Pure-tone Average Thresholds Research Articles

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

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

Executive Function Associations With Audibility-Adjusted Speech Perception in Noise.

Speech recognition in noise is challenging for listeners and appears to require support from executive functions to focus attention on rapidly unfolding target speech, track misunderstanding, and sustain attention. The current study was designed to test the hypothesis that lower executive function abilities explain poorer speech recognition in noise, including among older participants with hearing loss who often exhibit diminished speech recognition in noise and cognitive abilities. A cross-sectional sample of 400 younger-to-older adult participants (19 to < 90 years of age) from the community-based Medical University of South CarolinaLongitudinal Cohort Study of Age-related Hearing Loss were administered tasks with executive control demands to assess individual variability in a card-sorting measure of set-shifting/performance monitoring, a dichotic listening measure of selective attention/working memory, sustained attention, and processing speed. Key word recognition in the high- and low-context speech perception-in-noise (SPIN) tests provided measures of speech recognition in noise. The SPIN scores were adjusted for audibility using the Articulation Index to characterize the impact of varied hearing sensitivity unrelated to reduced audibility on cognitive and speech recognition associations. Set-shifting, dichotic listening, and processing speed each explained unique and significant variance in audibility-adjusted, low-context SPIN scores (ps < .001), including after controlling for age, pure-tone threshold average (PTA), sex, and education level. The dichotic listening and processing speed effect sizes were significantly diminished when controlling for PTA, indicating that participants with poorer hearing sensitivity were also likely to have lower executive function and lower audibility-adjusted speech recognition. Poor set-shifting/performance monitoring, slow processing speed, and poor selective attention/working memory appeared to partially explain difficulties with speech recognition in noise after accounting for audibility. These results are consistent with the premise that distinct executive functions support speech recognition in noise.

Results of a New Treatment Protocol for Sudden Sensorineural Hearing Loss Using Betamethasone for Intratympanic Therapy.

Introduction Sudden sensorineural hearing loss (SSNHL) is defined as a rapid sensation of hearing impairment in one or both ears. Based on its personal impact on patients, the present study advances the analysis of new treatments for the prompt recognition and management of SSNHL, with higher chances of improvements in terms of hearing recovery and quality of life of the patients. Objective To describe the intratympanic (IT) corticoid infiltration technique, to demonstrate the efficacy of betamethasone injection as a sequential treatment in patients whose initial systemic steroid treatment failed, as well as to compare its use in different treatment periods. Methods The present clinical trial was conducted with 37 patients referred to our office with the diagnosis of SSNHL, from September 2019 to May 2022, who provided informed consent to participate. Results Even dividing the analysis of increasing the pure tone average (PTA) or speech recognition threshold (SRT) between the difference into initiation of the salvage therapy in up to 15 days of the sudden deafness event, and between 15 days and 3 months of the event, we did not find any difference in hearing improvement. Conclusion Intratympanic corticosteroid therapy is prescribed when conventional therapy fails or when there is a limitation to the use of corticosteroids due to the presence of systemic disorders. As such, new drugs, such as bethametasone, are studied and show promising results.

A comparative study of auditory and non-auditory characteristics of congenital, early, and late-onset auditory neuropathy spectrum disorder

BackgroundThe study explored the differences in audiological and non-audiological characteristics between congenital, early-onset, and late-onset auditory neuropathy spectrum disorder (ANSD). Ninety-five individuals diagnosed with ANSD were included in the study. They were divided into three groups congenital ANSD—children (30 individuals, 60 ears), adults with early-onset ANSD (30 individuals, 56 ears), and adults with late-onset ANSD (35 individuals, 62 ears). The non-audiological characteristics (gender, laterality, and risk factors) and audiological characteristics (behavioral and electrophysiological measures) were compared between the three groups.ResultsDiscriminant analyses showed that the pure tone average, audiogram configuration, and speech thresholds were the best auditory predictors of onset-based group differences in ANSD (congenital and early-onset versus late-onset ANSD). While the congenital and early-onset group showed poorer pure-tone and speech thresholds, along with flat configuration, the late-onset group demonstrated relatively better thresholds and other configurations (rising, tent-shaped, cookie-bite). In addition, long latency responses were delayed or absent in children with congenital ANSD, indicative of onset coding deficits at the cortical level.ConclusionsThe study highlights the audiological differences between congenital, early-, and late-onset ANSD groups. These differences could be because of variations in etiology, pathophysiology, site of lesion, or genetic variability between the groups, which needs to be explored further.

