Normal Hearing Thresholds Research Articles

Behavioral and Electrophysiological Assessment of Central Auditory Processing in Individuals with Sickle Cell Disease.

Sickle cell anemia has a genetic origin characterized by an autosomal recessive inheritance pattern. The nervous system may be subject to vaso-occlusion and, consequently, affect the proper functioning of the central portion of hearing. To assess central auditory skills and analyze short- and long-latency auditory evoked potentials in children with sickle cell disease. Cross-sectional study. All children had normal hearing thresholds, and their central auditory processing underwent behavioral assessment with a battery of tests involving dichotic and monotic listening, binaural interaction, and temporal processing. The electrophysiological assessment used short- and long-latency auditory evoked potentials. Descriptive statistics were performed. Of the 28 subjects evaluated (mean age of 9.46years), 18 were females and 10 were males. Central auditory processing disorder was identified in 85.7% of the children. The auditory skills of figure-ground for verbal sounds, binaural interaction, and complex temporal ordering were the most affected. An increase in the absolute latencies of Waves III and V was observed in the short-latency potential. Individuals with sickle cell disease have central auditory processing disorder, identified primarily by behavioral assessment.

Hearing loss and vestibular dysfunction in congenital CMV infection: could it be due to endolymphatic pressure anomaly? A preliminary study

ObjectivesTo describe the inner ear sectors after an inner ear MRI protocol and search for the presence of endolymphatic pressure anomaly in patients presenting with a congenital CMV infection and audio-vestibular dysfunction. MethodsA 3D FLAIR MRI sequence, 4 hours after gadolinium injection, was performed in patients with sensory-neural hearing loss secondary to a congenital CMV infection in order to analyse the morphology of the endolymphatic space. ResultsTwo patients presented with a unilateral SNHL and 4 patients a bilateral SNHL. Seven ears with SNHL demonstrated an endolymphatic hydrops on MRI images and 2 showed a membranous labyrinth atelectasis. All ears but two had a marked enhancement in the perilymph of the basal turn of the cochlea. One ear, with a normal hearing threshold but altered vestibular function, demonstrated cochlear and saccular hydrops. Two ears with normal or near normal hearing and normal vestibular function were radiologically normal on the MRI. ConclusionThe compartmental endolymphatic study using delayed contrast-enhanced MRI sequences in children with cCMV infection suggests a relationship between inner ear involvement and endolymphatic pressure anomaly.

Hyperacusis and Tinnitus in Vestibular Migraine Patients.

To estimate the prevalence of tinnitus and hyperacusis in patients with vestibular migraine (VM), and to define the association with hearing loss, anxiety, and depression. A cross-sectional, multicenter study including 51 adult patients with definite or probable VM, defined according to the Barany Society diagnostic criteria. Audiological examinations were performed by pure tones extended to high frequencies to assess hearing thresholds. Psychoacoustic (pitch, masking level, and residual inhibition) and psychometric assessment of tinnitus was performed in all patients that reported tinnitus with the following questionnaires: Tinnitus Handicap Inventory (THI), Hypersensitivity to Sound Questionnaire and Hospital Anxiety Depression Scale. Correlation and regression analyses were used to assess the relationship between THI scores hyperacusis, anxiety, and depression in patients with VM. Forty-five of 50 VM patients (90%) were females; 38 out of 50 (75%) patients reported tinnitus. In our series, the most common frequency (pitch) for tinnitus was 8000 Hz. Tinnitus was not associated with hearing loss in patients with VM and the hearing thresholds were similar in VM patients with or without tinnitus. Hyperacusis was reported in 35 (60%) individuals, and in patients with tinnitus, the THI scores were associated with higher scores in Hypersensitivity to Sound Questionnaire, and anxiety and depression subscales of Hospital Anxiety Depression Scale. There were differences in the distribution of hearing loss in patients with hyperacusis, however both groups did not exceed the normal hearing threshold (17.18 ± 13.43 patients with hyperacusis and 11.66 ± 5.41, p = 0.023 in patients without hyperacusis). Tinnitus is a common symptom in patients with VM and it is not related to hearing loss in the standard audiogram. Hyperacusis was associated with tinnitus, anxiety, and depression, but it was not associated with hearing thresholds.

