Microalbuminuria and Functional Iron Deficiency are Risk Factors for Hearing Loss in Adolescents.

OBJECTIVES: Renal impairment and some systemic diseases are associated with hearing loss (HL) in adults. However, studies of these relationship in adolescents are rare. The objective of this study was to determine the association between HL and renal or systemic disease in adolescents. METHODS: Subjects were extracted from the 5th Korea National Health and Nutrition Examination Survey from 2011 to 2012. We included adolescents aged 10-19 years old with normal tympanic membrane and those who underwent a physical and laboratory examination and pure tone audiometry. HL, high-frequency hearing loss (HFHL), albuminuria, impaired glomerular filtration rate, hypertension, diabetes, and obesity were evaluated based on the data. RESULTS: Individuals with microalbuminruia (MIA) exhibited higher prevalence of HL (p = 0.003) and HFHL (p = 0.012) than those without MIA. The prevalence of HL and HFHL appeared to increase according to the severity of albuminuria. Additionally, individuals with HL or HFHL showed lower transferrin saturation (TSAT) than individuals without HL (p = 0.002) or HFHL (p = 0.001). And, HFHL was associated with lower ferritin levels (p = 0.017). HL and HFHL were related to MIA (p = 0.004 and p = 0.022, respectively) and TSAT (p = 0.005 and p = 0.011, respectively) after controlling other factors. CONCLUSION: MIA and TSAT level were independently associated with the HL and HFHL. Since MIA can be easily detected by dipstick test and urine analysis, hearing evaluations for individuals with MIA might be helpful to identify hearing impairments earlier in adolescents. LEVEL OF EVIDENCE: 3 (individual cross-sectional study) Laryngoscope, 134:3329-3334, 2024.

Association Between Portable Music Player Use and Hearing Loss Among Children of School Age in the Netherlands.

Importance: Portable music player use may have harmful effects on hearing. The magnitude and effect of frequent music exposure, especially at younger ages, on hearing are unclear. Objectives: To examine the prevalence of noise-induced hearing loss in a 9- to 11-year-old population and associations with portable music player use and sociodemographic factors. Design, Setting, and Participants: A cross-sectional study within an ongoing, prospective, birth cohort study within Rotterdam, the Netherlands was conducted. Between ages 9 and 11 years, 5355 children underwent their first audiometric evaluation. Children were excluded if they had missing or failed tympanometry results. The study was conducted from April 16, 2012, to October 25, 2015. Exposures: Portable music player (PMP) use and sociodemographic factors assessed via parental questionnaires. Main Outcomes and Measures: Hearing acuity measured by pure-tone audiometry at 0.5 to 8 kHz. Possible noise-induced hearing loss was contingent on a high-frequency notch and/or high-frequency hearing loss in the audiogram, or reported hearing-related symptoms. Results: The final sample included 3116 participants who were a mean (interquartile range) age of 9.7 (9.6-9.9) years and equally distributed between boys (1550 [49.7%]) and girls (1566 [50.3%]). Of these, 1244 (39.9%) reported no PMP use, 577 (18.5%) reported use 1 or 2 days per week, 254 (8.2%) reported use 3 or more days per week, and for 1041 (33.4%), PMP use was not reported. Audiometric notches and high-frequency hearing loss were present in 443 (14.2%) of all children; 140 (4.5%) fulfilled the criteria of a notch, 238 (7.6%) of high-frequency hearing loss, and 65 (2.1%) of both. Of the cohort, 52 (1.7%) showed bilateral impairment. Hearing-related symptoms were reported for 232 (11.3%) of the respondents, and 831 (40.0%) of the respondents used portable music players. Portable music player use was associated with high-frequency hearing loss (odds ratio [OR], 2.88; 95% CI, 1.36-6.980 for 1 or 2 days per week and OR, 2.74; 95% CI, 1.22-6.96 for ≥3 days per week), but listening time and duration were not. There was no association of music exposure with high-frequency notches. Conclusions and Relevance: In this study, 14.2% of school-aged children showed audiometric notches or high-frequency hearing loss. This hearing impairment is already present prior to exposure to known noise hazards, such as club and concert attendance, and may have lifelong consequences. Repeated measurements are needed to confirm the association of portable music player use with hearing impairment in children.

