Pure Tone Audiometry Thresholds Research Articles

Differential cortical activation patterns: pioneering sub-classification of tinnitus with and without hyperacusis by combining audiometry, gamma oscillations, and hemodynamics.

The ongoing controversies about the neural basis of tinnitus, whether linked with central neural gain or not, may hamper efforts to develop therapies. We asked to what extent measurable audiometric characteristics of tinnitus without (T) or with co-occurrence of hyperacusis (TH) are distinguishable on the level of cortical responses. To accomplish this, electroencephalography (EEG) and concurrent functional near-infrared spectroscopy (fNIRS) were measured while patients performed an attentionally demanding auditory discrimination task using stimuli within the individual tinnitus frequency (fTin) and a reference frequency (fRef). Resting-state-fMRI-based functional connectivity (rs-fMRI-bfc) in ascending auditory nuclei (AAN), the primary auditory cortex (AC-I), and four other regions relevant for directing attention or regulating distress in temporal, parietal, and prefrontal cortex was compiled and compared to EEG and concurrent fNIRS activity in the same brain areas. We observed no group differences in pure-tone audiometry (PTA) between 10 and 16 kHz. However, the PTA threshold around the tinnitus pitch was positively correlated with the self-rated tinnitus loudness and also correlated with distress in T-groups, while TH experienced their tinnitus loudness at minimal loudness levels already with maximal suffering scores. The T-group exhibited prolonged auditory brain stem (ABR) wave I latency and reduced ABR wave V amplitudes (indicating reduced neural synchrony in the brainstem), which were associated with lower rs-fMRI-bfc between AAN and the AC-I, as observed in previous studies. In T-subjects, these features were linked with elevated spontaneous and reduced evoked gamma oscillations and with reduced deoxygenated hemoglobin (deoxy-Hb) concentrations in response to stimulation with lower frequencies in temporal cortex (Brodmann area (BA) 41, 42, 22), implying less synchronous auditory responses during active auditory discrimination of reference frequencies. In contrast, in the TH-group gamma oscillations and hemodynamic responses in temporoparietal regions were reversed during active discrimination of tinnitus frequencies. Our findings suggest that T and TH differ in auditory discrimination and memory-dependent directed attention during active discrimination at either tinnitus or reference frequencies, offering a test paradigm that may allow for more precise sub-classification of tinnitus and future improved treatment approaches.

Evaluation of inner ear damage by mastoid drilling with measurement of serum prestin (SLC26A5) levels

ObjectiveThe objective of this study is to demonstrate any inner ear injury caused by drilling in mastoid surgery with prestin, outer hair cell motor protein specific to the cochlea. MethodsThe patients with chronic otitis media requiring mastoidectomy (n = 21) and myringoplasty (n = 21) were included. Serum prestin level obtained from blood samples was measured before surgery and on postoperative days 0, 3, and 7 using Human Prestin (SLC26A5) ELISA Kit. All patients underwent the Pure Tone Audiometry (PTA) test before surgery and on the postoperative 7th day. The drilling time was also recorded for all patients who underwent mastoidectomy. ResultsIn both mastoidectomy and myringoplasty groups, the postoperative serum prestin levels increased on days 0 and 7 (pday-0 = 0.002, pday-7 = 0.001 and pday-0 = 0.005, pday-7 = 0.001, respectively). There was no significant difference in the serum prestin levels between the two groups, postoperatively. The PTA thresholds at day 7 did not change in either group. A significant decline at 2000 Hz of bone conduction hearing threshold in both groups and a decline at 4000 Hz in the myringoplasty group were found. There was no correlation between the drilling time and the increase of prestin levels in the postoperative day 0, 3, and 7. ConclusionOur results showed that mastoid drilling is not related to a significant inner ear injury. Although the myringoplasty group was not exposed to drill trauma, there was a similar increase in serum prestin levels as the mastoidectomy group. Also, a significant decline at 2000 Hz of bone conduction hearing threshold in both groups and a decline at 4000 Hz in the myringoplasty group were found. These findings suggest that suction and ossicular manipulation trauma can lead to an increase in serum prestin levels and postoperative temporary or permanent SNHL at 2000 and 4000 Hz. Level of evidenceLevel-4.

