Pure-tone Thresholds Research Articles

Soft Tissue Conduction Activates the Auditory Pathway in the Brain.

Soft tissue conduction is a mode of hearing which differs from air and bone conduction since the soft tissues of the body convey the audio-frequency vibrations to the ear. It is elicited by inducing soft tissue vibrations with an external vibrator applied to sites on the body or by intrinsic vibrations resulting from vocalization or the heartbeat. However, the same external vibrator applied to the skin sites also excites cutaneous mechanoreceptors, and attempts have been made to assist patients with hearing loss by audio-tactile substitution. The present study was conducted to assess the contribution of the auditory nerve and brainstem pathways to soft tissue conduction hearing. The study involved 20 normal hearing students, equipped with ear plugs to reduce the possibility of their response to air-conducted sounds produced by the external vibrator. Pure tone audiograms and speech reception (recognition) thresholds were determined in response to the delivery of the stimuli by a clinical bone vibrator applied to the cheek, neck and shoulder. Pure tone and speech recognition thresholds were obtained; the participants were able to repeat the words they heard by soft tissue conduction, confirming that the auditory pathways in the brain had been stimulated, with minimal involvement of the somatosensory pathways.

Vestibular function and hearing preservation in children following a minimally invasive cochlear implantation

PurposeThis retrospective cohort study aimed to investigate the effect of minimally invasive cochlear implantation (CI) on the vestibular function (VF) and residual hearing (RH) as well as their relationship in pediatric recipients before and after surgery.MethodsTwenty-four pediatric patients with preoperative low frequency residual hearing (LFRH) (250 or 500 Hz ≤ 80 dB HL) who underwent minimally invasive CI were enrolled. Pure-tone thresholds, the cervical/ocular vestibular-evoked myogenic potential (cVEMP/oVEMP), and video head impulse test (vHIT) were all evaluated in the 24 pediatric patients with preoperative normal VF before and at 1 and 12 months after surgery. The relationship between changes in hearing and VF was analyzed preoperatively and at 1 and 12 months postoperatively.ResultsThere were no significant differences on VF preservation and hearing preservation (HP) at both 1 and 12 months post-CI (p > 0.05). At 1 month post-CI, the correlations of the variations in vestibulo-ocular reflex (VOR) gains of horizontal semicircular canal (HSC) and posterior semicircular canal (PSC) and the shift in 250 Hz threshold were negatively correlated (r = − 0.41, p = 0.04 and r = − 0.43, p = 0.04, respectively). At 12 months post-CI, the shift in 250 Hz threshold negatively correlated to the variations in VOR gain of superior semicircular canal (SSC) (r = − 0.43, p = 0.04); the HP positively correlated to the variation in oVEMP-amplitude ratio (AR) (r = 0.41, p = 0.04).ConclusionOur study confirmed that there were partial correlations between VF preservation and HP both in the short- and long-terms after atraumatic CI surgery, especially with the 250 Hz threshold. Regarding the variation of PSC function, the correlation with hearing status was variable with time after atraumatic CI surgery. Minimally invasive techniques for HP are successful and effective for the preservation of VF in pediatric patients both in the short- and long-terms.

Insertion Results and Hearing Outcomes of a Slim Lateral Wall Electrode.

