Worse Hearing Loss Research Articles

Prevalence of Childhood Hearing Loss and Secular Trends: A Systematic Review and Meta-Analysis

BackgroundBetter epidemiologic information on childhood hearing loss would inform research priorities and efforts to prevent its progression. ObjectivesTo estimate prevalence and secular trends in children's hearing loss. Data SourcesWe searched MEDLINE and Embase from January 1996 to August 2017. Study Eligibility CriteriaWe included epidemiologic studies in English reporting hearing loss prevalence. Study Appraisal and Synthesis MethodsThe modified Leboeuf-Yde and Lauritsen tool was used to assess methodological quality. Meta-analyses combined study-specific estimates using random-effects models. ParticipantsChildren 0 to 18 years of age. ResultsAmong 88 eligible studies, 43.2% included audiometric measurement of speech frequencies. In meta-analyses, pooled prevalence estimates of slight or worse bilateral speech frequency losses >15 decibels hearing level (dB HL) were 13.1% (95% confidence interval [CI], 10.0–17.0). Using progressively more stringent cutpoints, pooled prevalence estimates were 8.1% (95% CI, 1.3–19.8) with >20 dB HL, 2.2% (95% CI, 1.4–3.0) with >25 dB HL, 1.8% (95% CI, 0.4–4.1) with >30 dB HL, and 0.9% (95% CI, 0.1–2.6) with >40 dB HL. Also, 8.9% (95% CI, 6.4–12.3) had likely sensorineural losses >15 dB HL in 1 or both ears, and 1.2% (95% CI, 0.5–2.1) had self-reported hearing loss. From 1990 to 2010, the prevalence of losses >15 dB HL in 1 or both ears rose substantially (all P for trend <.001). LimitationsThe studies had high heterogeneity and offered limited information for hearing loss types and secular trend. Conclusions and ImplicationsChildhood slight or worse hearing loss is prevalent and may be increasing. Advances in understanding hearing loss trajectories, causes, and prevention would require international repositories and longitudinal studies with audiometric data beginning in childhood. Systematic Review Registration NumberPROSPERO 2016 CRD42016034148.

Tunnel driving occupational environment and hearing loss in train drivers in China

ObjectiveHearing loss caused by high levels of noise is a potential occupational health disorder among train drivers around the world. This study aims to investigate the relationship between tunnel driving...

Type 2 diabetes and the risk of incident hearing loss.

Type 2 diabetes mellitus has been implicated as a risk factor for hearing loss, with possible mechanisms including microvascular disease, acoustic neuropathy or oxidative stress. A few small studies have examined the longitudinal association between type 2 diabetes and hearing loss, but larger studies are needed. Our objective was to examine whether type 2 diabetes (including diabetes duration) is associated with incident hearing loss in two prospective cohorts: Nurses' Health Studies (NHS) I and II. We conducted a longitudinal study of 139,909 women to examine the relationship between type 2 diabetes and the risk of self-reported incident hearing loss. A physician-diagnosis of diabetes was ascertained from biennial questionnaires. The primary outcome was hearing loss reported as moderate or worse in severity (categorised as a 'moderate or severe' hearing problem, or 'moderate hearing trouble or deaf') on questionnaires administered in 2012 in NHS I and 2009 or 2013 in NHS II. Cox proportional hazards regression was used to adjust for potential confounders. During >2.4 million person-years of follow-up, 664 cases of moderate or worse hearing loss were reported among those with type 2 diabetes and 10,022 cases among those without type 2 diabetes. Compared with women who did not have type 2 diabetes, those with type 2 diabetes were at higher risk for incident moderate or worse hearing loss (pooled multivariable-adjusted HR 1.16 [95% CI 1.07, 1.27]). Participants who had type 2 diabetes for ≥8years had a higher risk of moderate or worse hearing loss compared with those without type 2 diabetes (pooled multivariable-adjusted HR 1.24 [95% CI 1.10, 1.40]). In this large longitudinal study, type 2 diabetes was associated with a modestly higher risk of moderate or worse hearing loss. Furthermore, longer duration diabetes was associated with a higher risk of moderate or worse hearing loss.

