Analysing use of the Chinese HHIE-S for hearing screening of elderly in a northeastern industrial area of China.

OBJECTIVE: The aim of the present study was to investigate the use of Chinese version of HHIE-S as a hearing screening tool for the elderly in an industrial area in northeast China. DESIGN: Prevalence, sensitivity and specificity of Chinese version of HHIE-S were calculated. Factors that had impact on HHIE-S were analysed. STUDY SAMPLE: Five hundred and seventy Mandarin speaking participants, aged from 50 to 85 years were included. They were tested with pure tone audiometry and Chinese version of HHIE-S. RESULTS: The prevalence of hearing handicap was 55.3%. The sensitivity and specificity of HHIE-S were 84.5% and 58.3% respectively when the pass/fail criteria were set at PTA0.5-4kHz >40 dBHL. In general, HHIE-S total and subscale scores were significantly associated with severity of hearing impairment. After stratified by severity of hearing impairment, both the prevalence of reported handicap and the scores of HHIE-S were not significantly associated with age. Male participants had significantly higher HHIE-S scores than female participants did. CONCLUSIONS: The Chinese version of HHIE-S contributes useful information to identifying hearing handicap and addressing the rehabilitative needs in the elderly in an industrial city in Mainland China.

Chinese-adapted youth attitude to noise scale: evaluation of validity and reliability.

Noise exposure is central to hearing impairment, especially for adolescents. Chinese youth frequently and consciously expose themselves to loud noise, often for many hours. Hence, a Chinese-adapted evaluative scale to measure youth's attitude toward noise could rigorously evaluate data validity and reliability. After authenticating the youth attitude to noise scale (YANS) originally developed by Olsen and Erlandsson, we purposively sampled and surveyed 642 freshmen at Capital Medical University in Beijing, China. To establish validity, we conducted confirmatory factor analysis according to Olsen's classification. To establish reliability, we calculated Cronbach's alpha coefficient and split-half coefficient. We used Bland-Altman analysis to calculate the agreement limits between test and retest. Among 642 students, 550 (85.67%) participated in statistical analysis (399 females [72.55%] vs. 151 males [27.45%]). Confirmatory factorial analysis sorted 19 items into four main subcategories (F1-F4) in terms of factor load, yielding a correlation coefficient between factors <0.40. The Cronbach's alpha coefficient (0.70) was within the desirable range, confirming the reliability of Chinese-adapted YANS. The split-half coefficient was 0.53. Furthermore, the paired t-test reported a mean difference of 0.002 (P = 0.9601). Notably, the mean overall YANS score (3.46) was similar to YANS testing in Belgium (3.10), but higher than Sweden (2.10) and Brazil (2.80). The Chinese version of the YANS questionnaire is valid, reliable, and adaptable to Chinese adolescents. Analysis of the adapted YANS showed that a significant number of Chinese youth display a poor attitude and behavior toward noise. Therefore, Chinese YANS can play a pivotal role in programs that focus on increasing youth awareness of noise and hearing health.

The cochlear nerve canal and internal auditory canal in children with normal cochlea but cochlear nerve deficiency.

BACKGROUND: There is an increasing frequency of requests for cochlear implantation (CI) in deaf children and more detailed image information is necessary for selecting appropriate candidates. Cochlear nerve deficiency (CND) is a contraindication to CI. Magnetic resonance imaging (MRI) has been used to evaluate the integrity of the cochlear nerve. The abnormalities of the cochlear nerve canal (CNC) and internal auditory canal (IAC) have been reported to be associated with CND. PURPOSE: To correlate CNC manifestation, size, and IAC diameter on high-resolution CT (HRCT) with CND diagnosed by MRI in children. MATERIAL AND METHODS: HRCT images from 35 sensorineurally deaf children who had normal cochlea but bilateral or unilateral CND diagnosed by MRI were studied retrospectively. The CNC and IAC manifestation and size were assessed and correlated with CND. RESULTS: CND was diagnosed by MRI in 54/70 ears (77.1%). Thirty-two ears had an absent cochlear nerve (59.3%), while 22 ears had a small cochlear nerve (40.7%). The CNC diameter was <1.5 mm in 36 ears (66.7%). The CNC diameter ranged between 1.5 and 2.0 mm in seven ears (13.0%) and was >2.0 mm in 11 ears (20.4%). The IAC diameter was <3.0 mm in 25 ears (46.3%) and >3.0 mm in 29 ears (53.7%). CONCLUSION: The hypoplastic CNC might be more highly indicative of CND than that of a narrow IAC.

