[The research of the contralateral ear hearing thresholds and the hearing prognosis in unilateral Meniere's disease].

Objective:This study analyzed the pure tone audiometry results of the affected ear and the contralateral ear of unilateral Meniere's disease to investigate the correlation of the hearing threshold of the contralateral ear and the hearing prognosis of unilateral Meniere's disease. Methods:In this study, the follow-up data of 135 patients with unilateral Meniere's disease in Beijing Tongren Hospital were used to analyze the pure tone audiometry results of the affected and contralateral ears at the first visit and 1 year later. Results:①At the first visit, there was no statistically significant difference between the mean hearing thresholds of the affected ear in the normal hearing group and the high-frequency hearing loss group of the contralateral ear（P>0.05）. ②The range of improvement of hearing thresholds in the affected ear was greater in the contralateral ear normal hearing group than in the contralateral ear high-frequency hearing loss group. In the normal hearing group of the contralateral ear, the hearing thresholds of the affected ear at 0.25 kHz（P<0.01）, 0.50 kHz（P<0.01）, 1.00 kHz（P<0.01）, and 2.00 kHz（P<0.05） were significantly improved; and in the high-frequency hearing loss group of the contralateral ear, the hearing thresholds at 0.25 kHz（P<0.01） hearing thresholds improved significantly, and there was no significant difference between the rest of the frequencies before and after treatment（P>0.05）. A consistent pattern was observed in both higher and lower age groups. ③After 1 year of follow-up, the low and mid-frequency hearing of the affected ear improved. 0.25 kHz（P<0.01）, 0.50 kHz（P<0.01）, 1.00 kHz（P<0.01） hearing thresholds improved significantly; 8.00 kHz hearing thresholds decreased slightly（P<0.05）. Conclusion:After standardized treatment, the results of 1-year follow-up suggested that the low-frequency hearing of MD patients could be improved, but the high-frequency hearing was slightly decreased. The hearing prognosis of the affected ear with normal hearing threshold of the contralateral ear may be better.

Altered Fhod3 expression involved in progressive high-frequency hearing loss via dysregulation of actin polymerization stoichiometry in the cuticular plate.

Age-related hearing loss (ARHL) is a common sensory impairment with complex underlying mechanisms. In our previous study, we performed a meta-analysis of genome-wide association studies (GWAS) in mice and identified a novel locus on chromosome 18 associated with ARHL specifically linked to a 32 kHz tone burst stimulus. Consequently, we investigated the role of Formin Homology 2 Domain Containing 3 (Fhod3), a newly discovered candidate gene for ARHL based on the GWAS results. We observed Fhod3 expression in auditory hair cells (HCs) primarily localized at the cuticular plate (CP). To understand the functional implications of Fhod3 in the cochlea, we generated Fhod3 overexpression mice (Pax2-Cre+/-; Fhod3Tg/+) (TG) and HC-specific conditional knockout mice (Atoh1-Cre+/-; Fhod3fl/fl) (KO). Audiological assessments in TG mice demonstrated progressive high-frequency hearing loss, characterized by predominant loss of outer hair cells, and a decreased phalloidin intensities of CP. Ultrastructural analysis revealed loss of the shortest row of stereocilia in the basal turn of the cochlea, and alterations in the cuticular plate surrounding stereocilia rootlets. Importantly, the hearing and HC phenotype in TG mice phenocopied that of the KO mice. These findings suggest that balanced expression of Fhod3 is critical for proper CP and stereocilia structure and function. Further investigation of Fhod3 related hearing impairment mechanisms may lend new insight towards the myriad mechanisms underlying ARHL, which in turn could facilitate the development of therapeutic strategies for ARHL.

Prevalence and predictors of high-frequency hearing loss among mine workers in Gujarat, western India: a cross-sectional study on the need to implement a comprehensive hearing conservation program.

