Treatment Of Hearing Loss Research Articles

Prevalence of Hearing Impairment Among Systemic Lupus Erythematosus Patients

Background: Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease with varied manifestations, including potential auditory complications. Previous studies have indicated varying prevalence rates of hearing impairment among SLE patients, necessitating further research to understand the extent and nature of these auditory issues. Objective: The primary aim of this study was to assess the prevalence and characteristics of hearing impairment in SLE patients, with a focus on identifying the types and degrees of hearing loss and associated symptoms like tinnitus and vertigo. Methods: This observational, cross-sectional study involved 38 SLE patients from Sir Ganga Ram Hospital, Lahore, and DHQ Hospital, Bhimber, Kashmir. Participants underwent pure tone audiometry (PTA) to assess hearing impairment. Data were analyzed using SPSS version 24.0, with a focus on qualitative variables like gender, education, and socio-economic status. Patients with SLE-associated co-morbid factors affecting hearing were excluded. Results: The study found a 29% prevalence of hearing impairment among SLE patients, with sensorineural hearing loss being the most common type (21.1%). Conductive hearing loss and mixed hearing loss were observed in 2.6% and 5.3% of patients, respectively. The majority of hearing impairments were of mild to moderate degree. Additionally, 23.7% of patients reported tinnitus, and 18.45% experienced vertigo. Conclusion: The study concludes that hearing impairment, particularly sensorineural hearing loss of a mild to moderate degree, is a significant concern in SLE patients. The findings highlight the need for routine audiological assessments, including PTA and High Frequency Audiometry (HFA), in the management of SLE patients to facilitate early detection and treatment of hearing loss.

Injectable dexamethasone-loaded peptide hydrogel for therapy of radiation-induced ototoxicity by regulating the mTOR signaling pathway

Radiation-induced ototoxicity is associated with inflammation response and excessive reactive oxygen species in the cochlea. However, the effectiveness of many drugs in clinical settings is limited due to anatomical barriers in the inner ear and pharmacokinetic instability. To address this issue, we developed an injectable hydrogel called RADA32-HRN-dexamethasone (RHD). The RHD hydrogel possesses self-anti-inflammatory properties and can self-assemble into nanofibrous structures, ensuring controlled and sustained release of dexamethasone in the local region. Flow cytometry analysis revealed that the uptake of FITC-conjugated RHD gel by hair cells increased in a time-dependent manner. Compared to free dexamethasone solutions, dexamethasone-loaded RHD gel achieved a longer and more controlled release profile of dexamethasone. Additionally, RHD gel effectively protected against the inflammatory response, reduced excessive reactive oxygen species production, and reversed the decline in mitochondrial membrane potentials induced by ionizing radiation, leading to attenuation of apoptosis and DNA damage. Moreover, RHD gel promoted the recovery of outer hair cells and partially restored auditory function in mice exposed to ionizing radiation. These findings validated the protective effects of RHD gel against radiation-induced ototoxicity in both cell cultures and animal models. Furthermore, RHD gel enhanced the activity of the mammalian target of rapamycin (mTOR) signaling pathway, which was inhibited by ionizing radiation, thereby promoting the survival of hair cells. Importantly, intratympanic injections of RHD gel exhibited excellent biosafety and do not interfere with the anti-tumor effects of radiotherapy. In summary, our study demonstrates the therapeutic potential of injectable dexamethasone-loaded RHD hydrogel for the treatment of radiation-induced hearing loss by regulating the mTOR signaling pathway.

Communication is key: at-risk families’ perspectives on follow-up in New Jersey’s early hearing detection and intervention program

ABSTRACT Babies whose families possess multiple marginalized identities are at-risk for being late or lost to follow-up although there is a universal effort to screen and treat hearing loss in babies as part of state Early Hearing Detection and Intervention (EHDI) programs. Lack of timely follow-up puts young children at risk for delays in language acquisition, social skills, cognitive development, and school success. This qualitative study explored barriers to follow-up audiological care in at-risk families in New Jersey. Using thematic analysis, this research uncovered two major findings: 1) communication normalizes failed screenings, and 2) parents need clearer and more in-depth information. Health care social workers are well-suited to address these challenges due to their training in integrated social work practice, which can help them understand the complex interplay between individuals and their environments. In doing so social workers can improve access to needed services and promote health equity.

