Tests Of Auditory Function Research Articles

Hearing, balance, and imaging assessment in adolescent Menière's disease: A retrospective analysis.

To retrospectively analyze clinical features in adolescent Menière's disease (MD). The medical records of adolescents with MD (11-17 years old) from May 2014 to March 2023 in Shandong Provincial ENT Hospital were retrospectively analyzed, including clinical features, a battery of auditory and vestibular function tests, sensory organization test, and imaging assessments. Patients with recurrent vertigo of childhood (RVC) were as controls. Compared with RVC, adolescent MD showed higher pure tone average threshold (p < .001), lower speech discrimination score (p = .014), and lower otoacoustic emission pass rates (p = .005). Adolescents with MD exhibited significant reduction in equilibrium score (Conditions 1, 5, and 6; p1 = .035; p5 = .033; p6 = .003), composite sensory score (p = .014), and vestibular sensory score (p = .029). Adolescents with bilateral MD exhibited worse performance in equilibrium score and strategy score compared to adolescents with unilateral MD. For the affected ear, the more severe endolymphatic hydrops detected by gadolinium-enhanced magnetic resonance imaging, the higher the auditory brainstem response threshold (r = .850, p = .007), and the lower the otoacoustic emission pass rate (r = -.976, p < .001). Adolescent MD has similar vestibular information inputs with that of RVC, but the ability for the nerve center to use these clues to maintain balance is worse in adolescents with MD. There were potential differences in vestibular weights in adolescents with unilateral and bilateral MD, also potential effects on vision and proprioception. Level 4.

Comparative Study of Endoscopic Transcanal Tympanoplasty and Tympanoplasty by Conventional Postaural Approach in a Tertiary Care Hospital in Central India.

Background Chronic otitis media (COM) often necessitates tympanoplasty to repair the tympanic membrane. While conventional postaural tympanoplasty (PA) is well-established, endoscopic transcanal tympanoplasty (ET) is gaining traction for its minimally invasive benefits. This study aims to compare these two surgical techniques regarding their anatomical and functional outcomes and assess the role of platelet-rich plasma (PRP) in improving these outcomes. Material and methods This prospective comparative study was conducted at Acharya Vinoba Bhave Rural Hospital, involving 60 patients with COM. Participants were randomly assigned to receive either ET or PA, with each group further subdivided based on PRP use. Preoperative evaluations included auditory function tests and diagnostic endoscopy. Postoperative assessments were performed at seven days, one month, and three months to evaluate graft acceptance and hearing improvement using pure tone audiometry (PTA). Statistical analyses included the chi-square test, t-test, ANOVA, and paired t-test. Results The study included patients with a mean age of 38.1 years, predominantly female (71.67%). ET demonstrated superior anatomical outcomes compared to PA, with higher graft acceptance rates and better hearing improvements. The average hearing gain was 10.4 dB in the ET group versus 8.1 dB in the PA group. PRP uses enhanced graft acceptance and hearing restoration across both surgical approaches, contributing to better overall outcomes. Conclusion ET offers significant advantages over conventional postaural tympanoplasty in terms of anatomical and functional results. PRP further improves surgical outcomes, making ET a preferable option for tympanoplasty in COM patients. These findings support the broader adoption of ET and PRP to enhance patient outcomes in tympanoplasty procedures.

Clinical, Biomarker, and Research Tests Among US Government Personnel and Their Family Members Involved in Anomalous Health Incidents

Since 2015, US government and related personnel have reported dizziness, pain, visual problems, and cognitive dysfunction after experiencing intrusive sounds and head pressure. The US government has labeled these anomalous health incidents (AHIs). To assess whether participants with AHIs differ significantly from US government control participants with respect to clinical, research, and biomarker assessments. Exploratory study conducted between June 2018 and July 2022 at the National Institutes of Health Clinical Center, involving 86 US government staff and family members with AHIs from Cuba, Austria, China, and other locations as well as 30 US government control participants. AHIs. Participants were assessed with extensive clinical, auditory, vestibular, balance, visual, neuropsychological, and blood biomarkers (glial fibrillary acidic protein and neurofilament light) testing. The patients were analyzed based on the risk characteristics of the AHI identifying concerning cases as well as geographic location. Eighty-six participants with AHIs (42 women and 44 men; mean [SD] age, 42.1 [9.1] years) and 30 vocationally matched government control participants (11 women and 19 men; mean [SD] age, 43.8 [10.1] years) were included in the analyses. Participants with AHIs were evaluated a median of 76 days (IQR, 30-537) from the most recent incident. In general, there were no significant differences between participants with AHIs and control participants in most tests of auditory, vestibular, cognitive, or visual function as well as levels of the blood biomarkers. Participants with AHIs had significantly increased fatigue, depression, posttraumatic stress, imbalance, and neurobehavioral symptoms compared with the control participants. There were no differences in these findings based on the risk characteristics of the incident or geographic location of the AHIs. Twenty-four patients (28%) with AHI presented with functional neurological disorders. In this exploratory study, there were no significant differences between individuals reporting AHIs and matched control participants with respect to most clinical, research, and biomarker measures, except for objective and self-reported measures of imbalance and symptoms of fatigue, posttraumatic stress, and depression. This study did not replicate the findings of previous studies, although differences in the populations included and the timing of assessments limit direct comparisons.