BACKGROUND: High-frequency hearing loss (HFHL) stands as a prevalent occupational morbidity globally, with numerous associated risk factors, some of which are modifiable. In the context of a comprehensive hearing conservation program, the initial steps involve early screening and identification of workers with these modifiable risk factors, aiming to reduce the prevalence of hearing loss. Our objective was to estimate the prevalence of HFHL and determine its predictors among mine workers. METHODS: We conducted a cross-sectional study among 226 mine workers in ten open-cast mines in Gujarat state, the western part of India, in November 2020. We collected data on socio-demography, addiction, occupation history and comorbidities, along with anthropometric, blood pressure, and blood sugar measurements. Audiometric evaluations using a portable diagnostic audiometer were employed to assess HFHL, defined as a hearing threshold exceeding 25 decibels (dB) at high frequencies (3000, 4000, 6000, and 8000 Hz). A generalized linear model (GLM) with a binomial family was performed to determine the predictors significantly predicting HFHL after adjusting for confounding variables. RESULTS: The prevalence of HFHL was 35% (95% CI: 29-42%) in our study setting. Office workers demonstrated a prevalence of 19%, whereas other job categories displayed a higher prevalence of 42%, resulting in a significant prevalence difference of 23% and a prevalence ratio of 2.2. The GLM analysis revealed that variables, such as noise exposure during work [adjusted prevalence ratio (aPR) 2.3 (95% CI: 1.2-4.7, p = 0.018)] and noise exposure duration [aPR 1.1 (95% CI: 1.0-1.1, p = 0.042)], were significant predictors of HFHL. CONCLUSIONS: In our study setting, mine workers exhibited a high prevalence of HFHL, with exposure to workplace noise and duration being modifiable predictors. Because HFHL advances slowly and is generally undetected by the individual, we recommend periodic testing using audiometry to identify it among mine workers and, if possible, shifting them from mining activities to office. Furthermore, we advocate for the implementation of a comprehensive hearing conservation program to the extent possible.

Subcortical Auditory Processing and Speech Perception in Noise Among Individuals With and Without Extended High-Frequency Hearing Loss.

PURPOSE: The significance of extended high-frequency (EHF) hearing (> 8 kHz) is not well understood so far. In this study, we aimed to understand the relationship between EHF hearing loss (EHFHL) and speech perception in noise (SPIN) and the associated physiological signatures using the speech-evoked frequency-following response (sFFR). METHOD: Sixteen young adults with EHFHL and 16 age- and sex-matched individuals with normal hearing participated in the study. SPIN performance in right speech-right noise, left speech-left noise, and binaural listening conditions was evaluated using the Turkish Matrix Test. Additionally, subcortical auditory processing was assessed by recording sFFRs elicited by 40-ms /da/ stimuli. RESULTS: Individuals with EHFHL demonstrated poorer SPIN performances in all listening conditions (p < .01). Longer latencies were observed in the V (onset) and O (offset) peaks in these individuals (p ≤ .01). However, only the V/A peak amplitude was found to be significantly reduced in individuals with EHFHL (p < .01). CONCLUSIONS: Our findings highlight the importance of EHF hearing and suggest that EHF hearing should be considered among the key elements in SPIN. Individuals with EHFHL show a tendency toward weaker subcortical auditory processing, which likely contributes to their poorer SPIN performance. Thus, routine assessment of EHF hearing should be implemented in clinical settings, alongside the evaluation of standard audiometric frequencies (0.25-8 kHz).

High-frequency audiometry in the diagnosis of tinnitus.

BACKGROUND: Subjective tinnitus is an unpleasant perception of sound without any external acoustic stimulus. It can be manifested in the form of various phantom sounds, which most often resemble ringing, whistling, squeaking, noise, chirping, or buzzing. The sounds are heard solely by the sufferer and can occur in the middle of the head, but also in the ears-on one or both sides. AIM: The aim of the study was to evaluate the hearing capacity based on audiometric threshold measurements in the frequency range of 0.125-16 kHz in patients with tinnitus. In addition, we investigated the following questions: Can high-frequency audiometry be useful in the diagnosis of tinnitus? Does hearing loss occur in an increasingly wide frequency range with age compared to the control group? Can tinnitus be considered the first symptom of the onset of high-frequency hearing loss? METHODS: The study included 99 patients, all of whom underwent pure-tone audiometry (PTA) and extended high-frequency audiometry (HFA) in the ranges of 0.125-8 kHz and 8-16 kHz, respectively. In each patient (excluding the control group), tinnitus was characterized in terms of its frequency and intensity. RESULTS AND CONCLUSION: The study concluded that tinnitus may be a symptom indicating the presence of high-frequency hearing loss as hearing loss occurs in an increasingly wider frequency range with age, so HFA should be a routine audiological test in patients with tinnitus.

Utility of Extended High-Frequency Audiograms in Clinical Practice.

