Tone Audiometry Thresholds Research Articles

Diagnosis of auditory disorders in dental patients with altered occlusal relationships (Part 1)

Relevance. Recently, dental patients have been increasingly presenting with not only aesthetic, functional, and painrelated concerns, but also various otological symptoms, such as ear congestion, discomfort, and perceived hearing loss. These symptoms may be linked to underlying dental conditions, especially those involving a reduction in interalveolar distance (IAD), and must be carefully differentiated from ENT disorders and true hearing impairment.Objective: To evaluate the auditory function in dental patients with partial tooth loss and complaints of pathological otological symptoms.Materials and methods. The study included 357 dental patients aged 43 to 72 years, comprising 287 women (80.4%) and 70 men (19.6%) with partial tooth loss. The examination involved a functional-physiological method for determining the central relationship of the jaws using the Apparatus for Determining Central Occlusion (AOTSO) and tonal threshold audiometry.Results. A reduction in interalveolar height of varying degrees was confirmed in 325 (91%) patients with dental arch defects, while no decrease was observed in 23 (9%) patients. All patients with otological complaints exhibited a reduction in lower facial height. Of the 87 patients with otological complaints, 37 (42.5%) were diagnosed with significant hearing loss based on tonal threshold audiometry.Conclusion. The examination of this group of dental patients with dental arch defects, utilizing modern diagnostic methods, confirmed a reduction in interalveolar distance. Additionally, otological complaints were identified, and pathological auditory conditions, such as various forms of hearing loss, were verified through tonal threshold audiometry.

ОЦЕНКА ЭФФЕКТИВНОСТИ ПЕРВИЧНОЙ СТАПЕДОПЛАСТИКИ

Background. Evaluation of the effectiveness of primary stapedoplasty in patients with otosclerosis using the SPOT-25 questionnaire. Materials and methods. Primary piston stapedoplasty with titanium K-piston prosthesis was performed on 42 patients with fenestral and mixed forms of otosclerosis.. Patients were excluded from the study according to the following c: revision surgery on the previously operated ear, stapedoplasty on the second ear, the presence of concomitant pathology that may lead to the development of conductive hearing loss. A standard otorhinolaryngological examination, collection of complaints, medical history, clinical and laboratory examination, tone threshold audiometry, and SPOT-25 questionnaire were carried out. The control periods after surgery were 10 days, 3 and 6 months. Results. The average value of the bone-air interval before surgery was 24.0±9.9 dB; on the 10th day there was a reduction in the air-bone interval to 14.0±10.2 dB (p≤0.05), a significant reduction in the air-bone interval was noted by the 6th month after – surgery — 10.4±8.0 dB (p≤0.01). The results of the air conduction study before the surgery were 52.4±12.5 dB, by the 6th month after surgery a significant improvement of air conduction was noted — 32.5±13.6 dB (p≤0.05). There were no significant changes in bone conduction before the surgery, after 10 days and 6 months; the values were 28.4±11.2 dB, 26.4±11.6 dB, 22.1±10.8 dB, respectively. The results of the SPOT-25 questionnaire before the surgery were 52.2±9.2 points, on the 10th day after surgery they were 35.2±12.9 points (p≤0.05), and after 6 months there was a significant improvement to 35.2±12.9 points (p≤0.05). Conclusion. The use of the SPOT-25 questionnaire before and after primary stapedoplasty is a simple and accessible method for recording changes in the quality of life of patients, which, together with pure tone threshold audiometry data, can be an effective method of assessing the results of the surgery.