Amyloid and tau deposition is associated with performance on tests of auditory processing in the brain

AbstractBackgroundAlzheimer’s disease pathophysiology may affect sound processing (central auditory function) in the brain. This study aims to investigate the link between tests of central auditory function, such as dichotic digits, and brain pathology in older adults at high risk for developing dementia.Method28 individuals (13 cognitively unimpaired (CU) and 15 mild cognitively impaired (MCI)) were enrolled (Table 1). Amyloid deposition was assessed with [18F] AZD4694 PET and tau accumulation was assessed with [18F]MK6240 PET. Standard uptake value ratios (SUVR) were determined using the cerebellar and the inferior cerebellar cortex as reference region for amyloid and tau PET, respectively. Hearing assessments were conducted using a custom audiological testing system from Creare LLC. Voxel‐based regression models evaluated the association between dichotic digit scores and amyloid and tau deposition as assessed by PET, adjusting for Pure Tone Average (PTA) and a control condition for speech in noise (Triple digits score). Random field theory (RFT) was used to correct for multiple comparisons.ResultIn the voxel‐wise analysis, negative associations between dichotic digits scores and amyloid‐PET were found in the temporal, occipital and parietal areas. Negative associations between dichotic digits scores and tau‐PET were present in the temporal area, with higher t‐values in the primary and secondary somatosensory cortices (Figure 1, panel A). Negative correlations were found between dichotic digits scores and both amyloid (p&lt;0.001) and tau (p&lt;0.05) SUVRs (Figure 1, panel B). In addition, dichotic digits scores were significantly lower in MCI individuals (p&lt;0.001) (Figure 1, panel C).ConclusionThis study is the first to assess associations between central auditory hearing in CU and MCI individuals using PET biomarkers. These findings highlight the link between central auditory deficits and AD hallmarks in auditory processing‐related brain regions. This suggests a potential decreased capacity for interhemispheric transfer in mildly cognitively impaired individuals.

Amyloid and tau deposition is associated with performance on tests of auditory processing in the brain

AbstractBackgroundAlzheimer’s disease pathophysiology may affect sound processing (central auditory function) in the brain. This study aims to investigate the link between tests of central auditory function, such as dichotic digits, and brain pathology in older adults at high risk for developing dementia.Method28 individuals (13 cognitively unimpaired (CU) and 15 mild cognitively impaired (MCI)) were enrolled (Table 1). Amyloid deposition was assessed with [18F] AZD4694 PET and tau accumulation was assessed with [18F]MK6240 PET. Standard uptake value ratios (SUVR) were determined using the cerebellar and the inferior cerebellar cortex as reference region for amyloid and tau PET, respectively. Hearing assessments were conducted using a custom audiological testing system from Creare LLC. Voxel‐based regression models evaluated the association between dichotic digit scores and amyloid and tau deposition as assessed by PET, adjusting for Pure Tone Average (PTA) and a control condition for speech in noise (Triple digits score). Random field theory (RFT) was used to correct for multiple comparisons.ResultIn the voxel‐wise analysis, negative associations between dichotic digits scores and amyloid‐PET were found in the temporal, occipital and parietal areas. Negative associations between dichotic digits scores and tau‐PET were present in the temporal area, with higher t‐values in the primary and secondary somatosensory cortices (Figure 1, panel A). Negative correlations were found between dichotic digits scores and both amyloid (p&lt;0.001) and tau (p&lt;0.05) SUVRs (Figure 1, panel B). In addition, dichotic digits scores were significantly lower in MCI individuals (p&lt;0.001) (Figure 1, panel C).ConclusionThis study is the first to assess associations between central auditory hearing in CU and MCI individuals using PET biomarkers. These findings highlight the link between central auditory deficits and AD hallmarks in auditory processing‐related brain regions. This suggests a potential decreased capacity for interhemispheric transfer in mildly cognitively impaired individuals.