Bone-conducted hearing assessment with 80-Hz multiple auditory steady-state responses to brief tones in adults with normal hearing.

OBJECTIVE: To investigate interactions (if any) in the bone-conduction auditory steady-state response (BC ASSR) between multiple brief tones presented simultaneously. METHODS: 500-, 1,000-, 2,000-, and 4,000-Hz brief tones, repeated at a rate of 77-101 Hz, were presented using a B-71 vibrator. BC ASSR thresholds and amplitudes at 50 dB nHL were measured in two conditions where the stimulus was either presented alone or together with other stimuli. RESULTS: Significantly larger amplitudes in the single-stimulus condition were found at 50 dB nHL. However, there was no significant threshold difference between single- and multiple-stimulus conditions. The BC ASSR thresholds (means ± SD) at 500, 1,000, 2,000, and 4,000 Hz were 96.7 ± 9.7, 75.3 ± 11.5, 65.6 ± 7.4, and 57.8 ± 7.2 dB re 1 µN ppe, respectively. CONCLUSION: Interactions occurred in the multiple-stimulus condition at high presentation levels, but not at threshold levels. The results of the present study imply that BC ASSR thresholds to multiple brief-tone stimuli can be assessed at the same time, at least in normal-hearing adults.

Audiometric records analysis in a clinical population in China.

OBJECTIVE: The objective of this study was to characterize the typical hearing loss presenting at a clinical audiology center. METHODS: Audiometric records for 8,032 cases were obtained from the database at Beijing Tongren Hospital, Capital Medical University. Based on this information, age distribution, audiometric configuration, type, degree and asymmetry of hearing loss were characterized. RESULTS: Results showed that 48.4% of all cases of hearing loss occurred from 31 to 60 years of age, sloping hearing loss was the most common audiometric configuration, and sensorineural hearing loss dominated the type of hearing loss for both males and females. Mean pure-tone hearing thresholds revealed significant differences between genders, that is, thresholds for females were poorer than those for males from 250 to 1,000 Hz, whereas thresholds for males were poorer than those for females from 2,000 to 8,000 Hz. Analysis showed that 57.3% of audiograms showed some degree of asymmetry. No significant difference was found between genders for the average asymmetric thresholds. CONCLUSION: This study provides the characteristics of age distribution, audiometric configuration, type, degree and asymmetry of hearing loss from a representative clinical audiology center. These data are useful for public policy efforts involving hearing loss prevention and rehabilitative program development.

Audiological results in a group of children with auditory neuropathy spectrum disorder.

OBJECTIVE: To enrich clinical information of auditory neuropathy spectrum disorder. METHODS: Forty-eight infants and young children with severely abnormal auditory brainstem responses (ABRs) along with preserved distortion product otoacoustic emissions (DPOAEs) and/or cochlear microphonics (CMs) were included in this retrospective study. Click ABRs, CMs, DPOAEs, behavioral thresholds and tympanograms were established. RESULTS: Audiological information of 88 ears (40 cases were bilateral and 8 unilateral) that met the inclusion criteria were analyzed. Most of the ears (68.2%) had absent click ABRs at the maximum presentation level of 100 dB nHL, while other ears had repeatable wave V with lowest thresholds of 80 dB nHL. Behavioral hearing of 23 cases ranged from mild (n = 1), moderate (n = 2) to severe and profound loss (n = 20). CMs were present in all ears in spite of those with middle ear pathology, while DPOAEs were present only in 40% of the affected ears. CONCLUSION: Diverse results of audiological assessments are shown in this group of children. Concurrent pathologies may make auditory neuropathy spectrum disorder undetected. Absent or severely abnormal ABR along with present CMs are the most reliable measures for detecting this disorder at this stage.

