Risk Of Hearing Loss Research Articles

Effects of Noise Exposure on Peripheral Auditory Function, Binaural Envelope Coding, and Speech Perception in Student Musicians With Normal Hearing

Objectives: Musicians face an increased risk of hearing loss due to prolonged and repetitive exposure to high-noise levels. Detecting early signs of hearing loss, which are subtle and often elusive to traditional clinical tests like pure-tone audiometry, is essential. The objective of this study was to investigate the impact of noise exposure on the electrophysiological and perceptual aspects of subclinical hearing damage in young musicians with normal audiometric thresholds. Design: The study included 33 musicians and 33 nonmusicians, all aged between 21 and 35 years, with normal audiometric thresholds. Participants underwent a comprehensive test battery, which encompassed standard and extended high-frequency (EHF) pure-tone audiometry (0.25 to 16 kHz), a Noise Exposure Structured Interview, auditory brainstem responses (ABRs) to clicks at various presentation rates and levels, thresholds for detecting interaural envelope time difference, and a spatial release from masking (SRM) paradigm in which the target speech was presented in the presence of either colocated or spatially separated time-reversed two-talker babble. Results: The results indicated the musician group reported greater lifetime noise exposure than the nonmusician group, but the Noise Exposure Structured Interview scores were neither correlated with the ABR results nor with the speech perception outcomes. The ABR analyses indicated diminished level-dependent growth and increased rate-dependent decline in wave I amplitudes among musicians compared with nonmusicians. The student musicians exhibited better binaural envelope processing skills than nonmusicians, emphasizing their perceptual advantages in auditory processing associated with musicianship. Speech perception results indicated no significant differences in SRM between student musicians and nonmusicians. However, in both groups, individuals with poorer EHF hearing exhibited reduced SRM compared with those with normal EHF hearing, underscoring the importance of assessing and addressing EHF hearing. Conclusions: Student musicians exhibit peripheral neural deficits; however, no clear relation was found between these neural deficits and their perceptual skills. Notably, reduced EHF thresholds were clearly related to reduced SRM, which poses a challenge for speech perception in complex multi-talker environments, affecting both musicians and nonmusicians alike.

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.

BIOS-02. DIFFERENT GROWTH PATTERN OF VESTIBULAR SCHWANNOMAS IN NEUROFIBROMATOSIS TYPE 2 PATIENTS ACCORDING TO AGE

Abstract The natural growth pattern of vestibular schwannoma (VS) associated with the rare disease neurofibromatosis type 2 (NF2) has not been sufficiently elucidated, and the rationale for proactive treatment for VS in NF2 is not firmly established. This study aimed to uncover the growth pattern of VS associated with NF2 and identify risk factors for rapid growth. A total of 68 VSs from 41 NF2 patients who were diagnosed in Seoul National University Bundang Hospital from July 2006 to July 2023 were retrospectively reviewed. NF2 was clinically diagnosed according to the Manchester criteria. The mean age was 34±16 years (mean ± standard deviation) at diagnosis. The initial tumor volume was a median of 0.263 cm³ (interquartile range [IQR], 0.053-0.754 cm³), and 51 VSs exhibited serviceable hearing classified as Gardner-Robertson grade 1 or 2. Patients were followed for a median of 45 months (IQR, 30-80 months), during which the median volume increased by 0.145 cm³ (IQR, 0.020-0.783 cm³), representing an annual growth rate of 0.044 cm³/yr (IQR, 0.003-0.202 cm³) or 12.4%/yr (IQR, 2.2-27.5%). Patients younger than 25 years (15 patients with 28 VSs) had significantly smaller initial tumor sizes (0.170 cm³ [IQR, 0.031-0.339 cm³] vs. 0.510 cm³ [0.099-1.399 cm³]) but faster tumor growth rates (annual growth rate; 27.3%/yr [IQR, 11.3-81.4%/yr] vs. 4.7%/yr [IQR, 0.0-16.1%/yr]) compared to those 25 years or older (26 patients with 40 VSs). Among the 51 VSs with serviceable hearing at diagnosis, 40 VSs were followed up for more than 12 months. Among them, 13 (32.5%) experienced unserviceable hearing deterioration at a median of 58 months. The risk of hearing loss significantly increased with faster tumor growth rates. The growth rate of NF2-related VS was higher in patients under the age of 25, which may be helpful in determining indications for proactive treatments like radiosurgery for NF2-related VS.