Analysis of Prognostic Factors in Patients with Sudden Sensorineural Hearing Loss.

Background: To explore the relevant risk factors of poor prognosis in patients with sudden sensorineural hearing loss (SSNHL), constructing prognostic prediction model, formulating effective treatment strategies, and providing reliable theoretical basis for clinical prevention of and treatment for poor prognosis in SSNHL. Methods: A retrospective analysis was conducted on the clinical data of 123 patients with SSNHL who received treatment at Zhongxian People's Hospital of Chongqing from March 2022 to March 2024. According to the prognosis, they were divided into an effective group (68 cases with an average hearing threshold increase of ≥15 dB, as good prognosis) and an ineffective group (55 cases with an average hearing threshold increase of <15 dB, as poor prognosis). The clinical data from the two patient groups were subjected to both univariate and multivariate logistic regression analyses, allowing for the identification of factors associated with the prognosis of patients with SSHNL. The prediction accuracy of the model was calculated using the receiver operating characteristic (ROC) curves. Results: The results of univariate analysis showed that patients with disease onset time ≥7 days (X2 = 35.54, P < .01), past hearing loss (X2 = 5.05, P = .03), combined vertigo (X2 = 9.45, P < .01), and neutrophil-to-lymphocyte ratio (NLR) (t = 0.46, P = .04) were associated with poor prognosis of SSNHL. The results of multivariate logistic regression analysis showed that disease onset time ≥7 days [odds ratio (OR) = 0.09, P < .01], combined vertigo (OR = 0.24, P < .01), and NLR (OR = 0.92, P = .036) were independent risk factors for the poor prognosis of SSNHL. These factors could also be used as reliable indicators to predict the poor prognosis of SSNHL [area under the ROC curves = 0.766, 0.612, 0.553 respectively]. Conclusion: Disease onset time ≥7 days, combined vertigo, and NLR are independent risk factors and reliable indicators to predict the poor prognosis of SSNHL. Treatment strategies should be developed for high-risk patients of the above types to reduce the occurrence of poor prognosis.

Normative Data of Extended High Frequency Audiometry in Normal Hearing Subjects with Different Aged Groups.

Background/Objectives: Conventional audiometry assesses hearing in the frequency range of 250-8000 Hz, while humans can detect sounds from 20 to 20,000 Hz. Hearing sensitivity above 8000 Hz can be assessed through "Extended high-frequency audiometry (EHFA)", which is useful for early detection and monitoring of hearing loss and counseling for tinnitus patients. Despite its usefulness, age significantly affects hearing sensitivity. Currently, there are no standard hearing thresholds in the EHF range categorized by age groups in Thailand. In this study, the aim was to determine normative EHFA data across different age groups in a healthy Thai population. Methods: This study included 134 participants aged 18-70 years, categorized into five age groups. All participants had normal hearing thresholds and type A tympanograms bilaterally. Following this, EHFA measurement was performed. Results: Across all age groups, there was an observed increase in median hearing thresholds as age increased. In comparison, no significant difference in median hearing thresholds was found between individuals aged 18-30 and >30-40 years. However, those over 40 years had significantly higher median thresholds across all frequencies compared to those under 40 years (p < 0.05). Based on these findings, we propose two new subgroups of 18-40 years and >40-70 years. Median hearing thresholds for those aged 18-40 was ≤20 dB HL across most frequencies, except at 16,000 Hz (30 dB HL). In the >40-70 age group, thresholds ranged from 20 dB HL at 9000 Hz to 70 dB HL at 14,000 and 16,000 Hz. However, no significant differences were found in hearing thresholds between sexes and ear sides. Conclusions: In this study, normative EHFA data were established for healthy Thai adults, appropriately divided into two groups (18-40 and >40-70 years) for clinical use. Further studies with more participants per age group are also needed to validate the results.

Psychometric Evaluation of the Misophonia Impact Questionnaire using a Clinical Population of Patients Seeking Help for Tinnitus, Hyperacusis, and/or Misophonia.