OUR EXPERIENCE IN SURGICAL TREATMENT OF MUCOSAL HYPERTROPHY OF TORI TUBARII

Puprose. Evaluation of the effectiveness of surgical treatment of mucous hypertrophy of tori tubarii by submucosal tissue destruction using Ho:YAG laser radiation. Materials and methods. The study involved 48 adult patients with symptoms of Eustachian tube dysfunction. The patency of the auditory tube was assessed by standard tests, the ETDQ 7 questionnaire, tympanometry, pure tone threshold audiometry, and endoscopic video recording of the results were performed. Surgical intervention was carried out by forming under the influence of pulsed radiation from a Ho:YAG laser with a frequency of 10 Hz and a pulse energy of 2 J, 4–6 tunnels with a depth of 5–7 mm in the hypertrophied mucous membrane of the torui tubarii along the posteromedial surface and 2 tunnels up to 3 mm up and down from the pharyngeal mouth of the auditory tube. The control periods after surgery were 1, 3 and 6 months. Results. A significant improvement in the results of the auditory tube according to ETDQ-7 was noted by 3 months after surgery in 71% of patients and in 84% by 6 months. By 6 months after surgery, type C tympanometry and clinically significant conductive hearing loss persisted in 8 and 5% of patients, respectively. The subjective feeling of fully performing the Valsalva test improved in 58% after 3 months and in 82% by the 6th month, and the Toynbee test in 42% and 64% in the 3rd and 6th months, respectively. In 16% of patients, despite a visual decrease in mucosal hypertrophy during endoscopic examination, signs of dysfunction remained according to ETDQ 7. There were no complications after surgical treatment during 6 months of observation. Conclusion. The use of endoscopic diagnosis of the nasopharynx in patients with signs of dysfunction of the auditory tubes in combination with functional tests and the ETDQ-7 questionnaire allows to determine the indications for the surgical treatment of hypertrophy of the mucous membrane of the tori tubarii using the Ho:YAG laser, the effectiveness of which in our study was 84%.

Self-reporting of hearing loss and tinnitus in the diagnosis of ototoxicity by meglumine antimoniate in patients treated for American tegumentary Leishmaniasis.

American Tegumentary Leishmaniasis (ATL) treatment is based on pentavalent antimonials (Sb5+), but these drugs have been associated to several adverse effects. Hearing loss and tinnitus during treatment with meglumine antimoniate (MA) have already been reported. This study aimed to describe the usefulness of self-reporting of hearing loss and tinnitus in diagnosing MA-induced ototoxicity. A prospective longitudinal study was conducted with 102 patients with parasitological diagnosis of ATL, treated with different MA schemes. The presence of clinical auditory toxicity was defined as the emergence or worsening of self-reporting hearing loss and/or tinnitus during monitoring. Measures of sensitivity, specificity, and the positive and negative predictive value of the patient's self-reporting of hearing loss and tinnitus in relation to the result of the audiometric test (considered the gold standard) were calculated. The age of the evaluated patients ranged from 15 to 81 years, with a median of 41 years, and most were male (73.5%). Seventy-five patients (73.5%) had cutaneous leishmaniasis and 27 (26.5%) mucosal leishmaniasis. Eighty-six patients (84.3%) received intramuscular (IM) treatment and 16 (15.7%) were treated with intralesional MA. During treatment, 18 (17,6%) had tinnitus and 7 (6,9%) had complaint of hearing loss. 53 (52%) patients had cochlear toxicity confirmed by tone threshold audiometry and high frequency audiometry, from which 60% received a dose of 20 mg Sb5+/kg/day (p = 0.015) and 96.2% were treated with IM MA (p = 0.001). Tinnitus has greater specificity and positive predictive value than hearing loss, with a low number of false positives, but with a high false negative value. Although the large number of false negatives suggests that self-report of hearing loss or tinnitus cannot be considered a good screening test for referring the patient to an audiometry, the low number of false positives suggests the need to value the patient's complaint for referral. Otherwise, this study reinforces the importance of audiological monitoring during treatment with MA, especially in those patients with self-reporting of hearing loss or tinnitus when treated with 20 mg Sb5+/kg/day via IM.

Psychophysical and Electrophysiological Parameters of the Auditory Analyzer as Indicators of the Effectiveness of Cochlear Implantation in Children with Bilateral Deafness

