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In this study of 45 patients with COVID-19 undergoing tracheostomy, nasopharyngeal and tracheal cycle threshold (Ct) values were analyzed. Ct values rose to 37.9 by the time of tracheostomy and remained >35 postoperatively, demonstrating that persistent test positivity may not be associated with persistent transmissible virus in this population.
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COVID-19 , SARS-CoV-2 , Humanos , Traqueostomia , Nasofaringe , Teste para COVID-19RESUMO
PURPOSE: To identify areas of critical otolaryngology contributions to inpatient care resistant to disruption by the COVID-19 pandemic. METHODS: Medical records of 614 otolaryngology consults seen between January and June of 2019 and 602 seen between January and June of 2020 were reviewed. Extracted data included patient demographics, SARS-CoV-2 status, medical comorbidities, consult location, consult category, reason for consult, procedures performed, and overall outcome. Prevalence of data items was compared using t tests and Chi-squared tests. RESULTS: The number of monthly consults to the otolaryngology service remained approximately stable after the onset of the COVID-19 pandemic. However, there was a substantial increase in ICU consults and a decrease in ER and floor consults. The proportion of otology, rhinology, and head and neck consults decreased while that of airway consults-most of which were tracheostomy-related-greatly increased. While the top ten reasons for consult remained essentially the same, they dramatically increased as a percentage of consults during COVID-19 (55-92%), whereas there was a dramatic decrease in the proportion of less frequent consults. CONCLUSION: The changes in otolaryngology consultation patterns seen after the onset of the pandemic are multifactorial, but may be attributed to novel pathologies, attitudes, and policies. Nonetheless, these patterns reveal that a set of core otolaryngologic issues, including acute airway issues, head and neck lesions, severe sinusitis and epistaxis, are essential and need to be addressed in the inpatient setting, whereas the significant drop in other consults suggests that they may be appropriately managed on an outpatient basis.
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COVID-19 , Otolaringologia , Humanos , Pacientes Internados , Pandemias , Encaminhamento e Consulta , SARS-CoV-2RESUMO
OBJECTIVE: The aim of this study was to report the safety, efficacy, and early results of tracheostomy in patients with COVID-19 and determine whether differences exist between percutaneous and open methods. SUMMARY BACKGROUND DATA: Prolonged respiratory failure is common in symptomatic patients with COVID-19, the disease process caused by infection with the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Tracheostomy, although posing potential risk to the operative team and other healthcare workers, may be beneficial for safe weaning of sedation and ventilator support. However, short- and long-term outcomes remain largely unknown. METHODS: A prospectively collected database of patients with COVID-19 undergoing tracheostomy at a major medical center in New York City between April 4 and April 30, 2020 was reviewed. The primary endpoint was need for continued mechanical ventilation. Secondary outcomes included complication rates, sedation weaning, and need for intensive care unit (ICU) level of care. Patient characteristics, perioperative conditions, and outcomes between percutaneous and open groups were analyzed. RESULTS: During the study period, 67 consecutive patients underwent tracheostomy, including 48 males and 19 females with a median age of 66 years [interquartile range (IQR) 52-72]. Two surgeons alternated techniques, with 35 tracheostomies performed percutaneously and 32 via an open approach. The median time from intubation to tracheostomy was 23 days (IQR 20-26). At a median follow-up of 26 days, 52 patients (78%) no longer required mechanical ventilation and 58 patients (87%) were off continuous sedation. Five patients (7.5%) died of systemic causes. There were 11 total complications (16%) in 10 patients, most of which involved minor bleeding. There were no significant differences in outcomes between percutaneous and open methods. CONCLUSIONS: Tracheostomy under apneic conditions by either percutaneous or open technique can be safely performed in patients with respiratory failure due to COVID-19. Tracheostomy facilitated weaning from continuous intravenous sedation and mechanical ventilation. Continued follow-up of these patients to ascertain long-term outcome data is ongoing.
