In Utero Gene Therapy and its Application in Genetic Hearing Loss.

For monogenic genetic diseases, in utero gene therapy (IUGT) shows the potential for early prevention against irreversible and lethal pathological changes. Moreover, animal models have also demonstrated the effectiveness of IUGT in the treatment of coagulation disorders, hemoglobinopathies, neurogenetic disorders, and metabolic and pulmonary diseases. For major alpha thalassemia and severe osteogenesis imperfecta, in utero stem cell transplantation has entered the phase I clinical trial stage. Within the realm of the inner ear, genetic hearing loss significantly hampers speech, cognitive, and intellectual development in children. Nowadays, gene therapies offer substantial promise for deafness, with the success of clinical trials in autosomal recessive deafness 9 using AAV-OTOF gene therapy. However, the majority of genetic mutations that cause deafness affect the development of cochlear structures before the birth of fetuses. Thus, gene therapy before alterations in cochlear structure leading to hearing loss has promising applications. In this review, addressing advances in various fields of IUGT, the progress, and application of IUGT in the treatment of genetic hearing loss are focused, in particular its implementation methods and unique advantages.

Prestin in Human Perilymph, Cerebrospinal Fluid, and Blood as a Biomarker for Hearing Loss.

OBJECTIVE: Determining the concentration of prestin in human blood, cerebrospinal fluid (CSF), and perilymph (PL), and evaluating its suitability as a clinical biomarker for sensori-neural hearing loss (SNHL). STUDY DESIGN: Human blood, CSF, and PL samples were intraoperatively collected from 42 patients with tumors of the internal auditory canal or with intracochlear tumors undergoing translabyrinthine or middle fossa tumor removal. Prestin concentration was measured using enzyme-linked immunosorbent assay and linear regression analyses were performed to investigate its associations with audiological as well as vestibular test results. SETTING: Tertiary referral center. RESULTS: The median prestin concentration in blood samples of the 42 study participants (26 women, mean ± standard deviation age, 52.7 ± 12.5 years) was 1.32 (interquartile range, IQR, 0.71-1.99) ng/mL. CSF prestin levels were significantly higher with 4.73 (IQR, 2.45-14.03) ng/mL (P = .005). With 84.74 (IQR, 38.95-122.00) ng/mL, PL prestin concentration was significantly higher compared to blood (P = .01) and CSF (P = .03) levels. Linear regression analyses showed significant associations of CSF prestin concentration with preoperative hearing levels (pure-tone average and word recognition; P = .008, R2 = 0.1894; P = .03, R2 = 0.1857), but no correlations with blood or PL levels. CONCLUSION AND RELEVANCE: This study's findings highlight the volatile nature of prestin levels and provide the first insights into this potential biomarker's concentrations in body fluids apart from blood. Future investigations should comprehensively assess human prestin levels with different etiologies of SNHL, prestin's natural homeostasis and systemic circulation, and its temporal dynamics after cochlear trauma. Finally, clinically approved detection kits for prestin are urgently required prior to considering a potential translational implementation of this diagnostic technique.

Hypertrophic Pachymeningitis, Associated with Eosinophilic Granulomatosis with Polyangiitis, and ANCA-Negative Serology.

Background: Hypertrophic pachymeningitis (HP) is a disease with diverse aetiologies, including the autoimmune one, either associated with antineutrophil cytoplasmic antibodies or immunoglobulin G4. Case description: A 65-year-old woman with a history of systemic arterial hypertension, presented with intense progressive headaches. HP and hemispheric vasogenic oedema were observed by nuclear magnetic resonance (NMR) study. During the six months before the headache, she had developed progressive hearing loss which she attributed to age. A biopsy of dura mater showed necrotising vasculitis with peripheral inflammatory infiltrate, made up of accumulations of epithelioid cells and multinucleated giant cells, and abundant eosinophils. A final diagnosis of HP with eosinophilic granulomatosis with polyangiitis (EGPA) was made. Discussion: The patient had eosinophilic granulomatosis with polyangiitis (EGPA) histology, ANCA-negative serology and HP. This case is important because it shows that EGPA seems to have a spectrum of clinical diseases, including HP with negative serology, and bilateral sensorineural hearing loss. Conclusion: We are facing a wide spectrum of EGPA, breaking the paradigm of only systemic involvement. LEARNING POINTS: Hypertrophic pachymeningitis (HP) has several aetiologies; if the systemic investigation is not contributory to a diagnosis, a meningeal biopsy is necessary.This is the first case report of HP, associated with eosinophilic granulomatosis with polyangiitis (EGPA), and ANCA-negative serology.EGPA is probably a spectrum of diseases with predominant systemic involvement, but there may be cases where there is histological evidence, without the systemic context or positive serology.

