Pure-tone Thresholds Research Articles

Intraoperative Acoustic Monitoring Using Threshold and Suprathreshold Pure Tone Audiometry during Cochlear Implantation Under Local Anesthesia: A Simple and Novel Method to Potentially Enhance Hearing Preservation Cochlear Implant Surgery.

To report the feasibility and potential utility of monitoring acoustic hearing on awake patients using intraoperative behavioral responses to threshold and suprathreshold stimuli while undergoing cochlear implantation (CI) under local anesthesia, without any form of sedation. Retrospective review of the first five cases performed by one surgeon. Tertiary care academic medical center. Adult patients with residual acoustic hearing undergoing CI. CI under local anesthesia, without any form of sedation. Procedural tolerance, reliability of intraoperative pure tone threshold and suprathreshold audiometry, and correlation of intraoperative findings with early postoperative residual hearing. Five ears in four patients underwent CI, including three males and one female, with a median age of 61 years. Intraoperatively, patients reported reliable behavioral responses to pure tone threshold and suprathreshold stimuli and provided real-time feedback on perceived stimulus change to the surgeon just prior to, during, and immediately following electrode insertion. All patients were able to complete the operation under local anesthesia. During electrode insertion, three cases reported no change and two cases reported diminished stimulus perception that reversed with limited electrode pull back near terminal insertion. Immediate postoperative audiograms demonstrated preservation of bone conduction thresholds within 10 dB of their preoperative baseline for all cases, suggesting hearing preservation. Three-month postoperative AzBio in quiet scores were available for two patients, measuring 45% and 94%, respectively. This report describes the feasibility of intraoperative behavioral audiometry during CI under local anesthesia, using patient feedback during electrode insertion to optimize hearing preservation surgery. Akin to other surgical subspecialties that use real-time patient feedback where objective intraoperative measures of neurofunction are imperfect, we demonstrate feasibility and potential utility of live acoustic monitoring during CI.

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.

Occupational epidemiological characteristics of noise-induced hearing loss and the impact of combined exposure to noise and dust on workers' hearing-a retrospective study.

The aim of the study was to investigate the occupational epidemiological characteristics of hearing loss among noise-exposed workers through a cross-sectional study and to explore the impact of combined noise and dust exposure on workers' hearing loss through a longitudinal study. This cross-sectional study revealed that the risk of speech-frequency hearing loss increases with age (OR = 1.096, 95%CI = 1.081-1.111). Independent factors influencing high-frequency hearing loss include sex, age, hazardous factors, industry category, and enterprise size. Scientific research and technical services (OR = 1.607, 95%CI = 1.111-2.324), wholesale and retail (OR = 2.144, 95%CI = 1.479-3.107), manufacturing (OR = 1.907, 95%CI = 1.429-2.545), and other industries (OR = 1.583, 95%CI = 1.002-2.502) are risk factors for high-frequency hearing loss, whereas being female (OR = 0.297, 95%CI = 0.236-0.373) is a protective factor against high-frequency hearing loss. Independent factors influencing occupational noise-induced hearing loss include sex, working age, hazardous factors, industry category, smoking, and drinking, with the risk of occupational noise-induced hearing loss increasing with working age (OR = 1.045, 95%CI = 1.031-1.058). Noise and dust work (OR = 1.271, 95%CI = 1.011-1.597), other work (OR = 0.619, 95%CI = 0.479-0.800), manufacturing (OR = 2.085, 95%CI = 1.336-3.254), other industries (OR = 2.063, 95%CI = 1.060-4.012), occasional smokers (OR = 0.863, 95%CI = 0.652-1.142), regular smokers (OR = 1.216, 95% CI = 0.987-1.497), and excessive drinkers (OR = 2.171, 95%CI = 1.476-3.193) are risk factors for occupational noise-induced hearing loss, whereas being female (OR = 0.496, 95%CI = 0.347-0.709) is a protective factor against occupational noise-induced hearing loss. The longitudinal study revealed differences in pure-tone hearing threshold test results at 500 Hz, 1,000 Hz, 3,000 Hz, 4,000 Hz, and 6,000 Hz in both ears before and after enrollment among noise-exposed workers (p < 0.05). Combined noise and dust exposure (OR = 4.660, 95%CI = 1.584-13.711), 1st year (OR = 1.540, 95%CI = 1.128-2.103), 2nd year (OR = 1.994, 95%CI = 1.409-2.821), and 3rd year (OR = 1.628, 95%CI = 1.170-2.264) were risk factors for high-frequency hearing loss. Combined noise and dust exposure is a risk factor for occupational noise-induced hearing loss. Additionally, occupational noise-induced hearing loss is influenced by gender, working age, enterprise industry category, smoking, and drinking. Employers should enhance occupational health management and improve workers' occupational health literacy, with a particular focus on older male workers of long working age, and those with unhealthy habits. Combined exposure to noise and dust may have a synergistic effect on causing high-frequency hearing loss, and comprehensive protective measures should be implemented for workers exposed to both.