Hearing Loss and Annual Earnings Over a 20-Year Period: The HUNT Cohort Study.

The association between hearing loss and income has only been examined in cross-sectional studies. We aim to study annual increase in earnings over 20 years, comparing people with and without hearing loss. We used data from a population-based hearing study in Norway (The Trøndelag Health Study, 1996-1998), including 14,825 persons (46.2% men, mean age at baseline 30.6 years, age range 20 to 40 years). Hearing loss was defined as the pure-tone average threshold of 0.5 to 4 kHz in the better hearing ear ≥20 dB HL (n = 230). Annual earnings were assessed from 1997 to 2017. Longitudinal analyses were performed with linear mixed models adjusted for age, sex, and education. People without hearing loss at baseline (before age 40) had a greater annual increase in earnings over a 20-year follow-up period compared with people with hearing loss. For people with normal hearing, annual earnings over 20 years increased by 453 Euro (EUR) (95% confidence interval [CI] = 384 to 522) or 13.2% more per year than for people with hearing loss, adjusted for age and sex. The difference in annual earnings over 20 year was greater among women (462 EUR, 95% CI = 376 to 547) than men (424 EUR, 95% CI = 315 to 533), greater among younger than older adults, and greater among lower than higher educated persons. When including adjustment for education in the model, in addition to age and sex, the difference in annual earnings over 20 years between persons with and without hearing loss was reduced (337 EUR, 95% CI = 269 to 405). The results from this large population-based study indicates that people with hearing loss experience lower long-term earnings growth compared with people with normal hearing. The findings highlight the need for increased interventions in the workplace for people with hearing loss.

Age-Related Hearing Loss, Cognitive Decline, and Social Interaction: Testing a Framework.

Aging increases risk for hearing loss, cognitive decline, and social isolation; however, the nature of their interconnection remains unclear. This study examined the interplay between age-related hearing loss, cognitive decline, and social isolation in adults by testing the ability to understand speech in background noise, a challenge frequently reported by many older adults. We analyzed data collected from 128 adults (20-79 years of age, Mage = 51 years) recruited as part of the Aging Brain Cohort at the University of South Carolina repository. The participants underwent testing for hearing, cognition, and social interaction, which included pure-tone audiometry, a words-in-noise (WIN) test, a hearing questionnaire (Speech, Spatial and Qualities of Hearing Scale [SSQ12]), a social questionnaire (Patient-Reported Outcomes Measurement Information System-57 Social), and the Montreal Cognitive Assessment. We used a single pure-tone average (PTA) threshold value and a single WIN threshold value for each participant because there were no differences on average between the left and right ears. Poorer hearing was significantly associated with cognitive decline, through both PTA and WIN thresholds, with a stronger association observed for WIN threshold. Adults with poorer hearing also exhibited greater social isolation, as evidenced by their WIN threshold and SSQ12 score, although not through PTA. This connection was more pronounced with the WIN threshold than with the SSQ12 score. Cognition was not related to social isolation, suggesting that social isolation is affected more by the ability to understand words in noise than by cognition in a nondemented population. Understanding speech in challenging auditory environments rather than mere threshold detection is strongly linked to social isolation and cognitive decline. Thus, inclusion of a word-recognition-in-noise test and a social isolation survey in clinical settings is warranted. https://doi.org/10.23641/asha.26237060.

Hearing, balance, and imaging assessment in adolescent Menière's disease: A retrospective analysis.