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COVID-19/terapia , Cuidados Críticos , Complicações Pós-Operatórias/epidemiologia , Respiração Artificial , Traqueostomia/efeitos adversos , Adulto , Idoso , Idoso de 80 Anos ou mais , COVID-19/complicações , COVID-19/mortalidade , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cidade de Nova Iorque , Taxa de Sobrevida , Traqueostomia/métodosRESUMO
Dementia is a devastating disease and global health challenge that is highly prevalent worldwide. A growing body of research has shown an independent association between age-related hearing loss (ARHL) and dementia, identifying ARHL as a compelling potential target in preventive strategies for dementia. However, a causal linkage between ARHL and dementia needs to be investigated before making definitive clinical guidelines and treatment recommendations regarding ARHL as a modifiable risk factor. In this review, we discuss the association between ARHL and dementia, the importance of addressing this finding, as well as common mechanisms (eg, microvascular disease) and causal mechanisms (eg, depletion of cognitive reserve and social isolation) that may explain the nature of this relationship. Future directions for research are also highlighted, including randomized controlled trials, developing high-resolution microvascular imaging, and further refining audiometric testing.
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Envelhecimento , Demência , Presbiacusia/epidemiologia , Demência/complicações , Demência/epidemiologia , Humanos , Microvasos , Prevalência , Fatores de RiscoRESUMO
Musical rhythm and the grammatical structure of language share a surprising number of characteristics that may be intrinsically related in child development. The current study aimed to understand the potential influence of musical rhythmic priming on subsequent spoken grammar task performance in children with typical development who were native speakers of English. Participants (ages 5-8â¯years) listened to rhythmically regular and irregular musical sequences (within-participants design) followed by blocks of grammatically correct and incorrect sentences upon which they were asked to perform a grammaticality judgment task. Rhythmically regular musical sequences improved performance in grammaticality judgment compared with rhythmically irregular musical sequences. No such effect of rhythmic priming was found in two nonlinguistic control tasks, suggesting a neural overlap between rhythm processing and mechanisms recruited during grammar processing. These findings build on previous research investigating the effect of rhythmic priming by extending the paradigm to a different language, testing a younger population, and employing nonlanguage control tasks. These findings of an immediate influence of rhythm on grammar states (temporarily augmented grammaticality judgment performance) also converge with previous findings of associations between rhythm and grammar traits (stable generalized grammar abilities) in children. Taken together, the results of this study provide additional evidence for shared neural processing for language and music and warrant future investigations of potentially beneficial effects of innovative musical material on language processing.
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Julgamento , Idioma , Música , Periodicidade , Percepção Auditiva , Criança , Pré-Escolar , Feminino , Humanos , MasculinoRESUMO
In an era of concern over the rising cost of health care, cost-effectiveness of auxiliary services merits careful evaluation. We compared costs and benefits of Helicopter Emergency Medical Service (HEMS) with Ground Emergency Medical Service (GEMS) in patients with an isolated ankle fracture. A medical record review was conducted for patients with an isolated ankle fracture who had been transported to a level 1 trauma center by either HEMS or GEMS from January 1, 2000 to December 31, 2010. We abstracted demographic data, fracture grade, complications, and transportation mode. Transportation costs were obtained by examining medical center financial records. A total of 303 patients was included in the analysis. Of 87 (28.71%) HEMS patients, 53 (60.92%) had sustained closed injuries and 34 (39.08%) had open injuries. Of the 216 (71.29%) GEMS patients, 156 (72.22%) had closed injuries and 60 (27.78%) had open injuries. No significant difference was seen between the groups regarding the percentage of patients with open fractures or the grade of the open fracture (p = .07). No significant difference in the rate of complications was found between the 2 groups (p = 18). The mean baseline cost to transport a patient via HEMS was $10,220 + a $108/mile surcharge, whereas the mean transport cost using GEMS was $976 per patient + $16/mile. Because the HEMS mode of emergency transport did not significantly improve patient outcomes, health systems should reconsider the use of HEMS for patients with isolated ankle fractures.