Background. The results of rehabilitation of patients with deafness after cochlear implantation (CI) depends on many factors related on both the individual characteristics of the patient and the technical parameters of auditory nerve stimulation — fitting of the CI system processor. Article presents the results of a study of the relationship between psychophysical (subjective) auditory sensations and electrophysiological (objective) responses of the structures of the auditory analyzer to electrical stimulation. Aims — to evaluate the relationship between the electrophysiological responses of the auditory analyzer and the psychophysical parameters of the thresholds of sound perception and speech intelligibility in patients with deafness after CI. Methods. The study involved 88 patients with IV bilateral sensorineural hearing loss, borderline with deafness, aged 6 to 17 years 11 months, among whom 54.5% (n = 48) of girls and 45.5% (n = 40) of boys. Of the patients included in the follow-up, 40% (n = 35) underwent unilateral CI; 60% (n = 53) of children underwent bilateral sequential CI. In our study, slightly more than half of the patients (51.1%) had experience using the CI system for more than 5 years. At the first stage of the study, we studied the relationship between sound perception thresholds (tonal audiometry in a free field) and registered ASSR (auditory steady state response) thresholds in patients with deafness receiving rehabilitation after CI surgery. The relationship between behavioral and electrophysiological (objective) thresholds was assessed by comparing the results of tonal threshold audiometry and the responses received during ASSR registration to acoustic stimulation in a free field. At the second stage, patients with indications for processor fitting (decreased speech intelligibility, uncomfortable sensations) underwent speech audiometry, evoked compound action potentials (ECAP) registration, according to the results of which the parameters of the CI processor were changed. Results. Research data showed the effectiveness of the approach of including the ECAP registration test, followed by the creation of a fitting card and correction of the level of auditory nerve stimulation under the control of speech audiometry in the protocol of fitting the CI processor. Conclusions. The results of the conducted studies allow us to recommend the use of the developed method of objective recording of sound perception thresholds in patients with CI as one of the indicators of the effectiveness of CI in the early period of auditory-speech rehabilitation in patients with undeveloped speech skills and when it is impossible to conduct objective tests accompanied by supra-threshold stimulation of the auditory nerve.

Plasma Levels of Interferon Gamma associated with Hearing Loss and Hearing Loss Sensation through the Handicap Questionnaire Inventory for the Elderly Screening Version.

The aim of this study was to verify the association between the auditory handicap found in the Hearing Handicap Inventory for the Elderly-Screening Version (HHIE-S) questionnaire and hearing loss and the plasma levels of inflammatory biomarkers. Cross-sectional study with 76 participants, 67 (88%) females and 9 (12%) males, with a mean age of 70 years. Tonal threshold audiometry and self-assessment with HHIE-S questionnaire were performed to measure the plasma levels of interleukin-2 (IL-2), IL-4, IL-6, and IL-10; tumor necrosis factor alpha; and interferon gamma (IFN-γ) flow cytometry method. For all data analyzed, the significance level adopted was P < 0.05 and 95% confidence interval. An inverse correlation was observed between the increase in plasma levels of IFN-γ and normal auditory handicap (P = 0.015; rs = -0.280). The severe handicap group showed an increase in the averages I (P = 0.005; rs = 0.350) and II (P = 0.016; rs = 0.368) in the right ear and the light/moderate handicap group increased the means I (P = 0.027; rs = 0.350) and II (P = 0.046; rs = 0.310) of the left ear. A statistically significant association was found between the speech recognition threshold (SRT) test results of the right ear and the severe handicap group (P = 0.002; rs = 0.271). There was an association between the increase in plasma levels of IFN-γ and normal auditory handicap. Additionally, statistically significant associations were observed between the mild/moderate and severe handicap groups with the increase in hearing means and an increase in SRT associated with the severe handicap group.

Assessment of the risk of hearing loss in children with cystic fibrosis

Cystic fibrosis (CF) is a severe hereditary disease with a multisystem lesion. Manifestations of CF include severe infectious purulent lesions of all parts of the respiratory tract, including purulent rhinosinusitis with nasal polyps. The involvement of the sinonasal region and the need for systemic use of ototoxic drugs (primarily aminoglycosides to treat resistant bacterial infection) potentially create a risk of both conductive and sensorineural hearing loss (SNHL). The available data on the epidemiology of hearing disorders in CF is contradictory. Currently, genetic determinants of the development of aminoglycoside SNHL have been identified. For 136 CF patients (75 girls, 61 boys) aged 3 to 17 (9.4±3.9) years were performed audiological examination: tympanometry, transient-evoked otoacoustic emission and the pure tone threshold audiometry (standard frequency range) (n=126). History of systemic therapy with aminoglycosides was evaluated for each patient. Sequencing of c.35delG mutations in the GJB2 gene (nuclear DNA) and A1555G in the 12S rRNA gene (mitochondrial DNA) was performed in 215 patients with cystic fibrosis (the group partially overlaps with the audiological group), and as a control - 106 children with bronchial asthma and 103 healthy children, their age ranged from 3 to 17 (8.8±3.8) years. Audiological examination of CF children reveled a prevalence of conductive hearing loss comparable to the general population (2.4%). The frequency of SNHL was 1.6%, wich exceeds that of non-CF children. A genetic study revealed one case of heterozygous carriage of the c.35delG mutation in the GJB2 gene in a patient with bronchial asthma. In the group of patients with CF (n=215), mutations in the connexin 26 gene were not detected. No A1555G mutation was detected either in the group of patients with CF or in the control groups. Children with CF are at risk for the development of sensorineural, but not conductive hearing loss. Routine total screening for A1555G and c.35delG mutations probably seems not to be recommended.