The causal relationship between diabetes mellitus and the risk of sensorineural hearing loss: A Mendelian randomization study.

An increasing body of evidence suggests that diabetes mellitus (DM) plays a role in sensorineural hearing loss (SNHL). However, the specific causal relationship between DM and SNHL remains partially uncertain. This study aimed to investigate the causal relationship between DM and the risk of SNHL using a Mendelian randomization (MR) study. Single nucleotide polymorphisms closely related to DM were selected as instrumental variables using open genome-wide association study datasets. Three methods based on inverse variance weighted were utilized to investigate the causal relationship between DM and SNHL. Subsequently, multivariable MR (MVMR) was executed to adjust for confounding genetic associations. In addition, a range of sensitivity analyses were performed to assess the stability and reliability of the MR results. The inverse variance weighted analysis indicated a potential genetic causality between DM and SNHL (odds ratio [OR]: 2.179; 95% confidence interval [CI]: 1.123-4.231; P = .021). The sensitivity analyses showed that the included single nucleotide polymorphisms had no heterogeneity, horizontal pleiotropy, and outliers (P > .05). Moreover, the leave-one-out method further verified the robustness of the MR analysis results. Finally, the results of the MVMR study predicted that there was a genetic causal relationship between type 1 DM and SNHL (OR: 1.032; 95%CI: 1.018-1.047; P = 5.45 × 10-6), while there was no causality between type 2 DM and SNHL (OR: 1.000; 95%CI: 0.958-1.036; P = .853). Our study suggested that DM and type 1 DM may be genetically responsible for SNHL. Although our study did not detect a genetic causal relationship between type 2 DM and SNHL, this does not rule out a relationship between them at other mechanistic levels. Further studies are required to confirm the findings and look into the physiological and pathological mechanism underlying these relationships.

NOISE POLLUTION AND ITS EFFECTS ON HUMAN HEALTH: A REVIEW

Noise pollution is a pervasive environmental issue with significant adverse effects on human health. This abstract explores the impact of noise pollution on both physical and mental well-being, emphasizing its role in increasing risks for cardiovascular diseases, hearing loss, sleep disturbances, and cognitive impairments. Vulnerable populations, including children and the elderly, are particularly affected by high noise levels, which exacerbate stress, anxiety, and depression, and impair cognitive development in children. The economic implications of noise pollution are considerable, with substantial costs associated with healthcare and productivity losses, as well as negative effects on community cohesion and quality of life. Effective noise management is essential, requiring robust regulations, improved urban planning, and heightened public awareness. Further research is needed to understand the long-term health impacts, refine noise reduction technologies, and assess effects on specific populations. Interdisciplinary studies will be crucial in developing comprehensive strategies to mitigate the health impacts of noise pollution. KEYWORDS: Noise Pollution; Health Impacts; Noise Reduction Technologies; Economic Costs; Interdisciplinary Research

Phthalate Metabolites Were Related to the Risk of High-Frequency Hearing Loss: A Cross-Sectional Study of National Health and Nutrition Examination Survey

Phthalate Metabolites Were Related to the Risk of High-Frequency Hearing Loss: A Cross-Sectional Study of National Health and Nutrition Examination Survey

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.

Listening Habits to Music during COVID-19 Pandemic: Is There a Risk to Hearing?