Sound in context: Comprehension of auditory scenes by listeners with normal and impaired hearing

Sounds of everyday environments are rarely heard in isolation. Usually, they occur in the context of complex auditory scenes, where they are preceded and followed by other sounds or overlap with other sounds in time. In contrast, behavioral tests of auditory function are typically focused on isolated and often artificially constructed sounds which do not represent real world objects and events or the context in which they occur. Thus, results of such tests may have limited generalizability to important aspects of everyday listening. This presentation will review alternative approaches that focus on comprehension of auditory scenes and require integration of semantic information across multiple sounds. For listeners with hearing loss, our results suggest that comprehension of auditory scenes constitutes an important aspect of auditory assessment which, combined with findings from more traditional auditory tests, can provide a basis for auditory rehabilitation.

Neuroinflammatory disorders of the brain and inner ear: a systematic review of auditory function in patients with migraine, multiple sclerosis, and neurodegeneration to support the idea of an innovative 'window of discovery'.

Hearing can be impaired in many neurological conditions and can even represent a forme fruste of specific disorders. Auditory function can be measured by either subjective or objective tests. Objective tests are more useful in identifying which auditory pathway (superior or inferior) is most affected by disease. The inner ear's perilymphatic fluid communicates with the cerebrospinal fluid (CSF) via the cochlear aqueduct representing a window from which pathological changes in the contents of the CSF due to brain inflammation could, therefore, spread to and cause inflammation in the inner ear, damaging inner hair cells and leading to hearing impairment identifiable on tests of auditory function. A systematic review of the literature was performed, searching for papers with case-control studies that analyzed the hearing and migraine function in patients with neuro-inflammatory, neurodegenerative disorders. With data extracted from these papers, the risk of patients with neurological distortion product otoacoustic emission (DPOAE) was then calculated. Patients with neurological disorders (headache, Parkinson's disease, and multiple sclerosis) had a higher risk of having peripheral auditory deficits when compared to healthy individuals. Existing data lend credence to the hypothesis that inflammatory mediators transmitted via fluid exchange across this communication window, thereby represents a key pathobiological mechanism capable of culminating in hearing disturbances associated with neuroimmunological and neuroinflammatory disorders of the nervous system.

Triple Semicircular Canal Plugging versus Labyrinthectomy for Meniere Disease: A Retrospective Study.

The study goals were to compare the long-term efficacy of semicircular canal plugging (SCP) with labyrinthectomy in the treatment of advanced Meniere's disease (MD). A retrospective study. Single tertiary medical center. A total of 116 MD patients (TSCP group of 90; labyrinthectomy group of 26) with complete medical documents in Shandong Provincial ENT Hospital, from March 2017 to March 2019 were retrospectively analyzed, including a battery of auditory and vestibular function tests, recovery time from imbalance and function level scores (FLS). The total control rate of vertigo in the TSCP group was 96.7% (87/90). The rate of hearing loss was 23.3% (21/90). The control rate of vertigo in the labyrinthectomy group was 100% (26/26). All patients lost their auditory function after labyrinthectomy with a 100% hearing loss rate. There was no significant difference in the vertigo control rate between the two groups (P > 0.05). The hearing loss rate in the TSCP group was significantly lower than that in the labyrinthectomy group (P < 0.00). The median time recovered from imbalance was 15 days in TSCP group and 21 days in labyrinthectomy group, which is significantly different (P < 0.05). There was no significant difference in the FLS between the two groups (P > 0.05). Compared to labyrinthectomy, TSCP can preserve hearing at a high probability; meanwhile, otolith organ function preservation benefits patients from faster vestibular compensation. 3 Laryngoscope, 133:3178-3184, 2023.

Comparison of Cytotoxic and Ototoxic Effects of Lipoplatin and Cisplatin in Neuroblastoma In Vivo Tumor Model.