Adherence to Healthful Dietary Patterns Is Associated with Lower Risk of Hearing Loss in Women

Specific nutrients have been associated with hearing status, but associations between healthful dietary patterns and risk of hearing loss have not been prospectively evaluated. We sought to prospectively examine the relations between adherence to the Alternate Mediterranean diet (AMED), the Dietary Approaches to Stop Hypertension (DASH), and the Alternative Healthy Eating Index-2010 (AHEI-2010), and risk of hearing loss. We conducted a longitudinal cohort study (1991-2013) of 81,818 women in the Nurses' Health Study II, aged 27-44 y at baseline. We assessed diet every 4 y with the use of food frequency questionnaires and calculated AMED, DASH, and AHEI-2010 adherence scores. Baseline and updated information from validated biennial questionnaires was used in Cox proportional hazards regression models to examine independent associations between adherence scores and risk of self-reported moderate or worse hearing loss. During >1 million person-years of follow-up, 2306 cases of moderate or worse hearing loss were reported. Higher cumulative average AMED and DASH scores were significantly inversely associated with risk of hearing loss. For women with scores in the highest compared with the lowest quintile, the multivariable-adjusted relative risks (MVRRs) of hearing loss were 0.70 (95% CI: 0.60, 0.82) (P-trend <0.001) for AMED and 0.71 (95% CI: 0.61, 0.83) (P-trend <0.001) for DASH. Higher recent AHEI-2010 score was also associated with lower risk [MVRR=0.79 (95% CI: 0.69, 0.91); P-trend <0.001]. Among participants with additional hearing-related information (n=33,102), higher cumulative average adherence scores for all 3 dietary patterns were associated with lower risk; the MVRR was 0.63 (95% CI: 0.49, 0.81) for AMED, 0.64 (95% CI: 0.50, 0.83) for DASH, and 0.71 (95% CI: 0.56, 0.89) for AHEI-2010. Adherence to healthful dietary patterns is associated with lower risk of hearing loss in women. Consuming a healthy diet may be helpful in reducing the risk of acquired hearing loss.

Characteristics and Progression of Hearing Loss in Children with Down Syndrome

To evaluate hearing impairment in children with Down syndrome, and to describe the factors that influence the severity of hearing loss or changes in hearing over time. Using the Audiological and Genetic Database (AudGenDB), audiograms of children with Down syndrome were analyzed retrospectively for type, severity, and laterality of hearing loss, as well as changes over time. Medical charts and imaging results were reviewed to identify factors influencing hearing loss. Among the 1088 patients with Down syndrome included in the study, 921 had hearing loss in at least 1 ear, 91.1% had bilateral hearing loss, and 8.9% had unilateral hearing loss (1760 total ears with hearing loss). Of the ears with hearing loss, 18.8% (n = 180) had moderate or worse hearing loss. "Undefined" hearing loss and pure conductive hearing loss (CHL) were the most common types, followed by mixed hearing loss and sensorineural hearing loss (SNHL). Three-quarters (75.4%) of the children had experienced chronic otitis media or more than 2 episodes of acute otitis media. Patients with bilateral, mixed hearing loss or a history of seizures were at risk for more severe hearing loss. CHL, absence of cholesteatoma, and placement of first ear tubes before age 2 years were associated with greater improvement in hearing over time, whereas SNHL and mixed hearing loss were associated with progressive decline. Children with Down syndrome who have bilateral, mixed hearing loss or a history of seizures are at risk for more severe hearing loss. SNHL and mixed hearing loss should not be overlooked in patients with CHL. All patients with Down syndrome will benefit from serial audiograms, especially those children with SNHL or mixed hearing loss, which is likely to worsen over time.

Audiologic and otologic phenotype in children with Duane's Retraction Syndrome: A rare ophthalmologic disorder

ObjectiveThe focus of this study was to evaluate the prevalence, type, and severity of hearing impairment in patients with Duane's Retraction Syndrome and to relate these measures to patient demographics and other otologic and audiologic factors. Study designRetrospective AudGen Database analysis SettingTertiary academic referral center PatientsPediatric patients in AudGenDB with a diagnosis of Duane's Retraction Syndrome (DRS). InterventionsAppropriate audiologic, otologic, and demographic data were recorded. Main outcome measureSeventy-nine patients (n = 79) met inclusion criteria. The first encounter with available audiometric data or the first encounter with hearing loss were documented. Audiograms were stratified by type and severity of hearing loss, and common associated medical issues were documented. Results57 children had normal hearing; 22 had hearing loss. 9 ears had pure conductive hearing loss, 1 had pure sensorineural, 14 ears had components of both, and 79 had hearing loss that could not be specified. Multivariate regression revealed episodes of chronic otitis and craniofacial anomalies are associated with worse hearing loss. ConclusionThis study presents a detailed characterization of hearing loss in patients with Duane's retraction syndrome. Conductive and sensorineural hearing loss are both prevalent among these children. Careful and early audiologic evaluation of all patients with DRS is important.