To retrospectively analyze clinical features in adolescent Menière's disease (MD). The medical records of adolescents with MD (11-17 years old) from May 2014 to March 2023 in Shandong Provincial ENT Hospital were retrospectively analyzed, including clinical features, a battery of auditory and vestibular function tests, sensory organization test, and imaging assessments. Patients with recurrent vertigo of childhood (RVC) were as controls. Compared with RVC, adolescent MD showed higher pure tone average threshold (p < .001), lower speech discrimination score (p = .014), and lower otoacoustic emission pass rates (p = .005). Adolescents with MD exhibited significant reduction in equilibrium score (Conditions 1, 5, and 6; p1 = .035; p5 = .033; p6 = .003), composite sensory score (p = .014), and vestibular sensory score (p = .029). Adolescents with bilateral MD exhibited worse performance in equilibrium score and strategy score compared to adolescents with unilateral MD. For the affected ear, the more severe endolymphatic hydrops detected by gadolinium-enhanced magnetic resonance imaging, the higher the auditory brainstem response threshold (r = .850, p = .007), and the lower the otoacoustic emission pass rate (r = -.976, p < .001). Adolescent MD has similar vestibular information inputs with that of RVC, but the ability for the nerve center to use these clues to maintain balance is worse in adolescents with MD. There were potential differences in vestibular weights in adolescents with unilateral and bilateral MD, also potential effects on vision and proprioception. Level 4.

Intraoperative Hearing Monitoring Using ABR and TT-ECochG and Hearing Preservation during Vestibular Schwannoma Resection.

Background: Quick and appropriate diagnostics and the use of intraoperative monitoring (IM) of hearing during vestibular schwannoma (VS) resection increase the likelihood of hearing preservation. During surgery, various methods of IM can be used, i.e., auditory brainstem responses (ABRs), transtympanic electrocochleography (TT-ECochG), and direct cochlear nerve action potentials. The aim of the study was to evaluate the prognostic values of IM of hearing using ABR and TT-ECochG in predicting postoperative hearing preservation and to evaluate relationships between them during various stages of surgery. Methods: This retrospective study presents the pre- and postoperative audiological test results and IM of hearing records (TT-ECochG and ABR) in 75 (43 women, 32 men, aged 18-69) patients with diagnosed VS. Results: The preoperative pure tone average hearing threshold was 25.02 dB HL, while after VS resection, it worsened on average by 30.03 dB HL. According to the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) Hearing Classification, before and after (pre/post) surgery, there were 47/24 patients in hearing class A, 9/8 in B, 2/1 in C, and 17/42 in D. In speech audiometry, the average preoperative speech discrimination score at an intensity of 60 dB SPL was 70.93%, and after VS resection, it worsened to 38.93%. The analysis of electrophysiological tests showed that before the tumor removal the I-V ABR interlatencies was 5.06 ms, and after VS resection, it was 6.43 ms. Conclusions: The study revealed correlations between worse postoperative hearing and changes in intraoperatively measured ABR and TT-ECochG. IM of hearing is very useful in predicting postoperative hearing in VS patients and increases the chance of postoperative hearing preservation in these patients.

Accuracy and Consistency of Confidence Limits for Monosyllable Identification Scores Derived Using Simulation, the Harrell-Davis Estimator, and Nonlinear Quantile Regression.

Audiological diagnosis and rehabilitation often involve the assessment of whether the maximum speech identification score (PBmax) is poorer than expected from the pure-tone average (PTA) threshold. This requires the estimation of the lower boundary of the PBmax values expected for a given PTA (one-tailed 95% confidence limit, CL). This study compares the accuracy and consistency of three methods for estimating the 95% CL. The 95% CL values were estimated using a simulation method, the Harrell-Davis (HD) estimator, and non-linear quantile regression (nQR); the latter two are both distribution-free methods. The first two methods require the formation of sub-groups with different PTAs. Accuracy and consistency in the estimation of the 95% CL were assessed by applying each method to many random samples of 50% of the available data and using the fitted parameters to predict the data for the remaining 50%. A total of 642 participants aged 17 to 84 years with sensorineural hearing loss were recruited from audiology clinics. Pure-tone audiograms were obtained and PBmax scores were measured using monosyllables at 40 dB above the speech recognition threshold or at the most comfortable level. For the simulation method, 6.7 to 8.2% of the PBmax values fell below the 95% CL for both ears, exceeding the target value of 5%. For the HD and nQR methods, the PBmax values fell below the estimated 95% CL for approximately 5% of the ears, indicating good accuracy. Consistency, estimated from the standard deviation of the deviations from the target value of 5%, was similar for all the methods. The nQR method is recommended because it has good accuracy and consistency, and it does not require the formation of arbitrary PTA sub-groups.