Association of Cardiovascular Comorbidities With Hearing Loss in the Older Old.

Importance: In the United States, the population of individuals older than 80 years is expected to double in the next 40 years. Cardiovascular comorbidities are prevalent in this older old population, and their relationship with hearing loss has not been well characterized. Objective: To investigate the association of cardiovascular disease (CVD)-related risk factors with auditory function among the older old (>80 years). Design, Setting, and Participants: Audiological data and medical records from 2001 through 2014 of 433 patients aged 80 to 106 years at an academic medical center were analyzed in 2017. Main Outcomes and Measures: The degree of low- and high-frequency hearing loss of participants with coronary artery disease, diabetes, hypertension, history of cerebrovascular accident, and smoking status was compared with that of disease-free individuals. Rate of hearing loss was also determined. Results: Among the 433 patients (67% female; mean [SD] age, 89 [5.8] years), the presence of at least 1 cardiovascular morbidity was associated with elevated mean (SD) low-frequency pure-tone average (LFPTA) of 42.4 (1.6) vs 36.9 (3.5) decibels hearing loss (dB HL), a difference of 5.47 (95% CI, 4.15-9.49) dB HL. Among the 96 patients with 2 audiograms performed at age 80 years or older from which the rate of hearing loss could be calculated, 32 patients had CVD or related risk factors and 64 were healthy controls. Those with at least 1 disease had accelerated hearing loss. Patients with cardiovascular morbidity experienced a faster mean (SD) decline in LFPTA of 1.90 (0.27) vs 1.18 (0.42) dB HL/y, a difference of 0.72 (95% CI, 0.08-1.36) dB HL/y. Of the conditions studied, coronary artery disease had the highest association with audiometric thresholds and was associated with hearing loss at all frequencies tested and with poor word recognition score. Hearing loss was more strongly associated with CVD risk factors in men than in women. Conclusions and Relevance: In this study of the older old, cardiovascular risk factors and disease were associated with worse hearing and a greater rate of hearing deterioration. Hearing loss in women was less associated with the presence of CVD, possibly owing to the cardioprotective effects of estrogen. The association of hearing with CVD severity and management remains to be determined.

Occupational Noise Exposure, Bilateral High-Frequency Hearing Loss, and Blood Pressure.

OBJECTIVE: The aim of this study was to investigate the relationships between occupational noise exposure and blood pressure using self-reported occupational exposure and bilateral high-frequency hearing loss. METHODS: This study included 4548 participants aged 20 to 69 years from the National Health and Nutrition Examination Survey 1999 to 2004. On the basis of self-reported exposure status, participants were divided into the current, former, or never exposed groups. Bilateral high-frequency hearing loss was defined as the average high-frequency hearing threshold at least 25 dB in both ears. RESULTS: The currently exposed participants had slightly increased diastolic blood pressure compared with those never exposed. Among previously exposed participants, those with bilateral high-frequency hearing loss had increased systolic blood pressure, heart rate, and the prevalence of hypertension compared with those with normal high-frequency hearing. CONCLUSION: Although there were some significant results, the evidence was not consistent to support the associations between occupational noise exposure and blood pressure.

Differences in clinical characteristics and prognosis of sudden low- and high-frequency hearing loss.

