Risk Factors For Hearing Loss Research Articles

The role of toxoplasma, rubella, cytomegalo virus, herpes virus infection as a risk factor for sensory hearing loss in children

Toxoplasma, rubella, cytomegalovirus and herpes virus infection (TORCH) are syndromes that are considered risk factors for deafness.. This study aims to prove the risk factors which play the most significant role in the incidence of Sensory Hearing Loss in children. This used a case-control design, conducted at JIH Yogyakarta Hospital started from December 2023 to June 2024. All participants aged less than 5 years underwent oto-acoustic emission (OAE) examination, then determined presence or absence toxoplasma, rubella, cytomegalovirus and herpes virus using the electrochemiluminescence immunoassay (ECLIA) method. The inclusion criteria for the case group were: 1) patients diagnosed with sensory hearing loss (SHL), while the control group was normal. The exclusion criteria for the case and control groups there were non-infectious risk factors. Based on a type I error of 5% and type II error of 20%. The recommended sample size is 18 samples per group. Statistical analysis used stratified statistical analysis. The results of this study show that the combination of rubella + CMV had the greatest odds ratio (OR: 8) of sensory hearing loss, CMV OR: 0.62, herpes simplex virus OR: 0.28, combination of rubella + herpes simplex virus OR: 0.28, toxoplasma + CMV OR: 0.28, rubella obtained OR: 1 .5, and the combination of rubella + CMV + herpes simplex virus OR: 0.1. Based on these results the combination of rubella + CMV had the greatest OR compared to the combination of other risk factors and single risk factor.

Knowledge, attitudes, and practices of gynaecologists and paediatricians regarding newborn hearing screening in Odisha

Background: Gynaecologists and paediatricians are crucial in detecting hearing loss at the first level of intervention. These healthcare workers are the ones who initially interact with infants and their parents. Therefore, they must understand the risk factors for newborn hearing loss and have a positive attitude toward early intervention. There were few studies conducted to evaluate the Knowledge Attitude and Practices (KAP) of New Born Hearing Screening (NBHS) among paediatricians and other physicians in Western countries and few in the Indian context. Thus, the current study aims to compare and examine the knowledge, attitudes, and practices of gynaecologists and paediatricians regarding newborn hearing screening in Odisha. Methods: A survey questionnaire containing 45 close-ended and 5 open-ended questions was developed. This questionnaire was validated by paediatricians, gynaecologists, and audiologists and then applied among 300 professionals in Odisha. Results: In all the sections it was found that paediatricians have greater knowledge than gynaecologists, however, both professionals have a positive attitude towards NBHS in Odisha. Mann-Whitney U test revealed significant differences in knowledge, attitudes, and practices among paediatricians and gynaecologists in Odisha. Conclusions: From this survey, it can be concluded that most of the paediatricians know more about paediatric hearing loss in comparison to gynaecologists, while both of them have positive attitude in implementing NBHS in Odisha. An awareness should be created among both the professionals about NBHS, effect of hearing loss and to whom they can refer for NBHS, which will benefit the newborns and their parents.

Risk Factors for Hearing Loss in the Railway Transportation Sector: Literature Review

Introduction: Hearing loss, a significant global health problem, can significantly impact quality of life. The railway sector, with its high noise levels, is particularly vulnerable. To address this, it is crucial to focus on mitigating risk factors through noise control, PPE promotion, and regular hearing assessments. Objective: The study aims to identify factors related to hearing loss in railway sectors. By understanding these factors, the research seeks to contribute to improved workplace safety and hearing conservation programs. Method: This study employed a literature review methodology, utilizing sources from Scopus and Google Scholar. Articles were searched using the keywords "hearing loss," "NIHL," "hearing impairment," "railway transport," "railway industry," and "train transportation" published within the last 10 years from 2014 to 2024. Result: The result of the article search revealed 10 articels that match the criteria set. The result show that various factors were identified that can increase the risk of hearing loss in the railway sector. Overall, risk factors for hearing loss among workers include duration of noise exposure, age, sex, individual habits, and the use of personal protective equipment (PPE). Conclusion: The need for comprehensive hearing conservation programs in the railway sector that address not only noise control, but also individual risk factors and the effective use of personal protective equipment. Further research is needed to investigate the long-term effects of combined noise and vibration exposure and the potential benefits of advanced audiometric techniques in the early detection and prevention of hearing loss.

