Risk Factors For Hearing Loss Research Articles

Risk Factors for Hearing Loss at Birth in Newborns With Congenital Cytomegalovirus Infection

With a prevalence between 0.2% and 6.1% of all live births, congenital cytomegalovirus (cCMV) infection is a major cause of congenital nonhereditary sensorineural hearing loss. Despite the large amount of research on cCMV-related hearing loss, it is still unclear which newborns are at risk of hearing loss. To identify independent risk factors for cCMV-related congenital hearing loss and predictors of hearing loss severity at birth. This cross-sectional study of newborns with cCMV infection used data included in the Flemish CMV registry that was collected from 6 secondary and tertiary hospitals in Flanders, Belgium, over 15 years (January 1, 2007, to February 7, 2022). Data were analyzed March 3 to October 19, 2022. Patients were included in the study after confirmed diagnosis of cCMV infection and known hearing status at birth. Patients who presented with other possible causes of sensorineural hearing loss were excluded. Primary outcome was hearing status at birth. Clinical, neurological, and laboratory findings along with the timing of seroconversion and blood viral load were separately considered as risk factors. Binary logistic regression was performed to identify independent risk factors for congenital hearing loss in newborns with cCMV. Effect sizes were measured using Hedges g, odds ratio, or Cramer V. Of the 1033 newborns included in the study (553 of 1024 [54.0%] boys), 416 (40.3%) were diagnosed with symptomatic cCMV infection and 617 (59.7%) with asymptomatic cCMV infection. A total of 15.4% of the patients (n = 159) presented with congenital hearing loss; half of them (n = 80 [50.3%]) had isolated hearing loss. The regression model revealed 3 independent risk factors for congenital hearing loss: petechiae at birth (adjusted odds ratio [aOR], 6.7; 95% CI, 1.9-23.9), periventricular cysts on magnetic resonance imaging (MRI; aOR, 4.6; 95% CI, 1.5-14.1), and seroconversion in the first trimester (aOR, 3.1; 95% CI, 1.1-9.3). Lower viral loads were seen in patients with normal hearing compared with those with congenital hearing loss (median [IQR] viral load, 447.0 [39.3-2345.8] copies per milliliter of sample [copies/mL] vs 1349.5 [234.3-14 393.0] copies/mL; median difference, -397.0 [95% CI, -5058.0 to 174.0] copies/mL). Findings of this cross-sectional study suggest that newborns with cCMV infection and petechiae at birth, periventricular cysts on MRI, or a seroconversion in the first trimester had a higher risk of congenital hearing loss. Clinicians may use these risk factors to counsel parents in the prenatal and postnatal periods about the risk of congenital hearing loss. Moreover, linking clinical features to hearing loss may provide new insights into the pathogenesis of cCMV-related hearing loss. The importance of viral load as a risk factor for congenital hearing loss remains unclear.

Hearing screening test in neonates born to COVID-19-positive mothers.

Infection with COVID-19 during pregnancy was not a risk factor for hearing loss, similar to other studies. • The pathogenetic mechanism of the viral-induced impairment of the organ of Corti includes direct damage to the hair cells and indirect damage due to the induction of the innate inflammatory response. • Early data suggested that the SARS-CoV-2 virus also has neurotropic properties with manifestations from the sensory epithelia. • Although the intrauterine infection remains controversial, the expression of the ACE-2 receptor on the placenta and the detection of IgM antibodies, as well as the covid-19 genome in fetuses, make the vertical transmission tenable. • In our study, the newborn hearing screening results indicate that COVID-19 infection during pregnancy is not a risk factor for hearing loss.

Cumulative risk factors contributing to hearing loss in preterm infants

ObjectiveTo investigate individual and concomitant risk factors for hearing loss during neonatal care.DesignCase–control study.SettingCommunity.Population237 children born <32 weeks of gestation; 57 with hearing loss and 180 with normal hearing born...

