Normal Hearing Thresholds Research Articles

Psychometrically Equivalent Fante Speech Recognition Threshold Materials by a Female Talker.

This study aimed to create and evaluate digitally recorded speech materials for speech recognition threshold (SRT) testing among children and adults in Fante. Fifty-one (51) familiar trisyllabic words were chosen from a list of 107 widely used trisyllabic Fante words. They were digitally captured and edited to create the same root mean square as a 1-kHz calibration tone. The study used a three-phase cross-sectional study method. Twenty native Fante speakers with normal hearing thresholds were selected at random for listener evaluation. For each of the words, the researchers used logistic regression to measure the slope, intercepts, and psychometric function slope at 50% and from 20% to 80%. In the study, the intensity of each word was modified digitally, so that the threshold at 50% of each word was equal to the mean pure-tone average (PTA) of the participants to increase the homogeneity of the thresholds of the selected words. A final list of 25 familiar homogenous words with the same tone patterns of slopes greater than 7%/dB was finally selected and recorded for speech audiometry in Fante. Psychometrically equivalent trisyllabic words in Fante were successfully developed and evaluated for SRT testing in Ghana. There is a need for the development of speech audiometry materials in other Ghanaian languages.

Asymmetry of Occupational Noise Induced Hearing Loss: An Electrophysiological Approach.

Introduction The question as to whether occupational noise exposure causes symmetrical or asymmetrical hearing loss is still controversial and incompletely understood. Objective Two electrophysiological methods (cortical evoked response audiometry: CERA and auditory steady state responses: ASSR) were used to address this issue. Method 156 subjects with a well-documented history of noise exposure, a wide range of noise induced hearing loss (NIHL) and without middle ear pathology underwent both a CERA and an ASSR examination in the context of an exhaustive medicolegal expert assessment intended for possible compensation. Results Whatever the method (CERA or ASSR), the average electrophysiological hearing thresholds (1-2-3 kHz) are significantly worse in the left ear. The right - left differences in CERA and ASSR thresholds are strongly correlated with each other. No significant effect of frequency is found. No correlation is observed between right - left differences in hearing thresholds and either age or degree of hearing loss. Conclusion In NIHL, there is an actual average right - left difference of about 2.23 dB, i.e., 3.2%, the left ear being more impaired.

Is Pattern of Acceptable Noise Level Growth for Apparently Normal Contralateral Ear Similar to Affected Ear in Unilateral Meniere’s Disease?

Background and Aim: The Acceptance Noise Level (ANL) which determines the tolerable noise level while listening to running speech, is related to factors such as hearing loss and speech presentation level. This study aims to investigate the effect of speech presentation level on the ANL in people with unilateral Meniere’s Disease (MD) compared to the normal-hearing people. Methods: In this study, 33 people aged 32–60 years with unilateral MD and 38 normal-hearing people aged 20–46 years participated. The ANL growth was evaluated unilaterally at four different speech presentation levels: Most Comfortable Level (MCL), –10 dB lower than the MCL, +10 dB higher than the MCL, and a range between MCL and uncomfortable level. Results: In MD patients, the ANL of the affected ear was significantly different from that of the contralateral ear (p<0.010). Compared to the normal-hearing people, the pattern of ANL growth in MD patients was significantly different, but the ANL growth patterns were similar between the affected and contralateral ears. Conclusion: ANL and its growth pattern are different between the affected and contralateral ears of patients with unilateral MD, but are similar compared to normal-hearing people. Despite the apparently normal hearing thresholds, the performance of the contralateral ear in noise at various speech presentation levels in patients with unilateral MD seems to be similar to that of the affected ear. Keywords: Meniere disease; hearing loss; acceptable noise level

Real-time measurement of ambient noise levels during hearing screening in point-of-care settings

Access to hearing healthcare is a global issue that will necessitate several novel approaches to resolve. By evaluating the effectiveness of a hearing screening program in a non-traditional, acoustically hostile point-of-care setting, this study contributes to the global need for access to hearing healthcare. Specifically, this study measured the noise environment of a hearing screening conducted at the Minnesota State Fair, using a Sivantos Dosimeter and a custom Tabsint program, to measure ambient noise levels during hearing screenings using the Creare Wireless Automatic Hearing Testing System (WAHTS). The noise levels were measured and analyzed to determine the average and peak noise levels encountered during the hearing screenings. Normal hearing thresholds were obtained at ambient noise levels ranging from 40 to 65 dBSPL. These findings were compared to the recommended noise levels for hearing testing to determine whether current standards should be revised considering innovations aimed at improving access to hearing healthcare services in point-of-care settings.

