Moderate Hearing Loss Research Articles

Spontaneous shrinkage of vestibular schwannoma with the recovery of impaired hearing: A case report and literature review

Sporadically occurring vestibular schwannomas (VSs) are the most frequent tumors in the cerebellopontine cistern and internal meatus and are commonly associated with hearing loss. These tumors have demonstrated spontaneous shrinkage rates of 0-22%; however, the relationship between tumor shrinkage and changes in hearing remains unclear.We report a case of a 51-year-old woman with a diagnosis of a left-sided VS and accompanying moderate hearing loss. The patient was treated with a conservative approach for 3 years, and the tumor showed a regression along with an improvement in her hearing ability during the yearly follow-ups.The spontaneous shrinkage of a VS along with an associated improvement in hearing is a rare phenomenon. Our case study may support that the "wait and scan" approach is an alternative option for patients with VS and moderate hearing loss. Further investigations are needed to understand spontaneous VS regression and hearing changes.

Hearing rehabilitation in patients with congenital aural atresia: an observational study in a tertiary center

BackgroundCongenital aural atresia (CAA) and stenosis is a rare defect affecting the external auditory canal which causes varying degrees of hearing impairment. This malformation may be unilateral or bilateral. Timely hearing rehabilitation in these patients is paramount to ensure appropriate speech and language development. Thus, early detection and hearing assessment with timely intervention in the form of hearing device is crucial. There is a wide range of hearing amplification devices available for these patients, catering to individual needs and preferences. This study investigated the options and choices of hearing rehabilitation among patients with CAA in our center. This study also compared the hearing gain of different types of hearing devices and patient satisfaction levels.MethodsThis was a retrospective analysis of 55 patients with congenital aural atresia or stenosis under follow-up at the Otorhinolaryngology and Audiology Clinic of a tertiary academic institution. Data on the timing of hearing loss diagnosis and intervention, type of hearing rehabilitation, hearing gain, Jahrsdoerfer score from temporal bone computed tomography, and patient satisfaction level was collected and analyzed.ResultsFifty-five patients were recruited with ages between 3.6 months to 58 years old. The majority of patients (63.6%) had moderate hearing loss, followed by severe hearing loss (18.2%), mild hearing loss (9.1%) and profound hearing loss (7.3%). 32.7% of patients had early hearing loss diagnosed by 3 months old, while 67.3% were diagnosed after 3 months of age. Bone anchored hearing implant (BAHA Attract/Connect) gave the highest mean hearing gain of 35.23 dB (SD ± 9.75) compared to air conduction hearing aid, bone conduction hearing aid, and canalplasty. Patients implanted with BAHA Attract/Connect reported the highest average satisfaction scores of 7.74.ConclusionA significant proportion of patients have delayed diagnosis and intervention. Bone-anchored hearing implants provide excellent hearing improvements in patients with CAA with good patient satisfaction.

Therapeutic Response of Tinnitus Retraining in Patients With Tinnitus and Hearing Loss: A Short-Term Comparisonal Study on the Effect of Hearing Aid

Background and Objectives Tinnitus retraining therapy (TRT) is one of the most effective treatment methods for tinnitus. This study aimed to evaluate the treatment response to TRT in tinnitus patients with hearing loss and to analyze an additive treatment effect of an hearing aid.Subjects and Method In this retrospective observational case-control study, we reviewed the medical records of the 80 patients who were diagnosed with sensorineural tinnitus with mild to moderate hearing loss and managed by TRT. The changes of tinnitus after TRT with or without hearing aids were measured by the questionnaire of visual analog scale (VAS) and the Tinnitus Handicap Inventory (THI) at 3, 6, 12, and 24 months after the treatment. Subjects were divided into two groups according to patients’ hearing aided condition: non-hearing aided TRT group (NHAG, n=40) and hearing aided TRT group (HAG, n=40). Treatment responses to TRT from both groups were also compared.Results All VAS scores of loudness, awareness, annoyance and effect on life of tinnitus, and THI scores were significantly decreased in both groups at 1-year follow-up period (<i>p</i><0.001). None of the delta scores of VAS and THI showed significant differences between two groups at 1-year follow-up period.Conclusion TRT turned out to be an effective treatment modality for tinnitus patients with mild to moderate hearing loss. Directive counseling with environmental sound therapy seems to be effective enough to improve patients’ symptom of tinnitus. There was no significant additive effect of hearing aids in the treatment of tinnitus following TRT during the study period; nevertheless, patients using hearing aids showed the tendency of better control of their relevant symptoms. A long-term follow-up study using a larger group should be conducted in the future.

