results: The main challenges included inadequate health literacy, weak intrasectoral and intersectoral cooperation, the inadequacy of policy responses, nonintegration of the EHC in the primary health care system, poor standard processes, and resources of EHC, and lack of EHC surveillance system. The 6 major interventions and strategies extracted as identifying the capacities of both the public and private sectors, reinforcement of intersectoral cooperation and intersectoral collaboration, standardizing the processes and integrating of EHC services in the PHC, reorganizing the referral system, promoting hearing health literacy, and minimizing hearing loss risk factors. Conclusion: Implementing the proposed interventions and strategies is essential to improve the situation of Iran EHC management system during the next 5 years.

Refining surgical techniques for efficient posterior semicircular canal gene delivery in the adult mammalian inner ear with minimal hearing loss

Hearing loss is a common disability affecting the world’s population today. While several studies have shown that inner ear gene therapy can be successfully applied to mouse models of hereditary hearing loss to improve hearing, most of these studies rely on inner ear gene delivery in the neonatal age, when mouse inner ear has not fully developed. However, the human inner ear is fully developed at birth. Therefore, in order for inner ear gene therapy to be successfully applied in patients with hearing loss, one must demonstrate that gene delivery can be safely and reliably performed in the mature mammalian inner ear. In this study, we examine the steps involved in posterior semicircular canal gene delivery in the adult mouse inner ear. We find that the duration of perilymphatic leakage and injection rate have a significant effect on the post-surgical hearing outcome. Our results show that although AAV2.7m8 has a lower hair cell transduction rate in adult mice compared to neonatal mice at equivalent viral load, AAV2.7m8 is capable of transducing the adult mouse inner and outer hair cells with high efficiency in a dose-dependent manner.

Changes in Orientation Behavior due to Extended High-Frequency (5 to 10 kHz) Spatial Cues.

Objectives:Current hearing aids have a limited bandwidth, which limits the intelligibility and quality of their output, and inhibits their uptake. Recent advances in signal processing, as well as novel methods of transduction, allow for a greater useable frequency range. Previous studies have shown a benefit for this extended bandwidth in consonant recognition, talker-sex identification, and separating sound sources. To explore whether there would be any direct spatial benefits to extending bandwidth, we used a dynamic localization method in a realistic situation.Design:Twenty-eight adult participants with minimal hearing loss reoriented themselves as quickly and accurately as comfortable to a new, off-axis near-field talker continuing a story in a background of far-field talkers of the same overall level in a simulated large room with common building materials. All stimuli were low-pass filtered at either 5 or 10 kHz on each trial. To further simulate current hearing aids, participants wore microphones above the pinnae and insert earphones adjusted to provide a linear, zero-gain response.Results:Each individual trajectory was recorded with infra-red motion-tracking and analyzed for accuracy, duration, start time, peak velocity, peak velocity time, complexity, reversals, and misorientations. Results across listeners showed a significant increase in peak velocity and significant decrease in start and peak velocity time with greater (10 kHz) bandwidth.Conclusions:These earlier, swifter orientations demonstrate spatial benefits beyond static localization accuracy in plausible conditions; extended bandwidth without pinna cues provided more salient cues in a realistic mixture of talkers.

Dexamethasone (DXM)‐Coated Poly(lactic‐co‐glycolic acid) (PLGA) Microneedles as an Improved Drug Delivery System for Intracochlear Biodegradable Devices

AbstractUniform drug delivery techniques are challenging to develop for the inner ear due to the complexity of the cochlear anatomy. A promising solution is the use of biodegradable polymers because the continuous release of therapeutics without introducing toxic compounds is desirable. Using a microneedle approach lends the polymeric microneedle the capability to be placed inside of the scala tympani, releasing drugs overtime. Poly(lactic‐co‐glycolic acid) (PLGA) microneedles is prepared by dissolving dimethyl sulfoxide with either a) Rhodamine B, to study the drug release profile in vitro, b) FM1‐43, to study the drug release profile in vivo, or c) dexamethasone (DXM), to protect hair cell (HC) loss in vivo. The Rhodamine B studies show that the dye begins release from the microneedles within 30 min. The ototoxicity assessment of the DXM‐coated microneedles in vitro shows a significant reduction of HC losses when compared to control microneedles in an ototoxic environment. In vivo data show reduced hearing threshold for animals treated with DXM‐infused microneedles, providing a proof of concept of the methodology developed. Drug‐infused polymeric microneedles provide a promising method to deliver DXM to the inner ear over controlled periods of time protecting hair cells, thus minimizing hearing loss (HL).