Development of methodological approaches to assess the functional state of the inner ear labyrinth

Modeling the propagation of sound vibrations from the foot plate of the stirrup in the oval window to the perceiving formations of the organ of Corti is a difficult experimental problem. In the search for the causes of hearing loss, tone threshold audiometry has traditionally been considered as the basis of diagnosis. The presence of an air-bone gap on an audiogram was associated with a dysfunction of the middle ear; however, in many cases, an air-bone gap is detected when the pathology is localized in the structures of the inner ear. The review shows that pathological conditions that impair intracochlear sound conduction are successfully detected using computed tomography of the temporal bones. The classification of pathological conditions of the labyrinth, giving the bone-air gap on the tone threshold audiogram, was performed.

Characteristics of cognitive functioning in persons with chronic sensorineural hearing loss

Aim to identify the features of cognitive status in chronic sensorineural hearing loss (CNHL) by analyzing the subscales of the Montreal Cognitive Assessment test.&#x0D; Material and methods. The study involved 45 people (aged 44 - 86 years, average age 57.8711.74 years) with chronic sensorineural hearing loss. The study design included assessment of complaints and anamnesis, examination of ENT organs, tonal threshold audiometry (AC-40, Interacoustics, Denmark), tympanometry (AC 226, Interacoustics, Denmark). Cognitive status was assessed using the Montreal Cognitive Assessment tool (MoCA) on seven subscales: Executive and visuospatial function, Naming, Attention, Language, Abstraction, Delayed recall, and Orientation.&#x0D; Results. The average total score for MoCA in persons with chronic SNHL (n=45) was 25.092.86 points out of 30 possible points, which indicates a trend towards a decrease in cognitive function. Cognitive impairments in individuals with SNHL were more pronounced on the subscales Executive and visuospatial function, Language and Delayed recall. Despite rather high average scores on the subscale Executive and visuospatial function, 100% completion was noted less than in half of the subjects in 46.66% (n = 21).&#x0D; Conclusion. Considering the cognitive characteristics of individuals with SNHL may improve the effectiveness of rehabilitation.

Change in the Characteristics of Patients Qualified for Hearing Aids over the Last 25 Years in Poland.

Hearing loss is one of the most common causes of disability worldwide. The aim of the study was to compare the demographic structure and the results of hearing tests in people qualified for hearing aids over the last 25 years. The material covered 1246 patients qualified for hearing aids in the years 1996-2001 and 2016-2021. Patients were divided into two groups according to the time of qualifying for hearing aids. Group 1 (G1) consisted of 759 people qualified in the years 1996-2001, and Group 2 (G2) comprised 487 people qualified in the years 2016-2021. Statistical analysis was performed on the results of pure tone threshold audiometry and the demographic structure in both groups. Patients in G1 had statistically significantly elevated hearing thresholds (HT) in the air conduction range at frequencies from 2000 to 8000 Hz in relation to G2 patients. The opposite situation was observed for the bone conduction threshold. G2 patients had significantly elevated bone conduction HT at frequencies from 250 to 1000 Hz compared to G1 patients. The age structure in both groups was similar; however, the gender distribution was statistically significantly different. In G1 women accounted for 40%, and in G2, they became the dominant gender (53%). Over the last twenty years, there has been a change in the structure of patients qualified for hearing aids. Although the age has remained similar, today, patients decide to use hearing aids at an earlier stage of hearing loss than 25 years ago. Modern women began to use hearing aids much more often.