Effect of HbA1c Level on Hearing Sensitivity Among Patients with Diabetic Mellitus

Diabetes Mellitus (DM) appears to be a risk factor for hearing loss. Meta-analyses of cross-sectional studies reported that diabetes had a greater risk of hearing impairment. Hearing loss and hemoglobin A1c (HbA1c), a glycemic management biomarker, have been linked in a few studies. HbA1c and hearing impairment as measured by a pure-tone average threshold of frequencies (500 Hz, 1 kHz, and 2 kHz), while the other two found a link between HbA1c and high-frequency hearing impairment. The goal of this study is to see if the amount of HbA1c level is linked to the occurrence of hearing loss. Participants were 430 of both genders between the ages of 21 to 60 years and based on the duration of HbA1c level. Results indicated that the higher HbA1c level patient had high-frequency hearing loss when compared to speech frequencies in both ears. As the HbA1c level increases an increase in the high-frequency hearing loss was also noticed. A positive correlation exists between the duration of diabetics and high-frequency hearing loss. Moreover, when diabetic duration increases, the hearing loss is more affected in extended high frequency, high frequency followed by speech frequency among uncontrolled DM than controlled DM in both ears. These findings suggest that proper glycemic management might help avoid diabetic hearing loss.

Characteristics of Hearing Loss in Patients with Systemic Lupus Erythematosus.

To investigate the clinical characteristics of hearing loss (HL) in patients with systemic lupus erythematosus (SLE) and its related factors. Ninety-one hospitalized SLE patients and thirty healthy controls were enrolled. All subjects completed pure tone audiometry (PTA), extended high frequency audiometry (EHFA) and distortion product otoacoustic emission (DPOAE) to assess hearing function. SLE patients were divided into two groups according to the presence or absence of HL, and the risk factors of HL were determined by multivariate logistic regression. The incidence of HL was 27.47% in SLE patients, significantly higher than in the control group (3.3%) and most cases were mild-to-moderate, bilateral and predominantly sensorineural. Compared with the control group, the hearing thresholds of SLE patients increased significantly in the middle and high frequencies starting from 2000 Hz. Even though the PTA test results were normal, the EHFA test results showed significant differences in hearing impairment between SLE patients and normal controls. For patients with abnormal PTA results, the signal-to-noise ratio (SNR) in DPOAE was markedly reduced, and the pass rate was also decreased. The Systemic Lupus International Collaborating Clinics Damage Index (SDI, OR 9.13) and secondary Sjögren's syndrome (sSS, OR 8.20) were identified as independent associated factors for HL, and there was no difference in PTA and EHFA at all frequencies between hydroxychloroquine users and non-users. HL is not rare in SLE patients, and EHFA can help identify early hearing impairment. Having a high SDI score and secondary Sjögren's syndrome may predict the presence of HL in SLE.

The role of autophagy and ferroptosis in sensorineural hearing loss.

Hearing loss has become a common sensory defect in humans. Because of the limited regenerative ability of mammalian cochlear hair cells (HCs), HC damage (caused by ototoxic drugs, aging, and noise) is the main risk factor of hearing loss. However, how HCs can be protected from these risk factors remains to be investigated. Autophagy is a process by which damaged cytoplasmic components are sequestered into lysosomes for degradation. Ferroptosis is a novel form of non-apoptotic regulated cell death involving intracellular iron overloading and iron-dependent lipid peroxide accumulation. Recent studies have confirmed that autophagy is associated with ferroptosis, and their crosstalk may be the potential therapeutic target for hearing loss. In this review, we provide an overview of the mechanisms of ferroptosis and autophagy as well as their relationship with HC damage, which may provide insights for a new future in the protection of HCs.