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.

Primary and revision myringoplasty in children: Long-term outcome and analysis of the factors influencing the results

ObjectiveAssess the long-term outcome of pediatric myringoplasty. MethodsTympanoplasty type I, myringoplasty, was performed on 85 children (91 consecutive operations, 74 primary and 17 revisions) under 16 years of age. The perforations were sequela either to acute or chronic inflammatory middle ear disease. Medial grafting technique was employed with temporalis fascia. Adenoidectomy was performed earlier on all but five children. The preoperative observation period exceeded one year for all patients. The mean follow-up was 5.4 (SD 3.6) years. ResultsThe long-term graft take rate was 84% for primary myringoplasty, and 53% for revision operations. The re-perforations were associated with postoperative discharge, subtotal or total perforation and revision surgery. In the cohort, sixty ears (66%) were completely healthy (intact tympanic membrane in normal position without adhesions and with good mobility) after follow-up. Spontaneous healing took place in 37% after re-perforation. The preoperative ventilation tube treatment did not affect the outcome and there were no differences between age groups. Preoperative sonotubometry or Valsalva test results did not correlate with outcome. Four ears needed a ventilation tube during the follow-up due to poor ventilation. The mean pure tone thresholds improved significantly after operation. ConclusionsMyringoplasty in children is a reliable procedure without age restrictions. One year of preoperative observation excludes most unstable ears, and high tendency of spontaneous healing after re-perforation suggests the need for a lengthy follow-up before revision surgery.

Predictors of Abnormal MRI Findings in Patients with Asymmetrical Sensorineural Hearing Loss.

This study aimed to determine the predictive factors of abnormal MRI findings in patients with asymmetrical sensorineural hearing loss (ASNHL). A retrospective review of medical records. A tertiary care hospital. Patients with asymmetries of ≥10 dB in at least 1 frequency, who underwent an MRI study of the temporal bone or brain during 2019-2021, were included. Age, sex, clinical symptoms, past medical history, and audiometric parameters, including pure tone thresholds, speech reception thresholds, and speech discrimination scores, were retrieved from the electronic database. The MRI findings reported by radiologists were reviewed and extracted. Of 390 patients, 50 (12.8%) patients had relevant abnormal MRI findings that could explain ASNHL. The most prevalent abnormal MRI finding was an internal acoustic canal (IAC) or cerebellopontine angle (CPA) tumor (n = 38; 76.0%), with other notable abnormalities including labyrinthitis, stroke, mucocele, and epidermoid. Multiple logistic regression analysis highlighted that hearing asymmetry of 15 dB at 1000 Hz (OR = 4.8; 95% CI 2.2-10.5) was a significant variable. The proposed predictor demonstrated 84% sensitivity and 48% specificity in detecting abnormal MRI findings. A hearing asymmetry of 15 dB at 1000 Hz was an important clinical predictor of abnormal MRI findings in patients with ASNHL. This finding has the potential to serve as a referral guide for further MRI investigations. Level 3 Laryngoscope, 2024.

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.