Population Based Study and Global Estimates of Hearing Impairment in Schoolchildren

Hearing impairments in schoolchildren affects learning and communication. Reliable data on hearing loss prevalence in this group are necessary for planning the audiological care. Aim. To compare data from a population based study of the hearing loss prevalence in schoolchildren and estimates from the Global Burden of Disease (GBD) study in the Republic of Yemen. Materials and methods. Data extraction was performed from the GBD database on the prevalence of bilateral hearing loss &gt;20 dB among children aged 5–9 years in the Republic of Yemen. A two stage study of hearing loss prevalence among primary school students aged 6–9 years in Sana’a, Republic of Yemen, in a sample of 2200 children using screening audiometry at 20 dB at 0.5, 1, 2, and 4 kHz is school settings, followed by tonal threshold audiometry and tympanometry in a specialized clinic. Hearing loss was assessed as unilateral or bilateral when hearing thresholds were higher than 25 dB. Results. According to GBD estimates, bilateral hearing impairment in this population is 2.2%, including 1.4% of mild degree. According to the results of a Yemenian population study, mild and moderate hearing impairment was detected in 10.6%, of which 6.8% – unilateral, 3.8% – bilateral hearing loss. There were no cases of severe or profound hearing loss. The prevalence of otitis media with effusion was 6%, chronic suppurative otitis media – 1.8%, sensorineural hearing loss – 1.6%. Conclusion. Bilateral hearing impairments occur in 2.2–3.8% of primary school students, with unilateral impairments the prevalence is up to 10.6%. Of these, at least 65% have conductive hearing loss due to pathology of the middle ear. The data obtained will improve the efficiency of ear and hearing care for schoolchildren.

ОЦЕНКА СОСТОЯНИЯ СЛУХОВОГО АНАЛИЗАТОРА И АНАЛИЗ ФАКТОРОВ РИСКА У СТУДЕНТОВ

The modern lifestyle of young people is reflected in the state of hearing. Using gadgets and listening to loud music leads to the early development of hearing loss. The purpose of the study is to assess the condition of the auditory analyzer in students. The results of our own research allowed us to identify the main factors leading to hearing loss and assess the condition of the auditory analyzer in 20 students aged 20-22 years. Data collection was carried out on the basis of comprehensive surveys, questionnaires and reports. To assess hearing, anamnesis was collected, external examination of the ear, palpation, otoscopy, whispering and colloquial speech, tests with tuning forks, tonal threshold audiometry at four typical frequencies. The results of the study of the condition of the auditory analyzer showed that in 10% of cases sulfur plugs were detected in the external auditory canal, in 5% of cases – the presence of scars and pathological color of the membrane. The study of auditory function revealed that in 20% of cases, whispered speech was detected from a distance of 4 meters, and not from 6. The values of air and bone conduction during the Rinne test in all cases did not reach the standard values, in 20% of cases the test on the right ear was negative, and on the left ear – in 10%. In Federici's experiment, it was revealed that in 15% of cases, bone conduction was higher than air. The results of the Weber test showed that in 45% of cases the sound was shifted and uneven. The data obtained using a high-frequency tuning fork 2048 showed that in 85% of cases, the air conductivity values of both the right and left ears were below normal values. The study of hearing acuity demonstrated that in 15% of cases the values reached the upper limit of the norm. The results of the questionnaire to identify the determining factors showed that 30% of students noticed hearing impairment. More than 50% of students answered that they often listen to loud music and use headphones. Thus, the main risk factors and the first signs of hearing loss in students were identified.

Effectiveness of transcranial electrical stimulation in the comorbid course of occupational hearing loss and hypertension

