Tone Thresholds Research Articles

High Frequency of AIFM1 Variants and Phenotype Progression of Auditory Neuropathy in a Chinese Population.

To decipher the genotype-phenotype correlation of auditory neuropathy (AN) caused by AIFM1 variations, as well as the phenotype progression of these patients, exploring the potential molecular pathogenic mechanism of AN. A total of 36 families of individuals with AN (50 cases) with AIFM1 variations were recruited and identified by Sanger sequencing or next-generation sequencing; the participants included 30 patients from 16 reported families and 20 new cases. We found that AIFM1-positive cases accounted for 18.6% of late-onset AN cases. Of the 50 AN patients with AIFM1 variants, 45 were male and 5 were female. The hotspot variation of this gene was p.Leu344Phe, accounting for 36.1%. A total of 19 AIFM1 variants were reported in this study, including 7 novel ones. A follow-up study was performed on 30 previously reported AIFM1-positive subjects, 16 follow-up cases (53.3%) were included in this study, and follow-up periods were recorded from 1 to 23 years with average 9.75 ± 9.89 years. There was no hearing threshold increase during the short-term follow-up period (1-10 years), but the low-frequency and high-frequency hearing thresholds showed a significant increase with the prolongation of follow-up time. The speech discrimination score progressed gradually and significantly along with the course of the disease and showed a more serious decline, which was disproportionately worse than the pure tone threshold. In addition to the X-linked recessive inheritance pattern, the X-linked dominant inheritance pattern is also observed in AIFM1-related AN and affects females. In conclusion, we confirmed that AIFM1 is the primary related gene among late-onset AN cases, and the most common recurrent variant is p.Leu344Phe. Except for the X-linked recessive inheritance pattern, the X-linked dominant inheritance pattern is another probability of AIFM1-related AN, with females affected. Phenotypical features of AIFM1-related AN suggested that auditory dyssynchrony progressively worsened over time.

Minimal and Mild Hearing Loss in Children: Association with Auditory Perception, Cognition, and Communication Problems.

"Minimal" and "mild" hearing loss are the most common but least understood forms of hearing loss in children. Children with better ear hearing level as low as 30 dB HL have a global language impairment and, according to the World Health Organization, a "disabling level of hearing loss." We examined in a population of 6- to 11-year-olds how hearing level ≤40.0 dB HL (1 and 4 kHz pure-tone average, PTA, threshold) is related to auditory perception, cognition, and communication. School children (n = 1638) were recruited in 4 centers across the United Kingdom. They completed a battery of hearing (audiometry, filter width, temporal envelope, speech-in-noise) and cognitive (IQ, attention, verbal memory, receptive language, reading) tests. Caregivers assessed their children's communication and listening skills. Children included in this study (702 male; 752 female) had 4 reliable tone thresholds (1, 4 kHz each ear), and no caregiver reported medical or intellectual disorder. Normal-hearing children (n = 1124, 77.1%) had all 4 thresholds and PTA <15 dB HL. Children with ≥15 dB HL for at least 1 threshold, and PTA <20 dB (n = 245, 16.8%) had minimal hearing loss. Children with 20 ≤PTA <40 dB HL (n = 88, 6.0%) had mild hearing loss. Interaural asymmetric hearing loss ( left PTA - right PTA ≥10 dB) was found in 28.9% of those with minimal and 39.8% of those with mild hearing loss. Speech perception in noise, indexed by vowel-consonant-vowel pseudoword repetition in speech-modulated noise, was impaired in children with minimal and mild hearing loss, relative to normal-hearing children. Effect size was largest (d = 0.63) in asymmetric mild hearing loss and smallest (d = 0.21) in symmetric minimal hearing loss. Spectral (filter width) and temporal (backward masking) perceptions were impaired in children with both forms of hearing loss, but suprathreshold perception generally related only weakly to PTA. Speech-in-noise (nonsense syllables) and language (pseudoword repetition) were also impaired in both forms of hearing loss and correlated more strongly with PTA. Children with mild hearing loss were additionally impaired in working memory (digit span) and reading, and generally performed more poorly than those with minimal loss. Asymmetric hearing loss produced as much impairment overall on both auditory and cognitive tasks as symmetric hearing loss. Nonverbal IQ, attention, and caregiver-rated listening and communication were not significantly impaired in children with hearing loss. Modeling suggested that 15 dB HL is objectively an appropriate lower audibility limit for diagnosis of hearing loss. Hearing loss between 15 and 30 dB PTA is, at ~20%, much more prevalent in 6- to 11-year-old children than most current estimates. Key aspects of auditory and cognitive skills are impaired in both symmetric and asymmetric minimal and mild hearing loss. Hearing loss <30 dB HL is most closely related to speech perception in noise, and to cognitive abilities underpinning language and reading. The results suggest wider use of speech-in-noise measures to diagnose and assess management of hearing loss and reduction of the clinical hearing loss threshold for children to 15 dB HL.

