Moderate Sensorineural Hearing Loss Research Articles

COVID-19 and Spectrum of Vestibular Dysfunctions: A Case Report

COVID-19 infection had shown to affect multiple systems. A positive COVID-19 case with multiple vestibular problems, its management and a review of the literature were reported. A 63-year-old lady who was a Category 5 COVID-19 infection patient, complicated by mild frontal stroke, left isolated mononeuropathy causing foot drop, had persistent dizziness lasting hours to days in the first month after being extubated. She underwent vestibular rehabilitation which did not resolve her vertigo. Upon presentation to the vestibular clinic at 3-months post-extubation, she complained of vertigo on changing positions lasting a few seconds with dizziness in between. Her Dizziness Handicap Inventory (DHI) was severe, with severe abnormal Depression Anxiety Stress Scale 21 (DASS 21). Vestibular assessments showed oculomotor abnormalities with positive left posterior Benign Paroxysmal Positional Vertigo (BPPV) on Dixhallpike test. During Epley maneuver, there was canal conversion to the anterior canal which was resolved with a deep head hanging maneuver. The canal repositioning maneuver was done in serial, and her vertigo reduced tremendously. Her Video Head Impulse Test showed abnormalities in all semicircular canals bilaterally, rotatory chair showed lateral vestibular weakness and videonystagmography showed abnormal smooth pursuit, saccade and optokinetic suggesting central lesion. Her cervical and ocular vestibular evoked myogenic potential were normal reflecting normal saccular and utricular function. Tympanometry showed type A bilaterally with right mild and left mild to moderate sensorineural hearing loss. Magnetic resonance imaging of the Internal Acoustic Meatus showed bilateral vascular loop with no cerebellopontine angle tumour. Upon review three months later, the patient was asymptomatic of vestibular complaint with normal DHI and DASS21 score. Her foot drop had also resolved. Evidence in the literature showed up to 16.8% of COVID-19 patients reported vestibular symptoms. The mechanism of this vestibular neuritis is unclear but may be similar to the pathogenesis causing anosmia or vasculopathy. International Journal of Human and Health Sciences Supplementary Issue: 2023 Page: S26

Automated Adaptive Wideband Acoustic Stapedius Reflex Thresholds in Adults With Normal Hearing and Sensorineural Hearing Loss.

This study compared the measurement of the acoustic stapedius reflex threshold (ART) obtained using a traditional method with that obtained using an automated adaptive wideband (AAW) method. Participants included three groups of adults with normal hearing (NH), mild sensorineural hearing loss (SNHL), or moderate SNHL. The purpose of the study was to compare ARTs for the three groups and to determine which method had the best performance in detecting SNHL. Ipsilateral and contralateral ARTs were obtained using 0.5, 1, and 2 kHz tonal activators, and broadband noise (BBN) activators on a traditional admittance system (Clinical) at tympanometric peak pressures (TPP) and on an experimental wideband system using an AAW method at both ambient pressure and TPP. ART data previously reported for 39 NH adults with a mean age of 47.7 years were compared with data for 25 participants with mild SNHL with a mean age of 63.8 years, and 20 participants with moderate SNHL with a mean age of 65.7 years. Differences in ARTs between the normal-hearing and SNHL groups for the three methods were examined using a General Linear Model Repeated-Measures test. A receiver operating characteristic curve (ROC) analysis was also used to determine the ability of an ART test to detect SNHL. For the 0.5 kHz activator condition, there were no significant group mean differences in ART between NH and SNHL groups for either ipsilateral or contralateral activator presentation modes for the Clinical or AAW methods. There were significant group mean differences for the 1 and 2 kHz tonal activators and BBN activator for both ipsilateral and contralateral modes with greater differences in ART between groups for the AAW method than the Clinical method. In these conditions, the mean ART was lower for the AAW tests relative to the Clinical test. The greatest difference between groups was for the ipsilateral AAW tests for the comparison of NH with moderate SNHL for the BBN activator. This difference was approximately 20 dB for the AAW tests and 8 dB for the Clinical test. The ROC analysis showed that the area under the ROC curve (AUC) increased with the frequency of the activator stimulus and with the degree of hearing loss and was maximal for the BBN activator for both the AAW and Clinical methods for both ipsilateral and contralateral presentations. For ipsilateral and contralateral ART tests for activator frequencies above 0.5 kHz and BBN, listeners with SNHL generally had elevated ARTs compared with those with NH. The AAW method resulted in greater differences between SNHL groups and NH than the Clinical method. The AUC for detecting SNHL also increased with activator frequency and degree of hearing loss and was greatest for the BBN activator for the AAW method in both the ambient and TPP conditions. The results are encouraging for the use of an AAW ART method for the assessment of individuals with SNHL.