ОЦЕНКА ЭФФЕКТИВНОСТИ ПЕРВИЧНОЙ СТАПЕДОПЛАСТИКИ

Background. Evaluation of the effectiveness of primary stapedoplasty in patients with otosclerosis using the SPOT-25 questionnaire. Materials and methods. Primary piston stapedoplasty with titanium K-piston prosthesis was performed on 42 patients with fenestral and mixed forms of otosclerosis.. Patients were excluded from the study according to the following c: revision surgery on the previously operated ear, stapedoplasty on the second ear, the presence of concomitant pathology that may lead to the development of conductive hearing loss. A standard otorhinolaryngological examination, collection of complaints, medical history, clinical and laboratory examination, tone threshold audiometry, and SPOT-25 questionnaire were carried out. The control periods after surgery were 10 days, 3 and 6 months. Results. The average value of the bone-air interval before surgery was 24.0±9.9 dB; on the 10th day there was a reduction in the air-bone interval to 14.0±10.2 dB (p≤0.05), a significant reduction in the air-bone interval was noted by the 6th month after – surgery — 10.4±8.0 dB (p≤0.01). The results of the air conduction study before the surgery were 52.4±12.5 dB, by the 6th month after surgery a significant improvement of air conduction was noted — 32.5±13.6 dB (p≤0.05). There were no significant changes in bone conduction before the surgery, after 10 days and 6 months; the values were 28.4±11.2 dB, 26.4±11.6 dB, 22.1±10.8 dB, respectively. The results of the SPOT-25 questionnaire before the surgery were 52.2±9.2 points, on the 10th day after surgery they were 35.2±12.9 points (p≤0.05), and after 6 months there was a significant improvement to 35.2±12.9 points (p≤0.05). Conclusion. The use of the SPOT-25 questionnaire before and after primary stapedoplasty is a simple and accessible method for recording changes in the quality of life of patients, which, together with pure tone threshold audiometry data, can be an effective method of assessing the results of the surgery.

Development and evaluation of a novel user-operated slider-based audiometry method.

To evaluate a novel user-operated audiometry method allowing users full control in determining their pure-tone hearing thresholds. Comparative study. Participants were recruited from a hearing clinic after undergoing manual audiometry (six frequencies). They then performed test-retests of a new test (slider audiometry, eight frequencies) and completed the System Usability Scale questionnaire. 37 adult participants, including 30 hearing-impaired and seven normal-hearing individuals. Mean (SD) threshold differences for octave frequencies between 250 to 2000 Hz between manual and slider audiometry ranged from -7.8 (6.6) to -5.7 (6.5) dB and were significant. For 4000 and 8000 Hz mean differences were -0.3 (8.4) and 0.0 (9.7) dB and insignificant. Standard deviations ranged from 6.5 to 9.7 dB across six tested frequencies. Slider test-retest mean threshold differences ranged from -1.4 (4.7) to 0.3 (6.0) dB across eight tested frequencies, with standard deviations ranging from 4.1 to 8.5 dB. The average usability score for the slider audiometry was 88.3. When compared to manual audiometry, the slider audiometry demonstrated validity at 4000 and 8000 Hz but found significantly lower thresholds for octave frequencies between 250 to 2000 Hz. Test-retests of the new method revealed small mean differences and acceptable SDs.

Comprehensive Analysis of the Contributing Factors to the Hearing Abilities of Patients With Vestibular Schwannoma

Background and Objectives This study aimed to comprehensively assess the factors influencing hearing ability in patients with vestibular schwannoma, focusing on tumor size, location, primary complaint, and contralateral hearing threshold.Subjects and Method This was a retrospective analysis of 50 patients diagnosed with vestibular schwannoma by magnetic resonance imaging (MRI) at Nowon Eulji Medical Center. Tumor size and location were evaluated using a 3-T MRI system, and pure-tone threshold and speech discrimination were retrieved. To investigate the relationship between tumor size and hearing, we conducted a multiple regression analysis with several variables, including tumor size, tumor location, patient age, and gender.Results When patients were categorized into groups according to their primary complaint at initial presentation, no significant differences were observed in pure tone thresholds but different speech discrimination were detected among the groups. When patients were classified according to the tumor location, the extrameatal group exhibited lower pure-tone thresholds and higher speech discrimination scores than the intrameatal group. Multiple regression analysis indicated that differences in pure tone thresholds and speech discrimination scores between affected and unaffected sides were more pronounced in cases with smaller tumor sizes and extrameatal tumor locations, emphasizing the greater impact of location over size.Conclusion Using both tumor size and location, it is possible to predict the differences in pure-tone thresholds and speech discrimination between the affected and unaffected sides. Extrameatal invasion of the tumor appears to be the most important factor among them.

Effects of Personality Traits on the Severity of Chronic Subjective Tinnitus: A Cross-Sectional Analysis.