OBJECTIVES/HYPOTHESIS: We compared the clinical characteristics between acute low- and high-frequency hearing loss (LF and HF, respectively) patients, and the efficacy of three different treatment protocols (systemic steroids, intratympanic steroid injection, and combination therapy). STUDY DESIGN: Prospective, randomized controlled study. METHODS: A total of 111 patients diagnosed with LF or HF were treated on an outpatient basis. Each group was randomly divided into three equal subgroups based on therapy: oral steroid, intratympanic dexamethasone injection (IT), and combination therapy. Hearing gain was estimated by comparing pre- and post-treatment pure-tone averages. Recovery rate was assessed by Clinical Practice Guideline: Sudden Hearing Loss from the American Academy of Otolaryngology-Head and Neck Surgery. RESULTS: In comparison of chief complaints, ear fullness and hearing loss were more common in the LF and HF group, respectively (P = .033 and P = .001, respectively). Hearing recovery rates were significantly different between the two groups (i.e., 74.1% [40/54] in the LF group and 45.6% [26/57] in the HF group; P < .001). Oral steroid therapy was most effective in the LF group (P = .017). In the HF group, all three modalities showed similar results, although IT tended to be the most effective (P = .390). CONCLUSIONS: There were differences in chief complaints and treatment responses between LF and HF patients. Although they showed similar partial damage in the cochlea, the pathophysiology of LF and HF may be quite different. LEVEL OF EVIDENCE: 1b. Laryngoscope, 127:1878-1884, 2017.

The Sensitivity of Adolescent School-Based Hearing Screens Is Significantly Improved by Adding High Frequencies.

High frequency hearing loss (HFHL), often related to hazardous noise, affects one in six U.S. adolescents. Yet, only 20 states include school-based hearing screens for adolescents. Only six states test multiple high frequencies. Study objectives were to (1) compare the sensitivity of state school-based hearing screens for adolescents to gold standard sound-treated booth testing and (2) consider the effect of adding multiple high frequencies and two-step screening on sensitivity/specificity. Of 134 eleventh-grade participants (2013-2014), 43 of the 134 (32%) did not pass sound-treated booth testing, and 27 of the 43 (63%) had HFHL. Sensitivity/specificity of the most common protocol (1,000, 2,000, 4,000 Hz at 20 dB HL) for these hearing losses was 25.6% (95% confidence interval [CI] = [13.5, 41.2]) and 85.7% (95% CI [76.8, 92.2]), respectively. A protocol including 500, 1,000, 2,000, 4,000, 6,000 Hz at 20 dB HL significantly improved sensitivity to 76.7% (95% CI [61.4, 88.2]), p < .001. Two-step screening maintained specificity (84.6%, 95% CI [75.5, 91.3]). Adolescent school-based hearing screen sensitivity improves with high frequencies.

The Sensitivity of Adolescent Hearing Screens Significantly Improves by Adding High Frequencies.

PURPOSE: One in 6 US adolescents has high-frequency hearing loss, often related to hazardous noise. Yet, the American Academy of Pediatrics (AAP) hearing screen (500, 1,000, 2,000, 4,000 Hertz) primarily includes low frequencies (<3,000 Hertz). Study objectives were to determine (1) sensitivity and specificity of the AAP hearing screen for adolescent hearing loss and (2) if adding high frequencies increases sensitivity, while repeat screening of initial referrals reduces false positive results (maintaining acceptable specificity). METHODS: Eleventh graders (n = 134) participated in hearing screening (2013-2014) including "gold-standard" sound-treated booth testing to calculate sensitivity and specificity. RESULTS: Of the 43 referrals, 27 (63%) had high-frequency hearing loss. AAP screen sensitivity and specificity were 58.1% (95% confidence interval 42.1%-73.0%) and 91.2% (95% confidence interval 83.4-96.1), respectively. Adding high frequencies (6,000, 8,000 Hertz) significantly increased sensitivity to 79.1% (64.0%-90.0%; p = .003). Specificity with repeat screening was 81.3% (71.8%-88.7%; p = .003). CONCLUSIONS: Adolescent hearing screen sensitivity improves with high frequencies. Repeat testing maintains acceptable specificity.

Health-related quality of life and mental distress in patients with partial deafness: preliminary findings.