OBJECTIVES: Extended high-frequency (EHF) audiometry elicits pure-tone thresholds at frequencies above 8 kHz, which are not included in routine clinical testing. This study explores the utility of EHF audiometry in patients with various audiologic symptoms despite normal-hearing thresholds at ≤8 kHz. METHODS: A retrospective review was performed of all patients receiving conventional (250-8 kHz) and EHF (9-20 kHz) audiometry at a tertiary otological referral center between April 2021 and August 2022. Only patients with audiologic symptoms and pure-tone thresholds ≤25 dB HL at ≤8 kHz bilaterally on routine testing were included in subsequent analysis. EHF-PTA was defined for each ear as an average of the air conduction thresholds at 9.0, 10.0, 11.2, 12.5, 14.0, 16.0, 18.0, and 20.0 kHz. RESULTS: Of the 50 patients who received EHF testing, 40 had audiologic symptoms and normal conventional audiograms at ≤8 kHz. Twenty-five of the 40 (62.5%) were found to have hearing loss in the highest frequencies. Patients with EHF hearing loss (EHF-HL) were more likely to report subjective hearing loss. Age was significantly greater in those with EHF-HL compared with those without EHF-HL, and age was positively correlated with the degree of EHF-HL. CONCLUSION: EHF testing correlates with audiologic symptoms in patients with normal testing at ≤8 kHz and may be considered when standard audiometry is normal. Additional data are warranted to create an evidenced-based, clinical algorithm for EHF audiometry that can guide treatment, direct mitigation strategies, and potentially identify those at higher risk of hearing loss over time. LEVEL OF EVIDENCE: 4 Laryngoscope, 134:907-910, 2024.

Abnormal white and gray matter functional connectivity is associated with cognitive dysfunction in presbycusis.

Presbycusis is characterized by high-frequency hearing loss and is closely associated with cognitive decline. Previous studies have observed functional reorganization of gray matter in presbycusis, but the information transmission between gray matter and white matter remains ill-defined. Using resting-state functional magnetic resonance imaging, we investigated differences in functional connectivity (GM-GM, WM-WM, and GM-WM) between 60 patients with presbycusis and 57 healthy controls. Subsequently, we examined the correlation between these connectivity differences with high-frequency hearing loss as well as cognitive impairment. Our results revealed significant alterations in functional connectivity involving the body of the corpus callosum, posterior limbs of the internal capsule, retrolenticular region of the internal capsule, and the gray matter regions in presbycusis. Notably, disrupted functional connectivity was observed between the body of the corpus callosum and ventral anterior cingulate cortex in presbycusis, which was associated with impaired attention. Additionally, enhanced functional connectivity was found in presbycusis between the internal capsule and the ventral auditory processing stream, which was related to impaired cognition in multiple domains. These two patterns of altered functional connectivity between gray matter and white matter may involve both bottom-up and top-down regulation of cognitive function. These findings provide novel insights into understanding cognitive compensation and resource redistribution mechanisms in presbycusis.

Magnitude of extended high frequency hearing loss associated with auditory related tinnitus distress, when controlling for magnitude of hearing loss at standard frequenciesa).

Impaired thresholds at extended high frequencies (EHF) are tightly linked to the prevalence of tinnitus, but little is known about how EHF status relates to tinnitus characteristics. In the present study, 93 individuals with tinnitus underwent standard (from 0.125 to 8 kHz) and EHF (from 10 to 16 kHz) audiometry and indicated their degree of tinnitus distress by completing the tinnitus functional index and their perceived tinnitus loudness by using a numeric rating scale. Partial correlation analyses indicated that the magnitude of EHF loss was significantly associated with degree of auditory related tinnitus distress (r = 0.343, p < 0.001) when controlling for pure tone average at standard frequencies and compensating for multiple testing. It is concluded that EHF status is related specifically to auditory related tinnitus distress, but not to intrusive-, sense of control-, cognitive-, sleep-, relaxation-, quality of life-, emotional-related tinnitus distress, total tinnitus distress, or perceived tinnitus loudness.

Subjective and Objective Hearing Loss Among US Adult Cancer Survivors.

