Subjective Hearing Impairment Research Articles

Value of patient-reported outcome measures for evaluating the benefit of speech processor upgrading in patients with cochlear implants.

Patients with acochlear implant (CI) should be evaluated for anew speech processor every 6years. The aim of this analysis was to assess the subjective and audiological benefit of upgrades. Speech understanding and subjective benefit were analyzed in 99patients with the old and the new speech processor after 4weeks of wearing. Speech understanding was assessed using the Freiburg monosyllabic test in quiet (FBE) at 65 dB and 80 dB, and the Oldenburg Sentence Test (OLSA) at 65 dB noise with adaptive speech sound level. The Abbreviated Profile of Hearing Aid Benefit (APHAB) was used to assess subjective hearing impairment, and the Audio Processor Satisfaction Questionnaire (APSQ) was used to assess subjective satisfaction. The speech processor upgrade resulted in asignificant improvement of speech understanding in quiet at 65 dB (mean difference 8.9 ± 25.9percentage points, p < 0.001) and 80 dB (mean difference 8.1 ± 29.7percentage points, p < 0.001) and in noise (mean difference 3.2 ± 10.7 dBsignal-to-noise ratio [S/N], p = 0.006). Using the APHAB, asignificant improvement (mean difference 0.07 ± 0.16, p < 0.001) in hearing impairment was demonstrated in all listening situations. The APSQ showed significantly higher patient satisfaction with the new speech processor (mean difference 0.42 ± 1.26, p = 0.006).A comparative assessment of the benefit based on subjective and speech audiometric results identified aproportion of patients (35-42%) who subjectively benefited from the upgrade but had no measurable benefit based on speech audiometry. There was asignificant improvement in audiologically measurable and subjectively reflected speech understanding and patient satisfaction after the upgrade. In patients with only asmall improvement in audiologically measurable speech understanding, the subjective benefit should also be assessed with validated measurement instruments in order to justify an upgrade to the payers in the health sector.

Value of patient-reported outcome measures for evaluating the benefit of speech processor upgrading in patients with cochlear implants. German version

Patients with acochlear implant (CI) should be evaluated for anew speech processor every 6years. The aim of this analysis was to assess the subjective and audiological benefit of upgrades. Speech understanding and subjective benefit were analyzed in 99patients with the old and the new speech processor after 4weeks of wearing. Speech understanding was assessed using the Freiburg monosyllabic test in quiet (FBE) at 65 dB and 80 dB, and the Oldenburg Sentence Test (OLSA) at 65 dB noise with adaptive speech sound level. The Abbreviated Profile of Hearing Aid Benefit (APHAB) was used to assess subjective hearing impairment, and the Audio Processor Satisfaction Questionnaire (APSQ) was used to assess subjective satisfaction. The speech processor upgrade resulted in asignificant improvement of speech understanding in quiet at 65 dB (mean difference 8.9 ± 25.9percentage points, p < 0.001) and 80 dB (mean difference 8.1 ± 29.7percentage points, p < 0.001) and in noise (mean difference 3.2 ± 10.7 dBsignal-to-noise ratio [S/N], p = 0.006). Using the APHAB, asignificant improvement (mean difference 0.07 ± 0.16, p < 0.001) in hearing impairment was demonstrated in all listening situations. The APSQ showed significantly higher patient satisfaction with the new speech processor (mean difference 0.42 ± 1.26, p = 0.006).A comparative assessment of the benefit based on subjective and speech audiometric results identified aproportion of patients (35-42%) who subjectively benefited from the upgrade but had no measurable benefit based on speech audiometry. There was asignificant improvement in audiologically measurable and subjectively reflected speech understanding and patient satisfaction after the upgrade. In patients with only asmall improvement in audiologically measurable speech understanding, the subjective benefit should also be assessed with validated measurement instruments in order to justify an upgrade to the payers in the health sector.