Hearing Impairment and Allostatic Load in Older Adults

Allostatic load, the cumulative strain that results from the chronic stress response, is associated with poor health outcomes. Increased cognitive load and impaired communication associated with hearing loss could potentially be associated with higher allostatic load, but few studies to date have quantified this association. To investigate if audiometric hearing loss is associated with allostatic load and evaluate if the association varies by demographic factors. This cross-sectional survey used nationally representative data from the National Health and Nutrition Examination Survey. Audiometric testing was conducted from 2003 to 2004 (ages 20-69 years) and 2009 to 2010 (70 years or older). The study was restricted to participants aged 50 years or older, and the analysis was stratified based on cycle. The data were analyzed between October 2021 and October 2022. A 4-frequency (0.5-4.0 kHz) pure tone average was calculated in the better-hearing ear and modeled continuously and categorically (<25 dB hearing level [dB HL], no hearing loss; 26-40 dB HL, mild hearing loss; ≥41 dB HL, moderate or greater hearing loss). Allostatic load score (ALS) was defined using laboratory measurements of 8 biomarkers (systolic/diastolic blood pressure, body mass index [calculated as weight in kilograms divided by height in meters squared], and total serum and high-density lipoprotein cholesterol, glycohemoglobin, albumin, and C-reactive protein levels). Each biomarker was assigned a point if it was in the highest risk quartile based on statistical distribution and then summed to yield the ALS (range, 0-8). Linear regression models adjusted for demographic and clinical covariates. Sensitivity analysis included using clinical cut points for ALS and subgroup stratification. In 1412 participants (mean [SD] age, 59.7 [5.9] years; 293 women [51.9%]; 130 [23.0%] Hispanic, 89 [15.8%] non-Hispanic Black, and 318 [55.3%] non-Hispanic White individuals), a modest association was suggested between hearing loss and ALS (ages 50-69 years: β = 0.19 [95% CI, 0.02-0.36] per 10 dB HL; 70 years or older: β = 0.10 [95% CI, 0.02-0.18] per 10 dB HL) among non-hearing aid users. Results were not clearly reflected in the sensitivity analysis with clinical cut points for ALS or modeling hearing loss categorically. Sex-based stratifications identified a stronger association among male individuals (men 70 years or older: β = 0.22 [95% CI, 0.12-0.32] per 10 dB HL; women: β = 0.08 [95% CI, -0.04 to 0.20] per 10 dB HL). The study findings did not clearly support an association between hearing loss and ALS. While hearing loss has been shown to be associated with increased risk for numerous health comorbidities, its association with the chronic stress response and allostasis may be less than that of other health conditions.

Potential Clinical and Economic Outcomes of Over-the-Counter Hearing Aids in the US