Importance: Cancer survivors are at a higher risk of developing hearing loss (HL) due to older age, chemotherapy, and radiotherapy. However, the prevalence of HL among US cancer survivors remains unknown. Additionally, there is a lack of uniform HL screening guidelines for this enlarging population. Objective: To estimate the prevalence of subjective HL and objective HL by audiometry test among cancer survivors and compare them with the general population as well as to assess the performance of subjective HL questions in detecting true (ie, audiometry-confirmed) HL. Design, Setting, and Participants: In a cross-sectional design, adults between ages 20 and 80 years who had audiometry testing and responded to a hearing questionnaire from the National Health and Nutrition Examination Survey (2011-2012, 2015-2016, and 2017 to March 2020 prepandemic survey cycles) were selected. Data analysis was conducted from August 13, 2022, to July 26, 2023. Main Outcomes and Measures: The weighted prevalence of subjective HL (troublesome hearing and tinnitus) and objective HL (speech-frequency HL and high-frequency HL) by audiometry were calculated. Analyses with χ2 testing and multiadjusted logistic regression models were used to compare HL between cancer survivors and the general population. To evaluate the performance of subjective HL questions as a tool to screen for objective HL by audiometry, areas under the curve were estimated using age- and gender-adjusted logistic regression. Results: Among the total 9337 participants (weighted n = 90 098 441; 51.2% women), 10.3% were cancer survivors. Compared with the general population, cancer survivors had a higher prevalence of troublesome hearing (adjusted odds ratio [AOR], 1.43; 95% CI, 1.11-1.84), tinnitus (AOR, 1.28; 95% CI, 0.94-1.74), speech-frequency HL (AOR, 1.43; 95% CI, 1.11-1.85), and high-frequency HL (AOR, 1.74; 95% CI, 1.29-2.34). When using the subjective HL tool and questioning regarding whether the participants were having troublesome hearing and/or tinnitus in screening for HL, the age- and gender-adjusted area under the curve was 0.88 in detecting speech-frequency HL and 0.90 in detecting high-frequency HL. Conclusion and Relevance: The findings of this study suggest that cancer survivors have a significantly higher prevalence of HL than the general population. Two subjective HL questions could potentially accurately identify those who have true HL and provide a simple and efficient screening tool for health care professionals. Cancer survivors and their families should be educated and encouraged to discuss hearing concerns, and health care professionals should facilitate raising awareness and provide early screening and timely referral when HL is identified.

Association of coffee consumption with the prevalence of hearing loss in US adults, NHANES 2003-2006.

OBJECTIVE: This study aims to explore the association between coffee consumption and the prevalence of hearing loss in American adults based on a national population-based survey. DESIGN: Cross-sectional analysis of reported audiometric status and coffee intake from the 2003-2006 National Health and Nutrition Examination Survey (NHANES). Multivariate logistic regression, forest plots and restricted cubic spline (RCS) analyses were used to explore the associations and dose-response relationships between coffee consumption frequency and hearing loss. SETTING: The USA. PARTICIPANT: This study included 1894 individuals aged ≥ 20 from the 2003-2006 NHANES. RESULTS: In this study, the prevalence of speech-frequency hearing loss (SFHL) and high-frequency hearing loss (HFHL) among the participants was 35·90 % and 51·54 %, respectively. Compared with those who no consumed coffee, non-Hispanic White who consumed ≥ 4 cups/d had higher prevalence of SFHL (OR: 1·87; 95 % CI: 1·003. 3·47). And a positive trend of coffee consumption frequency with the prevalence of HFHL was found (Ptrend = 0·001). This association of HFHL was similar for participants aged 20-64 (Ptrend = 0·001), non-Hispanic White (Ptrend = 0·002), non-noise exposure participants (Ptrend = 0·03) and noise-exposed participants (Ptrend = 0·003). The forest plots analysis found that the association between 1 cup-increment of daily coffee consumption and the prevalence of HFHL was statistically significant in males. RCS model supported a positive linear association of coffee consumption with SFHL (P for overall association = 0·02, P for nonlinearity = 0·48) and a positive non-linear association of coffee consumption with HFHL (P for overall association = 0·001, P for nonlinearity = 0·001). CONCLUSION: Our findings suggested that coffee consumption was associated with higher prevalence of hearing loss. Further cohort studies in larger population are needed to investigate these findings.

Impacts of an age-related hearing loss allele of cadherin 23 on severity of hearing loss in ICR and NOD/Shi mice.