Efficacy of hearing aid treatment on sound perception and residual hearing preservation in patients with tinnitus and coexisting hearing loss: study protocol for a randomized controlled trial

BackgroundChronic subjective tinnitus poses significant challenges in clinical practice, and it is usually associated with hearing impairment, particularly with high-frequency sensorineural hearing loss (SNHL). Patients suffering from tinnitus with SNHL experience one of the most severe sensory disabilities, and this has devastating effects on their quality of life. Nowadays, mild to moderate SNHL can be managed with a properly fitted hearing aid (HA) that provides sound amplification, and several studies suggest that HAs may also benefit those with tinnitus. However, inadequate attention has been paid by medical personnel to the impact of HA use in residual hearing protection for patients with tinnitus and coexisting SNHL, and existing evidence is still at a preliminary stage. This study aims to identify and evaluate the efficacy of the use of HAs in both sound perception and residual hearing preservation among patients with tinnitus and coexisting SNHL.Methods and designThe present study is a prospective, single-center, outcome assessor and data analyst-blinded, randomized, controlled trial. Eligible participants will be recruited and randomly allocated into the HA intervention group and the waiting list control group at a ratio of 1:1. The primary outcome is to evaluate the severity of tinnitus using the Tinnitus Handicap Inventory as a continuous variable at 6 months from randomization. Secondary outcome measures include changes in hearing status and mental states. The trial will last 6 months, with follow-up visits at 3 months and 6 months.DiscussionThis will be the first randomized, controlled trial to identify and evaluate HAs’ efficacy on residual hearing preservation among tinnitus patients with coexisting high-frequency SNHL in China. We are aiming for novelty and generalizability, and strengths of this study are that it will examine the effectiveness of HA in patients with tinnitus and hearing impairment and will further explore the residual hearing protection provided by HA treatment in the tinnitus group.Trial registrationClinicalTrials.gov NCT05343026. Registered on April 25, 2022

Hearing Loss from S. Suis Meningitis In A Middle-Aged Couple

Hearing Loss from S. Suis Meningitis In A Middle-Aged Couple

Results of the detailed examinations in patients suffering from tinnitus

Introduction: Tinnitus is a sound without an external sound stimulus, usually only perceived by the sufferer. Inner ear damage might be found in its background, although many other possible causes exist. Therefore, there is a need for a detailed examination in all cases. Method: In the present investigation, 100 patients (38 men, 62 women; mean age +/- SD: 59 years +/- 11.3) suffering from tinnitus were enrolled. The data and examination results of these patients were analysed in detail. The outcomes of the brain MRI, carotid-vertebral ultrasound, cervical X-ray, pure-tone audiometry, and tinnitometry were analyzed regarding the detailed examinations. Results: In terms of tinnitus laterality, left-sided (34%) and both-sided (53%) were the most frequent ones. The frequency of the examinations was the following: audiometry and tinnitometry (100%), cervical X-ray (80%), cerebral MRI (76%) and carotid-vertebral Doppler ultrasound (21%). Cervical spondylosis/spondyloarthrosis (69 patients), vascular encephalopathy (56 patients) and atherosclerosis of the carotid artery (20 patients) were observed as the most common aberrations. Using the audiometry, normal hearing was detected in 14%, slight sensorineural hearing loss in 25%, moderate sensorineural hearing loss in 44% and severe sensorineural hearing loss in 17%. Tinnitometry detected tinnitus with a mean frequency of 4200 +/- 2200 Hz and intensity of 40 +/- 14.4 dB. Conclusion: The detailed examination of patients suffering from tinnitus is essential in multidisciplinary therapy planning. Possible complications in other organs can also be detected using the carotid-vertebral ultrasound as screening method. Based on the cervical X-ray, the somatosensory tinnitus form can be observed. Pure-tone audiometry and tinnitometry help detect hearing loss combined with tinnitus, pitch, and loudness, which are also essential in therapy planning.

