Pure-tone Hearing Thresholds Research Articles

The significance of right ear auditory processing to balance

Although the association between balance and hearing thresholds at different frequencies in the right/left ear is crucial, it has received scant empirical attention. Balance is widely ignored when evaluating hearing in adults. This study examined the relative contribution of left versus right ear hearing at different frequencies to balance, and the mediating role of suprathreshold speech perception on age-balance associations. Pure tone hearing thresholds (500–4000 Hz), suprathreshold speech perception, balance, and risk of falling were evaluated in 295 adults. The results indicate that the right ear contributes more to balance than the left ear. This might imply dominance of the left hemisphere in processing hearing cues for balance. Frequencies within the speech range (500/1000/2000 Hz) were correlated with balance and mediated the interaction between age and balance. These results should be considered when tailoring hearing and balance rehabilitation programs.

Cognitive function in Meniere’s disease

ABSTRACT Meniere’s disease is an otological disease characterized by various symptoms that include episodic peripheral vertigo, sensorineural hearing loss, tinnitus, and aural fullness, all of which deteriorate the maintenance of daily activities. We aimed to investigate cognitive function in Meniere’s disease patients and compare their results to those of healthy controls. Eighteen patients diagnosed with definite Meniere’s disease without any psychiatric, neurological or otological comorbidity, and 30 healthy controls with normal cognitive functions were included in the study. General cognitive status, attention, verbal memory, visual memory, executive and visuospatial function were measured by detailed neuropsychological tests in both groups. In the patients with Meniere’s disease, pure-tone hearing thresholds, and speech discrimination scores were also measured. Patients with Meniere’s disease showed lower levels of performance in the trail making test, Oktem verbal memory processes, Rey Complex Figure Test, Wisconsin Card Sorting Test, semantic and phonemic fluency than did healthy controls. In other words, there were deficits in attention, recognition and recall in verbal memory, recall in visual memory, visual spatial construction, and planning skills in patients with Meniere’s disease. Education years and depression scores of participants had a significant effect on cognitive function in all groups. This study is an update and confirmation of the findings of studies showing cognitive impairment in patients with Meniere’s disease. In addition to previous findings, this study found a decrease in executive function performance in patients with Meniere’s disease compared to healthy controls. Unlike previous studies, this study comprehensively addressed all cognitive functions and included a control group. Our results emphasize that executive functions, which are high-level cognitive processes, may affect the compliance of patients with Meniere’s disease treatment and follow-up processes.

Recurrent Vestibulopathy: Comparison of Vestibular Test Results with Ménière’s Disease and Vestibular Migraine

Introduction: Recurrent and episodic vestibular symptoms not fulfilling criteria for known episodic vestibular syndromes are named as recurrent vestibulopathy (RV). We aimed to compare the vestibular test results of RV patients with vestibular migraine (VM) and Ménière’s disease (MD). Methods: Twenty patients with MD, 20 patients with VM, 18 patients with RV, and 20 healthy volunteers (HC) were evaluated. Pure-tone hearing thresholds (PTHTs), video head impulse test (vHIT), functional head impulse test (fHIT), and cervical vestibular evoked myogenic potentials (cVEMPs) were studied. Results: PTHT of the MD-affected ears were significantly high, and cVEMP-corrected amplitudes were low when compared with the VM, RV, and HC (p < 0.001 for all). Amplitude asymmetry ratio was significantly high in MD-affected ears when compared with the HC (p = 0.014), VM (p = 0.038), and RV (p = 0.045). VEMP latencies and lateral canal vHIT gain were not different between groups (p > 0.05). The percentage of correctly identified optotypes on fHIT of the MD (p > 0.001), VM (p = 0.004), and RV (p = 0.001) patients were low in comparison with the HC. Conclusion: Apart from hearing loss, low cVEMP amplitudes on the affected side were the main feature in MD differentiating it from VM and RV. Vestibular test results of patients with RV and VM were similar. Low fHIT results in all groups indicate a functional deficit in gaze stabilization. Disabling vertigo attacks disturbing attention may be the cause of this functional impairment. MD, VM, and RV may be parts of a broad-spectrum disorder, RV patients representing milder forms not associated with cochlear or migrainous features.