Study of the peripheral and central auditory pathways in patients with mucopolysaccharidosis

ObjectiveTo investigate the peripheral and central auditory pathways in mucopolysaccharidosis (MPS) individuals. MethodThe research sample comprised 15 individuals (one female and 14 males), aged 8 to 46 years. The following procedures were used: medical history survey, otoscopy, speech and pure-tone threshold audiometry, acoustic immittance measures, and central auditory pathway assessment with brainstem auditory evoked potentials (BAEP) and long-latency auditory evoked potentials (LLAEP). ResultsThe pure-tone audiometry identified hearing loss in 13 individuals, and more than 90 % of the hearing loss was sensorineural. The degree of hearing loss was between mild to moderately severe with descendent configuration. Type A tympanogram predominated, and acoustic reflexes were present according to the types and degrees of hearing loss. Among the individuals with abnormal BAEP, longer wave III and V absolute latencies were the main findings. In addition, the unilateral absence of wave I was observed in two cases. In the LLAEP, longer latencies were observed in 14 individuals, and the most impaired components were the P1 and P3 in children and adolescents and the P2, N2 and P3 in adult individuals. ConclusionThe peripheral auditory pathway assessment revealed a predominantly sensorineural hearing loss, affecting mainly high frequencies, and in the central pathway was observed abnormal brainstem and cortical auditory processing in individuals with MPS.

Raised Hematocrit at High Altitude: Its Relation to Sensorineural Hearing Loss

Abstract Background: Military troops deployed in high altitude areas (HAAs) may suffer from illnesses peculiar to the terrain which are usually due to hypoxia. The physiological dynamics at high altitude (HA) are different from those in the plains and hence environmental factors play an important role at HA. The effect, if any, of hemodynamic changes in terms of raised hemoglobin (Hb) levels in HA on otological disorders is not very well researched and needs to be explored further. This study was undertaken to study the clinical manifestations, if any, of the hemodynamic alterations in the inner ear and their correlation with the Hb levels after 1 year deployment at HA. Methods: A longitudinal descriptive study was conducted over 1 year duration at a Military Hospital located at HAA on 99 soldiers who were <40 years of age with no history of prior ear complaints/ear surgery and with normal pure tone audiometry (PTA) thresholds and Hb levels at initial evaluation. Each soldier underwent PTA and Hb estimation twice: initially, at the time of induction, and later after completion of 1 year deployment at HAA. Statistical analysis was done using simple paired t-test. Results: On data analysis, no hearing loss was found in any participant of the study cohort at frequencies 500 Hz and 1 kHz in either ear on second evaluation. At 2 kHz, for left ear, the mean Hb level for the group with hearing thresholds greater than 25 dB was 17.07 g% with a standard deviation of 0.66, and for right ear, it was 16.95 g% with standard deviation of 0.64. At 4 kHz, the mean Hb level was 16.50 g% and 16.49 g% for hearing thresholds below and up to 25 dB for left and right ear, respectively. It was 16.99 g% and 16.96 g% for hearing thresholds above 25 dB. The results were statistically significant for both right and left ear at 4 kHz. Conclusion: A statistically significant deterioration of hearing thresholds for 4 kHz frequency with corresponding increase in Hb levels was observed in our study. Hb levels can therefore be used as a marker to ensure no further exposure to other risk factors like loud noise exposure, further deployment at higher altitudes to prevent deterioration, and progression of hearing loss.