O-DEM: a new cognitive screening in patients with hearing loss

Hearing loss is asignificant risk factor for dementia. To date, cognitive impairment and dementia in patients with hearing impairment (HI) cannot be adequately diagnosed by commonly administered cognitive screening tests due to sensory impairments. Therefore, an adapted screening is needed. The aim of the present study was to develop and evaluate acognitive screening for people with HI. The new cognitive screening, called O‑DEM, entails aword fluency test, the Trail Making TestA (TMT-A), and asubtraction task. First, the O‑DEM was tested in alarge clinical sample (N = 2837) of people without subjective HI. In asecond step, the O‑DEM was evaluated in 213patients with objectively assessed HI and compared with the Hearing-Impaired Montreal Cognitive Assessment (HI-MoCA). The results indicate that the O‑DEM subtests significantly discriminate between participants with no, mild, and moderate to severe cognitive impairment. Based on the mean and standard deviation of the participants without cognitive impairment, atransformation of the raw scores was performed and atotal score with amaximum value of 10 was determined. In the second part of the study, the O‑DEM was shown to be as sensitive as the HI-MoCA in differentiating between people with and without cognitive impairment. Compared to other screenings, the O‑DEM is aquickly administrable screening for the detection of mild and moderate cognitive impairment in people with HI.

Association between Subjective Hearing Impairment and Cognitive Status among Korean Elderly.

The goal of this study was to investigate the impact of subjectively assessed hearing impairment on cognitive function in elderly Koreans living in the community. In the 2020 Survey of Living Conditions and Welfare Needs of Korean Older Persons Survey, 9920 subjects (5949 females; 60%) aged 65 or more years were examined. Using the Korean version of the Mini-Mental Status Examination (MMSE-KC), cognitive function was evaluated. To investigate the relationship between hearing impairment and cognitive status, multiple logistic regression analysis was performed with adjustment for multiple confounding variables (socioeconomic, health behavior, psychological factors, and functional status). There were 2297 participants in the hearing impairment group (23.2%) and 7623 subjects in the no-hearing impairment group. Cognitive impairment was significantly higher in the hearing impairment group (37.2%) compared to the no-hearing impairment group (27.5%). After adjusting for confounders, hearing impairment was significantly associated with an increased risk of cognitive decline (odds ratio [OR] 1.21; 95% confidence interval [CI] 1.08-1.35) compared to no-hearing impairment group. Although a cross-cectional design of this study does not allow a causal reasoning, our findings show a significant association between the hearing loss of older adults and their cognitive impairment. Hearing impairment should be regarded as a risk factor for cognitive disorders.

Influence of linguistic properties and hearing impairment on visual speech perception skills in the German language.

Visual input is crucial for understanding speech under noisy conditions, but there are hardly any tools to assess the individual ability to lipread. With this study, we wanted to (1) investigate how linguistic characteristics of language on the one hand and hearing impairment on the other hand have an impact on lipreading abilities and (2) provide a tool to assess lipreading abilities for German speakers. 170 participants (22 prelingually deaf) completed the online assessment, which consisted of a subjective hearing impairment scale and silent videos in which different item categories (numbers, words, and sentences) were spoken. The task for our participants was to recognize the spoken stimuli just by visual inspection. We used different versions of one test and investigated the impact of item categories, word frequency in the spoken language, articulation, sentence frequency in the spoken language, sentence length, and differences between speakers on the recognition score. We found an effect of item categories, articulation, sentence frequency, and sentence length on the recognition score. With respect to hearing impairment we found that higher subjective hearing impairment is associated with higher test score. We did not find any evidence that prelingually deaf individuals show enhanced lipreading skills over people with postlingual acquired hearing impairment. However, we see an interaction with education only in the prelingual deaf, but not in the population with postlingual acquired hearing loss. This points to the fact that there are different factors contributing to enhanced lipreading abilities depending on the onset of hearing impairment (prelingual vs. postlingual). Overall, lipreading skills vary strongly in the general population independent of hearing impairment. Based on our findings we constructed a new and efficient lipreading assessment tool (SaLT) that can be used to test behavioral lipreading abilities in the German speaking population.

Sense of Purpose in Life and Markers of Hearing Function: Replicated Associations across Two Longitudinal Cohorts

Introduction: A sense of purpose in life is a psychological resource that is associated with healthier outcomes. The present research examines whether a greater sense of purpose in life is associated with subjective and objective markers of hearing health and whether hearing acuity contributes to the association between purpose and episodic memory. We sought to evaluate whether these associations were replicable across 2 independent samples. Methods: Participants in the Health and Retirement Study (N = 14,291) and the English Longitudinal Study of Ageing (N = 8,844) reported on their purpose in life and perceived hearing quality at baseline. Hearing acuity was measured using an audiometer 2–4 years later, and episodic memory was measured at baseline and 6–8 years later. Results: In both samples, higher purpose in life was associated with better hearing quality measured concurrently, lower risk of either subjective or objective hearing impairment, and hearing acuity accounted for some of the longitudinal relation between sense of purpose and better episodic memory. Discussion: Across samples, measures, and analytical approaches, the present research indicates replicable associations between sense of purpose in life and hearing health. It further indicates that hearing may be one factor that associates purpose with better episodic memory.

