Hearing Subjects Research Articles

Extensive cranial langerhans cell histiocytosis revealed by acute mastoiditis

Langerhans cell histiocytosis is a group of diseases characterized by an inflammatory neoplasia of myeloid precursor cells driven by mutations in the mitogen-activated protein kinase pathway leading to the proliferation and accumulation of Langerhans cells [1,2]. Clinical manifestations range from isolated disease to multifocal lesions and systemic involvement with a worse prognosis [2,3]. The otologic features are rare and may include otorrhea, otalgia, subjective hearing loss and vertigo misleading the diagnosis to an inflammatory process [3]. The CT scan shows destruction of the skull with characteristic “punched out” lytic lesions that can be multiple and multifocal. Tissue biopsy confirms the diagnosis [3].

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.

DEGREE OF HEARING LOSS IN INACTIVE MUCOSAL CHRONIC OTITIS MEDIA AND ITS CORRELATION WITH SITE AND SIZE OF TYMPANIC MEMBRANE PERFORATION- AN OBSERVATIONAL STUDY

Background: Studies have persistently associated the site and size of the tympanic membrane (TM) with the magnitude of hearing loss;however,the results are mixed and inconclusive on the effect of the site of the perforation on the hearing loss. Therefore, we conducted the present study to investigate the relationship between the size and site of TM perforation and hearing loss in inactive mucosal chronic otitis media. Methods: We conducted a hospital-based observational, prospective study in the Postgraduate Department of Otorhinolaryngology, Head and Neck Surgery, Government Medical College Srinagar, and recruited 94 patients diagnosed to have inactive mucosal chronic otitis media with dry tympanic membrane perforation. In addition to the site and size of TM perforation, the magnitude of hearing loss was also estimated. Results: We recruited 94 subjects presenting acute otitis media with TP perforation. The mean age (±SD) of cases was 36.3(±4) and males showed a marginal over-representation over females (male to female ratio: 1.2:1). We observed a positive correlation of the size of TM perforation with the average hearing loss. Moreover, subjects having perforations in the posterior ear reported higher average hearing loss. Conclusion: We report a positive correlation of the size of TM perforation with the average hearing loss and subjects having perforations in the posterior ear reported higher average hearing loss. However, more replicative studies with a larger sample size are warranted to substantiate our findings.

Cognitive, physical, and mental profiles of older adults with misplaced self-evaluation of hearing loss

Background: Although inconsistency between objective and subjective hearing loss among older adults has been suggested, a systematic examination of the cognitive and physical functioning among such older adults is lacking. Our objective was to assess the cognitive, physical, and mental profiles associated with the discrepancy. Methods: The auditory acuity of 696 community-dwelling older adults was evaluated using a pure-tone average of hearing thresholds at 1.0 and 4.0 kHz in the better-hearing ear. Participants were then stratified as follows: normal hearing ≤ 25 dB, mild loss >25 dB and ≤40 dB, and moderate loss >40 dB and ≤70 dB. Global cognition, gait speed, and depressive symptoms were also assessed. Results: Among older adults, 63.5% of those with mild hearing loss and 22.2% of those with moderate hearing loss did not recognize hearing difficulties. Significantly lower cognition and gait performance were observed in those with moderate hearing loss without subjective hearing loss (i.e., overestimation of hearing acuity) than in those with subjective hearing loss. Furthermore, older adults with subjective hearing loss showed a higher tendency toward depression than those without subjective hearing loss, irrespective of objective hearing loss. Conclusions: Our results suggest that failure to recognize a high level of age-related hearing loss may be related to impaired cognition and gait performance among older adults. Subjective hearing loss may indicate a tendency toward depression.

Hearing Aid Usage and Reported Hearing Difficulty in Americans With Subclinical Hearing Loss.