Electrically evoked stapedial reflex threshold and behavioral method usefulness in the cochlear implant programming in pediatric population.

To determine the utility of the electrically evoked stapedial reflex test (ESRT) and behavioral method in the CIs programming as an objective method to identify MCL levels in the CIs programming in pediatric patients. Cross-sectional cohort study that included 20 pediatric patients with postlingual deafness and CI unilateral. They were performed clinical history, tympanometry, ESRT and by free field audiometry, before and after programming modifications according to MCL levels obtained by ESRT were performed. ESRT threshold was assessed with individual 300ms stimuli on the 12 electrodes and recorded through manual decay. Likewise, the maximum comfort threshold (MCL) of each electrode was obtained through a behavioral analysis. No significant differences were found between the ESRT and behavioral method in MCLs levels in each of the electrodes evaluated. In addition, the correlation coefficients were significant and located in a range of 0.55-0.81, higher in electrodes 7, 8, and 9 (r=0.77, 0.76, and 0.81, respectively). However, the median hearing threshold established by the ESRT was significantly lower compared to the behavioral threshold (36.0 vs. 47.0dB, p<0.0001), regardless of age (p=0.249) or the etiology of hearing loss (p=0.292). The difference between the tests was in the number of times to do it, the ESRT was done once and the behavioral on average 4±1 times. Similar MCL thresholds were obtained in both ESRT and behavioral test, establishing that both methods are reliable for use in pediatric patients; however, ESRT allows shortening the time to achieve normal hearing and language acquisition thresholds in a more optimal time.

Effect of noise and organic solvents on acoustic stapedial reflex

Objective Noise and solvents are two occupational exposures with possible hearing effects. We aimed to assess the effect of exposure to noise and organic solvents on acoustic reflex. Methods This cross-sectional study was conducted on three groups: 80 workers exposed to impermissible amounts of organic solvents (mainly styrene), 78 workers exposed to loud noise and 67 subjects as a control group. The hearing status of the subjects was assessed by pure tone audiometry and acoustic reflex. Data were analysed by SPSS (ver. 20) (SPSS Inc., Chicago, IL) using Student’s t-test, chi-square test and ANOVA. Results The mean hearing threshold at high frequencies was significantly higher in the noise group, followed by the solvent group, compared to the control group (p<.0001). Mean acoustic reflex was higher in the solvent group, followed by the noise group (p<.05). The frequency of absent acoustic reflex was also significantly higher in noise and solvent groups than in controls (p<.05). Conclusion This study suggests that exposure to organic solvents alone without simultaneous noise, despite a normal hearing threshold, can affect acoustic reflex, so conducting preventive hearing tests such as acoustic reflex test, in workers exposed to organic solvents, may be one of the effective ways to prevent occupational hearing loss in these workers.

Outcomes of transcanal endoscopic middle ear surgery for congenital cholesteatoma

Background Transcanal endoscopic surgery offers advantages for congenital cholesteatoma (CC) which is expanding cystic mass located on an intact tympanic membrane. Objectives To determine the efficacy of transcanal endoscopic ear surgery for the treatment of CC. Material and methods Eleven patients with CC confined to the middle ear underwent transcanal endoscopic ear surgery by surgeons who were skilled in otoscopic surgery. According to the Potsic classification, four, three, and four patients had lesions in stages 1, 2, and 3, respectively. The mean follow-up duration was 24.5 months. We retrospectively analyzed the recurrence rate, complications, and average hearing thresholds of the patients with CC. Results All CCs were successfully resected via the transcanal endoscopic approach, without any immediate or serious complications. The only complication was external auditory canal stenosis due to postoperative scarring, which occurred in a patient with a stage-3 cholesteatoma that recurred and required reoperation and second-stage ossicular chain reconstruction. Two more patients underwent one-stage ossicular chain reconstruction. All three patients received a total artificial ossicular replacement prosthesis, and two of them also received cartilage grafts. Conclusions and significance Transcanal endoscopic ear surgery is an effective method to treat CC belonging to Potsic stages 3 or below.