Maternal Perspectives of Newborn Hearing Loss in Resource Constrained Settings of Rawalpindi Pakistan

Objective: The objective of this study was to assess knowledge of mothers regarding risk factors, early identification, and intervention for infant hearing loss and to determine association between hearing loss and consanguineous marriages in Pakistan. Study Design: Analytical cross-sectional study. Place and Duration of Study: Out Patient Department of tertiary care hospitals in Rawalpindi Pakistan, from Mar to Jun 2021. Methodology: 111 mothers consented to participate. Data was collected using a structured researcher administered questionnaire. It included four sections with 37 questions that were answered in yes, no, or unsure. Analysis was done using SPSS software. Results: Mothers' knowledge of two risk factors was high with most respondents being aware of head injury or slap to the ear (n=94) being a risk for hearing loss, followed by ear pain/discharge (n=88). 66.7%(n=72) of participants considered use of ototoxic drugs by mother during pregnancy to be a potent risk factor for neonatal hearing loss. The mothers' understanding of natal causes such as delayed birth cry and neonatal jaundice was poor. Their understanding of postnatal causes such as high fever, frequent hospitalization, and long stay in NICU was also limited. Mothers who were employed had significantly more awareness in certain factors than housewives. 45.4% (n=49) of the mothers believed being in a cousin marriage influenced infant hearing loss while 38.9% (n=42) disagreed, and 15.7% (n=17) were unsure.Conclusion: Only half of all participating mothers were fully aware of the possible risk factors and causes of infant hearing loss. Seminars and public awareness programs should be arranged to educate mothers about risks of infant hearing loss.

Hypothesis testing for detecting outlier evaluators.

In epidemiological studies, the measurements of disease outcomes are carried out by different evaluators. In this paper, we propose a two-stage procedure for detecting outlier evaluators. In the first stage, a regression model is fitted to obtain the evaluators' effects. Outlier evaluators have different effects than normal evaluators. In the second stage, stepwise hypothesis tests are performed to detect outlier evaluators. The true positive rate and true negative rate of the proposed procedure are assessed in a simulation study. We apply the proposed method to detect potential outlier audiologists among the audiologists who measured hearing threshold levels of the participants in the Audiology Assessment Arm of the Conservation of Hearing Study, which is an epidemiological study for examining risk factors of hearing loss.

Follow-Up of Neonatal Hearing Screening in the Risk Factor Group for Hearing Loss: Results from a Tertiary Medical Center.

Universal newborn hearing screening has been successfully implemented in many places around the world, and it is recommended that cases with risk factors for hearing loss be followed-up regardless of hearing screening results. However, there is a need for clarity regarding the recommended rate of follow-up and which tests should be performed. The aim of this study was to assess the audiologic follow-up program for the group with risk factors. Our retrospective study involved children of various ages with a risk factor for hearing loss who passed the initial neonatal hearing test but were later diagnosed with hearing loss. Out of 113,708 children born at Hadassah University Medical Center during the years 2013-2021, 6763 were at risk of hearing loss, and their follow-up audiologic test results were studied. Audiologic testing including ABR, OAE, tympanometry and behavioral audiometry was performed in 1534 of 6763 (23%) of the risk factor group that returned to the hospital. In total, 73 children (4.7%) were diagnosed with hearing loss, 54 of whom failed the initial screening and 19 who had passed it. Further examination of the children that passed the initial screening and were later diagnosed with a hearing loss revealed that four cases had been missed in screening (one familial mild hearing loss, one familial progressive loss, one premature infant with a high tone loss, and one NICU graduate with CNS involvement). Another nine cases had late-onset hearing loss (three meningitis, five CMV, and one with a mitochondrial disease). An additional six cases were diagnosed late, and the age of onset of the hearing loss was unknown (two intubated, two with hydrocephalus, one with Cerebral Palsy, and one with general developmental delay). These results reveal the importance of implementing a refined protocol for monitoring hearing in the high-risk group of children that pass neonatal hearing screening with respect to which hearing tests should be conducted, at what age, and the duration of follow-up. Also, barriers to follow-up must be dealt with, and parents should be more involved in the monitoring process.

