Results Of Pure Tone Audiometry Research Articles

Evaluation of auditory system in obstructive sleep apnea patients.

Obstructive sleep apnea (OSA) has been associated with auditory dysfunction both to the cochlear and higher auditory pathways. However, available literatures presented conflicting results. We aimed to study the impact of OSA severity and their polysomnography parameters on hearing function. A total of 44 patients were included after evaluation for sleep disorders and were divided into four groups in accordance with apnea-hypopnea index (AHI). Pure tone audiometry (PTA), distortion product otoacoustic emission (DPOAE) and auditory brainstem response (ABR) were compared in commensurate with the severity of AHI. Polysomnography oximetry parameters of oxygen desaturation index, mean SPO2, minimum SPO2 and percent SPO2 < 90% were correlated with their respective PTA, DPOAE and ABR results. There was no significant change in the PTA, DPOAE and ABR results in connection with AHI severity. However, we found significant correlations between mean SPO2 and percent SPO2 < 90% with ABR wave I, III and V absolute latencies. Minimum SPO2 was also significantly correlated with wave III peak latency changes. Mean SPO2, percent SPO2 < 90% and minimum SPO2 could be key prognostic indicators of central auditory dysfunction in OSA patients. These parameters should be explored further as indicators of OSA severity rather than utilizing AHI alone. The hypoxic burden derived could be a better predictor of auditory function abnormalities rather than one derived from AHI.

Relationship between size and site of tympanic membrane perforations and pure tone audiometry results

Background: Chronic otitis media is a condition commonly presenting with tympanic membrane perforation and resulting in conductive hearing loss. The aim of the study was to assess the relationship between the site and size of tympanic membrane perforation with the degree of hearing impairment in patients with inactive chronic otitis media of mucosal type. Methods: Hospital based cross sectional study of 174 patients with tympanic membrane perforation at government medical college, Alappuzha from November 2017 to March 2019. Patients were enrolled based on history and clinical examination findings. Images obtained by otoendoscopy were analyzed by measuring the percentage area of membrane perforation in relation to total area of the tympanic membrane using adobe acrobat area tool. Degree of hearing loss was calculated by pure tone audiometry test and calculating the average hearing thresholds at frequencies of 500Hz, 1000Hz, 2000Hz and 4000Hz. Results: The age distribution of patients ranged from 14 to 72 years with a mean age of 41.78years. Male to female ratio was 1.59:1. The degree of hearing loss increased as the size of the perforation increased which was statistically significant (p &lt;0.001). Posterior quadrant perforations resulted in more hearing impairment than anterior quadrant perforations. Conclusion: The size of the tympanic membrane perforation is closely related to the degree of hearing loss and posterior quadrant perforations have more degree of hearing impairment than anterior quadrant perforations which signifies improvement in hearing in patients with chronic otitis media by reconstructive surgeries, especially for perforations involving the posterior quadrant.

Evaluation of hearing in familial Mediterranean fever children

Aim of the workFamilial Mediterranean fever (FMF) is the most prevalent monogenic auto-inflammatory illness worldwide. It is characterised by periods of self-limiting fever and polyserositis, including pleuritis as well as peritonitis. This study attempted to assess hearing in paediatric FMF patients on colchicine treatment. Patients and methodsA hundred children with FMF (7–18 years old) (male/female: 43/57) were recruited. Audiological assessments were performed for all patients, including transient-evoked otoacoustic emission (TEOAE), tympanometry, as well as pure-tone audiometry (PTA) tests. Severity score, response to treatment and type of MEFV gene mutation were assessed. ResultsThe mean age of patients was 11 ± 3 years and disease duration 7.1 ± 2.7 years. Fourteen patients were normal in all audiological tests, whereas 86 patients had impaired hearing (Sensorineural hearing loss (SNHL) in one or both ears). PTA results were normal in 23 patients and bilaterally impaired in 50 patients and unilaterally impaired in 27 patients. TEOAE results showed that 37 patients had a bilateral pass test, nine patients had a unilateral pass test, 11 patients had a bilateral partial pass test, eight patients had a unilateral partial pass test, and 40 patients had a bilateral fail test, and seven patients had a unilateral fail test. The patients were 22 % homozygous, 52 % heterozygous, and 26 % compound heterozygous. M694I was the most prevalent allele (32 %) in the current study. There were no statistically substantial correlations between audiological parameters and other variables. ConclusionsChildren with FMF seem to have an increased risk of hearing impairment due to the affection of cochlear functions.