Subclinical hearing loss (SCHL) (previously defined by our group as a four-frequency pure tone average [PTA4] >0 to ≤25 dB) has recently been associated with depressive symptoms and cognitive decline. This suggests that the common 25 dB adult cutpoint in the United States for normal hearing may not be sensitive enough. We aim to characterize real-world hearing difficulties, as measured by hearing aid use and self-reported hearing difficulty, among individuals with SCHL. Analysis of biennial cross-sectional epidemiologic survey (National Health and Nutrition Examination Survey, 1999-2012, 2015-2016). Community, multicentered, national. Noninstitutionalized US citizens ≥12 years old, n = 19,246. PTA4 (500, 1,000, 2,000, 4,000 Hz), high-frequency pure tone average (PTAhf) (6,000, 8,000 Hz), reported hearing aid use, subjective difficulty hearing. There were 806,705 Americans with SCHL who wore hearing aids (or 0.35% of the 227,324,096 Americans with SCHL; 95% confidence interval = 0.23%-0.54%). Among those with SCHL, 14.6% (33.1 million Americans) perceived a little trouble hearing and 2.29% (5.21 million Americans) perceived moderate/a lot of trouble hearing. When restricted to the borderline subcategory (>20 to ≤25 dB), 42.43% (6.64 million Americans) had at least a little trouble hearing. Among those with SCHL who wore hearing aids, 81% had a PTAhf >25 dB. Despite hearing loss traditionally being defined by PTA4 ≤ 25 dB in the United States, nearly 1 million adults and adolescents with SCHL wore hearing aids, and nearly half with borderline HL had subjective difficulty hearing. To better reflect real-world difficulties, stricter definitions of hearing loss should be explored, including a lower cutpoint for the PTA4 or by using the more sensitive PTAhf.

Behavioural and Electrophysiological Evaluation of Loudness Growth in Clinically Normal Hearing Tinnitus Patients with and without Hyperacusis

Introduction: The common mechanism of tinnitus, hyperacusis, and loudness perception is hypothesized to be related to central gain. Although central gain increases with attempts to compensate hearing loss, reduced input can also be observed in those with clinically normal hearing. This study aimed to evaluate the loudness growth function of tinnitus patients with and without hyperacusis using behavioural and electrophysiological methods. Methods: The study consists of three groups with a total of 60 clinically normal hearing subjects, including the control group (10 men and 10 women; mean age 39.8, SD 11.8 years), tinnitus group (10 men and 10 women; mean age 40.9, SD 12.2 years), and hyperacusis group (also have tinnitus) (7 men and 13 women; mean age 38.7, SD 14.6 years). Loudness discomfort levels (LDLs), categorical loudness scaling (CLS), and cortical auditory evoked potentials were used for the evaluation of loudness growth. N1-P2 component amplitudes and latencies were measured. Results: LDL results of 500, 1,000, 2,000, 4,000, and 8,000 Hz showed a significant difference between the hyperacusis group and the other two groups (p < 0.001). In the loudness scale test performed with 500 Hz and 2,000 Hz narrow-band noise (NBN) stimulus, a significant difference was observed between the hyperacusis group and the other two groups in the “medium,” “loud,” and “very loud” categories (p < 0.001). In the cortical examination performed with 500 Hz and 2,000 Hz NBN stimulus at 40, 60, and 80 dB nHL intensities, no significant difference was observed between the groups in the N1, P2 latency, and N1-P2 peak-to-peak amplitude. Conclusion: Although the hyperacusis group is significantly different between groups in behavioural tests, the same cannot be said for electrophysiological tests. In our attempt to differentiate tinnitus and hyperacusis with electrophysiological tests over the loudness growth function, N1 and P2 responses were not seen as suitable methods. However, it appears to be beneficial to use CLS in addition to LDLs in behavioural tests.