Self-Perception of Hearing Difficulties and Quality of Life in Individuals with Hearing Loss.

Objectives: To characterize the results of the Short Form Health Survey-36 (SF-36), Abbreviated Profile of Hearing Aid Benefit (APHAB), and the Hearing Handicap Inventory for Adults (HHIA) questionnaires in individuals with mild to moderate sensorineural hearing loss and compare them with brainstem auditory evoked potentials (BAEPs). Methods: There were 26 individuals with mild to moderate bilateral symmetrical sensorineural hearing loss who participated in the study. They were aged between 13 and 59 years old, right-hand preference, of both sexes, and were assigned to one of two groups according to the result of a BAEP test: normal (n = 16) or altered (n = 10). All subjects underwent a brief, cognitive screening battery and answered the SF-36, APHAB, and HHIA self-assessment questionnaires. For analysis of results, descriptive measures and inferential analysis were used. Results: On the SF-36 questionnaire, scores below 80 points were found in both groups, signifying minimal impact in the domains of pain, general health, vitality, and mental health compared to the other domains. The results of the APHAB questionnaire showed worse scores on the environmental noise subscale, and evaluation with the HHIA revealed a perception of severe restriction in participation in daily life activities. In a comparison between the groups, normal or abnormal BAEPs, no significant differences were found for any of the questionnaires. Conclusions: The results of the self-assessment questionnaires indicate that individuals with hearing loss can experience reduced quality of life, with limitations and restrictions for participation in daily living. The use of BAEPs as a criterion for dividing the groups was not effective in isolating the central component in the results of the self-assessment questionnaires.

Prevalence of severity and type of hearing loss in Rheumatoid Arthritis patients

Rheumatoid arthritis (RA) is a chronic heterogeneous autoimmune disease characterized by painful joint inflammation which may cause destructive bone erosions. It also affects the auditory system and cause hearing loss. Objective: To find out the prevalence of Severity and type of Hearing Loss in Rheumatoid Arthritis Patients. Methods: Cross sectional descriptive study was conducted to find the prevalence of Severity and type of Hearing Loss in Rheumatoid Arthritis Patients. The study was performed at DHQ Hospital Bhimber, Mayo Hospital Lahore. The duration of data collection was 6 months (April 2022 to September 2022). Non-probability convenient sampling technique was used for data collection. Patients of both gender with ages 30 to 50 years were included. Patients with rheumatoid arthritis with other co-morbid factors were excluded. Results: Out of 117 patients, there were 33 (28.2%) male patients and 84 (71.8%) female patients. Most patients were in age group 41-45 years 38 (32.5 %). There were 19 (16.2%) lower class patients, 93 (79.5%) middle class patients and 5 (4.3%) upper class patients. The prevalence of Hearing Loss in Rheumatoid Arthritis patients was high 70 (59.5%). Sensorineural hearing loss 66 (56.4) was most prevalent. Majority of them had mild to moderate degree hearing loss 50 (42.7%). Conclusion: The study showed the prevalence of Hearing Impairment in Rheumatoid Arthritis was high. The result of this study also concluded that majority of the patients had mild to moderate degree sensorineural hearing loss.