[Quality of life after cochlear implantation in postlingually deaf adults].

OBJECTIVE: To evaluate the quality of life after cochlear implantation in adult cochlear implant recipients and to assess the applicability of Nijmegen Cochlear implant Questionnaire (NCIQ). METHODS: Thirty-two postlingually deaf patients, 19 males and 13 females, underwent cochlear implantation with the age at operation of 35.27 (18-66) during the period from 1996 to the end of 2006. NCIQ was used to investigate the application of the equipment, hearing ability, and emotional exchange ability. RESULTS: All of the patients used their cochlear implants for 16 h every day on average with an experience in using such implant of more than 6 months. Improvement was seen in sound recognition, speech recognition, confidence, daily life, social exchange, and emotional behavior ability at different degrees. The improvement of confidence was very obvious. The speech communication ability of those with a hearing deprivation time longer than 5 years was lower than that of those with a shorter hearing deprivation time. Age and educational level did not influence the efficiency. CONCLUSION: Cochlear implantation is a cost effective intervention in the postlingually deaf adults. NCIQ test can be used to evaluate the quality of life among postlingually deaf adult cochlear implant recipients in China.

Comparisons between neural response imaging thresholds, electrically evoked auditory reflex thresholds and most comfortable loudness levels in CII bionic ear users with HiResolution sound processing strategies.

CONCLUSIONS: The data collected in this study indicated that first Neural Response Imaging (NRI) thresholds had a better correlation with HiResolution most comfortable loudness (M) levels than tNRI thresholds. Electrically evoked auditory reflex thresholds (EARTs) had a higher correlation with HiResolution M levels than tNRI thresholds and a lower correlation than first NRI thresholds. NRI is a very useful method for programming the cochlear implants of young children who cannot demonstrate a reliable judgment of loudness. OBJECTIVE: To investigate how HiResolution sound processing, designed to deliver high-rate stimuli, relates to EARTs and electrically evoked compound action potential measurements produced by low-rate stimuli. MATERIAL AND METHODS: Nine profoundly hearing-impaired children and adults aged 6-29 years participated in the study. NRI responses were elicited using pulse trains consisting of biphasic pulses at a pulse width per phase of 32 micros delivered at a frequency of 30 Hz using SoundWave programming software. Stimuli were delivered to the odd electrodes (1, 3, 5, 7, 9, 11, 13 and 15) along the array. tNRI (NRI threshold) and first NRI thresholds were recorded for each stimulating electrode. "Speech bursts" stimuli used in EARTs recording were delivered to four electrodes at a time and stapedial reflexes were recorded from the impedance bridge. The M levels used were those used by each patient in their everyday HiResolution programs. RESULTS: For 8 patients (53 stimulating electrodes) the correlation between tNRI threshold and M level was r=0.675 (p=0.000) and that between first NRI thresholds and M level was r=0.741 (p=0.000). On average the M-level value was 20 CU (Current Unit) lower than the first NRI threshold value and 12 CU higher than the tNRI threshold value. The M-level patterns across the electrode array overall were similar to the tNRI or first NRI threshold patterns. For 7 patients (112 stimulating electrodes) the correlation between EART and M levels was r=0.710 (p=0.000). On average the EART value was 14 CU higher than the M-level value.

[Cross-sectional study of hearing loss among freshmen in university].

OBJECTIVE: The purpose of the present study was to investigate the prevalence of hearing loss by studying the current status of hearing loss, risk factors of hearing loss, exposure level of noise, and everyday habit of hearing in a group of university students, so as to provide information for hearing loss prevention in university students. METHOD: According to the purposive sampling method, 642 freshmen students participated in the study. Pure tone audiometry, and exposure level of noise scale were performed in all participants. RESULT: (1) According to the hearing loss criterion of WHO/PDH97.3, high frequency hearing loss, and noise induced threshold shifts, the hearing loss prevalence was 0.36%, 20.91% and 6.73%, respectively. (2) Multivariant Logistic regression analysis of high-frequency hearing loss indicated that traffic noise exposure and ear infection were risk factor of high frequency hearing loss. CONCLUSION: There is a high prevalence of high frequency hearing loss in university students (20.91%), which was high related with traffic noise exposure and ear infection.