Abstract Background The coronavirus disease 2019 (COVID-19) pandemic introduced a unique situation by consigning people to their homes, with free time for music listening, joined with increased anxiety and stress levels. The question arises whether listening habits to music have changed during the pandemic. Such a change in listening habits might pose a greater potential risk to hearing than in routine days. Purpose To evaluate listening habits to music using earphones during the COVID-19 pandemic and assess if any change occurred in these habits compared with routine days before the pandemic. Research Design Self-reported listening habits were collected using a purpose-built questionnaire submitted online. Study Sample In total, the questionnaire was distributed among 242 young adults aged 18 to 30 years (mean: 24.3 ± 2.8). A total of 192 participants, regular listeners to music using earphones, provided information concerning their listening habits. Data Collection and Analysis Collected listening habits included: listening levels, duration, and frequency of listening during the pandemic compared with routine days. Symptoms and circumstances that occurred following music listening were reported as well. We compared statistically listening habits of participants that stayed home during the pandemic versus those that kept their office routine. In addition, we performed statistical analysis on hearing symptoms following unsafe versus safe music listeners. Results Most reported listening durations were 2 to 4 days (28.5%) and 7 days a week (29.7%), for at least 30 minutes, at high to very high listening levels, and volume control settings at 75 to 100%. Almost 50% of the participants reported a change in their listening habits during the pandemic, mainly a more frequent and longer listening duration. Overall, 29.1% of the participants were at potential risk of hearing loss due to unsafe listening habits. Conclusion The change in listening habits during the COVID-19 pandemic underscores the need to monitor listening habits and raise awareness of the one cause for hearing loss that can be prevented.

Changes in Auditory Performance Following a Virtual Reality Music Concert.

The purpose of this study was to evaluate threshold and suprathreshold auditory risk from a newly popular platform of music concert entertainment; virtual reality (VR) headsets. Recreational noise exposure to music is the primary source of hearing hazard in young-adults, with noise doses of in-person concert venues and music festivals well in excess of the recommended daily exposure recommendation from the National Institute for Occupational Safety and Health. While research on the relationship between personal music players and noise-induced hearing loss risk is abundant, no study has yet evaluated noise-induced hearing loss risk from VR headsets, which are newest to the commercial market at this time. Thirty-one young-adult participants (18 to 25 years) with normal-hearing sensitivity (0 to 16 dB HL) experienced a VR music concert and participated in three data collection timepoints: Session A preexposure, Session A post-exposure, and Session B post-exposure. Participants underwent baseline testing for audiometry (0.25 to 20 kHz), distortion product otoacoustic emission testing (1 to 10 kHz), and Words-in-Noise testing. Participants then wore a commercially available VR headset (Meta Quest 2) and experienced a freely available online VR music concert (via the video-sharing website "YouTube"). The VR music concert duration was 90 min set to maximum volume, which yielded an average sound level equivalent of 78.7 dBA, max sound level of 88.2 dBA, and LC peak sound level of 98.6 dBA. Post-exposure testing was conducted immediately at the conclusion of the VR concert, and again within 24 hr to 1 week after the exposure. Participants also answered a questionnaire that estimated noise exposure history (National Acoustics Laboratory "Noise Calculator"). Post-exposure deficit was not observed in DPOAEs or Words-in-Noise score (p's > 0.05). However, statistically significant temporary post-exposure deficit was observed in audiometry at 4, 8, and 12.5 kHz (p's < 0.05) (mean differences: 2 to 3 dB HL). Twenty-four hours and 1-week post-exposure measurements revealed no permanent changes from baseline measurements (p's > 0.05) aside from one spurious difference at 12.5 kHz. Males tended to exhibit a significantly higher noise history score on average than females. The primary, secondary, and tertiary sources of noise hazard history in this young-adult cohort included amplified music. These preliminary data suggest that VR music concerts-which are likely to produce a substantially lower noise dose than in-person music concerts-may still be capable of producing at least slight, temporary threshold shifts on the order of 2 to 3 dB HL. Future research should include VR headsets in personal music player risk assessment, as the VR music concert platform is increasing rapidly in popularity among young-adults.

Efficacy and safety of reoperation for residual or recurrent hemifacial spasm after microvascular decompression: a systematic review and meta-analysis.