Over-the-counter (OTC) hearing aids are now available in the US; however, their clinical and economic outcomes are unknown. To project the clinical and economic outcomes of traditional hearing aid provision compared with OTC hearing aid provision. This cost-effectiveness analysis used a previously validated decision model of hearing loss (HL) to simulate US adults aged 40 years and older across their lifetime in US primary care offices who experienced yearly probabilities of acquiring HL (0.1%-10.4%), worsening of their HL, and traditional hearing aid uptake (0.5%-8.1%/y at a fixed uptake cost of $3690) and utility benefits (0.11 additional utils/y). For OTC hearing aid provision, persons with perceived mild to moderate HL experienced increased OTC hearing aid uptake (1%-16%/y) based on estimates of time to first HL diagnosis. In the base case, OTC hearing aid utility benefits ranged from 0.05 to 0.11 additional utils/y (45%-100% of traditional hearing aids), and costs were $200 to $1400 (5%-38% of traditional hearing aids). Distributions were assigned to parameters to conduct probabilistic uncertainty analysis. Provision of OTC hearing aids, at increased uptake rates, across a range of effectiveness and costs. Lifetime undiscounted and discounted (3%/y) costs and quality-adjusted life-years (QALYs) and incremental cost-effectiveness ratios (ICERs). Traditional hearing aid provision resulted in 18.162 QALYs, compared with 18.162 to 18.186 for OTC hearing aids varying with OTC hearing aid utility benefit (45%-100% that of traditional hearing aids). Provision of OTC hearing aids was associated with greater lifetime discounted costs by $70 to $200 along with OTC device cost ($200-$1000/pair; 5%-38% traditional hearing aid cost) due to increased hearing aid uptake. Provision of OTC hearing aids was considered cost-effective (ICER<$100 000/QALY) if the OTC utility benefit was 0.06 or greater (55% of the traditional hearing aid effectiveness). In probabilistic uncertainty analysis, OTC hearing aid provision was cost-effective in 53% of simulations. In this cost-effectiveness analysis, provision of OTC hearing aids was associated with greater uptake of hearing intervention and was cost-effective over a range of prices so long as OTC hearing aids were greater than 55% as beneficial to patient quality of life as traditional hearing aids.

Self-assessment of adults with acquired hearing loss in the context of self-esteem and psychosocial functioning

&amp;lt;p&amp;gt;&amp;lt;strong&amp;gt;Introduction.&amp;lt;/strong&amp;gt; The consequences of acquired hearing loss in adults condition their psychosocial functioning and imply changes in the quality of life related to disorders in social and emotional functioning. Hearing loss is considered a risk factor for reduced psychosocial functioning and self-esteem. Psychosocial well-being and preserved self-esteem imply having a positive self-image and realizing that a person is an important part of the social community in which he/she lives. The paper deals with self-esteem and psychosocial functioning of adults with acquired hearing loss. The aim of this research is to determine the level of self-esteem and the degree of expression of consequences in psychosocial functioning, that is, the connection between the level of self-esteem and the degree of expression of consequences in psychosocial functioning in adults with acquired hearing loss. &amp;lt;strong&amp;gt;Methods.&amp;lt;/strong&amp;gt; The research was conducted on a sample of 60 adult subjects with acquired hearing loss and 60 subjects with normal hearing. The average age of the respondents with hearing loss was 54.1 (SD = 10.84), and the sample consisted mostly of male respondents (56.7%) with moderate hearing loss (25.4%). The Rosenberg Self-Esteem Scale and the questionnaire for the subjective assessment of the hearing condition - the HHIA questionnaire (Hearing Handicap Inventory for Adults) were used as instruments. &amp;lt;strong&amp;gt;Results. &amp;lt;/strong&amp;gt;The results showed that the respondents expressed moderate or average self-esteem and that there was a connection between self-esteem and psychosocial functioning in adults with acquired hearing loss.&amp;lt;strong&amp;gt; Conclusion. &amp;lt;/strong&amp;gt;Future research could be directed more towards examining self-esteem in more detail in more specific domains of psychosocial functioning of adults with acquired hearing loss.&amp;lt;/p&amp;gt;

Comparative Evaluation of Eustachian Tube Changes in Oral Submucous Fibrosis Patients.