The Impact of Piezoelectric Device in Cholesteatoma Endoscopic Surgery: Retrospective Evaluation of Safety and Functional Results.

Atticotomy represents an essential surgical step within the management of attical cholesteatoma during endoscopic ear surgery. The aim of the present study was to evaluate the safety and functional results of an endoscopic atticotomy performed with piezosurgery, in terms of audiological outcomes and tissue's healing. This is an observational retrospective study on patients with attical cholesteatoma who underwent endoscopic ear surgery with piezoelectric atticotomy and subsequent scutum reconstruction either with tragal cartilage or temporalis muscle fascia. Scutumplasty's status was evaluated via scheduled outpatient controls through an endoscopic check and classified as stable or unstable at least 10 months after surgery. A pre- and postoperative audiometric examination was performed in each patient. Eighty-four patients were enrolled. In 50 out of 84 patients (59.52%), an exclusive endoscopic procedure was performed, whereas in 34 patients (40.48%) a combined microscopic/endoscopicapproach was adopted. In 72 cases (85.71%), scutum's reconstruction appeared to be normally positioned, whereas 12 patients developed a retraction pocket, which was self-cleaning in 8 of them and non-self-cleaning in the remaining 4. In 17 patients, a slight sensorineural hearing loss (between 5 and 15 dBHL) was observed, and in 2 patients, the loss was greater than 15 dBHL. Overall, no significative differences between pre- and postoperative pure-tone average bone thresholds resulted (p = 0.4983), though a mild significant hearing deterioration was detected by the specific analysis at 4000 Hz (p = 0.0291). Piezosurgery represents an extremely useful tool in performing atticotomy during endoscopic tympanoplasties. Our data seem to support the safety of its usage in this specific step, as it did not lead to any significant sensorineural damage on overall pure-tone average. Moreover, satisfactory tissue healing in regard to scutum reconstruction was observed.

Agreement between audiometric hearing loss and self-reported hearing difficulty on the Revised Hearing Handicap Inventory differs by demographic factors

BackgroundNew standardised measures of self-reported hearing difficulty can be validated against audiometric hearing loss. This study reports the influence of demographic factors (age, sex, race and socioeconomic position (SEP)) on...

Effects of hearing acuity on psychophysiological responses to effortful speech perception

In recent studies, psychophysiological measures have been used as markers of listening effort, but there is limited research on the effect of hearing loss on such measures. The aim of the current study was to investigate the effect of hearing acuity on physiological responses and subjective measures acquired during different levels of listening demand, and to investigate the relationship between these measures. A total of 125 participants (37 males and 88 females, age range 37–72 years, pure-tone average hearing thresholds at the best ear between -5.0 to 68.8 dB HL and asymmetry between ears between 0.0 and 87.5 dB) completed a listening task. A speech reception threshold (SRT) test was used with target sentences spoken by a female voice masked by male speech. Listening demand was manipulated using three levels of intelligibility: 20 % correct speech recognition, 50 %, and 80 % (IL20 %/IL50 %/IL80 %, respectively). During the task, peak pupil dilation (PPD), heart rate (HR), pre-ejection period (PEP), respiratory sinus arrhythmia (RSA), and skin conductance level (SCL) were measured. For each condition, subjective ratings of effort, performance, difficulty, and tendency to give up were also collected. Linear mixed effects models tested the effect of intelligibility level, hearing acuity, hearing asymmetry, and tinnitus complaints on the physiological reactivity (compared to baseline) and subjective measures. PPD and PEP reactivity showed a non-monotonic relationship with intelligibility level, but no such effects were found for HR, RSA, or SCL reactivity. Participants with worse hearing acuity had lower PPD at all intelligibility levels and showed lower PEP baseline levels. Additionally, PPD and SCL reactivity were lower for participants who reported suffering from tinnitus complaints. For IL80 %, but not IL50 % or IL20 %, participants with worse hearing acuity rated their listening effort to be relatively high compared to participants with better hearing. The reactivity of the different physiological measures were not or only weakly correlated with each other. Together, the results suggest that hearing acuity may be associated with altered sympathetic nervous system (re)activity. Research using psychophysiological measures as markers of listening effort to study the effect of hearing acuity on such measures are best served by the use of the PPD and PEP.