Research on early warning model of the hearing loss of workers exposed to noise

Objective: To explore the change of hearing threshold of workers exposed to noise, establish an individual-based hearing loss early warning model, accurately and differentiated the health of workers exposed to noise. Methods: In September 2019, all physical examination data of 561 workers exposed to noise from an enterprise were collected since their employment. Three indicators of average hearing threshold of the better ear, namely, at high frequency, 4000 Hz and speech frequency, were constructed. The generalized estimating equation (GEE) was used to adjust gender and age and establish the warning model of each indicator. Finally, sensitive indicators and warning models were screened according to AUC and Yoden index. Results: Among the 561 workers exposed to noise, 26 (4.6%) workers had hearing loss. The sensitivity indicators were the average hearing threshold at speech frequency ≥20 dB, high frequency ≥30 dB and 4000 Hz ≥25 dB. The AUC of each index was 0.602, 0.794 and 0.804, and the Youden indexes were 0.204, 0.588 and 0.608, respectively. In GEE of hearing loss warning models, high-frequency hearing threshold ≥20 dB and 4000 Hz hearing threshold ≥25 dB were the optimal models, with AUC of 0.862. Conclusion: Combined with the changes of individual hearing threshold over the years, can accurately assess the risk of individual hearing loss of workers exposed to noise.

STATE OF HEARING FUNCTION AND EUSTACHIAN TONSILS IN PATIENTS WITH SECRETORY OTITIS MEDIA AT DIFFERENT STAGES OF ITS DEVELOPMENT

The problem of hearing pathology is relevant as we have seen the number of those patients increasing yearly. According to the literature, about 30% of all cases of hearing loss are related to middle ear pathology. The cause of the development of many forms of hearing loss is the dysfunction of the Eustachian tube which can lead to retraction of the tympanic membrane, development of secretory otitis media or even adhesive otitis media that can be the reason for constant conductive hearing loss, and require surgical intervention to restore mechanism of sound conduction.&#x0D; Prevention and treatment of hearing disorders is not only a medical, but also a social-economic problem. In our researches, we’ve decided to study the peculiarities of hearing impairment in patients with secretory otitis media in different stages of its development, depending on the condition of the tubal tonsils and lymphoid tissue around the orifice of the Eustachian tube.&#x0D; The aim. Study the relationship between the state of auditory function and pathomorphological changes of the tubal tonsils and lymphoid tissue around the orifice of the Eustachian tube in patients with secretory otitis media in different stages of its development.&#x0D; Material and methods. There were examined 89 patients, age between 18 and 65 years old, with secretory otitis media. All patients were performed a detailed collection of complaints, disease anamnesis, examination of the ENT-organs – by a routine method and with the help of endoscopic and microscopic equipment, as well as pure-tone audiometry and tympanometry. Patients were divided into III groups. Group I – 21 patients with catarrhal stage of secretory otitis media, group II – 38 patients with serous stage, group III – 30 patients with mucous stage.&#x0D; The results. When examining patients with secretory otitis media during nasopharyngeal endoscopy, the changes in the tubal tonsils and surrounding area in the form of inflammation, hypertrophy, or hyperplasia were found. The form of these changes affects the nature of the disease stage. According to pure-tone audiometry, the average hearing thresholds at speech frequencies by air conductivity in all patients were significantly increased. At the same time, in patients of group III with mucous exudate in the middle ear space, average hearing thresholds by bone conduction were slightly increased, which is associated with significantly restricted or absent movement of the tympanic membrane and ossicular chain in the presence of thick mucous exudate.&#x0D; Conclusions. Analyzing the patients’ complaints, clinical picture, data of otoscopy, endoscopy of the nasal cavity and nasopharynx, data of pure-tone audiometry and tympanometry – there was determined a cause-and-effect relationship between the condition of the tubal tonsils, the stage of secretory otitis media and, accordingly, hearing impairment in the examined patients. The performed studies indicate that one of the reasons for the development of secretory otitis media in adults may be pathomorphological changes in the tubal tonsils and lymphoid tissue surrounding the orifice of the Eustachian tube, namely their pathomorphological changes: inflammation, hypertrophy, or hyperplasia. Inflammation of the tubal tonsils, as a rule, is the cause of the development of the catarrhal and serous stage of secretory otitis media, and their hypertrophy or hyperplasia leads to the long-term dysfunction of the Eustachian tube, which in turn is the cause of the mucous stage of secretory otitis media.