The relationship between subjective hearing impairment and mild behavioral impairment – A study of older adults without dementia in the COMPASS‐ND Study

AbstractBackgroundHearing loss and mild behavioral impairment (MBI) are both early warning signs of cognitive decline and dementia in older adults and have been recommended for use as non‐cognitive markers of dementia. To date, few studies have directly investigated the relationship between these two markers.MethodBaseline data from 219 non‐demented participants (10 cognitively normal; CN, 48 subjective cognitive decline; SCD, 161 mild cognitive impairment; MCI) in the COMPASS‐ND study (February 2020 release) were analyzed. Hearing impairment was measured in three ways: with a 10‐item self‐report measure using the Hearing Handicap Inventory for the Elderly – Screening Version (HHIE‐S), with a speech and noise test using the Canadian Digit Triplet Test (CDTT), and with screening audiometry using 2 discrete input levels at 2000 Hz to generate 6 hearing loss categories. Global and domain‐specific MBI burden was approximated using the Neuropsychiatric Inventory Questionnaire (NPI‐Q) with a published algorithm. Multivariable linear regressions were conducted to examine the association between the three hearing impairment measures and global MBI burden, adjusting for sex, age, education, hearing aid use, and Montreal Cognitive Assessment (MoCA) score or diagnosis. Multivariable logistic regressions were used to investigate whether the hearing variables could predict MBI domains.ResultHalf of all participants showed MBI symptoms (Figure 1). Greater self‐reported hearing impairment measured by the HHIE‐S was significantly associated with greater global MBI burden and the presence of apathy and affective dysregulation when controlling for global cognition or diagnosis (Table 1). These associations remained significant in analyses restricted to MCI alone. Performance on CDTT and screening audiometry, were not associated with global or domain‐specific MBI burden.ConclusionThe HHIE‐S, which was designed to capture the emotional and social aspects of hearing loss, was positively related to global MBI burden and more specifically to apathy and affect. Unlike audiometry and speech and noise measures, self‐reported measures of hearing impairment can be influenced by age, sex, other comorbidities, and social factors. Our findings underscore that value of self‐report measures of hearing impairment as distinct from audiometry and speech and noise measures in their association with behavioral impairment and as non‐cognitive markers of dementia.

Infrafloccular approach effectively prevents hearing complication in microvascular decompression surgery for hemifacial spasm

Objective The infrafloccular approach in microvascular decompression (MVD) surgery for hemifacial spasm (HFS) was investigated for the prevention of hearing complications. Methods Retrospective analysis of 136 patients who underwent MVD for HFS in 2019. The infrafloccular approach for MVD was adopted to resolve the symptom and protect hearing function. Postoperative hearing function was evaluated subjectively and objectively within 30 postoperative days, and later mainly subjectively. Postoperative condition of mastoid air cells based on the CT scan of the following day was also recorded. Results No final postoperative subjective hearing impairment was found in all patients. Mastoid air cells were opened in 105 patients, and subjective hearing impairment was recorded in 57 patients within 30 postoperative days, but all improved later. Increases in thresholds of greater than 10 dB in air conduction were observed in 28 patients, including 26 of transient conductive hearing loss (increases in the threshold of less than or equal to 10 dB). The other 2 patients with increases in the threshold of greater than 10 dB in both air and bone conduction had improvement confirmed by later audiometry. Conclusions Infrafloccular approach in MVD for HFS provides a good hearing outcome. Inclusion of postoperative hearing conditions in the later period is ideal for a precise hearing evaluation.