Confirmatory factor analysis of the Tinnitus Impact Questionnaire using data from patients seeking help for tinnitus alone or tinnitus combined with hyperacusis.

A confirmatory factor analysis (CFA) of the Tinnitus Impact Questionnaire (TIQ) was performed. In contrast to commonly used tinnitus questionnaires, the TIQ is intended solely to assess the impact of tinnitus by not including items related to hearing loss or tinnitus loudness. This was a psychometric study based on a retrospective cross-sectional analysis of clinical data. Data were available for 155 new patients who had attended a tinnitus and hyperacusis clinic in the UK within a five-month period and had completed the TIQ. The mean age was 54 years (standard deviation = 14 years). The TIQ demonstrated good internal consistency, with Cronbach's α = 0.84 and McDonald's ω = 0.89. CFA showed that two items of the TIQ had low factor loadings for both one-factor and two-factor models and their scores showed low correlations with scores for other items. Bi-factor analysis gave a better fit, indicated by a relative chi-square (χ2) of 18.5, a Root-Mean Square Error of Approximation (RMSEA) of 0.103, a Comparative Fit Index (CFI) of 0.97, a Tucker Lewis Index (TLI) of 0.92, and a Standardized Root-Mean Residual (SPMR) of 0.038. Total TIQ scores were moderately correlated with scores for the Visual Analogue Scale of effect of tinnitus on life and the Screening for Anxiety and Depression-Tinnitus questionnaire, supporting the convergent validity of the TIQ. The TIQ score was not correlated with the pure-tone average hearing threshold, indicating discriminant validity. A multiple-causes multiple-indicator (MIMIC) model showed no influences of age, gender or hearing status on TIQ item scores. The TIQ is an internally consistent tool. CFA suggests a bi-factor model with sufficient unidimensionality to support the use of the overall TIQ score for assessing the impact of tinnitus. TIQ scores are distinct from the impact of hearing impairment among patients who have tinnitus combined with hearing loss.

Relationship Between Hypertension and Hearing Loss: Analysis of the Related Factors.

The impact of hypertension extends to hearing loss, aging, and mental Health. The purpose of this study was to investigate the characteristics of hearing loss and hearing thresholds at different frequencies in individuals with hypertension. Through a comprehensive analysis, in the present study, it aimed to uncover the contributing factors that underlie hearing loss in this patient cohort, shedding light on the complex relationship between hypertension and auditory impairment. This was a single-center population-based observational study, and clinical, biological, and hospital data were collected from the inpatient ward. In the present study, 517 patients (1034 ears) with or without hypertension were included, and the proportion of patients with hearing loss, mean pure-tone average hearing threshold, low-frequency pure-tone average hearing threshold (LFPTA), medium-frequency pure-tone average hearing threshold (MFPTA) and high-frequency pure-tone average hearing threshold (HFPTA) were evaluated. Risk factors related to hearing loss and hearing threshold were also estimated at different frequencies. The proportion of patients with hearing loss was higher in the hypertensive group than in the nonhypertensive group (P<0.05). After including risk factors for cardiovascular disease that can have an impact on the parameters of hearing and ambulatory blood pressure in the regression model, factors related to hearing loss included the albumin-to-creatinine ratio (ACR) and the standard deviation of the 24-hour systolic blood pressure (24h-SSD). ACR, 24h-SSD, and day systolic blood pressure (Day SBP) were associated with the mean pure-tone average hearing threshold, LFPTA, MFPTA, and HFPTA. The area under the receiver operating characteristic curve of ACR + 24h-SSD for hearing loss was 0.873, with a sensitivity of 86.73%, specificity of 90.52%, and a 95% confidence interval of 0.821-0.914. Hypertension is correlated with hearing loss, and the combination of ACR and 24h-SSD demonstrates an improved predictive capacity for hearing loss in hypertensive patients.