[Cochlear implantation in patients with inner ear malformations, clinical analysis of 25 cases].

OBJECTIVE: To explore the clinical experience of multi-channel cochlear implantation in patients with bilateral inner ear malformations. METHOD: Multi-channel cochlear implantation was conducted among 180 patients from 1997 to 2001. Twenty-five of them, being with inner ear malformations, were given hearing and speech rehabilitation including sound detection, word discrimination, auditory comprehension and spoken language skill development. A follow-up lasting 4 - 24 months was conducted after the operation. A retrospective analysis was performed among these 25 patients to observe the surgical outcomes and mapping characteristics after surgery. RESULTS: (1) All patients restored their auditory sensations after the operation. (2) Stapedial gusher was found in 13 cases with inner ear malformations, especially those with Mondini malformation, much more frequently than among the patients with other malformations. (3) Most of the action electrodes were inserted in the "cochleostomy" in full length, only 2 pairs of them remained outside of the "cochleostomy". (4) No serious complications occurred after implantation. (5) The impedance of the electrodes, T level and C level were higher in the 25 cases than in the normal cochlear implantation, however, with the hearing similar hearing threshold. (6) After training, the abilities of speech discrimination and spoken language were improved in comparison with those before operation. CONCLUSION: The cochlear implantation can be performed safely in patients with bilateral inner ear malformations. The primary outcome of cochlear implantation in hearing rehabilitation is similar for both the patients with inner ear malformations and those with normal cochlear structure.

[Wide band tympanometry energy reflectance in Chinese infants and children with normal outer and middle ears].

OBJECTIVE: To explore the law of wide band tympanometry energy reflectance (WBTER) in Chinese infants of Han nationality with normal outer and middle ears, and to provide the normal values for the clinical application of WBTER. METHODS: Ninety four infants (170 ears) of Han nationality with normal outer and middle ears evidenced by temporal bone CT, and 226 Hz and 1 000 Hz tympanometry at the ages between three and 48 months (median age: 14 months) were selected and divided into four groups: 3-6 months (32 ears), 7-12 months (53 ears), 13-24 months (46 ears) and 25-48 months (39 ears). WBTER was conducted on these infants, and the basic law of energy reflectance under different frequencies, as well as the influence of age on energy reflectance were analyzed using SPSS 15.0. RESULTS: The normal value of energy reflectance was higher at low frequency, gradually decreased with the increase of frequency, reached the minimum near 4 000 Hz , followed by constantly increased till 8 000 Hz. In the scope of frequency below 1 000 Hz and above 6 350 Hz, the energy reflectance values of infants in the group of 3-6 months were significantly lower than those of infants in other age groups (P < 0.05). In comparison to the group below six months, the groups over six months generally had higher energy reflectance and lower fluctuation. CONCLUSIONS: The pattern of energy reflectance across frequency range for Chinese infants and children was consistent with that of other races reported in foreign countries. The WBTER changes with the growing of age, which tends to be stable after the first six months of birth.

[A comparison of 226 Hz and 1 000 Hz tympanometry in diagnosis of infants otitis media effusion].