Universal Newborn Screening for Congenital Cytomegalovirus Infection - From Infant to Maternal Infection: A Prospective Multicenter Study.

Introduction:Most infants at risk for cytomegalovirus (CMV)-associated sensorineural hearing loss (SNHL) are unrecognized because of the absence of a universal neonatal CMV screening. The search of CMV-DNA by molecular methods in salivary swabs was demonstrated to be a reliable approach. This study describes the results obtained by carrying out a universal screening for congenital CMV (cCMV) infection including all live-born newborns in three Italian sites, as well as the therapeutic interventions and clinical outcome of the CMV-infected neonates. Moreover, CMV maternal infection's characteristics were evaluated.MethodsTo confirm or exclude cCMV infection, a CMV-DNA-positive result on a first salivary swab was followed by repeated saliva and urine samples collected within 21 days of age. Breast milk samples were also collected. The search of CMV-DNA was performed with a single automated quantitative commercial real-time PCR assay, regardless of the type of samples used.ResultsA total of 3,151 newborns were enrolled; 21 (0.66%) of them were congenitally infected (median saliva viral load at screening, 6.65 [range, 5.03–7.17] log10 IU/ml). Very low/low viral load in screening saliva samples (median value, 1.87 [range, 1.14–2.59] log10 IU/ml) was associated with false-positive results (n = 54; 1.7%). CMV-DNA was detected in almost half of the breast milk samples of mother–infant pairs with a false-positive result, suggesting that contamination from breast milk may not be the only explanation in the study population. cCMV infection confirmation with the search of CMV-DNA in a urine sample proved to be the gold standard strategy, since false-positive results were observed in 4/54 (7.5%) of the repeated saliva samples. Symptomatic cCMV infection was observed in 3/21 (14.3%) infants; notably, one (4.7%) developed moderate unilateral SNHL at 5 months after birth. Finally, two symptomatic cCMV infections were associated with primary maternal infection acquired in the first trimester of gestation; one newborn with severe cCMV symptoms was born to a mother with no CMV checkups in pregnancy.ConclusionWithout universal neonatal CMV screening, some infected infants who develop late neurological sequelae may not be recognized and, consequently, they are not able to benefit early from instrumental and therapeutic interventions to limit and/or treat CMV disease.

Using Auditory Characteristics to Select Hearing Aid Compression Speeds for Presbycusic Patients

ObjectivesThis study aimed to select the optimal hearing aid compression speeds (fast-acting and slow-acting) for presbycusic patients by using auditory characteristics including temporal modulation and speech-in-noise performance.MethodsIn total, 24 patients with unilateral or bilateral moderate sensorineural hearing loss who scored higher than 21 on the Montreal Cognitive Assessment (MoCA) test participated in this study. The electrocochleogram (ECochG) results, including summating potentials (SP) and action potentials (AP), were recorded. Subjects' temporal modulation thresholds and speech recognition at 4 individualized signal-to-noise ratios were measured under three conditions, namely, unaided, aided with fast-acting compression (FAC), and aided with slow-acting compression (SAC).ResultsThe results of this study showed that modulation discrimination thresholds in the unaided (−8.14 dB) and aided SAC (−8.19 dB) conditions were better than the modulation thresholds in the FAC (−4.67 dB) conditions. The speech recognition threshold (SRT75%) for FAC (5.21 dB) did not differ significantly from SAC (3.39 dB) (p = 0.12). A decision tree analysis showed that the inclusion of the AP, unaided modulation thresholds, and unaided SRT75% may correctly identify the optimal compression speeds (FAC vs. SAC) for individual presbycusic patients with up to 90% accuracy.ConclusionBoth modes of compression speeds improved a presbycusic patient's speech recognition ability in noise. The SAC hearing aids may better preserve the modulation thresholds than the FAC hearing aids. The measurement of AP, along with the unaided modulation thresholds and unaided SRT75%, may help guide the selection of optimal compression speeds for individual presbycusic patients.