Newborn Hearing Screening at a Single Tertiary Care Hospital in the United Arab Emirates

Background and Aim: The United Arab Emirates has been successfully identifying and rehabilitating children having congenital hearing loss. A dearth of published data regarding the newborn hearing screening programs in the country demands the current study. The study aimed to find incidence of hearing loss and impact of known risk factors for hearing loss in a cohort of newborn babies in a single tertiary hospital in the United Arab Emirates. Methods: A retrospective analysis of hearing screening from January 2010 to December 2019 on a total of 37661 newborn babies were conducted using a screening protocol in auditory brainstem responses. Results: We report an overall incidence of 0.16% for congenital hearing loss in the current study population. Babies with prolonged stay in Newborn Intensive Care Unit (NICU) had an incidence of 0.87% and in babies with positive family history of hearing loss, it was as high as 2.2%. Chi square analysis revealed the significance of these risk factors (p&lt;0.001). 72% (44.61) received hearing rehabilitation by being fitted with cochlear implants and hearing aids except in few having other comorbidities. Conclusion: The newborn screening program has run a successful journey since the beginning in the country and the current study is an example. A majority of children identified has received early audiological rehabilitation helping the country in promoting inclusive education and better quality of life for them. Further studies may be implicated to see the outcome of early rehabilitation initiated in the identified population. Keywords: Hearing loss; newborn screening; newborn intensive care unit; family history; risk factors

Neonatal Hearing Screening and Prevalence of Hearing Impairment in the Time Period of COVID-19 Epidemic in the North of Iran

Background and Aim: COVID-19 is an acute respiratory disease, caused by a coronavirus named SARS-CoV-2. Previous reports suggest an association between COVID-19 infection and Hearing Loss (HL). We have investigated the Universal Newborn Hearing Screening (UNHS) results in the time period of COVID-19 epidemic in Guilan Province, north of Iran. Methods: We analyzed UNHS results from10 major obstetrics hospitals from 20th Mar 2020 to 19th Mar 2021, and compared the total UNHS positive/“refer” and total neonatal HL reports with the same time periods of recent three years. The prevalence of risk factors for HL were analyzed during the same period. Results: The total number of childbirth was decreased significantly from 27735 birth cases in Mar 2017-2018 to 18216 births in Mar 2020-2021 (p&lt;0.001), but the total “refer” rate was significantly increased from 63.0 per 1,000 births in Mar 2019-2020 to 79.8 in Mar 2020-2021 (OR=1.29, 95% CI: 1.19-1.39, p&lt;0.001), and also increased from 74.7 per 1,000 births in Mar 2017-2020 to 79.8 in Mar 2020-2021 (OR=1.07, 95% CI: 1.01-1.14, p=0.020). The HL rate increased from 10.3 per 10,000 births in Mar 2019-2020 and from 11.4 per 10,000 births in Mar 2017-2020 to 18.7 in Mar 2020-2021 (OR=1.81 and 1.63, 95% CI: 1.06-3.09 and 1.10-2.44, p=0.028 and 0.015, respectively). The prevalence of preterm birth (p=0.039) and neonatal intensive care unit stay (p=0.016) was increased significantly during Mar 2020-2021. Conclusion: The chance of “refer” results and neonatal HL, found in the UNHS program, increased during the COVID-19 epidemic in comparison to the past years. Keywords: Newborn; hearing screening; hearing loss; COVID-19

Follow-up of children diagnosed with deafness in a neonatal hearing screening program in Manaus.

To evaluate the follow-up of children diagnosed with deafness in neonatal hearing screening and risk factors for hearing loss. Quantitative, cross-sectional, and retrospective study to evaluate factors associated with hearing loss and the follow-up of cases of children diagnosed with audiological dysfunction, by analyzing electronic medical records of 5,305 children referred to a Specialized Center in Type I Rehabilitation, from January/2016 to February/2020, in the city of Manaus, Amazonas. The statistical study used Pearson's chi-square test and binary logistic regression in which odds ratio scans were obtained with reliability intervals of 95%. Of the 5,305 children referred for the otoacoustic emission retest, 366 (6.9%) failed the retest. Children diagnosed with sensorineural hearing loss continued in the study, totaling 265 (72.4%). Only 58 (21.9%) children continued in the study to its end, of these 39 had received hearing aids at that point; and 16 (41%) had surgical indication for cochlear implants, of which only 3 (18.7%) had undergone surgery. Among the risk factors for hearing loss, we found 2.6 times more chance of failure in the otoacoustic emissions retest in those children who had a family history of hearing loss and ICU stay. Although the screening flow reaches a large part of live births, the dropout rates during the process are high, therefore, the socioeconomic and geographic characteristics of regions such as the Amazon should be considered as relevant factors to the evasion of rehabilitation programs of these children. Hospitalization in the neonatal ICU and family history of hearing loss in the investigations could be identified as the main and most important factors for alteration of the otoacoustic emissions retests.