Cause, severity, and efficacy of treatment for hearing loss in children with Trisomy 18: A single institution-based retrospective study.

Trisomy 18 is a common chromosomal aberration syndrome, characterized by variable clinical manifestations, including cardiovascular, pulmonary, genitourinary, and musculoskeletal findings, leading to a shorter survival and severe developmental delay in survivors. However, recently, intensive therapeutic intervention has allowed for prolonging survival. In terms of otological complications, only a limited number of relevant reports have been published. To demonstrate the characteristic of hearing loss (HL) in children with Trisomy 18, we retrospectively evaluated 22 patients (44 ears) by comprehensive auditory evaluation with the auditory steady-state response (ASSR) test and temporal bone computed tomography (CT). ASSR revealed that 20 patients (91%) had bilateral moderate to profound HL, more frequent and severe than that in Trisomy 21; among 42 ears having HL, 12 ears (29%) had conductive HL, and 26 ears (62%) had mixed HL. CT scans of 38 ears revealed that 34 ears (89%) had an external and middle ear malformation. Hearing aids (HA) were fitted in 17 patients (air and bone-conduction HAs). The threshold hearing with HA was improved in all of them. Accurate otological evaluation using ASSR and CT and intervention by HAs could be a feasible choice for children with Trisomy 18.

Drug screening identifies aldose reductase as a novel target for treating cisplatin-induced hearing loss

Cisplatin is a frequently used chemotherapeutic medicine for cancer treatment. Permanent hearing loss is one of the most serious side effects of cisplatin, but there are few FDA-approved medicines to prevent it. We applied high-through screening and target fishing and identified aldose reductase, a key enzyme of the polyol pathway, as a novel target for treating cisplatin ototoxicity. Cisplatin treatment significantly increased the expression level and enzyme activity of aldose reductase in the cochlear sensory epithelium. Genetic knockdown or pharmacological inhibition of aldose reductase showed a significant protective effect on cochlear hair cells. Cisplatin-induced overactivation of aldose reductase led to the decrease of NADPH/NADP+ and GSH/GSSG ratios, as well as the increase of oxidative stress, and contributed to hair cell death. Results of target prediction, molecular docking, and enzyme activity detection further identified that Tiliroside was an effective inhibitor of aldose reductase. Tiliroside was proven to inhibit the enzymatic activity of aldose reductase via competitively interfering with the substrate-binding region. Both Tiliroside and another clinically approved aldose reductase inhibitor, Epalrestat, inhibited cisplatin-induced oxidative stress and subsequent cell death and thus protected hearing function. These findings discovered the role of aldose reductase in the pathogenesis of cisplatin-induced deafness and identified aldose reductase as a new target for the prevention and treatment of hearing loss.

Age-Related Hearing Loss and Prevention Strategies

With increasing life expectancy and percentage of older population, USA is experiencing a rise in the diseases of old age. One such disease is presbycusis, or hearing loss in elderly. In 2023, approximately two-thirds of Americans aged 70 or above are affected by this disease (1). Many of these cases often go undiagnosed and untreated. In this article, we provide an overview of presbycusis and discuss strategies to prevent hearing loss and review treatment options when impacted.

Cognitive function in older adults with hearing loss; outcomes for treated versus untreated groups at 3‐year follow‐up.