The efficacy and safety of revision microscopic microvascular decompression (microscopic MVD) for treating residual or recurrent hemifacial spasm (HFS) remain uncertain. We conducted a systematic review and meta-analysis to evaluate the benefits and risks associated with this reoperation, focusing primarily on spasm relief, facial palsy, and hearing impairment. This study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. We performed a comprehensive search of PubMed, Embase, Web of Science, and the Cochrane Library for eligible articles from their inception through June 2024. A total of 17 studies involving 719 patients were included in this meta-analysis. Among these patients, 668 experienced overall symptom relief following reoperation, resulting in a relief rate of 94% (95% CI: 92-96%). Complete relief was achieved in 603 patients, corresponding to a rate of 87% (95% CI: 80-93%). Transient facial palsy developed in 4% (95% CI: 1-8%) of patients, while persistent facial palsy was observed in 5% (95% CI: 2-8%) of patients following reoperation. Transient hearing impairment occurred in 1% (95% CI: 0-3%) of patients, while persistent hearing impairment was reported in 4% (95% CI: 1-7%) of patients. Patients with recurrent HFS have significantly lower overall and complete relief rates after reoperation compared to those with residual HFS and are at higher risk of long-term hearing loss. Our study suggests that reoperation for residual or recurrent HFS after microscopic MVD could be considered a safe and effective treatment option. Early reoperation may be indicated in specific cases, and the timing should be tailored to each patient's specific circumstances to optimize outcomes.

Comparison of the risk of noise-induced hearing loss between male police officers and male non-police officers: a nationwide cohort study using propensity score matching in South Korea

BackgroundPolice officers are at a high risk of noise-induced hearing loss (NIHL) owing to the nature of their work. Therefore, this study aimed to compare the risk of NIHL in police officers and controls.MethodsThis study used the National Health Insurance claims data of workers aged 25–65 years obtained from 2005 to 2015. The case group comprised police officers, while the control group comprised general workers and public officers. The study followed a three-phase cohort design. The standardized incidence ratio (SIR) was calculated using an indirect standardization method based on age. Propensity score matching was performed using the greedy matching method, with a police officer-to-control group ratio of 1:3. Cox regression analysis was performed for each matched control group. Statistical significance was determined by a lower limit of greater than 1, based on the 95% confidence interval (CI).ResultsThe SIR values for police officers were 1.62 (95% CI: 1.44–1.82) compared with general workers and 1.78 (95% CI: 1.66–1.73) compared with public officers. Police officers exhibited an increased risk of NIHL compared with general workers (hazard ratio (HR): 1.71, 95% CI: 1.49–1.98) and public officers (HR: 2.19, 95% CI: 1.88–2.56).ConclusionsIt is necessary to prevent NIHL by reducing occupational noise exposure through measures such as wearing earplugs, improving shooting training methods, and improving the shift work system.

Associations of Blood Lipids with the Risk and Prognosis of Sudden Sensorineural Hearing Loss: A Meta-analysis.

Patients with sudden sensorineural hearing loss (SSNHL) may lose their hearing. The relationship between SSNHL and total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) levels is still unclear. The association of TC, TG, HDL-C, and LDL-C levels with the risk and prognosis of SSNHL was explored in this study. After searching for literature in different databases, 13 researches were used to summarize the risk and prognosis of SSNHL associations with TC, TG, HDL-C, and LDL-C using meta-analysis. Total cholesterol had a significant association with the risk of SSNHL (95% CI, 1.34-2.91). Adjustment for confounding factors and grouping criteria of TG were all significant sources of heterogeneity. One of the significant sources of heterogeneity in the LDL-C subgroup analyses was an adjustment for confounders. Sensitivity analysis revealed a robust association between TC and the risk of SSNHL. There was a significant publication bias in the association between TC and SSNHL prognosis High TC level is a risk factor for SSNHL.

Antiviral Treatment and Risk of Hearing Loss in Asymptomatic and Mild Symptomatic Infants With Congenital Cytomegalovirus.