Listening effort in patients with sensorineural hearing loss with and without hearing aids

BackgroundPersons with hearing loss may have difficulty in speech understanding, so they need to shift more resources from other on-going cognitive tasks. This increase in cognitive resources has been referred to as an increase in “listening effort: (LE). Two research questions were addressed: (Q1) Does hearing loss increase LE? (Q2) Can hearing aid (HA) amplification improve LE?MethodsThis study included 55 subjects that were divided into two groups: control group (I), which consisted of 15 adults with normal peripheral hearing, and study group (II), which consisted of 40 patients with bilateral SNHL. They were subdivided into two subgroups: study subgroup (IIa), which consisted of 20 patients did not use (HAs). The study subgroup (IIb) consisted of 20 patients using unilateral or bilateral HAs. LE was measured by subjective (Speech, Spatial and Qualities of Hearing Scale (SSQ), Fatigue Assessment Scale (FAS)) and behavioral measures (dual-task paradigm test (simultaneous primary auditory task (QuickSIN test) and secondary visual task (reaction time and Stroop test)).ResultsHearing loss patients showed higher fatigue scores and lower scores in SSQ than the normal hearing subjects. They also showed significantly longer reaction times (RTs) in dual conditions. No significant difference was found between patient with SNHL with and without HAs in all tests.ConclusionPatients with SNHL with and without HAs showed more LE than the normal hearing subjects (Q1). Hearing aid fitting does not reduce LE (Q2). HA users showed less listening effort in favorable listening situation (higher signal-to-noise ratio) than those who did not use HAs. Increased LE is a consequence of hearing loss which could not be measured by standard audiometric measures, so it should be considered when measuring disability in those with hearing loss.

Associations between Demographics, Tinnitus Specific-, Audiological-, General- and Mental Health Factors, and the Impact of Tinnitus on Daily Life.

Our objective was to study associations between demographics, tinnitus specific-, audiological-, general- and mental health characteristics, and impact of tinnitus in the general population. In this cross-sectional survey study in the Dutch population, data were prospectively gathered. Tinnitus impact was assessed with the Tinnitus Functional Index (TFI). We included participants who experienced tinnitus and for whom a total TFI score could be calculated (n = 212). We performed univariable and multivariable regression analyses. Due to logarithmical transformation, the B-scores were back-transformed to show the actual difference in points on the TFI. People who considered hyperacusis a small problem had a 12.5-point higher TFI score, those who considered it a mediocre problem had a 17.6-point higher TFI score and those who considered it a large problem had a 24.1-point higher TFI score compared to people who did not consider hyperacusis a problem. People who indicated having minor hearing problems had a 10.5-point higher TFI score, those with mediocre hearing problems had a 20.4-point higher TFI score and those with severe hearing problems had a 41.6-point higher TFI score compared to people who did not have subjective hearing problems. In conclusion, audiological risk factors, such as hearing problems and hyperacusis, have the largest association with the impact of tinnitus on daily life, compared to other assessed variables. The results of this study can be used in future research to find targeted interventions to diminish the impact of tinnitus.

Kernel SVM Classifiers based on Fractal Analysis for Estimation of Hearing Loss

Hearing screening consists of analyzing the hearing capacity of an individual, regardless of age. It identifies serious hearing problems, degree, type and cause of the hearing loss and the needs of the person to propose a solution. Auditory evoked potentials (AEPs) which are detected on the EEG auditory cortex area are very small signals in response to a sound stimulus (or electric) from the inner ear to the primary auditory areas of the brain. AEPs are noninvasive methods used to detect hearing disorders and to estimate hearing thresholds level. In this paper, due to the nonlinear characteristics of EEG, Detrented Fluctuation Analysis (DFA) is used to characterize the irregularity or complexity of EEG signals by calculating the Fractal Dimension (FD) from the recorded AEP signals of the impaired hearing and the normal subjects. This is to estimate their hearing threshold. In order to classify both groups, hearing impaired and normal persons, support vector machine (SVM) is used. For comparably evaluating the performance of SVM classifier, three kernel functions: linear, radial basis function (RBF) and polynomial are employed to distinguish normal and the abnormal hearing subjects. Grid search technique is selected to estimate the optimal kernel parameters. Our results indicate that the RBF kernel SVM classifier is promising; it is able to obtain a high training as well as testing classification accuracy.