AbstractBackgroundHearing loss has been identified as the largest potentially modifiable risk factor for dementia and affects 50% adults aged 50‐64 years, and 70% aged 70 years and older. The quality of evidence the effect of hearing aid use on cognition in older adults is currently poor due to methodological limitations. Few studies have objectively studied these outcomes beyond 6‐12 months. This prospective longitudinal observational cohort study investigated the effects of hearing aid use on cognitive performance in older adults over 3 years.Method183 first‐time hearing aid users aged 60 years and older with mild to severe hearing loss were assessed using gold standard measures before hearing aid fitting, with subsets of this group re‐assessed after 18 and 36 months as they reached these timepoints. Outcomes for the treatment group were compared with those of participants of a large longitudinal cohort study of community‐living older adults (AIBL) using the same measures. Objective assessment measures included cognitive function, hearing loss, hearing aid use, genetic phenotyping, and speech perception. Subjective measures included hearing disability, mood, quality of life, social isolation, and loneliness.ResultThe treatment group showed good hearing aid compliance, significant improvement in speech perception (quiet and noise) and decreased self‐reported listening disability despite further significant hearing loss over the 3‐year follow‐up. There was significant improvement in cognitive performance from baseline for the treatment group versus the comparative group for working memory, attention, psychomotor function, and visual learning. Comparatively, AIBL participants showed statistically significant decline across all cognitive functions.ConclusionOlder adults with untreated hearing loss are expected to decline cognitively at 2‐5 times the rate of adults without hearing loss. Comparatively, cognitive performance in treated participants in this study instead improved after 3 years of hearing aid use, while the comparative group declined. These results suggest that treatment of hearing loss with hearing aids may delay cognitive decline.

Assessing the feasibility of a randomised controlled trial examining the effect of hearing aids on cognitive decline in elderly individuals: a study protocol

IntroductionHearing loss is one of the leading potentially modifiable risk factors for dementia. There is growing evidence suggesting that treating hearing loss with hearing aids could be a relatively low-cost...

Pregnant Patients with Sudden Sensorineural Hearing Loss: Treatments and Efficacy.

The aim of this study was to study the safety and effectiveness of oral and tympanic hormone injection in the treatment of sudden sensorineural hearing loss during pregnancy. Data were collected via prospective method. A total of 102 pregnant women with sensorineural hearing loss as experimental group and another 102 patients of sensorineural hearing loss without pregnancy as control group were simultaneously included in the study. Pure tone audiometry test was examined at pre- and posttreatment in 1 week, 2 weeks, and 12 weeks. The experimental group received oral and tympanic hormones, while the control group was treated with the Clinical Practice Guideline: Sudden Hearing Loss (2019) of USA. Recovery rate and hearing gain were assessed by the Clinical Practice Guidelines. After treatment, the effects of the experimental group and the control group were compared at the 1st, 2nd, and 12th week after treatment. It was found that at the 12th week after treatment, the curative effect of the experimental group was significantly different from that of the control group, and the difference was statistically significant. The pregnant women with sensorineural hearing loss were more serious than nonpregnant women, and the treatment efficacies were worse than control group. For pregnancy patients with sudden deafness, oral steroids and tympanic cavity injection is an effective, safe first-line treatment options.

SA11 A Systematic Review on the Safety and Effectiveness of the Active Middle Ear Implant in the Treatment of Conductive and Mixed Hearing Loss

SA11 A Systematic Review on the Safety and Effectiveness of the Active Middle Ear Implant in the Treatment of Conductive and Mixed Hearing Loss

HSD122 A Systematic Review on Equal Access to Treatment for Hearing Loss in Chile: Do All People Have the Same Opportunities to Receive Appropriate Treatment?

HSD122 A Systematic Review on Equal Access to Treatment for Hearing Loss in Chile: Do All People Have the Same Opportunities to Receive Appropriate Treatment?

Optogenetics Reveals Roles for Supporting Cells in Force Transmission to and From Outer Hair Cells in the Mouse Cochlea.

Outer hair cells (OHCs) of the organ of Corti (OoC), acting as bidirectional cellular mechanoelectrical transducers, generate, receive, and exchange forces with other major elements of the cochlear partition, including the sensory inner hair cells (IHCs). Force exchange is mediated via a supporting cell scaffold, including Deiters' (DC) and outer pillar cells (OPC), to enable the sensitivity and exquisite frequency selectivity of the mammalian cochlea and to transmit its responses to the auditory nerve. To selectively activate DCs and OPCs in male and female mice, we conditionally expressed in them a hyperpolarizing halorhodopsin (HOP), a light-gated inward chloride ion pump, and measured extracellular receptor potentials (ERPs) and their DC component (ERPDCs) from the cortilymph, which fills the OoC fluid spaces, and compared the responses with similar potentials from HOP-/- littermates. The compound action potentials (CAP) of the auditory nerve were measured as an indication of IHC activity and transmission of cochlear responses to the CNS. HOP light-activated hyperpolarization of DCs and OPCs suppressed cochlear amplification through changing the timing of its feedback, altered basilar membrane (BM) responses to tones at all measured levels and frequencies, and reduced IHC excitation. HOP activation findings reported here complement recent studies that revealed channelrhodopsin activation depolarized DCs and OPCs and effectively bypassed, rather than blocked, the control of OHC mechanical and electrical responses to sound and their contribution to timed and directed electromechanical feedback to the mammalian cochlea. Moreover, our findings identify DCs and OPCs as potential targets for the treatment of noise-induced hearing loss.