Background:This study aimed to compare the cytotoxic, cytostatic, and ototoxic effects of lipoplatin compared to cisplatin application in the subcutaneous xenograft nude mouse neuroblastoma tumor model.Methods:In this study, C1300 neuroblastoma cells were administered subcutaneously to 21 male nude mice. When the tumor reached 150 mm3 diameter, mice were randomized into 3 groups. Saline, cisplatin, and lipoplatin were given intraperitoneally. The auditory function tests were performed before administration and 72 hours after administration. Mice were sacrificed and the tumor and cochlea were removed after 72 hours. Histopathologic evaluation of necrosis and apoptosis was determined by the TdT-mediated dUTP-biotin nick end labeling (TUNEL) method. Cyclooxygenase 2, superoxide dismutase 2, and inducible nitric oxide synthase levels were determined by immunohistochemistry in tissue samples.Results:Apoptosis and necrosis rates were higher in lipoplatin group than in cisplatin group (P = .035 and P = .010, respectively) in tumor tissue. In the spiral ganglion, apoptosis and necrosis were lower in the lipoplatin group than in cisplatin group (P = .002 and P = .002, respectively). Cyclooxygenase 2 pattern in the cochlea was positive in both control and lipoplatin group and negative in cisplatin group (P = .001). Superoxide dismutase 2 and inducible nitric oxide synthase 2 protein expressions showed no difference between groups. The auditory functions were similar to baseline values and had a better threshold value in lipoplatin group than cisplatin group.Conclusion:For the treatment of neuroblastoma, the use of lipoplatin seems to be beneficial in reducing side effects of cisplatin. We recommend that the mechanism of these properties of lipoplatin should be evaluated in further studies.

Effects of long-term azithromycin therapy on auditory functions in children with chronic respiratory diseases

Background and objectivesIn recent years, long-term azithromycin (AZT) use has been increased in pediatric patients with chronic respiratory tract problems. In this study, we aimed to assess auditory functions in children on long-term AZT therapy. MethodThe study included 43 patients who received long-term AZT treatment and 27 age-matched, healthy controls. In the study and control groups, ear-nose-throat examination, pure tone audiometry, speech recognition threshold (SRT), speech discrimination score (SDS), uncomfortable loudness level (UCL), acoustic reflex tests, and otoacoustic emission tests were performed. The test results were statistically compared between groups. ResultsMean age was 11.3 ± 0.56 years in the study group and 9.3 ± 3.07 years in the control group. The medain hearing examination was 8 months after end of AZT treatment (Ranged: 1–12 months). No significant difference was found in normal- and high-frequency audiogram tests at any frequency between study and control groups. Also, no significant difference was found in distortion product otoacoustic emissions (DPOAE) and transient evoked otoacoustic emissions (TEOAE) tests between groups. Also, there was no significant difference in acoustic reflex, SRT, SDS, and UCL test results between study and control groups. ConclusionThis is the first study assessing auditory functions comprehensively in pediatric patients who received long-term AZT therapy. In this study, it was shown that long-term AZT use had no deleterious effect on auditory function tests.

Deletion of Clusterin Protects Cochlear Hair Cells against Hair Cell Aging and Ototoxicity.

Hearing loss is a debilitating disease that affects 10% of adults worldwide. Most sensorineural hearing loss is caused by the loss of mechanosensitive hair cells in the cochlea, often due to aging, noise, and ototoxic drugs. The identification of genes that can be targeted to slow aging and reduce the vulnerability of hair cells to insults is critical for the prevention of sensorineural hearing loss. Our previous cell-specific transcriptome analysis of adult cochlear hair cells and supporting cells showed that Clu, encoding a secreted chaperone that is involved in several basic biological events, such as cell death, tumor progression, and neurodegenerative disorders, is expressed in hair cells and supporting cells. We generated Clu-null mice (C57BL/6) to investigate its role in the organ of Corti, the sensory epithelium responsible for hearing in the mammalian cochlea. We showed that the deletion of Clu did not affect the development of hair cells and supporting cells; hair cells and supporting cells appeared normal at 1 month of age. Auditory function tests showed that Clu-null mice had hearing thresholds comparable to those of wild-type littermates before 3 months of age. Interestingly, Clu-null mice displayed less hair cell and hearing loss compared to their wildtype littermates after 3 months. Furthermore, the deletion of Clu is protected against aminoglycoside-induced hair cell loss in both in vivo and in vitro models. Our findings suggested that the inhibition of Clu expression could represent a potential therapeutic strategy for the alleviation of age-related and ototoxic drug-induced hearing loss.