Self-determination and Physical Functioning as Mediators of the Association between Self-reported Sensory Impairments and Happiness among Older Adults

ABSTRACT Introduction The prevalence of vision and hearing impairments increases through age. This development is individually associated with physical functioning difficulties, self-determination issues, and lower levels of happiness. Method This study examined how self-reported sensory impairments relate to happiness with physical autonomy and social engagement as mediators using structural equation modelling. Using the nationally representative 2017 Survey of Older Persons in Thailand, the analytic sample size was 34,195 with an age range of 60-103 years and a mean age of 69.6 years. Results A negative association between subjective vision impairment and happiness was observed through the mediation of limitations in physical functioning and community activity. Subjective hearing impairment was observed to lack association with happiness taking into account all the mediating factors. Conclusion 4The care needs of older adults in Thailand where the ageing of the population progresses could then differ depending on their health and well-being status.

A Longitudinal Exploration of Self-Reported Hearing Loss, Tinnitus, and Posttraumatic Stress Disorder Treatment Outcomes in Australian Veterans.

Tinnitus, hearing loss, and posttraumatic stress disorder (PTSD) are common conditions among veterans. Shared underlying symptoms, such as hypervigilance and heightened sense of threat, may interfere with talk-based psychological treatments. The aim was to investigate the prevalence and risk factors for self-reported tinnitus and hearing loss among Australian treatment-seeking veterans, as well as links with PTSD symptoms and quality of life (QOL) after treatment. Australian veterans participating in hospital-based PTSD treatment (n = 523) completed self-report measures of subjective hearing impairment, service-related factors, PTSD symptoms, and QOL at treatment intake and discharge, as well as 3- and 9-month follow-ups. Univariate analyses of covariance modeled symptom change over time. More than half of veterans on PTSD treatment self-reported doctor-diagnosed hearing loss or tinnitus, whereas 43% reported both. However, 75% reported subjective mild to moderate hearing impairment, and only 1% reported severe impairment. Service-related factors, such as longer length of service and exposure to explosions, were risk factors for having any hearing condition. After controlling for intake scores, there were no significant differences on PTSD or QOL outcomes over time between those with and without hearing conditions. Although self-reported tinnitus and hearing loss are prevalent among veterans, those with severe hearing impairments are unlikely to be represented in this context. There is a need for psychological treatments that are accessible to patients with severe hearing impairments, which should be examined routinely among military members accessing psychological treatments.

Subjective vision and hearing impairment and falls among community-dwelling adults: a prospective study in the Survey of Health, Ageing and Retirement in Europe (SHARE).

To investigate the association between vision and hearing impairment and falls in community-dwelling adults aged ≥ 50 years. This is a prospective study on 50,986 participants assessed in Waves 6 and 7 of the Survey of Health, Ageing and Retirement in Europe. At baseline, we recorded socio-demographic data, clinical factors and self-reported vision and hearing impairment. We classified participants as having good vision and hearing, impaired vision, impaired hearing or impaired vision and hearing. We recorded falls in the six months prior to the baseline and 2-year follow-up interviews. The cross-sectional and longitudinal associations between vision and hearing impairment categories and falls were analysed by binary logistic regression models; odds ratios (OR) and 95% confidence intervals (CI) were calculated. All analyses were adjusted for socio-demographic and clinical factors. Mean age was 67.1 years (range 50-102). At baseline, participants with impaired vision, impaired hearing, and impaired vision and hearing had an increased falls risk (OR (95% CI)) of 1.34 (1.22-1.49), 1.34 (1.20-1.50) and 1.67 (1.50-1.87), respectively, compared to those with good vision and hearing (all p < 0.001). At follow-up, participants with impaired vision, without or with impaired hearing, had an increased falls risk of 1.19 (1.08-1.31) and 1.33 (1.20-1.49), respectively, compared to those with good vision and hearing (both p < 0.001); hearing impairment was longitudinally associated with falls in middle-aged women. Vision impairment was cross-sectionally and longitudinally associated with an increased falls risk. This risk was highest in adults with dual sensory impairment.

Subjective hearing ability, physical and mental comorbidities in individuals with bothersome tinnitus in a Swedish population sample.