Misophonia is a decreased tolerance of certain sounds related to eating noises, lip smacking, sniffing, breathing, clicking sounds, and tapping. While several validated self-report misophonia questionnaires exist, none focus solely on the impact of misophonia on the patient's life. Additionally, there are no available validated pediatric self-report measures of misophonia. Therefore, a tool was needed to assess the impact of misophonia on both adult and pediatric patients. To evaluate the psychometric properties of the 8-item Misophonia Impact Questionnaire (MIQ). This was a retrospective cross-sectional study. Patients who attended the Tinnitus and Hyperacusis Therapy Specialist Clinic in the United Kingdom seeking help for tinnitus, hyperacusis, and/or misophonia (n = 256). A subsample of children aged 16 years or younger (n = 15) was included for preliminary analyses of a version of the MIQ to be filled in by a parent (MIQ-P). Data were collected retrospectively from the records of patients held at the audiology department. These included demographic data, audiological measures, and self-report questionnaires taken as part of routine care. Descriptive statistics and psychometric analyses were conducted. The MIQ was analyzed for item difficulty, factor structure, reliability, and construct validity. Confirmatory factor analysis revealed that a one-factor model for the MIQ gave an excellent fit and its estimated reliability was excellent, with Cronbach's α = 0.94. The total MIQ scores were highly correlated with scores for the Hyperacusis Impact Questionnaire and Sound Sensitivity Symptoms Questionnaire. MIQ scores were not significantly correlated with scores for the Tinnitus Impact Questionnaire or average hearing thresholds. Preliminary data from the subsample indicated excellent internal consistency for the MIQ-P, with Cronbach's α = 0.92. The MIQ is a promising questionnaire for assessing the impact of misophonia. Future studies should focus on establishing test/retest reliability, identifying clinically significant change in MIQ scores, defining the severity of misophonia impact categories, and further exploring the psychometric properties of the MIQ-P.

Relation Between Glycated Hemoglobin Level and Hearing Loss in Type 2 Diabetic Patients.

Glycemic control and the efficacy of therapy in diabetic patients with type 2 diabetes during the previous 2-3 months are usually evaluated by measuring the glycated hemoglobin (HbA1c). Our aim is to study the correlation between serum glycated hemoglobin level (HbA1c) and the hearing thresholds in diabetic patients. A case-control study was conducted in the Audio-Vestibular Medicine Unit, xxxx University on 82 subjects. The subjects were divided into 2 groups: the first group consisted of 42 diabetic patients and the second group consisted of 40 healthy subjects. All the participants underwent a pure tone audiogram and speech audiometric evaluation. All participants also underwent diabetes laboratory assessments, including fasting blood glucose serum level and serum HbA1c level. The average hearing threshold at frequencies from 250 Hz to 16 000 Hz in both groups was calculated and correlated to different variables. Diabetic patients showed higher hearing thresholds than those of the control group, with an increasing tendency of elevation of the hearing threshold levels toward the higher frequencies in both groups. There was no statistically significant difference in the hearing thresholds between patients with diabetes < 5 years (20 subjects) and those with a duration of ≤ 5 years (22 subjects). Also, there was no statistically significant difference in the average hearing thresholds among type 2 diabetic patients based on fasting blood sugar level results, except at 16 000 Hz. Poor glycemic control status [Hb A1c ≥ 7%] is significantly associated with elevated hearing thresholds.

Consideration of Sufficient and Insufficient Benefits in Hearing Aid Fitting.

During hearing aid (HA) fitting, individuals may experience better speech discrimination at normal speech levels and worse discrimination at loud speech levels than without an HA. Therefore, we investigated factors that worsen speech discrimination when the speech sound level increases. Speech discrimination was measured in patients aged >20 years who had average hearing thresholds <90 dB on pure-tone audiometry. An insufficient benefit was defined as speech discrimination being better at 65 dB sound pressure level (SPL) with HAs than without HAs and worse at 80 dB SPL. Of the 251 participants (296 ears), 229 and 25 had sufficient benefit and insufficient benefit, respectively. Functional gains (FGs) of sufficient benefit were approximately 1/3 gain (1/3 G) at 500 and 4000 Hz and slightly larger at 1000 and 2000 Hz. Functional gains of insufficient benefit were approximately 1/2 G at 1000 and 2000 Hz, smaller at 500 and 4000 Hz, and approximately 1/3 G at 250 Hz. Moreover, the difference between 1/2 G and FG was significantly larger in the sufficient benefit group at 250 500, and 4000 Hz than in the insufficient benefit group. Additionally, the average compression ratio at 50-80 dB SPL in the insufficient benefit group was approximately 1.1 to 1.2, slightly lower than the standard values. Adjusting the compression ratio and lowering the FG to approximately 1.5 and 1/3 G, respectively, may help improve speech discrimination if it worsens with increasing sound levels during HA fitting.