Idiopathic sudden sensorineural hearing loss after COVID-19 vaccination: a systematic review and meta-analysis.

OBJECTIVE: To provide pooled analyses on the association between COVID-19 vaccine and the incidence of idiopathic sudden sensorineural hearing loss (ISSNHL). DATA SOURCES: "Medline" via "PubMed", "EMBASE", and "Google scholar". REVIEW METHODS: Data sources were inspected from January 2020 to January 2024 using search terms relevant to vaccines for COVID-19. Included were papers with reported numbers of vaccinated populations and incidence if ISSNHL in those populations. Quality assessment was performed with the Newcastle-Ottawa Quality Assessment Scale Criteria. RESULTS: Three publications encompassing more than 191.8 million patients and at least 283 million vaccine doses were included in the quantitative data synthesis. The pooled reported incidence (95%confidence interval) of ISSNHL among COVID-19 vaccine recipients was 1.2588 per 100,000 (0.1385-3.4836). This incidence is significantly lower than the incidence of 5-27 and 60 per 100,000/year reported in the United States and in the European Union, respectively (P < 0.0001). CONCLUSION: There is no evidence to indicate that the COVID-19 vaccine is associated with the incidence of ISSNHL.

The PATCH study: Prevalence of Hearing Loss During Ageing and Treatment Choices in Osteogenesis Imperfecta: A Danish Nationwide Register-Based Cohort Study.

Osteogenesis imperfecta (OI) is a group of rare hereditary collagen disorders. Hearing loss (HL) is a known complication linked to changes in the bones of the middle ear seen in OI. We aimed to determine the prevalence, age at debut, incidence, and risk of HL, surgery on bones of the middle ear, and use of hearing aids. A Danish nationwide, register-based cohort study. Data were extracted from the Danish National Patient register. Anyone with an OI diagnosis between January 1st 1977 and December 31st 2018, matched 1:5 with a reference population (Ref.Pop) on birthyear and sex, were included. 864 persons (487 women) with OI were included in the study and 4276 (2330 women) in the Ref.Pop. The sub-hazard ratio (SHR) for any HL was 4.56 [95% CI 3.64-5.71], with a prevalence of 17.0% and 4.0% in the OI cohort and Ref.Pop. Median age at debut was 42 and 58 years, respectively. The risk of otosclerosis and/or surgery was higher in the OI cohort (SHR 22.51 [95% CI 12.62-40.14]), with a median age at debut of 43 and 32 years in the OI cohort and Ref.Pop, respectively. Hearing aid use was more frequent in the OI cohort (SHR 4.16 [95% CI 3.21-5.40]) than in the Ref.Pop. The median age at debut was 45 and 60 years in the OI cohort and Ref.Pop, respectively. Persons with OI have a higher risk and prevalence of HL, hearing aids, and surgery, debuting younger, and prevalence increases with age.

A novel variant in GAS2 is associated with autosomal dominant nonsyndromic hearing impairment in a Chinese family.

Knockout of GAS2 (growth arrest-specific protein 2), causes disorganization and destabilization of microtubule bundles in supporting cells of the cochlear duct, leading to hearing loss in vivo. However, the molecular mechanism through which GAS2 variant results in hearing loss remains unknown. By Whole-exome sequencing, we identified a novel heterozygous splicing variant in GAS2 (c.616-2 A > G) as the only candidate mutation segregating with late-onset and progressive nonsyndromic hearing loss (NSHL) in a large dominant family. This splicing mutation causes an intron retention and produces a C-terminal truncated protein (named GAS2mu). Mechanistically, the degradation of GAS2mu via the ubiquitin-proteasome pathway is enhanced, and cells expressing GAS2mu exhibit disorganized microtubule bundles. Additionally, GAS2mu further promotes apoptosis by increasing the Bcl-xS/Bcl-xL ratio instead of through the p53-dependent pathway as wild-type GAS2 does, indicating that GAS2mu acts as a toxic molecule to exacerbate apoptosis. Our findings demonstrate that this novel variant of GAS2 promotes its own protein degradation, microtubule disorganization and cellular apoptosis, leading to hearing loss in carriers. This study expands the spectrum of GAS2 variants and elucidates the underlying pathogenic mechanisms, providing a foundation for future investigations of new therapeutic strategies to prevent GAS2-associated progressive hearing loss.