Association between HbA1c and hearing loss: a tertiary care center-based study

The purpose of this study was to investigate the correlation between glycated hemoglobin (HbA1c) levels and hearing loss (HL) using data from a tertiary hospital. Our hypothesis regarding the relationship between HL and HbA1c levels was that elevated HbA1c levels are associated with an increased risk of HL. We retrospectively reviewed the medical charts of patients diagnosed with sensorineural HL or diabetes between 2006 and 2021 at the Catholic Medical Center (CMC). Data were collected from the CMC’s Clinical Data Warehouse. Participants were selected from patients who were prescribed pure-tone audiometry and an HbA1c blood test. The survey was completed for 5287 participants. The better ear pure-tone audiometry (PTA) for air conduction thresholds at 500, 1000, 2000, and 4000 Hz was calculated. Sensorineural HL was defined as a better ear PTA of 25 dB or higher. We used the HbA1c level as a diagnostic criterion for diabetes. The following criteria were used to define the HbA1c level: normal, HbA1c level below 5.6%; prediabetes, level between 5.6 and 6.4%; and diabetes, level of 6.5% or more. Among 5287 participants, 1129 were categorized as normal, 2119 as prediabetic, and 2039 as diabetic. The diabetic group was significantly older (p < 0.05). The PTA also significantly deteriorated in the diabetes group (p < 0.05). We analyzed the effects of age, sex, and HbA1c level on frequency-specific hearing using multiple regression. The hearing thresholds at all frequencies deteriorated significantly with increasing age and HbA1c level (p < 0.05). A case–control study was also performed to facilitate a comprehensive comparison between distinct groups. The participants were categorized into two groups: a case (PTA > 25 dB) and control group (PTA ≤ 25 dB), based on their PTA threshold of four frequencies. After adjusting for age and sex, we found no significant odds ratio (OR) of HL between the prediabetes group and the normal group. Notably, the OR of HL was significantly higher in the diabetes group with each PTA threshold and frequency. The 6.3% HbA1c level cutoff value was determined by analyzing the receiver operating characteristic curve for predicting hearing impairment > 25 dB. Diabetes was associated with hearing loss in all frequency ranges, particularly at high frequencies. Screening for HL is strongly recommended for patients with elevated HbA1c levels.

New Age Hearing Testing at your Fingertips: Shravana Mitra App.

WHO estimated the prevalence of disabling hearing loss is 5% of the world population (430million). People with a risk of hearing loss from noise exposure, ototoxic drugs, and comorbidities need regular hearing assessments. It is done by pure tone audiometry (PTA), requiring a skilled audiologist, special equipment, and a soundproof room. Modern technologies can help in overcoming these barriers. This study aimed to fill the lacuna by developing a new android-based application "Shravana Mitra" (Hearing companion) with features of both air conduction (AC) and bone conduction (BC) testing. To develop, corroborate and compare smartphone application-based audiometry with PTA. This study was done in three phases -(i) development of a mobile application, (ii) app validation in healthy individuals (iii) testing and comparison of results with PTA in individuals visiting OPD. The third phase was done as a cross-sectional observational study including 780 individuals visiting OPD of 10-60 years of age. The mean age of the study population was 32.89 years with female preponderance (57%). In AC testing, 83% of the pure tone average of the mobile application was within 5 dB of PTA thresholds and 99% was within 10 dB and for BC testing, 81% was within 5 dB of PTA thresholds and 98% within 10 dB. Our user-friendly mobile application- Shravana Mitra is the first Indian application available in the google play store with both AC & BC testing, multiple language options and accuracy similar to PTA. Thus, it can be used as the best hearing screening tool in camps, high-risk individuals, or any healthcare setup requiring initial hearing assessment.

Change in the Characteristics of Patients Qualified for Hearing Aids over the Last 25 Years in Poland.

Hearing loss is one of the most common causes of disability worldwide. The aim of the study was to compare the demographic structure and the results of hearing tests in people qualified for hearing aids over the last 25 years. The material covered 1246 patients qualified for hearing aids in the years 1996-2001 and 2016-2021. Patients were divided into two groups according to the time of qualifying for hearing aids. Group 1 (G1) consisted of 759 people qualified in the years 1996-2001, and Group 2 (G2) comprised 487 people qualified in the years 2016-2021. Statistical analysis was performed on the results of pure tone threshold audiometry and the demographic structure in both groups. Patients in G1 had statistically significantly elevated hearing thresholds (HT) in the air conduction range at frequencies from 2000 to 8000 Hz in relation to G2 patients. The opposite situation was observed for the bone conduction threshold. G2 patients had significantly elevated bone conduction HT at frequencies from 250 to 1000 Hz compared to G1 patients. The age structure in both groups was similar; however, the gender distribution was statistically significantly different. In G1 women accounted for 40%, and in G2, they became the dominant gender (53%). Over the last twenty years, there has been a change in the structure of patients qualified for hearing aids. Although the age has remained similar, today, patients decide to use hearing aids at an earlier stage of hearing loss than 25 years ago. Modern women began to use hearing aids much more often.