Efficacy of high dose glucocorticoid in the salvage treatment of sudden deafness

Objective:To observe the efficacy and safety of high dose dexamethasone injection in the tympanic cavity in the patients with sudden and severe deafness who failed conventional treatment. Method:A total of 43 patients with unilateral sudden and severe deafness were recruited in this study. All patients were not cured with conventional comprehensive treatment in the department of otology. They were divided into two groups: 21cases were treated with high dose dexamethasone injection into the tympanic cavity by ventilation tube （dexamethasone group）, while routine treatment was continued in 22 cases （conventional control group）. Each patient underwent a hearing test before treatment, the hearing thresholds of 6 frequencies （0.25, 0.5, 1.0, 2.0, 4.0, 8.0 kHz） were recorded. After one week of treatment, the above-mentioned six frequencies were re-recorded. A decrease of the pure tone threshold average （PTA） more than 15 dB was set for effective. Result:After 1 week treatment, comparison of the PTA value before and after treatment in dexamethasone group（t=11.749） and in conventional control group （t=7.364），comparison of the PTA value of the two groups （t=-2.628），comparison of the PTA value of hearing improvement between the two groups （t=2.717）,the differences were statistically significant（P<0.01 or 0.05）. Sixteen cases in dexamethasone group were effective, the effective rate was 76.2%;10 cases in conventional control group was effective, the effective rate was 45.5%,the difference of the two curative effects was statistically significant（χ²=3.058,P<0.05）. Eighteen patients in dexamethasone group had vertigo before treatment. The patients were followed up for 6 months after treatment. The vertigo disappeared or decreased in 14 cases, the improve rate is 77.8%.17 patients in the conventional control group had vertigo before treatment, the patients were followed up for 6 months after treatment, the vertigo disappeared or decreased in 6 cases, the improve rate is 35.3%,the difference was statistically significant（P=0.018）. Conclusion:High dose dexamethasone injection into the tympanic cavity is more effective than conventional therapy in the salvage treatment of sudden and severe deafness, and it is helpful to improve vertigo.

Role of Otoacoustic Emission in Early Detection of Cisplatin Induced Ototoxicity.

Cisplatin is a chemotherapeutic agent effective against head and neck carcinoma but unfortunately it is cochleotoxic. This study has been designed to investigate the efficacy of OAE in identifying early effects of cisplatin on the cochlea and the importance of protocol for audiological monitoring of cisplatin induced ototoxicity. This is a prospective observational study conducted from October 2012 to September 2014 on 70 patients, receiving Cisplatin for various malignant conditions. Audiological criteria for ototoxicity was considered as a difference of 10 d B or more in pure tone thresholds of two or more adjacent frequencies in conventional audiometry and in DPOAE-Signal noise ratio less than 6dB or DPOAE amplitude less than 20 dBSPL (irrespective of SNR > 6dB). According to PTA, 60.7% patients showed ototoxicity after completion of chemotherapy. In DPOAE, according to SNR and amplitude criteria more than 60% patients showed ototoxicity after first cycle of cisplatin at high frequencies (4-8kHz). DPOAEs is a sensitive tool for early detection of ototoxicity and protocol is necessary for monitoring ototoxicity in patients receiving cisplatin to improve the quality of life.

Aided Hearing Moderates the Academic Outcomes of Children With Mild to Severe Hearing Loss.