Cultural Adaptation and administration of public awareness questionnaire on hearing health and hearing loss in Karnataka: A cross-sectional study

Background: Maintaining good hearing health is crucial for effective communication and awareness of one’s surroundings. However, if not adequately addressed, various factors such as lifestyle, illness, genetic disorders, age, and leisure activities can contribute to hearing loss. This study seeks to culturally adapt, administer, and evaluate public awareness of hearing loss and hearing health in Karnataka. It is essential to prioritize hearing health and take proactive measures to prevent and treat hearing loss. Methods: The design used in this study was a cross-sectional survey design. The sampling method used in this study was Quota sampling. In total, 720 participants aged 20–60 completed a culturally adapted questionnaire. The questionnaire consisted of 22 questions targeting the awareness of hearing loss and hearing health, focusing on four domains: (1) Knowledge about infant hearing loss, (2) Cleaning and treatment, (3) The effect of overexposure to noise and loud sounds, (4) Diagnostic delay. Results: Approximately 70% of the correct responses were given to almost all the statements. However, specific essential Knowledge on the impact of tinnitus on hearing and the use of ear protective devices during noise exposure was lacking. Only 56% and 50.23% knew about specialized tests available for a hearing evaluation and the recommended standards on the duration of noise exposure. Conclusions: It is essential to increase public awareness of the impact of ringing sensation on a person’s daily activities. Many people need to be aware of the guidelines for reducing exposure to high-intensity noises, which underscores the need for informative initiatives on noise reduction. The audiological questionnaire used was simple, practical, and reliable, and the results showed the need for ongoing development of hearing conservation programs. To ensure continued progress, these programs should focus on hearing aid management, early detection of infant hearing loss, and noise exposure prevention.

Comparison of Transcutaneous and Percutaneous Implantable Hearing Devices for the Management of Congenital Aural Atresia: A Systematic Review and Meta-Analysis

Objective To compare audiometric outcomes, complications, and revisions required for percutaneous (pBCD) versus transcutaneous (tBCD) implantable bone-conduction devices for the treatment of hearing loss associated with congenital aural atresia (CAA). Databases Reviewed. PubMed, Scopus, CINAHL. Methods A systematic review was performed searching for English language articles from inception to December 14, 2022. Studies reporting audiometric outcomes or complications for either pBCDs or tBCDs for the treatment of CAA were selected for inclusion. A meta-analysis of single means and meta-analysis of proportions with comparison (Δ) of weighted proportions was conducted. Results A total of 56 articles with 756 patients were selected for inclusion. One hundred ninety patients were implanted with pBCDs, whereas the remaining 566 were implanted with tBCDs. Mean pure-tone audiometry improvement in the pBCD group (39.1 ± 1.1 dB) was significantly higher than in the tBCD group (34.6 ± 1.6 dB; Δ4.5 dB; 95% confidence interval, 4.2–4.7 dB; p < 0.0001). The average improvement in speech reception threshold was 38.6 ± 2.5 dB in the percutaneous group as compared with 32.7 ± 1.6 dB in the transcutaneous group (Δ5.9 dB [5.3–6.5 dB], p < 0.0001). Overall complication rates for patients implanted with pBCDs and tBCDs were 29.0% (15.7–44.4%) and 9.4% (6.5%–13.0%), respectively (Δ19.6% [12.0–27.7%], p < 0.0001). Conclusions Patients with CAA implanted with pBCDs had significantly better audiometric outcomes than those implanted with tBCDs. However, complication rates were significantly higher among the pBCD group.