School Hearing Screening With a Portable, Tablet-Based, Noise-Attenuating Audiometric Headset in Rural Nicaragua.

To investigate the utility and effectiveness of a noise-attenuating, tablet-based mobile health system combined with asynchronous telehealth evaluations for screening rural Nicaraguan schoolchildren for hearing loss. Prospective population-based survey. Rural Nicaraguan communities. There were 3,398 school children 7 to 9 years of age. Diagnostic automated and manual audiometry, detailed asynchronous telehealth evaluations. Referral rates, ambient noise levels, and audiometric results as well as hearing loss prevalence, types, and risk factors. Despite high ambient noise levels during screening (46.7 dBA), no effect of noise on referral rates on automated audiometry or confirmatory manual audiometry in those who failed automated testing was seen. The overall audiometric referral rate was 2.6%. Idiopathic sensorineural hearing loss (SNHL) and cerumen impaction were the most common types of hearing loss in this population with an estimated prevalence of hearing loss (all types) of 18.3 per 1,000 children. SNHL was associated with both drug exposure during pregnancy (p = 0.04) and pesticide exposure in the home (p = 0.03). Hearing screening using a tablet-based, noise-attenuating wireless headset audiometer is feasible and effective in rural low-resource environments with moderately elevated ambient noise levels. The referral rate with noise-attenuating headsets was much lower than that previous reports on this population. In addition, manual audiometry resulted in much lower referral rates than automated audiometry. The confirmed hearing loss rate in this study is comparable to reports from other low-income countries that use some form of noise attenuation during screening. Pesticide exposure and drug exposure during pregnancy are potential causes of SNHL in this population.

Is Gestational COVID-19 a Risk Factor for Congenital Hearing Loss?

The aim of this study was to investigate whether COVID-19 during pregnancy is a risk factor for congenital hearing loss. Retrospective cohort. Tertiary referral center. Hearing screening test results of 60,223 newborns between March 2020 and May 2021 were screened using the national database. Newborn babies of 570 pregnant women with positive COVID-19 PCR test during pregnancy who met the study criteria were included in the gestational COVID-19 group, and 570 healthy newborns born in the same period were included in the control group. Diagnostic. Results of up to three automatic auditory brainstem response tests in the first 30 days of life were used for newborn hearing screening. When the gestational COVID-19 and control groups were compared in terms of demographic data, there was no statistically significant difference for any of the variables (maternal age, gestational age, birth weight, neonate gender, mode of delivery, p > 0.05 for all variables). Of the mothers in the gestational COVID-19 group, 62 (10.9%) had COVID-19 in the first trimester, 181 (31.8%) in the second trimester, and 327 (57.3%) in the third trimester. When the first and second test results of newborn hearing screening were compared between the groups, the number of babies with hearing loss was higher in the gestational COVID-19 group than in the control group (p = 0.025; odds ratio, 1.357; 95% confidence interval, 1.039-1.774; p = 0.006; odds ratio, 4.924; 95% confidence interval, 1.410-17.193, respectively). For the third test results, hearing loss was detected in only one baby in both groups (p = 0.284). When the first, second, and third test results for newborn hearing screening were compared according to the trimesters when COVID-19 positivity was identified, the difference between trimesters was not found to be statistically significant (p > 0.05). To the best of our knowledge, this is the largest study in the literature of the impact of COVID-19 on newborn hearing. The findings in the study suggest that gestational COVID-19 is not a risk factor for permanent congenital hearing loss. However, because the risk of detecting hearing loss is high in the first 15 days, we emphasize the importance of the third screening test.