There are very limited data regarding the spoken language and academic outcomes of children with mild to severe hearing loss (HL) during the elementary school years, and the findings of these studies are inconsistent. None of these studies have examined the possible role of aided hearing in these outcomes. This study used a large cohort of children to examine these outcomes and in particular to examine whether aided hearing moderates the effect of HL with regard to these outcomes. The spoken language, reading, writing, and calculation abilities were measured after second and fourth grades in children with mild to severe HL (children who are hard of hearing; CHH, n = 183) and a group of children with normal hearing (CNH, n = 91) after the completion of second and fourth grades. Also, among the CHH who wore hearing aids, aided better-ear speech intelligibility index values at the age of school entry were obtained. Oral language abilities of the CHH with mild and moderate HL were similar to the CNH at each grade. Children with moderately-severe HL (better-ear pure tone threshold >59 but <76 dB HL) had significantly poorer oral language and reading skills than the CNH at each grade. The children with mild and moderate HL did not differ from the CNH in oral language or reading. No differences were found between the CHH regardless of severity and CNH with regard to spelling, passage writing, or calculation. The degree to which hearing aids provided audible speech information played a moderating role in the oral language outcomes of CHH and this moderation of language mediated the relationship between the unaided hearing ability of the CHH and their academic outcomes. As a group, children with mild and moderate HL have good outcomes with regard to language and academic performance. Children with moderately-severe losses were less skilled in language and reading than the CNH and CHH children with mild and moderate losses. Audibility provided by hearing aids was found to moderate the effects of HL with respect to these outcomes. These findings emphasize the importance of including the effects of clinical interventions such as aided hearing when examining outcomes of CHH.

Auditory Performance and Subjective Satisfaction with the ADHEAR System

Background: The ADHEAR device, a new nonsurgical bone conduction hearing device, has been developed for patients with conductive hearing loss. Objectives: This study aims to assess the impact of the ADHEAR device on the audiological performance and satisfaction level in subjects with conductive hearing loss. Methods: Twelve patients with conductive hearing loss were included. All patients received the device for 3 months. The audiological outcomes were determined using basic audiological assessments, including pure tone audiometry and sound field measurements of pure tone and speech audiometry with the contralateral ear occluded with a specific earplug. Additionally, the patients were subjectively evaluated using (1) the Speech, Spatial, and Qualities Questionnaire (SSQ), and (2) the custom-made ADHEAR questionnaire. Results: Analysis of the measured audiological outcomes revealed an average improvement in pure tone thresholds (functional gain) of 23 (± 4.4) dB HL when the ADHEAR system was used compared to the unaided condition in the sound field. Moreover, speech reception thresholds improved by an average of 23 (± 15.3) dB SPL in the aided condition with plugged contralateral ear. Additionally, when using ADHEAR in the sound field, subjects’ speech recognition scores improved by 32% (± 17.7) in quiet and 21% (± 15.1) in the presence of interfering noise. The average SSQ questionnaire scores improved from 3.9 at the study initiation to 6.6 after 3 months of device usage. ADHEAR custom questionnaire assessments revealed high satisfaction and acceptance of the device with no pain or skin irritation. Conclusion: During the study period, this new adhesive system yielded improved audiological outcomes with high patient satisfaction and acceptance and no reported skin irritation or pain.

Effects of Contrast Therapy Using Infrared and Cryotherapy as Compared with Contrast Bath Therapy on Blood Flow, Muscle Tone, and Pain Threshold in Young Healthy Adults.

BackgroundThe aim of this research was to compare the effects of contrast bath therapy (CBT) and contrast therapy (CT) using infrared (IR) and cryotherapy (CR) on blood flow, muscle tone, and pain in the forearm.Material/MethodsTwenty healthy individuals participated in this study. Each participant received 2 kinds of CT separated by a week. CBT involved immersion in hot water (38–40°C) for 4 minutes, followed by 1 minute of immersion in cold water (12–14°C) for four rotations. CT using IR and CR was performed in the same manner as CBT.ResultsThe variables measured were blood flow, muscle tone, and pain before and after intervention. Both types of CT produced fluctuations in the blood flow (P<0.05). The pain threshold increased on both therapies; a significant increase was noted with IR and CR (P<0.05) therapies. Muscle elasticity was induced and stiffness was reduced with all therapies (P<0.05). IR and CR resulted in significant changes (P<0.05) in blood flow as compared with the CBT.ConclusionsThe results of this study suggest that CT using IR and CR is more effective in improving blood flow than CBT and has the same effect on muscle tone and pain. Nonetheless, using IR and CR is efficient with regard to mobility and maintaining temperature; therefore, it would be convenient to use these in clinical settings. Further studies involving CT should be carried out to determine whether our findings are clinically relevant.