Risk assessment of hearing loss of noise workers in three petrochemical enterprises

To evaluate the risk of noise induced hearing loss among workers in petrochemical enterprises. Number of workers exposed to noise were recruited from three petrochemical enterprises. The noise exposure level(L_(EX, W)) of the research objects was measured, their occupational history was investigated, and the audiometric testing was carried out. The ISO 1999:2013 model was used to calculate the change of hearing threshold level and the risk of hearing loss in each post, and compared the result of model with the result of the audiometric testing. The median of L_(EX, W) is range from 79.8 to 85.0 dB(A). L_(EX, W) among all posts were greater than 80 dB(A) except naphtha processing operators. The result of pure tone hearing threshold test showed that the prevalence of high-frequency hearing loss among workers exposed to noise was 12.8%. According to the classification of noise operation according to the maximum value of L_(EX, W), the operator for styrene dry gas combined unit is the only post that is extremely dangerous in the department of chemical, the other posts in the department of chemical and all posts in the department of public works are exposed to light and medium noise hazards, and 62.5% the external operators of the oil refining department are under heavy and extremely hazardous. According to the evaluation result of ISO 1999:2013, the risk of high-frequency hearing loss among workers in crude distillation unit, hydrogen production unit and the electricians of electrical system is high. The measured median of noise-induced pernament threshold shift(NIPTS) among male workers in different workstation was higher than the predicted median of NIPTS of ISO 1999, and the difference was statistically significant(P&lt;0.01), and the predicted values for four-fifths of positions were more than 10 dB lower than the measured value. The risk of noise induced hearing loss of workers in petrochemical enterprises is high.

Age-related declines to serum prestin levels in humans

Measurement of the motor protein prestin offers a novel approach to assessing outer hair cell (OHC) status using serological techniques. Motivated by our prior work showing reduced serum prestin levels in healthy young adults at-risk for noise damage, the current study examined serum prestin levels, measured from circulating blood, across the age span from 18 to 82 years old. Results suggest that serum prestin levels negatively correlate with age, with young adults having higher levels of circulating serum in the blood than older adults. Group-level analyses showed minimal differences in prestin levels between 18 and 29, 30–39, and 40–49 year olds, but significant reductions in the 50+ years-old age group compared to the three younger groups, even though all groups significantly differed from each other in audiometric thresholds and distortion product otoacoustic emissions signal-to-noise ratio. Serum prestin levels declined with increasing levels of hearing loss, with a statistically significant relationship emerging between prestin and low-frequency hearing thresholds (0.25–2 kHz) but a weaker non-significant relationship for high-frequency hearing thresholds (3–8 kHz). This differential pattern between low- and high- frequency thresholds is consistent with the basal-to-apical progression of OHC loss with age. Findings support the idea that serum prestin is the product of residual OHCs in the less age-affected apical regions. Moreover, when entered in a regression model with audiometric thresholds, age was a stronger predictor than pure tone hearing threshold level for predicting serum prestin levels.

Assessment Of Pure Tone Hearing Threshold In Niddm &amp; Its Comparison With Healthy Individual

Aim: To assess whether patients of NIDDM have a higher incidence of sensorineural hearing loss.Methodology: A cross-sectional study was conducted included 100 participants such that 50 were diabetics and another werenondiabetics. Pure Tone Audiometry was performed on the patient, and the results were assessed by comparing them to the patient'sdiabetes duration. The IBM SPSS version 20 software was used for all data analysis. The tables were created using cross tabulation andfrequency distribution.Results: On comparing the degree of hearing loss between both the groups and the mean hearing threshold of both the ears with durationof diabetes it was found that distribution of degree of hearing loss between the cases and control was significantly different.Conclusion: The study concluded that age had the direct association with the pure tone threshold level which means by increasing theage of the diabetes patients, hearing loss also increases as revealed by the significant p value of &lt;0. 005.

Effects of erinacine A-enriched Hericium erinaceus on elderly hearing-impaired patients: A double-blind, randomized, placebo-controlled clinical trial

We aimed to investigate the effects and mechanisms of Hericium erinaceus (HE) on hearing degeneration. By a double-blind, randomized, clinical trial, all 80 hearing-impaired patients aged 50–79 were randomly divided into the two groups, which received HE mycelia (2000 mg/day) and placebo boluses for eight months, respectively. A student’s t-test was used to evaluate the differences of the average pure tone hearing threshold of all, low, and high frequencies (PTA-all, PTA-low, and PTA-high); speech recognition threshold (SRT); speech discrimination score (SDS); and serum concentrations of brain-derived neurotrophic factor (BDNF) and neurotrophic growth factor (NGF) between the two study groups. Subgroup analysis by age showed that PTA-high-Right, PTA-all-Left, PTA-high-Left, SRT-Right, SRT-Left, and NGF were significantly different between the two groups among patients aged ≧ 65. HE mycelia treatment could ameliorate hearing loss, especially for high frequencies and speech recognition, and increase NGF in patients aged ≧ 65.