Background and Objectives: We hypothesized that an individual's personality traits would have an impact on the distress of subjective tinnitus. To investigate this, 32 participants were recruited; we followed up with this cohort. This study is a cross-sectional analysis of a part of this cohort, identifying how their personality traits make a difference in the severity of tinnitus distress. Materials and Methods: Thirty-two participants completed a personality test based on the Big Five theory, consisting of 160 items. Additionally, the severity of tinnitus was assessed using the Tinnitus Handicap Inventory (THI), and the accompanying level of depression was measured using the Beck Depression Inventory (BDI). Audiometry tests, including pure-tone audiometry, were also conducted. Participants were categorized into the 'mild group' if their total THI score was 36 or below, and into the 'severe group' if their score was 38 or above. Results: In the traditional five domains of the Big Five Inventory (Openness, Conscientiousness, Extraversion, Agreeableness, Neuroticism), only the 'Neuroticism' domain showed a difference between the two groups (25.1 ± 21.0 in the mild group and 43.1 ± 18.2 in the severe group, p = 0.014). Among ego-related factors, the 'Helplessness' domain (26.3 ± 22.9 in the mild group and 62.3 ± 27.9 in the severe group, p < 0.001) and the communication-related factor of 'Listening' (58.7 ± 18.8 in the mild group and 37.8 ± 27.9 in the severe group, p = 0.020) showed differences between the two groups. In the multivariate analysis, 'Helplessness' (estimate 0.419, 95% confidence interval 0.249-0.589, p < 0.001), 'Emotional Trauma' (0.213, 0.020-0.406, p = 0.032), and 'Pure-tone threshold at 2000 Hz' (0.944, 0.477-1.411, p < 0.001) were identified as factors influencing the severity of tinnitus distress. Conclusions: Ego-related factors, particularly Helplessness and Emotional Trauma, can influence tinnitus distress and should be considered in the management of tinnitus.

Audiograms and Prevalence of Hearing Loss in U.S. Children and Adolescents 6-19 Years of Age.

The aim of this study was to determine median audiograms and prevalence of hearing loss for U.S. 6- to 19-year-olds. U.S. national audiometric data for 2,709 six- to 19-year-olds from the National Health and Nutrition Examination Survey 2017-2020 were analyzed. Analyses were primarily descriptive and relied on distribution-free medians, cumulative distribution functions (CDFs), and population-weighted prevalence estimates. Differences between CDFs were examined using Cohen's h effect size. Results are presented for the age range of 6-19 years. Main effects of sex, age, and race/ethnicity were examined. Differences in the audiograms between the sexes and among the various race/ethnicity groups were minor, but age group differences were notable. Pure-tone thresholds at 500 and 8000 Hz for the 6- to 9-year age group were 3-5 dB higher (worse) than those of the other age groups. The overall prevalence of hearing loss among 6- to 19-year-olds, defined as either of the pure-tone averages (PTAs) for 500, 1000, and 2000 Hz (PTA512) or 3000, 4000, 6000, and 8000 Hz (PTA3468k) exceeding 15 dB HL in either ear, was 11.24% (95% confidence interval [10.00%, 12.48%]). Binary logistic regression analyses found the odds of hearing loss to be significantly higher for individuals from families with a low income as well as for those with abnormal otoscopy or abnormal tympanometry. For children and adolescents in the United States, hearing was unaffected by differences in sex and race/ethnicity, with only age impacting pure-tone thresholds and only at the lowest (500 Hz) and highest (8000 Hz) frequencies examined. The overall prevalence of hearing loss was about 11%.

Audiological Profile of Yakshagana Artists.

Yakshagana is an India's traditional folk theatre musical dance drama. The purpose of the study is to profile audiological characteristics and document hearing-related symptoms in Yakshagana artists. A cross-sectional study was performed on 96 Yakshagana artists. Participants' demographic data were captured, and audiological evaluations, including high frequency audiometry (HFA), tympanometry, acoustic reflex threshold and transient evoked otoacoustic emission (TEOAE), were performed. The majority of the individuals had minimal and mild hearing loss. The mean scores of pure tone thresholds were greater at 4kHz and 8kHz. The majority of the HFA thresholds at 10kHz, 12.5kHz, and 16kHz indicated no responses, which can be accredited to the fact that noise-induced hearing loss (NIHL) first affects the higher frequencies. TEOAE analysis showed a greater percentage of failures in the higher frequencies, particularly at 3 and 4kHz in both ears, which can be an indicator of bilateral cochlear damage. These findings indicate that Yakshagana artists are at risk of hearing loss due to noise exposure. Hearing evaluation and regular monitoring of hearing thresholds is advisable for this population as it can impact their careers.

Extended High-Frequency Thresholds: Associations With Demographic and Risk Factors, Cognitive Ability, and Hearing Outcomes in Middle-Aged and Older Adults.