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Resgate Aéreo/estatística & dados numéricos , Fraturas do Tornozelo/complicações , Fraturas do Tornozelo/cirurgia , Complicações Pós-Operatórias/epidemiologia , Transporte de Pacientes/métodos , Adulto , Resgate Aéreo/economia , Ambulâncias/economia , Ambulâncias/estatística & dados numéricos , Fraturas do Tornozelo/diagnóstico , Estudos de Coortes , Análise Custo-Benefício , Serviços Médicos de Emergência/organização & administração , Feminino , Fixação de Fratura/efeitos adversos , Fixação de Fratura/métodos , Consolidação da Fratura/fisiologia , Humanos , Incidência , Escala de Gravidade do Ferimento , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/economia , Estudos Retrospectivos , Medição de Risco , Transporte de Pacientes/economia , Centros de Traumatologia , Estados Unidos , Adulto JovemRESUMO
OBJECTIVES: Social media plays an ever-growing part in modern life and is a frequent source of health information for patients. Singers are particularly likely to receive health information solely from fellow musicians and may experience barriers to seeking vocal healthcare. However, there have been no studies to date evaluating vocal health information on social media. Our study aimed to assess the quality, reliability, and accuracy of vocal health content on TikTok. STUDY DESIGN: Cross-sectional analysis. METHODS: Three searches were carried out on Tiktok, using the terms "vocal health," "vocal injury," and "voice tips." The top 50 videos in each category were cataloged for extraction of data and for analysis on three discrete scales. Two independent reviewers rated each video using the Global Quality Scale (GQS), modified DISCERN scale, and Accuracy in Digital-health Instrument (ANDI). RESULTS: After the removal of duplicates and unavailable content, 146 videos were analyzed. The mean (range) length was 59.8 seconds (5-239), and number of views per video was 886,265 (432-36,700,000). The vast majority of videos (94.5%) were created by non-clinicians; only two videos (1.37%) were posted by otolaryngologists. The mean (SD) GQS score was 2.34 (0.75) out of a maximum of five, the DISCERN score was 0.97 (0.56) out of five, and the ANDI score was 2.85 (0.87) out of four. Video length was positively correlated with GQS and DISCERN scores, but views, likes, and shares were either not associated or negatively associated with GQS, DISCERN, and ANDI. CONCLUSIONS: Most videos were of low quality and reliability and moderate accuracy. Measures of popularity were either uncorrelated or negatively correlated with quality, reliability, and accuracy, suggesting that TikTok users are more likely to engage with lower-quality content online. This implies a potential role for vocal health professionals to fill a crucial gap with reliable information on social media.
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OBJECTIVE: Cochlear implant (CI) users frequently complain about speech quality perception (SQP). In patients undergoing cochlear implantation for single-sided deafness, there is concern that poor SQP from the implanted ear will negatively impact binaural (CI + normal hearing [NH]) SQP. In this study, we investigate if binaural SQP is measurably different than unimplanted NH alone. STUDY DESIGN: Cross-sectional study. SETTING: Tertiary care center. METHODS: Fifteen unilateral CI users with NH in the contralateral ear completed the validated Columbia Speech Quality Instrument. This instrument consists of 9 audio clips rated across 14 specific speech qualities using a 10-point visual analog scale. SQP was assessed in 3 conditions: CI only, NH only, and CI + NH. RESULTS: Median speech quality scores were worse in the CI only condition compared to the NH only (50.0 vs 72.6, P = .0003) and binaural (50.0 vs 71.0, P = .007) conditions. Median speech quality scores were not significantly different between the NH only and binaural conditions (72.6 vs 71, P = .8). Compared to NH, CI speech quality sounded less clear, less natural, and more mechanical. CONCLUSION: Compared to NH, SQP is poorer with a CI alone. However, in contrast to expectation, there is no significant difference between NH and binaural SQP. This suggests poorer CI speech perception does not negatively impact binaural SQP in patients undergoing cochlear implantation for single-sided deafness.