Aim and Objective:Oral submucous fibrosis (OSMF) is a potentially premalignant disorder affecting the oral cavity and its adjacent structures. The present study was aimed at a comparative evaluation of eustachian tube (ET) changes in OSMF patients using audiometry and cone-beam computed tomography (CBCT). Materials and Methods:A total of 40 patients who were clinically diagnosed with OSMF were taken for the study and were graded into clinical and functional staging. After grading, the patients were subjected to audiometry to evaluate their hearing deficit. Subsequently, the patients were subjected to CBCT analysis for the evaluation of the length and volume of the ET. The length of ET was measured in the axial sections of the full-face CBCT images taken at the level of the root tip of the upper first molar. The radiolucency from the nasopharyngeal opening to the maximum distance was considered. The volume of ET was measured using third-party software (ITK-SNAP) in the radiolucent area. Result:The age group in which a higher number of OSMF cases were seen was between 41 and 50 years. There was mild to moderate hearing loss observed in the right and/or left ear, with little variation between right and left ear changes in audiometry. The CBCT analysis did not show a significant difference in the mean length of the eustachian tube when comparing OSMF cases with normal. However, as the disease worsened, the length on the right and left sides significantly decreased. Additionally, there was no statistically significant difference in the mean eustachian tube volume between disease cases and controls. According to the clinical subgrades, the overall volume decreased from lower grade to higher grade, but there was no discernible difference between the left and right ear. The volume on function sub-grading between the right and left ear, however, was significantly reduced. Thus, the length and volume of ET decreased as the disease severity increased, but the mild to moderate hearing loss found in different clinical and functional grades of OSMF cases was not statistically significant. Conclusion:Therefore, from the present study, it can be concluded that all OSMF cases should be evaluated for hearing deficit, and imaging of the eustachian tube should be part of the OSMF assessment for morphological changes of the ET that may cause hearing deficit.

Maximizing the Detection of Copy Number Variants in the Highly Homologous Deafness-Infertility Syndrome Locus in Standard-of-care Testing

Genome-wide chromosomal microarrays (CMA) can identify pathogenic copy number variants (CNVs) associated with patients’ clinical indications but also have the potential to detect incidental findings and carrier status for recessive disorders. Patients can benefit from maximizing the detection and reporting of potentially clinically significant CNVs from this standard-of-care genome-wide test in accordance with professional guidelines (1); however, accurate detection of specific CNVs can be limited by the technology used and the complexity of the genomic regions under consideration. One example of this complexity is in the detection of disease-causing variants in the STRC gene associated with DFNB16, the second most frequent cause of autosomal recessive nonsyndromic hearing loss (NSHL), which is a common sensory disorder with high genetic heterogeneity. DFNB16 is estimated to account for up to 16% of individuals with NSHL (2). Most pathogenic STRC alterations are deletions encompassing all or part of the gene. These deletions often extend into the neighboring gene CATSPER2, which is associated with male fertility. Homozygous, contiguous deletions involving both STRC and CATSPER2 cause deafness-infertility syndrome (DIS), a contiguous gene deletion syndrome characterized by nonsyndromic, congenital to post-lingual onset of mild to moderate bilateral sensorineural hearing loss in both males and females and exclusive male infertility. Several studies have reported that 1%–2% of individuals are asymptomatic heterozygous carriers for a deletion of STRC with or without CATSPER2 (2, 3). The high frequency of STRC deletions has also led to reports of “pseudodominant inheritance,” in which a parent and child both have hearing loss as a result of homozygous STRC deletions (3, 4).

Siblings with 4H leukodystrophy – A rare cause of hypomyelination

A 35-year-old man presented with slowly progressive ataxia since childhood, failure of development of secondary sexual characteristics, primary infertility, delayed dentition, and moderate sensorineural hearing loss on both sides. On physical examination, there were unerupted first molar teeth on both sides, lack of axillary and facial hair and a small-sized penis. He underwent a magnetic resonance imaging (MRI) examination of the brain which showed diffuse hypomyelination with relative sparing of bilateral posterior limbs of the internal capsule, the ventrolateral nucleus of the thalamus, and optic radiations, along with a hypoplastic anterior pituitary gland. Hence, 4H leukodystrophy was suggested radiologically which made us curious to ask for family history which revealed similar symptoms (absence of secondary sexual characters) in his younger male sibling. MRI brain screening was also performed for the sibling, which showed diffuse cerebral hypomyelination.

The Association of Hearing Loss with Hospitalization.