The clinical outcomes of cochlear implantation vary for several reasons. It is necessary to study the different electrodes and variables for further development. The aim of this study is to report the clinical outcomes of a new slim lateral wall electrode (SlimJ). Data of 25 cochlear implantations in 23 patients with the SlimJ electrode were retrospectively collected. The insertion results were assessed by image fusion of the preoperative computed tomography (CT), magnetic resonance imaging (MRI), and postoperative cone-beam CT. The hearing outcomes were evaluated by the improvement of speech recognition in noise, measured preoperatively and at follow-up. Postoperative pure-tone thresholds were obtained in cases with preoperative functional low frequency hearing [PTA (0.125-0.5 kHz) ≤ 80 dB HL]. The preoperative mean speech reception threshold (SRT) was +0.6 dB signal-to-noise ratio (SNR) (SD ± 4.2 dB) and the postoperative -3.5 dB SNR (SD ± 2.3 dB). The improvements between the preoperative and postoperative SRT levels ranged from 0.0 to 15.1 dB, with a mean improvement of 4.2 dB (SD ± 3.6 dB). Residual hearing in low frequencies (mean PTA(125-500 Hz)) was preserved within 30 dB HL in 70% and within 15 dB HL in 40% of patients who had preoperatively functional low frequency hearing. Mean insertion depth angle (IDA) was 401° (SD ± 41°). We observed scalar translocations from scala tympani to scala vestibuli in 2 ears (9%). The relatively atraumatic insertion characteristics make the SlimJ array feasible for hearing preservation cochlear implantation. The hearing outcomes are comparable to those reported for other electrodes and devices.

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.

Cortical Auditory Evoked Potential Indices of Impaired Sensory Gating in People With Chronic Tinnitus.

The primary aim of this study was to evaluate whether there is cortical auditory evoked potential (CAEP) evidence of impaired sensory gating in individuals with tinnitus. On the basis of the proposed mechanism of tinnitus generation, including a thalamocortical inhibitory deficit, it was hypothesized that individuals with tinnitus would lack the normal inhibitory effect on the second CAEP response in a paired-click sensory gating paradigm, resulting in larger sensory gating ratios in individuals with tinnitus relative to age-, sex-, and hearing-matched controls. Further, this study assessed the relative predictive influence of tinnitus presence versus other related individual characteristics (hearing loss, age, noise exposure history, and speech perception in noise) on sensory gating. A paired-click CAEP paradigm was used to measure sensory gating outcomes in an independent group's experimental design. Adults who perceived chronic unilateral or bilateral tinnitus were matched with control group counterparts without tinnitus by age, hearing, and sex (n = 18; 10 females, eight males in each group). Amplitude, area, and latency sensory gating ratios were determined for measured P1, N1, and P2 responses evoked by the first and second click in the paradigm and compared between groups by independent t tests. The relative influence of tinnitus (presence/absence), age (in years), noise exposure history (subjective self-report), hearing loss (pure-tone audiometric thresholds), and speech perception in noise (signal to noise ratio-50) on sensory gating was determined based on the proportional reduction in error associated with each variable using multiple regression. A significantly larger was identified in the tinnitus group relative to the control group, consistent with the hypothesis of poorer sensory gating and poorer thalamocortical inhibition in individuals with chronic tinnitus. On the basis of the proportional reduction in error, the influence of tinnitus presence better predicted compared with other related individual characteristics (age, noise exposure history, hearing loss, and speech perception in noise). Results consistent with poorer sensory gating, including a larger , were found for the tinnitus group compared with the controls. This finding supported a thalamocortical inhibitory deficit in the tinnitus group and suggests that individuals with tinnitus may have poorer sensory gating. However, the tinnitus group did differ from controls in meaningful ways including having worse pure-tone thresholds in the extended high-frequency region, lower high-frequency distortion product otoacoustic emissions, and poorer speech perception in noise. Although tinnitus best predicted sensory gating outcomes, the specific effects of tinnitus presence versus absence and other individual characteristics on sensory gating cannot be completely separated.

The effects of music listening time with headphones on hearing thresholds among the young population