ASSOCIATION BETWEEN BODY MASS INDEX AND HEARING LOSS : A CROSSSECTIONAL STUDY IN A TERTIARY CARE HOSPITAL.

Hearing loss is a growing important global public health concern. Emerging evidence implicates high BMI as a risk factor for hearing loss. Identication of modiable factors for hearing loss that could be useful to prevent or at least delay the condition. We aimed to assess relation between body mass index and hearing loss and also to asses the parameters closely associated with obesity such as lipid parameters, blood sugars and their association on hearing threshold.In this cross sectional study conducted for a period of 6 months on 460 subjects presented with hearing loss, tinnitus and vertigo. BMI of each individual was calculated and categorized. They were subjected to audiometric evaluation.Overweight (88.1%) and obese participants (85.5%) showed association with hearing loss. Mild and moderate hearing loss was more common in both over weight and obese patients with signicant p value (&lt;0.001). BMI categories with deranged RBS, deranged lipid parameters there was association with hearing loss. Our study demonstrated association was found between obesity and hearing loss.We emphasize that obesity and various risk factors associated with obesity may play role in hearing loss, So early screening of obese subjects may provide early diagnosis of hearing loss.

Association Between Social Disadvantage and Otitis Media Treatment in US Children With Commercial Insurance

It is well established that social disadvantage is associated with earlier, more frequent, and more severe otitis media in children. Appropriate medical and surgical treatment of otitis media can prevent hearing loss and other complications, which may affect future academic and employment opportunities in socially disadvantaged populations. Clinical treatment patterns for otitis media in the US are unclear. To describe and quantify social disparities in the treatment patterns of otitis media in children in the US. This cross-sectional study included claims data from the Optum Clinformatics Data Mart Database between January 1, 2003, and March 31, 2021, with linked inpatient, outpatient, and pharmaceutical claims for 4 831 408 children with otitis media. Age at first otitis media diagnosis, sex, environmental allergies, gastroesophageal reflux, adenotonsillar hyperplasia, zip code, social deprivation index score, social vulnerability index score. Treatment of recurrent and suppurative otitis media in children, insertion of tympanostomy tubes, and treatment for severe complications of undertreated otitis media. The principal measure of social disadvantage was the social deprivation index. The social vulnerability index was used for sensitivity analyses to ensure external validity. Multiple logistic regression analyses were used to quantify the association of all projected variables with the study outcomes. Among 4 831 408 US children with otitis media (median [IQR] age, 4 [1-8] years; 2 491 557 boys [51.57%]), 994 921 (20.59%) were treated for recurrent otitis media, 717 978 (14.86%) were treated for suppurative otitis media, 335 949 (6.95%) received tympanostomy tubes, and 10 975 (0.23%) had severe complications of otitis media. In multivariable regression models including patient factors and social indices, earlier age at diagnosis, male sex, environmental allergies, gastroesophageal reflux, and adenotonsillar hyperplasia were associated with increased treatment for otitis media, whereas social deprivation index was associated with lower odds of medical treatment for recurrent otitis media (odds ratio [OR], 0.86; 95% CI, 0.85-0.87), suppurative otitis media (OR, 0.61; 95% CI, 0.60-0.62), and insertion of tympanostomy tubes (OR, 0.76; 95% CI, 0.75-0.78) but higher odds of having severe complications (OR, 1.28; 95% CI, 1.19-1.37). The findings of this cross-sectional study suggest that children with otitis media who were socially disadvantaged were less likely to receive treatment and more likely to experience complications for undertreated otitis media. As otitis media is a modifiable risk factor for hearing loss, efforts need to be made to ensure equitable access to treatment for all children.

The prevalence and risk factors for congenital hearing loss in neonates: A birth cohort study based on CHALLENGE study.