The aim of the study was to evaluate mental distress and health-related quality of life in patients with bilateral partial deafness (high-frequency sensorineural hearing loss) before cochlear implantation, with respect to their audiological performance and time of onset of the hearing impairment. Thirty-one patients and 31 normal-hearing individuals were administered the Beck Depression Inventory (BDI), the State-Trait-Anxiety-Inventory (STAI) and the World Health Organization Quality of Life-BREF questionnaire (WHOQOL-BREF). Patients also completed the Nijmegen-Cochlear-Implant-Questionnaire (NCIQ), a tool for evaluation of quality of life related to hearing loss. Patients revealed increased depressive and anxiety symptoms, as well as decreased health-related quality of life (psychological health, physical health), in comparison with their healthy counterparts (t tests, p < 0.05). Furthermore, a General Linear Model demonstrated in patients with a prelingual onset of hearing loss enhanced self-evaluated social interactions and activity (NCIQ), when their outcomes were contrasted with those obtained in individuals with postlingual partial deafness (p < 0.05). The study failed to show any effect of collateral tinnitus. Patients not using hearing aids had better audiological performance and, therefore, better sound perception and speech production, as measured with NCIQ. There was no effect of hearing aid use with respect to mental distress. Additional statistically significant correlations seen in patients included those between a steeper slope hearing loss configuration (averaged pure-tone thresholds at 1 and 2 kHz with subtracted threshold at 0.5 kHz) and better audiometric speech detection, between audiometric thresholds and the subjectively rated sound perception (NCIQ), as well as left-ear audiometric word recognition scores and the subjectively perceived ability to recognize advanced sounds (NCIQ). In addition, a longer duration of postlingual deafness, as well as a younger age at the onset were both related to worse speech detection thresholds. The results of the study provide evidence that successful rehabilitation in patients with partial deafness might have to go beyond the standard speech therapy. Enhancement of the regular diagnostic assessment with additional psychological tools is highly recommended. Further investigation is required as to the role of functional residual hearing, hearing aid use and tinnitus, in relation to future outcomes of cochlear implantation.

[The treatment effects analysis of 164 patients with sudden sensorineural hearing loss].

OBJECTIVE: To explore the effective treatment of sudden sensorineural hearing loss and factors affecting its prognosis. METHOD: The clinical data and follow-up results of 164 patients with sudden sensorineural hearing loss were analyzed retrospectively. All the 164 patients were given intravenous vasodilator, neurotrophic drugs treatment, oral prednisone treatment, and intratympanic dexamethasone injection. All patients were divided into low frequency hearing loss type,intermediate frequency hearing loss, high frequency hearing loss, all frequency hearing loss and total deafness group. Pure tone hearing threshold test were performed before and 3 months after treatment. All patients and different groups were compared before and after treatment damage frequency of average air conduction and various frequency air conduction hearing. Analysis of gender, age, process and hearing curve type, frequency hearing of impaired before treatment, the symptoms with or without vertigo. RESULT: All the patients' hearing improved after treatment. The treatment efficiency was 46.3%, and low frequency hearing improvements were better than the high frequency hearing. Including age, process, frequency hearing of impaired before treatment, with or without vertigo isindependent factors influencing its prognosis. CONCLUSION: Based on the regular treatment,oral and intratympanic injection glucocorticoid therapy are safe and effective for sudden hearing loss,The prognosis and age, course, impaired hearing before curve type, treatment frequency hearing level is closely related, with or without vertigo.

The incidence of high-frequency hearing loss after microvascular decompression for trigeminal neuralgia, glossopharyngeal neuralgia, or geniculate neuralgia.

OBJECT: The primary aim of this study was to evaluate the incidence and discuss the pathogenesis of high-frequency hearing loss (HFHL) after microvascular decompression (MVD) for trigeminal neuralgia (TGN), glossopharyngeal neuralgia (GPN), or geniculate neuralgia (GN). METHODS: The authors analyzed preoperative and postoperative audiogram data and brainstem auditory evoked potentials (BAEPs) from 93 patients with TGN, 6 patients with GPN, and 8 patients with GN who underwent MVD. Differences in pure tone audiometry > 10 dB at frequencies of 0.25, 0.5, 1, 2, 4, and 8 kHz were calculated preoperatively and postoperatively for both the ipsilateral and the contralateral sides. Intraoperative monitoring records were analyzed and compared with the incidence of HFHL, which was defined as a change in pure tone audiometry > 10 dB at frequencies of 4 and 8 kHz. RESULTS: The incidence of HFHL was 30.84% on the side ipsilateral to the surgery and 20.56% on the contralateral side. Of the 47 patients with HFHL, 20 had conductive hearing loss, and 2 experienced nonserviceable hearing loss after the surgery. The incidences of HFHL on the ipsilateral side at 4 and 8 kHz were 17.76% and 25.23%, respectively, and 8.41% and 15.89%, respectively, on the contralateral side. As the audiometric frequency increased, the number of patients with hearing loss increased. No significant postoperative difference was found between patients with and without HFHL in intraoperative BAEP waveforms. Sex, age, and affected side were not associated with an increase in the incidence of hearing loss. CONCLUSIONS: High-frequency hearing loss occurred after MVD for TGN, GPN, or GN, and the greatest incidence occurred on the ipsilateral side. This hearing loss may be a result of drill-induced noise and/or transient loss of cerebrospinal fluid during the course of the procedure. Changes in intraoperative BAEP waveforms were not useful in predicting HFHL after MVD. Repeated postoperative audiological examinations may be useful in assessing the prognosis of HFHL.