To assess hearing outcomes at 24 months of age in infants with mild congenital cytomegalovirus (cCMV) infection, depending on whether they have received antiviral treatment or not. A retrospective study within the European Registry of Children with cCMV was performed. Included children had cCMV diagnosed in utero/in the first 21 days of life, with normal physical examination, alanine aminotransferase <80 U/L and platelets >100,000 cs/mm3 and absence of hearing loss (HL) at birth. Cranial ultrasound (cUS) and/or cranial magnetic resonance imaging was normal or with minor findings (isolated lenticulostriate vasculopathy and/or germinolysis/caudothalamic or subependymal cysts, and/or focal/multifocal white matter involvement). The main outcome was the presence of HL at 24 months of age. One hundred ninety-six patients met inclusion criteria. A total of 34.7% received antiviral treatment with valganciclovir/ganciclovir. Children treated had lower gestational age, birth weight and head circumference, and maternal primary infection was less frequent. Among treated children, 21.3% presented minor findings in cUS versus 6.3% in nontreatment group (P = 0.003). Nine patients (4.6%) developed HL at 24 months. Among children with HL, 20% presented minor findings in cUS versus 11.3% in non-HL group (P = NS). HL rate was similar in treated and nontreated groups (4.6% vs. 6.3%; P = 0.6). One-third of the children were treated with antivirals and infants with minor neuroimaging findings at birth were more likely to receive antiviral. There were no differences in the prevalence of HL at 2 years of age between treated and not-treated children. Minor neuroimaging findings were not clearly associated with an increased risk of delayed onset HL.

Comparing Kurtosis-adjusted weighted levels with other metrics to assess the risk of hearing loss from non-Gaussian noise exposures

Several studies have shown that impulsive noise can cause more damage to hearing than steady-state noise of equal energy. As a result, a large body of research has been devoted to evaluating the hazards of impulsive noise. However, work environments often have varying noise patterns, including Gaussian background noise combined with high-level transient noises contributing to the worker's daily dose. Thus, an energy-based noise metric underestimates the risk of hearing loss unless incorporating a temporal structure correction term. Kurtosis has been reported as an effective adjunct to energy for predicting hearing hazards from non-Gaussian noise exposures. In this work, recordings of real impulsive noise were conducted using a portable measuring system at a very high sampling frequency and using high-pressure microphones. Controlled synthetic non-Gaussian noise was generated using these impulsive signals and steady-state background noise. After exploring the detailed temporal structure of the noise, the daily exposure time has been determined using different metrics, including kurtosis-adjusted weighted levels, weighted peak levels, and auditory risk units. The examples presented here aim to demonstrate how kurtosis can help develop more accurate methods to prevent noise-induced hearing loss.

Combined effects of benzene, toluene, xylene, ethylbenzene, and styrene exposure on hearing loss mediated by oxidative stress at realistic low levels

The link between benzene, toluene, ethylbenzene, xylene, and styrene (BTEXS) exposure and hearing loss (HL) is not well-established. This study investigated 1694 petrochemical workers in southern China to examine the effects of BTEXS urinary metabolites on auditory function, considering oxidative stress (OS) as a potential cause. Using generalized linear models, elastic net regression, and quantile g-computation, we evaluated the single and combined effects of BTEXS, OS indicators, and HL. Subgroup analysis explored interactions between BTEXS and cumulative noise exposure (CNE), while mediation analysis assessed OS's role in BTEXS-related HL. Positive associations were found between hippuric acid (HA) and HL (OR = 1.20, P < 0.05) and high-frequency hearing loss (HFHL) (OR = 1.22, P < 0.05). The ENET model linked 3&4-methylhippuric acid (3&4-MHA) with increased HFHL risk. The qgcomp model showed a 23% increased HL risk and a 20% increased HFHL risk per quartile increase in BTEXS exposure. Toluene metabolites (SBMA and HA) were significant contributors to HL, HFHL, and speech-frequency hearing loss (SFHL). Higher BTEXS SBMA, MA and HA levels exacerbated HL risk in workers exposed to CNE. Interaction analysis revealed synergistic effects between tt-MA and other metabolites on HFHL risk. Total SOD (TSOD) significantly mediated the BTEXS-HL relationship. These findings highlight a dose-effect association between BTEXS exposure and HL due to oxidative damage, with toluene metabolites being critical pollutants. BTEXS exposure also synergistically increased HL risk with noise.