This study investigates associations of subjective hearing ability, physical comorbidities, and mental comorbidities with bothersome (vs. non-bothersome) tinnitus and mediating effects between these influences. The Swedish LifeGene cohort was used to sample cross-sectional survey data (collected 2009-2016) of 7615 participants with tinnitus, 697 (9.2%) of whom rated their tinnitus as bothersome. Associations between bothersome tinnitus and subjective hearing ability, physical and mental comorbidities were investigated by separate age- and gender-adjusted multiple logistic regression models. Interrelationships between these associations were investigated by logistic mediation models. Compared to non-bothersome tinnitus, bothersome tinnitus was associated with higher age, reduced subjective hearing ability, hearing-related difficulties in social situations, cardiovascular disease, chronic shoulder pain, thyroid disease, Ménière's disease, depression, anxiety syndrome, and social anxiety. Subjective hearing impairment or hearing-related difficulties mediated 13-36% of the effects of mental comorbidities on bothersome tinnitus. Depression or anxiety syndrome mediated 5-8% of most relationships between physical comorbidities and bothersome tinnitus. Depression, anxiety syndrome, or social anxiety mediated 2-4% of the effects of subjective hearing impairment or hearing-related difficulties on bothersome tinnitus. Psychological factors, subjective hearing impairment, and hearing-related difficulties in social situations play key roles in predicting bothersome (vs. non-bothersome) tinnitus in a large population sample. Psychological factors contribute to explaining the impact of physical comorbidities and hearing-related effects on bothersome tinnitus. This highlights their transdiagnostic importance for aggravating varied physical symptom clusters. Interventions to improve or prevent high tinnitus burden should be interdisciplinary/multimodal and target auditory, physical, and psychological factors.

The inflammatory potential of the diet is prospectively associated with subjective hearing impairment

Abstract Background Age-related hearing loss is prevalent yet insufficiently addressed by public health research. Subjective hearing loss has been highlighted as a key determinant of reduced quality of life, while chronic low-grade inflammation is an established determinant of adverse age-related outcomes. To our knowledge, this study was the first to investigate the link between the inflammatory potential of the diet and hearing loss. Methods We prospectively studied 3,435 French adults enrolled in the SU.VI.MAX (1994-2002) and SU.VI.MAX 2 (2007-2009) cohorts. The inflammatory potential of the diet was estimated by the Dietary Inflammatory Index (DII) using established methodology and repeated, baseline 24-h dietary records. Subjective hearing impairment was assessed after a median of 12 years by 3 Yes/No items and by a composite score, dichotomized for analyses. We fit multivariable logistic regression models adjusted for pertinent covariates. Results Compared to men, women exhibited higher DII (more pro-inflammatory diet) and less hearing impairment (both p &amp;lt; 0.0001). Given significant interaction results, sex-specific models were fit. Among men, a significant positive association between DII (continuous scale) and inability to follow a conversation in a noisy place was found (OR = 1.10; 95% CI: 1.02, 1.18), while the inverse association was seen among women (OR = 0.92; 95% CI: 0.87, 0.98). Regarding the need to turn up the volume on the television/radio, a significant positive association with DII (continuous scale) was found only among men (OR = 1.09; 95% CI: 1.01, 1.18). The only significant association with the composite score of subjective hearing loss was found among women, when modeling DII as quartiles (OR Q3 vs Q1=0.74; 95% CI: 0.57, 0.97). Conclusions The findings among men support the hypothesis that a pro-inflammatory diet could increase risk of age-related hearing loss, whereas the findings among women were unexpected and merit further investigation. Key messages Given rapid population aging worldwide, there is an urgent need for public health research on modifiable risk factors of hearing impairment. The role of diet in hearing impairment is complex and likely sex-specific; a pro-inflammatory diet might be a risk factor for hearing impairment, especially among men.

Proton therapy for head and neck paragangliomas: A single institutional experience.

Although slow growing, head and neck paragangliomas (HNPG) can cause significant morbidity. We evaluated the efficacy of proton therapy in the management of HNPG. Retrospective review of an institutional proton therapy experience of treating patients between 1997 and 2016; 37 patients and 40 tumors were included. Proton therapy was delivered to a median of 50.4 Gy(RBE) (range: 45-68). Having a genetic/family predisposition for HNPG was associated with multifocal tumors (P = .02) and younger diagnosis age (P = .02). Twenty-six (70%) patients had symptom improvement posttreatment, and 65% of treated tumors showed ≥20% volumetric shrinkage. The 5-year recurrence-free and overall survival rates were both 97%. Grade 2 to grade 3 toxicities (54%) included subjective hearing impairment (19%), middle ear inflammation (14%), and dry mouth (8%). There were no grade 4-5 toxicities. Patients with HNPGs can be effectively and safely treated with proton therapy with excellent tumor control, successful volumetric tumor reduction, and symptomatic improvement.