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.

Assessment of the Audiological Profile and Related Risk Factors for Sensorineural Hearing Loss in Children with Speech and Language Delay

Assessment of the Audiological Profile and Related Risk Factors for Sensorineural Hearing Loss in Children with Speech and Language Delay

Risk factors for treatment-related sensorineural hearing loss and hearing aid use in medulloblastoma patients: an observational cohort study.

This study aimed to analyze treatment-related risk factors for sensorineural hearing loss (SNHL) and an indication for hearing aids (IHA) in medulloblastoma patients after craniospinal radiotherapy (CSRT) and platin-based chemotherapy (PCth). Atotal of 58patients (116 ears) with medulloblastoma and clinically non-relevant pre-treatment hearing thresholds were included. Cranial radiotherapy and PCth were applied sequentially according to the HIT 2000 study protocol or post-study recommendations, the NOA-07 protocol, or the PNET (primitive neuroectodermal tumor) 5MB therapy protocol. Audiological outcomes up to amaximum post-therapeutic follow-up of 4years were assessed. The incidence, post-treatment progression, and time-to-onset of SNHL, defined as Muenster classification grade ≥MS2b, were evaluated. Risk factors for IHA were analyzed separately. While 39patients received conventionally fractionated RT (CFRT; group1), 19patients received hyperfractionated RT (HFRT; group2). Over amedian follow-up of 40months, 69.2% of ears in group1 experienced SNHL ≥MS2b compared to 89.5% in group2 (p = 0.017). In multivariable Cox regressions analysis, younger age and increased mean cochlear radiation dose calculated as the equivalent dose in 2‑Gy fractions (EQD2) were associated with time-to-onset of SNHL ≥MS2b (p = 0.019 and p = 0.023, respectively) and IHA (p < 0.001 and p = 0.016, respectively). Tomotherapy and supine positioning were associated with alower risk for IHA in univariable modelling only (p = 0.048 and p = 0.027, respectively). Young age and cochlear EQD2 Dmean ≥40 Gy are significant risk factors for the incidence, degree, and time-to-event of SNHL as well as for IHA in medulloblastoma patients.

The Prevalence and Related Factors of Hearing Loss Among Adults: A Systematic Review and Meta-Analyses

Objectives: We aimed to estimate the global prevalence of hearing loss among adults and to explore its associated factors. Methods: Our systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement (PRISMA). We retrieved corresponding documents published up to Sep 24, 2021 in PubMed and Web of Science. Random-effects models were used to calculate the pooled prevalence of hearing loss. Subgroup analyses were conducted to explore potential heterogeneity. Results: The pooled prevalence of any hearing loss across 100 studies was 31.0% (95% CI: 26.9-35.1, P &lt; .001, I2 = 99.9%), and the pooled prevalence of disabling hearing loss across 34 studies was 15.9% (95% CI: 11.1-20.7, P &lt; .001, I2 = 99.9%). The prevalence of hearing loss was higher in the year range of 2000 to 2009, among the elder (≥70) or males, in studies using either ear side of hearing loss definition or in the region of the Americas. Ear disease or surgery, job noise exposure, current smoking, off-work noise exposure, males, cardiovascular disease, past drinking, diabetes mellitus, hypertension, older age, and past smoking are risk factors of hearing loss while education level surpasses high school acts as a protect factor for hearing. Conclusion: Our results demonstrate high prevalence of hearing loss among adults worldwide and verify several related factors of the disease. Prevention and intervention measures should be implemented.