An Evaluation of the Relationship between Retinal Nerve Fiber Thickness, Cochlear Nerve Thickness, the Level of Tinnitus, and Hearing Loss in Unilateral Tinnitus Patients

Background: In this study, optic coherence tomography (OCT) examination was performed to check whether there was any interaction between ophthalmic axonal structures in unilateral tinnitus patients, and the relationship between optic nerve thickness and cochlear nerve thickness was evaluated. Objective: The aim of the study was to evaluate the relatioship between hearing loss, tinnitus, and nerve thicknesses. Study Design: Prospective study. Setting: Tertiary referral university hospital. Patients: The study included 88 patients with unilateral tinnitus, for which no organic cause could be found in physical examination, psychiatric evaluation, or with imaging methods. Study groups were formed of the tinnitus side and control groups were formed of the healthy side as follows: Group 1 (Non-tinnitus side normal hearing values – n = 30), Group 2 (non-tinnitus side minimal hearing loss – n = 27), Group 3 (non-tinnitus side moderate hearing loss – n = 31), Group 4 (tinnitus side normal hearing values – n = 25), Group 5 (tinnitus side minimal hearing loss – n = 25), and Group 6 (tinnitus side moderate hearing loss – n = 38). Intervention: Retinal nerve fiber layer (RNFL) thickness was evaluated with OCT, and the cochlear nerve cross-sectional area was evaluated with MRI. Main Outcome Measures: RNFL measurements were taken with OCT from the subfoveal area (RNFL-SF) and 1.5 mm temporal to the fovea (RNFL-T µm) and nasal (RNFL-N µm) sectors. On MRI, 3 measurements were taken along the nerve from the cerebellopontine angle as far as the internal auditory canal, and the mean value of these 3 measurements was calculated. Results: When the groups were evaluated in respect of cochlear nerve thickness, a significant difference was seen between Group 1 and both the groups with hearing loss and the tinnitus groups. In the subgroup analysis, a statistically significant difference was determined between Group 1 and Groups 3, 4, 5, and 6 (p = 0.013, p = 0.003, p < 0.001, and p < 0.001, respectively). When the groups were evaluated in respect of the RNFL-SF (µm), RNFL-T (µm), and RNFL-N (µm) values, the differences were determined to be statistically significant (p < 0.001 for all). In the correlation analysis, a negative correlation was determined between hearing loss and cochlear nerve diameter (r: −0.184, p = 0.014), and RNFL-N (r: −0.272, p < 0.001) and between tinnitus and cochlear nerve diameter (r: −0.536, p < 0.001), and RNFL-T (r: −0.222, p < 0.009). Conclusion: The study results clearly showed a relationship between cochlear nerve fiber thickness and hearing loss and the severity of tinnitus in cases with unilateral tinnitus and that there could be neurodegenerative factors in the disease etiology. A similar relationship seen with the RNFL supports the study hypothesis.

Audiometric profiles in children with speech sound disorder: Subclinical hearing loss as a potential factor

ABSTRACT In the present study, hearing sensitivity in children with speech sound disorder (SSD) is scrutinized. Middle ear function (wideband tympanometry and acoustic stapedial reflexes, ASR) and inner ear function (audiometric thresholds in the conventional1-8 kHz and extended10-16 kHz high frequency (EHF) range, and distortion product otoacoustic emissions (DPOAEs2-10 kHz) were investigated. Hearing results were analyzed in relation to speech discrimination of phonemic contrasts (quiet and in noise conditions) and reproduction. Thirty-two children with SSD and 41 children with typical development (TD) ages 4–5 years participated. Children with SSD exhibited significantly less sensitive hearing compared to children with TD. This was demonstrated as more absent contralateral ASR (right ear SSD 43.7%; TD 22.0%), a higher prevalence of minimal hearing loss (MHL, > 15 dB HL at one or more frequencies or ears1-8 kHz and PTA ≤ 20 dB HL, SSD 53.1%; TD 24.3%) and EHF hearing impairment (EHF HI, > 20 dB HL at one or more frequencies or ears10-16 kHz, SSD 31.3%; TD 24.3%). At 2 kHz bilaterally, children with SSD showed significantly higher hearing thresholds than children with TD (mean difference, left ear 3.4 dB: right ear 4.3 dB), together with a significantly lower SNR in DPOAEs at 2.2 kHz (left ear 5.1 dB mean difference between groups). In all children, audiometric thresholds at the key-frequencies for speech, 2 and 4 kHz and DPOAEs within similar spectral regions, predicted 7–12% of the variance in phonemic discrimination and reproduction. Overall, these results suggest that hearing should be more fully investigated in children with SSD.