The Efficacy of Routine Screening for High-Frequency Hearing Loss in Adults and Children.

PURPOSE: This study was conducted to investigate the efficacy of routine screening for high-frequency hearing loss (HFHL) including 3000, 6000, and 8000 Hz frequencies with conventional test frequencies (1000, 2000, and 4000 Hz) in adults and children in a university outreach program. METHOD: Screening outcomes were examined in 2 cohorts of adults (Cohort 1, N = 315, M = 66.2 years; Cohort 2, N = 67, M = 68.3 years) and children (Cohort 1, N = 177, M = 6.5 years; Cohort 2, N = 57, M = 6.9 years) with a high-frequency screen protocol (1000-8000 Hz at 25 dB HL for adults and 20 dB HL for children) using supra-aural headphones. A rescreen was conducted in Cohort 2 with a modified protocol using insert earphones and monitored ambient noise levels. RESULTS: Average total test time significantly increased (p < .0001) and nearly doubled with inclusion of 3000-, 6000-, and 8000-Hz frequencies, adding approximately 1 min. Rescreen referral rates decreased by approximately 2%-16% at 1000-8000 Hz (approximately 13%-16% at 6000 and 8000 Hz) using the modified protocol in adults and children, supporting false-positive responses using supra-aural headphones. CONCLUSION: Screening for HFHL should include insert earphones in order to prevent potential errors, particularly at 6000 and 8000 Hz.

Hearing disorders in Turner's syndrome: a survey from Iran.

Turner syndrome (TS) is one of the most frequently encountered sex-linked chromosomal abnormalities, occurring in one per 2,000 female births. These patients present with short stature and failure to begin puberty. In this syndrome, there are multiple organ abnormalities, including auditory disorders. TS patients were referred to the ENT clinic by a pediatric endocrinologist. A questionnaire was filled out and the patients went through a complete otologic examination. They were then referred to the audiology clinic to undergo audiologic test battery plus high-frequency pure tone audiometry. From a total of 48 ears examined, 11 (22.9 %) had a normal audiometry. Mid-frequency sensorineural hearing loss (SNHL), high-frequency SNHL, combined and mixed hearing loss were diagnosed in 6 (12/5 %), 20 (41/7 %), 6 (12/5 %) and 1 (2/1 %) ear, respectively. Tympanogram results showed normal compliance (A, As, Ad) in the majority of cases. B and C patterns were found in a few cases. Speech discrimination score was normal in all patients whereas speech reception threshold was normal in 92 % of the ears. Audiometry abnormality especially SNHL is common in TS patients, with the high-frequency pattern being the most frequent.

Hearing threshold estimation by auditory steady-state responses with narrow-band chirps and adaptive stimulus patterns: implementation in clinical routine.