The Influence of Personal Listening Devices on Hearing in Egyptian University Students: A Cross-Sectional Study

Background: Improper use of personal listening devices (PLDs) is associated with an increased risk of hearing loss. The purpose is to investigate the use of PLDs among university students and their impact on hearing. Methodology: A study involved 310 University students, surveyed on their PLDs habits. They shared their daily PLD use, volume level, and duration of use. Participants also discussed PLD-related hearing issues and other risk factors for hearing loss. Screening used the Five-minute hearing test (FMHT) and the “Hear WHO” app. Positive cases in both tests received diagnostic pure-tone audiometry (PTA). Results: About 70% used in-earpiece PLDs for studying, 53% used them for over 5 years. Also 83% used PLDs for over 60 mins daily, and 72% used them above volume level 6. Most (74%) were low-risk users. 10.6% tested positive for hearing loss in both screenings, with 1.6% confirmed by PTA. A shift in the 4 kHz average hearing threshold was noted. Tinnitus was reported by 49%, and ear pain by 42% of students. Higher risk PLD use predicted tinnitus, ear pain and excessive ear wax in multivariable analysis. Conclusions: Students' high-volume PLD use is linked to auditory problems like tinnitus and ear pain. Regular hearing screenings are recommended.

Personal Listening Devices (PLDs) Usage and Auditory Effects among University Students in Egypt: A Cross-Sectional Study

Abstract Background The improper use of personal listening devices (PLDs) among young adults has been associated with an increased risk of hearing loss. Objectives This study aimed to investigate the PLDs listening practices among university students and to assess their auditory effects. Methods A cross-sectional study was conducted, involving a sample of 310 university students from Ain Shams University. The participants were conveniently selected from the Faculty of Medicine and Science. Participants were surveyed about their PLDs listening practices, including the daily duration of PLDs use, the volume at which they were typically used, and the number of years they had been using their PLDs. Participants were asked about common hearing problems associated with PLDs, and other risk factors for hearing loss were assessed. Hearing loss screening was done using the Five-minute hearing test (FMHT) and the “Hear WHO” mobile application. Participants who tested positive for hearing loss by both tests were referred for diagnostic pure-tone audiometry (PTA). Results Approximately 69% of the students used PLDs with an in-earpiece mainly during studying. A considerable proportion of students (53%) stated that they had been using their PLDs for over 5 years. Moreover, a notable percentage of students reported extended usage, with 83% using their PLDs for more than 60 minutes per day, and 72% using them at a volume level above 6. The majority of students (74%) were classified as low-risk users in terms of PLDs use. Thirty-three (10.6%) students tested positive for hearing loss on both screening tests, but only 5 (1.6%) had confirmed hearing loss by PTA. A Shift in the average hearing threshold at 4 kHz was detected in both ears, while remained within the normal range. Tinnitus was the most common symptom reported by 151 (49%) of the students, followed by ear pain reported by 130 (42%) of them. It was also detected that there was no statistically significant difference in hearing threshold levels based on the duration of PLDs use or the risk status of PLDs use. Moreover, in the multivariable logistic regression analysis, it was found that risk category of PLDs use was a significant predictor of tinnitus (OR: 2.69; 95% CI, 1.46-4.65), ear pain (OR: 2.62; 95% CI, 1.70-4.80), and excessive ear wax (OR: 2.43; 95% CI, 1.30-4.20) in higher risk categories compared to lower risk group. Conclusion Most students used PLDs for more than one hour daily with high volume (&amp;gt; 6). PLDs use was associated with auditory problems including tinnitus and ear pain. Regular hearing screenings is recommended for early detection of hearing loss among PLDs users.

Selective Vulnerability of GABAergic Inhibitory Interneurons to Bilirubin Neurotoxicity in the Neonatal Brain.