Inner Ear Hemorrhage : A Cause of Sensorineural Hearing Loss in Leukemia

Inner Ear Hemorrhage : A Cause of Sensorineural Hearing Loss in Leukemia

Listening Effort in Hearing Aid Users: Is It Related to Hearing Aid Use and Satisfaction?

Listening effort is primarily reflective of real-world performance. Therefore, it is crucial to evaluate the listening effort to predict the performance of hearing aid (HA) users in their daily lives. This study aimed to investigate the relationship between listening effort, daily HA use time, and HA satisfaction. This is a cross-sectional study. Thirty-three bilateral behind-the-ear HA users (17 females and 16 males) between 19 and 37 years were participated. All participants had bilateral, symmetric, moderate sensorineural hearing loss and at least 6 months of experience using HAs. The pure-tone average thresholds (PTA) of the participants' left and right ears were 55.34 ± 4.38 and 54.85 ± 5.05, respectively. First, daily HA use times of the last 30 days were derived from data logging. Second, participants were asked to fill in the Satisfaction with Amplification in Daily Life Scale questionnaire (SADL). Lastly, participants performed the dual-task paradigm to evaluate listening effort. The dual-task paradigm consisted of a primary speech recognition task that included three different individualized signal-to-noise ratio (SNR) conditions, that is, SNR100, SNR80, and SNR50, which the participant could understand 100, 80, and 50% of the speech, respectively. The secondary task was a visual reaction time task that required participants to press the key in response to a visual probe (an image of a white or red rectangle). Multiple linear regression analyses were used to model the effect of factors (daily HA use time and HA satisfaction) on reaction times (RT) of each three individualized SNR sessions. Mean daily HA use time of the participants was 5.72 ± 4.14 hours. Mean RTs of SNR50, SNR80, and SNR100 conditions were 1,050.61 ± 286.49, 893.33 ± 274.79, and 815.45 ± 233.22 ms, respectively. Multiple linear regression analyses showed that daily HA use time and HA satisfaction are significantly related to listening effort in all SNR conditions. For SNR80 condition; F (2,30) = 47.699, p < 0.001, with an adjusted R 2 of 0.745. As far as we know, this study is the first to demonstrate a strong link between listening effort, daily HA use time, and HA satisfaction. Evaluating listening effort following the HA fitting session may provide preliminary information about the treatment success of HA.

Hearing Profile of Children Below Three Years Old at Jatinangor Integrative Health Care Center, West Java, Indonesia

Background: Hearing function is one of the most important factors affecting children’s development process. The first three years of life is a golden period of growth and development of children. This study was conducted to investigate the hearing profile of children below three years old at Jatinangor Integrative Health Care Center (Pos Pelayanan Terpadu, Posyandu), West Java, Indonesia. Methods: An observational cross-sectional study was conducted to 86 children below three years old who was selected by using multistage cluster sampling at 12 Posyandu in Jatinangor sub-district by using in-depth interview related to hearing loss risk factors, reaction test, and tympanometry test. Results: The hearing loss prevalence of children below three years old in the Jatinangor sub-district was 7.0%. Of the 86 children, there were 2.3% (n=2) children with moderate conductive hearing loss, 1.2% (n=1) children with moderate sensorineural hearing loss, and 3.5% (n=3) children with very severe sensorineural hearing loss. Fifty percent of children with sensorineural hearing loss were discovered without any risk factor. Conclusions: The prevalence of hearing loss in children under three years old at the Jatinangor Integrative Health Care Center is slightly higher than the national prevalence. Fifty percent of children are found without risk factors, therefore Universal Newborn Hearing Examination (UNHS) needs to be implemented at the national level in accordance with the guidelines of the Joint Committee for Infant Hearing (JCIH) in which are integrated with primary health care units, tertiary health care centers otorhinolaryngology, and also the audiological center.