Introduction. Diseases of the cardiovascular system, which are an additional unfavourable factor for the development and progression of occupational sensorineural hearing loss (OSNHS), should be taken into account when carrying out therapeutic and preventive measures among workers of noise professions. The aim of the study was to evaluate the effectiveness of transcranial electrical stimulation (TES) in the comorbid course of OSNHS and arterial hypertension (AH). Materials and methods. Two groups of OSNHS patients in combination with AH were examined. Group 1 (128 people) received only basic drug therapy, in group 2 (126 people), TES was carried out along with basic therapy. The dynamics of treatment was assessed by daily monitoring of blood pressure (DMBP), audiological parameters, and indicators of the quality of life according to the SF-36 questionnaire. Results. As a result of treatment, in group 2 of patients receiving TES, there was a more pronounced positive dynamics of DMBP indicators and normalization of the daily blood pressure profile, an increase in the adaptive capabilities of the body from the level of “functional overstrain” to “sufficient, satisfactory adaptation” was found. TES contributed to the improvement of hearing, which was confirmed by the data of tonal threshold audiometry and optoacoustic emission, and indicators of quality of life according to the SF-36 questionnaire. Limitations. The study is limited to the study of the effectiveness of the use of TES in patients with mild and moderate OSNHS on the background of stage 1-2 AH with mild and moderate arterial hypertension. Conclusion. The results obtained give grounds to recommend the TPP methodology in a complex of therapeutic and preventive measures for OSNHS patients in combination with AH to ensure the most adequate therapy and effective prevention aimed at preserving health and longevity.

Prevalence of hearing loss in schoolchildren: populational study and global estimates

Introduction. Hearing impairments in schoolchildren affects learning and communication. Reliable data on hearing loss prevalence in this group are necessary for planning the audiological care.Aim. To compare data from a population-based study of the hearing loss prevalence in schoolchildren and estimates from the Global Burden of Disease (GBD) study in the Republic of Yemen.Materials and methods. Data extraction was performed from the GBD database on the prevalence of bilateral hearing loss &gt;20 dB among children aged 5–9 years in the Republic of Yemen. A two-stage study of hearing loss prevalence among primary school students aged 6–9 years in Sana’a, Republic of Yemen, in a sample of 2200 children using screening audiometry at 20 dB at 0.5, 1, 2, and 4 kHz is school settings, followed by tonal threshold audiometry and tympanometry in a specialized clinic. Hearing loss was assessed as unilateral or bilateral when hearing thresholds were higher than 25 dB.Results. According to GBD estimates, bilateral hearing impairment in this population is 2.2%, including 1.4% of mild degree. According to the results of a Yemenian population study, mild and moderate hearing impairment was detected in 10.6%, of which 6.8% – unilateral, 3.8% – bilateral hearing loss. There were no cases of severe or profound hearing loss. The prevalence of otitis media with effusion was 6%, chronic suppurative otitis media – 1.8%, sensorineural hearing loss – 1.6%.Conclusion. Bilateral hearing impairments occur in 2.2–3.8% of primary school students, with unilateral impairments the prevalence is up to 10.6%. Of these, at least 65% have conductive hearing loss due to pathology of the middle ear. The data obtained will improve the efficiency of ear and hearing care for schoolchildren.

High frequency hearing loss may act as a screening index evaluating otolith function in vertigo patients with normal semi-circular canal function.

ObjectiveTo investigate whether otolith dysfunction is related to hearing impairment in vertigo patients with normal semicircular canal function, and to clarify the types of hearing impairment that may be related to otolith organ damage.MethodsThe demographic data, pure tone threshold audiometry (PTA) results (air-conduction), data of bithermal and video-head impulse test (vHIT), and vestibular evoked myogenic potential (VEMP) results (reaction threshold, P1–N1 amplitude) of patients with vertigo in outpatient clinic from April 2017 to January 2020 were collected. The clinical records of 51 vertigo patients with normal semicircular canal function were included in this study. Low-frequency, speech-frequency, high-frequency, full-frequency PTA were defined as the average of PTA in different frequency bands, respectively (low: 0.125, 0.25, 0.5 kHz; speech: 0.5, 1, 2 kHz, high: 4, 8 kHz, full 0.125–8 kHz). The correlations between hearing impairment in different frequency bands and otolith function impairment were analyzed.ResultsThe mean thresholds of 51 patients (102 ears) in low-PTA, speech-PTA, high-PTA, full-PTA were 20.95 ± 6.01, 21.92 ± 6.90, 40.12 ± 17.47, 26.97 ± 8.53 dB nHL, respectively. Among 102 ears, 87 ears (85.3%) could elicit c-VEMP waveforms and 65 ears (63.7%) had o-VEMP waveforms. The mean threshold and P1–N1 amplitude of c-VEMP were 83.10 ± 6.96 dB nHL and 176.79 ± 103.10 uV, while those of o-VEMP were 87.92 ± 5.99 dB nHL and 21.45 ± 32.22 uV. The mean threshold in high-PTA was significantly linearly correlated with c-VEMP threshold (P = 0.01) and P1–N1 amplitude (P = 0.028). There were not significant linear correlations between the mean threshold in each frequency band of PTA and o-VEMP threshold (low-PTA: P = 0.266, speech-PTA: P = 0.33, high-PTA: P = 0.311) or P1–N1 amplitude (low-PTA: P = 0.414, speech-PTA: P = 0.069, high-PTA: P = 0.08).ConclusionsThere is a positive linear correlation between saccule dysfunction and high-frequency hearing impairment in vertigo patients with normal semi-circular canal function. High frequency hearing loss can be expected in patients who have saccular damage. It suggests that high frequency hearing loss in PTA may act as a screening index that otolith organ function should be comprehensively evaluated.