Location of the AICA influences the severity but not occurrence of ISSNHL: A reappraisal using high-resolution 3 T MRI

ObjectiveTo investigate the potential influence of anatomical variation in the anterior inferior cerebellar artery (AICA) on the occurrence and severity of idiopathic sudden sensorineural hearing loss (ISSNHL). MethodsNinety ISSNHL patients were enrolled. The anatomical location of the AICA was exhibited using high-resolution magnetic resonance imaging (MRI), and the various AICA types classified by previously reported Chavda and Gorrie methods were analyzed. The severity of hearing loss in the ipsilateral ear among different AICA types was compared. ResultsApproximately 85.6% of subjects had unilateral ISSNHL (uISSNHL), and the others had bilateral ISSNHL (bISSNHL). In the uISSNHL group, the ratios of different AICA types were similar between the ipsilateral and contralateral ears. The ratios of the different AICA types in the bISSNHL group were similar to those in the uISSNHL group. In the uISSNHL group, pure tone audiometry (PTA) thresholds at 2 kHz, 4 kHz and 8 kHz of patients with Chavda type II AICA were higher than those of patients with Chavda type I and type III, with a significant difference at 4 kHz between type I and type II. There was a tendency of the PTA threshold in patients with Chavda type II or Gorrie type C to gradually increase from low to high frequency zones. ConclusionWhen the AICA enters the IAC (Chavda type II) or crosses between the 7th and 8th cranial nerves (Gorrie type C), the severity and frequency of hearing impairment in ISSNHL but not the occurrence of ISSNHL will be affected.

Diagnostic Role of Combined Electrocochleography and Pure-Tone Audiometry Monitoring During Dehydrating Test in Ménière's Disease: A Case Series.

To evaluate the diagnostic role of combined electrocochleography and pure-tone audiometry monitoring during dehydrating test in Ménière's disease and consider its suitability as a diagnostic tool to differentiate those patients with unclear differential diagnosis and therefore identify those with clear endolymphatic hydrops responsive to dehydrating test. To study the efficacy of dehydrating therapy on vertiginous symptoms and hearing loss in patients with Ménière's disease. Prospective case series. University hospital, secondary referral center. Thirty patients, 20 women and 10 men, age range of 25 to 75 years, matching the criteria for definite Ménière's disease according to the Barany Society classification. Diagnostic. During an active phase of the disease, electrocochleography and pure-tone audiometry were performed, and repeated at 30th, 45th, and 60th minutes after intramuscular injection of 40 mg furosemide and 40 mg methylprednisolone. Data related to symptoms, electrocochleography, and pure-tone audiometry during the dehydrating test were collected at different times and statistically analyzed. After the administration of dehydrating therapy, we observed that both summating potential and action potential ratio and summating potential and action potential area ratio were normalized in 21 of 30 subjects. Furthermore, pure-tone audiometry thresholds improved significantly. An improvement of ear fullness was also observed, whereas tinnitus unchangeably persisted. The monitoring of the electrocochleography and pure-tone audiometry thresholds during dehydrating tests with furosemide and methylprednisolone could allow to detect an improvement of instrumental features and clinical symptoms related to endolymphatic hydrops, and therefore, it could be used as a diagnostic tool in the identification of those patients affected by Ménière's disease with unclear differential diagnosis.

Isolated tinnitus – premonitory symptom of an evolving auditory dysfunction: a retrospective analysis