BackgroundToday, young people who listen to loud music, especially through headphones, are at an extremely high risk of noise-induced hearing loss. The aim of this study was to investigate how young people’s listening habits affect their hearing thresholds. A total of 88 young adults between the ages of 18 and 25 took part in the study, 44 of whom listened to music through headphones while the others did not. The control group was exposed to white noise at 55–65 dB with the Interacoustic AC 40 Hybrid Audiometer, and people who did not use headphones and said they were not exposed to higher levels of sound than the given sample were included in the study. Participants were given a survey to assess their music listening preferences. One hundred twenty-five to 18,000 Hz air conduction hearing thresholds were assessed for all participants.ResultsWhen the pure tone thresholds of the groups were compared, the independent t-test showed that the thresholds of the study group were significantly worse than those of the control group. Bilaterally in the 4000 Hz band and for the left ear in the 6000 Hz band (p < 0.05). There were also significant differences between the groups in the 14,000 Hz and 16,000 Hz bands in the right ear and the 14,000 Hz, 16,000 Hz, and 18,000 Hz bands in the left ear (p < 0.05). Twenty-two participants reported listening to music at a high level, 16 participants at a moderate level, and 6 participants at a very high level.ConclusionAlthough the hearing thresholds of the study group were worse than those of the control group in the 4000 Hz, 6000 Hz, 14,000 Hz, 16,000 Hz, and 18,000 Hz bands, the hearing thresholds of both groups were still within the hearing range and could be classified as normal. It should be remembered that hearing will deteriorate if a person listens to loud or very loud music continuously through headphones. The public, especially young people, should be made aware of this.

A Multicenter Validity Study of Four Smartphone Hearing Test Apps in Optimized and Home Environments.

Pure tone audiometry (PTA) is the gold standard for hearing assessment. However, it requires access to specialized equipment. Smartphone audiometry applications (apps) have been developed to perform automated threshold audiometry and could allow patients to perform self-administered screening or monitoring. This study aimed to assess the validity and feasibility of patients using apps to self-assess hearing thresholds at home, with comparison to PTA. A multi-center, prospective randomized study was conducted amongst patients undergoing PTA in clinics. Participants were randomly allocated to one of four publicly-available apps designed to measure pure tone thresholds. Participants used an app once in optimal sound-treated conditions and a further three times at home. Ear-specific frequency-specific thresholds and pure tone average were compared using Pearson correlation coefficient. The percentage of app hearing tests with results within ±10 dB of PTA was calculated. Patient acceptability was assessed via an online survey. One hundred thirty-nine participants submitted data. The results of two at-home automated smartphone apps correlated strongly/very strongly with PTA average and their frequency-specific median was within ±10 dB accuracy. Smartphone audiometry performed in sound-treated and home conditions were very strongly correlated. The apps were rated as easy/very easy to use by 90% of participants and 90% would be happy/very happy to use an app to monitor their hearing. Judicious use of self-performed smartphone audiometry was both valid and feasible for two of four apps. It could provide frequency-specific threshold estimates at home, potentially allowing assessments of patients remotely or monitoring of fluctuating hearing loss. 2 Laryngoscope, 134:2864-2870, 2024.

Voice acoustic characteristics of children with late-onset cochlear implantation: Correlation to auditory performance

Objectives To study the voice acoustic parameters of congenitally deaf children with delayed access to sounds due to late-onset cochlear implantation and to correlate their voice characteristics with their auditory performance. Methods The study included 84 children: a control group consisting of 50 children with normal hearing and normal speech development; and a study group consisting of 34 paediatric cochlear implant (CI) recipients who had suffered profound hearing loss since birth. According to speech recognition scores and pure-tone thresholds, the study group was further subdivided into two subgroups: 24 children with excellent auditory performance and 10 children with fair auditory performance. The mean age at the time of implantation was 3.6 years for excellent auditory performance group and 3.2 years for fair auditory performance group. Voice acoustic analysis was conducted on all study participants. Results Analysis of voice acoustic parameters revealed a statistically significant delay in both study groups in comparison to the control group. However, there was no statistically significant difference between the two study groups. Discussion Interestingly, in both excellent and fair performance study groups, the gap in comparison to normal hearing children was still present. While late-implanted children performed better on segmental perception (e.g. word recognition), suprasegmental perception (e.g. as demonstrated by objective acoustic voice analysis) did not progress to the same extent. Conclusion On the suprasegmental speech performance level, objective acoustic voice measurements demonstrated a significant delay in the suprasegmental speech performance of children with late-onset CI, even those with excellent auditory performance.