Objective multidisciplinary measurements of sleep disturbance and autonomic dysfunction as risk factors for chronic subjective tinnitus

This observational study assessed sleep disturbance and autonomic dysfunction as risk factors for chronic subjective tinnitus through polysomnography (PSG) and autonomic function tests. Adult patients with chronic subjective tinnitus who visited the department of otolaryngology in our hospitals (n=40), along with controls without tinnitus (n=80), were recruited. Individuals with an average hearing threshold level (HL) exceeding 25dB HL and a known diagnosis of insomnia were excluded. Objective assessments comprised pure-tone audiometry, PSG, and autonomic function tests (e.g., the cold pressor test). Patients with prolonged sleep latency, lower sleep efficiency, and sympathetic hyperactivity had significantly higher risks of developing tinnitus. No interaction effect between poor sleep quality and sympathetic hyperactivity on tinnitus was detected. This is the first study to administer PSG and autonomic function tests to patients with chronic subjective tinnitus. Poor sleep quality and autonomic dysfunction were implicated as risk factors for tinnitus. PSG and the autonomic function tests helped identify tinnitus-related comorbidities and inform tinnitus treatment. Sleep disturbance and autonomic dysfunction did not exert an interaction effect on tinnitus. Further studies with a larger sample size and the inclusion of patients with more severe tinnitus are warranted.

Influence of Gender on Auditory Temporal Processing: A Cross-sectional study in Security Personnel in Puducherry, India

ABSTRACT Introduction: It is no wonder that men and women have their fair share of differences. Scientific evidences are scarce to justify the clear-cut role of gender differences on the human brain. It is a well-known fact that perception and accurate processing of sound stimuli in the auditory pathway is a necessary skill for efficient learning and language development. This study aimed to investigate the role of gender on auditory processing by comparing the temporal resolution ability of healthy, adult males and females. Methods: Forty-three apparently healthy individuals (F = 18; M = 25) in the age group of 25–60 years with a normal hearing threshold on audiometry participated in this study. Audiometry and random gap detection test (RGDT) were used to assess hearing threshold and auditory temporal processing ability. In RGDT, a pair of pure tones was presented to participants’ ears at different frequencies (500–4000 Hz) and they were instructed to identify a silent-gap (in milliseconds) between each pair of tones. Values were compared using an unpaired student “t” test. Results: The mean age of participants was 40.5 ± 8.45 years. The average hearing threshold levels (in dB) of male and female participants were 15.6 ± 2.5 and 14.5 ± 2.8, respectively (P-value = 0.1293). Temporal processing values of males and females were 10.48 ± 0.49 and 10.67 ± 0.51, respectively (P-value = 0.2338). Conclusion: The temporal processing ability was slightly higher in males than the females. However, the difference was insignificant. Therefore, it can be concluded that gender does not affect auditory temporal processing ability in middle-aged adults.

Bone Auditory Thresholds Variations in Cholesteatoma Middle Ear Surgery

Objective: To investigate the changes of bone auditory thresholds variations in cholesteatoma middle ear surgery and its related factors and its related factors. Methods: 122 cases (122 ears) of unilateral cholesteatoma otitis media were treated by mastoidectomy and/or tympanoplasty plus stage I tympanoplasty, and tragus cartilage ring-cartilage membrane (Referred to as cartilage group, 62 ears) and temporalis muscle fascia (Referred to as fascia group, 60 ears) were used as tympanic membrane grafts respectively. The changes of bone conduction hearing threshold were compared between the two groups before and 1, 3, 6 months and 1, 3 years after operation. And compare the difference in the incidence of ossicular chain fixation or necrosis, vestibular window or cochlear window dysfunction between the two groups of patients with increased (positive) and decreased (negative) bone conduction threshold before operation. Results: Compared with the healthy side, 95 ears of 122 ears in the two groups had higher bone conduction hearing threshold before operation. Among them, 48 ears were in cartilage group and 47 ears were in fascia group; In 72 ears (76.34%) of these cases, the bone conduction hearing threshold decreased after operation, and the difference between the two groups was statistically significant (P < 0.01). During operation, 57 ears (79.17%, 57/72) were found to have ossicular chain or two windows dysfunction, including 30 ears in cartilage group and 27 ears in fascia group. Of the 27 patients with normal hearing threshold, 5 had the above-mentioned lesions, including 3 in cartilage group and 2 in fascia group. Conclusion: The improvement of bone conduction hearing threshold in patients with cholesteatoma otitis media is mainly related to the fixation or necrosis of ossicular chain and the dysfunction of two windows. The tragus cartilage ring-perichondrium tympanoplasty can not only reduce the air-bone conduction difference, but also reduce the bone conduction hearing threshold, which has the advantage of stable and lasting hearing improvement.