Frequency and Severity of Auditory Impairment in Children with Cerebral Palsy in a Selected Tertiary Health Care Centre

Cerebral palsy is the most common chronic motor disorder in children and frequently associated with sensorineural pathology. Deafness is very important public health concern. Because it determines long-term life span disability in individuals, decrease their quality of life. To observe the rate of occurrence of hearing impairment in children with cerebral palsy (CP) and to assess the severity of hearing impairment children with CP and correlate the auditory impairment with different types of CP were aim of the study. Total 50 children with Cerebral Palsy were taken. A structured questionnaire was filled up including history of patient and important variables related to hearing status like family history of deafness, consanguinity, antenatal history, preterm LBW, perinatal asphyxia, kernicterus, neonatal septicemia, neonatal seizure and meningitis were included in study. Physical examination and neurological examination like hearing, vision, motor, cognitive, speech delay were assessed. In this study, among the 50 children with CP, Tympanometry showed that negative middle ear pressure was 32% in spastic quadriplegia (SQ), 24% in spastic hemiplegia (SH), 16% in spastic diplegia (SD) and 24% in mixed type. Eustachian tube dysfunction was 62.5% in spastic hemiplegia. Secretory otitis media was 36.4% in spastic quadriplegia. Auditory brain stem response revealed severe sensorineural hearing loss was 8% in spastic quadriplegic type. Moderate sensorineural hearing loss was 2% in spastic hemiplegia group. Hearing loss was frequent in children with Cerebral Palsy. Spastic Quadriplegic cerebral palsy patients had the maximum incidence of hearing impairment.

The relationships between language, working memory and rapid naming in children with mild to moderate hearing loss

ObjectiveHearing loss is associated with reduced quality and quantity of auditory input, and difficulty in cognitive and language skills. This study aimed to investigate the relationship between language, working memory, and rapid naming skills in children with mild to moderate sensorineural hearing loss (MMHL). MethodsTwenty children with MMHL with the same auditory experience and demographical conditions using bilateral hearing aids were included. Verbal memory subscale of the Working Memory Scale (WMS), consisting of verbal short-term memory (V-STM) and verbal working memory (V-WM) subtests, was administered to all participants. They also completed rapid automatized naming tasks and standardized language measures. ResultsThe language score showed a moderate and significant correlation with verbal memory (VM) score (p = 0.03, r = 0.48) and a moderate and negative correlation with rapid automatized naming (RAN) duration (p = 0.06, r = −0.61). The VM score showed a moderate and significant negative correlation with RAN duration (p = 0.01, r = −0.67). The language level has a strong and significant positive correlation with V-STM (p = 0.007, r = 0.60), V-WM (p = 0.009, r = 0.58), and VM level (p = 0.003, r = 0.65). VM subtests levels have a strong and significant positive correlation with each other (p = 0.017, r = 0.53). RAN level has a strong and significant negative correlation with VM (p = 0.001, r = −0.70), V-WM (p = 0.001, r = −0.76), V-STM (p = 0.001, r = −0.69), and language level (p = 0.001, r = −0.77). ConclusionThe results suggest that the language, verbal working memory, and rapid naming skills of children with MMHL are closely related. It is recommended that the relationship between verbal short-term memory, verbal working memory, rapid naming skills, and language skills should be considered in therapeutic and educational settings. To the best of our knowledge, this is the first study to examine the relationships between verbal-short-term -working memory, duration of rapid automatized naming, and language skills in children with MMHL.