A Step Toward Precision Audiology: Individual Differences and Characteristic Profiles From Auditory Perceptual and Cognitive Abilities.

Older adults with normal hearing or with age-related hearing loss face challenges when listening to speech in noisy environments. To better serve individuals with communication difficulties, precision diagnostics are needed to characterize individuals' auditory perceptual and cognitive abilities beyond pure tone thresholds. These abilities can be heterogenous across individuals within the same population. The goal of the present study is to consider the suprathreshold variability and develop characteristic profiles for older adults with normal hearing (ONH) and with hearing loss (OHL). Auditory perceptual and cognitive abilities were tested on ONH (n = 20) and OHL (n = 20) on an abbreviated test battery using portable automated rapid testing. Using cluster analyses, three main profiles were revealed for each group, showing differences in auditory perceptual and cognitive abilities despite similar audiometric thresholds. Analysis of variance showed that ONH profiles differed in spatial release from masking, speech-in-babble testing, cognition, tone-in-noise, and binaural temporal processing abilities. The OHL profiles differed in spatial release from masking, speech-in-babble testing, cognition, and tolerance to background noise performance. Correlation analyses showed significant relationships between auditory and cognitive abilities in both groups. This study showed that auditory perceptual and cognitive deficits can be present to varying degrees in the presence of audiometrically normal hearing and among listeners with similar degrees of hearing loss. The results of this study inform the need for taking individual differences into consideration and developing targeted intervention options beyond pure tone thresholds and speech testing.

Primary Stapedectomy: A Retrospective Review of Surgical Results Using a Cold Steel Technique and Pre-Operative CT Correlates.

Stapedectomy is an effective treatment option for patients with symptomatic otosclerosis. A common surgical technique today is laser stapedotomy, although the equipment required adds a significant cost to the procedure and may not be available in certain, particularly remote, centers. This study aimed to evaluate cold steel stapedectomy in a modern otology practice as a cost-effective and versatile alternative. The primary objective was to evaluate the efficacy and safety of cold steel stapedectomy. The secondary objectives included characterizing the prevalence of relevant computed tomography (CT) findings and evaluating other factors such as piston size. A retrospective case series from April 2006 to November 2021. A single tertiary care hospital in Montreal, QC, Canada. Patients with suspected otosclerosis and no prior stapes surgery. Cold steel primary stapedectomy. In primary analysis, change in pure tone thresholds, pure tone average (PTA), and complication rates were obtained. Secondary analysis measures included rates of relevant CT findings and change in PTA with piston size. A total of 302 cases were included in the analysis. The average change in air conduction PTA was a decrease of 27 dB, with 91% (276/302) having over 10 dB of improvement. The air-bone gap was closed to within 10 dB in 82% (248/302) of cases and within 20 dB in 96% (290/302) of cases. Overclosure occurred in 19% of cases, while only 4% resulted in worsened PTA bone conduction thresholds. In secondary analysis, 74% of CT scans demonstrated radiologic otosclerosis. Other findings included suspected superior semicircular canal dehiscence in 1.8%. Cold steel stapedectomy was demonstrated to be a safe and effective technique, with audiometric results comparable to laser and drill studies in recent literature. It should be considered as a cost-effective and global health accessible alternative. Additionally, CT scans can provide valuable information in the pre-operative workup.