The Effect of Breathy Vocal Quality on Speech Intelligibility and Listening Effort in Background Noise.

Speech perception is challenging under adverse conditions. However, there is limited evidence regarding how multiple adverse conditions affect speech perception. The present study investigated two conditions that are frequently encountered in real-life communication: background noise and breathy vocal quality. The study first examined the effects of background noise and breathiness on speech perception as measured by intelligibility. Secondly, the study tested the hypothesis that both noise and breathiness affect listening effort, as indicated by linear and nonlinear changes in pupil dilation. Low-context sentences were resynthesized to create three levels of breathiness (original, mild-moderate, and severe). The sentences were presented in a fluctuating nonspeech noise with two signal-to-noise ratios (SNRs) of -5 dB (favorable) and -9 dB (adverse) SNR. Speech intelligibility and pupil dilation data were collected from young listeners with normal hearing thresholds. The results demonstrated that a breathy vocal quality presented in noise negatively affected speech intelligibility, with the degree of breathiness playing a critical role. Listening effort, as measured by the magnitude of pupil dilation, showed significant effects with both severe and mild-moderate breathy voices that were independent of noise level. The findings contributed to the literature by demonstrating the impact of vocal quality on the perception of speech in noise. They also highlighted the complex dynamics between overall task demand and processing resources in understanding the combined impact of multiple adverse conditions.

Hidden Hearing Loss: Causes, Current Knowledge, and Future Directions

Introduction: Hidden hearing loss (HHL) is a type of auditory disorder that affects the auditory neural processing and hearing sensitivity in subjects with normal hearing thresholds. Unlike central auditory processing disorders, HHL happens when the cochlea (the peripheral auditory organ) is affected. There are several known risk factors to HHL which includes noise exposure, ototoxic drugs, and peripheral neuropathies, and age. Recent studies have shed light on this type of hearing loss, its etiology, prevalence, and how it can affect the auditory acuity in humans. Methods: This paper covers the current research regarding HHL, its causes, the different mechanisms involved in this disorder, and the diagnosis and potential treatments related to it. We will delve deeply into different researches concerning HHL. 4 articles from 285 were selected focusing on normal hearing individuals with bad speech intelligibility were discussed in this paper. In addition, articles discussing the effects of noise exposure on hearing impaired individuals were not considered as this study solely aims to focus on normal hearing sensitivity individuals with HHL, resulting in 4 articles from 285. Results: Numerous literatures over the decades have suggested that HHL is due to the degeneration of cochlear ribbon synapses, or hair cells synapses without hair cell damage. Their association with HHL was noted several times through this study, whether we were studying the effect of noise exposure, of age, or of ototoxicity. In all cases, no significant hair cell damage was observed, and normal thresholds were recovered. However, a decline in the amplitude of Auditory Brainstem Response (ABR) peak I from auditory nerve (AN) responses in noise exposed subjects and a decline in compound action potential (CAP) was measured when certain drugs were applied to the round window of Guinea pigs. Conclusion: Most studies, have proven that cochlear synaptophysin is the major contributor to noise induced, age, and ototoxic related HHL. There are several audiometric tests that were used to help identify HHL including Puretone audiometry in background noise, ABR, CAP, Distortion Product Otoacoustic Emission (DPOAE).

Middle Ear Muscle Reflex in Normal-Hearing Individuals with Occupational Noise Exposure.

Noise-induced cochlear synaptopathy is studied extensively in animal models. The diagnosis of synaptopathy in humans is challenging and the roles of many noninvasive measures in identifying synaptopathy are being explored. The acoustic middle ear muscle reflex (MEMR) can be considered as a vital tool since noise exposure affects the low-spontaneous rate fibers that play an important role in elicitation of MEMR. The present study aimed at measuring MEMR threshold and MEMR strength. The study participants were divided into two groups. All the participants had normal-hearing thresholds. The control group consisted of 25 individuals with no occupational noise exposure whereas noise exposure group had 25 individuals who were exposed to occupational noise of 85 dBA for a minimum period of 1 year. MEMR threshold and strength was assessed for pure tones (500 Hz and 1000 Hz) and broadband noise. The results showed that the MEMR threshold was similar in both the groups. MEMR strength was reduced in noise exposure group compared to control group. The results of the study suggest that MEMR strength could be used as a sensitive measure in identifying cochlear synaptopathy with careful consideration of the stimulus characteristics.