Objective hearing threshold estimation by auditory steady-state responses (ASSR) can be accelerated by the use of narrow-band chirps and adaptive stimulus patterns. This modification has been examined in only a few clinical studies. In this study, clinical data is validated and extended, and the applicability of the method in audiological diagnostics routine is examined. In 60 patients (normal hearing and hearing impaired), ASSR and pure tone audiometry (PTA) thresholds were compared. ASSR were evoked by binaural multi-frequent narrow-band chirps with adaptive stimulus patterns. The precision and required testing time for hearing threshold estimation were determined. The average differences between ASSR and PTA thresholds were 18, 12, 17 and 19 dB for normal hearing (PTA ≤ 20 dB) and 5, 9, 9 and 11 dB for hearing impaired (PTA > 20 dB) at the frequencies of 500, 1,000, 2,000 and 4,000 Hz, respectively, and the differences were significant in all frequencies with the exception of 1 kHz. Correlation coefficients between ASSR and PTA thresholds were 0.36, 0.47, 0.54 and 0.51 for normal hearing and 0.73, 0.74, 0.72 and 0.71 for hearing impaired at 500, 1,000, 2,000 and 4,000 Hz, respectively. Mean ASSR testing time was 33 ± 8 min. In conclusion, auditory steady-state responses with narrow-band-chirps and adaptive stimulus patterns is an efficient method for objective frequency-specific hearing threshold estimation. Precision of threshold estimation is most limited for slighter hearing loss at 500 Hz. The required testing time is acceptable for the application in everyday clinical routine.

Automated screening for high-frequency hearing loss.

OBJECTIVE: Hearing loss at high frequencies produces perceptual difficulties and is often an early sign of a more general hearing loss. This study reports the development and validation of two new speech-based hearing screening tests in English that focus on detecting hearing loss at frequencies above 2000 Hz. DESIGN: The Internet-delivered, speech-in noise tests used closed target-word sets of digit triplets or consonant-vowel-consonant (CVC) words presented against a speech-shaped noise masker. The digit triplet test uses the digits 0 to 9 (excluding the disyllabic 7), grouped in quasi-random triplets. The CVC test uses simple words (e.g., "cat") selected for the high-frequency spectral content of the consonants. During testing, triplets or CVC words were identified in an adaptive procedure to obtain the speech reception threshold (SRT) in noise. For these new, high-frequency (HF) tests, the noise was low-pass filtered to produce greater masking of the low-frequency speech components, increasing the sensitivity of the test for HF hearing loss. Individual test tokens (digits, CVCs) were first homogenized using a group of 10 normal-hearing (NH) listeners by equalizing intelligibility across tokens at several speech-in-noise levels. Both tests were then validated and standardized using groups of 24 NH listeners and 50 listeners with hearing impairment. Performance on the new high frequency digit triplet (HF-triplet) and CVC (HF-CVC) tests was compared with audiometric hearing loss, and with that on the unfiltered, broadband digit triplet test (BB-triplet) test, and the ASL (Adaptive Sentence Lists) speech-in-noise test. RESULTS: The HF-triplet and HF-CVC test results (SRT) both correlated positively and highly with high-frequency audiometric hearing loss and with the ASL test. SRT for both tests as a function of high-frequency hearing loss increased at nearly three times the rate as that of the BB-triplet test. The intraindividual variability (SD) on the tests was about 2.1 (HF-triplet) and 1.7 (HF-CVC) times less than that for the BB-triplet test. The effect on the HF-triplet test of varying presentation method (professional or cheap headphones and loudspeakers) was small for the NH group and somewhat larger, but nonsignificant for the hearing-impaired group. Test repetition produced a moderate, significant learning effect for the first and second retests, but was small and nonsignificant for further retesting. The learning effect was about two times larger for the HF-CVC test than for the HF-triplet test. The sensitivity of both new tests for high-frequency hearing loss was similar, with an 87% true-positive and 7% false-positive ratio for detecting an average high-frequency hearing loss of 20 dB or more. CONCLUSIONS: The new HF-triplet and HF-CVC tests provide a sensitive and accurate method for detecting high-frequency hearing loss. The tests may signal developing hearing impairment at an early stage. The HF-triplet is preferred over the HF-CVC test because of its smaller learning effect, smaller error rate, greater simplicity, and lower cultural dependency.

Pilot study of a high-frequency school-based hearing screen to detect adolescent hearing loss.