Hyperbilirubinemia (HB) is a key risk factor for hearing loss in neonates, particularly premature infants. Here, we report that bilirubin (BIL)-dependent cell death in the auditory brainstem of neonatal mice of both sexes is significantly attenuated by ZD7288, a blocker for hyperpolarization-activated cyclic nucleotide-gated (HCN) channel-mediated current (I h), or by genetic deletion of HCN1. GABAergic inhibitory interneurons predominantly express HCN1, on which BIL selectively acts to increase their intrinsic excitability and mortality by enhancing HCN1 activity and Ca2+-dependent membrane targeting. Chronic BIL elevation in neonatal mice in vivo increases the fraction of spontaneously active interneurons and their firing frequency, I h, and death, compromising audition at the young adult stage in HCN1+/+, but not in HCN1-/- genotype. We conclude that HB preferentially targets HCN1 to injure inhibitory interneurons, fueling a feedforward loop in which lessening inhibition cascades hyperexcitability, Ca2+ overload, neuronal death, and auditory impairments. These findings rationalize HCN1 as a potential target for managing HB encephalopathy.

Prevalence and risk factors of hearing loss in the Chinese population aged 45 years and older: Findings from the CHARLS baseline survey.

This study aimed to determine the prevalence of hearing loss and identify associated risk factors in a Chinese population aged 45 years and older. This study employed a cross-sectional research design. Data from the 4th wave survey of the China Health and Retirement Longitudinal Study (CHARLS) conducted in 2018 were utilized. Participants were assessed using self-reported questionnaires, and various demographic and comorbidity factors were analyzed to elucidate the risk factors associated with hearing loss. A total of 17,695 individuals from 10,257 households in 450 villages and urban settlements were included in the study. Hearing loss was assessed through self-reported questionnaires. Risk factors, including demographic characteristics and comorbidities, were analyzed to identify associations with hearing loss. The study population had a hearing loss prevalence rate of 17.9% (n = 3,179). Regional variations were observed, with highest rates in Chongqing (28.67%), Yunnan (25.12%), and Qinghai (24.36%), and lowest rates in Zhejiang (17.71%), Tianjin (10.56%), and Shanghai (9.26%). Age ≥70 was associated with higher risk (OR = 3, p<0.05), while being female was associated with reduced risk (OR = 0.81, p<0.05). Higher education level showed lower risk (OR<1, p<0.05). Non-agricultural workers had lower risk (OR = 0.67, p<0.05). Fewer social activities were correlated with decreased risk (OR = 0.89, p = 0.024). Ethnic minorities had slightly higher risk (OR = 1.23, p<0.05). This study provides valuable insights into the prevalence and risk factors associated with hearing loss in the Chinese population aged 45 years and older. The findings emphasize the importance of early detection and intervention, particularly among older individuals and those residing in specific regions, for effective hearing loss management.

Hearing loss secondary to variants in the OTOF gene

ObjectiveGenetic variants in the OTOF gene are responsible for non-syndromic hearing loss with an autosomal recessive inheritance pattern. The objective of our work was to evaluate the clinical characteristics of patients with biallelic pathogenic variants in OTOF and their evolution after treatment. MethodsA cohort of 124 patients with prelingual hearing loss, studied from 1996 to 2023, was included in this study. A genetic analysis was conducted to identify the type and frequency of variants in the OTOF gene and their relation to the clinical characteristics of the patients. ResultsThe homozygous p. Gln829* variant in the OTOF gene was detected in 3 probands (2.4 %) of a group of 124 individuals with prelingual hearing loss. Another 6 family members to a total of 9 individuals were finally included. All presented with severe/profound bilateral sensorineural hearing loss of congenital onset. Three of these individuals were diagnosed with auditory neuropathy spectrum disorder. One individual passed the OAE test during the screening program, and since he did not have risk factors for hearing loss that would warrant ABR testing, this led to a delay in his hearing loss diagnosis. Four individuals underwent cochlear implants (three bilateral) with good functional outcomes in three of them. However, in 17 familial cases with heterozygous variants, either no hearing loss was observed or it was within the expected range for their age. ConclusionsHearing loss secondary to the p.Gln829* variant of the OTOF gene is relatively rare in our medical area. Its presence in homozygosity is the cause of severe/profound bilateral prelingual sensorineural hearing loss, responsible for auditory neuropathy with a good response to cochlear implantation.