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.

Real-Ear-to-Coupler Difference: Physical and Perceptual Differences.

The real-ear-to-coupler difference (RECD) is a recommended measure for accurate hearing aid fittings, especially for pediatric populations. However, for adults, many clinicians question whether it is necessary. Hearing aids were fit on two groups of 85 older adults seen at a Veterans Administration audiology clinic. One group was fit using RECD measurements, whereas the second group was fit with population-based average RECD values. The two groups had similar pure-tone hearing thresholds. Like previous studies, there was little difference between the measured RECD for the right and left ears among the participants. Although the majority of the measured RECDs were within 1 SD of the mean, approximately 20% of those measured were outside of the normal range. It also was found that all participants produced lower (improved) Hearing Handicap Inventory for Elderly-Screening (HHIE-S) scores from pre- to postfitting, thus suggesting a reduction in self-perceived hearing handicap. Despite having similar prefitting HHIE-S scores, those participants who had their hearing aids fit using measured RECD values had lower postfitting scores than the group that was fit with average RECD values. Furthermore, there was a significant difference between the groups on several questions of the International Outcome Inventory-Hearing Aids, suggesting that there was higher satisfaction with the fittings based on the custom RECD rather than the fittings based on the average RECD. This study demonstrated that, in addition to performing verification using real-ear measurements, accurate conversion of dB HL to dB SPL using personalized RECD likely improved hearing aid satisfaction.

Predicting Aided Outcome With Aided Word Recognition Scores Measured With Linear Amplification at Above-conversational Levels.

Many hearing aid (HA) users receive limited benefit from amplification, especially when trying to understand speech in noise, and they often report hearing-related residual activity limitations. Current HA fitting strategies are typically based on pure-tone hearing thresholds only, even though suprathreshold factors have been linked to aided outcomes. Furthermore, clinical measures of speech perception such as word recognition scores (WRSs) are performed without frequency-specific amplification, likely resulting in suboptimal speech audibility and thus inaccurate estimates of suprathreshold hearing abilities. Corresponding measures with frequency-specific amplification ("aided") would likely improve such estimates and enable more accurate aided outcome prediction. Here, we investigated potential links between either unaided WRSs or aided WRSs measured at several above-conversational levels and two established HA outcome measures: The Hearing-In-Noise Test (HINT) and the International Outcome Inventory for Hearing Aids (IOI-HA). Thirty-seven older individuals with bilateral hearing impairments participated. Two conditions were tested: unaided and aided, with all stimuli presented over headphones. In the unaided condition, the most comfortable level (MCL) for the presented speech stimuli, WRS at MCL+10 dB as well as uncomfortable levels (UCLs) for narrowband noise stimuli were measured. In the aided condition, all stimuli were individually amplified according to the "National Acoustic Laboratories-Revised, Profound" fitting rule. Aided WRSs were then measured using an Interacoustics Affinity system at three above-conversational levels, allowing for the maximum aided WRS as well as the presence of "rollover" in the performance-intensity function to be estimated. Multivariate data analyses were performed to examine the relations between the HINT (measured using a simulated HA with the NAL-RP amplification) or IOI-HA scores (for the participants' own HAs) and various potential predictors (age, pure-tone average hearing loss, unaided WRS, aided WRS, rollover presence [ROp], and UCL). Aided WRSs predicted the HINT scores better than any other predictor and were also the only significant predictor of the IOI-HA scores. In addition, UCL and ROp in the aided WRSs were significant predictors of the HINT scores and competed for variance in the statistical models. Neither age nor pure-tone average hearing loss could predict the two aided outcomes. Aided WRSs can predict HA outcome more effectively than unaided WRSs, age or pure-tone audiometry and could be relatively easily implemented in clinical settings. More research is necessary to better understand the relations between ROp, UCL and speech recognition at above-conversational levels.