OBJECTIVE: To provide a clinical reference by comparing the conventional 226 Hz tympanometry with 1000 Hz tympanometry in two groups of young children with otitis media effusion evidenced by CT scan. METHOD: One hundred and seventy-seven young children (226 ears), from 1 to 60 months, with otitis media effusion were involved in this study. They were divided into six groups by age: 0-6 months group, 6-12 months group, 12-18 months group, 18-24 months group, 24-36 months group, 36-60 months group. They were tested with tympanometry of 2 probe-tones of 226 and 1 000 Hz. Type A tympanogram was defined as a normal middle ear function in 226 Hz and single-or double-peak in 1 000 Hz tympanometry. One hundred and fifty-eight normal young children (266 ears) were selected as control group. The results were analysed with Chi square test. Receiver operator characteristic (ROC) analysis was performed to evaluate the two methods. RESULT: In the young children with otitis media effusion, the detection rate of 226 Hz tympanogram in six groups was 21.1%, 35.2%, 46.9%, 42%, 62.5% and 68% respectively, while 94.7%, 98.1%, 96.9%, 91.2%, 95.8% and 88% respectively in 1 000 Hz tympanogram. In the young children with normal middle ear function, the detection rate of 226 Hz tympanogram in six groups was 95.1%, 88.6%, 85.1%, 93.3%, 88.5% and 93.5%, while 87.8%, 94.3%, 89.4%, 95.6%, 94.2% and 97.8% respectively in 1 000 Hz tympanogram. The detection rate was significantly different between 226 and 1 000 Hz tympanogram in the young children under 36-month old. CONCLUSION: A single-or double-peak 1000 Hz tympanometric patterns as normal criteria was a simple way to evaluate young children s' middle ear function. 1 000 Hz tympanometry should be given priority to the children within 36-month old in detection middle ear function,the 226 and 1 000 Hz tympanometry should be done at the same time within 36-60 months old.

[Cochlear implant performance evaluation with cortical auditory evoked potential in a group of post-lingually deaf adults].

OBJECTIVE: To investigate the law of auditory remodeling by studying the Cortical Auditory Evoked Potential in a group of post-lingually deaf adults in the early stage of the cochlear implant use. METHOD: Ten post-lingually deaf adults implanted with PULSAR ci 100 of Medel device ranged from 19 to 52 years old with duration of deafness from 3 months to 23 years.were involved. Their P1-N1-P2 responses to /ba/ at around 60-70 dB SPi and open-set speech recognition scores of mono-syllabic words were recorded at 1. 3 and 6 months after the switch-on of cochlear implants. RESULT: Six out of 10 typical waveforms of Pl-N1-P2 were obtained. The other I were with atypical waveforms. The group with atypical waveform was characterized by long duration and early onset of deafness. There was no significant difference regarding either the amplitude or the latency of each peak at the 3 data collection time points. There was significant difference among the 3 data collection time points about the speech recognition scores with the highest score at the 6th month of switch on. There was no significant correlation between the peak of the CAEP and speech recognition score. CONCLUSION: In the first 6 months of cochlear implant use in the post-lingually deaf adults, the duration and the onset age of deafness played important role in respect of the presence and waveform morphology of the CAEPs. It needs at least 6 months for the central auditory system to make use of the audio input from the cochlear implant.

Cochlear implants with fine structure processing improve speech and tone perception in Mandarin-speaking adults.

CONCLUSION: This study indicates that Mandarin-speaking subjects acquire significant benefit from a cochlear implant (CI) and audio processor with the fine structure processing (FSP) coding strategy. It can take adult Mandarin CI users time to become accustomed to their CI and appreciate the benefits. OBJECTIVES: This study aimed to determine speech perception outcomes in Mandarin-speaking adults who received the FSP coding strategy. METHODS: This was a prospective study. Ten adults who were implanted unilaterally with a PULSARCI(100), and received an OPUS 1 or OPUS 2 speech processor, were included in this study. The mean age at implantation was 31.1 years. We determined the benefit to postlingually deafened Mandarin-speaking adults with a severe to profound hearing loss using the tests: monosyllables in quiet, sentences in quiet and the Mandarin Hearing in Noise Test (MHINT). Tone perception was evaluated using a tone perception test. A visual analog scale (VAS) was used to score sound quality and ease of listening. RESULTS: The results showed a significant improvement between first fitting and 6 months in all speech tests and in tone perception. The VAS scores showed a significant improvement over 6 months in sound quality and an immediate benefit in ease of listening.

[Effectiveness of cochlear implantation in children with auditory neuropathy and cochlear nerve aplasia].