A Comparative Study: Platelet-Rich Fibrin Packing as an Alternative to the Absorbable Gelatine in Tympanoplasty.

Background:We aimed to investigate platelet-rich fibrin’s potential role as packing material in both the middle ear and external auditory canal.Methods:Twenty-nine patients undergoing transcanal endoscopic type 1 cartilage tympanoplasty were included in this controlled prospective clinical study. Patients were randomly assigned to platelet-rich fibrin (n = 14) or absorbable gelatine (n = 15) groups. Preoperative and postoperative pure-tone audiometry results, graft healing rates, tympanometry values, and Glasgow Benefit Inventory scores were compared.Results:No significant postoperative complications were observed and the graft intake rate was 100% in both groups. Mean air-bone gap gain was 9.82 ± 4 dB HL in the postoperative first month and 10.08 ± 4.91 dB HL in the sixth postoperative month in the platelet-rich fibrin group. There was no statistically significant difference between the postoperative air-bone gap gains of the groups in the first (P = .537) and sixth month (P = .723) controls. There was no statistically significant difference in compliance (P = .453) between groups. The physical benefit scores of the Glasgow Benefit Inventory were significantly higher in the platelet-rich fibrin group (P = .01). There was no difference in general and social benefit scores (P > .05).Conclusion:As a middle and external auditory canal packing agent, platelet-rich fibrin was as successful as absorbable gelatine in transcanal endoscopic cartilage tympanoplasty with similar functional results and graft healing rate.

Analysis of clinical parameters as predictors of hearing recovery in patients with sudden sensorineural hearing loss

ObjectiveTo investigate the impact of certain clinical parameters on likelihood of hearing recovery after SSNHL and to detect potential variables that predict its outcome. MethodsA retrospective study was conducted in order to identify the clinical parameters which influence hearing recovery after SSNHL. Medical charts of 87 patients diagnosed with SSNHL and treated in the clinic from January 2015 to December 2019 were retrospectively reviewed. The effects of several parameters on the success of the treatment were statistically evaluated. Such parameters studied were age, gender, the severity of hearing loss, audiometric curve pattern, the time treatment was initiated, and metabolic factors. ResultsPatient categorization according to tonal audiometric curve results statistically differed in terms of recovery (complete, partial, no recovery) (χ2 = 32.5; p< 0.001). There are 2× more diabetic patients in the group no recovery than in the group partial recovery (OR = 3.1; 95% CI 0.95‒10; p= 0.061), and 5.3× more than in the group complete recovery (OR = 10.4; 95% CI 2.3‒45; p= 0.002) (χ2 = 11.2; p= 0.004). There is a statistically significant correlation between onset of therapy and recovery on a scale of significance of 93% (χ2 = 5.3, p= 0.069). ConclusionIn our study tonal audiometry results, diabetes mellitus and onset of therapy were shown to be a statistically significant negative predictive factors for recovery. Results of pure tone audiometry suggest a flat profound curve is statistically associated with the no recovery rates, and a down sloping curve proved to be statistically associated with complete recovery rates. Level of evidenceLevel 1.