Hearing Screening Failure Among Students With Reading Impairment: Rate and Relation to Specific Reading Deficits

Background The purpose of this preliminary study was to explore one potential underlying factor that may contribute to poor reading outcomes: minimal hearing loss. Additionally, we compared decoding and comprehension deficits in students who passed or failed the hearing screening. Method Forty-three school-age students completed a hearing screening and a literacy assessment. Results Fifty-four percent of children with reading impairments failed the hearing screening, compared to only 21% of children with typical reading. Additionally, students who failed the hearing screening were more likely to exhibit decoding deficits; comprehension skills between the hearing screening groups did not differ. Conclusions Thus, children with reading impairments are more likely to fail hearing screenings than children with typical reading, and the deficits of those who fail hearing screenings appear to center on decoding rather than comprehension skills. Supplemental Material https://doi.org/10.23641/asha.12818252

Clinical Asssessment of Sensorineural Hearing Loss among Diabetes Mellitus Patients

Background: Hearing impairment is known to hamper the quality of life among patients, especially among diabetics due to the association of neuropathy with diabetes. However, the prevalence and degree of the SNHL depends upon different factors, such as age, gender, disease duration of DM, family history and glycemic status of the patients. Therefore, this study aimed to assess the association of SNHL with DM duration and familial DM and gender preponderance among SNHL–DM patients.&#x0D; Methods: Total 140 patients with DM were assessed for hearing impairment using Rinne, Weber and Absolute Bone Conduction Tests along with pure tone audiometry. Patients’ glycaemic status was determined by estimating fasting blood glucose (FBG) and post prandial blood glucose (PPBG) levels. Independent t-test, chi-square, ANOVA and Pearson’s correlation tests along with linear regression model were used to find association and correlation using R software.&#x0D; Results: Out of 140 patients, 60 were suffering from SNHL and majority were suffering from bilateral minimal hearing loss. SNHL was significantly associated with family history, age, duration of DM, FBG and PPBG levels were(Pvalues:1.79E08, 4.41E-06 and 0.02), however, significant correlated with duration of DM, FBS and PPBG level (r value:0.14–0.41).Furthermore, significant SNHL at 500 and 8000Hz was observed in the present study (Pvalue:0.002).&#x0D; Conclusion: A conclusive proof was drawn that family history of DM serve as a valuable variable in assessing the SNHL among DM patients.

Minimal and Mild Hearing Loss in Children: Association with Auditory Perception, Cognition, and Communication Problems.

"Minimal" and "mild" hearing loss are the most common but least understood forms of hearing loss in children. Children with better ear hearing level as low as 30 dB HL have a global language impairment and, according to the World Health Organization, a "disabling level of hearing loss." We examined in a population of 6- to 11-year-olds how hearing level ≤40.0 dB HL (1 and 4 kHz pure-tone average, PTA, threshold) is related to auditory perception, cognition, and communication. School children (n = 1638) were recruited in 4 centers across the United Kingdom. They completed a battery of hearing (audiometry, filter width, temporal envelope, speech-in-noise) and cognitive (IQ, attention, verbal memory, receptive language, reading) tests. Caregivers assessed their children's communication and listening skills. Children included in this study (702 male; 752 female) had 4 reliable tone thresholds (1, 4 kHz each ear), and no caregiver reported medical or intellectual disorder. Normal-hearing children (n = 1124, 77.1%) had all 4 thresholds and PTA <15 dB HL. Children with ≥15 dB HL for at least 1 threshold, and PTA <20 dB (n = 245, 16.8%) had minimal hearing loss. Children with 20 ≤PTA <40 dB HL (n = 88, 6.0%) had mild hearing loss. Interaural asymmetric hearing loss ( left PTA - right PTA ≥10 dB) was found in 28.9% of those with minimal and 39.8% of those with mild hearing loss. Speech perception in noise, indexed by vowel-consonant-vowel pseudoword repetition in speech-modulated noise, was impaired in children with minimal and mild hearing loss, relative to normal-hearing children. Effect size was largest (d = 0.63) in asymmetric mild hearing loss and smallest (d = 0.21) in symmetric minimal hearing loss. Spectral (filter width) and temporal (backward masking) perceptions were impaired in children with both forms of hearing loss, but suprathreshold perception generally related only weakly to PTA. Speech-in-noise (nonsense syllables) and language (pseudoword repetition) were also impaired in both forms of hearing loss and correlated more strongly with PTA. Children with mild hearing loss were additionally impaired in working memory (digit span) and reading, and generally performed more poorly than those with minimal loss. Asymmetric hearing loss produced as much impairment overall on both auditory and cognitive tasks as symmetric hearing loss. Nonverbal IQ, attention, and caregiver-rated listening and communication were not significantly impaired in children with hearing loss. Modeling suggested that 15 dB HL is objectively an appropriate lower audibility limit for diagnosis of hearing loss. Hearing loss between 15 and 30 dB PTA is, at ~20%, much more prevalent in 6- to 11-year-old children than most current estimates. Key aspects of auditory and cognitive skills are impaired in both symmetric and asymmetric minimal and mild hearing loss. Hearing loss <30 dB HL is most closely related to speech perception in noise, and to cognitive abilities underpinning language and reading. The results suggest wider use of speech-in-noise measures to diagnose and assess management of hearing loss and reduction of the clinical hearing loss threshold for children to 15 dB HL.