Diagnostic accuracy of CE Chirp

ObjectiveThere has been an increase in the use of the CE-Chirp stimulus in automated auditory brainstem response (AABR) equipment for neonatal hearing screening. The purpose of this study is to evaluate the diagnostic accuracy of the LS CE-Chirp-evoked auditory brainstem response (ABR) compared to the click-evoked ABR for the identification of different degrees and configurations of sensorineural (SNHL) hearing loss. Method49 ears with mild to moderate SNHL were assessed: 16 ears with rising SNHL and 33 ears with sloping high frequency SNHL. Behavioural pure tone thresholds were obtained at 125–8000 Hz and ABR thresholds were measured using the click and LS CE-Chirp stimuli respectively. Click- and LS CE-Chirp-evoked thresholds were compared with each other and with behavioural pure tone average at 500, 1000, 2000 Hz (PTA), high frequency average at 2000, 4000, 8000 Hz (HFA) and low frequency average at 250, 500, 1000 Hz (LFA). Diagnostic accuracy of the two ABR stimuli was also compared by using ROC curves. ResultsDifferences between click- and LS CE Chirp-evoked ABR, and behavioural thresholds were not statistically significant (p > 0.05). The highest significant correlations for ABR using clicks to behavioural thresholds was found at 2000 and 4000 Hz, whereas, the highest correlation for LS CE-Chirp ABRs to behavioural thresholds was found at 1000, 2000 and 4000 Hz (r > 0.7, p < 0.001). A very strong, positive correlation was found between both click (r = 0.805, p < 0.001) and LS CE-Chirp (r = 0.825, p < 0.001) and the behavioural PTA. LS CE-Chirp ABR thresholds were closer to mid and low frequency thresholds than the click ABR while the click-evoked thresholds were in closer proximity to HFA. Sensitivity and specificity and false negative rates were identical. Diagnostic accuracy of the LS CE-Chirp ABR was equal to or better than click for low (area under the curve (AUC) = 0.83), mid (AUC = 0.89) and high frequency hearing losses (AUC = 0.73). However, scatterplots indicated more frequent underestimation of behavioural pure tone thresholds at mid and high frequencies with the LS CE-Chirp than for the click ABR. ConclusionThe diagnostic accuracy of the LS CE Chirp-evoked ABR is equivalent or better than the click-evoked ABR. The importance of ongoing surveillance and consideration of ABR screening protocols is consequently emphasized.

The ongoing search for cochlear synaptopathy in humans: Masked thresholds for brief tones in Threshold Equalizing Noise

This study aimed to advance towards a clinical diagnostic method for detection of cochlear synaptopathy with the hypothesis that synaptopathy should be manifested in elevated masked thresholds for brief tones. This hypothesis was tested in tinnitus sufferers, as they are thought to have some degree of synaptopathy. Near-normal-hearing tinnitus sufferers and their matched controls were asked to detect pure tones with durations of 5, 10, 100, and 200 ms presented in low- and high-level Threshold Equalizing Noise. In addition, lifetime noise exposure was estimated for all participants. Contrary to the hypothesis, there was no significant difference in masked thresholds for brief tones between tinnitus sufferers and their matched controls. Masked thresholds were also not related to lifetime noise exposure. There are two possible explanations of the results: 1) the participants in our study did not have cochlear synaptopathy, or 2) synaptopathy does not lead to elevated masked thresholds for brief tones. This study adds a new approach to the growing list of behavioral methods that attempted to detect potential signs of cochlear synaptopathy in humans.

Audiological Research Methods in the Diagnosis of Postoperative Cognitive Dysfunction