Assessment of Hearing Loss by Audiometry - Our Experience at Tertiary Care Hospital

Objective: To analyze the results of pure tone audiometry in the terms of age, sex, and type of hearing loss attending the hospital with the complaint of hearing loss. Materials and Methods: In this descriptive study, patients attending Benazir Bhutto hospital with complaints of hearing loss were included. The data analysis was done under the terms of age, sex and unilateral/bilateral, and type of loss after pure tone audiometry of every case. The type of hearing loss was determined as conductive, SNHL, and mixed hearing loss.Results: There were 47 patients. Males were 34 (72.34%) outnumbering13females 13(27.66). Adults were44 (93.61%) and children were 3(6.34%). Mixed hearing loss was28 (59.57%)% compared to conductive hearing loss 15 (31.91) and SNHL4 (8.51%). Conclusion: Hearing loss is more common in adults and more prevalent in males. It is mostly bilateral. Mixed hearing loss is more common as compared to conductive and SNHL respectively. Sociacusis is to be taken seriously.

The Importance of Considering the Minimum Interaural Attenuation Value in the Masking Procedure of Pure-Tone Audiometry

In pure-tone audiometry (PTA) testing, air conduction (AC) and bone conduction (BC) thresholds are documented accordingly to obtain complete information on the hearing status. Nevertheless, due to the cross-hearing phenomenon, a masking procedure is typically implemented in PTA as an effort to obtain the exact (masked) AC and BC thresholds. As indicated by the respective masking rules, the decision to carry out the masking procedure is based on the “suggested” minimum interaural attenuation (IAA), which is 40 dB (for headphones), regardless of frequency. In this case report, the importance of considering the minimum IAA value based on research findings is highlighted. In particular, to produce more reliable PTA results, the masking procedure can be conducted by considering a lower IAA value (&lt;40 dB).

Evaluation of Carhart’s Notch in Patients with Serous Otitis Media

Objective: To investigate the changes in bone-conduction and air-bone gap in patients with serous otitis media and to evaluate the presence of Carhart’s notch. Material and Methods: Patients with unilateral serous otitis media were included in the study. Audiometric evaluation comprised air-conduction and bone-conduction hearing thresholds, and air-bone gap values. The preoperative and postoperative pure tone audiometry results of 45 patients were compared in terms of the air-bone gap and bone-conduction thresholds. Results: Carhart’s notch was present in 17 (37.8%) patients preoperatively. For pure tone audiometry, there was a statistically significant decrease in air-bone gap at all frequencies postoperatively. The postoperative decrease in the bone-conduction thresholds was statistically significant only at 2 kHz. In the postoperative period, a 4.7 dB improvement was observed in the bone-conduction threshold at 2 kHz for patients with Carhart’s notch. Conclusion: Carhart’s notch may be present in patients with serous otitis media. It is not specific to otosclerosis.

The moderating effect of personality traits on acute tinnitus sensation in idiopathic sudden sensorineural hearing loss.

People may experience tinnitus after sudden hearing impairment. The details of the relationship between tinnitus improvement and hearing recovery are still unclear. Personality traits may play a role in the modulation of tinnitus sensation. We investigated the moderating effect of personality traits on pretreatment and posttreatment tinnitus sensation in patients with idiopathic sudden sensorineural hearing loss (ISSHL). This prospective longitudinal study enrolled 33 patients diagnosed with unilateral ISSHL and acute tinnitus in 2018-2019 at one institute. Clinical data were collected before and after treatment, including results of pure-tone audiometry (PTA), the Clinical Tinnitus Questionnaire (CTQ), the Tinnitus Handicap Inventory (THI), tinnitus loudness and annoyance (Visual Analog Scale; VAS), the Hospital Anxiety and Depression Scale (HADS), and the Big Five Inventory (BFI)-44. Eighteen men and 15 women with an average age of 48.3 ± 15.8 years were enrolled. The pretreatment hearing threshold and THI score were 58.0 ± 27.4 dB HL and 42.9 ± 26.2 (range: 0-88), respectively; the posttreatment values were 39.8 ± 22.4 dB HL and 20.7 ± 22.5 (range: 0-64), respectively. There were significant differences between pretreatment and posttreatment hearing thresholds as well as THI, VAS, and HADS scores (p < 0.001) but not BFI-44 results. Neuroticism and openness had significant positive and negative correlations, respectively, with acute tinnitus stress before treatment (r = 0.561, p = 0.001; r = -0.359, p = 0.040). After 3 months of follow-up, all patients were analyzed separately by dividing them into recovery (n = 16) and nonrecovery groups (n = 14) according to their hearing improvement status by Siegel's criteria. Neuroticism showed a significant moderating effect on acute tinnitus sensation in the ISSHL recovery group (p < 0.001) but not in the nonrecovery group (p = 0.106). Neuroticism and openness may affect acute tinnitus stress in ISSHL patients. Practitioners should consider personality traits when managing ISSHL patients with bothersome tinnitus.