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BACKGROUND: Sheep have been proposed as a large-animal model for studying cochlear implantation. However, prior sheep studies report that the facial nerve (FN) obscures the round window membrane (RWM), requiring FN sacrifice or a retrofacial opening to access the middle-ear cavity posterior to the FN for cochlear implantation. We investigated surgical access to the RWM in Hampshire sheep compared to Suffolk-Dorset sheep and the feasibility of Hampshire sheep for cochlear implantation via a facial recess approach. METHODS: Sixteen temporal bones from cadaveric sheep heads (ten Hampshire and six Suffolk-Dorset) were dissected to gain surgical access to the RWM via an extended facial recess approach. RWM visibility was graded using St. Thomas' Hospital (STH) classification. Cochlear implant (CI) electrode array insertion was performed in two Hampshire specimens. Micro-CT scans were obtained for each temporal bone, with confirmation of appropriate electrode array placement and segmentation of the inner ear structures. RESULTS: Visibility of the RWM on average was 83% in Hampshire specimens and 59% in Suffolk-Dorset specimens (p = 0.0262). Hampshire RWM visibility was Type I (100% visibility) for three specimens and Type IIa (> 50% visibility) for seven specimens. Suffolk-Dorset RWM visibility was Type IIa for four specimens and Type IIb (< 50% visibility) for two specimens. FN appeared to course more anterolaterally in Suffolk-Dorset specimens. Micro-CT confirmed appropriate CI electrode array placement in the scala tympani without apparent basilar membrane rupture. CONCLUSIONS: Hampshire sheep appear to be a suitable large-animal model for CI electrode insertion via an extended facial recess approach without sacrificing the FN. In this small sample, Hampshire specimens had improved RWM visibility compared to Suffolk-Dorset. Thus, Hampshire sheep may be superior to other breeds for ease of cochlear implantation, with FN and facial recess anatomy more similar to humans.
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Implante Coclear , Modelos Animais , Animais , Implante Coclear/métodos , Ovinos , Osso Temporal , Janela da Cóclea/cirurgia , Janela da Cóclea/anatomia & histologia , Implantes CoclearesRESUMO
OBJECTIVE: In this study, we examine how impairments in vision, hearing, touch, and olfaction relate to depression in older adults, considering both individual and multisensory impairments (MSIs). STUDY DESIGN: Analysis of cross-sectional data from a longitudinal investigation involving black and white older adults aged 70 to 79 at enrollment. SETTING: We studied 1640 black and white participants in the Health ABC study using complete sensory evaluation data from years 3 to 5. METHODS: Our MSI assessment utilized data obtained for visual acuity, hearing perception, olfactory performance, and tactile function. We performed multivariable logistic regression analyses to examine the associations between the presence of individual and MSIs and depression which was defined as the presence of antidepressants prescribed for depression, or a Center for Epidemiological Studies Depression Scale score of greater than 10. RESULTS: We observed a possible dose-response relationship between the number of sensory impairments and depression. In adjusted models, when compared to no impairments, vision (odds ratio [OR] = 1.45, 95% confidence interval [CI]: 1.09-1.93) and hearing impairments (OR = 1.49, 95% CI: 1.11-1.99) were significantly associated with depression, whereas olfaction (OR = 1.11, 95% CI: 0.83-1.47) and tactile impairments (OR = 1.28, 95% CI: 0.96-1.70) were not. Participants with 3 sensory impairments had a higher rate of depression (OR = 2.05, 95% CI: 1.22-3.54) compared to those without impairments, and this risk increased further for those with 4 sensory impairments (OR = 2.95, 95% CI: 1.48-5.88). CONCLUSION: The findings suggest that individuals with MSI represent a high-risk population for depression, warranting close monitoring to screen for depression. The study emphasizes the importance of considering multiple sensory impairments in the context of mental health and supports the early identification and monitoring of depression in this population.