The age-related hearing loss allele (Cdh23ahl) of the cadherin 23 gene leads to a more severe hearing loss phenotype through additive effects with risk alleles for hearing loss. In this study, we genome edited the Cdh23ahl allele to the wild-type Cdh23+ allele in outbred ICR mice and inbred NOD/Shi mice established from ICR mice and investigated their effects on hearing phenotypes. Several hearing tests confirmed that ICR mice developed early onset high-frequency hearing loss and exhibited individual differences in hearing loss onset times. Severe loss of cochlear hair cells was also detected in the high-frequency areas in ICR mice. These phenotypes were rescued by genome editing the Cdh23ahl allele to Cdh23+, suggesting that abnormal hearing phenotypes develop because of the interaction of the Cdh23ahl and risk alleles in the genetic background of ICR mice. NOD/Shi mice developed more severe hearing loss and hair cell degeneration than ICR mice. Hearing loss was detected at 1 month old. Hair cell loss, including degeneration of cell bodies and stereocilia, was observed in all regions of the cochlea in NOD/Shi mice. Although these phenotypes were partially rescued by genome editing to the Cdh23+ allele, the phenotypes associated with high-frequency hearing were mostly unrecovered in NOD/Shi mice. These results strongly suggest that the genetic background of NOD/Shi mice contain a potential risk allele for the acceleration of early onset high-frequency hearing loss.

Prevalence of Childhood Hearing Loss in Rural Alaska.

OBJECTIVES: Childhood hearing loss has well-known lifelong consequences. Certain rural populations are at higher risk for infection-related hearing loss. For Alaska Native children, historical data on hearing loss prevalence suggest a higher burden of infection-related hearing loss, but updated prevalence data are urgently needed in this high-risk population. DESIGN: Hearing data were collected as part of two school-based cluster-randomized trials in 15 communities in rural northwest Alaska over two academic years (2017-2019). All enrolled children from preschool to 12th grade were eligible. Pure-tone thresholds were obtained using standard audiometry and conditioned play when indicated. The analysis included the first available audiometric assessment for each child (n = 1634 participants, 3 to 21 years), except for the high-frequency analysis, which was limited to year 2 when higher frequencies were collected. Multiple imputation was used to quantify the prevalence of hearing loss in younger children, where missing data were more frequent due to the need for behavioral responses. Hearing loss in either ear was evaluated using both the former World Health Organization (WHO) definition (pure-tone average [PTA] > 25 dB) and the new WHO definition (PTA ≥ 20 dB), which was published after the study. Analyses with the new definition were limited to children 7 years and older due to incomplete data obtained on younger children at lower thresholds. RESULTS: The overall prevalence of hearing loss (PTA > 25 dB; 0.5, 1, 2, 4 kHz) was 10.5% (95% confidence interval [CI], 8.9 to 12.1). Hearing loss was predominately mild (PTA >25 to 40 dB; 8.9%, 95% CI, 7.4 to 10.5). The prevalence of unilateral hearing loss was 7.7% (95% CI, 6.3 to 9.0). Conductive hearing loss (air-bone gap of ≥ 10 dB) was the most common hearing loss type (9.1%, 95% CI, 7.6 to 10.7). Stratified by age, hearing loss (PTA >25 dB) was more common in children 3 to 6 years (14.9%, 95% CI, 11.4 to 18.5) compared to children 7 years and older (8.7%, 95% CI, 7.1 to 10.4). In children 7 years and older, the new WHO definition increased the prevalence of hearing loss to 23.4% (95% CI, 21.0 to 25.8) compared to the former definition (8.7%, 95% CI, 7.1 to 10.4). Middle ear disease prevalence was 17.6% (95% CI, 15.7 to 19.4) and was higher in younger children (23.6%, 95% CI, 19.7 to 27.6) compared to older children (15.2%, 95% CI, 13.2 to 17.3). High-frequency hearing loss (4, 6, 8kHz) was present in 20.5% (95% CI, 18.4 to 22.7 [PTA >25 dB]) of all children and 22.8% (95% CI, 20.3 to 25.3 [PTA >25 dB]) and 29.7% (95% CI, 27.0 to 32.4 [PTA ≥ 20 dB]) of children 7 years and older (limited to year 2). CONCLUSIONS: This analysis represents the first prevalence study on childhood hearing loss in Alaska in over 60 years and is the largest cohort with hearing data ever collected in rural Alaska. Our results highlight that hearing loss continues to be common in rural Alaska Native children, with middle ear disease more prevalent in younger children and high-frequency hearing loss more prevalent with increasing age. Prevention efforts may benefit from managing hearing loss type by age. Lastly, continued research is needed on the impact of the new WHO definition of hearing loss on field studies.