OBJECTIVE: Like most of the United States, school-based hearing screening in Pennsylvania focuses on low-frequency, conductive hearing losses typical for young children, rather than the high-frequency, noise-induced hearing loss more prevalent among adolescents. The objective of this study was to compare the sensitivity and specificity of current school hearing screening in Pennsylvania with hearing screening including high frequencies, designed to detect adolescent hearing loss. SETTING: A single public high school. METHODS: In the Autumn of 2011 the high-frequency screen was delivered alongside the Pennsylvania school screen for students in the 11(th) grade. Screening referrals and a subset of passes returned for "gold standard" testing with audiology in a sound treated booth, in order to determine the sensitivity and specificity of the screening tests. RESULTS: Of 282 participants, five (2%) were referred on the Pennsylvania school screen, and 85 (30%) were referred on the high-frequency screen. Of the 48 who returned for gold standard testing with audiology, hearing loss was diagnosed in 9/48 (19%). Sensitivity of the Pennsylvania and high-frequency screens were 13% (95% confidence interval [CI] 0-53%) and 100% (95% CI 66-100%) respectively. Specificity of the Pennsylvania and high-frequency screens were 97% (95% CI 87-100%) and 49% (95% CI 32-65%) respectively. CONCLUSIONS: Current school hearing screens have low sensitivity for detection of adolescent hearing loss. Modifying school-based protocols may be warranted to best screen adolescents, and make optimal use of school nurse time and effort.

Distortion-product otoacoustic emissions at ultra-high frequencies in parents of individuals with autosomal recessive hearing loss / Emissões otoacústicas evocadas por produto de distorção em frequências ultra-altas em pais de indivíduos com deficiência auditiva autossômica recessiva

Purpose: To evaluate the cochlear function of parents of individuals with autosomal recessive gene Gap Junction Protein Beta-2 hearing loss by ultra-high frequencies distortion-product otoacoustic emissions (DPOAEs), compared with responses of a control group matched for age and gender. Methods: We studied 56 subjects aged from 20 to 58 years, divided into two groups. The study group comprised 28 parents of hearing-impaired patients due to autosomal recessive inheritance, 14 females aged 20.0-55.0 years (mean 32.8 years) and 14 males aged 20.0-58.0 years (mean 35.2 years). Control group was composed of normal hearing individuals, 14 males and 14 females age-matched to the study group. The subjects underwent tests for audiometry, tympanometry, and DPOAE in the frequency range of 9.000-16.000 Hz. Results: We found 64.3% of normal results of DPOAE in the study group compared to 91.1% in the control. There were significant differences between groups in the ears and DPOAE responses, and the mean level of response was in 10 dBNPS in study group and 14 dBNPS in the control. The Pearson's correlation between age and DPOAE in ultra-high frequencies showed no statistical significance. Conclusion: DPOAE at ultra-high frequencies were able to identify individuals from both groups, suggesting that heterozygous individuals for the Gap Junction Protein Beta-2 gene mutation may have damage to the cochlear function before clinical manifestation in audiometry. .

Objetivo: Avaliar a função coclear em pais de indivíduos com deficiência auditiva de herança autossômica recessiva do gene Gap Junction Bet-2 Protein por meio das emissões otoacústicas evocadas por produto de distorção (EOA-PD) em frequências ultra-altas, comparando com as respostas de um grupo controle, pareadas por gênero e idade. Métodos: Foram avaliados 56 indivíduos, entre 20 a 58 anos de idade, distribuídos em dois grupos. O grupo estudo foi constituído por 28 pais de deficientes auditivos decorrentes de herança autossômica recessiva, sendo 14 mulheres com idade entre 20,0 a 55,0 anos (média 32,8) e 14 homens de 20,0 a 58,0 anos (média 35,2), enquanto o grupo controle era formado por indivíduos sem queixa auditiva, composto por 14 homens e 14 mulheres, com idades pareadas ao grupo estudo. Os indivíduos foram submetidos aos exames de audiometria tonal, imitanciometria e EOA-PD na faixa de frequência de 9.000 a 16.000 Hz. Resultados: Foram observados 64,3% de resultados normais das EOA-PD no grupo estudo em comparação a 91,1% no controle. Houve diferença estatisticamente significante entre as orelhas e grupos nas respostas de EOA-PD, sendo que a média do nível de resposta foi 10 dBNPS no grupo estudo e 14 dBNPS no controle. A correlação de Pearson entre a idade e as EOA-PD em frequências ultra-altas não demonstrou correlação significativa. Conclusão: As EOA-PD em frequências ultra-altas foram capazes de distinguir os indivíduos de ambos os grupos, sugerindo que indivíduos heterozigotos para a mutação do gene GJB2 podem apresentar dano na função coclear antes da manifestação clínica na avaliação audiológica convencional. .