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Depressão , Humanos , Idoso , Masculino , Feminino , Estudos Transversais , Depressão/epidemiologia , Transtornos de Sensação/epidemiologia , Transtornos da Visão/epidemiologia , Transtornos da Visão/psicologia , Estudos Longitudinais , Transtornos do Olfato/epidemiologia , Transtornos do Olfato/psicologiaRESUMO
BACKGROUND: From 1821 to 1829, Sir Charles Bell presented cases of facial paralysis from infection, trauma, and unknown causes. As such, "Bell's palsy" initially referred to facial palsy of any etiology. Today, the term is reserved for idiopathic peripheral facial palsy. The objectives of this analysis were to establish when the eponym came to vogue and delineate the semantic shift from its original definition to its current one. METHODS: Extensive review of available 19th and 20th century literature mentioning "Bell's palsy" and "Bell's paralysis." RESULTS: Historical accounts have eponymously attached Bell's name to facial paralysis as early as the 1840s-Bell's palsy was first used to describe cases of facial palsy of any cause. In 1886, Gowers characterized Bell's palsy as a "neuritis usually within the Fallopian Canal," distinguishing it as a separate etiology. Over the next decades, the definition narrowed to peripheral facial paralysis from cold exposure or unknown causes. By the 1940s, its natural history was well described-an acute, unilateral, idiopathic, and usually self-limited peripheral facial palsy. CONCLUSION: The semantic change of a word over time can tell us a remarkable story of its history and origins. Absence of a discrete lesion, lack of proven treatment, and good prognosis without intervention distinguished Bell's palsy from other causes of facial paralysis. Over time, the definition has narrowed from a facial palsy of any cause to an idiopathic peripheral facial palsy. Recent evidence supporting Bell's palsy as a viral mononeuritis may have driven its recent semantic change toward this specific etiology.
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Paralisia de Bell , Paralisia Facial , Humanos , Paralisia Facial/complicações , Paralisia de Bell/diagnóstico , Paralisia de Bell/históriaRESUMO
INTRODUCTION: Social media has an ever-growing presence in patients' lives, particularly with the dissemination of both useful and misleading information. We performed an exploration and analysis of content pertaining to cochlear implantation on a popular social media platform. METHODS: "Cochlear implant" (CI) was queried on TikTok in early October 2022 in a cross-sectional analysis. The 100 top videos were collected. Non-English and duplicate videos were excluded. Two independent researchers used the Global Quality Scale (GQS) and modified DISCERN tool to score videos; higher ratings indicate increased quality and reliability. Demographic data were also recorded. RESULTS: Of the 100 videos assessed, 95 met the inclusion criteria. The average video had 2.36 million views, 328 thousand likes, and a duration of 36.1 seconds. The mean GQS was 1.91 (standard deviation (SD) 0.85), and the modified DISCERN score was 1.48 (SD 1.20). Posters were predominantly laypersons (93.7%), including CI users or parents of pediatric CI users. No videos featured audiologists or otolaryngologists. Nearly half of the videos (48.4%) discussed the experience of a patient or parent of a pediatric patient with CIs, and 24.2% were aimed at directly educating the viewers about CIs or the deaf community. CONCLUSIONS: Most videos featured CI users or families of pediatric CI users and detailed specific patient experiences. The deaf and CI communities have strong social media presences. Most videos had limited quality and reliability, measured via the GQS and modified DISCERN tool, and no videos featured hearing healthcare professionals, highlighting opportunities for clinicians to use the platform as a patient resource.