Tinnitus features and masking in patients with normal hearing and with high frequency hearing loss

To access tinnitus features and effectiveness of its masking in relation to sensorineural hearing loss (SHL), gender, age, affected side and tinnitus pitch. 53 patients (32 (60.4%) females and 21 (39.6%) males) aged 20 to 46 years with unilateral chronic tinnitus without any external or middle ear pathology were enrolled in the study. All patients underwent pure tone audiometry, evaluating SHL, tinnitus pitch and tinnitus masking. Pure-tone thresholds were measured at all standard frequencies from 0.25 to 8 kHz, and at 10 kHz, 12.5 kHz, 14 kHz, 16 kHz, and 20 kHz. Normal hearing at the studied frequencies was observed in 24 patients, and 29 patients were found to have SHL. Patients with high-frequency SHL identified tinnitus pitch more often identified tinnitus pitch compared to those with normal hearing (75.9% vs. 45%, respectively; p=0.02). Tinnitus pitch in patients with normal hearing was 8 (6-13) kHz, whereas in all patients with SHL tinnitus pitch was always located in the range of maximum hearing loss and reached 10 (8-12) kHz. The mean tinnitus pitch, which was successfully masked, was 8 Hz, and tinnitus pitches with mean value above 12 kHz were not associated with effective masking (p=0.04). No statistically significant differences were found between the effectiveness of tinnitus masking and the affected side, gender, presence of SHL. The higher tinnitus pitch (above 12 kHz) was more common in younger patients and was associated with less successful masking. Our study included patients of predominantly young age (up to 48 years old), in whom, probably, the factors influencing the tinnitus characteristic differ and have a correlation with anxiety-depressive spectrum disorders prevailing at a younger age. In this regard, further research is needed.

Umbrales estimados (esdB HL) para potenciales evocados auditivos con estímulo Narrow Band CE-Chirp®

ABSTRACT Purpose: to correlate pure-tone audiometry thresholds with electrophysiological thresholds, using NB CE-Chirp® stimuli in listeners aged 18 to 30 years from Santiago, Chile, and determine the estimated threshold at 500, 1000, 2000, and 4000 Hz. This can contribute to the battery of objective and subjective tests applicable to children, aiding the timely detection and implementation before 3 months old, as recommended by the Joint Committee on Infant Hearing. Methods: a quantitative, nonexperimental study with a sample of 30 hearing subjects, aged 18 to 30 years. The Pearson´s correlation test was applied, with a significance p-value of 0.01. Results: higher frequencies (2000 and 4000 Hz) have lower correction factors than medium and lower frequencies (1000 and 500 Hz), which tend to be higher as the frequency is lower. Conclusions: the study obtained the following estimated thresholds: 15 dB at 500 Hz, 10 dB at 1000 and 2000 Hz, and 5 dB at 4000 Hz.

Establishment of the Norwegian hearing register for children.

The Norwegian Directorate of Health approved the Norwegian Hearing Register for Children in 2022. The main objective of the register is to improve the quality of treatment for children with permanent hearing loss, by measures, follow-ups and monitoring the quality and results of the health care system. Inclusion criteria are children who do not pass universal newborn hearing screening and/or children with permanent hearing loss <18 years of age. Hearing loss is defined as pure-tone audiometry threshold of (PTA4) > 20 dB in at least one ear. Data are registered at the Ear, Nose and Throat departments at inclusion and at follow-ups at the age of 3, 6, 10, and 15 years. The register collects information about the child within a holistic perspective. The key elements of the register are (a) data concerning newborn hearing screening; (b) data concerning hearing, medical information, hearing amplification and intervention (c) patient reported outcome measures registered by caregivers using three questionnaires; Pediatric Quality of Life Inventory, Strengths and Difficulties Questionnaire and Parents' Evaluation of Aural/Oral Performance of Children. The register has established four quality indicators regarding newborn hearing screening and early intervention (a) the rate of false positive neonatal screens; (b) testing for congenital cytomegalovirus within 3 weeks of age for children who do not pass newborn hearing screening; (c) audiological evaluation to confirm the hearing status no later than 3 months of age and (d) initiated intervention within 3 months after confirmation of hearing status. The register will include the total population of hearing impaired children over long time periods. Thus, the register enables each hospital to monitor their quality indicator scores continuously and compare them with national levels in real time. This facilitates and accelerates identification of improvement areas in the hospitals and will be an important contributor for quality improvement in NHS, diagnostics and hearing intervention for children in Norway. In addition, data from the register will be a unique source for research, and study designs with a long follow-up time can be applied.