Modern approaches to the diagnosis of occupational hearing loss in workers exposed to noise

Due to the high prevalence of professional hearing loss, the difficulty of making decisions on the further working capacity of the employee, the issues of objectification of the assessment of the hearing condition among employees of «noise» productions, ensuring their reliability are very relevant. Based on the analysis of the results of tonal threshold audiometry and registration of short-latency auditory evoked potentials in 30 patients with impaired auditory function of professional origin, the difference in latencies of registered potentials, amplitudes and intervals was determined in comparison with a group of persons without industrial acoustic contact. The present study has shown that the test has sufficient informativeness in solving complex examination issues of interned patients with comorbid pathology of the circulatory organs by this age, and can be recommended for use for differential diagnosis of lesions of the central parts of the auditory analyzer in case of discrepancy with the results of tonal threshold audiometry.

Comparative assessment of the effectiveness of hearing assessment protocols in identifying SNHL in elderly and senile people

Introduction. The article discusses methods of screening for hearing impairments in patients of the older age group in the frame-work of primary health care.Aim of the study. Conduct a comparative analysis of the effectiveness of different hearing assessment protocols in primary health care.Materials and methods. Сlinical and demographic data were collected in 585 elderly and senile patients (mean age 76.43 ± 9.83), tonal threshold audiometry was performed in the frequency range from 250 Hz to 12000 Hz, hearing was studied using the web application “Automated primary hearing assessment” (patent No. 2019664671) and analyzed the self-assessment of hearing with the HHIE questionnaire.Results. Most of the patients were elderly people (57.44%) with a high percentage of concomitant diseases (up to 89.23%). When interviewing a geriatrician about a complaint of hearing loss, a sensitivity of 91.5% and a specificity of 82.2% for detecting mild hearing loss, a sensitivity of 95.5% and a specificity of 71.8% for screening for moderate to severe hearing loss were obtained. When assessing the total score of the HHIE questionnaire (&gt;17 points) and moderate hearing loss, the sensitivity was 84.7% and the specificity was 88.7%. The sensitivity index of the web application «Automated primary hearing assessment» for detecting moderate hearing impairment was 90.6% for the left ear and 88.5% for the right ear, and specificity – 88.5% for the left ear and 97.5% for the right ear.Discussion. Raising awareness of hearing problems through the introduction of feasible methods of assessing hearing function should lead to an increase in the number of older adults receiving adequate hearing rehabilitation.Conclusions. The authors conclude that it is important to take preliminary account of data on the sensitivity and specificity of assessment protocols for detecting hearing impairments of varying severity at the stage of examination of an older patient by a geriatrician and an otorhinolaryngologist.

Approaches to the correction of auditory tube dysfunction in children with allergic rhinitis

To assess the state of ventilation of the middle ear in various forms of AR in children and the effectiveness of drug correction. We conducted a comprehensive examination of 100 children with various forms of AR. The examination complex included the analysis of anamnestic data, the clinical picture of the disease, subjective otological symptoms, data from otoscopy, acoustic impedansometry and tonal threshold audiometry. 1. Regardless of the form of AR, every third patient has auditory tube dysfunction, which develops mainly on both sides, is asymptomatic and is not accompanied by otoscopic changes.