To determine the prevalence and risk factors of congenital hearing loss (HL) in neonates based on China Longitudinal Environmental, Genetic, and Economic Cohort (CHALLENGE cohort). Maternal and neonatal data were collected based on the CHALLENGE cohort study from July 2018 to September 2020. Total 7287 neonates underwent the universal newborn hearing screening (UNHS). Babies who did not pass the initial screening and the rescreening were given the formal audiological diagnosis for possible HL. The data was analyzed to find out the prevalence and risk factors for congenital HL in this cohort study. The prevalence of congenital HL was 3.43‰, and temporary HL was 0.07‰ (5 neonates). The statistical data showed that risk factors, including craniofacial anomalies, neonatal intensive care unit (NICU) admission, family history and advanced maternal age (AMA), could be associated with congenital HL. Additionally, exchange transfusion, assisted ventilation and NICU admission, these three factors could be associated with congenital sensorineural HL (SNHL). Risk factors including craniofacial anomalies, NICU admission, family history and AMA might be contributed to congenital conductive HL(CHL). There were several common risk factors could be contributed to congenital HL, which were consistent with previous studies. However, some risk factors were no longer causing congenital HL due to the improvement of medical treatment and prenatal care. This study has not only helped explain the status quo of the prevalence of congenital HL in China but also laid foundation for future studies.

The Absence of Permanent Sensorineural Hearing Loss in a Cohort of Children with SARS-CoV-2 Infection and the Importance of Performing the Audiological "Work-Up".

Currently, the novel coronavirus (SARS-CoV-2) causes an acute respiratory illness named COVID-19 and is a controversial risk factor for hearing loss (HL). Herein, we aim to describe the associated symptoms and to evaluate hearing function in the COVID-19 pediatric population. A retrospective cross-sectional observational study was carried out on 37 children who contracted COVID-19 infection with no previous audio-vestibular disorders. Clinical data on the infections were collected, and an audiological assessment of all affected children was performed by using different diagnostic protocols according to their age. Fever, upper respiratory and gastrointestinal manifestations were common presentations of infection. Audiological function was normal in 30 (81.08%) children, while 7 children showed an increased hearing threshold: 6 (16.21%) had transient conductive hearing loss (CHL) due to middle ear effusion and normalized at the follow-up and 1 had sensorineural hearing loss (SNHL). A single child was affected by bilateral SNHL (2.7%); however, he underwent a complete audiological work-up leading to a diagnosis of genetic HL due to a MYO6 gene mutation which is causative of progressive or late onset SNHL. HL needs to be considered among the manifestations of COVID-19 in children, nevertheless, we found cases of transient CHL. The onset of HL during or following COVID-19 infection does not eliminate the indication for maintaining audiological surveillance and audiological work-ups, including genetic diagnosis, to avoid the risk of mistaking other causes of HL.

Multifactorial analysis of the degree of hearing loss and outcome in patients with sudden hearing loss

Objective:To investigate the relationship between the severity and curative effect of hearing loss and clinical indicators in patients with sudden hearing loss （SHL）. Methods:The Spearman correlation coefficient was used to analyze the correlation between the efficacy of SHL and clinical indicators.A total of two hundred and seventy-three patients with SHL were selected and divided into three quantile groups according to the average hearing threshold of the the involved ear frequency of the first pure tone audiometry at admission. Univariate and multivariate ordered logistic regression were used to evaluate the relationship between initial hearing level and clinical indicators of SHL patients. The Spearman correlation coefficient was used to analyze the correlation between efficacy of SHL and clinical indicators. Results:Compared with patients with lower hearing loss （≤50 dB HL），patients with higher hearing loss （>50 dB HL） had higher Neutrophil, Monocyte, Triglycerides, Hemoglobin, Fibrinogen, Glucose, Neutrophil/high-density lipoprotein cholesterol ratio （NHR）, Monocyte/high-density lipoprotein cholesterol ratio, Monocyte/lymphocyte cell ratio, age, dizziness, and lower Platelet/ lymphocyte cell ratio and High-density lipoprotein cholesterol, and poor final hearing threshold.Multivariate logistic regression showed that NHR and age were independent risk factors for initial hearing loss in SHL patients.And the NHR, Neutrophil/lymphocyte cell ratio （NLR）, course of disease, type of hearing curve, and final hearing threshold were significantly negatively correlated with curative effect. Conclusion:SHL patients with higher NHR and NLR values, the longer time from onset to visit, and the more severe hearing loss had worse efficacy.However, SHL patients with higher NHR and age values had greater initial hearing loss,the degree of hearing loss and curative effect are different in SHL patients with different types of hearing threshold curve and age.