Newborn and infant hearing screening for early detection of hearing loss in Nairobi, Kenya.

Background: Early detection of hearing loss and subsequent intervention leads to better speech, language and educational outcomes giving way to improved social economic prospects in adult life. This can be achieved through establishing newborn and infant hearing screening programs. Objective: To determine the prevalence of hearing loss in newborns and infants in Nairobi, Kenya. Methods: A cross-sectional pilot study was conducted at the National hospital and at a sub county hospital immunization clinic. A total of 9,963 babies aged 0-3 years, were enrolled in the hearing screening program through convenient sampling over a period of nine months. A case history was administered followed by Distortion Product Oto-acoustic emissions (DPOAEs) and automated auditory brainstem response (AABR) hearing screening. Results: The screening coverage rate was 98.6% (9963/10,104). The referral rate for the initial screen was 3.6% (356/ 9,963), the return rate for follow-up rescreening was 72% (258 babies out of 356) with a lost to follow-up rate of 28% (98/356). The referral rate of the second screen was 10% (26/258). All the 26 babies referred from the second screen returned for diagnostic hearing evaluation and were confirmed with hearing loss, yielding a prevalence of 3/1000. Conclusions: Establishing universal newborn and infant hearing screening programs is essential for early detection and intervention for hearing loss. Data management and efficient follow-up systems are an integral part of achieving diagnostic confirmation of hearing loss and early intervention.

A Clinical Neurological Approach to the Child With Adenosine Deaminase Deficiency.

BACKGROUND: Severe combined immunodeficiency secondary to adenosine deaminase deficiency is rare. The deficiency of this enzyme results in the accumulation of substrates in the tissues, including the brain. Clinical signs of neurological involvement may include seizures, neurodevelopmental disorders, hypotonia, and sensorineural hearing loss. Hematopoietic stem cell transplantation corrects the failure of the immune system but not the neurological involvement. OBJECTIVES: To describe the spectrum of neurological complications identified in a series of children with severe combined immunodeficiency due to adenosine deaminase deficiency. Additionally, we propose a neurological approach including electrophysiological, radiological, and neurocognitive studies to address this group of children in an efficient and timely manner. METHODS: A descriptive, observational, retro-, and prospective analysis of patients with a confirmed immunological diagnosis seen between 1996 and 2021 and referred to the Department of Neurology for neurological evaluation was conducted. RESULTS: Ten patients met the inclusion criteria. The median age at diagnosis was 4 months (range, 1-36 months). All patients had neurodevelopmental delay with hypotonia in six, language delay in three, sensorineural hearing loss in four, and spastic paraparesis in one patient. Two children developed an epileptic syndrome, consisting of generalized epilepsy in one and focal epilepsy in the other. Neuroimaging showed brain calcifications in the basal ganglia and/or centrum semiovale in four patients and enlarged subarachnoid spaces in two other patients. CONCLUSION: In this pediatric series, the rate of neurological involvement associated with abnormalities on neuroimaging was high. Although this involvement could be related to accumulation of adenosine metabolites in the central nervous system, the possibility of associated chronic infections should be ruled out. Given the neurological manifestations, it is important to involve the pediatric neurologist in the multidisciplinary follow-up team.

[Effects of cochlear implantation on tinnitus in patients with single-sided deafness and asymmetrical hearing loss].