The Association of Race With Decreased Access to Pediatric Hearing Healthcare in the United States.

Successful intervention to support a child with congenital hearing loss requires early identification and consistent access to frequent professional services. In the early 2000s, the United States implemented an initiative, Early Hearing Detection and Intervention (EHDI), to provide timely identification and treatment of congenital hearing loss. This national program aims to screen hearing by 1 month of age, diagnose hearing loss by 3 months of age, and provide intervention to infants with hearing loss by 6 months of age. To date, the United States is successfully implementing hearing screening by 1 month of age but continually struggling to diagnose and treat congenital hearing loss promptly for many infants. This article begins by exploring the current state of American children and families, focusing on social determinants of health, specifically race and poverty. The objective is to understand how race affects social determinants of health, and ultimately hearing healthcare access for children. A narrative literature review spanning public health, sociology, and hearing research was completed to inform this work. The current body of literature supports the conclusion that race and racism, separate from poverty, lead to decreased access to pediatric hearing healthcare. Interventions targeting these issues are necessary to improve timely access to hearing loss diagnosis and treatment for American children.

Evaluation of different strategies for using steroids in the treatment of sudden sensorineural hearing loss

Introduction. Sudden sensorineural hearing loss is manifested by sudden or rapid hearing loss without obvious disturbances in the outer and middle ear. Often the cause of this condition is not established. At the moment, various methods are used in the treatment, including corticosteroids, which are most often used as primary therapy. Recent studies demonstrate the effectiveness of topical steroid administration.Aim. Assess the effectiveness and safety of various methods of topical and standard systemic use dexamethasone in the treatment of patients with acute sensorineural hearing loss, as well as to determine the optimal timing of therapy.Materials and methods. 61 patients with this disease were treated in the study. 20 of them received dexamethasone transtubarly, 21 – transtympanic, and 20 – systemically. Audiological examination was performed on all patients before treatment, at discharge, a month and six months after discharge. All participants regularly assessed their discomfort on a 10-point scale. Results. The results of treatment demonstrated the effectiveness of both systemic and local steroid therapy in patients with sensorineural hearing loss; however, with topical use of the drug, the proportion of patients with complete hearing restoration was greater. Transtympanic introduction of steroids after radiowave myringotomy turned out to be the most comfortable for patients the level of discomfort was 1.5 points out of 10, while against the background of transtubal administration of the drug and systemic treatment it was 4.5 and 2.3 points, respectively.Conclusions. The method of transtympanic administration of corticosteroids in patients with acute sensorineural hearing loss after radiowave myringotomy is a reliable and effective method of drug delivery to the windows of the labyrinth. This approach allows you to visually control the process of introducing the medication into the tympanic cavity. Transtympanic and transtubal methods of steroid administration are comparable in effectiveness to classical systemic steroid therapy in the treatment of patients with acute sensorineural hearing loss.

Controlled release of dexamethasone from fibrin sealant for intratympanic administration in inner ear therapy

The aim of the present work was to show the sustainability of fibrin sealant in releasing dexamethasone and adjust the protocol for clinical application of the novel method in the treatment of Meniere's disease (MD) and sudden sensorineural hearing loss (SSHL). Gelation occurred shortly after mixing dexamethasone-containing fibrinogen with thrombin. Dexamethasone was constantly released for at least 16 d at a stable level after 7 d in protocol 1 (low-dose), while it was robustly released within 4 d and slowed afterward until 10 d in protocol 2 (high-dose). There were significant differences among the time points in Protocol 2 (p < 0.01, ANOVA), and the exponential model with the formula y = 15.299 * e−0.483 *t fits the association. The estimated concentration of dexamethasone released on 7 d in protocol 2 was slightly lower than that observed in protocol 1. The fibrin sealant is capable of constantly releasing dexamethasone with adjustable dynamics. Targeted and minimally invasive administration of the material can be achieved in the clinic by sequential injections of the fluids using a soft-tipped catheter.