Subjective tinnitus patients with normal pure-tone hearing still suffer more informational masking in the noisy environment.

Subjective tinnitus patients experience more hearing difficulties than normal peers in complex hearing environments, even though most of these patients have normal pure-tone hearing thresholds. Using speech recognition tasks under different masking conditions can provide insight into whether the effects of tinnitus are lateralized and the mechanisms behind the effects. By simulating sound field recordings, we obtain a target speech sentence that can be perceived as presented on one side and noise or speech masking with or without spatial separation from it. Our study used the virtual sound field technique to investigate the difference in speech recognition ability between chronic subjective tinnitus patients and a normal-hearing control group under the four masking conditions (speech-spectrum noise masking or two-talker speech masking, with or without perceived spatial separation). Experiment 1 showed no differences for target speech perceived location (left or right), which rules out a lateralization of the effect of tinnitus patients. Experiment 2 further found that although tinnitus patients had weaker performance than normal people in very complex auditory scenarios, when the spatial cue of the target speech exists, they can make good use of this cue to make up for the original processing disadvantage and achieve a similar performance as the normal-hearing group. In addition, the current study distinguished the effects of informational masking and energetic masking on speech recognition in patients with tinnitus and normal hearing. The results suggest that the impact of tinnitus on speech recognition in patients is more likely to occur in the auditory center rather than the periphery.

Increased rate of listening difficulties in autistic children

IntroductionAuditory challenges are both common and disruptive for autistic children and evidence suggests that listening difficulties may be linked to academic underachievement (Ashburner, Ziviani & Rodger, 2008). Such deficits may also contribute to issues with attention, behavior, and communication (Ashburner et al., 2008; Riccio, Cohen, Garrison & Smith, 2005). The present study aims to summarize the auditory challenges of autistic children with normal pure-tone hearing thresholds, and perceived listening difficulties, seen at auditory-ASD clinics in the US and Australia. MethodsData were compiled on a comprehensive, auditory-focused test battery in a large clinical sample of school-age autistic children with normal pure-tone hearing to date (N = 71, 6–14 years). Measures included a parent-reported auditory sensory processing questionnaire and tests of speech recognition in noise, binaural integration, attention, auditory memory and listening comprehension. Individual test performance was compared to normative data from children with no listening difficulties. ResultsOver 40% of patients exhibited significantly reduced speech recognition in noise and abnormal dichotic integration that were not attributed to deficits in attention. The majority of patients (86%) performed abnormally on at least one auditory measure, suggesting that functional auditory issues can exist in autistic patients despite normal pure-tone sensitivity. ConclusionIncluding functional listening measures during audiological evaluations may improve clinicians’ ability to detect and manage the auditory challenges impacting this population. Learner Outcomes: 1) Readers will be able to describe the auditory difficulties experienced by some autistic patients (ASD). 2) Readers will be able to describe clinical measures potentially useful for detecting listening difficulties in high-functioning autistic children.

Clinical Efficacy of Retroauricular Injection of Methylprednisolone Sodium Succinate in the Treatment of Sudden Deafness with Type 2 Diabetes.

Background The etiology of sudden deafness is still unclear. In recent years, people's life rhythm is getting faster and faster. Fatigue, environment, diet, psychology, and other factors have increased the morbidity rate of sudden deafness and improved the quality of life of patients. And work efficiency is greatly affected. Aims A study to investigate the clinical efficacy of postauricular injection of methylprednisolone sodium succinate in the treatment of sudden deafness with type 2 diabetes. Materials and Methods Sixty patients with sudden deafness who were treated in our hospital from January 2018 to October 2020 were selected as the subjects of this prospective study and divided into 30 cases each in the comparison group and the observation group according to the random number remainder grouping method. The comparison group was treated conventionally, and the observation group was treated with postauricular injection of methylprednisolone sodium succinate on the basis of the comparison group. Patients in the two groups were observed and compared on the 3rd, 6th, and 9th days after treatment with pure-tone hearing threshold checks and regular monitoring of blood glucose, blood rheology, and other indexes. Results On the 7th, 14th, and 30th days after treatment, the pure-tone audiometric thresholds of the two groups were gradually decreased, and the changes in the pure-tone audiometric thresholds in the observation group were greater than those in the control group. After lunch on the 6th day and after lunch on the 9th day, it was lower than that in the control group, and the difference was statistically significant (P < 0.05). 30 days after treatment, the blood viscosity, fibrin, and platelet aggregation rate of the observation group were significantly lower than those of the control group. After treatment, the clinical efficacy rate of the observation group was 96%, which was significantly higher than that of the control group, 80%, and the above differences were statistically significant (P < 0.05). Conclusion Treatment with postauricular injection of methylprednisolone sodium succinate has shown better therapeutic recovery in patients with sudden deafness, improved pure-tone hearing threshold, reduced risk of blood glucose elevation, and improved clinical outcomes for patients with sudden deafness, providing some reference for the treatment of patients with sudden deafness.