Spectrotemporal Modulation Discrimination in Infants With Normal Hearing.

Spectral resolution correlates with speech understanding in post-lingually deafened adults with cochlear implants (CIs) and is proposed as a non-linguistic measure of device efficacy in implanted infants. However, spectral resolution develops gradually through adolescence regardless of hearing status. Spectral resolution relies on two different factors that mature at markedly different rates: Resolution of ripple peaks (frequency resolution) matures during infancy whereas sensitivity to across-spectrum intensity modulation (spectral modulation sensitivity) matures by age 12. Investigation of spectral resolution as a clinical measure for implanted infants requires understanding how each factor develops and constrains speech understanding with a CI. This study addresses the limitations of the present literature. First, the paucity of relevant data requires replication and generalization across measures of spectral resolution. Second, criticism that previously used measures of spectral resolution may reflect non-spectral cues needs to be addressed. Third, rigorous behavioral measurement of spectral resolution in individual infants is limited by attrition. To address these limitations, we measured discrimination of spectrally modulated, or rippled, sounds at two modulation depths in normal hearing (NH) infants and adults. Non-spectral cues were limited by constructing stimuli with spectral envelopes that change in phase across time. Pilot testing suggested that dynamic spectral envelope stimuli appeared to hold infants' attention and lengthen habituation time relative to previously used static ripple stimuli. A post-hoc condition was added to ensure that the stimulus noise carrier was not obscuring age differences in spectral resolution. The degree of improvement in discrimination at higher ripple depth represents spectral frequency resolution independent of the overall threshold. It was hypothesized that adults would have better thresholds than infants but both groups would show similar effects of modulation depth. Participants were 53 6- to 7-month-old infants and 23 adults with NH with no risk factors for hearing loss who passed bilateral otoacoustic emissions screening. Stimuli were created from complexes with 33- or 100-tones per octave, amplitude-modulated across frequency and time with constant 5 Hz envelope phase-drift and spectral ripple density from 1 to 20 ripples per octave (RPO). An observer-based, single-interval procedure measured the highest RPO (1 to 19) a listener could discriminate from a 20 RPO stimulus. Age-group and stimulus pure-tone complex were between-subjects variables whereas modulation depth (10 or 20 dB) was within-subjects. Linear-mixed model analysis was used to test for the significance of the main effects and interactions. All adults and 94% of infants provided ripple density thresholds at both modulation depths. The upper range of threshold approached 17 RPO with the 100-tones/octave carrier and 20 dB depth condition. As expected, mean threshold was significantly better with the 100-tones/octave compared with the 33-tones/octave complex, better in adults than in infants, and better at 20 dB than 10 dB modulation depth. None of the interactions reached significance, suggesting that the effect of modulation depth on the threshold was not different for infants or adults. Spectral ripple discrimination can be measured in infants with minimal listener attrition using dynamic ripple stimuli. Results are consistent with previous findings that spectral resolution is immature in infancy due to immature spectral modulation sensitivity rather than frequency resolution.