Objective:To evaluate the effects of cochlear implantation in patients with single-sided deafness（SSD） and asymmetrical hearing loss（AHL）. Methods:Seventeen Mandarin-speaking CI patients diagnosed as SSD/AHL were recruited in our study. The Tinnitus Handicap Inventory（THI） and the Visual Analogue Scale（VAS） were used to assess changes in tinnitus distress and tinnitus loudness in SSD patients at each time point（pre-operation and post-operation）. Results:The THI score and all 3 dimensions were significant decreased with CI-on than pre-operation（P<0.05）. Tinnitus VAS scores were also decreased, and VAS scores were lower with CI-on than with CI-off, and were both significantly different at each time point after CI switch-on（P<0.05）. Conclusion:CI could help SSD/AHL patients to suppress tinnitus and reduce the loudness of tinnitus. However, CI should not be a treatment of tinnitus.

[Prognosis of 109 cases of sudden sensorineural hearing loss in children].

Objective:To analyze the factors influencing the prognosis of sudden sensorineural deafness in children, and to provide theoretical basis for clinical prevention and treatment. Methods:The clinical data of 109 children with sudden deafness admitted to our hospital from 2016 to 2023 were retrospectively analyzed. The children were grouped according to eight related factors, including gender, age, climate, duration of hearing loss, concomitant symptoms, degree of hearing loss, sicken ear, and auditory curve. The chi-square test was used for univariate analysis, and logistic regression was employed to identify factors influencing prognosis. Results:After conventional treatment, 56 cases were ineffective（51.40%）, 30 cases were effective（27.5%）, 13 cases were effective（11.9%）, 10 cases were cured（9.2%）, and the total effective rate was 48.6%. Among concomitant symptoms, children with tinnitus had better treatment results（P<0.05）; In the degree of hearing loss, the effective rate of mild hearing loss was the highest（83.3%）, and the effective rate of very severe hearing loss was the lowest（40.0%）. The prognosis of low frequency decline and high frequency decline were better（P<0.05）; There was no significant correlation between gender, age, climate, duration of hearing loss, sicken ear and prognosis（P>0.05）. Conclusion:The auditory curve and the degree of hearing loss are the factors affecting the prognosis of children with sudden deafness. Additionally, children with tinnitus tend to have a better prognosis.

[Advances in vestibular function and rehabilitation of large vestibular aqueduct syndrome].

Large vestibular aqueduct syndrome（LVAS） is a common recessive hereditary hearing loss disease, and some patients may also experience vestibular dysfunction. With the wide application of cochlear implant（CI） and the development of vestibular medicine, the pathophysiological mechanism of LVAS and the influence mechanism of CI on vestibular function are gradually elucidated. Consequently, the evaluation and rehabilitation of vestibular dysfunction function have also become research hotspots. This article reviews studies on vestibular function and related rehabilitation in patients with large vestibular aqueduct syndrome.

[Advances in glucocorticoid resistance in otorhinolaryngological diseases].

Glucocorticoids（GC） are widely used in the clinical treatment of autoimmune inner ear diseases, sudden sensorineural hearing loss, Meniere's disease, sinusitis and other otolaryngology diseases. However, GC resistance remains a major factor contributing to the poor efficacy of clinical treatments. The mechanism of GC resistance is still unclear. This paper reviews the related mechanisms of GC resistance from the perspectives of GC receptor factors and non-GC receptor factors. Additionally, it summarizes the latest research progress on GC resistance in otolaryngological diseases, with the aim of identifying effective clinical alternative treatment options for reversing GC resistance in the future.

[Research status and progress of bilateral cochlear implantation].

With the development of social economic and technology, Cochlear Implantation has became an effective therapy for patients who suffered from severe or profound hearing impairment. In the meantime, patients' demands for sound and auditory quality are also increasing. In terms of speech recognition, localization, and auditory quality, bilateral hearing is closer to the auditory experience of normal individuals, so bilateral cochlear implantation（BCI） emerged as the times require. In this article, we will introduce the status and progress of bimodal regarding to the following aspects: the brief history, the advantages of BCI, different methods for BCI, and the problems encountered in BCI.

The Relationship Between Lower Vitamin D Levels and Hearing Loss in Older Adults.