Individuals with hearing loss (HL) are at higher risk for hospitalizations, and may be for readmissions, compared with their hearing peers. The objective of this prospective study was to confirm retrospective studies suggesting that HL increases hospital readmissions, and, if confirmed, possible causes for it. A prospective cohort study of English-speaking patients >55 years old admitted to general medical and surgical floors at 2 large hospital systems in southeastern Michigan over a 2-year period was conducted. All patients underwent bedside audiometric testing. HL presence and severity were categorized using World Health Organization pure tone assessment parameters. Readmission rates, Charlson comorbidity index, socio-demographic and medical variables were obtained from Epic EMR databases. There were 1247 hospitalized patients enrolled. Of these, 76.8% had documented HL of which 50.5% (630) was mild HL and 26.3% (328) moderate or worse HL. Patients with any HL were older and more likely to be non-Hispanic, white, male, and had less education, lower health literacy, more comorbidities, and more difficulty communicating with their doctor. Readmission rates at 30 and 90-days were similar between HL and hearing groups, after adjusting for HL severity, Charlston index, and numerous potential confounders. Patients with HL do not seem to have higher rates of hospital readmissions. We did find high frequency of HL in hospitalized patients along with significant communication difficulties that patients had with their clinicians. These findings have implications for measures to improve patient-physician communication, potentially improving long-term health outcomes.

The Population Attributable Fraction of Dementia From Audiometric Hearing Loss Among a Nationally Representative Sample of Community-Dwelling Older Adults.

The population attributable fraction (PAF) of dementia from hearing loss (HL) in the United States is ~2% when incorporating self-reported HL measures. However, self-report might underestimate clinically significant audiometric HL among older adults. Here, we quantified PAFs of dementia from audiometric HL overall and by age, sex, and race/ethnicity groups among a nationally representative sample of community-dwelling older adults in the United States. We used cross-sectional data from Round 11 (2021) of the National Health and Aging Trends Study, a prospective cohort study representing the U.S. Medicare population aged 65+ years (N = 2 470). We estimated model-adjusted PAFs of prevalent dementia by audiometric HL (pure-tone averages: normal hearing, <26 dB HL; mild HL, 26-40 dB HL; moderate or greater HL, ≥41 dB HL). Among eligible participants (34.8% aged ≥80 years; 55.3% female; 82.4% non-Hispanic White), 37.5% had mild, and 28.8% had moderate or greater HL. Dementia prevalence overall was 10.6%, with the PAF predominately driven by moderate or greater HL (PAF = 16.9%; 95% confidence interval [CI]: 4.1-28.7%). The PAF from any degree of HL was larger but with a wider CI (PAF = 18.7%, 95% CI: -5.3% to 40.1%). There was evidence associations differed by sex but not age or race/ethnicity; moderate or greater HL exhibited stronger associations among males (PAF = 40.5%; 95% CI: 19.5% to 57.2%) than females (PAF = 3.2%; 95% CI: -12.7% to 17.9%). In a nationally representative sample of community-dwelling older adults in the United States, 17% of dementia cases were attributable to moderate or greater audiometric HL, an estimate that is eightfold higher relative to studies relying on self-reported hearing measures only.

The noise profile and hearing impact of commercial fiberglass reinforced plastic speed boats in Port Blair, Andaman and Nicobar Islands

Background: Hearing impairment may result from tourism-related vehicle engine noise in Port Blair, Andaman, and Nicobar Islands. Aims and Objectives: Measure noise levels and test commercial fiberglass-reinforced plastic (FRP) speedboat operators for hearing loss. Materials and Methods: Hearing loss and noise impacts were checked in a total of 145 male crew members and workers exposed to commercial FRP-speedboat outboard engine noise. 18–50-year-olds with 1–20 years of experience participated. To detect hearing loss, noise-induced hearing loss (NIHL) risk indicators that could appear as a 4 kHz noise notch and the existence of high-frequency sloping hearing loss were detected using pure tone audiometry. The level of noise exposure was measured in conjunction with a questionnaire to assess an individual’s general knowledge of the effects of noise and hearing loss. Results: A 4 kHz noise notch, some high-frequency slope hearing loss, and an overall hearing loss rate of 42.1% were found in 145 participants. Out of these, 15.9% had the most common bilateral notch. Bilateral high-frequency sloping was 10.3%, Unilateral high-frequency sloping was 4.9%, and unilateral 4 kHz notch was 11.0%. According to the questionnaire, research participants are shockingly unaware of noise-induced hearing loss. The FRP Speedboat outboard engine’s measured noise level ranged from 79.7 to 89.4 dB (A). Conclusion: The FRP Speedboat crews were at risk of hearing loss, specifically NIHL with continuous noise exposure. High frequency sloping hearing loss, mild to moderate hearing loss, and a substantial 4 kHz noise notch are found in noise-exposed employees. Awareness is needed to prevent irreversible hearing loss.