Background: Tinnitus manifests frequently with hearing loss. Isolated tinnitus in patients with self-professed normal hearing may have underlying auditory dysfunction. Methods: We retrospectively reviewed the audiometry record of our department from January 2019 to October 2021. Pure tone audiometry thresholds of patients with isolated tinnitus were analyzed along with the demographics, degree and type of hearing loss.   Results: Of 255 (132 males/123 females) patients, mean age 39.7±15.2 years (range: 10-80 years), tinnitus was maximum (49%) prevalent among 20-40 years group, 5.8% among the pediatric population and 8.6% amidst ≥60 years populace. Males predominated (52%) throughout except at 21-30 years age. 83% exhibited some degree of hearing loss (42% bilateral minimal loss, 11% bilateral mild hearing loss). 7% right ears (mostly &gt;50 years age group) and 11% left ears showed greater than mild hearing loss. Bilateral tinnitus presented more (52%) followed by left tinnitus (29%) than right (19%). Mild hearing loss predominated right tinnitus presentation while minimal loss was recorded in left and bilateral tinnitus. However, greater than mild degree of hearing loss was clustered among bilateral tinnitus (14%) followed by left tinnitus (11%) than right tinnitus (6%). 18% had sensorineural deafness and all these patients had bilateral tinnitus. 30% had high frequency hearing loss and 39% among these had 4 kHz dip. Conclusions: Isolated tinnitus may be a premonitory symptom of an underlying or an evolving auditory dysfunction. Bilateral tinnitus followed by left tinnitus presentation warrant higher index of suspicion.

Republication de : Positive and negative post stapedotomy effects on cervical VEMP recordings; a STROBE analysis

The primary goal of the present study was to compare the pre- and post-stapedotomy elicitation and waveform characteristics of both air- and bone-conduction (AC-, BC-) cervical vestibular evoked myogenic potentials (cVEMPs) through an individualized approach. A possible association between audiological characteristics, such as AC- and BC- pure tone audiometry thresholds and air-bone gap and the production of cVEMPs before and after stapedotomy was also investigated. Twenty-five ears were subjected to full audiological evaluation as well as AC- and BC-cVEMPs pre- and post-stapedotomy. Four subgroups were studied; consistently present/absent, post-operatively disappeared and restored cVEMPs. Post-stapedotomy changes in cVEMP elicitability did not reach significance for either AC-cVEMP (OR = 5.41, 95% CI 0.88–33.36, P = 0.06) or BC-cVEMP (OR = 2.40, 95% CI 0.42–13.60, P = 0.3). Normal or abnormal AC-cVEMPs were equally subject to post-operative changes (OR = 1.95, 95% CI 0.32–12.01, P = 0.5), as were BC-cVEMPs (OR = 3.75, 95% CI 0.66–21.25, P = 0.1). Neither the audiological characteristics nor the surgical outcome, in terms of ABG results, were relevant to the presence or absence of AC- and BC-cVEMPs before or after stapedotomy. The presumed changes brought to the sacculus by stapedotomy are minor and beyond the diagnostic abilities of either AC-cVEMPs or BC-cVEMPs, both in terms of cVEMPs elicitability and waveform characteristics. In individual cases, however, which may deserve further investigation, cVEMPs may reappear or disappear after stapedotomy probably following minor changes toward a lower or higher vestibular system resistance for pressure and sound transmission.

Is atrial fibrillation a risk factor for hearing loss?

In the present study, we sought to evaluate the results of hearing loss in AF patients.This study involved 50 patients with AF, as determined by means of electrocardiogram, and 50 patients without AF. The pure-tone audiometry (PTA) threshold values were measured at low, medium and high frequencies for both ears. The signal-to-noise ratio (SNR) DPOAEs and TEOAEs were also analyzed for both ears separately.Both the airway and bone conduction PTA thresholds at 3, 4 and 6 kHz (kilohertz) were significantly lower in the AF group than in the control group (p<0.05). The AF patients exhibited worse hearing and worse TEOAE results at 1, 2, 3 and 4 kHz. In fact, the TEOAE amplitudes of the AF group were significantly lower in both the right and left ears at 2, 3 and 4 kHz when compared with the control group (p<0.05). Moreover, the DPOAE amplitudes in the AF group were statistically significantly lower at 3.4 kHz in both ears when compared with the control group (p<0.05).In light of these findings, we believe that AF is a risk factor for hearing.

Simplified cochlear frequency selectivity measure for sensorineural hearing loss screening: comparison with digit triplet test (DTT) and shortened speech, spatial and qualities of hearing scale (SSQ) questionnaire.