Possible Existence of Cochlear Synaptopathy in Patients Completely Recovered from Idiopathic Sudden Sensorineural Hearing Loss.

Cochlear synaptopathy refers to a subclinical hearing pathology which could potentially explain hearing difficulties within the normal hearing threshold; it is also called “hidden hearing loss”. We hypothesized that a temporary threshold shift in sudden sensorineural hearing loss (ISSNHL) also affects the function in the synapse. The aim of the study was to evaluate the presence of cochlear synaptopathy in patients who had completely recovered from unilateral SSNHL Nineteen patients who had completely recovered from ISSNHL from January 2018 to June 2021 were assessed. Complete recovery was established by pure tone audiometry (PTA) 3 months after treatment, according to the American Academy of Otolaryngology–Head and Neck Surgery criteria. Subjects completed the pure tone audiometry, speech audiometry and auditory brain stem response (ABR) test, and completed a questionnaire regarding hearing loss after hearing recovery. The ABR amplitudes of wave I and wave V, and the ratio of wave I/V of both ears (recovered side and healthy side) were assessed. A visual analog scale (VAS) and a hidden hearing loss questionnaire were used to evaluate subjective hearing difficulty. The ABR waves I of the recovered ears had a significantly lower amplitude (p = 0.002) than those of the healthy side, whereas there was no difference in wave V (p = 0.985) or in the ratio of wave I/V (p = 0.107). Some patients still felt mild hearing difficulty although their PTA results were normal, but there was no clear relationship between the VAS score, wave I amplitude and speech recognition scores. The present findings point to the possible existence of cochlear synaptopathy in ears that have completely recovered from unilateral sudden sensorineural hearing loss. We suggest that the causes of cochlear synaptopathy and of idiopathic sudden hearing loss may have something in common.

Does COVID-19 have an impact on hearing?

Backgrounds SARS-CoV-2 is known to be a neurotrophic virus. However, the effect of this virus on the hearing system is still uncertain. Objectives We aimed to investigate the possible effect of COVID-19 on hearing. Materials and Methods Thirty healthcare workers who had COVID-19 after hearing evaluation with pure tone audiometry (PTA) for any reason in the last 1 year were included in the study. PTA and transient evoked otoacoustic emissions (TEOAE) tests were performed in 15 of 30 patients during the active infection period. For all 30 patients, otoscopic examination plus PTA and TEOAE tests were performed at the end of the first month after their treatment. Results When the PTA results of 30 patients (60 ears) before and after COVID-19 were compared, a significant decrease in hearing level was found only at 1000 Hz (p < .05). There were no significant differences at other frequencies. When the PTA and TEAOE test results of 15 patients (30 ears) that were performed during and after COVID-19 were compared, no significant differences were found. Conclusion and significance We conclude that COVID-19 may cause hearing loss. However, this result needs to be confirmed with comprehensive studies to be conducted in larger patient groups.

Ambient Noise Monitoring during Pure-Tone Audiometry.