Efficacy of Mesotympanum Injection and Posterior Auricular Injection in Sudden Hearing Loss of Diabetes Patients.

The efficacy of tympanum injection and posterior auricular injection in diabetes with sudden hearing loss (SHL) was analyzed. A mobile terminal-based portable pure tone audiometry system and its processing method were established. Based on mobile terminals, a portable pure tone audiometry system including an Android system, pure sound signal generation, pure tone hearing threshold, and client module was established. A masking model and self-adaptive algorithm were used to detect and reduce noise. Besides, the performance of the portable pure tone audiometry system was detected. A total of 46 diabetes patients with SHL diagnosed at the otolaryngology department in BeiChen Hospital between August 2019 and November 2021 were selected as the research objects and randomly divided into the retroauricular group (posterior auricular injection) and the tympanic group (tympanum injection). Each group included 23 cases. All patients received pure tone audiometry (PTA) before and after the treatment. The changes in fasting blood glucose (FPG), 2h postprandial blood glucose (2hPG), and glycosylated hemoglobin (HbA1c) of the patients were monitored before and after the treatment. Besides, tinnitus loudness visual analog scale (VAS), pain VAS, efficacy, and the incidence of adverse reactions of the patients in two groups were compared. The results indicated that the hear threshold error detected by the medical audiometer and a portable pure tone audiometry system was within 2dB. Before the optimization, there was an error of about 10dB between the hear thresholds detected by the self-adaptive algorithm and a medical audiometer. After the treatment, the hear threshold and average PTA of the patients in the retroauricular and the tympanic groups under different frequencies were both reduced compared with those before the treatment (P < 0.05). The tinnitus VAS score in the retroauricular group was decreased more notably than that in tympanic group (P < 0.01), and the pain VAS score was much lower than that in the tympanic group (P < 0.001). The comparison of FPG, 2hPG, HbA1c, the proportions of cured, significantly effective, effective, ineffective patients, and the total effective rate in the patients in the retroauricular and the tympanic groups before and after the treatment all showed no statistical differences (P > 0.05). The incidence of adverse reactions in tympanic group after the treatment was dramatically higher than that in retroauricular group (P < 0.001). The above results demonstrated that posterior auricular injection showed potential application values in the treatment of SHL with diabetes and established a portable pure tone audiometry system as well as its noise processing method.

Re-estimated normal hearing threshold levels for pure tones using the calculation procedure of ISO 7029:2017

Objective The objectives of this study were (1) to re-calculate hearing threshold levels (HTLs) for pure tones as described in an international standard, ISO 7029:2017, and (2) to explain the procedure of how HTLs in the standard had been derived. Design Pure-tone hearing threshold data used for developing ISO 7029:2017 and additional data sets were combined to re-estimate median HTLs and the distribution of individual HTLs around the median. The calculation was done for audiometric frequencies from 125 Hz to 8000 Hz and extended high frequencies from 9000 Hz to 12,500 Hz for ages from 18 to 80 years. Study sample Approximately 9000 men and 20,000 women employed in 15 studies in nine countries. They had been rigorously screened for hearing abnormalities. Results A new set of median HTLs and distribution around the median was obtained as a function of age for males and females separately and compared with the estimates in ISO 7029. The differences among these threshold values were discussed. Conclusions The calculation procedure described would help understand how the normative HTLs in ISO 7029:2017 had been obtained. Re-calculated HTLs could serve as a basis for the next edition of the standard that covers a wider range of population.