Rate and management of tympanic membrane perforations in children with Down syndrome and middle ear disorder

ObjectiveTo characterize the management and outcomes of observation versus surgical intervention of tympanic membrane (TM) perforations in children with Down syndrome (DS). In addition, to estimate the prevalence of TM perforations in children with DS. MethodsRetrospective case review analysis of TM perforation rate in children with DS with history of tympanostomy tube (TT) insertion at a tertiary pediatric referral center. Patients were divided into observation or surgical intervention groups and then further evaluated for the type of intervention, the number of required procedures, and success rate of hearing improvement. Risk factors contributing to perforations were analyzed, including TT type, number of TT surgeries, and perforation size. ResultsThe TM perforation rate in children with DS with TT history was 7.0 %. Tympanoplasty was performed in 41.5 % of perforated ears with a success rate of 53.1 %. There was no statistical difference between the surgical intervention and observation groups regarding perforation characteristics or TT number and type, but the surgical intervention cohort was older. Hearing improvement based on postoperative pure tone average (PTA) threshold was noted in the successful surgical intervention group. ConclusionThe rate of TM perforations in children with DS after TTs is comparable to the general population. Improved PTA thresholds were noted in the surgical success group influencing speech development. The overall lower success rate of tympanoplasty in patients with DS emphasizes the need to factor in the timing of surgical intervention based on the predicted age of Eustachian tube maturation.

Functional outcomes and caloric response changes after endolymphatic sac decompression

ObjectiveTo evaluate caloric response changes after endolymphatic sac decompression (ESD), together with hearing outcomes and the functional benefit of the operation. MethodsA retrospective chart review of subjects who underwent endolymphatic sac decompression at a tertiary referral centre was performed. Data on audiological results, caloric testing, and functional level scale of the patients were analysed. ResultsTwenty-eight patients who met our criteria were eligible for enrolment in the study. The average follow-up after surgery was 25 months (range, 13–41). Postoperative pure-tone threshold averages and reduced vestibular response values (RVR) were not significantly altered by ESD; whereas, functional level scores improved significantly. ConclusionEndolymphatic sac decompression is a surgical procedure that preserves hearing and vestibular function, and improves the daily functional level of patients with Ménière's disease. ESD can be preferred both in bilateral and unilateral disease because it does not alter vestibular function and preserves hearing.

A phase I/IIa safety and efficacy trial of intratympanic gamma-secretase inhibitor as a regenerative drug treatment for sensorineural hearing loss

Inhibition of Notch signalling with a gamma-secretase inhibitor (GSI) induces mammalian hair cell regeneration and partial hearing restoration. In this proof-of-concept Phase I/IIa multiple-ascending dose open-label trial (ISRCTN59733689), adults with mild-moderate sensorineural hearing loss received 3 intratympanic injections of GSI LY3056480, in 1 ear over 2 weeks. Phase I primary outcome was safety and tolerability. Phase lla primary outcome was change from baseline to 12 weeks in average pure-tone air conduction threshold across 2,4,8 kHz. Secondary outcomes included this outcome at 6 weeks and change from baseline to 6 and 12 weeks in pure-tone thresholds at individual frequencies, speech reception thresholds (SRTs), Distortion Product Otoacoustic Emissions (DPOAE) amplitudes, Signal to Noise Ratios (SNRs) and distribution of categories normal, present-abnormal, absent and Hearing Handicap Inventory for Adults/Elderly (HHIA/E). In Phase I (N = 15, 1 site) there were no severe nor serious adverse events. In Phase IIa (N = 44, 3 sites) the average pure-tone threshold across 2,4,8 kHz did not change from baseline to 6 and 12 weeks (estimated change −0.87 dB; 95% CI −2.37 to 0.63; P = 0.252 and −0.46 dB; 95% CI −1.94 to 1.03; P = 0.545, respectively), nor did the means of secondary measures. DPOAE amplitudes, SNRs and distribution of categories did not change from baseline to 6 and 12 weeks, nor did SRTs and HHIA/E scores. Intratympanic delivery of LY3056480 is safe and well-tolerated; the trial’s primary endpoint was not met.