The Combined Effect of Elevated Blood Pressure and Occupational Noise Exposure on Bilateral High-Frequency Hearing Loss: Evidence From a Large Sample Cross-sectional Study.

BACKGROUND: Combined effect of elevated blood pressure and occupational noise exposure on hearing loss have rarely been evaluated among Chinese population. METHODS: This cross-sectional study was conducted in 242,811 participants. Logistic regression model was performed to estimate the independent and combined associations. RESULTS: Compared with participants without occupational noise exposure, the risk of bilateral high-frequency hearing loss (BHFHL) was significantly higher for noise exposure 10 years or more (odds ratio [OR] = 1.29, 95% confidence interval [95% CI] = 1.23-1.35). Compared with no hypertension, participants with grade 1 hypertension had higher risk of BHFHL in all age groups (OR, 1.14; 95% CI, 1.09-1.20). As to the combined effect, the highest BHFHL risk was found in males (OR, 1.51; 95% CI, 1.37-1.67), especially among participants with grade 1 hypertension older than 50 years (OR, 1.65; 95% CI, 1.46-1.88). CONCLUSIONS: Elevated blood pressure may synergistically influence hearing loss combined with occupational noise exposure.

Associations between medical conditions and auditory dysfunction in US Veterans.

OBJECTIVE: To examine associations between non-otologic medical conditions and auditory dysfunction. DESIGN: Cross-sectional analysis of baseline data from the Noise Outcomes in Service members Epidemiology (NOISE) study. Logistic regression was used to estimate the association between medical conditions (0, 1, and 2 or more conditions) and auditory dysfunction (hearing loss pure tone average ≥20 dB HL and tinnitus), adjusting for key confounders including noise exposure. Secondarily, the association between specific medical conditions and auditory dysfunction was examined. All variables were self-reported. STUDY SAMPLE: United States military Veterans (n = 580) with mean age 34.1 years (standard deviation = 9.2), who were within approximately 2.5 years of separation from service. RESULTS: Compared to Veterans reporting no medical conditions, Veterans reporting two or more had increased odds on low-frequency hearing loss and on tinnitus but not on high or extended-high frequency hearing loss. Furthermore, specific conditions sleep disorder and arthritis were associated with auditory dysfunction. CONCLUSIONS: Non-otologic medical conditions were associated with low-frequency hearing loss and tinnitus in this sample of young Veterans. This suggests medical conditions may play a role in Veterans' hearing health. Whether management of medical conditions earlier in life reduces the risk of hearing loss and tinnitus requires further study.

[Analysis of influencing factors of high frequency hearing loss in workers exposed to noise based on multilevel model].

Objective: To understand the current situation of high-frequency hearing loss of workers exposed to occupational noise in Hubei Province and its multi-level influencing factors. Methods: In June 2021, the basic information, occupational history, physical examination results and other relevant information in the "Occupational Health Examinations Case Cards" for noise workers in Hubei Province in 2020 were extracted from the subsystem of the "China Disease Prevention and Control Information System". Multilevel level of logistic model was used to analyze the related factors of high-frequency hearing loss of noise-exposed workers. Results: In 2020, the incidence rate of occupational high-frequency hearing loss in Hubei Province was 8.25% (6450/78152), and the incidence rate in various regions of the province ranged from 1.13% to 19.87%. At the individual level, male, ≥ 30 years of age, 6-10 years of service, small and micro enterprises, as well as construction, mining, manufacturing, transportation and rental services were the risk factors for high-frequency hearing loss (P<0.05). The risk of high-frequency hearing loss among workers in foreign-funded enterprises was significantly lower than that of workers in state-owned/collective enterprises (P<0.05). At the regional level, the younger the age of the employees, the lower the risk of high-frequency hearing loss (P<0.05). There was no significant correlation between the regional economic level and the risk of high-frequency hearing loss (P>0.05) . Conclusion: The incidence rate of occupational high-frequency hearing loss in Hubei Province is low in 2020, but the incidence rate varies greatly in different regions of the province, mainly due to differences in employment age, while the development of regional economic level has not reduced the risk of occupational high-frequency hearing loss.

[Risk assessment of hearing loss of noise workers in three petrochemical enterprises].