A prospective observational study of ototoxicity in head and neck cancers treated with chemoradiotherapy

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Head and neck cancer is a major global health problem. Cisplatin has been widely used in the treatment of head and neck malignancies. Ototoxicity is considered as the primary outcome of interest and the type of hearing loss is the secondary variable of interest. The Chi-square test/Fisher’s exact test is used to test statistical significance. P value&amp;lt;0.05 is considered statistically significant. IBM statistical package for the social sciences (SPSS) version 22 is used for statistical analysis.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; In this prospective observational study, 62 patients with head and neck cancers were evaluated for chemoradiotherapy-induced ototoxicity. The hearing assessment included air and bone conduction thresholds, frequency, and pattern of hearing loss. The assessment was done at baseline, at the end of treatment, and after 8 weeks of completion of chemoradiotherapy. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Results showed the mean age group to be, between 61 to 70 years. Gender distribution showed that 80.65% are males and 19.35% are females. The most common site of malignancy is the larynx (20.97%). Cisplatin is used in 51 patients (82.26%) and carboplatin in 7 patients (11.29%). Radiotherapy was given to 82.26% of the patients. Results showed an increased incidence of sensorineural hearing loss (SNHL) after 8 weeks of treatment. There was a statistically significant difference between pure tone average (PTA) values before treatment, at the end of treatment, and after 8 weeks of chemoradiotherapy.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Pure-tone hearing threshold was most affected at 8 kHz and sensorineural hearing loss at higher frequencies is the most common finding.&lt;/p&gt;

Tinnitus assessment: Chinese version of the Tinnitus Primary Function Questionnaire.

The aim of this study is to evaluate the Chinese Version of the Tinnitus Primary Function Questionnaire (TPFQ). One hundred and sixteen patients who had been suffering from tinnitus for over 3 months were included in this study. Those tinnitus patients were administered the TPFQ, the Tinnitus Handicap Inventory (THI), the Beck Anxiety Inventory (BAI), the Beck Depression Inventory (BDI), and the Pittsburgh Sleep Quality Index (PSQI). Additionally, the magnitude estimate of tinnitus loudness, pure tone audiogram, and tinnitus matching was obtained. The factor structure was measured using the Kaiser-Meyer-Olkin test. The internal consistency was examined using Cronbach's α coefficient. The relationships between the TPFQ scores and other measurements were compared using Spearman's rank correlation coefficient. The Cronbach's α of the 20-item version of TPFQ was 0.94, and that of the 12-item version of TPFQ was 0.92. Both the 20-and 12-item versions of TPFQ were significantly correlated with magnitude estimation of tinnitus loudness, THI, PSQI, BDI, and BAI. The average pure tone hearing threshold was significantly correlated with the hearing subscale. The 20-and 12-item Chinese versions of TPFQ are reliable and valid measures of tinnitus. The TPFQ can be applied to the assessment and management of tinnitus among the Chinese-speaking population.

IGST Combined with Conventional Drug Therapy and TCM Therapy for Treatment of Bilateral Vestibular Hypofunction.

Objective To investigate the effects of intensive gaze stability training (IGST) combined with conventional drug therapy and traditional Chinese medicine (TCM) therapy on hearing recovery and quality of life (QOL) in patients with bilateral vestibular dysfunction. Materials and Methods A total of 120 patients with bilateral vestibular dysfunction admitted to our hospital from January 2019 to January 2020 were recruited and assigned to group A (n = 60) and group B (n = 60) based on the order of admission. Group B received conventional medication and TCM therapy, and group A received IGST plus conventional medication and TCM therapy. The serum biochemical indexes, blood rheology indexes, symptoms disappearance time, hearing recovery time, pure-tone hearing threshold, vestibular symptom index (VSI), and QOL of the two groups were compared. Results The serum biochemical indexes and blood rheology indexes in group A were lower than those in group B after treatment (P < 0.001). Patients in group A had a shorter time lapse before symptoms disappearance and hearing recovery than those in group B (P < 0.001). Group A had lower results of the pure-tone hearing threshold (P < 0.001) and of VSI (P < 0.05) than group B. Patients in group A had higher QOL scores than those in group B after treatment (P < 0.001). Conclusion IGST plus conventional drug therapy effectively improves the serum biochemical indexes and blood rheological indexes of patients with bilateral vestibular hypofunction, accelerates their hearing recovery process, and alleviates their clinical symptoms, thereby improving their QOL, which shows good potential in clinical application.