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BACKGROUND: Popular culture and music have long served as windows into the common attitudes, trends, and issues of the time. The representation of vertigo in music has not been previously explored. The objective of this study was to analyze the portrayal of vertigo in music through content and sentiment analysis of song lyrics. METHODS: A large song lyric database was queried to identify English language song titles containing the word "vertigo." A sentiment and content analysis of the lyrics was performed to delineate the most frequently used words, the accuracy of vertigo depictions, and emotional valence (i.e., the ratio of positive to negative references to vertigo). RESULTS: Between 1969 and 2022, there were a total of 54 songs specifically titled "Vertigo." Most songs (73%) portrayed vertigo negatively, and the prevalence of negative sentiment within music increased with each decade. The three most common words being used in association with vertigo within music were "feel" (n = 97), "love" (n = 66), and "falling" (n = 57). In early decades, songs using the word vertigo misrepresented the condition and associated perceptions relative to common medical understanding. In more recent decades, vertigo was used in a way more representative of medical interpretations. CONCLUSION: The depiction of vertigo in songs has changed over time, and more recently, usage has reflected Bárány Society definitions. Interestingly, the negative sentiment has also increased with time. This work provides a lyrical analysis of vertigo that may improve physician understanding of the cultural usage of this challenging symptom.
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Música , Humanos , Música/psicologia , Idioma , Prevalência , Gerenciamento de Dados , Bases de Dados FactuaisRESUMO
BACKGROUND: Social determinants of health (SDoH) are environmental conditions that influence health outcomes. As olfactory dysfunction (OD) in older individuals is associated with increased morbidity and mortality, we sought to investigate the impact of specific SDoH on olfactory function. METHODS: A cross-sectional analysis of the Health, Aging and Body Composition Study, a US population-based epidemiologic cohort study, was performed. Olfactory function was assessed utilizing both a self-report and a psychophysical olfactory test (CC-SIT test). Multivariable logistic regressions were performed to examine associations between specific SDoH with self-reported anosmia (sOD) and objective anosmia (oOD) as assessed by psychophysical testing. Differences in sensitivity and specificity were evaluated with sample tests for equality of proportions. RESULTS: Of 2219 participants, 13% had oOD and 18% had objective hyposmia; only 10% had sOD. Individuals identifying as Black race had higher odds of oOD (odds ratio [OR]:1.41, 95% confidence interval [CI]:1.02-1.95), while females and those reporting family incomes ≥$50,000 had lower odds of oOD (OR: 0.46, CI:0.34-0.62; OR:0.52, CI:0.29-0.93), adjusting for covariates. No specific SDoH was significantly associated with sOD. The sensitivity and specificity of sOD for oOD was 23.1% and 92.0%, respectively. sOD had greater sensitivity in females than males (30.8% vs. 18.8%, p = 0.030), while specificity varied significantly depending on family income (range: 90.0%-94.8%, p = 0.033). CONCLUSIONS: Utilizing a large population-based study, we find disparities in the prevalence and self-recognition of OD among individuals of different gender, race, and income levels. Further effort is needed to evaluate factors propagating these disparities and to raise awareness of OD across all patient populations.
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Transtornos do Olfato , Masculino , Feminino , Humanos , Idoso , Transtornos do Olfato/diagnóstico , Transtornos do Olfato/epidemiologia , Estudos de Coortes , Anosmia , Estudos Transversais , Determinantes Sociais da SaúdeRESUMO
PURPOSE: Sheep are used as a large-animal model for otology research and can be used to study implantable hearing devices. However, a method for temporal bone extraction in sheep, which enables various experiments, has not been described, and literature on middle ear access is limited. We describe a method for temporal bone extraction and an extended facial recess surgical approach to the middle ear in sheep. METHODS: Ten temporal bones from five Hampshire sheep head cadavers were extracted using an oscillating saw. After craniotomy and removal of the brain, a coronal cut was made at the posterior aspect of the orbit followed by a midsagittal cut of the occipital bone and disarticulation of the atlanto-occipital joint. Temporal bones were surgically prepared with an extended facial recess approach. Micro-CT scans of each temporal bone were obtained, and anatomic dimensions were measured. RESULTS: Temporal bone extraction was successful in 10/10 temporal bones. Extended facial recess approach exposed the malleus, incus, stapes, and round window while preserving the facial nerve, with the following surgical considerations: minimally pneumatized mastoid; tegmen (superior limit of mastoid cavity) is low-lying and sits below temporal artery; chorda tympani sacrificed to optimize middle ear exposure; incus buttress does not obscure view of middle ear. Distance between the superior aspect of external auditory canal and tegmen was 2.7 (SD 0.9) mm. CONCLUSION: We identified anatomic landmarks for temporal bone extraction and describe an extended facial recess approach in sheep that exposes the ossicles and round window. This approach is feasible for studying implantable hearing devices.