Formant-frequency discrimination in listeners with hearing loss: Behavioral results and neural models

In responses of the healthy ear to harmonic sounds, the amplitude of f0-related fluctuations of auditory-nerve (AN) responses varies along the tonotopic axis. Neural fluctuation amplitudes encode spectral peaks, including formant frequencies of vowels, because responses of inner-hair-cells (IHCs) tuned near spectral peaks are captured (or dominated) by a single harmonic, resulting in lower fluctuation amplitudes than IHCs tuned between spectral peaks. This code is robust across a wide range of sound levels and in background noise, and is converted into a rate-place representation in the auditory midbrain, where neurons are sensitive to low-frequency fluctuations. This neural-fluctuation code is vulnerable to sensorineural hearing loss (SNHL), because it depends upon saturation of IHCs and the interaction of cochlear amplification with IHC transduction. We tested formant-frequency discrimination in listeners with normal hearing or mild to moderate SNHL. The difficulty of the task was modulated by varying formant bandwidth. The relationship between spectral peaks and harmonic frequencies was also varied. Formant frequencies were 600 and 2000 Hz, in the range of first and second formants of many vowels. Results were compared to predictions made using model AN and midbrain neurons, with audiograms for the individual listeners included in the peripheral model. [Work supported by NIDCD-R01-001641]

Hearing Loss, Congenital HIV, and Medulloblastoma: A Case Report

Hearing Loss, Congenital HIV, and Medulloblastoma: A Case Report

Effect of Hearing Rehabilitation Therapy Program in Hearing Aid Users: A Prospective Randomized Controlled Study.

ObjectivesDespite sufficient hearing gains, many patients with hearing loss have difficulty using hearing aids due to poor word recognition ability. This study was performed to introduce our hearing rehabilitation therapy (HRT) program for hearing aid users and to evaluate its effect on hearing improvement.MethodsIn this prospective randomized case-control study, 37 participants with moderate or moderate-severe sensorineural hearing loss who had used bilateral hearing aids for more than 3 months with sufficient functional hearing gain were enrolled in this study. Nineteen participants were randomly assigned to the control group (CG) and 18 patients were assigned to participate in our HRT program once a week for 8 consecutive weeks (hearing rehabilitation therapy group [HRTG]). Their hearing results and questionnaire scores for hearing handicap and hearing aid outcomes were prospectively collected and compared between the two groups.ResultsAfter completing 8 weeks of the HRT program, the HRTG showed a significantly greater improvement in scores for consonant-only and consonant-vowel sound perception than the CG (P<0.05). In addition, the HRTG showed a significant improvement in hearing ability as measured by two questionnaires (P<0.05), while no differences were observed in the CG. However, word and sentence recognition test results did not show significant differences between the two groups.ConclusionEven after short-term HRT, patients had subjectively better hearing outcomes and improved phoneme perception ability; this provides scientific evidence regarding a possible positive role for HRT programs in hearing aid users. Further validation in a larger population through a long-term follow-up study is needed.

The Characteristics of Patients with Presbycusis in Bandung in 2019

Presbycusis is a progressive hearing loss that is associated with aging. The audiogram shows a sensorineural hearing loss at high frequency on both side. Hearing loss is the second largest disability experienced by the elderly with 30-35% of people aged 65-75 years experiencing presbycusis in Indonesia. This study aims to review the characteristics of patients with presbycusis in Bandung. This is a descriptive cross-sectional study, conducted from March to May 2019 at the West Java Province Social Protection Center, Dorkas Nursing Home, and Alamanda Nursing Home. The inclusion criteria was all residents with hearing loss and the exclusion criteria was congenital deafness. This study was participated by 135 subjects, 87 women (64.44%) and 48 men (35.56%). Presbycusis was found mainly in 63 women (71.59%), older than 65 years (57.95%), with moderate (32.95%) sensorineural and mixed hearing loss (65.19%). The most common symptom complained was tinnitus (68.18%). In conclusion, presbycusis was mainly found in female aged ?65 years old, with tinnitus and moderate hearing loss as chief complaint. The most common comorbidity was hypertension. However, in individuals with risk factors, presbycusis can be found sooner.&#x0D; Keywords: hearing loss, sensorineural, elderly, presbycusis

Prevalence of abnormal vestibular responses in children with sensorineural hearing loss.