Differential mode of cholesterol inclusion with 2-hydroxypropyl-cyclodextrins increases safety margin in treatment of Niemann-Pick disease type C.

Niemann-Pick disease type C (NPC) is a lysosomal storage disorder with disrupted intracellular cholesterol trafficking. A cyclic heptasaccharide, 2-hydroxypropyl-β-cyclodextrin (HP-β-CD), is a cholesterol solubilizer that is being developed to treat NPC, but its ototoxicity and pulmonary toxicity remain important issues. We have characterized 2-hydroxypropyl-γ-cyclodextrin (HP-γ-CD), a cyclic octasaccharide with a larger cavity than HP-β-CD, as a candidate drug to treat NPC. However, the molecular target of HP-γ-CD with respect to NPC and its potential for clinical application are still unclear. We investigated the mode of interaction between HP-γ-CD and cholesterol by phase-solubility analysis, proton NMR spectroscopy and molecular dynamics simulations. We then evaluated the therapeutic effects of HP-γ-CD compared with HP-β-CD using cellular and murine NPC models. Mouse auditory and pulmonary function tests were also conducted. HP-γ-CD solely formed a 1:1 inclusion complex with cholesterol with an affinity similar to that of HP-β-CD. In vitro, HP-γ-CD and HP-β-CD amelioration of NPC-related manifestations was almost equivalent at lower concentrations. However, at higher concentrations, the cholesterol inclusion mode of HP-β-CD shifted to the highly soluble 2:1 complex whereas that of HP-γ-CD maintained solely the 1:1 complex. The constant lower cholesterol solubilizing ability of HP-γ-CD conferred it with significantly reduced toxicity compared with HP-β-CD, but equal efficacy in treating a mouse model of NPC. HP-γ-CD can serve as a fine-tuned cholesterol solubilizer for the treatment of NPC with a wider safety margin than HP-β-CD in terms of ototoxicity and pulmonary toxicity.

Auditory testing outcomes with hearing aids in patients with auditory neuropathy spectrum disorder

ObjectiveThe objective of this study is to evaluate the audiologic outcomes with hearing aids in pediatric patients with auditory neuropathy spectrum disorder (ANSD) using the Infant Toddler-Meaningful Auditory Integration Scale (IT-MAIS), and the Ling 6 Sound Test (Ling 6). Study designCase series. SettingSingle tertiary care academic medical center.Subjects and Methods.All pediatric patients with a confirmed diagnosis of ANSD on Auditory Brainstem Response (ABR) testing who presented to a single tertiary medical center between September 2008 and September 2018 were included. Only patients that underwent Infant Toddler-Meaningful Auditory Integration Scale (IT-MAIS) and/or Ling 6 Sound Test (Ling 6) were included in the study. Audiologic testing performed after cochlear implantation was excluded. Results60 pediatric patients with ANSD were analyzed. There were 10 patients included in the study with documented hearing aid use who underwent IT-MAIS and/or Ling 6 testing. Average IT-MAIS score improved by 20.4% after initial or extended trial of amplification. Similarly, average Ling 6 score improved from 3.6 to 4.8 after initial or extended trial of amplification. The four patients who did not receive amplification had higher average IT-MAIS and Ling 6 scores. ConclusionIn most children with ANSD, IT-MAIS and Ling 6 Sound Test scores improved with initial hearing aid use and over time with extended hearing aid use. Long-term prospective, multi-institutional studies are needed to determine the impact of the natural history of ANSD, comorbidities, and socioeconomic variables on auditory function testing results in children with ANSD using hearing aids.

Automatic Recognition of Auditory Brainstem Response Characteristic Waveform Based on Bidirectional Long Short-Term Memory.

Background: Auditory brainstem response (ABR) testing is an invasive electrophysiological auditory function test. Its waveforms and threshold can reflect auditory functional changes in the auditory centers in the brainstem and are widely used in the clinic to diagnose dysfunction in hearing. However, identifying its waveforms and threshold is mainly dependent on manual recognition by experimental persons, which could be primarily influenced by individual experiences. This is also a heavy job in clinical practice.Methods: In this work, human ABR was recorded. First, binarization is created to mark 1,024 sampling points accordingly. The selected characteristic area of ABR data is 0–8 ms. The marking area is enlarged to expand feature information and reduce marking error. Second, a bidirectional long short-term memory (BiLSTM) network structure is established to improve relevance of sampling points, and an ABR sampling point classifier is obtained by training. Finally, mark points are obtained through thresholding.Results: The specific structure, related parameters, recognition effect, and noise resistance of the network were explored in 614 sets of ABR clinical data. The results show that the average detection time for each data was 0.05 s, and recognition accuracy reached 92.91%.Discussion: The study proposed an automatic recognition of ABR waveforms by using the BiLSTM-based machine learning technique. The results demonstrated that the proposed methods could reduce recording time and help doctors in making diagnosis, suggesting that the proposed method has the potential to be used in the clinic in the future.