Investigation of hearing aid users' speech understanding in noise and their spectral-temporal resolution skills

PurposeOur study aims to compare speech understanding in noise and spectral- temporal resolution skills with regard to the degree of hearing loss, age, hearing aid use experience and gender of hearing aid users. MethodsOur study included sixty-eight hearing aid users aged between 40-70 years, with bilateral mild and moderate symmetrical sensorineural hearing loss. Random gap detection test, Turkish matrix test and spectral-temporally modulated ripple test were implemented on the participants with bilateral hearing aids. The test results acquired were compared statistically according to different variables and the correlations were examined. ResultsNo statistically significant differences were observed for speech-in-noise recognition, spectral-temporal resolution among older and younger adults in hearing aid users (p>0.05). There wasn’t found a statistically significant difference among test outcomes as regards different hearing loss degrees (p>0.05). Higher performances were obtained in terms of temporal resolution in male participants and participants with more hearing aid use experience (p<0.05). Significant correlations were obtained between the results of speech-in-noise recognition, temporal resolution and spectral resolution tests performed with hearing aids (p<0.05). ConclusionOur study findings emphasized the importance of regular hearing aid use and it showed that some auditory skills can be improved with hearing aids. Observation of correlations among the speech-in-noise recognition, temporal resolution and spectral resolution tests have revealed that these skills should be evaluated as a whole to maximize the patient's communication abilities.

The role of hearing professionals for over-the-counter hearing aids

Adults with all levels of hearing loss have faced financial and accessibility constraints in obtaining prescription hearing aids. To increase access to hearing aids, the Food and Drug Administration (FDA) has created a new designation of over-the-counter (OTC) hearing aids for adults with perceived mild to moderate hearing loss. The goal of this article is to describe the incorporation of OTC hearing aid users into established audiology services. A proposed workflow was created by otolaryngologists and audiologists at Johns Hopkins University School of Medicine and is being implemented at outpatient audiology offices. We used published criteria for appropriate OTC hearing aid usage and disqualifying criteria hearing specialists should be aware of. The proposed workflow describes the multiple entry points for OTC hearing aid users seeking access to care and appropriate objectives for these visits. The new FDA ruling has increased the accessibility of hearing assistance devices; however, the varying degrees of retailer support systems could lead to improper fitting and other technical problems for some patients trialing new hearing aids. Our proposed workflow aims to describe the incorporation of established hearing assistance services with the new OTC hearing aid market.

Effectiveness of an Over-the-Counter Self-fitting Hearing Aid Compared With an Audiologist-Fitted Hearing Aid