Dysfunction of the vestibular organs has a great deal of influence on children's balance. Children with sensorineural hearing loss (SNHL) may often have accompanying abnormal vestibular responses. Video head impulse test (vHIT) combined with a test battery of cervical and ocular vestibular evoked myogenic potentials (cVEMPs, oVEMPs) make it possible to determine the prevalence of abnormal vestibular response in any of the five paired vestibular organs amongst children with SNHL. Prospective cross-sectional study including children aged 3-17years with uni- or bilateral SNHL (bone-conduction (BC) pure tone average (PTA4) above 20dB). Assessments included vHIT, cVEMP, and oVEMP. Descriptive data were analyzed. T-tests were performed to detect any correlation between the degree of SNHL and abnormal vestibular responses. 42 children (27 males), a total of 63 ears with SNHL, mean BC PTA4 SNHL of 42.3dB (32.0; 58.4 IR) were included. 28.6% had at least one ear with abnormal vestibular response. 97.6% (41/42) completed one and 75.0% (27/36) completed all vestibular examinations. Ears with two pathological examinations had significantly more severe SNHL than ears with one pathological or normal vestibular examinations (p = 0.008, p = 0.005). All test methods used with this study were easy, fast, and comfortable for children (as young as 3years of age) to undergo. Even a moderate SNHL might be associated with abnormal vestibular response. Structural damage to the organs is the most likely cause of vestibular deficit. Consensus on criteria defining pathological examinations with both vHIT and VEMPs are required for more accurate comparison with previous studies.

Electrical stimulation of the cochlea for treatment of chronic disabling tinnitus: an open-label trial towards the development of an implantable device

BackgroundChronic tinnitus affects millions of people globally and constitutes the most commonly compensated disability among military service members in the United States. Existing treatment options largely surround helping patients cope with their disease as opposed to directly suppressing tinnitus perception. The current study investigated the efficacy of electrical stimulation of the cochlea on chronic disabling tinnitus.MethodsIn this single-arm, open-label clinical trial, 22 adult subjects with severe-range asymmetric or unilateral non-pulsatile tinnitus underwent electrical stimulation of the cochlea through use of an extra-cochlear electrode positioned on the cochlear promontory. Each subject underwent 3 stimulation treatments over 3 weeks at 7-day intervals. Tinnitus severity was determined by Tinnitus Handicap Inventory (THI), Tinnitus Functional Index (TFI), and Tinnitus Visual Analog Scale (VAS). Inclusion criteria required subjects have no worse than moderate sensorineural hearing loss determined by pre-enrollment audiometric testing. The primary outcome was nadir post-treatment THI scores, obtained at seven timepoints following electrical stimulation, with clinically significant improvement defined as a decrease of ≥ 7.ResultsAll 22 (100%) subjects experienced clinically significant improvement in the THI during the study period with a mean decrease in scores of − 31 (95% CI − 38 to − 25) from a baseline of 48. Twenty (91%) experienced clinically significant improvement detectable on at least two of the three tinnitus survey instruments and 17 (77%) experienced clinically significant improvement detectable on all three survey instruments (i.e., THI, TFI, and VAS). Eight (36%) subjects reported either complete (THI of 0; n = 3) or near-complete (THI 1–4; n = 5) suppression of their tinnitus following a stimulation session. Thirteen (59%) subjects reported a nadir following stimulation at or below the threshold for “no or slight handicap” on the THI (≤ 16). No adverse events were observed.ConclusionsThese findings establish the foundation for the development of an extra-cochlear implantable device that delivers electrical stimulation to the cochlea for the treatment of disabling tinnitus. For patients considering device implantation, trans-tympanic cochlear promontory stimulation can facilitate patient selection.Trial Registration ClinicalTrials.gov Identifier: NCT03759834. URL: https://clinicaltrials.gov/ct2/show/NCT03759834