Comparison of Hearing Abnormalities in Non-Diabetic and Diabetic End-Stage Renal Disease Patients Undergoing Hemodialysis

Background and Aim: Hearing loss is a highly prevalent symptom in patients with chronic kidney diseases (CKD). Comorbidities such as Diabetes Mellitus is known as the most common cause of CKD and a significant risk factor for sensorineural hearing loss (SNHL). The aim of this study was to compare SNHL among diabetic with non-diabetic hemodialysis patients.&#x0D; Methods: In this study, 33 diabetic patients on hemodialysis were selected from Hami center, Arak, Iran. Non-diabetic subjects were 31 hemodialysis patients without diabetes were matched for age, duration of CKD and hemodialysis. Data were obtained via questionnaire, patients’ files, physical examination, otoscopy and tympanometry. Hearing was analyzed using pure-tone audiometry for both groups.&#x0D; Results: In the study, 66.2% of diabetic patients and 52.1% of non-diabetic subjects had SNHL. Results showed that diabetic patient has 1.3 times more likely to have hearing impairment. This difference was not statistically significant. Bilateral mild SNHL was the most prevalent in both groups. No significant difference was reported in SNHL prevalence, mean thresholds of hearing and ear laterality between the groups. Gender and age had a significant effect on hearing loss after adjusting covariables. No significant association was found between diabetes and hearing loss.&#x0D; Conclusion: SNHL was more common in hemodialysis patients with diabetes. Patients with diabetes had poorer hearing thresholds compared to non-diabetic group, with no significant difference between groups. The periodical assessment of hearing and extending audiological care in this high-risk population is recommended due to long-term irreversible symptoms of the disease.&#x0D; Keywords: Diabetes mellitus; hearing loss; end-stage renal disease

The Association Between Midlife Leisure-Time Physical Activity and Hearing Loss in Late Life in the Atherosclerosis Risk in Communities Study.

Hearing loss is highly prevalent in older ages and has several health consequences. Some cardiovascular risk factors are associated with worse hearing at older ages. Still, the role of midlife leisure-time physical activity (PA) as a risk factor for hearing loss is yet to be investigated. Among 3198 participants of the Atherosclerosis Risk in Communities study, we investigated the associations of midlife and change from mid- to late-life PA (assessed via modified Baecke questionnaire) with hearing loss (audiometric battery [worse-ear pure-tone average, and speech-in-noise test]) at older ages. We used regression analyses, adjusted for demographics, medical conditions, and noise exposure, to estimate differences in hearing between those who met and did not meet PA recommendations at midlife and at late life. A total of 1386 (43.3%) participants met PA recommendations at midlife. These participants, compared to those who did not meet recommendations, had lower (better) pure-tone average by 1.51 (0.46, 2.55) decibels, identified 0.37 (0.01, 0.74) more words (better score) in the speech-in-noise test, and had a lower relative risk of having hearing loss at older ages (eg, relative risk ratio for severe hearing loss vs normal hearing=0.70 [0.52, 0.95]). Similarly, those who persistently met PA recommendations from mid- to late life had, compared with those who did not, a better hearing at older ages. Meeting PA public health recommendations in midlife and mid- to late life was associated with better hearing at older ages and reduced risk of hearing loss. Promoting adequate levels of PA may be an essential component of hearing care.

The Effectiveness of the School-Age Hearing Screening Program in Turkey and the Effects of the COVID-19 Pandemic

The aim of the study is to evaluate the effectiveness of the hearing screening program in school-age children in Turkey, and to discuss alternative methods for children who cannot be screened due to the COVID-19 pandemic. Within the scope of the school-age hearing screening program, children who fail the screening are referred to reference centers. The effectiveness of the screening program was investigated by recording the ear examinations and definitive audiometric examination results of the children who were referred to a tertiery-level center. Evaluations were made of a total of 87 children, comprising 49 boys (56.3%) and 38 girls (43.7%) with a mean age of 6.97 years, and no risk factors for hearing loss. The physical examination results showed that 53 children were normal, 15 had cerumen impaction, 3 otitis externa, 13 otitis media with effusion and 3 acute otitis media. The audiometric examination results were recorded as 72 normal, 13 conductive hearing loss, and 2 sensorineural hearing loss. Thus, the false positive rate of screening audiometry performed at school was 82.7%. School-age hearing screening is an important test to ensure the cognitive and academic development of children. Pure tone audiometry is indispensable in the evaluation of children who fail the test. For the evaluation of children who could not be tested for 1.5 years due to the COVID-19 pandemic, alternative methods such as tele-audiometry may be utilized.