Auditory Function Testing for Types of Dementia: Systematic Reviews and Meta-Analysis

It is acknowledged that there is a negative relationship between dementia and auditory function in older adults. This study conducted a systematic review and meta-analysis based on the data of audiologic testings from patients with neurodegenerative diseases in terms of auditory eventrelated potentials and central auditory processing tests, while focusing on Alzheimer’s disease (AD), dementia with Lewy bodies (DLB), and Parkinson’s disease dementia (PDD). A total of 34765 articles were retrieved from the seven electronic databases. After being screened by Participants, Index test, Control, Outcomes, Study design (PICOS) criteria, 129 articles for AD were included and then 72 articles were applied to the meta-analysis. However, five and six articles were systematically reviewed for the auditory functions of DLB and PDD, respectively, due to a small number of articles. The results of meta-analysis showed a significant difference between patients with AD and age-matched normal subjects, for N200 and P300 latency, P300 amplitude, and the behavioral central auditory processing tests, although there was a high heterogeneity. On the other hand, the systematic review indicated that the results of mismatch negativity test might distinguish auditory performance of DLB patients from that of PDD. Furthermore, for P300 amplitude, anterior to posterior distribution of brain resulted in meaningful difference of auditory function between AD and DLB patients. In sum, current review study suggests that lesion and degree of auditory (dys)function may be different depending on the type of dementia, although future research should be followed.

Speech and language outcomes in mild-moderate unilateral sensorineural hearing loss

ObjectiveThe impact of mild-moderate unilateral sensorineural hearing loss (USNHL) on speech and language delay (SLD) is not well established. Objectives included (1) determining SLD prevalence in patients with mild-moderate USNHL in comparison to prevalence in the general population and severe-profound USNHL patients and (2) examining speech, language, and auditory function testing (SLAT) results in USNHL patients. MethodsA retrospective chart review of pediatric patients with USNHL, classified using pure tone averages (PTA) into mild-moderate (PTA 21–60) and severe-profound (PTA ≥ 61) USNHL groups was conducted. Abnormal SLAT values defined SLD. Prevalence and association of SLD based on USNHL severity was calculated. Onesample binomial tests compared observed frequencies of SLD to reported values. ResultsForty-nine patients were identified with USNHL; 34 patients underwent SLAT. SLD frequency for mild-moderate USNHL was 25% (95% CI, 9–49%), higher than the general population rate (5.95%). No statistically significant difference was noted between SLD frequency in mild-moderate versus severe-profound USNHL. There were no significant correlations between SLAT measures and PTA thresholds. ConclusionThere was a statistically significant increase in SLD in mild-moderate USNHL compared to the general population. There were no correlations between SLAT measures and PTA thresholds. Children with USNHL need close monitoring of speech, language and auditory development and functioning. Studies with larger sample sizes will help delineate if these findings truly reflect results in children with USNHL.

Interpreting auditory brainstem evoked responses and distortion product otoacoustic emissions in diabetic patients with normal hearing

ObjectiveHearing impairment is a reported late complication of diabetes mellitus (DM). Previous studies have suggested that microangiopathic complications may cause cochlear nerve function deterioration. We evaluated the auditory brainstem evoked responses (ABRs) and distortion product otoacoustic emission (DPOAE) results according to the presence of DM in subjects with normal hearing. MethodsA cross-sectional comparative study was conducted from January 2016 to January 2018. Auditory function tests including ABR and DPOAE were performed for outpatients complaining of unilateral tinnitus. All of analyses were conducted in ears without tinnitus on contralateral side of tinnitus ears. We included subjects showing hearing thresholds within 25 dB at 0.5, 1k, 2k, and 4k on pure tone audiometry. 45 ears in patients with type 2 diabetes mellitus and 85 ears in non-diabetic patients were finally enrolled in our study. ResultsDiabetic subjects showed significantly more prolonged absolute peak latencies (I, III, V) and inter-peak latencies (I–V, III–V) than non-diabetic subjects. However, there was no significant difference in the inter-peak latency (I–III) between these two groups. Diabetic subjects also showed significantly lower amplitudes at f2 frequencies of 1001, 1200, 1587, 4004, 5042, and 6348 Hz than non-diabetic subjects. Additionally, the prevalence of a DPOAE response, defined as 3 dB above the noise floor, was significantly lower in diabetic subjects than that in non-diabetic subjects. ConclusionDiabetic patients with normal hearing can still have abnormal ABR and DPOAE results due to diabetic neuroangiopathy. ABR and DPOAE assessments can help in detecting subclinical auditory dysfunction, which precedes the manifestation of hearing impairment in diabetic patients.