OBJECTIVE: To evaluate the risk of noise induced hearing loss among workers in petrochemical enterprises. METHODS: Number of workers exposed to noise were recruited from three petrochemical enterprises. The noise exposure level(L_(EX, W)) of the research objects was measured, their occupational history was investigated, and the audiometric testing was carried out. The ISO 1999:2013 model was used to calculate the change of hearing threshold level and the risk of hearing loss in each post, and compared the result of model with the result of the audiometric testing. RESULTS: The median of L_(EX, W) is range from 79.8 to 85.0 dB(A). L_(EX, W) among all posts were greater than 80 dB(A) except naphtha processing operators. The result of pure tone hearing threshold test showed that the prevalence of high-frequency hearing loss among workers exposed to noise was 12.8%. According to the classification of noise operation according to the maximum value of L_(EX, W), the operator for styrene dry gas combined unit is the only post that is extremely dangerous in the department of chemical, the other posts in the department of chemical and all posts in the department of public works are exposed to light and medium noise hazards, and 62.5% the external operators of the oil refining department are under heavy and extremely hazardous. According to the evaluation result of ISO 1999:2013, the risk of high-frequency hearing loss among workers in crude distillation unit, hydrogen production unit and the electricians of electrical system is high. The measured median of noise-induced pernament threshold shift(NIPTS) among male workers in different workstation was higher than the predicted median of NIPTS of ISO 1999, and the difference was statistically significant(P<0.01), and the predicted values for four-fifths of positions were more than 10 dB lower than the measured value. CONCLUSION: The risk of noise induced hearing loss of workers in petrochemical enterprises is high.

[A case-control study of occupational noise exposure induced high-frequency hearing loss and the risk of hypertension].

Objective: To investigate the relationship between high frequency hearing loss caused by occupational noise and the risk of hypertension. Methods: In March 2020, a case-control study was conducted. All noise exposed workers who participated in occupational health examination in Wuxi City in 2019 were selected as the study subjects (95432 cases in total) . The hypertension group was defined as the case group, and the normotensive group was defined as the control group. According to the hearing threshold, they were divided into the non high frequency hearing loss group (<40 dB) and the high frequency hearing loss group (≥ 40 dB) . Univariate statistical method and binary logistic regression were used to evaluate the relationship between high-frequency hearing loss and hypertension risk. Stratified analysis was used to compare the risk of hypertension among workers with high-frequency hearing loss of different ages and length of service. Results: There were significant differences in gender, age, length of service, enterprise scale, economic type and high-frequency hearing loss between control group and hypertension group (P<0.05) . Binary logistic regression analysis showed that after adjusting for gender, age, length of service, enterprise scale and economic type, the risk of hypertension in the high-frequency hearing loss group was still increased (OR=1.062, 95%CI: 1.007~1.121, P=0.027) . The risk of hypertension in high-frequency hearing loss patients was higher than that in non high-frequency hearing loss patients in 20-39 years old and 40-59 years old age groups (OR=1.536, 95%CI: 1.353~1.743; OR=1.179, 95%CI: 1.111~1.250; P<0.05) . The risk of hypertension in high-frequency hearing loss patients in <5years, 5-9years, 10-14 years, 15-19 years and ≥20 years working age groups were higher than that in non high-frequency hearing loss groups (OR=1.926, 95%CI=1.007-1.121; OR=1.635, 95%CI=1.478-1.810; OR=1.312, 95%CI=1.167-1.474; OR=1.445, 95%CI=1.238-1.686; OR=1.235, 95%CI=1.043-1.463; P<0.05) . Conclusion: There is a certain relationship between high-frequency hearing loss caused by occupational noise and the risk of hypertension, and the risk of hypertension is different among high-frequency hearing loss patients of different ages and working years.

Slight High-Frequency Hearing Loss, Effect of COVID-19 or Hydroxychloroquine Usage?