Introduction. faring loss may be a predictor or a kind of catalyst for cognitive disorders. This may indicate that audiological research methods can take their place in the diagnosis of cognitive impairments or in assessing the risk of their occurrence. The aim is to determine the sensitivity and specificity of audiological methods for the diagnosis of postoperative cognitive dysfunction (POCD). Material and methods . The study involved 40 patients (17 women and 23 men) aged 22 to 77 years. All patients underwent planned abdominal surgery or reconstructive operations on the vessels of the lower extremities using different types of anesthesia. Before and after the operation, all patients underwent neuropsychological assessment of their cognitive status and audiological examination (otoscopy, tonal threshold audiometry, speech tests). Results. The hearing thresholds in a tonal audiometry in all young patients were within normal limits. Peripheral hearing loss was detected in 11,8% of middle-aged patients and 81,8% of the elderly. Initial cognitive impairment based on the results of the MoCA test was also most often observed in a group of elderly patients. POCD was diagnosed in 63,6% of elderly patients, 35,3% of middle-aged and 8,3% of young patients. The results of preoperative speech testing revealed pronounced signs of a deficit in central processing of acoustic information in patients of all age groups. In all elderly patients, there were deviations in at least one of the speech tests, and in 63,6% ofpatients — in both tests (dichotic, RuMatrix). The high sensitivity of speech tests to the assessment of the probability of occurrence of POCD was revealed: for the dichotic test, the sensitivity was 85,7%, for the RuMatrix test 78,6%. Conclusions. Speech audiological tests are highly sensitive, which makes it appropriate to use them at the stage of preoperative diagnosis. Identify deviations from the norm in both speech tests at the preoperative stage may indicate a high probability of development of POCD.

Three-Year Follow-Up with the Bone Conduction Implant

Background: The bone conduction implant (BCI) is an active transcutaneous bone conduction device where the transducer has direct contact to the bone, and the skin is intact. Sixteen patients have been implanted with the BCI with a planned follow-up of 5 years. This study reports on hearing, quality of life, and objective measures up to 36 months of follow-up in 10 patients. Method: Repeated measures were performed at fitting and after 1, 3, 6, 12, and 36 months including sound field warble tone thresholds, speech recognition thresholds in quiet, speech recognition score in noise, and speech-to-noise thresholds for 50% correct words with adaptive noise. Three quality of life questionnaires were used to capture the benefit from the intervention, appreciation from different listening situations, and the ability to interact with other people when using the BCI. The results were compared to the unaided situation and a Ponto Pro Power on a soft band. The implant functionality was measured by nasal sound pressure, and the retention force from the audio processor against the skin was measured using a specially designed audio processor and a force gauge. Results: Audiometry and quality of life questionnaires using the BCI or the Ponto Pro Power on a soft band were significantly improved compared to the unaided situation and the results were statistically supported. There was generally no significant difference between the two devices. The nasal sound pressure remained stable over the study period and the force on the skin from the audio processor was 0.71 ± 0.22 N (mean ± 1 SD). Conclusion: The BCI improves the hearing ability for tones and speech perception in quiet and in noise for the indicated patients. The results are stable over a 3-year period, and the patients subjectively report a beneficial experience from using the BCI. The transducer performance and contact to the bone is unchanged over time, and the skin area under the audio processor remains without complications during the 3-year follow-up.

Stroke risk in African Americans with subclinical auditory dysfuntion evidenced by Distortion Product Otoacoustic Emissions: the Jackson heart study

Objective: Distortion product otoacoustic emissions (DPOAEs) are sensitive to early indices of cochlear pathology. Pathology to the cochlea is in part mediated by ischaemic related mechanisms. We propose that DPOAEs may provide an objective measure of cardiovascular risk. Design: Cross-sectional. Study sample: The relationships between stroke risk and DPOAEs of 1,107 individuals from the Jackson Heart Study (JHS), an all-African-American cohort, were assessed. Linear regression models were used for analysis among all participants and delimited to normal hearing, defined as either a pure-tone threshold average of 500, 1000, 2000, and 4000 Hz (PTA4) ≤ 25 dBHL or pure-tone thresholds for all individual tested frequencies for each ear (500, 1000, 2000, 4000, and 8000 Hz) ≤ 25 dBHL. Results: We observed a significant inverse relationship between DPOAE amplitudes and stroke risk scores in the pooled cohort and in the subgroups with normal hearing defined by pure tone thresholds. Participants in the high-risk group had significantly lower DPOAE amplitudes than those in the low stroke risk group. Conclusions: Our results indicate that auditory dysfunction as measured by DPOAEs are related to stroke risk. Further prospective studies are needed to determine if DPOAEs could be used as a predictive tool for cardiovascular disease.