Genedrive kit for detecting single nucleotide polymorphism m.1555A>G in neonates and their mothers: a systematic review and cost-effectiveness analysis.

Neonates with suspected sepsis are commonly treated with gentamicin, an aminoglycoside. These antibiotics are associated with high risk of ototoxicity, including profound bilateral deafness, in people with the m.1555A>G mitochondrial genetic variant. This early value assessment summarised and critically assessed the clinical effectiveness and cost-effectiveness of the Genedrive MT-RNR1 ID Kit for identifying the gene m.1555A>G variant in neonates and mothers of neonates needing antibiotics or anticipated to need antibiotics. Following feedback from the scoping workshop and specialist assessment subgroup meeting, we also considered the Genedrive MT-RNR1 ID Kit for identifying the m.1555A>G variant in mothers prior to giving birth. For clinical effectiveness, we searched three major databases in October 2022: MEDLINE, EMBASE and CINAHL (Cumulative Index to Nursing and Allied Health Literature). For cost-effectiveness, in addition to the three mentioned databases we searched Cochrane and RePEc-IDEAS. Study selection and risk-of-bias assessment were conducted by two independent reviewers (Ryan PW Kenny and Akvile Stoniute for clinical effectiveness and Hosein Shabaninejad and Tomos Robinson for cost-effectiveness). Any differences were resolved through discussion, or by a third reviewer (Nick Meader). Risk of bias was assessed using Quality Assessment of Diagnostic Accuracy Studies-2. One study (n = 751 neonates recruited) was included in the clinical effectiveness review and no studies were included in the cost-effectiveness review. All except one outcome (test failure rate: low risk of bias) were rated as being at moderate risk of bias. The study reported accuracy of the test (sensitivity 100%, 95% confidence interval 29.2% to 100%; specificity 99.2%, 95% confidence interval 98% to 99.7%), number of neonates successfully tested (n = 424/526 admissions), test failure rate (17.1%, although this was reduced to 5.7%), impact on antibiotic use (all those with a m.1555A>G genotype avoided aminoglycosides), time taken to obtain a sample (6 minutes), time to genotyping (26 minutes), time to antibiotic treatment (55.18 minutes) and the number of neonates with m.1555A>G (n = 3). The economic component of this work identified key evidence gaps for which further data are required before a robust economic evaluation can be conducted. These include the sensitivity of the Genedrive MT-RNR1 ID Kit for identifying the gene m.1555A>G variant in neonates, the magnitude of risk for aminoglycoside-induced hearing loss in neonates with m.1555A>G, and the prevalence of the m.1555A>G variant. Other potentially important gaps include how data regarding maternal inheritance may potentially be used in the clinical pathway. This early value assessment suggests that the Genedrive MT-RNR1 ID Kit has the potential to identify the m.1555A>G variant and to be cost-effective. The Genedrive MT-RNR1 ID Kit dominates the current standard of care over the lifetime, as it is less costly and more effective. For a 50-year time horizon, the Genedrive MT-RNR1 ID Kit was also the dominant strategy. For a 10-year time horizon, the incremental cost-effectiveness ratio was estimated to be £103 per quality-adjusted life-year gained. Nevertheless, as anticipated, there is insufficient evidence to conduct a full diagnostic assessment of the clinical effectiveness and cost-effectiveness of the Genedrive MT-RNR1 ID Kit in neonates directly or in their mothers. This report includes a list of research priorities to reduce the uncertainty around this early value assessment and to provide the additional data needed to inform a full diagnostic assessment, including cost-effectiveness modelling. This study is registered as PROSPERO (CRD42022364770). This award was funded by the National Institute for Health and Care Research (NIHR) Evidence Synthesis programme (NIHR award ref: NIHR135636) and is published in full in Health Technology Assessment; Vol. 28, No. 75. See the NIHR Funding and Awards website for further award information.