Characterization of the Acoustic Reflex Latency Test in Adults with Normal Hearing

Objective: There are a limited number of studies on Acoustic reflex latency (ARL) test in the literature. In this study, we aimed to examine the ARL test results and parameters in young adults in Türkiye and evaluate the difference in interaural latency. Materials and Methods: A total of 50 individuals with normal-hearing thresholds, 25 females and 25 males, between the ages of 18 and 35 years were included in the study. Parameters of ARL; 10% – on latency, 90% – on latency, 10% – off latency, and 90% – off latency were recorded and analyzed in 500, 1000, 2000, and 4000 Hz frequencies. Study results were compared between ears and genders. Results: When comparing the right and left ears, ARL parameter values of men and women, 90% on and 10% off latency on the right and 90% on latency on the left ear, were found to be longer in women only at a frequency of 4000 Hz. At 500, 1000, and 2000 frequencies, no significant difference was observed between the genders. There was no interaural difference of ARL. As the frequency increased, it was observed that the ARL onset latencies were prolonged in both men and women. Conclusion: Our study indicated that there was no interaural difference of ARL in normal-hearing subjects. İnteraural difference of ARL may provide diagnostic information clinically.

A Case of Eosinophilic Otitis Media Implanted with Bone-Anchored Hearing Aid

Eosinophilic otitis media (EOM) is characterized by the presence of highly viscous middle ear effusion containing eosinophils, and is usually associated with bronchial asthma. Intratympanic corticosteroid administration and/or systemic steroid administration are effective treatments. However, the middle ear effusion and progressive hearing loss are difficult to control, significantly affecting the patient’s quality of life. Therefore, appropriate care is important not only for controlling the middle ear effusion and otorrhea, but also for preventing the progression of hearing loss.A 46-year-old woman was referred to our hospital with suspected eosinophilic otitis media. She had a history of asthma and aspirin sensitivity. In addition, she had recurrent nasal polyps despite having undergone nasal polypectomy on two occasions. She was diagnosed as having bilateral EOM according to the diagnostic criteria. She was started on steroid treatment, but after showing initial response, the middle ear effusion recurred immediately after withdrawal of steroid treatment. Although the patient also had difficulty in communication because of bilateral hearing loss, she could not wear hearing aids because of the middle ear effusion. Hearing aids sometimes aggravate middle ear infection by blocking aeration, increasing the risk of sensorineural hearing loss. Therefore, we implanted a bone-anchored hearing aid (Baha®) in her right ear. Average hearing threshold of 500, 1000 and 2000 was 35 dB using Baha®. Although audiometry revealed deterioration of the bone-conduction threshold in the right ear at five years after the Baha® implantation, she still had sufficient bone conduction hearing using Baha® because of the preserved bone-conduction in the contralateral ear. The Baha® hearing system is a clinically effective and good hearing rehabilitative device for patients with EOM.

Effect of Contralateral Acoustic Stimulation on Temporal Processing Abilities in Individuals with Normal Hearing.

The aim of the article was to compare the conditions of silent and contralateral noise on the temporal processing parameters. A total of 40 participants (20 males and 20 females) were enrolled in the study with a mean age of 21.7years, participants with normal hearing thresholds and no history of middle ear pathology were enrolled for the study. The temporal processing tests such as duration discrimination test, gap detection test, and temporal modulation transfer function tests were carried out in these 40 individuals in the two conditions of silent and contralateral noise using MATLAB. Statistical analysis was carried out using the SPSS version 25.0 were descriptive and inferential statistics were carried out. Data was normally distributed on the Shapiro-Wilk's test of normality due to which a paired t test was carried out to establish the nature of significance between the silent and contralateral noise condition. Results reveal the presence of significant difference (p < 0.01) between the groups for all the parameters of temporal resolution with contralateral noise condition performing better than silent condition for the parameters. There is a positive effect of the efferent auditory pathway on the temporal resolution parameters thus implying that speech perception in noise is improved in the presence of background noise for normal hearing individuals due to this effect.

Conductive Hearing Loss Estimated From Wideband Acoustic Immittance Measurements in Ears With Otitis Media With Effusion.