Longitudinal Effect of Music Exposure on Hearing Among Vocal Performance Students

The effects of music exposure on vocal performers remain relatively unknown. This study aimed to assess the immediate and long-term effects of music and singing practice on the peripheral auditory system of vocal performers using otoscopy, pure-tone audiometry, and noise dosimetry. The hearing status, sound pressure levels (SPLs), and sound doses of 12 vocal performers with normal hearing at the study’s onset were evaluated. Pre- and post-study questionnaires regarding the participants’ otologic health and music-making activities, as well as repeated hearing evaluations, were implemented. Additionally, noise dosimetry was conducted on each participant’s most vocally active day of the week. Audiometric assessments generally revealed normal hearing thresholds, with some exceptions. Half of the participants exhibited elevated low-frequency thresholds and over half of the participants displayed emerging audiometric “notches” at 6000 Hz. Noise dosimetry measurements indicated that most of the participants were consistently exposed to SPLs during music-making activities that exceeded recommended limits. Questionnaire responses highlighted that the participants often engaged in extra-curricular music-making activities, frequently with piano accompaniment, and with little to no use of hearing protection devices. A few of the participants reported histories of otologic issues and potential hearing problems.

Efficacy Analysis of Endoscopic Type 1 Tympanoplasty for Chronic Suppurative Otitis Media with Otomycosis.

Objective: To analyze the clinical effect of tympanoplasty performed for chronic suppurative otitis media (CSOM) patients with otomycosis under the oto-endoscope. Methods: A retrospective analysis was conducted on the healing of the tympanic membrane and hearing improvement of 431 CSOM patients who underwent endoscopic type 1 tympanoplasty. The patients with CSOM were divided into the control group (n = 203, without otomycosis) and the trial group (n = 184, with otomycosis). The patients were followed up for at least 3 months. The graft uptake rate and hearing improvement were compared. Results: The graft uptake rate was 94.57% (174/184) in the trial group and 96.06% (195/203) in the control group, indicating no significant difference between the 2 groups. The preoperative and postoperative average air-conduction hearing thresholds of CSOM with otomycosis were 42.68 ± 11.46 dBHL and 33.01 ± 11.51 dBHL, respectively (P = .000). Mean air-bone gap (ABG) reduction values were 3.96 ± 7.20 dBHL and 3.34 ± 7.96 dBHL, respectively. There was no significant difference in the average ABG (P = .420) and average air-conduction hearing threshold (P = .649) between the trial group and the control group after operation. The culture results of the CSOM group with otomycosis showed that the most common fungal genus was Aspergillus (87/173), with 32 cases of mixed infection of fungi and bacteria, and the most common mixed infection of bacteria was Staphylococcus epidermidis (9/32). The failure graft uptake was noticed in 8.8% (5/57) cases in the trial group with postoperative fungal infection and 3.9% (5/127) without otomycosis (P = .289). No significant difference was found in the successful healing rate among age, duration, perforation size, fungal type, postoperative fungal infection. Conclusion: CSOM with otomycosis is not a contraindication for endoscopic type 1 tympanoplasty, and external auditory canal fungal infection does not affect postoperative healing and hearing improvement. Intraoperative repeated rinsing with povidone-iodine may reduce the occurrence of postoperative infection.

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

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

Research on the prognosis and efficacy criteria of sudden sensorineural hearing loss

Sudden sensorineural hearing loss is a common and frequently-occurring disease. Looking at the efficacy evaluation of the diagnosis and treatment of sudden sensorineural hearing loss at home and abroad, each country has its own characteristics in the indicators and criteria of the treatment efficacy evaluation, and the common indicators of efficacy evaluation include: average pure-tone hearing threshold, the absolute value of hearing improvement of impaired frequency, the percentage of average pure-tone hearing threshold increase, speech discrimination score, speech recognition threshold, etc. The evaluation criteria mostly take the efficacy grade or the improvement level of average hearing threshold as the criterion of effective treatment, and the lack of unified standards is not conducive to the homogenization of global research related to sudden sensorineural hearing loss. In order to provide reference for the clinical evaluation of sudden sensorineural hearing loss in China, this study systematically reviewed the clinical practice guidelines and the evaluation indexes and criteria of clinical efficacy in high quality clinical multicenter studies of the disease in many countries.