Identifying paediatric patients at risk of severe hearing impairment after treatment for malignancies of the H&N/CNS with proton therapy

Background and purposeA risk calculation model was presented in 2021 by Keilty et al. for determining the likelihood of severe hearing impairment (HI) for paediatric patients treated with photon radiation therapy. This study aimed to validate their risk-prediction model for our cohort of paediatric patients treated with proton therapy (PT) for malignancies of the head and neck (H&N) or central nervous system (CNS). Materials and methodsThis was a single-institution study which extracted data on all patients aged ≤ 18 years treated with PT between Feb 2010 – Feb 2022 for malignancies of the H&N/CNS. The factors required for input into the Keilty model were extracted: age at PT, time since end of PT, mean cochlea dose, and platinum chemotherapy doses. Validation was performed using the statistical software R v 4.3.1, which analysed event discrimination and model calibration. Results587 patients met the criteria. Validation of the model demonstrated excellent discriminative ability, with an “optimal” cut-off value of 16% at a specificity and sensitivity of 82%. However, model calibration was less satisfactory, indicating an overestimation of risk of severe hearing loss (HI) by the model as compared to clinically observed events in our cohort, possibly linked to differences in event scoring between the model developers and this study, and short follow-up time in this study. ConclusionThe published (photon-based) model of Keilty et al. was validated in a PT context, demonstrating a high discriminative ability to determine patients at high risk versus low risk for severe HI. However the overall observed risk was lower than model predictions.

Evaluation of angiotensin converting enzyme insertion/deletion, alpha adducin (ADD1) G460W, and IL-10 gene polymorphisms, and determination of prognostic effects in idiopathic sudden sensorineural hearing loss

ObjectiveThe aim of this study was to examine angiotensin converting enzyme (ACE) insertion/deletion, alpha adducin, and interleukin-10 (IL-10) gene polymorphisms (GPs) in terms of both idiopathic sudden sensorineural hearing loss (ISSNHL) risk and their potential prognostic effects. MethodsThe study group consisted of 70 patients and the control group consisted of 50 patients. Venous blood samples were analyzed for relevant GPs via kompetitive allele-specific polymerase chain reaction. Age, sex, affected side, tinnitus, and vertiginous symptom status, number of days between symptom onset and hospital admission, pure tone audiometry results at admission and after treatment were included in the study. Data were compared statistically. ResultsThe D allele of ACE insertion/deletion GP was significantly more frequent in patients with ISSNHL than in the control group (p = 0.032). II genotype was associated with a reduced risk of ISSNHL (p = 0.036). The amount of hearing loss was significantly higher in patients with the TT genotype (p = 0.027) and T allele of the IL-10 GP (p = 0.035) than in the patients without this allele. Severe hearing loss was a poor prognostic factor (p = 0.008). ConclusionsThe D allele of ACE insertion/deletion GP may be involved in the ISSNHL etiology. Due to the association of this allele with occlusive vascular pathologies, ischemia is believed to be a common pathway in the etiopathogenesis of ISSNHL.

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.

The effect of active rheumatoid arthritis on hearing impairment.

To assess hearing loss in rheumatoid arthritis (RA) patients, and to explore its association with disease attributes and activity. The cross-sectional case-control study was conducted from June to December 2022 at Al-Imamein Al- Kadhimein Hospital, Medical City, Baghdad, Iraq, and comprised rheumatoid arthritis patients and healthy controls of either gender aged 18-45 years. Data was collected using electronic instruments and a physical examination, including pure tone audiometry and tympanogram. Data was analysed using SPSS 24. Of the 90 subjects, 60(66.7%) were patients; 45(75%) female and 15(25%) males with mean age 32.9 1±7.21 years and mean body mass index 27.14±8.58kg/m2. There were 30(33.3%) controls; 18(60%) female and 12(40%) males with mean age 30.25±5.51 years and mean body mass index 26.92±6.66kg/m2. The control group had thresholds below 25dB for all frequencies in both ears, which were notably lower than those of the RA patients (p=0.005). The left ear showed significant variation at 2000Hz and 4000Hz, while the right ear showed substantial differences at all frequencies except 1000Hz. The risk of hearing loss was found to be increased in rheumatoid arthritis patients, and it seemed to be related to illness duration.