Ultrasound regional lymphotropic therapy for protracted forms of serous otitis media

To improve the method of conservative treatment of patients with protracted forms of SOM by clinically substantiating and developing a method of ultrasound regional lymphotropic therapy. The study included 75 patients (102 cases of diseased ears) with SOM. Previously, they repeatedly underwent outpatient courses of conservative treatment for 1 to 3 months, but all had symptoms of the disease. In the department of otorhinolaryngology, each of the patients with protracted forms of SOM was given a course of ultrasound regional lymphotropic therapy. The criteria of the treatment results were subjective and objective data of a special examination, which included: the presence of relevant complaints, otoscopy, determination of the levels of perception of live speech, indicators of air and bone sound conduction, tonal threshold audiometry, tympanometry characterizing the dynamics of hearing, the airiness of the tympanic cavity, the functioning of the auditory tubes. The examination was performed before and after treatment. Confirmation of the effectiveness of ultrasound regional lymphotropic therapy in protracted forms of SOM was the restoration in 52% of patients of whispering and in 68% of patients of colloquial speech to socially adequate values; a decrease in the level of sound perception thresholds at all frequencies by air conduction; an increase in tonal hearing; a complete restoration of the airiness of the tympanic cavity in 57% of patients (type A tympanogram). A new method of treating patients with protracted forms of SOM has been developed and clinically justified by the combined use of low-frequency ultrasound and medications with lymphotropic effect.

КОМПЛЕКСНАЯ ДИАГНОСТИКА СЛУХА У ДЕТЕЙ С ЗАБОЛЕВАНИЕМ СПЕКТРА АУДИТОРНЫХ НЕЙРОПАТИЙ В РЕСПУБЛИКЕ БЕЛАРУСЬ

Auditory Neuropathy Spectrum Disorders, ANSD is a state of the auditory system in which the patient has otoacoustic emissions (OAEs) and/or cochlear microphonic potential (CMP), and auditory brainstem responses (ABRs) are absent or significantly reduced. In contrast to sensorineural hearing loss, where the outer and inner hair cells of the cochlea are damaged, in ANSD the outer hair cells are preserved. The complexity of ANSD detection and the variety of clinical symptoms of this disorder make it difficult to differentiate this disease from sensorineural hearing loss. Purpose. Improvement of the differential diagnosis of ANSD and sensorineural hearing loss by defining the main anamnestic and audiological criteria. Materials and methods. The research included 2 groups of patients: the core group - 48 patients with bilateral ANSD and the control group - 30 patients with bilateral chronic sensorineural hearing loss. All patients underwent assessment of the anamnesis data, impedance measurement, tone threshold audiometry, registration of OAE (TEOAE), registration of ABR with allocation of CMP, registration of stationary auditory evoked potentials. Results. In patients with ANSD the incidence of prematurity, low birth weight, and hyperbilirubinemia is significantly higher (p &lt;0.05) than in patients with sensorineural hearing loss. In patients with ANSD the 35delG mutation in the GJB2 gene was not identified, in contrast to patients with sensorineural hearing loss (genetic factor was confirmed in 23.3%) (p &lt;0.05). Newborn hearing screening on both sides was conducted in 15 children (31.3%) with ANSD and only 1 child (3.3%) with sensorineural hearing loss (p &lt;0.05). In 8 patients (16.7%) with ANSD was recorded TEOAE during the initial audiological diagnosis, in contrast to sensorineural hearing loss (TEOAE was not recorded in 100% of patients) (p &lt;0.05). In contrast to sensorineural hearing loss, the ABR thresholds in ANSD did not correspond to the behavioral hearing thresholds. CMP was recorded on the right and left ear in all patients (100%) with ANSD and remained unchanged during the observation process, in contrast to patients with sensorineural hearing loss, in whom CMP was not recorded on both sides (p &lt;0.05). Conclusions. The structure of the main risk factors for hearing loss in children with ANSD and sensorineural hearing loss is different. In the differential diagnosis with sensorineural hearing loss, the possibility of TEOAE disappearance in ANSD should be taken into account. Registration of ABRs with the allocation of CMP is the most informative method of ANSD diagnostics. CMP registration should be conducted for all patients who do not have ABR peaks at the maximum stimulus intensity, regardless of the OAE registration results.