The evaluation of auditory processing skills and late latencies in children with ventilation tube history

Objective(s): This study aims to evaluate the changes in temporal auditory processing skills in children who underwent bilateral ventilation tube insertion (VTI) due to Otitis Media with Effusion (OME) and the effect of these changes on speech comprehension in noisy environments. MethodsThis is a case-control study. In total, 60 children were included in the study in two groups. The control group included 30 children aged 11 to 15, who had normal hearing thresholds and normal immitancemetric evaluation, and were not diagnosed with OME. The study group included 30 children, aged 11–15 who underwent bilateral VTI surgery after their diagnosis of OME during the ages of 3–10 and currently had normal hearing thresholds and normal immitancemetric values. Each group underwent the Turkish Matrix Test (TMT), Random Gap Detection Test (RGDT), Frequency Pattern Test (FPT), Duration Pattern Test (DPT), and Cortical Auditory Evoked Potential Test (CAEP). ResultsWhen the temporal processing tests (FPT, DPT, RGDT) were compared, a significant difference was obtained between the study group and the control group (p < 0.05). With the TMT, significantly lower scores were obtained in the study group compared to the control group (p < 0.01). In addition, the latency values in the cortical auditory evoked potential test were longer in the study group compared to the control group, but these results were not statistically significant (p > 0.05). ConclusionAs a result of the study, it is concluded that the central auditory processing skills were affected in children with a history of bilateral VTI due to OME. Temporal processing tests, Turkish Matrix Test and Cortical Auditory Evoked Potential tests can be recommended as reliable and easily applicable tests, together with traditional hearing test methods in children with a history of OME, in order to evaluate comprehension skills in classroom noise.

Hidden hearing loss in a Charcot-Marie-Tooth type 1A mouse model.

Hidden hearing loss (HHL), a recently described auditory neuropathy characterized by normal audiometric thresholds but reduced sound-evoked cochlear compound action potentials, has been proposed to contribute to hearing difficulty in noisy environments in people with normal hearing thresholds and has become a widespread complaint. While most studies on HHL pathogenesis have focused on inner hair cell (IHC) synaptopathy, we recently showed that transient auditory nerve (AN) demyelination also causes HHL in mice. To test the effect of myelinopathy on hearing in a clinically relevant model, we studied a mouse model of Charcot-Marie-Tooth type 1A (CMT1A), the most prevalent hereditary peripheral neuropathy in humans. CMT1A mice exhibited the functional hallmarks of HHL together with disorganization of AN heminodes near the IHCs with minor loss of AN fibers. These results support the hypothesis that mild disruptions of AN myelination can cause HHL and that heminodal defects contribute to the alterations in the sound-evoked cochlear compound action potentials seen in this mouse model. Furthermore, these findings suggest that patients with CMT1A or other mild peripheral neuropathies are likely to suffer from HHL. Furthermore, these results suggest that studies of hearing in patients with CMT1A might help develop robust clinical tests for HHL, which are currently lacking.

Loss of C1q alters the auditory brainstem response.