Extended high frequency audiometry in polycystic ovary syndrome.

OBJECTIVE: Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder affecting 5-10% of women in reproductive age. Insulin resistance, dyslipidemia, glucose intolerance, hypertension, and obesity are metabolic disorders accompanying the syndrome. PCOS is a chronic proinflammatory state and the disease is associated with endothelial dysfunction. In diseases with endothelial damage, hearing in high frequencies are mostly effected in early stages. We evaluated extended high frequency hearing loss in PCOS patients. MATERIAL METHODS: Forty women diagnosed as PCOS and 25 healthy controls were included in this study. Age and BMI of PCOS and control groups were comparable. Each subject was tested with low (250-2000 Hz), high (4000-8000 Hz), and extended high frequency audiometry (8000-20000). Hormonal and biochemical values including LH, LH/FSH, testosterone, fasting glucose, fasting insulin, HOMA-I, and CRP were calculated. RESULTS: PCOS patients showed high levels of LH, LH/FSH, testosterone, fasting insulin, glucose, HOMA-I, and CRP levels. The hearing thresholds of the groups were similar at frequencies of 250, 500, 1000, 2000, and 4000 Hz; statistically significant difference was observed in 8000-14000 Hz in PCOS group compared to control group. CONCLUSION: PCOS patients have hearing impairment especially in extended high frequencies. Further studies are needed to help elucidate the mechanism behind hearing impairment in association with PCOS.

Efficient hearing screening in noise-exposed listeners using the digit triplet test.

OBJECTIVES: Hearing screening in occupational medicine is generally based on pure-tone threshold audiometry. However, reliable and valid thresholds can only be obtained in a sound-proof room, using a high-quality, well-calibrated audiometer, and by a well-trained administrator. Thresholds also need to be determined for several audiometric frequencies. This makes the test time-consuming and expensive, which is not ideal for the screening of large populations. A Speech-In-Noise test (SPIN), by contrast, does not have the abovementioned requirements. Because it can be implemented as a quick automated self-test, possibly over the Internet, a SPIN test is highly advantageous for screening purposes. However, its sensitivity for (isolated) high-frequency hearing loss, as typically seen in noise-exposed listeners, was unclear up to present. In this study, the authors investigated the sensitivity and specificity of the Digit Triplet SPIN test for detecting and monitoring (early-stage) high-frequency hearing loss, and its similarity across two different language versions. DESIGN: One-hundred eighteen noise-exposed workers, representing a wide range from no to severe high-frequency hearing loss, completed the French or Dutch version of the broadband Digit Triplet self-test in an office-like room. Pure-tone thresholds, collected by a professional audiologist in favorable settings, served as the reference. RESULTS: The 84 Dutch-speaking participants showed a very strong linear relation between the reference and the Digit Triplet test, with the pure-tone average at 2, 3, 4, and 6 kHz as a strong predictor (R = 0.86) for the speech-reception threshold. The sensitivity and specificity to detect mild high-frequency hearing loss were 92% (61 of 66) and 89% (16 of 18), respectively. The area under the receiver operating characteristic (ROC) curve was very high (≥0.91) for several degrees of high-frequency hearing loss. With a within-subject standard deviation of only 0.8 dB, the Digit Triplet test also had a low measurement error. The results of the 34 French-speaking subjects showed a highly similar trend. CONCLUSIONS: The Digit Triplet test proves to have a high sensitivity and specificity for detecting different degrees of high-frequency hearing loss. Given its ease of use, this test is very suitable for screening purposes in occupational medicine, and potentially for the screening of adolescents at risk of recreational noise-induced hearing loss.