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Otolaringologia , Osso Temporal , Ovinos , Animais , Osso Temporal/cirurgia , Orelha Média , Processo Mastoide/cirurgia , Janela da CócleaRESUMO
OBJECTIVE: Hearing aids (HAs) are designed for speech rather than music listening. The impact of HAs on music enjoyment is poorly studied. We examine the effect of HAs on active music enjoyment in individuals with varying levels of hearing loss (HL). STUDY DESIGN: Cross-sectional study. SETTING: Tertiary medical center and community. METHODS: Adult (≥18 years) bilateral HA users and normal hearing (NH) controls actively listened to musical stimuli and rated their enjoyment across 3 measures (pleasantness, musicality, naturalness) with and without HAs using a visual analog scale. Multivariable linear regression was used to assess the association between HL (measured by a pure-tone average [PTA] and word recognition score [WRS] of the better ear) and music enjoyment with and without HAs, adjusting for covariates. Music enjoyment was compared between HA users and NH controls, and HA users with and without their HAs. RESULTS: One hundred bilateral HA users (mean age 66.0 years, 52% female, better ear mean [SD] PTA 50.2 [13.5] dBHL, mean WRS 84.5 [16.5]%) completed the study. Increasing severity of HL (PTA) was independently associated with decreased music enjoyment (pleasantness, musicality, naturalness) with and without HAs (p < .05). HA usage increased music enjoyment (musicality) in those with moderate to moderately severe HL. Music enjoyment in NH controls (n = 20) was significantly greater across all measures compared to HA users. CONCLUSION: Increased severity of HL is associated with decreased music enjoyment that can be enhanced with HA usage. Thus, HA usage can positively enhance both speech and music appreciation.
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Implantes Cocleares , Surdez , Auxiliares de Audição , Perda Auditiva , Música , Adulto , Humanos , Feminino , Idoso , Masculino , Prazer , Estudos Transversais , Perda Auditiva/reabilitaçãoRESUMO
OBJECTIVE: Age-related hearing loss (HL) may be a risk factor for incident dementia. The objective was to use population-based claims data from the New York Statewide Planning and Research Cooperative System (SPARCS) to establish if HL is associated with incident dementia. STUDY DESIGN: Retrospective cohort study. SETTING: Comprehensive all-payer data reporting system (2007-2017). PATIENTS: Two hundred six thousand eight hundred one subjects more than 60âyears (56,523 with HL, random sample of 150,278 without HL). INTERVENTIONS: None. MAIN OUTCOME MEASURES: The main outcome was incident dementia, measured by initial dementia diagnosis (ICD-9/ICD-10 code) associated with a patient visit/insurance claim. The main exposure was HL, measured by at least two separate HL diagnoses associated with claims before dementia diagnosis. Cox proportional-hazards models were used to examine the relationship of baseline HL with incident dementia, adjusting for age, sex, cardiovascular disease, cerebrovascular disease, diabetes, and smoking. RESULTS: Dementia incidence rates per 1,000 person-years were 10.16 (95% confidence interval [CI]â=â9.81-10.51; subjects with HL) and 5.43 (5.28-5.57; subjects without HL). Fewer (2-10) HL claims (nâ=â56,523), compared with no (0) HL claims, was associated with 1.10 (95% CIâ=â1.05-1.15, pâ<â0.001) times the hazard of incident dementia, adjusting for covariates. Greater (>10) HL claims (nâ=â3,414), compared with no (0) HL claims, was associated with 1.63 (95% CIâ=â1.42, 1.86, pâ<â0.001) times the hazard of incident dementia, adjusting for covariates. CONCLUSIONS: HL diagnosis was associated with increased risk of incident dementia based on a comprehensive all-payer data reporting system. Individuals with a more established diagnosis of HL (more HL claims) demonstrated an increased hazard ratio.