Benefit of sequential bilateral cochlear implantation in children between 5 to 18 years old: A prospective cohort study.

To determine the benefit of sequential cochlear implantation after a long inter-implantation interval in children with bilateral deafness receiving their second implant between 5 and 18 years of age. Prospective cohort-study. Tertiary multicenter. 85 children with bilateral deafness and unilateral implantation receiving a contralateral cochlear implant at the age of 5 to 18 years. The primary outcomes were speech recognition in quiet and noise (CVC) scores. The secondary outcomes were language outcomes and subjective hearing abilities, all measured before and 12 months after sequential bilateral cochlear implantation. Medians of the paired data were compared using the Wilcoxon signed-rank test. Univariable linear regression analyses was used to analyze associations between variables and performance outcomes. A significant benefit was found for speech recognition in quiet (96% [89-98] vs 91% [85-96]; p < 0.01) and noise (65% [57-75] vs 54% [47-71]; p = 0.01) in the bilateral CI condition compared to unilateral (n = 75, excluded 10 non-users). No benefit was seen for language outcomes. The subjective sound quality score was statistically significant higher in bilateral compared to the unilateral CI condition. Pre-operative residual hearing level in the ear of the second implant, the inter-implant interval and age at time of second implantation was not significantly associated with performance scores. After 12 months of use, sequential bilateral cochlear implantation showed improved speech perception in quiet and noise and improved subjective sound quality outcomes in children despite a great inter-implantation interval (median of 8 years [range 1-16 years]).

Writing composition ability and spelling competence in deaf subjects: a psycholinguistic analysis of source of difficulties

We studied the compositional written skills and spelling competence of individuals with a severe hearing impairment, examining qualitative and quantitative characteristics of their texts, the psycholinguistic variables modulating their productions, and writing errors following a fine-grained analysis. Sixteen deaf young adults, educated in bilingual settings, were examined and compared to a group of control hearing subjects matched for gender, age, and education. Writing skills were examined through both written composition and written picture-naming tasks. Concerning compositional skills, deaf participants produced shorter and less informative texts, with fewer adjectives and subordinates, and were qualitatively worse with respect to texts produced by hearing controls. Words produced by deaf participants were those acquired earlier and facilitated by a higher lexical neighbourhood. Errors were mainly semantic, morphological, and syntactic errors, reflecting general linguistic weakness. Spelling errors were few, with phonologically nonplausible misspellings relative to controls, and with phonologically plausible ones being quite rare. In the picture-naming task, deaf people had a greater number of all types of errors with respect to their text, including semantic and morphological errors. Their spelling performance featured mainly phonologically nonplausible misspellings, while phonologically plausible ones were relatively few and comparable to controls. Overall, the writing of deaf adults reveal limitations in grammar and lexical-sematic linguistic competence. This was associated with spelling deficits characterized mainly by the poorer use of phonological sublexical spelling procedures. However, in an ecologic context, their spelling deficits appear not so important as has been claimed in the literature.

Association of Dry Eye Diseases and Auditory Sensitivity.