BACKGROUND AND OBJECTIVES: Concerns about ototoxic and vestibulotoxic effects have been raised with the use of antiviruses in the treatment of COVID-19. This study aimed to determine the effect of hydroxychloroquine (HCQ) and examine the auditory system and its associated auditory and vestibular symptoms in patients with COVID-19. STUDY DESIGN: Prospective study. PATIENTS: Thirty patients with a history of HCQ (HCQ+) and 30 patients without drug use (HCQ-), and 30 healthy adults as the control group participated. MAIN OUTCOME MEASURES: Audiological assessments and evaluation of audio-vestibular symptoms. Evaluations were also repeated 1 month later. RESULTS: Both HCQ+ and HCQ- groups showed poor pure-tone audiometry (PTA) thresholds and decreased transient evoked otoacoustic emission amplitudes at high frequencies in comparison to the healthy group. Despite the lack of significant differences in PTA between the two groups of patients, the differences in transient evoked otoacoustic emission amplitudes were significant. PTA thresholds and otoacoustic emission showed improvement after 1 month. Dizziness was the most common symptom that was reduced after 1 month. CONCLUSION: Slight hearing loss was seen in patients with COVID-19 with or without HCQ. Also, hearing thresholds in the HCQ+ group did not show a significant difference compared with the HCQ- group. Nevertheless, it seems that more damage is done to the hair cells of patients with HCQ intake than in other patients. Hence, the ototoxicity effect of high doses of HCQ use in the COVID-19 patients should be considered. A relative improvement in the hearing was seen over time in both patient groups.

Association of weight change across adulthood with hearing loss: A retrospective cohort study.

OBJECTIVES: We aimed to investigate the relationship of weight change across adulthood with the risk of hearing loss. METHODS: The data from National Health and Nutrition Examination Surveys. Cox proportional hazards models were applied to explore the association between weight change and risk of hearing loss. Kaplan-Meier method was used to plot the survival curves associated with weight change patterns. RESULTS: Compared with participants who remained at normal weight, those with stable obese participants had increased risks of total hearing loss across adulthood, with hazard ratios of 1.24 (95% confidence intervals 1.11-1.38) from age 25 years to baseline, 1.09 (1.001-1.18) from 10 years before baseline to baseline, and 1.23 (1.10-1.37) from age 25 years to 10 years before baseline. Moving the obese to non-obese weight change pattern from middle to late adulthood was not significantly associated with an increased risk of total hearing loss (1.04, 0.91-1.19) and high-frequency hearing loss (1.02, 0.90-1.17), whereas changing from non-obese to obese body mass index over this period was associated with total hearing loss risk (1.20, 1.11-1.29), and speech- and high-frequency hearing loss (1.21, 1.07-1.36; 1.18, 1.09-1.28). Those moving from the non-obese to obese category between young and middle adulthood had a 16% (1.16, 1.02-1.33) higher risk of speech-frequency hearing loss. CONCLUSIONS: Stable obesity and weight gain across adulthood are both associated with increased risks of hearing loss. Our findings imply that maintaining normal weight across adulthood is of great importance for preventing hearing loss in later life.

Age-related High-frequency Hearing Loss Is Not Associated With Horizontal Semicircular Canal Function.

OBJECTIVE: Investigate the association between age-related hearing loss and reduced peripheral vestibular function using paired assessments of high-frequency hearing and horizontal semicircular canal (HSC) function. We hypothesized that age-related high-frequency hearing loss would be correlated with reduced HSC function and, therefore, useful to predict age-related vestibular hypofunction. DESIGN: We conducted a single center, retrospective cross-sectional study in a tertiary/academic referral hospital. This study included 185 patients who were diagnosed with a cerebellopontine angle (CPA) tumor and referred to the academic hospital to evaluate treatment options. Data collected included pure-tone audiometry, caloric reflex test, video head-impulse test (vHIT), and medical history. High-frequency hearing loss was quantified by the high Fletcher index (hFI), and horizontal semicircular canal (HSC) function were quantified by the caloric reflex test and vHIT. RESULTS: We observed a significant association between age and high-frequency hearing loss that was significantly worse in men compared with women. In contrast, we observed no significant association between age and HSC function assessed by either the caloric reflex test or vHIT. We observed associations between HSC function and sex, with male sex predicting reduced HSC function by caloric reflex testing but enhanced HSC function by vHIT. High-frequency hearing loss did not predict HSC hypofunction. CONCLUSIONS: We found no evidence indicating age-related decline in HSC function or an association between age-related high-frequency hearing loss and age-related decline in HSC function. We did observe sex-specific differences in HSC function. Our study highlights the need for sex-specific normative values for identifying age-related reduced peripheral vestibular function and for future work linking comprehensive assessments of inner ear function with tests of balance and stability to understand the complex interactions underlying hearing loss and imbalance, especially in the elderly.