There is an increasing need to administer hearing tests outside of sound-attenuating rooms. Maximum permissible ambient noise levels (MPANLs) from published in standards (Occupational Health and Safety Administration [OSHA] 1983; American National Standards Institute [ANSI] S3.1-1999 (R2018)) can be modified to account for the additional attenuation provided by circumaural earphones (relative to supra-aural earphones) that are used for pure-tone audiometry. Ambient noise can influence the results of pure-tone audiometry by elevating thresholds by direct masking and by producing distractions that affect the accuracy of the test. The effects of these distractions have not been studied in relation to pure-tone audiometry in adult listeners. In Part I MPANLs provided by ANSI and OSHA standards are extended to account for the greater attenuation provided by circumaural earphones. Rules ("alerts") were developed taking into account the listeners' thresholds. In Part II effects of distracting noise on pure-tone thresholds are reported. In Part I MPANLs two standards were modified for circumaural earphones by adding the additional attenuation provided by three circumaural earphones (relative to supra-aural earphones). A set of rules ("alerts") is provided for identifying masking effects from ambient noise in a variety of conditions (earphone type, threshold elevation, uncovered ear). In Part II the distracting effects of an industrial noise sample on thresholds obtained from five listeners with normal hearing are described. Pure-tone thresholds were measured in quiet and in distracting noise presented at various levels. The effects of the distracting noise on the following variables were measured: time per trial, number of trials required to measure threshold, threshold shift, and perceived distractibility of the noise. Time per trial was unaffected by distracting noise. Number of trials required for threshold, threshold shift, and perceived distractibility increased with distracting noise level. Part I: The modified MPANLs provide more relevant determinations of the potential effects of ambient noise on pure-tone thresholds than the values in the standards. Part II: Distracting noise affects pure-tone threshold measurements in a manner that is different from direct masking. The potential contaminating effect of distracting noise can be measured and reported.

Intratympanic treatment in chronic subjective tinnitus

Aims: The aim of our study was to determine the efficacy of this treatment by evaluating the results of pure-tone audiometry, tinnitus rating scale, and tinnitus handicap questionnaire performed before and after intratympanic (IT) steroid treatment in patients with chronic subjective tinnitus who were not treated despite receiving medical treatment. Settings and Design: Twenty-three patients between 27 and 79 years of age who had normal physical examination had tinnitus complaints at least 3-month duration and who had been treated with IT steroid treatment were enrolled to the current study. Patients smaller than 18 years of age, patients with mental, neurological and psychological pathology, patients who had used any kind of medical treatment for tinnitus in the past 3 months, were excluded from the study. Subjects and Methods: The study included patients who were admitted to Mersin University Medicine Faculty Otorhinolaryngology Department, Department with tinnitus and were treated with IT steroid treatment. Written informed consent was obtained from all patients participating in the study. Statistical Analysis Used: All analyses were performed using IBM SPSS 22 package software trial version. The normal distribution of the data was examined with Shapiro–Wilk test. Frequency and percentage were calculated for categorical values. Results: In the tinnitus grading scale, a significant decrease in before and after treatment was determined for 17 patients with tinnitus complaints and was found statistically significant (P < 0.001). The results of tinnitus handicap questionnaires were rated between 21.4 and 69.6 for before treatment and between 11.4 and 63.6 for after treatment and were found statistically significant (P < 0.001). Conclusion: In this study, we found that IT steroid treatment decreased both tinnitus rating scale and tinnitus handicap scores for patients with chronic idiopathic tinnitus without hearing loss.