Vitamin A supplementation in preschool children and risk of hearing loss as adolescents and young adults in rural Nepal: randomised trial cohort follow-up study

Objective To determine whether vitamin A supplementation administered in the preschool years can lower the risk of hearing loss in adolescence and adulthood.Design Follow-up study of adolescents and young adults...

Accuracy of Siemens HearCheck™ Navigator as a Screening Tool for Hearing Loss

Objective: To calculate the accuracy, sensitivity, specificity and positive predictive values of the Siemens HearCheck™ Navigator in detecting hearing loss and to compare values of these parameters when the examination is done in a soundproof booth and in a quiet room.&#x0D; &#x0D; Methods:&#x0D; Design: Analytical, cross-sectional study&#x0D; Setting: Tertiary Public University Hospital&#x0D; Patients: Patients seen at the Ear Unit of a tertiary public university hospital from June 2009 to August 2010 were tested using the Siemens HearCheck™ Navigator and pure tone audiometry, inside a soundproof audiometry booth and in a quiet room with an ambient noise of 50dB, with a different investigator for each examination. Each ear was treated as a separate subject. Results obtained from the HearCheck™ Navigator were designated as observed values and were classified as “no hearing loss” for green light, and “with hearing loss” for yellow or red lights. Results were compared with pure tone air conduction averages designated as gold standard values. Normal hearing acuity (0-25 dB) was classified as no hearing loss. Pure tone air conduction averages of 26dB and above were classified as “with hearing loss” and were further stratified as mild hearing loss (26-40dB) and moderate or worse hearing loss (&gt;41 dB). Observed and gold standard values were compared and tabulated in a 2x2 table for all levels of hearing loss, mild hearing loss, and moderate or worse hearing loss. Accuracy, sensitivity, specificity, positive and negative predictive values of the Siemens HearCheck™ Navigator inside a soundproof audiometry booth and in a quiet room were determined using pure tone audiometry as the gold standard.&#x0D; &#x0D; Results: 100 patients (200 ears) were tested, with a median age of 43 years old (range 15-75), and an almost equal number of male and female participants (52 males, 48 females). Accuracy rate of the Siemens HearCheck™ Navigator inside the soundproof audiometry booth and in a quiet room were 82.5% and 84% respectively for all levels of hearing loss. Sensitivity, specificity, positive and negative predictive values were similar whether the examination was done inside the soundproof audiometry booth or in a quiet room. These values were notably higher in patients with moderate or worse hearing loss compared to patients with mild hearing loss.&#x0D; &#x0D; Conclusion: The Siemens HearCheck™ Navigator shows potential as an accurate, portable, easy-to-use tool to screen for hearing loss, especially for cases of moderate or worse hearing loss, without the need for soundproof audiometry booths or special training. It is recommended that further studies be done to differentiate degrees of hearing loss, and to evaluate its usefulness in other target populations, including school children and the elderly.&#x0D; &#x0D; Keywords: hearing screening, hearing screening tool, accuracy, hearingloss, HearCheck™ Navigator

Relationship between self-reported hearing and measured hearing impairment in an elderly population in Finland

Objective: The objective of this study was to evaluate the usefulness of the Finnish version of the Hearing Handicap Inventory for Elderly Screening (HHIE-S) questionnaire and a simple single-question method in detecting hearing loss. Design: We compared the HHIE-S score and the single question with audiometry results. By analysing the receiver operating characteristic (ROC) curves of the HHIE-S scores we estimated the appropriate cut-off points for the different degrees of hearing loss. Study Sample: 164 home-dwelling subjects in the age cohorts of 70, 75, 80 and 85 years in an industrialized town in Finland filled in the questionnaire, and attended the audiometry. Results: For the detection of moderate or worse hearing loss (i.e., pure tone average at 0.5-4 kHz frequencies >40 dB), the HHIE-S cut-off score of >8 had a sensitivity of 100% and a specificity of 59.7%. The single question had a sensitivity of 100% and a specificity of 70.7%. Thus, the single question was equally sensitive and more specific in detecting moderate or worse hearing loss than the HHIE-S score. However, for the detection of mild hearing loss (i.e., pure tone average >25 dB), the HHIE-S was more sensitive but less specific than the single question.SumarioObjetivo: El objetivo de este estudio fue evaluar la utilidad de la versión finlandesa del Cuestionario para la Identificación de Discapacidad Auditiva de Adultos Mayores (HHIE-S) y la de un método simple de una sola pregunta para detectar pérdidas auditivas. Diseño: Comparamos la puntuación del HHIE-S y de la pregunta aislada con los resultados audiométricos. Al analizar las curvas caracter sticas de operación del receptor (ROC) y las puntuaciones del HHIE-S, estimamos los puntos de corte apropiados para los diferentes grados de pérdida auditiva. Muestra de Estudio: Llenaron el cuestionario 164 sujetos que vivían en sus propias casas, pertenecientes a las cohortes de edad de 70, 75, 80 y 85 ańos, en una localidad industrializada de Finlandia y que se sometieron a la audiometría. Resultados: Para la identificación de pérdidas moderadas o peores (p. ej. promedio de tonos puros en las frecuencias de 0.5–4 kHz, >40 dB), la puntuación para el corte del HHIE-S en >8, tuvo una sensibilidad de 100% y una especificidad de 59.7%. La pregunta aislada tuvo una sensibilidad de 100% y una especificidad de 70.7%. Por esto, la pregunta aislada fue igualmente sensible pero más específica para la identificación de pérdidas auditivas moderadas o peores que la puntuación del HHIE-S. No obstante, para la identificación de pérdidas leves (p. ej. promedio de tonos puros >25 dB), el HHIE-S tuvo mayor sensibilidad aunque su especificidad fue menor que para la pregunta aislada.