Previous work has shown that wideband acoustic immittance (WAI) is sensitive to the volume of effusion present in ears with otitis media with effusion (OME). Prior work also demonstrates that the volume of the effusion appears to drive, or at least play a significant role in, how much conductive hearing loss (CHL) a child has due to a given episode of OME. Given this association, the goal of this work was to determine how well CHL could be estimated directly from WAI in ears with OME. Sixty-three ears from a previously published study on OME (ages 9 months to 11 years, 2 months) were grouped based on effusion volume (full, partial, or clear) determined during tympanostomy tube placement surgery and compared with age-matched normal control ears. Audiometric thresholds were obtained for a subset of the 34 ears distributed across the four groups. An electrical-analog model of ear-canal acoustics and middle-ear mechanics was fit to the measured WAI from individual ears. Initial estimates of CHL were derived from either (1) average absorbance or (2) the model component thought to represent damping in the ossicular chain. The analog model produced good fits for all effusion-volume groups. The two initial CHL estimates were both well correlated (87% and 81%) with the pure-tone average hearing thresholds used to define the CHL. However, in roughly a third of the ears (11/34), the estimate based on damping was too large by nearly a factor of two. This observation motivated improved CHL estimates. Our CHL estimation method can estimate behavioral audiometric thresholds (CHL) within a margin of error that is small enough to be clinically meaningful. The importance of this finding is increased by the challenges associated with behavioral audiometric testing in pediatric populations, where OME is the most common. In addition, the discovery of two clusters in the damping-related CHL estimate suggests the possible existence of two distinctly different types of ears: pressure detectors and power detectors.

Clonazepam Usage Improves Chronic Tinnitus and Sleep Quality: A Prospective Cohort Study

Background and Objectives Tinnitus, although being a common chronic disease, can be an intractable disease that causes depression and insomnia. This study aimed to analyze the results of the Tinnitus Handicap Inventory (THI), Beck Depression Inventory (BDI), and Pittsburgh Sleep Quality Index (PSQI) questionnaire surveys before and after clonazepam therapy. In addition, we analyzed the association of three pre-treatment questionnaires and evaluated whether pre-treatment factors could predict the post-treatment THI index.Subjects and Method Patients were selected from those who visited a tertiary hospital from 2019 to 2021 for the treatment of chronic tinnitus they had for more than 3 months and who were over 20 years old. Patients were excluded from the study if they were diagnosed with acute sudden hearing loss, Meniere’s disease, brain/internal auditory canal tumors, or muscular/vascular tinnitus. The questionnaire surveys of THI, BDI, PSQI were conducted before and after 3 months of clonazepam therapy (Rivotril [Roche Inc.] 0.25 or 0.5 mg). Questionnaire scores were compared using the paired t-test. Multiple regression analysis was used to determine the relationships among the three questionnaires.Results A total of 76 patients (38 males and 38 females) with the mean age of 57.2±9.01 years was analyzed. The average hearing threshold was 30.4±20.67 dB HL on the right and 31.7±17.06 dB HL on the left. The pre-treatment THI, BDI, and PSQI scores were 44.3±23.4, 7.96±2.36, and 6.85±4.68, respectively. The relationships between the THI and BDI and the THI and PSQI were significant (&lt;i&gt;p&lt;/i&gt;=0.0027 and &lt;i&gt;p&lt;/i&gt;&lt;0.0001, respectively). The pre-THI score showed no significant association with age, sex, or hearing threshold (&lt;i&gt;p&lt;/i&gt;=0.91, 0.85, and 0.23, respectively). The post-treatment THI score was 33.6±17.1, which was significantly lower than the pre-THI scores (&lt;i&gt;p&lt;/i&gt;&lt;0.0001). Post-BDI and post-PSQI were 7.38±2.25 and 4.04±3.20, respectively. Post-PSQI also significantly decreased compared with pre-PSQI (&lt;i&gt;p&lt;/i&gt;=0.0002), but post-BDI did not significantly decrease (&lt;i&gt;p&lt;/i&gt;=0.1231). In the THI survey, Question 7 (sleep disturbance) showed decrease the most, followed by Question 25 (unstable mood). The post-treatment THI could be predicted by using the formula, 0.7673+0.6947×pre-THI+0.3572×pre-PSQI.Conclusion The appropriate/optional use of clonazepam at low doses (0.25-0.5 mg) can significantly improve chronic tinnitus and sleep quality. Tinnitus was significantly associated with the scores of THI, BDI, PSQI and the usage of Clonazepam significantly reduced the THI and PSQI scores. However, clonazepam did not affect the BDI score.