Background and Objectives: : Age-related hearing loss (ARHL) is a sensorineural disease that is associated with a number of factors. In addition to age, sex, environment, lifestyle, and comorbidities are all known to be related to ARHL as well. The prevalence of ARHL can be reduced by controlling the adjustable factors that cause it. Vitamin D levels are strongly related to calcium metabolism, which can affect ARHL. This study aimed to investigate the association between vitamin D and ARHL. Subjects and Methods: : A total of 1,104 subjects aged >65 years were enrolled from the fifth Korean National Health and Nutrition Examination Survey, which was conducted from 2010-2012. Every participant received both an audiological assessment and a nutritional survey. The association between ARHL and serum vitamin D concentration was analyzed using logistic regression analyses with complex sampling adjusted for confounding factors such as alcohol consumption, smoking status, mobility, and bone mineral density. Results: : Our multivariable analysis revealed that males in the group with lower serum levels of vitamin D (< 20 ng/mL) had a higher prevalence of ARHL (odds ratio, 1.638, 95% confidence interval, 1.058-2.538, p=0.027). Conclusions: : This finding suggests that lower serum levels of vitamin D are associated with ARHL in the older male population.

[Brainstem auditory evoked responses in horses with hearing loss and during general anesthesia]. / Hör- und Hirnstammfunktionsprüfung beim Pferd: Resultate bei ausgewählten klinischen Szenarien.

INTRODUCTION: The brainstem auditory evoked response (BAER) is a diagnostic approach to examine the hearing system of horses objectively. The aim of this BAER examination was the diagnosis of conductive or sensorineural hearing loss or deafness in horses with external otitis, head trauma, headshaking, tinnitus or skittish horses with eye disease. Brainstem dysfunction is induced by intracranial hypotension. BAER was used in horses with colic surgery which had a low arterial blood pressure during general anesthesia. The endoscopic finding of the guttural pouch was the ipsilateral mild to severe hypertrophy of the tympanostylohyoideum in horses with external otitis or head trauma. The otoscopic examination of standing sedated horses was done before BAER. The cartilagineous and osseous part of the external ear canal in horses with external otitis were obstructed with exsudate and tympanic membranes were not visible. Horses with right sided external otitis: right moderate to severe conductive hearing loss (significantly prolonged latencies of I, III, V and interpeak latencies I-III, I-V, III-V; thresholds of hearing levels 60 to 80 dB right); horses with left sided external otitis: left severe conductive hearing loss (no correct identification of BAER peaks, latencies not measurable, 80 dB); horse with left sided head trauma: severe left sided conductive hearing loss (blood in the left external ear canal, no visible tympanic membrane, no correct identification of BAER peaks, latencies not measurable, 80 dB); horses with head shaking: mild sensorineural hearing loss on both sides (on both sides osseous parts II/III with keratin scales of the junction, visible tympanic membranes, significantly prolonged V, I-III, I-V, 40 dB); moderate to severe skittish horses with chronic eye disease (mostly left sided equine recurrent uveitis): moderate sensorineural hearing loss on both sides (normal otoscopical findings, significantly prolonged latencies and interpeak latencies left; I-V, III-V right, 60 dB, pathological involvement in the auditory pathway of the brainstem between the cochlear nucleus and colliculus caudalis); horse with a tinnitus on both sides: mild sensorineural hearing loss on both sides (normal otoscopical findings, prolonged V, I-III, I-V, III-V, 40 dB, pathology of auditory nerve, cochlear nucleus and above the level of this nucleus); American paint horses: sensorineurale deafness on both sides (normal otoscopical findings, absent BAER peaks, isoelectric lines and 80 dB on both sides). The prolonged latencies of I, III and V including interpeak latencies I-III only left and I-V and III-V on both sides in horses with laparotomy during general anesthesia were associated with low arterial blood pressure (62 mmHg, median). These findings could demonstrate a hypotension in the brainstem too. The BAER could be a technical tool during general anesthesia for normalizing the arterial blood pressure and brainstem function to prevent imbalance of body movements after general anesthesia.