This study aimed to evaluate the association between dry eye and inner ear diseases in a Korean population. Methods: Data from the Korean National Health and Nutrition Survey (KNHANES V, 2010–2012), a national cross-sectional health examination and survey, were collected by the Korea Centers for Disease Control and Prevention. The association between dry eye and inner ear disease was determined using the chi-square test and logistic regression analysis. The individuals were divided into two age groups (<60 and ≥60 years). Results: In total, 17,542 individuals (n = 11,932 in the <60 years group and n = 5610 in the ≥60 years group) were enrolled. After adjusting for confounding factors, the logistic regression model revealed that the associated factors were dizziness and loss of balance experience (OR, 1.315; 95% CI, 1.143–1.513), self-awareness of abnormal voice (OR, 1.372; 95% CI, 1.120–1.679), subjective hearing discomfort (OR, 1.278; CI, 1.084–1.506), and tinnitus (OR, 1.265; 95% CI, 1.101–1.453). The inversely associated factor for dry eye was bilateral hearing loss (OR, 0.497; 95% CI, 0.367–0.672). The hearing threshold was lower in the dry eye group than in the non-dry eye group (p < 0.05). Conclusions: Tinnitus was associated with dry eye and bilateral hearing loss was inversely associated with dry eye. These results suggest that hypersensitivity of the senses and nerves, which is neuropathic hyperesthesia, is one of the main mechanisms of dry eye. Treatment of neuropathy may help in treating dry eye associated with dizziness or tinnitus.

The influence of tinnitus and hearing loss on the functional status of military Service members and Veterans

Objective This study evaluated the influence of tinnitus and hearing loss on the functional status of military Service members and Veterans. Design Participants completed audiologic testing and self-report instruments to assess tinnitus, hearing, and general functioning. We conducted multiple linear regression analyses using cross-sectional data with functional status as the dependent variable. The primary independent variables were tinnitus and average low-, high-, and extended high-frequency hearing thresholds. Secondary independent variables were subjective tinnitus severity and hearing difficulties. Each of the independent variables was modelled separately for Service members and Veterans; covariates for each multivariable model were identified a priori and, depending on the association being modelled, included age, gender, blast-wave exposure, and history of military traumatic brain injury. Study Sample Data were analysed from 283 Service members and 390 Veterans. Results After controlling for potential confounders, presence of tinnitus, tinnitus severity, average low-frequency hearing thresholds, and subjective hearing difficulties were significantly associated with functional status in Service members and Veterans. Conclusions These results suggest that tinnitus and poorer low-frequency hearing, and the perceived severity of tinnitus and hearing difficulties, may be associated with poorer functional status among Service members and Veterans.

Olfactory, Auditory, and Vestibular Performance: Multisensory Impairment Is Significantly Associated With Incident Cognitive Impairment

BackgroundDysfunction in the olfactory, auditory, and vestibular systems are commonly seen in aging and are associated with dementia. The impact of sensory loss(es) on cognition is not well understood. Our aim was to assess the relationships between performance on objective multisensory testing and quantify the impact of dysfunction on cognition.MethodsPatients presenting with subjective hearing loss presenting to a tertiary care otologic/audiologic clinic were identified and underwent multisensory testing using the Affordable, Rapid Olfactory Measurement Array (AROMA), pure tone audiometric evaluations, and the Timed “Up and Go” test. Cognitive impairment (CI) was assessed via the Montreal Cognitive Assessment (MoCA) was also administered.Key Results180 patients were enrolled. Thirty one percentage (n = 57) screened positive for cognitive impairment. When evaluating single sensory impairments, we found that olfactory dysfunction, gait impairment, and sensorineural hearing loss were all statistically significantly (p < 0.05) associated with a higher risk of cognitive impairment (ORs 3.89, 3.49, and 2.78, respectively) for CI. Multisensory impairment was significantly associated with cognitive impairment. Subjects with dysfunction in all domains were at the highest risk for cognitive impairment (OR 15.7, p < 0.001) vs. those with impairment in 2 domains (OR 5.32, p < 0.001).ConclusionDysfunction of the olfactory, auditory, and vestibular systems is associated with a significantly increased risk of CI. The dramatically increased risk of CI with multisensory dysfunction in all three systems indicated that MSD may synergistically contribute to CI.

The Functional Hearing Gain with an Active Transcutaneous Bone Conduction Implant Does Not Correlate with the Subjective Hearing Performance.