Neural circuits in the auditory brainstem compute interaural time and intensity differences used to determine the locations of sound sources. These circuits display features that are specialized for these functions. The projection from the ventral cochlear nucleus (VCN) to the medial nucleus of the trapezoid (MNTB) body travels along highly myelinated fibers and terminates in the calyx of Held. This monoinnervating synapse emerges during development as multiple inputs are eliminated. We previously demonstrated that elimination of microglia with a colony stimulating factor-1 inhibitor results in impaired synaptic pruning so that multiple calyceal terminals reside on principal cells of MNTB. This inhibitor also resulted in impaired auditory brainstem responses (ABRs), with elevated thresholds and increased peak latencies. Loss of the microglial fractalkine receptor, CX3CR1, decreased peak latencies in the ABR. The mechanisms underlying these effects are not known. One prominent microglial signaling pathway involved in synaptic pruning and plasticity during development and aging is the C1q-initiated compliment cascade. Here we investigated the classical complement pathway initiator, C1q, in auditory brainstem maturation. We found that C1q expression is detected in the MNTB by the first postnatal week. C1q levels increased with age and were detected within microglia and surrounding the soma of MNTB principal neurons. Loss of C1q did not affect microglia-dependent calyceal pruning. Excitatory and inhibitory synaptic markers in the MNTB and LSO were not altered with C1q deletion. ABRs showed that C1q KO mice had normal hearing thresholds but shortened peak latencies. Altogether this study uncovers the developmental time frame of C1q expression in the sound localization pathway and shows a subtle functional consequence of C1q knockdown.

Noise-induced cochlear synaptopathy in C57BL/6 N mice as a function of trauma strength: ribbons are more vulnerable than postsynapses.

Noise-induced cochlear synaptopathy is characterized by irreversible loss of synapses between inner hair cells (IHCs) and spiral ganglion neurons (SGNs) despite normal hearing thresholds. We analyzed hearing performance and cochlear structure in C57BL/6 N mice exposed to 100, 106, or 112 dB SPL broadband noise (8-16 kHz) for 2 h. Auditory brainstem responses (ABRs) were assessed before, directly after, and up to 28 days post-trauma. Finally, the number, size, and pairing of IHC presynaptic (CtBP2-positive) ribbons and postsynaptic AMPA receptor scaffold (Homer1-positive) clusters were analyzed along the cochlea. Four weeks after the 100 dB SPL trauma, a permanent threshold shift (PTS) was observed at 45 kHz, which after the higher traumata extended toward middle to low frequencies. Loss in ABR wave I amplitudes scaled with trauma strength indicating loss of functional IHC synaptic connections. Latencies of wave I mostly increased with trauma strength. No trauma-related OHC loss was found. The number of synaptic pairs was reduced in the midbasal and basal cochlear region in all trauma conditions, with ribbon loss amounting up to 46% of control. Ribbons surviving the trauma were paired, whereas 4-6 unpaired postsynapses/IHC were found in the medial, midbasal, and basal regions irrespective of trauma strength, contrasting findings in CBA/CaJ mice. Our data confirm the susceptibility of ribbon synapses and ABR wave I amplitudes to a noise trauma of 100 dB SPL or larger. Notably, peripheral dendrites bearing IHC postsynapses were less vulnerable than presynaptic ribbons in C57BL/6 N mice.

Personal Listening Devices (PLDs) Usage and Auditory Effects among University Students in Egypt: A Cross-Sectional Study

Abstract Background The improper use of personal listening devices (PLDs) among young adults has been associated with an increased risk of hearing loss. Objectives This study aimed to investigate the PLDs listening practices among university students and to assess their auditory effects. Methods A cross-sectional study was conducted, involving a sample of 310 university students from Ain Shams University. The participants were conveniently selected from the Faculty of Medicine and Science. Participants were surveyed about their PLDs listening practices, including the daily duration of PLDs use, the volume at which they were typically used, and the number of years they had been using their PLDs. Participants were asked about common hearing problems associated with PLDs, and other risk factors for hearing loss were assessed. Hearing loss screening was done using the Five-minute hearing test (FMHT) and the “Hear WHO” mobile application. Participants who tested positive for hearing loss by both tests were referred for diagnostic pure-tone audiometry (PTA). Results Approximately 69% of the students used PLDs with an in-earpiece mainly during studying. A considerable proportion of students (53%) stated that they had been using their PLDs for over 5 years. Moreover, a notable percentage of students reported extended usage, with 83% using their PLDs for more than 60 minutes per day, and 72% using them at a volume level above 6. The majority of students (74%) were classified as low-risk users in terms of PLDs use. Thirty-three (10.6%) students tested positive for hearing loss on both screening tests, but only 5 (1.6%) had confirmed hearing loss by PTA. A Shift in the average hearing threshold at 4 kHz was detected in both ears, while remained within the normal range. Tinnitus was the most common symptom reported by 151 (49%) of the students, followed by ear pain reported by 130 (42%) of them. It was also detected that there was no statistically significant difference in hearing threshold levels based on the duration of PLDs use or the risk status of PLDs use. Moreover, in the multivariable logistic regression analysis, it was found that risk category of PLDs use was a significant predictor of tinnitus (OR: 2.69; 95% CI, 1.46-4.65), ear pain (OR: 2.62; 95% CI, 1.70-4.80), and excessive ear wax (OR: 2.43; 95% CI, 1.30-4.20) in higher risk categories compared to lower risk group. Conclusion Most students used PLDs for more than one hour daily with high volume (&amp;gt; 6). PLDs use was associated with auditory problems including tinnitus and ear pain. Regular hearing screenings is recommended for early detection of hearing loss among PLDs users.