Study on the relationship between the morphology of the isthmus of the vestibular aqueduct and Meniere's disease based on 10 μm otology CT

Objective: To evaluate the morphology of isthmus of the vestibular aqueduct (VA) and its relationship with the occurrence, course of Meniere's disease (MD) and the degree of hearing loss based on 10 μm otology CT. Methods: A total of 13 patients with MD in Beijing Friendship Hospital, Capital Medical University from October 2020 to July 2021, including 4 males and 9 females, age from 16 to 77 (56±16) years, were prospectively enrolled. All patients underwent 10 μm otology CT examination. The included lesion side was the MD affected group (14 sides), and the non-lesion side was the MD healthy group (12 sides). According to the 1∶2 side, 16 sex-and side matched cases (28 sides) without external and middle ear disease were included in the control group, including 4 males and 12 females, age from 16 to 77 (56±14) years. The horizontal semicircular canal showed on the largest plane was considered as the standard cross-section, and continuous observation was made on this image. According to the display type of isthmus of the VA, it was divided into Ⅰ to Ⅳ grades. Kruskal Wallis test was used to compare the morphological differences of VA isthmus among the affected group, the healthy group and the control group. The degree of hearing impairment was assessed by pure tone audiometry (PTA) results, which were divided into normal/mild/moderate/moderately severe/severe/extremely severe hearing impairment. Spearman correlation analysis was used to compare the correlation between the morphological rating of VA isthmus on the affected side and age, course of disease and the results of pure tone audiometry (PTA). Results: The proportions of VA isthmic morphology GRADE Ⅰ,Ⅱ,Ⅲ,Ⅳ in the MD affected group were 28.6% (4/14), 42.9% (6/14), 21.4% (3/14), 7.1% (1/14), those in the MD healthy group were 0 (0/12), 33.3% (4/12), 33.3% (4/12), 33.3% (4/12), and those in the control group were 0 (0/28), 7.1% (2/28), 64.2% (18/28), 28.6% (8/28). The VA isthmus scores [M (Q1, Q3)] of MD affected group was lower than that of MD healthy group [2 (1, 3) vs 3 (2, 4)] and control group [2 (1, 3) vs 3 (3, 4)] (all P<0.05, respectively). The morphology of the VA isthmus on the affected side of MD was negatively correlated with age (r=-0.81, P=0.002), and there was no correlation with the course of disease and degree of hearing impairment (r=-0.40, r=-0.26; all P>0.05, respectively). Conclusion: The stenosis of the VA isthmus in MD was a possible anatomical factor for the occurrence of MD.

The Normative Data for Sensorineural Acuity Level (SAL) Test among Young Adults: Comparisons Between B71 and B81 Bone Transducers

Introduction: The sensorineural acuity level (SAL) test is a valuable clinical assessment for hearing diagnosis, especially when the results of pure tone audiometry (PTA) are incomplete or questionable. Nevertheless, the literature on the SAL test is extremely limited and more research efforts are warranted to promote the application of this test in clinical settings. Essentially, the aim of the present study was to compare the normative data for the SAL test between two different bone vibrators (Radioear B71 and Radioear B81) among Malaysian participants. Materials and Methods: Forty-two healthy Malaysian adults (aged 19 to 27 years) participated in this repeated-measures study. The PTA and SAL test was carried out according to the recommended protocols. The SAL normative data produced by the two bone transducers were then compared at different frequencies. Paired t-test and Bayesian inference were used for data analyses. Results: The normative data for the SAL test gathered in the present study were descriptively higher than those reported among Caucasian adults. Relative to the Radioear B81 bone vibrator, the SAL normative data were significantly higher for the Radioear B71 bone transducer at all tested frequencies (p &lt; 0.001, BF10 ≥ 48.67). Conclusions: The SAL normative data established by the two bone vibrators are statistically different. This information would be beneficial to provide clinicians with appropriate normative data when performing the SAL test on Malaysian patients.

Transcutaneous Osseo-integrated Auditory Devices: Analysis of Two Different Implants in Adults With Different Audiological Inclusion Criteria.