Pure-tone audiometry (PTA) is the gold standard for screening and diagnosis of hearing loss but is not always accessible. This study evaluated a simplified cochlear frequency selectivity (FS) measure as an alternative option to screen for early frequency-specific sensorineural hearing loss (SNHL). FS measures at 1 and 4kHz center frequencies were obtained using a custom-made software in normal-hearing (NH), slight SNHL and mild-to-moderate SNHL subjects. For comparison, subjects were also assessed with the Malay Digit Triplet Test (DTT) and the shortened Malay Speech, Spatial and Qualities of Hearing Scale (SSQ) questionnaire. Compared to DTT and SSQ, the FS measure at 4kHz was able to distinguish NH from slight and mild-to-moderate SNHLsubjects, and was strongly correlated with theirthresholds in quiet determined separately in 1-dB step sizes at the similar test frequency. Further analysiswith receiver operating characteristic (ROC) curvesindicatedarea under the curve (AUC) of 0.77 and 0.83for the FS measure at 4kHz when PTA thresholds of NH subjects were taken as≤ 15dB HL and ≤ 20dB HL,respectively. At the optimal FS cut-off pointfor 4 kHz, the FS measure had 77.8% sensitivity and 86.7% specificity to detect 20dB HL hearing loss. FS measure was superior to DTT and SSQ questionnaire in detecting early frequency-specific threshold shifts in SNHL subjects, particularly at 4 kHz. This methodcould be used for screening subjects at risk of noise-induced hearing loss.

Diagnostic Accuracy of Mobile Health-Based Audiometry for the Screening of Hearing Loss in Adults: A Systematic Review and Meta-Analysis.

Background: Hearing loss is one of the most prevalent chronic health conditions. Traditional pure tone audiometry (PTA) is the gold standard for hearing loss screening, but is not widely available outside specialized clinical centers. Mobile health (mHealth)-based audiometry could improve access and cost-effectiveness, but its diagnostic accuracy varies widely between studies. Therefore, we aimed to evaluate the diagnostic accuracy of mHealth-based audiometry for hearing loss screening in adults compared with traditional PTA. Methods: Ten English and Chinese databases were searched from inception until April 30, 2022. Two researchers independently selected studies, extracted data, and appraised methodological quality. The bivariate random-effects model was adopted to estimate the pooled sensitivity and specificity for each common threshold (i.e., the threshold to define mild or moderate hearing loss). The hierarchical summary receiver operating characteristic model was used to assess the area under the receiver operating characteristic curve (AUC) across all thresholds. Results: Twenty cohort studies were included. Only one study (n = 109) used the mHealth-based speech recognition test (SRT) as the index test. Nineteen studies (n = 1,656) used mHealth-based PTA as the index test, and all of them were included in the meta-analysis. For detecting mild hearing loss, the pooled sensitivity and specificity were 0.91 (95% confidence interval [CI] 0.80-0.96) and 0.90 (95% CI 0.82-0.94), respectively. For detecting moderate hearing loss, the pooled sensitivity and specificity were 0.94 (95% CI 0.87-0.98) and 0.87 (95% CI 0.79-0.93), respectively. For all PTA thresholds, the AUC was 0.96 (95% CI 0.40-1.00). Conclusions: mHealth-based audiometry provided good diagnostic accuracy for screening both mild and moderate hearing loss in adults. Given its high diagnostic accuracy, accessibility, convenience, and cost-effectiveness, it shows enormous potential for hearing loss screening, particularly in primary care sites, low-income regions, and settings with in-person visit limitations. Further work should evaluate the diagnostic accuracy of the mHealth-based SRT tests.

Difference in Thresholds Between Auditory Brainstem Response Test and Pure Tone Audiometry by Frequency