The influence of the daily-life relevance of APHAB-questions on answering the APHAB-questions itself

The APHAB questionnaire measures the subjective hearing impairment in different daily-life situations. Recently, a survey investigated the daily life relevance of APHAB-questions. This study should evaluate the influence of the daily-life relevance of each APHAB question on the answers of the APHAB questions itself. Between July 2016 and November 2017, the amount of 517 hearing impaired out-clinic patients from 11 different ENT-offices in the state of Schleswig-Holstein, Germany, have been investigated by using the APHAB. Additionally, every APHAB question ought to be evaluated with respect to its daily life relevance using a four-step scale (often - sometimes - rarely - never) as well. The answers have been listed in a cross-table and statistically analyzed using the χ2-test and Cramérs V. The average age of all subjects was 67.4 years (± 14.0 years); the gender of 45.3 % of all participants was female and 54.7 % was male. Using the χ2-test and Cramérs V, 4 questions of the EC-, 3 of the BN-, and 2 of the RV-subscale had a middle-grade level of coherence. Regarding a weak level of coherence, the results were exactly the opposite. However, most of the inverted APHAB-questions demonstrated such a weak coherence using Cramérs V (p < 0.001). Indeed, a correlation between daily-life relevance and ranking of APHAB-questions could be demonstrated. This coherence is in a half of the APHAB-questions weak and in a half middle-grade. The reasons are unclear and need further investigation.

Everyday relevance of APHAB questions : Influence on answer frequency

The Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire measures subjective hearing impairment in different situations. Recently, asurvey demonstrated that some APHAB questions were answered more rarely than others. This study aims to evaluate the everyday relevance of each APHAB question and investigate whether this relevance for daily life influences answer frequency. Between July 2016 and November 2017, 517hearing impaired patients from 11ENT practices in Schleswig-Holstein, Germany, were evaluated using the APHAB. In parallel, the everyday relevance of each APHAB question for the subjects was assessed on afour-step scale (often/sometimes/rarely/never). The answers were listed in across table and statistically analyzed. The average age of all subjects was 67.4years (±14.0years); 45.3% were female and 54.7% were male. One APHAB question (no.21) was answered noticeably less often than the others. Overall, five types of distribution for the everyday relevance of APHAB questions could be determined. Using the χ2-test, no correlation between the frequency of answers and their everyday relevance could be detected (p < 0.001). No correlation between everyday relevance and answer frequency was detected. However, the five types of distribution could be used for an individual interpretation of single APHAB answers. In the future, apossible influence of everyday relevance on ranking within aspecific APHAB answer should be investigated.

Severity of Tinnitus Distress Negatively Impacts Quality of Life in Patients With Vestibular Schwannoma and Mimics Primary Tinnitus.

Objective: Quality of life (QoL) and subjective symptoms are predominantly used to evaluate treatment outcome of patients with vestibular schwannoma (VS). However, for patients undergoing conservative treatment—the most frequently used intervention—the association between QoL and subjective symptoms is unclear. Moreover, it is unknown whether VS-related tinnitus could be associated with the audiological and psychological status of the patient. Our overall aim is to provide objective evidence of this association to better guide treatment of VS.Methods: In a prospective study, we analyzed factors that influence VS-related tinnitus and QoL in 72 patients receiving conservative management of unilateral sporadic VS. This was done through questionnaires that assessed QoL, anxiety, depression, and audiological examinations. We used the SF-36 Short Form to assess QoL; the Tinnitus Handicap Inventory, Dizziness Handicap Inventory, Facial Clinimetric Evaluation Scale, Visual Analog Scale for hearing impairment to assess symptoms subjectively; and pure tone audiometry, the speech discrimination for hearing measurements. For psychological status, we used the Hospital Anxiety and Depression Scale. For analyses, we used Pearson correlation analysis and multiple regression between variables and QoL.Results: Correlation and regression analyses revealed that the severity of tinnitus distress had the largest negative impact on QoL in all domains of SF-36. The severity of tinnitus was significantly associated with subjective hearing impairment and the degree of depression and anxiety. Hearing thresholds had no statistical association with severity of tinnitus.Conclusions: To our knowledge, this is the first study to investigate VS-related tinnitus with respect to both patients' hearing status and psychological condition. Our results suggest that tinnitus distress strongly affects VS patients' QoL and that its characteristics are similar to primary tinnitus. An intervention for VS-related tinnitus, therefore, should assess to what extent tinnitus bothers patients, and it should reduce any unpleasant emotions that may exacerbate symptoms. This approach should improve their QoL.