Hearing loss is a highly prevalent condition, with numerous debilitating consequences when left untreated. However, less than 20% of US adults with hearing loss use hearing aids. Over-the-counter (OTC) hearing aids became available in October 2022 to improve access and affordability. However, clinical effectiveness studies of available OTC hearing aids using the existing devices in the market are limited. To compare the clinical effectiveness of a self-fitting OTC hearing aid with remote support and a hearing aid fitted using audiologist-fitted best practices. This randomized clinical effectiveness trial was conducted between April 14 and August 29, 2022. Sixty-eight adults with self-perceived mild to moderate hearing loss were recruited and randomly assigned to either the self-fitting or the audiologist-fitted group. Following bilateral hearing aid fitting, participants first completed a 2-week, take-home field trial without any support. Access to fine-tuning for both groups was only available after the 2-week trial. Support and adjustment were provided remotely for the self-fitting group per request and by the audiologist for the audiologist-fitted group. Participants were then reassessed after an additional 4-week take-home trial. A commercially available self-fitting OTC hearing aid was provided to participants in the self-fitting group who were expected to set up the hearing aids using the commercially supplied instructional material and accompanying smartphone application. In the audiologist-fitted group, audiologists fitted the same hearing aid according to the National Acoustics Laboratories nonlinear version 2 algorithm for prescriptive gain target using real-ear verification with hearing aid use instruction. The primary outcome measure was self-reported hearing aid benefit, measured using the Abbreviated Profile of Hearing Aid Benefit (APHAB). Secondary measures included the International Outcome Inventory for Hearing Aids (IOI-HA) and speech recognition in noise measured using an abbreviated speech-in-noise test and a digits-in-noise test. All measures were completed at baseline and at 2 intervals following hearing aid fitting (2 and 6 weeks). Sixty-four participants were included in the analytic sample (33 men [51.6%]; mean [SD] age, 63.6 [14.1] years), with equal numbers of participants (n = 32) randomized into each group. The groups did not differ significantly in age (effect size r = -0.2 [95% CI, -0.3 to 0.2]) or 4-frequency pure-tone average (effect size r = 0.2 [95% CI, -0.1 to 0.4]). After the 2-week field trial, the self-fitting group had an initial advantage compared with the audiologist-fitted group on the self-reported APHAB (Cohen d = -0.5 [95% CI, -1.0 to 0]) and IOI-HA (effect size r = 0.3 [95% CI, 0.0-0.5]) but not speech recognition in noise. At the end of the 6-week trial, no meaningful differences were evident between the groups on any outcome measures. In this randomized clinical effectiveness trial, self-fitting OTC hearing aids with remote support yielded outcomes at 6 weeks post fitting comparable to those of hearing aids fitted using audiologist best practices. These findings suggest that self-fitting OTC hearing aids may provide an effective intervention for mild to moderate hearing loss. ClinicalTrials.gov Identifier: NCT05337748.

Update on surgical and nonsurgical treatment options for age-related hearing loss.

Age-related hearing loss (ARHL) is one of the most common chronic conditions that impacts on everyday life far beyonds speech understanding. Chronic hearing loss has been associated with social isolation, depression, and cognitive decline. Early diagnosis and appropriate treatment are recommended. To give an overview of surgical and non-surgical treatment options for ARHL and the gap between the high prevalence of ARHL and its inadequate treatment to date. A selective literature search was carried out in PubMed. In case of mild to moderate hearing loss, provision of air conduction hearing aids is still the method of choice as it leads to alarge benefit in speech understanding and hearing-specific quality of life, and to a slight improvement in overall quality of life. Implantable middle ear systems are used for the treatment of special types of hearing impairment. In case of severe to profound hearing loss, cochlear implantation should be considered; however, only asmall number of older people with hearing loss are supplied with hearing aids or cochlear implants despite the well-known benefits of both. This also applies to high-income countries where the costs are covered by health insurance funds. Considering the low rate of properly treated people with hearing loss, large-scale screening programs, including better counselling of older people, should be developed.

Effect of simulated acute bilateral severe conductive hearing loss on static balance function in healthy subjects: a prospective observational pilot study

PurposeMaintaining static balance is a process coordinated by central integration of visual, vestibular and somatosensory information. Whether or not hearing and spatial acoustic information contributes to the maintenance of static postural balance is unclear.MethodsA prospective observational pilot study was performed. Twenty-five normal hearing adults (68% female; 19–31 years) underwent a computerized dynamic posturography test battery including the Sensory Organization Test (SOT), the Motor Control Test (MCT), and the Adaptation Test (ADT). The balance tests were performed two times, in a randomized sequence without or with acute hearing loss. Earplugs (sound insulation 37 dB) or headphones with white noise (sound volume 75 dB) induced the conductive hearing loss. Hence, all participants passed through four sequences of the balance test battery. A repeated-measures analysis of variance (ANOVA) was used to analyze the results.ResultsThe ANOVA revealed no difference for any SOT and ADT subtest without hearing loss and simulated hearing loss (either earplugs or headphones; all p > 0.05). The ANOVA showed no longer latencies with simulated hearing loss compared to no hearing loss in both experiments with one exception: the reaction of the right foot during large forward translation was longer with hearing loss than without hearing loss in both experiments (p = 0.025).ConclusionsOverall, a simulated acute conductive bilateral moderate or severe hearing loss did not disturb the static balance function in normal hearing younger adults in this first small pilot study.