Risk factors and hearing outcomes in infants and young children in KwaZulu-Natal, South Africa.

Targeted new-born hearing screening, based on high risk factors is recommended in the absence of universal new-born hearing screening in resource-constrained settings. The relevance of risk factors listed in the guidelines of high-income countries and used bylow-middle income countriesremains relatively unknown. Risk factors consistent with the epidemiological profile, evolution of risks and disease burden in these countries need to be considered. This study aimed to profile the frequency of risk factors and their manifestation in hearing outcomesof youngchildren in the KwaZulu-Natal province of South Africa. A chart review ofN= 1433 patients' archival audiology records was conducted, conveniently sampled from a single tertiary hospital (n= 351), a provincial assessment and therapy centre (n= 649), a university clinic (n= 291), and two schools for the deaf (n= 142). Overall, 56% of the participants presented with either a conductive, sensorineural or a mixed hearing loss; 62% of the children had between 1 and 2 risk factors present (Mean [M] = 1.1; standard deviation [s.d.] = 0.98). Admission to neonatal intensive care unit, maternal infections, bacterial and viral infections and chemotherapy, from the Joint Committee on Infant Hearing list of high risk factors were significantly associated with hearing loss (p 0.05). Known non-JCIH risks, emerging risks and other statistically significant contextually relevant risk factors were also noted. Understanding the profile of high risk factors in a given context has implications forprevention, early hearing identification and intervention services.Contribution:Targeted new-born hearing screening needs to be based on risk factors that are contextually relevant. This study is one of the first profiling high risk factors for hearing loss in children in KZN, the province with the second highest population in South Africa.

Prevalence and Risk Factors of Hearing Loss in Children in Mumbai, India

Introduction: Hearing loss (GP) is a significant public health problem in India, especially in children. In Mumbai, the prevalence of GP among children is not yet known with certainty. This study aims to determine the prevalence and risk factors of GP in children in Mumbai. Methods: This research was conducted cross-sectionally involving 500 children aged 5-15 years in Mumbai. Data was collected through interviews and hearing examinations. Risk factors analyzed included age, gender, socioeconomic status, noise exposure, and history of ear infections. Results: The prevalence of GP among children in Mumbai is 12%. Risk factors significantly associated with GP were age, noise exposure, and history of ear infections. Conclusion: The prevalence of GP among children in Mumbai is quite high. The main risk factors for GP are age, noise exposure, and history of ear infections. Efforts to prevent GP in children in Mumbai need to focus on controlling noise exposure and treating ear infections early.

Prevalence and risk factors of self-reported hearing loss, tinnitus, and dizziness in a population-based sample from rural northeastern Germany

A close anatomical and physiological relationship is known between the senses of hearing and balance, while an additional pathophysiological interaction is supposed. The mechanisms underlying this association are not yet fully understood, especially in individuals without a known specific otologic disorder. In particular, only scarce information on the combined occurrence of audiovestibular sensory impairment is available so far. Therefore, this study aims to provide further insight into the prevalence and co-prevalence of the audiovestibular symptoms hearing loss, tinnitus and dizziness. Additionally, the influence of potential risk factors from lifestyle habits as well as cardiovascular and metabolic conditions on the development of those symptoms is studied. Data was analyzed from 8134 individuals from the population-based Study of Health in Pomerania (SHIP). SHIP pursues a broad and comprehensive examination program in chronologically separated cohorts with longitudinal follow-up. Cohorts are sampled from Western Pomerania, a rural region of north-eastern Germany. The study population represents a cross-sectional analysis from the cohorts SHIP-START (recruited 1997–2001) and SHIP-TREND (recruited 2008–2012), sampled for baseline investigations (SHIP-START-0 and SHIP-TREND-0) at the age of 20–79 years. Audiovestibular symptoms as outcome variables were assessed by structured questionnaires. Additionally, individuals were comprehensively characterized regarding modifiable lifestyle factors as well as cardiovascular and metabolic disorders, allowing the assessment of their role as exposure variables. We calculated a weighted prevalence of 14.2% for hearing loss, 9.7% for tinnitus, and 13.5% for dizziness in the population. Prevalence increased with age and differed among the sexes. A considerable share of 28.0% of the investigated individuals reported more than one symptom at once. The prevalence of hearing loss as well as tinnitus increased between the two cohorts. A moderate positive correlation was found between the occurrence of hearing loss and tinnitus (phi-coefficient 0.318). In multivariable regression analyses, education was identified as a significant protective factor while only smoking was significantly associated with all three symptoms. Furthermore, several cardiovascular risk factors contributed to both hearing loss and dizziness. In conclusion, audiovestibular symptoms are highly prevalent in the investigated population. A considerable but complex influence of risk factors points towards a relation with neuronal as well as cardiovascular disease processes. To clarify the underlying mechanisms, the interaction between the senses of hearing and balance as well as the mode of action of the risk factors should be evaluated in more detail in the future.