To determine and compare audiological and speech/language discrimination results in patients with osteo-integrated auditory devices, by comparing two different systems including different audiological indications in adult population. Descriptive and analytic, cross-sectional, cohort, and retrospective case review. Tertiary referral center. Fifty patients >14 years old, with conductive, mixed, or unilateral sensorineural hearing loss were compared. The variables studied were the following: pure tone audiometry results, air-bone gap, and the percentage of speech/language discrimination using Disyllabic Word Test. The patients were tested preoperative and 12 months after surgical procedure. Subsequently, a comparative analysis of the both systems was carried out. With both implants, pure tone audiometry results and the difference in auditory thresholds and between the air-bone gap improved significantly. Speech discrimination increased significantly after implantation too. A significant difference was observed after implantation of both devices. Patients implanted with one of the implants showed better audiological results, but no significant differences were found with the other device. So, it was shown that the type of device and the type of hearing loss have no influence on the audiological results or complications. Both implants represent a good choice for audiological rehabilitation in patients with transmissive hearing loss, mixed hearing loss, or unilateral sensorineural hearing loss with a high success and low complication rates.

Clinical manifestation and treatment of temporal bone tympanic plate fracture

Objective: To elucidate the clinical manifestations of temporal bone tympanic plate fracture and the correlation between treatment time after injury and its prognosis, and to discuss the importance of early treatment of tympanic fracture. Methods: Retrospective analysis was carried out on the clinical data of 15 patients(17 ears)with temporal bone tympanic plate fracture from March 2006 to July 2019. The course of disease was less than 1 month (initial stage) in 7 cases (7 ears), 1 month to 6 months (middle stage) in 2 cases (3 ears), and 6 months or more (late stage) in 6 cases (7 ears). The symptoms, signs, CT findings, pure tone audiometry results, surgical methods and clinical efficacy of each group were summarized. Results: Most patients with temporal bone tympanic plate fracture were referred to otology department by maxillofacial surgery. Fracture occured indirectly with the chin or zygomatic region as the direct stress point. Thirteen of the 15 patients had mental region wounds or scars, and 14 patients had external acoustic canal bleeding immediately after injury. In the initial-stage group, hearing was mostly unchanged, while in the middle and late-stage groups, hearing loss was mainly caused by conduction factors. In the initial stage group, 6 cases/7 cases were cured by external acoustic canal packing; External acoustic canal stenosis or atresia occurred in 2 cases in the middle-stage group and were cured by external acoustic canal plasty. All the 6 patients in the late-stage group had external acoustic canal stenosis or atresia, among whom 5 patients with external acoustic canal cholesteatoma were cured by external acoustic canal plasty, and the other one patient with middle ear cholesteatoma was cured by modified radical mastoidectomy and tympanoplasty after external acoustic canal plasty for three times. Conclusions: Temporal bone tympanic plate fracture is a special type of temporal bone fracture. In the early stage of temporal bone tympanic fracture, bleeding of the external acoustic canal is the main symptom, and hearing is normal mostly. Advanced conductive deafness may result from external acoustic canal stenosis and/or cholesteatoma formation later. Bleeding of the external acoustic canal and irregular bulge of the anterior wall of the external acoustic canal with mental region wound are important signs for early diagnosis of temporal bone fracture. Temporal bone tympanic fracture should be paid attention to, early detection and timely treatment can avoid external acoustic canal stenosis and atresia.

Characteristics of hearing loss in elderly outpatients over 60 years of age: an annual cross-sectional study

Background The prevention and treatment of presbycusis becomes a serious health challenge and socio-economic problem. Objectives We performed a cross-sectional analysis of the audiometry results of all elderly patients who visited our department throughout the year of 2018. Material and methods A total of 5520 people aged 60 and over were included and divided into three groups: young-old group (60–74 years old), old-old group (75–89 years old), and longevous group (over 90 years old). Pure-tone audiometry results of all patients were analyzed. Results Among the 5520 patients, there were 4445 cases in the young-old group, 1029 cases in the old-old group, and 46 cases in the longevous group, accounting for 80.53, 18.64, and 0.83%, respectively. In the young-old group, normal hearing and mild-moderate hearing loss were the most common, while moderate and severe hearing loss were more common among the old-old group and the longevous group. The hearing curve showed typical age-related hearing loss with a drop at high frequencies. Conclusions With an increase in age, patients tend to suffer from more serious hearing disorders. Presbycusis was associated with specific frequency and age characteristics. Understanding these characteristics is of great significance for the prevention and treatment of age-related hearing loss.