Assessment of the risk of hearing loss in children with cystic fibrosis

Cystic fibrosis (CF) is a severe hereditary disease with a multisystem lesion. Manifestations of CF include severe infectious purulent lesions of all parts of the respiratory tract, including purulent rhinosinusitis with nasal polyps. The involvement of the sinonasal region and the need for systemic use of ototoxic drugs (primarily aminoglycosides to treat resistant bacterial infection) potentially create a risk of both conductive and sensorineural hearing loss (SNHL). The available data on the epidemiology of hearing disorders in CF is contradictory. Currently, genetic determinants of the development of aminoglycoside SNHL have been identified. For 136 CF patients (75 girls, 61 boys) aged 3 to 17 (9.4±3.9) years were performed audiological examination: tympanometry, transient-evoked otoacoustic emission and the pure tone threshold audiometry (standard frequency range) (n=126). History of systemic therapy with aminoglycosides was evaluated for each patient. Sequencing of c.35delG mutations in the GJB2 gene (nuclear DNA) and A1555G in the 12S rRNA gene (mitochondrial DNA) was performed in 215 patients with cystic fibrosis (the group partially overlaps with the audiological group), and as a control - 106 children with bronchial asthma and 103 healthy children, their age ranged from 3 to 17 (8.8±3.8) years. Audiological examination of CF children reveled a prevalence of conductive hearing loss comparable to the general population (2.4%). The frequency of SNHL was 1.6%, wich exceeds that of non-CF children. A genetic study revealed one case of heterozygous carriage of the c.35delG mutation in the GJB2 gene in a patient with bronchial asthma. In the group of patients with CF (n=215), mutations in the connexin 26 gene were not detected. No A1555G mutation was detected either in the group of patients with CF or in the control groups. Children with CF are at risk for the development of sensorineural, but not conductive hearing loss. Routine total screening for A1555G and c.35delG mutations probably seems not to be recommended.

Clinical experience with the Nurotron™ cochlear implant in a Spanish-speaking postlingual population: Clinical safety and audiological results

Objectiveto assess clinical safety and postoperative audiological outcomes in postlingual deafness Spanish speaking patients, who underwent surgery with Nurotron™ cochlear implant. Material and methodsRetrospective descriptive case series study. We performed follow-up of complications and audiological measurements before and after cochlear implantation. Patients with bilateral severe to profound sensorineural hearing loss or patients with unilateral deafness with/without tinnitus were included. Repeated-measures within-subjects for assess pure tone thresholds and speech performance (bilingual test) with a detailed monitoring to establish security or adverse effects were performed. Analysis of variance tests, repetitive measures, were used for statistical analysis. Results31 patients were included, 17 (54.8%) men and 14 (45.2%) women. Mean age at the time of surgery was 49.82 ± 18.8 years. The mean follow-up of the group was 31.56 ± 9.57 months (minimum = 19.6 months and maximum = 52.50 months). As major complication one patient (3.23%) had a hard failure that required removal and re-implantation. 25.8% of the patients presented minor complications, the most frequent being vertigo/unsteadiness in 22.6%.The mean of language discrimination (free field at 65 dB SPL) was 62.19% ± 16.66; being 69.82% ± 7.35 in the group of severe to profound bilateral sensorineural hearing loss. A statistically significant reduction was observed in patients with tinnitus, assessed using the visual analogue scale, preoperative = 7.2 ± 1,6 vs postoperative (18months postoperative) = 1.7 ± 1.3 (p < .001). ConclusionsThe Nurotron™ cochlear implant shows satisfactory audiological results, in accordance with what has been reported in the literature. Minor complications were similar to previous studies, but the percentage of hard failure should continue to be observed, which was higher than other reports with comparable follow-up.

Assessment of hearing sequelae in individuals tested post-trauma.