Diagnostic capabilities of the vestibular evoked myogenic potential test in children with vestibular dysfunction

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Vestibular evoked myogenic potential (VEMP) testing is used in the diagnosis of vestibular disorders. It is an objective method for testing the the otolith organs of the vestibular system. VEMP test is an additional method for diagnosing vestibular neuritis (VN). The combination of cervical VEMP (cVEMP) and ocular VEMP (oVEMP) testing has an advantage in long-term monitoring of patients with VN. The VEMP test is well-studied for adults but studies involving children are insufficient. The aim of this study was to analysis and evaluation of the results from VEMP testing of children diagnosed with vestibular dysfunction. Analysis and evaluation of the results from VEMP testing of children diagnosed with vestibular dysfunction.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; History, examination of ENT organs, tone threshold audiometry, tympanometry, otoneurological examination, VEMP test. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Children with vestibular dysfunction who were examined showed changes predominantly in the oVEMP test. The upper branch of the vestibular nerve is affected. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; The VEMP test is an additional method for diagnosing patients with vestibular dysfunction. It is safe when used for children.&lt;/p&gt;

Study of effect of chronic suppurative otitis media on auditory brainstem response latency

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Chronic suppurative otitis media (CSOM) emerging as common hearing problems in the recent years with high prevalence requiring immediate attention. Hence, our study includes assessment of adult patients with CSOM using electrophysiological test, auditory brainstem response (ABR) and analysing the latency of ABR peaks in order to find the effect of CSOM on ABR latency with respect to shift in latency.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; The study followed cross sectional study design where data collected from March to September 2019 were used. A total of 50 subjects with unilateral CSOM were analysed. Descriptive statistics and paired t-test was used for statistical analysis of the data. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; The data was divided into 3 groups based on degree of hearing loss (mild, moderate and moderately severe). The Mean ABR peak latency was analysed and subjects showed a significant latency shift. Also, it was found that the magnitude of latency shift increased with increase in degree of hearing loss.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Hence the study concludes that as the amount of conductive component increases the pure tone threshold deteriorates and ABR latency gets affected. Also, the morphology of ABR peaks on comparison to the normal hearing ear gets affected due to constant conductive pathology in the pathological ear.&lt;/p&gt;&lt;p class="abstract"&gt; &lt;/p&gt;

Current principles of management of massive cholesteatoma and temporal bone pyramid defect

Objectives - to present a modern approach to the diagnosis and treatment of chronic suppurative otitis media with cholesteatoma, which led to a defect in the upper wall of the temporal bone pyramid. The case presented emphasizes the importance of timely diagnosis and treatment of this disease. Material and methods. Complaints, anamnesis, data from objective examination, additional methods of examination (high-frequency tone threshold audiometry multispiral computed tomography of temporal bones, diffusion-weighted magnetic resonance imaging of the brain). Conclusion. An innovative integrated approach, using radiological methods for studying the temporal bone (temporal bone multispiral CT, diffusion-weighted MRI of the brain), allows to diagnose cholesteatoma, the presence of bone-destructive changes in the structures of the middle and inner ear, as well as to determine the boundaries of the formed structure, which is important for planning modern surgical intervention.

Middle ear functional state in case of pathological changes of nose and throat

Objectives -to compare the functional state of middle ear in adults in case of various pathology of nasal cavity, paranasal sinuses and throat. Material and methods. In 2018-2019 period, 151 patient, aged from 16 to 70 years, was examined by acoustic impedancemetry. The patients reported the subjective satisfactory state of the acoustic organ, but had a pathology of the upper respiratory tract. Results. In the groups, there were no significant differences associated with gender. Most of the patients were of working age. In all study groups, the impaired function of the auditory tube, with various intensity, was registered, although the patients had no hearing complaints. At the same time, the acumetry and tonal threshold audiometry data indicated the normal acuity of hearing. Conclusion. Acute and chronic sinusitis was the most frequent risk factor for middle ear ventilation disorder. A quarter of patients with acute sinusitis, without otological complaints, had type B and C tympanograms. 93.7% of patients, who had undergone the surgical correction of the deviated nasal septum, did not have a middle ear ventilation disorder. Surgical intervention in the nasal cavity and oropharynx leads to a transient dysfunction of the auditory tube, but does not require special treatment due to self-recovery.

Mismatch Negativity Occurrence with Verbal and Nonverbal Stimuli in Normal-Hearing Adults.