Effect of noise and ototoxicants on developing standard threshold shifts at a U.S. Air Force depot level maintenance facility

Noise exposure has traditionally been considered the primary risk factor for hearing loss. However, ototoxicants commonly found in occupational settings could affect hearing loss independently, additively, or synergistically when combined with noise exposures. The purpose of this investigation was to determine the combined effect of metal and solvent ototoxicants, continuous noise, and impulse noise on hearing loss. Noise and ototoxicant exposure and pure-tone audiometry results were analyzed for U.S. Air Force personnel (n = 2,372) at a depot-level aircraft maintenance activity at Tinker Air Force Base, Oklahoma. Eight similar exposure groups based on combinations of ototoxicant and noise exposure were created including: (1) Continuous noise (reference group); (2) Continuous noise + Impulse noise; (3) Metal exposures + Continuous noise; (4) Metal exposures + Continuous noise + Impulse noise; (5) Solvent exposure + Continuous noise; (6) Solvent exposures + Continuous noise + Impulse noise; (7) Metal exposure + Solvent exposures + Continuous noise; and (8) Metal exposure + Solvent exposures + Continuous noise + Impulse noise. Hearing loss was assessed at center octave band frequencies of 500–6,000 Hz and using National Institute for Occupational Safety and Health Standard Threshold Shift (STS) criteria. Hearing changes were significantly worse at 2,000 Hz in the Metal exposure + Solvent exposure + Continuous noise group compared to the Continuous noise only reference group (p = 0.023). The Metal exposure + Solvent exposure + Continuous noise group had a significantly greater relative risk (RR) of 2.44; 95% CI [1.24, 4.83] for developing an STS at 2,000 Hz. While not statistically significant, the Solvent exposure + Continuous noise group had a RR of 2.32; 95%CI [1.00, 5.34] for developing an STS at 1,000 Hz. These results indicate that noise exposure may dominate hearing loss at ≥3,000 Hz while combined effects of concomitant exposure to ototoxic substances and noise are only noticeable at ≤2,000 Hz. These results also suggest combined exposures to ototoxicants and noise presents a greater hearing loss risk than just noise.

Autonomic Nervous Function in Patients with Sudden Sensorineural Hearing Loss and Its Association with Prognosis and Disease Severity

Introduction: Vascular disorder is considered one of the main mechanisms of sudden sensorineural hearing loss (SSNHL) due to the anatomy of the inner ear. One factor that can contribute to vascular disorder is impairment in the autonomic nervous system. This study aims to investigate autonomic function in patients with SSNHL and its association with prognosis and disease severity from January 2018 to October 2019. Methods: We conducted a cross-sectional study involving 40 healthy controls and 55 subjects with SSNHL. We compared the autonomic function of controls and patients using heart rate variability (HRV). SSNHL patients were divided into improvement and no-improvement groups and into mild and severe groups according to pure-tone audiometry results. Results: The SSNHL group had significantly decreased total power (TP), low frequency (LF), and high frequency (HF) compared to the control group. However, there were no significant differences between the mild and severe groups. In the no-improvement group, LF was significantly higher and normalized HF was significantly lower than in the improvement group. According to a multiple logistic regression analysis, age and LF were significantly correlated with improvement. Conclusion: This is the first study to evaluate the significance of HRV in patients with SSNHL, according to prognosis and disease severity. Further studies about the relationship between autonomic nervous system and SSNHL with larger sample size and prospective design are needed.