Diotic narrowband noises can be perceived as intracranially off center in listeners with symmetrical audiometric thresholds

The ability to localize sound sources in the horizontal plane depends on the interaural time (ITD) and level (ILD) difference. It is assumed that individuals with normal and symmetrical hearing thresholds perceive stimuli with zero ILD and ITD as fused centered auditory images, which is not always true. This study aimed to explore ILD lateralization biases in individuals with normal hearing and explain whether they can be explained byan interaural asymmetry in monaural loudness. An ILD lateralization task was performed where the ILDs ranged between ±10 dB. The stimulus was a 1-equivalent-rectangular-bandwidth narrowband noise centered at 250–8000 Hz or a wideband noise. Preliminary results showed that the participants exhibited ILD lateralization biases more often at higher frequencies and minimal bias in the wideband condition. These biases were not caused by headphones, as the transducers were reversed between testing blocks. Biases were also consistent across up to three separate testing days. A loudness balancing task showed that participants perceived stimuli as equally loud, ruling out interaural asymmetry in monaural loudness. Audiometry also confirmed the absence of hearing threshold asymmetries. Therefore, lateralization biases in individuals with normal hearing are not explained by interaural disparities in loudness perception or hearing threshold asymmetry.

The Influence of Personal Listening Devices on Hearing in Egyptian University Students: A Cross-Sectional Study

Background: Improper use of personal listening devices (PLDs) is associated with an increased risk of hearing loss. The purpose is to investigate the use of PLDs among university students and their impact on hearing. Methodology: A study involved 310 University students, surveyed on their PLDs habits. They shared their daily PLD use, volume level, and duration of use. Participants also discussed PLD-related hearing issues and other risk factors for hearing loss. Screening used the Five-minute hearing test (FMHT) and the “Hear WHO” app. Positive cases in both tests received diagnostic pure-tone audiometry (PTA). Results: About 70% used in-earpiece PLDs for studying, 53% used them for over 5 years. Also 83% used PLDs for over 60 mins daily, and 72% used them above volume level 6. Most (74%) were low-risk users. 10.6% tested positive for hearing loss in both screenings, with 1.6% confirmed by PTA. A shift in the 4 kHz average hearing threshold was noted. Tinnitus was reported by 49%, and ear pain by 42% of students. Higher risk PLD use predicted tinnitus, ear pain and excessive ear wax in multivariable analysis. Conclusions: Students' high-volume PLD use is linked to auditory problems like tinnitus and ear pain. Regular hearing screenings are recommended.

Cochlear Synaptopathy Evaluation With Electrocochleography in Patients With Hearing Difficulty in Noise Despite Normal Hearing Levels.

This study examined patients with normal hearing thresholds who had trouble understanding speech in noise. We used electrocochleography (ECochG) to detect and compare SP/AP amplitude area ratios, a potential indicator of cochlear synaptopathy, and investigate speech perception disorder in noise. The study included 68 people aged between 18 and 65 years, 35 patients and 33 healthy volunteers, who applied to the otorhinolaryngology clinic between November 2023 and March 2024 with a 2-month history of difficulty understanding speech in noisy environments. Everyone was given a tiptrode electrode ECochG test, and the results were compared between groups. An ECochG test was recorded with tiptrode electrodes and was performed on all participants, and the results were compared between groups. In the ECochG test, the summation potential/action potential (SP/AP) amplitude and area ratios of patients who had difficulty understanding speech in a noisy environment were statistically higher than those of the control group. ECochG testing may provide additional evidence to evaluate auditory nerve pathways.