Over 5% of the global population (430 million people) require rehabilitation for hearing loss. Individuals with hearing impairments face significant challenges in business, daily life, and social participation. Hearing loss (HL) and other permanent physical and sensory disabilities escalate dramatically in cases with brain damage and temporal bone trauma associated with head injuries. This study aims to identify the significant risk factors for hearing loss following head trauma, utilizing current data, and discuss the findings in the context of the literature. This could contribute to the development of standard approaches for assessing such cases. This retrospective study reviewed files and reports from individuals assessed for hearing loss at Dokuz Eylül University Faculty of Medicine, Department of Forensic Medicine. The study included cases that applied at least 12 months post-trauma, between January 1, 2016, and December 31, 2022, after their recovery process was completed. Sociodemographic data, types of temporal bone fractures, initial otoscopic examination findings, presence or absence of intracranial injury, type of hearing loss, and audiometry test results for air and bone conduction pure tone threshold averages were evaluated. Data analysis was conducted using SPSS 26.0 (Statistical Package for the Social Sciences). Out of 244 cases, 177 (72.5%) were male and 67 (27.5%) were female. It was observed that the majority of trauma cases occurred in the 19-40 age group (49.2%; n=120). In the initial otoscopic examinations post-trauma, otorrhagia/otorrhea was the most common finding, both as an isolated symptom (n=59, 24.2%) and when accompanied by other symptoms. No temporal bone fractures were detected in 43 cases (17.6%). Longitudinal fractures were found in 141 cases (57.8%), transverse fractures in 48 (19.7%), and mixed-type fractures in 12 (4.9%). The statistical difference in air conduction and bone conduction pure tone threshold averages between groups with and without intracranial injury was significant (p<0.001). Post-traumatic examinations should employ a multidisciplinary approach, adhering to standard medical improvement and assessment timelines. It is essential to verify whether each patient's medical improvement process has reached its maximum potential. We believe that adhering to these recommendations and utilizing standardized classifications for hearing loss will prevent the loss of rights.

Reabilitação auditiva com sistemas Baha® transcutâneo e percutâneo

ABSTRACT Purpose Longitudinally verify the influence of auditory tonal thresholds obtained with transcutaneous and percutaneous bone-anchored hearing aids on speech perception in individuals with external and/or middle ear malformation and chronic otitis media. Methods Observational, retrospective, longitudinal follow-up study of 30 unilateral users of the transcutaneous and percutaneous Baha® system for the collection of secondary data on pure tone thresholds obtained through free field audiometry and sentence recognition threshold in silence and noise in conditions: without the prosthesis; at the time of activation; in the first month of use (post 1); and in the third month (post 2). Results There was a significant difference between pure tone thresholds obtained at frequencies of 3 and 4kHz with better results for the percutaneous technique at all evaluation moments. For both systems, better performance was observed in sentence recognition in silence and in noise, with a significant difference in activation (p&lt;0.001), but it remained stable during the other evaluation moments. The percutaneous system showed better benefit in recognizing sentences in noise only on activation (p=0.036), when compared to the transcutaneous system. Conclusion The percutaneous system provided better audibility for high frequencies; however, such audibility did not influence sentence recognition in the silent situation for both systems. For the noise situation, better responses were observed in the percutaneous system, however, the difference was not maintained over time.

Comparative Analysis of Methods of Audiological Screening of the Adult Population: Global and Kazakhstani Experience