Background and Objectives There is no clear standard for the difference in the thresholds of auditory brainstem response (ABR) and pure tone audiometry (PTA) when using ABR to evaluate the reliability of PTA. Therefore, we assessed the difference in the thresholds of ABR and PTA for each frequency. Consequently, we present here the actual difference values between the two tests that can be used as a reference in the clinic.Subjects and Method We retrospectively assessed the audiometry results of 129 ears. Ears in which the hearing thresholds of each frequency continuously declined were classified as the downward group. We compared the average of differences between the two tests by frequency. The differences were compared for each hearing level from 50 dB or higher.Results For all ears, the appropriate range of difference value was ±5 dB at 2 kHz. At 1 kHz, the ABR threshold was 10 dB higher than PTA, and it was 10 dB less than PTA at 4 kHz. In the downward group, the difference value increased by 10 dB at 1 kHz and 4 kHz. In the subgroups at each hearing level, the difference value showed similar results (p&lt;0.05).Conclusion The difference in the threshold, regardless of the severity or tendency of hearing loss, was the smallest at 2 kHz and the range was ±5 dB. ABR was 10 dB higher at 1 kHz and and 10 dB lower at 4 kHz than PTA. In the downward group, the difference at 1 kHz and 4 kHz increased by 10 dB each.

Auditory function assessment in patients with chronic obstructive pulmonary disease.

Chronic obstructive pulmonary disease is a multisystem disease with multiple comorbidities. Hearing is dependent on the cochlear functions that may be affected by oxygenation. Affection of hearing is problematic and represents a major concern that should be seriously investigated as an important comorbidity in chronic obstructive pulmonary disease patients. To assess auditory status among chronic obstructive pulmonary disease patients. The current study was carried out at Al-Azhar University Hospitals, Cairo, from 1 August 2021 to 2022, including 120 participants. In addition to the control group (60 healthy participants), there were two study groups: chronic obstructive pulmonary disease patients with respiratory failure group (30 patients) and non-respiratory failure group (30 patients). Hearing functions were studied using pure tone audiometry, and auditory brain stem response. There was statistically significant hearing impairment in chronic obstructive pulmonary disease patients in comparison to control group. The hearing impairment was more significant in chronic obstructive pulmonary disease with respiratory failure group in comparison to chronic obstructive pulmonary disease without respiratory failure group. The auditory impairment shows a negative interrelationship with oxygen tension (PaO2) and a positive interrelationship with the smoking index. Hearing affection was meaningfully higher among chronic obstructive pulmonary disease patients and more prominent in patients with respiratory failure. Hypoxia results in deterioration of pure tone audiometry and increased absolute and interpeak latencies in auditory brain stem response. At every frequency, the mean pure tone audiometry thresholds were higher for chronic obstructive pulmonary disease groups than control group albeit remaining in the mild to moderate area of hearing loss. Retro-cochlear affection was suggested among patients with chronic obstructive pulmonary disease as evidenced with the prolongation of auditory brain stem response waves latencies.

Risk factors associated with cisplatin-induced ototoxicity in Japanese patients with solid tumors.

Cisplatin, a first-generation platinum agent, is used for managing various cancers and is associated with dose-dependent side effects of hearing impairment and tinnitus. However, the safety of high-dose cisplatin in hearing impairment, has not been fully investigated in Japan. We performed pure-tone threshold audiometry before and every 3-4 weeks after chemotherapy for patients receiving cisplatin-containing chemotherapy between April 2015 and October 2017 at Kobe Minimally Invasive Cancer Center. Hearing impairment was evaluated prospectively using the National Cancer Institute Common Terminology Criteria for Adverse Events version 4.0. We enrolled 100 patients and analyzed 96 patients for whom post-chemotherapy audiometry could be performed. The median patient age was 65 years, and most patients were male (75). The cancer types were as follows: esophageal, 36; head and neck, 35; lung, 23; and gastric, 2. Cisplatin monotherapy and combination therapy were administered to 33 and 63 patients, respectively. A single cisplatin dose was 60-100 mg/m2 ; the median number of doses and total dose were 3 and 240 mg/m2 , respectively. Additionally, 78 and 18 patients were treated with concurrent chemoradiotherapy and chemotherapy alone, respectively. Twenty-seven patients had grade 2 or higher hearing impairment. Furthermore, the prevalence was significantly higher in patients receiving a total dose of ≥300 mg/m2 . Twenty and 32 patients were aware of deafness and tinnitus, respectively. No patient discontinued treatment owing to hearing impairment. The total cisplatin dose was considered related to post-treatment hearing impairment frequency in Japanese patients. However, routine audiometric monitoring is recommended during high-dose cisplatin-based chemotherapy.