APHAB scores for individual assessment of the benefit of hearing aid fitting

The Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire measures subjective hearing impairment on four different subscales pertaining to different listening situations. Using a very large patient cohort, this study aims to show how answers are distributed within the four subscales before and after hearing aid fitting, and what benefit the patients experience. The results are discussed on the basis of the available literature. Between April 2013 and March 2016, 35,000APHAB questionnaires from nine German statutory health insurance providers were evaluated. The average values before and after hearing aid fitting, as well as the benefit, were determined for all four APHAB subscales and analyzed graphically. The results of the subjective evaluation of hearing impairment before and after hearing aid fitting and the resultant benefit were plotted by percentile distribution graphs and boxplots. The data were analyzed statistically. There was no overlap of the interquartile ranges before and after hearing aid fitting in any of the APHAB subscales. In three scales (EC, BN and RV), the median improvement after hearing aid fitting was nearly 30percentage points. In the AV subscale, this value was slightly negative. The percentile distribution graphs used in this study allow individual evaluation of subjective hearing impairment before and after hearing aid fitting, as well as of the resultant benefit, on the background of ahuge database. Additionally, it is demonstrated why presentation as boxplots and the average benefit values calculated from these is problematic.

The Category Subdivision Scale of Subjective Hearing Impairment a Screening Instrument for Reduced Hearing Capacity

Demographic development will lead to an aging working population. Therefore, dealing with age-related impairments like hearing impairment has become a central issue. Thus, there is need in a valid screening instrument for hearing impairment. So, a new simple method, the Category Subdivision Scale of Subjective Hearing Impairment (CSS-SHI), was tested. Data are collected within five different studies (236 employees): One pilot study and four studies to validate and replicate the results of the pilot study. In each study the participants first assessed their self-reported hearing impairment using the CSS-SHI and afterwards hearing capacity was measured by audiometry. The results show that self-reported hearing impairment measured with CSS-SHI correlates substantially with pure-tone audiometry. The CSS-SHI is a very fast and easy to use screening instrument that allows a valid statement about hearing impairment, also when the situation, sample size and/or environment do not allow the use of a pure-tone audiometry.

Subjective hearing impairment after subarachnoid haemorrhage: Prevalence and risk factors

BackgroundSensorineural hearing impairment is a key symptom in patients with superficial siderosis of the central nervous system, a disease caused by chronic or intermittent haemorrhage into the subarachnoid space. We investigated the prevalence and risk factors of subjective hearing impairment after SAH. MethodsWe systematically interviewed all SAH patients admitted between June 2011 and December 2014, who were able to visit the SAH outpatient clinic six to eight weeks after hospital discharge. We calculated the proportion of patients with subjective hearing impairment noticed after SAH onset, and adjusted risk ratios (aRR) with 95% confidence intervals (CI) for potential risk factors with Poisson regression. ResultsWe included 277 patients. Subjective hearing impairment was reported by 54/277 (19%) patients (aneurysmal SAH: 42/212 [20%;95%CI:15–26%]; perimesencephalic haemorrhage 8/36 [22%;95%CI:12–38%], non-aneurysmal non-perimesencephalic SAH: 4/29 [14%;95%CI:6–31%]). Hearing impairment was associated with a poor clinical condition on admission (defined as PAASH score 4–5) (aRR3.00;95%CI:1.43–6.28), aneurysm rupture at the middle cerebral artery (aRR2.72;95%CI:1.38–5.39), and moderate/severe disability 3months after ictus (aRR2.25;95%CI:1.28–3.97), but not with large amounts of extravasated blood (highest vs. lowest tertile of Hijdra score) (aRR0.77;95%CI:0.33–1.81) or endovascular treatment (aRR1.19;95%CI:0.61–2.33). ConclusionSubjective hearing impairment occurs in 1 of every 5 SAH patients. It is related to the clinical condition on admission, aneurysm rupture at the middle cerebral artery, and functional outcome, but not to the amount of subarachnoid blood or the method of aneurysm occlusion. Audiometric tests, auditory cognitive assessments, and follow-up studies are needed to determine the cause and prognosis of hearing impairment after SAH.