Effect of the diameter of tympanostomy with CO₂ laser on secretory otitis media after radiotherapy

Objective:To investigate the postoperative effect of different diameters of CO₂ laser tympanostomy in the treatment of secretory otitis media caused by radiotherapy in patients with head and neck tumor, and to find out the best diameter range of tympanostomy according to the curative effect. Methods:The 40 ears after radiotherapy in the otorhinolaryngology department. The average 40 ears were divided into two groups: the diameter of perforation ≤3 mm and the diameter of perforation > 3 mm. Each group was 20 ears. Both groups were compared with tympanum and pure tone threshold after perforation, and then performed pure tone threshold measurement, tympanoplasty, and otoendoscopy 1,3,6 month after operation respectively. Meanwhile, patients were asked to assist in filling in the score scale of eustachian tube dysfunction（ETDQ-7）, to understand the difference in clinical symptoms and to count the complications after the operation. The changes of the size of the holes were compared with the corresponding attractors during the follow-up. Results:①After the operation, the mean value of pure tone hearing threshold air bone conduction difference in the diameter of perforation ≤3 mm group was significantly lower than that in the diameter of perforation >3 mm group （P<0.05）, indicating that the postoperative hearing recovery in the diameter of perforation ≤3 mm group was better than that in the diameter of perforation >3 mm group. ②Within six months after the operation, the tympanic membrane in the group a healed more than that in the diameter of perforation >3 mm group（P< 0.01）; in patients with an unclosed tympanic membrane in the diameter of perforation ≤3 mm group and the diameter of perforation >3 mm group, the number of smaller tympanic membrane diameter in the diameter of perforation ≤3 mm group was more than that in the diameter of perforation >3 mm group（P< 0.01）. ③The effective rates of the diameter of perforation≤3 mm group and the diameter of perforation>3 mm group were 75% and 35%, respectively. ④The incidence of postoperative complications such as middle ear infection and tympanic membrane nonunion in the diameter of perforation ≤3 mm group and the diameter of perforation>3 mm group were 25% and 45%, respectively, the incidence of postoperative complications in the diameter of perforation ≤3 mm group was significantly lower than that in the diameter of perforation>3 mm group（P<0.05）. ⑤The subjective feelings of patients in the diameter of perforation ≤3 mm group was significantly improved after the operation（P<0.01）. Compared with the postoperative questionnaire, the scores of Eustachian tube dysfunction score in the the diameter of perforation ≤3 mm groups after treatment were significantly better than the diameter of perforation>3 mm group（P<0.01）. Conclusion:According to this experimental study, in the range of 2-4 mm, 2.5 mm ≤ diameter ≤ 3.0 mm, the postoperative effect is better.

The Correlation Between Detection Value of Distortion-Product Otoacoustic Emissions and the Early Prognosis of Sudden Sensorineural Hearing Loss.

Background: To explore the correlation between the detection value of distortion-product otoacoustic emissions and the early prognosis of sudden sensorineural hearing loss.Methods: Seventy-eight patients with first-onset sudden sensorineural hearing loss (all frequencies) from April 2018 to July 2019 were included in this study. Distortion-product otoacoustic emissions and pure-tone audiometry tests were performed at days 0, 3, and 6 of admission. Repeated measures analysis of variance was performed to evaluate the changes in the signal-to-noise ratio for different distortion-product otoacoustic emissions frequencies over time and the interaction of grouping factors and time factors.Results: The distortion-product otoacoustic emissions evocation rate in the 4 groups was significantly different starting at day 3 of treatment. It was higher in the cured (35.3%) and obviously effective (20.0%) groups than in the other 2 groups (0%, 0%). At the 6 f2 frequencies of 1105 Hz, 1560 Hz, 2211 Hz, 3125 Hz, 4416 Hz, and 8837 Hz, the signal-to-noise ratio was different among the groups (P < .05) and was notably higher in the cured group. The analysis of the signal-to-noise ratio change before and after treatment at the intermediate f2 frequencies of 1105 Hz, 1560 Hz, and 2211 Hz in all patients indicated a linear correlation between the signal-to-noise ratio change and the pure-tone hearing threshold change, with a correlation coefficient of 0.481.Conclusion: Distortion-product otoacoustic emissions evocation in the early stage (within 3 days of treatment) or the signal-to-noise ratio trend over time at intermediate frequencies may predict the prognosis of sudden sensorineural hearing loss.