This study had two objectives: to examine associations between extended high-frequency (EHF) thresholds, demographic factors (age, sex, race/ethnicity), risk factors (cardiovascular, smoking, noise exposure, occupation), and cognitive abilities; and to determine variance explained by EHF thresholds for speech perception in noise, self-rated workload/effort, and self-reported hearing difficulties. This study was a retrospective analysis of a data set from the MUSC Longitudinal Cohort Study of Age-related Hearing Loss. Data from 347 middle-aged adults (45 to 64 years) and 694 older adults (≥ 65 years) were analyzed for this study. Speech perception was quantified using low-context Speech Perception In Noise (SPIN) sentences. Self-rated workload/effort was measured using the effort prompt from the National Aeronautics and Space Administration-Task Load Index. Self-reported hearing difficulty was assessed using the Hearing Handicap Inventory for the Elderly/Adults. The Wisconsin Card Sorting Task and the Stroop Neuropsychological Screening Test were used to assess selected cognitive abilities. Pure-tone averages representing conventional and EHF thresholds between 9 and 12 kHz (PTA (9 - 12 kHz) ) were utilized in simple linear regression analyses to examine relationships between thresholds and demographic and risk factors or in linear regression models to assess the contributions of PTA (9 - 12 kHz) to the variance among the three outcomes of interest. Further analyses were performed on a subset of individuals with thresholds ≤ 25 dB HL at all conventional frequencies to control for the influence of hearing loss on the association between PTA (9 - 12 kHz) and outcome measures. PTA (9 - 12 kHz) was higher in males than females, and was higher in White participants than in racial Minority participants. Linear regression models showed the associations between cardiovascular risk factors and PTA (9 - 12 kHz) were not statistically significant. Older adults who reported a history of noise exposure had higher PTA (9 - 12 kHz) than those without a history, while associations between noise history and PTA (9 - 12 kHz) did not reach statistical significance for middle-aged participants. Linear models adjusting for age, sex, race and noise history showed that higher PTA (9 - 12 kHz) was associated with greater self-perceived hearing difficulty and poorer speech recognition scores in noise for both middle-aged and older participants. Workload/effort was significantly related to PTA (9 - 12 kHz) for middle-aged, but not older, participants, while cognitive task performance was correlated with PTA (9 - 12 kHz) only for older participants. In general, PTA (9 - 12 kHz) did not account for additional variance in outcome measures as compared to conventional pure-tone thresholds, with the exception of self-reported hearing difficulties in older participants. Linear models adjusting for age and accounting for subject-level correlations in the subset analyses revealed no association between PTA (9 - 12 kHz) and outcomes of interest. EHF thresholds show age-, sex-, and race-related patterns of elevation that are similar to what is observed for conventional thresholds. The current results support the need for more research to determine the utility of adding EHF thresholds to routine audiometric assessment with middle-aged and older adults.

Blast Exposure Associations With Hearing Loss and Self-Reported Hearing Difficulty.

Examine associations between military blast exposures on hearing loss and self-reported hearing difficulties among Active-Duty Service Members (ADSM) and Veterans from the Noise Outcomes in Servicemembers Epidemiology (NOISE) study. Cross-sectional. Multi-institutional tertiary referral centers. Blast exposure was assessed with a comprehensive blast questionnaire. Outcome measures included pure-tone hearing thresholds; Speech Recognition in Noise Test; Hearing Handicap Inventory for Adults (HHIA); and Speech, Spatial and Qualities of Hearing Scale (SSQ)-12. Twenty-one percent (102/494) of ADSM and 36.8% (196/533) of Veterans self-reported blast exposure. Compared to ADSM without blast exposure, blast-exposed ADSM had increased odds of high frequency (3-8 kHz) and extended-high frequency (9-16 kHz) hearing loss (odds ratio [OR] = 2.5, CI: 1.3, 4.7; OR = 3.7, CI: 1.9, 7.0, respectively). ADSM and Veterans with blast exposure were more likely than their nonblast exposed counterparts to report hearing difficulty on the HHIA (OR = 1.9, CI: 1.1, 3.3; OR = 2.1, CI: 1.4, 3.2, respectively). Those with self-reported blast exposure also had lower SSQ-12 scores (ADSM mean difference = -0.6, CI: -1.0, -0.1; Veteran mean difference: -0.9, CI: -1.3, -0.5). Results suggest that blast exposure is a prevalent source of hearing injury in the military. We found that among ADSM, blast exposure was associated with hearing loss, predominately in the higher frequencies. Blast exposure was associated with poorer self-perceived hearing ability in ADSM and Veterans. IRB: #FWH20180143H Joint Base San Antonio (JBSA) Military Healthcare System; #3159/9495 Joint VA Portland Health Care System (VAPORHCS) Oregon Health and Science University (OHSU).