Hearing status among cabin crew in a Swedish commercial airline company

To study hearing loss in commercial airline cabin crew (CC). Totally 155 male and 781 female CC (n = 936) in a Swedish airline company underwent repeated audiometric tests during 1974-2005. The last test was used to study hearing loss. The mean test values at 3, 4, 6 kHz were used for the ear with worse hearing loss. Data were compared with a Swedish population (n = 603) who were not occupationally exposed to noise. Equivalent noise levels (Leq) were measured in different aircraft. Leq was 78-84 dB (A), maximum A-weighted exposure was 114 dB. Median values for all ages were close to the reference group. No association was found between years of employment and hearing loss, when adjusting for age and gender by multiple logistic regression analysis. Cabin crew are exposed to equivalent noise levels below the current Swedish occupational standard, and have normal age-matched hearing threshold levels.

Otitis media as a cause of significant hearing loss among Nigerians

Mild or worse hearing loss, defined as pure tone average >25 decibel, is seen commonly with preventable etiologies. A tertiary care, urban referral hospital. Retrospective analysis of prospectively collected data of individuals attending the hearing loss clinic of National Hospital, Abuja, between May 2005 and April 2007. Data matching the diagnosis of acute otitis media (AOM), otitis media with effusion (OME) and chronic suppurative otitis media (CSOM) were extracted from the database and analyzed. A total of 298 cases with primary presenting complaints of hard of hearing were seen. A total of 77 cases had hearing loss due to otitis media. 44 (57.1%) had OME, 26 (33.8%) had CSOM, while 7 (9.1%) had AOM. The observed distribution of the OME was left OME (18.1%, n=14), right OME (9.1%, n=7) and bilateral OME (29.9%, n=23), while the CSOM is distributed into left CSOM (15.5%, n=12), bilateral CSOM (11.7%, n=9) and right CSOM (6.4%, n=5), and AOM is distributed into right AOM (2.6%, n=2), left AOM (3.9%, n=3), and bilateral AOM (2.6%, n=2). The mean pure tone averages for the three groups are AOM (30.5dB), OME (41.5dB) and CSOM (56.9dB). Otitis media is an important cause of preventable hearing loss in developing countries, and the predominance of unilateral otitis media in the left ear observed in this study deserves further studies.

Detection of hearing impairment and handicap in Paget's disease of bone using a simple scoring system: A case control study

Paget's disease of bone is known to be associated with hearing loss but there are limited data on the prevalence of hearing impairment and handicap in people with Paget's disease. Previous published population studies have used patient-completed questionnaires or review of GP records, none have included audiometry. 80 Paget's subjects were selected at random from a hospital database, 75 (94%) entered the study and were matched by age and gender with 76 controls. All participants completed a screening questionnaire for hearing handicap, the HHIE-S; a questionnaire on perception of hearing-related handicap, noise exposure, hearing aids and GP consultations regarding hearing; and audiometry. The results show significant problems from hearing loss in people with Paget's disease of bone. Paget's patients were significantly more likely to perceive hearing handicap ( P = 0.0001), 41% Paget's patients rated themselves moderate–severe compared to none of the controls. Paget's patients were significantly more likely to report difficulties such as hearing normal speech, watching TV or hearing over background noise (all P = 0.0001). They were more likely to consult their GP due to hearing problems ( P = 0.004) or tinnitus ( P = 0.0001), or use a hearing aid ( P = 0.0001). Audiometry confirmed higher rates of deafness in Paget's patients. 41/75 Paget's patients compared to 19/76 controls had at least 40 decibels hearing loss (dBHL) ( P = 0.0001). The HHIE-S proved to be an effective screening tool. A score of greater than 8 increased the odds ratio of detecting moderate hearing impairment (> 40 dBHL) in people with Paget's disease by 5.1. The specificity of HHIE-S > 8 as a screening tool to select for audiometry appears good, 1/46 (2%) of Paget's patients would have proved to have normal hearing thresholds. The sensitivity is better with worse hearing loss, 7/16 Paget's patients with moderate loss (> 40 dBHL) and 2/25 with severe-profound loss (> 60 dBHL) would have been missed. In conclusion, 55% unselected Paget's patients have at least moderate levels of hearing loss, compared to 25% of age and gender matched controls. Paget's patients and controls under-reported hearing problems, many of which can be ameliorated. Screening for hearing problems in Paget's disease of bone can be done using the HHIE-S.