UK and US risk factors for hearing loss in neonatal intensive care unit infants.

Early detection and intervention of hearing loss may mitigate negative effects on children's development. Children who were admitted to the neonatal intensive care unit (NICU) as babies are particularly susceptible to hearing loss and risk factors are vital for surveillance. This single-centre retrospective cohort study included data from 142 inborn infants who had been admitted to the NICU in a tertiary regional referral centre. Data were recorded for 71 infants with confirmed permanent congenital hearing loss hearing loss. To determine impact of NICU admission independently of prematurity, babies were individually matched with 71 inborn infants on gestational age, birthweight, and sex. Neonatal indicators were recorded for all children with permanent congenital hearing loss. Presence of UK and US risk factors for hearing loss were collected on the neonatal population with hearing loss and for the matched controls. A fifth (21%) of babies with hearing loss had one or more UK risk factors whereas most (86%) had at least one US risk factor. False positives would be evident if US factors were used whereas the matched controls had no UK risk factors. Ten babies who at birth had no UK or US risk factors did not have any significant neonatal indicators identified in their records, one was ventilated for one day and two had a genetic anomaly. Current risk factors for hearing loss we identified for follow-up in this high-risk group are highly specific for congenital hearing loss. UK risk factors were highly specific for hearing loss but not sensitive and conversely, US risk factors are sensitive but not specific so false positives would be recorded. A national study of neonatal indicators could provide the utility to test which combinations of risk factors provide high sensitivity without losing specificity.

Incidence of Hearing Loss in Patients With Neurofibromatosis Type 1 at a Tertiary Care Pediatric Hospital

BackgroundHearing loss has not been thoroughly investigated as a comorbidity in larger cohorts with neurofibromatosis type 1 (NF1). MethodsAvailable audiometric data were reviewed from patients with NF1 seen at a tertiary pediatric hospital to assess prevalence and risk factors for hearing loss. ResultsOf 1172 patients with NF1 seen between 2010 and 2022, 90 had available audiometric data and 48 of 90 patients (53%) had one or more audiogram revealing hearing loss. Those not referred to audiology were presumed to have normal hearing, resulting in a conservative hearing loss estimate of 4% for children and young adults with NF1. Of 90 patients with audiograms, 29 (32%) had conductive loss (CHL), 15 (17%) had sensorineural loss (SNHL), and 3 (3%) had mixed hearing loss. Hearing loss type was undetermined for one patient. For children with CHL, six had permanent CHL secondary to plexiform neurofibroma, 19 CHL were transient due to active middle ear dysfunction, and four CHL cases were indeterminate in etiology. For three children with SNHL or mixed hearing loss, etiology included history of ototoxic chemotherapy and/or family history of SNHL. In the 16 patients with SNHL or mixed hearing loss with more than one audiogram over time, progressive hearing decline was noted in eight of 16, and 26 of 178 hearing thresholds (15%) progressed. ConclusionsOur findings suggest that audiometric evaluations should be considered for at least a subset of children with NF1, given the higher-than-expected rate of hearing loss in patients with NF1 compared with the general population.