Exploring attentive listening in noise through the just-follow conversation task

Listening to a conversation demands comprehension, attention and prediction. To better understand the impact of these demands, as well as how hearing aids might alleviate them, a conversational listening test should be realistic, repeatable and relatable (i.e., have interpretable units). A test that potentially satisfies these needs is the just-follow conversation (JFC) task, where the listener adjusts the signal level to where they can understand, with effort, the gist of what is being said in a background of noise. Fifty-four participants sat in the centre of a circular loudspeaker array and adjusted the overall level of one monologue, one dialogue, two monologues or two dialogues presented in the front hemifield to where they could just follow the speech four times per trial. Signals were presented in surrounding fixed-level café and same-spectrum noise backgrounds. Bilateral hearing-aid users adjusted aided and unaided; non-users repeated each condition to evaluate reliability. Results showed an increase in JFC for dialogues re monologues. Individual JFC SNRs correlated with SSQ12 speech subscale scores as well as pure-tone threshold averages. JFC reliability was comparable to more objective speech understanding measures, but it may not be suitable to capture perceived conversational benefits for more subtle changes in hearing-aid processing. [Work supported by the UK Medical Research Council Grant No. MR/X003620/1 &amp; WS Audiology.]

Analysis of Loudness Discomfort Level Tests in Tinnitus Patients

Introduction: We aimed to investigate the clinical significance of the loudness discomfort level (LDL) test in tinnitus patients and its relationship with pure-tone audiometry, tinnitogram, and questionnaires. Methods: We retrospectively reviewed the medical records of 320 tinnitus patients who visited a tertiary university hospital’s tinnitus clinic and completed LDL tests between March 2020 and December 2022. Epidemiological data and psychoacoustic test results were collected. Results: The LDL showed no significant differences between frequencies for both ears. The mean LDL did not correlate with mean pure-tone average or hearing thresholds at each frequency. The hearing loss group had a higher LDL at 8 kHz compared to the normal hearing group (p < 0.01). Objective sound intolerance was found in a quarter, correlating with subjective hyperacusis, anxiety, and depression. Weak negative correlations were found between most of questionnaire’s scores and LDL on the left side. Tinnitus loudness weak negatively correlated with LDL at most frequencies, except 8 kHz. Discussion/Conclusion: Our findings suggest a notable association between LDL levels and emotional factors in tinnitus patients, rather than with auditory thresholds. While lateralized differences in LDL responses were observed, specifically on the left side, these preliminary results do not confirm a causal link and thus do not warrant changes to current clinical testing protocols without further research.

Validity and Reliability of Age-Related Hearing Loss Questionnaire in Korean Elderly

Purpose: The objective of this study is to investigate the validity and reliability of the Age-Related Hearing Loss Questionnaire (ARHLQ) for Korean elderly, originally developed by Choi, to evaluate the communication difficulties faced by Korean elderly individuals with hearing loss everyday life. The ARHLQ consists of twenty-three questions in four subcategories of communication difficulties (9 items), communication environment (5 items), emotion and other’s reaction (6 items), and communication strategy (3 items).Methods: The ARHLQ was administrated to a total ninety subjects composed of three or four subject groups based on mild, moderate, moderate severe, and severe hearing loss determined by the pure tone threshold average (PTA) and high frequency threshold average (HFPTA), with an average age with the age of 77.22 ± 6.36 years old. Validity and reliability were calculated using Pearson’s correlation coefficient, the Kruskal-Wallis test for nonparametric independent samples, and Cronbach alpha coefficient.Results: Pearson’s correlations coefficients between total scores and four subcategories of ARHLQ were high ranging from 0.813 to 0.971 and the correlation coefficient between ARHLQ and the Korean Hearing Handicap Inventory for the Elderly (K-HHIE) was high (0.736). The correlation coefficients between four subcategories of ARHLQ and the two subcategories of K-HHIE were high ranging from 0.598 to 0.770. The mean difference in total score and four subcategories of ARHLQ by the hearing degrees of PTA and HFPTA were significantly observed. For internal consistency, Cronbach’s alpha coefficient in total scores and four subcategories was high ranging from 0.807 to 0.966. The test-retest correlation for reliability was very high (0.996).Conclusion: These findings suggest that the ARHLQ is a clinically useful tool to evaluate age-related hearing loss according to the degree of hearing loss.