Tinnitus and Ménière’s disease: characteristics and prognosis in a tinnitus clinic sample

The aim of this study is to describe tinnitus epidemiological characteristics in Ménière's disease (MD), the prognosis and its interaction with other MD symptoms. It is a descriptive transversal study. One hundred two MD patients were referred to a tinnitus clinic. Tinnitus was evaluated according to psychoacoustical tinnitogram, visual analogue scale, and tinnitus handicap inventory (THI). All patients were diagnosed with definitive MD (following AAO-HNS' 95 criteria). Pitch was more commonly identified in low and medium frequencies. Psychoacoustical intensity was matched in 12.7 dB. The visual analogue scale showed a value of 7.1, while THI score reached an average of 49%. Compared with other aetiologies (acoustic trauma, otosclerosis), MD showed a statistical difference in tinnitus severity parameters (P<0.05). Tinnitus increased VAS and THI score as a function of duration and bilateral disease (P<0.01). We found a statistical association (P<0.05) between tinnitus intensity and worse hearing loss or hyperacusis, but it was not influenced by number of vertigo spells. Higher MD stage increased tinnitus intensity and handicap. Tinnitus in MD patients referred to our tinnitus clinic presents a high intensity and handicap levels and represents the most troublesome symptom. Severity is influenced by the longer duration of the disease, the bilateral affection, hearing impairment or hyperacusis and a higher MD stage.

The Role of Summating Potential in the Diagnosis and Management of Meniere's Disease

To assess the role of a negative summating potential (-SP) in the clinical diagnosis and management of Menière's disease, the relationship of -SP abnormality to clinical symptoms, hearing level and caloric test results was examined in 70 patients with unilateral Meniere's disease. The click-induced -SP and action potential (AP) were recorded by extratympanic electrocochleography. When SP/AP ratio exceeded 0.43, the -SP was considered to be abnormal. No significant relationship was found between abnormal -SP and clinical symptoms (the duration of cochlear and vestibular symptoms, recent hearing fluctuation and recent vertigo attack). Ears with abnormal -SP had a significantly worse hearing loss at high frequencies (2-8 kHz) than ears with normal -SP, whereas there was no significant difference in hearing loss at low frequencies (0.25-1 kHz) between both ears. No significant relation was found between abnormal -SP and abnormal unilateral weakness in caloric test. The results indicate that the click-induced -SP reflects the pathophysiology of Menière's disease basically in the cochlear partition at high frequencies.

Insulin infusion systems, diabetic control, and microvascular complications.

<h3>Objective</h3> Hearing loss caused by high levels of noise is a potential occupational health disorder among train drivers around the world. This study aims to investigate the relationship between tunnel driving occupational environment and hearing loss in train drivers, to provide some insights into helping reduce hearing loss among train drivers. <h3>Methods</h3> This study analysed cross-sectional data for 1214 train drivers who work at China Railway Guangzhou Group. Health examination was taken by physicians with professional licences, and audiometric testing was performed by health technicians in a sound-isolated room. T/R is defined as the ratio of the length of the tunnels to the length of the railway along drivers’ work routes. Different multivariate models and stratified models were established for sensitivity analysis. A multivariable logistic regression model was used to estimate the ORs of hearing loss associated with tunnel driving occupational environment. <h3>Results</h3> The adjusted OR for high-frequency hearing loss in association with the highest T/R levels (30%–45%) versus the lowest T/R levels (&lt;15%) was 3.72 (95% CI 1.43 to 9.69). The corresponding OR for speech-hearing loss was 1.75 (95% CI 0.38 to 8.06). The sensitivity analysis shows our results are suitable for various alternative models. <h3>Conclusions</h3> This study found that there was a significant association between tunnel driving occupational environment and hearing loss. Train drivers who work in a higher T/R environment have worse hearing loss.