Hearing Loss in Older People With Schizophrenia: Audiologic Characteristics and Association With Psychosocial Functioning

The severity and impact of hearing deficits among adults with schizophrenia spectrum disorders may become increasingly relevant with advancing age. This study evaluated hearing ability and associated psychosocial functioning among older adults aged 50-70. Cross-sectional analysis. Four outpatient psychiatry clinics in New York City. Individuals aged 50-70 years with diagnoses of schizophrenia or schizoaffective disorder. Unaided pure tone air conduction audiometry conducted using a portable audiometry system determined the pure tone average (PTA) hearing threshold across four frequencies: 500, 1k, 2k, and 4k Hz. Better ear PTA defined the hearing threshold. Audiometry data retrieved from the U.S. National Health and Nutrition Examination Survey aided interpretation of sample hearing loss rates. Standard measures evaluated psychiatric symptoms, perceived impact of hearing impairment, loneliness, and quality of life. Among audiometry completers (N = 40), 35% (n = 14) demonstrated subclinical hearing loss (16-25 dB) and 35% (n = 14) had mild or worse hearing loss (≥26 dB). Rates were higher than expected based on age-based population data. Those who perceived hearing handicap rated it moderate (12.2%) or severe (7.3%); those who perceived tinnitus rated the impact as mild to moderate (12.2%) or catastrophic (2.4%). Neither psychiatric symptoms nor interviewer-rated quality of life was associated with hearing ability. Greater loneliness was significantly correlated with worse audiologic performance (r = 0.475, p <0.01) and greater perceived hearing handicap (r = 0.480, p <0.01). Identifying the need for hearing loss treatment among aging adults with schizophrenia spectrum disorders is important given the potential implications for social functioning, cognitive, and mental health.

Digital Health Literacy: Evaluating the Readability and Reliability of Cochlear Implant Patient Information on the Web.

Hearing aids and implants are used to treat hearing loss, with cochlear implants being the most successful option for severe sensorineural hearing loss. Patients frequently use the internet as a trusted source of clinical information before committing to any therapeutic procedure, including receiving a cochlear implant. A health resource's readability and dependability influence its value to patients. Readability refers to how easily language can be understood, whereas reliability refers to the correctness and consistency of the information presented. JAMA standards and the DISCERN tool were used to assess the reliability of the websites listed. For readability analysis, the FRE, FKG and GFI were chosen. The acceptable readability level was set to < 7 for the FKG, GF score over 17 as the equivalent of college-level education and ≥ 80.0 for the FRE. The readability scores vary across the sources, suggesting a range of comprehension levels required for understanding the cochlear implant patient information found on Google. There was a statistical difference detected in Discern score between the groups (p = 0.008). The mean discern score was significantly higher in hospital generated sources when compared to industry (3.13±0.69 vs. 2.11±0.78, p = 0.03).

Associations Between Age-Related Hearing Loss, Cognitive Impairment, and Multiple Chronic Conditions in a Group Care Setting.

The purpose of this study was to explore the relationships between hearing loss, cognitive status, and a range of health outcomes over a period of 2 years in a sample of older adults who are enrolled in Program of All-Inclusive Care for the Elderly, which is a Medicare/Medicaid beneficiary program for individuals who are nursing home eligible but living in the community at time of enrollment. The sample (N = 144) includes a diverse (47% White/non-Hispanic, 35% Black/African American, and 16% Latin/Hispanic) group of adults ranging from 55 to 93 years old. We used medical chart data to measure respondents' cognitive and health status, including chronic conditions and hospital use. Hearing status was measured once at the beginning of the 2-year review period. We used logistic regression and negative binomial hurdle models for analyses. We used latent class analysis (LCA) to explore the extent to which respondents cluster into a set of "health profiles" characterized by their hearing, cognitive status, and health conditions. We found that hearing loss is weakly associated with heart disease and diabetes and associated with cerebrovascular disease and falls; cognitive impairment is also associated with cerebrovascular disease and the number of falls. LCA indicates that respondents cluster into a variety of health profiles with a consistent pairing of hearing loss and depression. The results are largely consistent with associations reported in epidemiological studies that include age-related hearing loss. Of particular interest in this study is the LCA that suggested that all of the profiles associated with a high likelihood of hearing loss included a high risk of depression. The co-occurrence of these two factors highlights the need to identify and treat hearing loss in older adults, especially as part of the treatment plan for individuals with depressive symptoms.