Effect of age-related extended high frequency hearing loss on the subjective impressions of dental drill noise

Fear and anxiety among patients are sometimes evoked in dental clinics due to the sound of dental drills. This study aimed to explore the impact of age-related hearing loss in the extended high frequency (EHF) range above 8 kHz on individuals' subjective discomfort towards dental drill noise. After measuring pure-tone audiometric thresholds at both conventional and extended high frequencies, we used a psychoacoustic approach to evaluate subjective impressions of four dental drill sound stimuli, which featured varying frequency components, in 62 participants (aged 12–67 years). We found a significant decrease in hearing sensitivity within the EHF range as age increased, with notable differences in hearing thresholds at 14 kHz between teenage and older adults exceeding 65 dB. Furthermore, significant differences were observed between younger and older (above 40 years) participants in the subjective impressions of dental drill noise, emphasizing age as a critical factor in the perception of high frequency components. Consequently, age may influence the unpleasantness of dental drilling noise. Compared to older individuals, young participants may exhibit increased fear of dental procedures owing to physiological factors. These results underscore the need for age-appropriate noise control strategies in dental clinics to mitigate anxiety and improve patient comfort.

The inflammatory and metabolic status of patients with sudden-onset sensorineural hearing loss.

Sudden sensorineural hearing loss (SSNHL) is a common emergency symptom in otolaryngology that requires immediate diagnosis and treatment. SSNHL has a multifactorial etiology, and its pathophysiologic mechanisms may be associated with inflammatory and metabolic changes that may affect the cochlear microenvironment or its nervous component, thus triggering the process or hindering hearing recovery. Therefore, the aim of this study was to assess metabolic and inflammatory changes to identify systemic parameters that could serve as prognostic factors for hearing recovery in patients with SSNHL. Thirty patients with a sudden hearing loss of at least 30 dB in three contiguous frequencies were enrolled in this study. Patients were followed up for 4 months and peripheral blood samples were collected at 7 days (V1), 30 days (V2) and 120 days (V3). Interleukins (IL)-1F7, IL-2, IL-4, IL-5, IL-6, IL-10, interferon γ (IFN-γ), tumor necrosis factor α (TNF-α) and adiponectin were quantified in serum. In addition, lipid and glycemic profiles as well as concentration of creatinine, uric acid, fructosamine, peroxide, total proteins and albumin were analyzed. Patients underwent weekly ear-specific hearing tests with standard pure tone thresholds for frequencies of 250-8,000 Hz, speech recognition threshold and word recognition score. Patients with SSNHL were divided into a group of patients who did not achieve hearing recovery (n = 14) and another group who achieved complete and significant recovery (n = 16). Most serologic parameters showed no significant changes or values indicating clinical changes. However, IFN-γ levels decreased by 36.3% between V1 and V2. The cytokine TNF-α showed a statistically significant decrease from V1 to V3 (from 22.91 to 10.34 pg./mL). Adiponectin showed a decrease from 553.7 ng/mL in V1 to 454.4 ng/mL in V3. Our results show that serologic cytokine levels change in the acute phase of manifestation of SSNHL and establish a parallel between systemic changes and improvements in hearing, especially TNF-α, which showed differences in hearing recovery. The use of IFN-γ, TNF-α and adiponectin may elucidate the clinical improvement in these patients.

Evaluation of a super powerful bone-anchored hearing system and its users: A retrospective study.