Hearing impairment is currently recognized as the most prevalent sensory impairment and one of the leading causes of disability worldwide. It is estimated that one in five people on Earth has at least minimal hearing loss, and more than 5% of the population has disabling hearing loss. There are many methods for screening detection of hearing impairment, and the most common ones are mobile applications, recognition of whispered speech, a portable audiometer, questionnaires, the speech intelligibility test in noise, and others. Nevertheless, the “gold standard” for hearing testing has been and remains the method of pure-tone threshold audiometry. The purpose of this review is to study the currently available literature, analyze ongoing research in the field of audiological screening of adults, study the cost-effectiveness of ongoing screening activities, study the situation in Kazakhstan, and the possibility of using these screening methods in Kazakhstan. We selected 25 full-text articles that met the following criteria: the 2018-2023 time interval, adult population, screening methods, effectiveness, and article language (English, Russian, Kazakh). Conclusions. Despite a sufficient number of hearing screening methods, their sufficient reliability, sensitivity, and specificity, and their obvious cost-effectiveness in comparison with the costs of rehabilitation of hearing impairments, none of the hearing assessment methods are included in the National Screening Program for examining adult population in any country in the world. In Kazakhstan, a screening test of hearing function using a one-question survey, the HHIA/HHIE questionnaire, a study of whispered speech at the primary health care level, and also the use of a mobile version of a hearing test as a hearing self-diagnosis are applicabl

BRAK NASTĘPSTW INFEKCJI COVID-19 W ODNIESIENIU DO STANDARDOWYCH TESTÓW AUDIOLOGICZNYCH

IntroductionCoronavirus disease (COVID-19), considered to be caused by a novel coronavirus (SARS-CoV-2), is an acute respiratory disease which was declared a pandemic by the World Health Organization. Previously published reports have shown contradictory findings on the involvement of the auditory system in individuals infected with COVID-19. The present study aims to assess auditory system functioning in individuals post-COVID-19 infection and compare the results with individuals without COVID-19 infection.Material and methodsParticipants in this study were 30 individuals who had experienced mild COVID-19 infection and 30 individuals who never had COVID-19. Participants were aged between 18 and 40 years. Testing was done 1 to 6 months after infection, and involved conventional and extended high-frequency audiometry, speech perception in quiet and at different signal-to-noise ratios (SPIN), transient evoked otoacoustic emissions (TEOAEs) in quiet and in the presence of contralateral noise, and auditory brainstem response (ABR) in the ipsilateral and contralateral mode.ResultsNone of the tests – pure-tone thresholds, speech perception in quiet and in noise, TEOAE with and without contralateral noise, and ABR – showed any significant difference between individuals who never had COVID-19 infection and those who had recovered from the infection. Both afferent and efferent auditory pathways showed normal findings in individuals post-COVID-19 infection.ConclusionsIndividuals who have been infected with mild COVID-19 did not show any significant deficit in any of the audiological tests, suggesting that the disease does not cause any permanent harm to the auditory system after the infection has subsided.

DOES HEARING LOSS MODERATE THE RELATIONSHIP BETWEEN COGNITION AND DEPRESSION?

Abstract Hearing loss, depression, and cognitive impairment are common, co-occurring conditions experienced by older adults, but the nature of the relationship among these conditions remains unclear. Both depression and hearing loss have been identified as risk factors for dementia, but for different stages of life (e.g., Singh-Manoux et al., 2017; Livingston et al., 2020). Hearing loss is described as the strongest modifiable risk factor in mid-life, and depression is second only to smoking as the strongest modifiable risk factor in late-life (Livingston et al., 2020). The association between hearing loss and depression is well documented in the literature (e.g., Lawrence et al., 2015). It is possible that hearing loss, as an earlier risk factor, moderates the relationship between depression and cognition. Therefore, as part of an ongoing longitudinal study of early indicators of cognitive decline, we examined the moderating effect of two measures of hearing (pure-tone hearing threshold average, Dichotic Sentence Identification test) on the relationship between depression (Geriatric Depression Scale) and cognition (Montreal Cognitive Assessment, Digit Symbol Substitution test) for a group of 65 older adults (mean age 74). Although none of the hearing or cognitive measures were significant predictors of depression scores on their own, there was a significant negative interaction between the Montreal Cognitive Assessment and pure-tone hearing threshold average, p = 0.048. These results may be interpreted to suggest that individuals with higher (poorer) hearing thresholds show a decrease in depression as their cognitive scores improve, whereas individuals with lower (better) hearing thresholds show the opposite pattern.