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Surdez , Demência , Perda Auditiva , Surdez/complicações , Demência/epidemiologia , Demência/etiologia , Perda Auditiva/diagnóstico , Humanos , Incidência , New York/epidemiologia , Osteonectina , Estudos Retrospectivos , Fatores de RiscoRESUMO
OBJECTIVE: There is a known association between hearing loss (HL) and depressive symptoms. The objective was to establish if there is a stronger association with the left or right ear. STUDY DESIGN: Cross-sectional analysis of an ongoing prospective epidemiologic cohort study. SETTING: Hispanic Community Health Study (US, multicentered). PATIENTS: Five thousand three hundred and twenty-eight adults 2:50 years old. INTERVENTIONS: None. MAIN OUTCOME MEASURES: The main outcome was depressive symptoms, measured by the 10-Item Center for Epidemiologic Studies Depression Scale-10 (CESD-10) and defined continuously and binarily. Subjects with CESD-10 2: 10 were categorized as having clinically significant depressive symptoms (CSDS). Linear and logistic regressions were performed to assess the association between depressive symptoms and hearing in each ear, controlling for hearing aid use, age, sex, educational level, study site, geographic background, cardiovascular disease, and antidepressant use. RESULTS: Mean age was 58.5 ± 6.3 years. Mean pure-tone average (PTA) was 20.3 ± 11.7 dB (range = 0 - 125) in the right ear and 20.3 ± 12.4 dB (range = -2.5 to 120) in the left. Multivariable regression adjusting for covariates demonstrated significant associations between depressive symptoms and HL in both the left and right ear. For every 20-dB worsening in right ear PTA, there was 0.89-point increase in CESD-10 (95% confidence interval = 0.59 - 1.2), and odds of CSDS increased 1.31 times (1.17 - 1.46). For every 20-dB worsening in left ear PTA, there was a 0.85-point increase in CESD-10 (0.55 - 1.14), and odds of CSDS increased 1.34 times (1.20 - 1.49). CONCLUSIONS: Worsening hearing in the right and left ears individually was associated with increased depressive symptoms and odds of CSDS. No ear laterality was demonstrated.
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Depressão , Presbiacusia , Adulto , Audiometria de Tons Puros , Estudos de Coortes , Estudos Transversais , Depressão/complicações , Humanos , Pessoa de Meia-Idade , Estudos ProspectivosRESUMO
Objectives: To analyze the association between neurocognitive performance and age-related hearing loss in the right and left ear, individually. Design: Subjects included 5277 participants (≥50 years) from the general Hispanic population who underwent audiometric testing in a US multicentered epidemiologic study. Linear regression was performed to assess the cross-sectional association between cognitive performance (Digit Symbol Substitution Test [DSST], Word Frequency Test, Spanish-English Verbal Learning Test [SEVLT] 3 Trials, SEVLT Recall, and Six-Item Screener) and hearing in each ear (4-frequency pure-tone average), adjusting for age, sex, education, cardiovascular disease, and hearing aid use. Results: Mean age was 58.4 ± 6.2 years; 3254 (61.7%) were women. Mean pure-tone averages were 20.2 ± 11.7 dB (right ear) and 20.2 ± 12.3 dB (left ear). Multivariable regression demonstrated significant associations between all cognitive tests and hearing loss in both ears. Conclusions: Worsening hearing loss in the right and left ear was associated with decreased performance across all tests. No laterality in the association was demonstrated.