INTRODUCTION: L'examen objectif de l'audition chez le cheval est réalisé par la mesure des Potentiels Évoqués Auditifs (PEA) ou Brainstem Auditory-Evoked Response (BAER). L'objectif de ces examens est de diagnostiquer une surdité de transmission ou neurosensorielle ou une surdité chez les chevaux souffrant d'otite externe, de traumatisme crânien, de headshaking, d'acouphènes ou chez des chevaux craintifs souffrant d'une maladie oculaire. Étant donné que l'audiométrie du tronc cérébral vérifie également la fonction du tronc cérébral, des chevaux ayant subi une laparotomie et une déshydratation préopératoire ont été examinés pour détecter un dysfonctionnement du tronc cérébral dû à une baisse de la pression artérielle. L'otoscopie et l'audiométrie du tronc cérébral (système AEP Corona) ont été réalisées. Les résultats de l'otoscopie chez les chevaux atteints d'otite externe: Pars cartilaginea et ossea degré III, tympan non visible. Les résultats de l'endoscopie des poches gutturales chez les chevaux atteints d'otite externe exsudative ou de traumatisme crânien: toujours une augmentation ou une hypertrophie ipsilatérale du tympanostylohyoïdien. Les résultats de la BAER des chevaux atteints d' une otite externe à droite sont les suivants: surdité de transmission moyenne à sévère à droite (ondes I, III, V significativement prolongées, latences interpicales I-III, I-V, III-V par rapport au groupe de contrôle, valeurs limites au-dessus du seuil auditif normal 60 à 80 dB); chevaux atteints d'otite externe à gauche: surdité de transmission de haut niveau à gauche (ondes non identifiables, 80 dB à gauche); chevaux avec une fistule auriculaire à droite: surdité de perception bilatérale de bas niveau (allongement significatif des ondes III, V et des latences interpicales des deux côtés, 40 dB); cheval avec traumatisme crânien à gauche: surdité de transmission de degré élevé (à gauche, sang dans le conduit auditif externe, tympan non visible, ondes non identifiables, 80 dB); chevaux avec headshaking: surdité de perception de degré faible (des deux côtés, pars ossea de degré II, tympans visibles, allongement significatif V, I-III, I-V, 40 dB); chevaux présentant une peur et une maladie oculaire: surdité moyenne, neurosensorielle (otoscopie normale, allongement significatif de toutes les ondes et des latences interpeak à gauche, I-V, III-V à droite, 60 dB, vitesse pathologique de conduction des voies auditives dans le tronc cérébral); American Paint Horses: surdité neurosensorielle (otoscopie normale, ligne isoélectrique bilatérale des HA, 80 dB). Les ondes I, III et V prolongées et les latences interpicales I-III, I-V et III-V chez les chevaux ayant subi une laparotomie sont associées à la baisse de la pression artérielle (62 mmHg, médiane) pendant l'anesthésie générale et indiquent une hypotension dans le tronc cérébral. Pendant l'anesthésie générale, l'audiométrie du tronc cérébral offre une possibilité particulière de détecter le dysfonctionnement du tronc cérébral, de réguler la pression artérielle et de garantir un lever sans problème avec un équilibre auditif et visuel de la posture après l'anesthésie générale.

[Occupational diseases related to otorhinolaryngology]. / Berufskrankheiten mit Bezug zur HNO-Heilkunde.

In the German Ordinance on Occupational Diseases (BKV), there are currently 82 occupational diseases listed, of which 18 partially or completely fall within the field of ENT medicine due to the associated health disorders. Noise-induced hearing loss is usually the focus of attention for the ENT specialist, but it has long since ceased to be the only occupational disease. In order to help uncover possible causalities between occupational noxious substances and diseases, it is important that physicians report their own observations and new scientific findings regarding suspected cases to the German Social Accident Insurance, especially in situations where cancer may be linked to occupational influences.

Blast Exposure Associations With Hearing Loss and Self-Reported Hearing Difficulty.