The functional hearing outcome with hearing implants does not always properly reflect the subjective benefit in everyday listening situations. In this study, the functional hearing gain and the impact on the subjective hearing ability and quality of life were assessed in patients with a Bonebridge. A chart review was performed on 45 patients with a Bonebridge who were provided with questionnaires regarding the hearing quality and health-related quality of life during their last clinical visit. The questionnaires consisted of the Speech, Spatial and Qualities (SSQ) and the Health Utility Index Mark 3 (HUI3). Eleven patients had to be excluded due to missing data. A total of 34 patients (37 ears) were included in the study. Aided hearing thresholds were significantly lower compared with the unaided condition, with a mean functional gain of 26.87 dB for patients with mixed/conductive hearing loss (MHL/CHL). Although patients with single-sided deafness (SSD) scored slightly lower on the SSQ compared with patients with MHL/CHL, all included patients reported improved subjective hearing quality with the BB compared with the hearing situation before implantation. No correlation was found between the functional hearing gain and the subdomains of the SSQ. SSD patients scored the HUI3 subdomain “hearing” slightly lower compared with MHL/CHL patients. Although not significant, a relationship was found between the functional gain and the “hearing” subdomain. No correlation was found for the other subdomains of the HUI3. Audiological measurements showed significantly improved hearing thresholds with the Bonebridge. Most importantly, the subjective benefit achieved in everyday listening situations was superior compared with the previous hearing condition. The lack of correlation between subjective questionnaire results and the functional hearing gain shows the importance of assessing both audiological and subjective hearing quality parameters in clinical routine.

Altered Amplitude of Low-Frequency Fluctuations and Degree Centrality in Patients with Acute Subjective Tinnitus: A Resting-State Functional Magnetic Resonance Imaging Study.

The difference in spontaneous brain activity between acute subjective tinnitus patients (with or without hearing loss) and control participants was explored using the amplitude of low-frequency fluctuations and degree centrality methods through resting-state functional magnetic resonance imaging. The study aimed to provide an objective basis for clinical diagnosis and pathogenesis of patients with acute subjective tinnitus. Fourteen acute subjective tinnitus (AST) patients with hearing loss (AST-HL), 6 AST patients with no hearing loss (AST-NHL), and 14 healthy controls (HCs) with age, sex, and education status matched were recruited for this study. Resting-state functional magnetic resonance imaging (fMRI) examinations were performed in a resting state and the amplitude of low-frequency fluctuations (ALFF) and degree centrality (DC) values of each group were acquired. Statistical analysis was performed to assess the ALFF and DC values of different brain areas of the participants (AST-HL and AST-NHL were compared with HCs, but AST-HL and AST-NHL were not). Patients with acute subjective tinnitus and hearing loss showed a significantly increased amplitude of low-frequency fluctuation values in the left middle temporal gyrus and bilateral frontal gyrus/marginal lobe/cingulate gyrus but a decreased amplitude of low-frequency fluctuations values in the bilateral superior temporal gyrus/anterior cerebellar lobe in comparison with healthy controls. The amplitude of low-frequency fluctuation values of patients with acute subjective tinnitus and hearing loss in the right posterior lobe of the cerebellum, bilateral temporal gyrus, bilateral lenticular nucleus, bilateral frontal gyrus, right inferior occipital gyrus, were higher, but were significantly lower in the bilateral anterior lobe of cerebellum/superior temporal gyrus and left posterior cerebellar lobe as compared with those of healthy controls. Degree centrality values in the healthy controls group were increased in the right superior marginal gyrus and decreased in the right thalamus in patients with acute subjective tinnitus and hearing loss, while patients with acute subjective tinnitus with no hearing loss presented significantly higher degree centrality values in the left frontal lobe and lower degree centrality values in the left center rear return. Aberrant amplitude of low-frequency fluctuations and values exist in various brain regions, indicating abnormal spontaneous brain activity in both acute subjective tinnitus and hearing loss and acute subjective tinnitus no hearing loss patients. The pathogenesis of acute subjective tinnitus may be related to abnormalities in both the auditory cortex and nonauditory cortex. These findings provide more evidence to help clarify the neuronal symptoms of acute subjective tinnitus patients.