Objective and Subjective Auditory Effects of Traumatic Brain Injury and Blast Exposure in Service Members and Veterans.

Service members and veterans (SMVs) with a history of traumatic brain injury (TBI) or blast-related injury often report difficulties understanding speech in complex environments that are not captured by clinical tests of auditory function. Little is currently known about the relative contribution of other auditory, cognitive, and symptomological factors to these communication challenges. This study evaluated the influence of these factors on subjective and objective measures of hearing difficulties in SMVs with and without a history of TBI or blast exposure. Analyses included 212 U.S. SMVs who completed auditory and cognitive batteries and surveys of hearing and other symptoms as part of a larger longitudinal study of TBI. Objective speech recognition performance was predicted by TBI status, while subjective hearing complaints were predicted by blast exposure. Bothersome tinnitus was associated with a history of more severe TBI. Speech recognition performance deficits and tinnitus complaints were also associated with poorer cognitive function. Hearing complaints were predicted by high frequency hearing loss and reports of more severe PTSD symptoms. These results suggest that SMVs with a history of blast exposure and/or TBI experience communication deficits that go beyond what would be expected based on standard audiometric assessments of their injuries.

High-resolution computed tomography evaluation of congenital aural atresia - how useful is this?

To depict various temporal bone abnormalities on high-resolution computed tomography in congenital aural atresia patients, and correlate these findings with auditory function test results and microtia subgroup. Forty patients (56 ears) with congenital malformation of the auricle and/or external auditory canal were evaluated. Auricles were graded according to Marx's classification, divided into subgroups of minor (grades I and II) and major (III and IV) microtia. Other associated anomalies of the external auditory canal, tympanic cavity, ossicular status, oval and round windows, facial nerve, and inner ear were evaluated. Minor and major microtia were observed in 53.6 and 46.4 per cent of ears respectively. Mean hearing levels were 62.47 and 62.37 dB respectively (p = 0.98). The malleus was the most commonly dysplastic ossicle (73.3 vs 80.8 per cent of ears respectively, p = 0.53). Facial nerve (mastoid segment) abnormalities were associated (p = 0.04) with microtia subgroup (80 vs 100 per cent in minor vs major subgroups). Microtia grade was not significantly associated with mean hearing levels or other ear malformations, except for external auditory canal and facial nerve (mastoid segment) anomalies. High-resolution computed tomography is essential in congenital aural atresia, before management strategy is decided.

Prognostic Value of a Test of Central Auditory Function in Conversion from Mild Cognitive Impairment to Dementia

Background/Objective: It has been suggested that central auditory processing dysfunction might precede the development of cognitive decline and Alzheimer’s disease (AD). The Dichotic Digits Test (DDT) has been proposed as a test of central auditory function. Our objective was to evaluate the predictive capacity of the DDT in conversion from mild cognitive impairment (MCI) to dementia. Methods: A total of 57 participants (26 females) with MCI were tested at baseline with pure tone audiometry, speech in quiet and in noise, and the DDT. The cognitive outcome was retrieved from medical files after 5 years. Groupwise comparisons of the baseline DDT scores were performed and the relative risk was calculated. Results: Altogether 22 subjects developed any kind of dementia. Of the original 57 individuals within the MCI group, 15 developed AD and 7 developed other types of dementia. There was no significant difference in baseline DDT scores between the participants who converted to AD and those who did not. However, the group who developed other types of dementia (especially frontotemporal dementia) had lower DDT scores in the left ear than those participants who did not develop dementia. With a baseline DDT score below 50% correct responses, the participants diagnosed with MCI had a 2.49-times-higher risk of developing dementia than those with scores of 50% or better. Conclusion: The DDT as a central auditory test may be suitable when evaluating cognitive decline.