Introduction The mismatch negativity (MMN) is a long-latency auditory evoked potential related to a passive elicited auditory event. Objective To verify the occurrence of MMN with different stimuli, to describe reference values in normal-hearing adults with verbal and nonverbal stimuli and to compare them with each other, besides analyzing the latency, area, and amplitude regarding gender and between the ears. Method Normal-hearing individuals, aged between 18 and 59 years old, participated in the study. As inclusion criterion in the study, all of them underwent tone threshold audiometry, logoaudiometry, tympanometry, and the Dichotic Sentence Identification (DSI) test, and later the MMN with 4 different stimuli, being 2 verbal (da/ta and ba/di) and 2 nonverbal stimuli (750/1,000Hz and 750/4,000Hz), which are considered stimuli with low and high contrast. Results A total of 90 individuals composed the sample, being 39 males and 51 females, with an average age of 26.9 years old. In the analysis of the latency, amplitude, and area of the four stimuli between the ears, they were not considered statistically different. There was a significant difference between all of the stimuli in terms of latency, amplitude and area, with the highest latency found in da/ta, and the greatest amplitude and area in ba/di. Regarding gender, there was only difference in the latency of the da/ta stimulus. Conclusion The da/ta and 750/1,000Hz stimuli elicited the most MMN in the population of normal-hearing adults. Among the genders, there was difference only regarding the latency of the verbal stimulus da/ta, and there was no difference between the ears.

Study protocol of the monocentric prospective randomized placebo-controlled double-blind phaseII study to explore the protective effects of the ginkgo biloba extract EGb761® from temporary noise-induced hearing loss

Hearing loss is frequently induced by occupational noise exposure and leads to rising hearing thresholds as well as reduced otoacoustic emissions (OAE), mostly caused by metabolic hair cell decompensation. Primary endpoint is the increase in average pure tone thresholds after noise exposure, secondary endpoints are loss of distortion product and click-evoked OAE as well as reduction of their contralateral suppression. The present study design describes the verification of the anti-oxidant and neuroprotective properties of EGb761® by evaluation of cochlear protection from noise impact as well as its safety and tolerance in 202 healthy male participants distributed equally to verum and placebo groups in a double-blind manner. Participants were assessed, medicated, exposed to noise, and then examined at timepoints up to 10min and 4weeks thereafter. This summary of the verification study protocol highlights the complexity of diligent and precise planning according to the European Medicines Agency criteria for controlled trials (EudraCT). Key points are the intervention rationale, definitions of in- and exclusion criteria, estimation of subject numbers, and examination method setting in terms of optimum endpoint description.

Labyrinth hydrops and its diagnosis

The article deals with the basic theories of maze and labyrinth hydrops, which are often used in clinical practice for its diagnosis according to the world literature. Tonal threshold, suprathreshold audiometry, broadband thympanometry, ultrasound tests, test for determination of lateralization of loud sounds, dehydration test, extra-timbanical electrocochleography, method of registration of evoked vestibular myogenic potentials, study of vestibular function (video pulse test, caloric sample), CT of temporal bones with gadolinium, MRI, and other methods are considered. None of these study methods gives an accurate confirmation of the presence of maze hydrops. Only taking into account the history, complaints of the patient, clinical manifestations of the disease and a comprehensive evaluation of the results of all the above methods of study can we speak with confidence about hydropse.

Hearing protective devices and its role in Noise induced hearing loss: An interventional study.

This Quasi experimental study was conducted with the objective to determine the effectiveness of preventive measures including awareness programme and use of hearing protective devices (HPDs) for the prevention and control of Noise Induced Hearing Loss among Oil and Gas field workers from January 2015 to March 2016. A total of 120 workers were selected by convenient sampling, and subjected to pure tone audiometry (PTA) to obtain hearing thresholds followed by intervention with HPDs and retesting a year later. The Mean pure tone thresholds on first visit was 21.19±11.60 dB in right and 24.66±13.26 dB in left ear, while means at second visit (after one year) were 20.65±10.44 dB and 21.45±11.74 dB for the right and left ears respectively with statistically significant difference (p=0.001) for the left ear on t-test. However the difference of frequency and percentage of the participants with normal and reduced hearing at both visits was significant (chi square P=0.001). Hearing protective devices (HPDs) are an effective means to prevent NIHL in workers of oil and gas fields.