Impact of occupational noise on the postural control of older adults

Introduction: The studies on the consequences of noise to the auditory system are well documented, particularly in workers’ health. Nevertheless, few studies in the field yet have related postural control to occupational noise exposure. Objective: To investigate the association between the history of occupational noise and the postural control in older adults. Materials and Methods: Cross-sectional study that included individuals of both sexes older than 60 years. All of them had their postural control assessed on a force platform. The occupational noise was assessed with an audiological anamnesis questionnaire. The hearing loss was assessed using the pure-tone threshold audiometry. The Tinnitus Handicap Inventory questionnaire was used to quantify the impact of tinnitus on daily life of the older adults. Results: 90 older adults (87.8% women, 70[64-75] years old) were analyzed. The history of occupational noise exposure was associated with a worse postural control in older adults, regardless of the person’s age (ANCOVA; P &lt; 0.05). Moreover, the greater the hearing loss, the greater the body instability of the older adults (r≤0.36 for all). Finally, postural control was related to tinnitus presenting correlations with catastrophic Tinnitus Handicap Inventory (r = 0.314; P = 0.038) and functional Tinnitus Handicap Inventory (r = 0.430; P = 0.010). Conclusion: Postural control of older adults is related to the history of occupational noise exposure, hearing loss and tinnitus impact on older adult’s daily life.

Assessment of auditory function in hepatitis “C” patients managed by combination of sofosbuvir and daclatsavir

BackgroundTo evaluate the effect of daclatasvir and sofosbuvir on auditory function in hepatitis C patients. Thirty hepatitis C virus (HCV) patients were included in this study with age ranged from 22 to 55 years. All patients underwent full audiological evaluation before beginning and after completion of their treatment with combination of daclatasvir and sofosbuvir.ResultWhen the results of audiological data were compared before and after treatment, we found that; there were statistically significant differences in the pure tone audiometry (PTA) threshold and ART bilaterally mainly in the high frequency region. Transient evoked otoacoustic emission (TEOAE) reproducibility showed a statistically significant difference bilateral. However, there was no statistically significant difference in the Auditory Brainstem Response (ABR) findings.Conclusion and recommendationsThe combination therapy of daclatasvir and sofosbuvir used in patients with HCV led to deterioration in the hearing threshold in the basic audiological tests (PTA and immitancemetry). In addition, it had an adverse effect on the cochlear OHCs, with no affection on auditory nerve, brain stem functions or in sub-thalamic function, it seems that it had no effect, we cannot confirm. The study evaluate hearing at the end of treatment immediately. We recommend performing a routine monitoring of auditory functions in HCV patients treated with daclatasvir and sofosbuvir combination by specialist for early detection of auditory changes to avoid further damage to auditory system.

RELATIONSHIP BETWEEN DISEASE ACTIVITY AND HEARING IMPAIRMENT IN PATIENTS WITH RHEUMATOID ARTHRITIS

Objectives:To compare hearing thresholds between control subjects and rheumatoid arthritis (RA) patients, and between active and remission status. Materials and Methods:Thirty(30) Rheumatoid patients (RA group) and Twenty (20) healthy subjects (control group) were included in the study. Both groups were subjected to audiological testing: Pure tone audiometry, extended high frequency audiometry and auditory brain stem response (ABR). In RA group, the disease activity was assessed using DAS28-CRP. Results:The air conduction pure-tone hearing thresholds were significantly higher at frequencies: 2000, 4000, 8000 Hz in the RA than control group. The extended high frequency audiometry hearing thresholds were significantly higher in Rheumatoid patients at 12000 and 16000 Hz. ABR showed a significant difference between the RA and control group regarding the absolute wave Vlatency only (P&lt;0.05).The thresholds of pure tone audiometry and extended high frequency audiometry were higher in active patients than patients with remission, with significant difference at 12000 and 16000 Hz. A significant difference was observed between the active patients and patients with remission for the absolute wave Vlatency only. There was a significant positive correlation between the hearing threshold, ABR wave V latencyand the activity of the RA patients (P&lt;0.05). Conclusion: RA patients are at risk of hearing impairement, especially those with active disease.