OBJECTIVE: Examine associations between military blast exposures on hearing loss and self-reported hearing difficulties among Active-Duty Service Members (ADSM) and Veterans from the Noise Outcomes in Servicemembers Epidemiology (NOISE) study. STUDY DESIGN: Cross-sectional. SETTING: Multi-institutional tertiary referral centers. METHODS: Blast exposure was assessed with a comprehensive blast questionnaire. Outcome measures included pure-tone hearing thresholds; Speech Recognition in Noise Test; Hearing Handicap Inventory for Adults (HHIA); and Speech, Spatial and Qualities of Hearing Scale (SSQ)-12. RESULTS: Twenty-one percent (102/494) of ADSM and 36.8% (196/533) of Veterans self-reported blast exposure. Compared to ADSM without blast exposure, blast-exposed ADSM had increased odds of high frequency (3-8 kHz) and extended-high frequency (9-16 kHz) hearing loss (odds ratio [OR] = 2.5, CI: 1.3, 4.7; OR = 3.7, CI: 1.9, 7.0, respectively). ADSM and Veterans with blast exposure were more likely than their nonblast exposed counterparts to report hearing difficulty on the HHIA (OR = 1.9, CI: 1.1, 3.3; OR = 2.1, CI: 1.4, 3.2, respectively). Those with self-reported blast exposure also had lower SSQ-12 scores (ADSM mean difference = -0.6, CI: -1.0, -0.1; Veteran mean difference: -0.9, CI: -1.3, -0.5). CONCLUSION: Results suggest that blast exposure is a prevalent source of hearing injury in the military. We found that among ADSM, blast exposure was associated with hearing loss, predominately in the higher frequencies. Blast exposure was associated with poorer self-perceived hearing ability in ADSM and Veterans. IRB: #FWH20180143H Joint Base San Antonio (JBSA) Military Healthcare System; #3159/9495 Joint VA Portland Health Care System (VAPORHCS) Oregon Health and Science University (OHSU).

Interaction of sensory processing and balance in adult cochlear implant users.

PUROPSE: The aim of this study was to evaluate the sensory processing skills, quality of life and balance performance in adult cochlear implant users. METHODS: A sample of 40 individuals was studied in two groups; 20 normal hearing individuals (37.84 ± 15.39 years old) and 20 cochlear implant users (35.58 ± 11.22 year old). Balance performance was assessed by Computerized Dynamic Posturography. The Adolescent/Adult Sensory Profile completed by the individual was used to assess sensory processing skills. Finally, quality of life was assessed with the Short Form-36. RESULTS: Among the different sensory processing parameters in the adolescent/adult sensory profile, a significant difference was found between the two groups in the parameters of low registration, sensory sensitivity and sensory avoidance (p < .05). Visual, vestibular and composite scores were found to be lower in cochlear implant users by Computerised Dynamic Posturography assessment (p < .05). When assessing quality of life, emotional well-being and social functioning parameters were found to be lower in cochlear implant users (p < .05). CONCLUSION: Factors such as the inability to reach sufficient auditory stimuli due to hearing loss and the occurrence of vestibular problems after cochlear implant surgery limit the quantity and quality of sensory stimuli from the environment. Individuals with cochlear implants may prefer to live isolated from society because they cannot adequately process incoming sensory stimuli due to hearing/balance problems, and this may negatively affect the quality of life of individuals. Our findings revealed the necessity of multisensory assessment and therapy protocols when rehabilitating individuals with cochlear implants.

Trends and projections of mild and moderate hearing loss among adolescents, young adults, middle-aged adults and age-standardised population in Malaysia from 1996 to 2030.

PURPOSE: This study aims to assess the prevalence of mild and moderate hearing loss spanning three decades, from 1990 to 2019, and to project the anticipated trends from 2020 to 2030 among adolescents, young adults, middle-aged adults, and age-standardised groups in Malaysia. METHODS: This study involved secondary data analysis of mild and moderate hearing loss prevalence over 30 years among the Malaysian population aged 15-19, 25-29, 35-39, 45-49, and age-standardised groups. Subsequently, three time-series models were evaluated and the best models with the minimal Mean Absolute Percentage Error (MAPE) and Root Mean Squared Error (RMSE) were selected for projecting the prevalence of hearing loss until 2030. RESULTS: A relatively stable trend of mild hearing loss prevalence and gradual decline of moderate hearing loss were observed across all age groups throughout the study period. The prevalence of mild hearing loss was consistently higher than moderate hearing loss across all age groups, with its prevalence increasing with age. The projected prevalence of hearing loss exhibits a gradual declining trend in the future for all age groups, except for mild hearing loss for the 15-19-year-old group. CONCLUSION: Over the past 30 years, there has been a relatively stable and slightly declining trend in the prevalence of mild and moderate hearing loss among the Malaysian population, respectively with projections showing a slow reduction in the future. These findings highlighted the need for identifying the best intervention and vulnerable age groups, directing increased resources and prioritization towards them.