Correlation between Workers’ Characteristics and Workplace Noise with Subjective Hearing Disorders in Textile Industry

Introduction: The textile manufacturing industry has a noisy work environment as a result of the weaving machines which have a noise intensity exceeding the threshold value. Noise can cause complaints of hearing disorders. Other factors that influence hearing disorders are agework period, and the use of ear protection equipment. This study aims to analyze the relationship between age, work period, the use of ear protection equipment, and noise intensity on complaints of subjective hearing disorders in the AJL Weaving Department of Textile Industry. Method: This research was a descriptive observational study with a cross sectional approach. Data were obtained by measuring noise intensity and distributing questionnaires to workers. Respondents in this study amounted to 45 people who were the total population of weaving operators and maintenance workers in the AJL Weaving Department of Textile Industry. Results: The results of this study indicate that age and work period have a sufficient relationship with complaints of subjective hearing disorders, while the use of ear protection equipment has a weak relationship with complaints of subjective hearing disorders, and noise intensity has a strong relationship with complaints of subjective hearing disorders. Conclusion: Individual characteristics only have a weak to moderate relationship with subjective hearing complaints. Meanwhile, exposure to noise intensity has a strong relationship with subjective hearing complaints.

Comprehensive Clinical Characterisation of Brain Fog in Adults Reporting Long COVID Symptoms.

(1) Introduction: A subset of individuals experiencing long COVID symptoms are affected by ‘brain fog’, a lay term that often refers to general cognitive dysfunction but one that is still poorly characterised. In this study, a comprehensive clinical characterisation of self-reported brain fog was conducted vis-à-vis other long COVID symptoms and parameters of mental, cognitive, and physical health. (2) Methodology: Adult participants reporting long COVID symptoms were recruited from hospital clinics and as self-referrals. Participants completed a battery of questionnaires and clinical assessments, including COVID-19 history, symptomatology, self-reported scales (Chalder Fatigue Scale [CFQ], Center for Epidemiological Studies Depression Scale, and Impact of Events Scale–Revised), computer-based cognitive assessments (simple response time and choice reaction time tasks), physical performance tests (gait velocity and muscle strength assessments), and an orthostatic active stand test. A systematic comparison between participants with and without self-reported brain fog was conducted, and a backwards binary logistic regression model was computed to identify the strongest independent associations with brain fog. This was complemented by an automatic cluster analysis to rank the importance of associations. Finally, a structural equation model was postulated with a causal model of key symptomatic indicators and functional consequences of brain fog as a latent variable. (3) Results: Of 108 participants assessed, brain fog was a self-reported symptom in 71 (65.7%) participants. Those with brain fog were at a longer point in time since COVID-19 onset and reported longer duration of low activity during the acute illness. When assessed, those with brain fog had higher frequencies of subjective memory impairment, word-finding difficulties, dizziness, myalgia, arthralgia, hyperhidrosis, cough, voice weakness, throat pain, visual and hearing problems, dysosmia, paraesthesia, chest pain, skin rashes, and hair loss; mean scores in fatigue, depression, and post-traumatic stress scales were higher; performance in both computer-based cognitive tasks was poorer; and measured gait speed and grip strength were lower. The logistic regression suggested that the best independent associations with brain fog were memory impairment, CFQ, and myalgia. The cluster analysis suggested that the most important associations with brain fog were CFQ, dizziness, myalgia, reduced gait speed, word-finding difficulties, reduced grip strength, and memory impairment. The SEM was consistent with key indicators of brain fog being CFQ, dizziness, myalgia, word-finding difficulties, and memory impairment; and reduced grip strength, gait speed, and cognitive response times its functional consequences. (4) Conclusions: The findings indicate that self-reported brain fog in long COVID is a recognisable symptom cluster primarily characterised by fatigue, dizziness, myalgia, word-finding difficulties, and memory impairment and has adverse psychological and psychomotor correlates. In long COVID, brain fog should be regarded as a wide-ranging symptom and addressed holistically with medical, psychological, and rehabilitative supports as guided by individual needs.