How Does Preoperative Pure Tone Audiometry Relate to the Findings at Surgery to Explain the Hearing Status in Chronic Otitis Media?

Pure tone audiometry (PTA) guides surgical decision-making in chronic otitis media (COM), and PTA values depend upon the type and extent of COM. Our cross-sectional study included patients with COM with/without cholesteatoma who were scheduled for surgery. Findings on examination of the middle ear under the microscope and at surgery which could explain the hearing loss were corroborated with preoperative PTA through appropriate statistical methods. The study included 114 patients (mean age: 31.07 years; range: 7-57). Following preoperative PTA, 50% of patients had moderate hearing loss and ~73% had air-bone gap (ABG) <35 dB. Conductive hearing loss affected 109 patients (97.61%); five had mixed hearing loss. At surgery, 27 patients (23.68%) had ossicular discontinuity, with the incus being the most affected. Twenty-one patients in this group had ABG ≥35 dB. Perforations involving the anterior and posterior halves of the pars tensa, and subtotal perforations, demonstrated the maximum mean hearing loss [45.39±8.29 dB HL (p=0.075), 51.08±12.51 dB HL (p=0.26), respectively]. The mean pure tone average in the intact ossicles group was 43.62±8.07 dB HL and that in the absent/eroded ossicles group was 58.15±11.05 dB HL (p<0.0001); the mean ABG was 27.89±4.77 dB and 38.88±6.47 dB, respectively (p<0.0001). Hearing loss was significantly associated with the size but not the site of the central perforation. With ossicular discontinuity, hearing loss and ABG deteriorated significantly. The findings re-establish the relationship between preoperative PTA and the middle ear status which should help surgeons plan surgery and counsel patients regarding hearing outcomes.

Aging and Speech-in-Noise Perception.

The objective was investigating the effect of age on speech-in-noise perception (SINP) using word perception score in white noise (WPS in WN). This cross-sectional study was conducted on 76 participants, including 30 elderly (older than 61years) and 46 young adults (between 14 and 35years) with normal levels of stress, night sleep and mini-mental states. Audiological evaluations included acoustic immittance testing, pure tone audiometry, determination of speech reception threshold and WPS in WN. Data analysis were performed using Mann-Whitney and Tukey HSD tests. Based on the results of the tests, the participants were divided into three groups: (1) young adults with normal hearing (n = 30), (2) elderly adults with normal hearing (n = 16), (3) elderly adults with mild to moderate high frequency hearing loss (n = 14). In both groups of old adults, the means WPS in WN differences were significant only in the left ears (Pv = 0.008, 0.033, 0.025 for SNR = 0, +5, +10dB). In the three groups and in the right ears, there were the significant differences between the means of WPS in WN (Pv = 0.002, 0.000, 0.001 for SNR = 0, +5, +10dB), and also the left ears (Pv = 0.000, 0.002, 0.002 for SNR = 0,+5, +10dB).There is a relationship between increasing age and decreasing WPS in WN. The deleterious effects of aging on SINP decline are greater than that of hearing loss.

The natural course of otitis media with effusion in infants who failed universal newborn hearing screening: a retrospective cohort study.

To analyse the natural course of infants with otitis media with effusion who failed universal newborn hearing screening and to explore the appropriate observation period. This retrospective cohort analysis included infants with otitis media with effusion who failed universal newborn hearing screening every 3 months for 12 months. The average recovery time of the 155 infants was 7.08 ± 0.32 months after diagnosis. Multivariate Cox regression analysis confirmed that frequent reflux, maxillofacial deformities and initial hearing status were independent factors affecting recovery. Moreover, the cumulative recovery of most infants with mild hearing loss and infants with moderate hearing loss accompanied by frequent reflux was significantly higher at six months after diagnosis than at three months. For most infants with mild hearing loss, as well as those with moderate hearing loss accompanied by frequent reflux, the observation period can be extended to six months after diagnosis.