Although the Baha 5SP has been commercially available for six years, very few studies have been performed on the device's efficacy. The current study aims to evaluate the characteristics and audiological results in patients with severe-to-profound mixed hearing loss fitted with this superpower sound processor. This retrospective evaluation was conducted at a tertiary referral centre where a series of 82 adult patients with severe-to-profound mixed hearing loss were implanted with a percutaneous bone-anchored hearing system and fitted with a superpower sound processor between 2016 and 2019. Patients with incomplete or unreliable audiological data (n = 24) were excluded, resulting in 58 data sets for analysis. The main outcome measures were unaided and aided pure-tone thresholds and aided free-field speech perception in quiet. The median unaided air conduction (AC) threshold averaged across 0.5, 1 and 2 kHz (PTA0.5-2kHz) of all patients was 75 dB hearing loss (HL); the median unaided AC averaged across 1, 2 and 4 kHz (PTA1-4kHz) was 84 dB HL. For bone conduction and direct bone conduction, the median PTA0.5-2kHz was 52 and 47 dB HL, respectively. With the superpower device, the median free-field speech reception threshold was 54 dB sound pressure level (SPL), and the median speech perception score at 65 dB SPL was 80%. At least 75% of the patients reached a maximum phoneme score of 70%. For patients with lower scores, the superpower device still provides a substantial hearing benefit. This makes the superpower device particularly suitable for patients with severe-to-profound mixed hearing loss with a contraindication for conventional hearing aids and/or cochlear implants.

OUR EXPERIENCE IN SURGICAL TREATMENT OF MUCOSAL HYPERTROPHY OF TORI TUBARII

Puprose. Evaluation of the effectiveness of surgical treatment of mucous hypertrophy of tori tubarii by submucosal tissue destruction using Ho:YAG laser radiation. Materials and methods. The study involved 48 adult patients with symptoms of Eustachian tube dysfunction. The patency of the auditory tube was assessed by standard tests, the ETDQ 7 questionnaire, tympanometry, pure tone threshold audiometry, and endoscopic video recording of the results were performed. Surgical intervention was carried out by forming under the influence of pulsed radiation from a Ho:YAG laser with a frequency of 10 Hz and a pulse energy of 2 J, 4–6 tunnels with a depth of 5–7 mm in the hypertrophied mucous membrane of the torui tubarii along the posteromedial surface and 2 tunnels up to 3 mm up and down from the pharyngeal mouth of the auditory tube. The control periods after surgery were 1, 3 and 6 months. Results. A significant improvement in the results of the auditory tube according to ETDQ-7 was noted by 3 months after surgery in 71% of patients and in 84% by 6 months. By 6 months after surgery, type C tympanometry and clinically significant conductive hearing loss persisted in 8 and 5% of patients, respectively. The subjective feeling of fully performing the Valsalva test improved in 58% after 3 months and in 82% by the 6th month, and the Toynbee test in 42% and 64% in the 3rd and 6th months, respectively. In 16% of patients, despite a visual decrease in mucosal hypertrophy during endoscopic examination, signs of dysfunction remained according to ETDQ 7. There were no complications after surgical treatment during 6 months of observation. Conclusion. The use of endoscopic diagnosis of the nasopharynx in patients with signs of dysfunction of the auditory tubes in combination with functional tests and the ETDQ-7 questionnaire allows to determine the indications for the surgical treatment of hypertrophy of the mucous membrane of the tori tubarii using the Ho:YAG laser, the effectiveness of which in our study was 84%.

The impact of age-related hearing loss on cognitive decline: The mediating role of brain age gap

In recent years, the relationship between age-related hearing loss, cognitive decline, and the risk of dementia has garnered significant attention. The significant variability in brain health and aging among individuals of the same chronological age suggests that a measure assessing how one’s brain ages may better explain hearing-cognition links. The main aim of this study was to investigate the mediating role of Brain Age Gap (BAG) in the association between hearing impairment and cognitive function.This research included 185 participants aged 20–79 years. BAG was estimated based on the difference between participant’s brain age (estimated based on their structural T1-weighted MRI scans) and chronological age. Cognitive performance was assessed using the Montreal Cognitive Assessment (MoCA) test while hearing ability was measured using pure-tone thresholds (PTT) and words-in-noise (WIN) perception. Mediation analyses were used to examine the mediating role of BAG in the relationship between age-related hearing loss as well as difficulties in WIN perception and cognition.Participants with poorer hearing sensitivity and WIN perception showed lower MoCA scores, but this was an indirect effect. Participants with poorer performance on PTT and WIN tests had larger BAG (accelerated brain aging), and this was associated with poorer performance on the MoCA test. Mediation analyses showed that BAG partially mediated the relationship between age-related hearing loss and cognitive decline.This study enhances our understanding of the interplay among hearing loss, cognition, and BAG, emphasizing the potential value of incorporating brain age assessments in clinical evaluations to gain insights beyond chronological age, thus advancing strategies for preserving cognitive health in aging populations.