Treatment of tegmen dehiscence using a middle fossa approach and autologous temporalis fascia graft: Outcomes from a single center

IntroductionAlthough bony defects of the tegmen surface are relatively common, the majority of dehiscences are asymptomatic. For those who experience symptoms, there is a wide spectrum of relatively benign manifestations such as hearing loss and otorrhea to potentially more serious but rare sequelae such as epilepsy and meningitis. Surgical management of tegmen dehiscences (TDs) can help prevent these symptoms. In this manuscript, we present one of the largest reported single team experiences of using a temporal craniotomy with middle cranial fossa approach and temporalis fascia graft in the treatment of tegmen defects. MethodsWe retrospectively reviewed every case of a TD surgically repaired by the same neurosurgeon/otolaryngologist team at Loyola University Medical Center from May 2015 to January 2022. In our chart review, we identified 44 patients with 48 cases of tegmen defect repair. We analyzed patient characteristics, operative details, and postoperative outcomes. Results44 patients met inclusion criteria for the presence of TD (mean age 55 years, 55% male, and average body mass index 35.6). 89% of these patients had no clear etiology for the dehiscence. Commonly reported symptoms were hearing loss (89%) and CSF otorrhea (82%). The least reported presenting signs and symptoms were seizures (5%) and meningitis (2%). Most defects were repaired with both temporalis fascial and calvarial bone grafts (63%), while a minority were treated with temporalis fascia only (33%), temporalis fascia with muscle (2%), or fascia lata (2%). Every patient in our sample experienced resolution of CSF otorrhea after tegmen repair and 81% of the sample reported subjective hearing improvements after surgery. 6% of our sample had post-operative infections and 8% of patients underwent repeat unilateral surgery for a surgical complication. ConclusionCraniotomy for middle fossa approach using autologous temporalis fascial grafts is a safe and effective method for the treatment of TD. These procedures should be performed by experienced and multidisciplinary teams.

Prediction of Speech Intelligibility by Means of EEG Responses to Sentences in Noise.

ObjectiveUnderstanding speech in noisy conditions is challenging even for people with mild hearing loss, and intelligibility for an individual person is usually evaluated by using several subjective test methods. In the last few years, a method has been developed to determine a temporal response function (TRF) between speech envelope and simultaneous electroencephalographic (EEG) measurements. By using this TRF it is possible to predict the EEG signal for any speech signal. Recent studies have suggested that the accuracy of this prediction varies with the level of noise added to the speech signal and can predict objectively the individual speech intelligibility. Here we assess the variations of the TRF itself when it is calculated for measurements with different signal-to-noise ratios and apply these variations to predict speech intelligibility.MethodsFor 18 normal hearing subjects the individual threshold of 50% speech intelligibility was determined by using a speech in noise test. Additionally, subjects listened passively to speech material of the speech in noise test at different signal-to-noise ratios close to individual threshold of 50% speech intelligibility while an EEG was recorded. Afterwards the shape of TRFs for each signal-to-noise ratio and subject were compared with the derived intelligibility.ResultsThe strongest effect of variations in stimulus signal-to-noise ratio on the TRF shape occurred close to 100 ms after the stimulus presentation, and was located in the left central scalp region. The investigated variations in TRF morphology showed a strong correlation with speech intelligibility, and we were able to predict the individual threshold of 50% speech intelligibility with a mean deviation of less then 1.5 dB.ConclusionThe intelligibility of speech in noise can be predicted by analyzing the shape of the TRF derived from different stimulus signal-to-noise ratios. Because TRFs are interpretable, in a manner similar to auditory evoked potentials, this method offers new options for clinical diagnostics.