OBJECTIVE: The aim of this study is to assess of cochlear implantation in children with auditory neuropathy and cochlear nerve aplasia by using Categories of Auditory Performance (CAP) and Speech Intelligibility Rating (SIR). METHODS: Twenty one children with cochlear implants participated in this study. They all received cochlear implant surgery at our hospital from January 2004 to October 2010. All children had hearing aid trial and hearing and speech rehabilitation before surgery at least three months.Nine children (7 male, 2 female) were diagnosed with auditory neuropathy, twelve (7 male, 5 female) with cochlear nerve aplasia. Twenty children (10 male, 10 female) with sensorineural hearing loss served as a control group. All the children received cochlear implant for more than six months. Forty two children with normal hearing served as another control group which were divided into three subgroups according to their age.Group A included 18 children aged under two yrs, group B consisted of 16 children aged from two to four yrs and group C comprised eight children aged above four yrs. CAP and SIR were used to evaluate among all the children and the scores were compared. RESULTS: The CAP scores of children with auditory neuropathy, cochlear nerve aplasia, sensorial neural hearing loss and the three subgroups children with normal hearing were 4.44 ± 1.50, 4.83 ± 1.69, 4.55 ± 1.66, 5.22 ± 1.11, 6.75 ± 0.45 and 7.00 ± 0.00 respectively, and SIR scores were 2.66 ± 1.11, 2.33 ± 1.15, 2.40 ± 0.75, 2.56 ± 1.04, 4.12 ± 0.81 and 5.00 ± 0.00 respectively. There were significant differences among the six groups for CAP scores(χ(2) = 35.481, P < 0.001) and SIR scores(χ(2) = 40.549, P < 0.001).No significant differences for CAP and SIR scores were observed between children with auditory neuropathy/cochlear nerve aplasia and sensorial neural hearing loss as well as group A (P > 0.05 for each), and there were significant differences were shown between children with auditory neuropathy/cochlear nerve aplasia and group B as well as group C (P < 0.01 for each aplasia). CONCLUSIONS: The auditory and speech capabilities of children with auditory neuropathy and cochlear nerve deficiency can can get benefits from cochlear implants as children with sensorineural hearing loss, however not achieve the level of those with normal hearing after cochlear implantation. The long term effects still need follow-up and evaluation.

[The effects of hearing level on auditory performance in infants with hearing aids].

OBJECTIVE: The purpose of this study is to investigate the effects of hearing level on auditory performance in infants with hearing aids and provide a clinical database for their hearing and speech habilitation. METHOD: A total of 32 infants with prelingual hearing loss participated in this study, ranging in age at hearing aid fitting from 3 to 34 months with a mean of 16 months. According to their hearing level, they were divided into three groups. Infants in group A were with moderate hearing loss (41-60 dB HL). Infants in group B were with severe hearing loss (61-80 dB HL). Infants in group C were with profound hearing loss (>81 dB HL). The infant-toddler meaningful auditory integration scale (IT-MAIS) was used to evaluate their auditory performance. The evaluation was performed before hearing aid fitting and 1, 3, 6, 9, 12 months after fitting. RESULT: The mean scores of auditory performance showed significant improvements with time of hearing aid use for the three groups of infants (P < 0.05). The mean score of auditory performance for group A at 3 months after fitting was significantly superior in comparison with the scores before hearing aid fitting and at 1 month after fitting (P < 0.05). The mean score of auditory performance for group B at 6 months after fitting was significantly superior in comparison with the scores before hearing aid fitting and at 1, 3 months after fitting (P < 0.05). The mean score of auditory performance for group C at 9 months after fitting was significantly superior in comparison with the scores before hearing aid fitting and at 1, 3, 6 months after fitting (P < 0.05). There were no significant differences in mean scores between group A and B at each evaluating interval (P > 0.05). However, significant differences were observed between group A and C at 3, 6, 9, 12 months after fitting (P < 0.05). Significant differences were also shown between group B and C at 1, 3, 6, 9, 12 months after fitting (P < 0.05). CONCLUSION: Auditory performance of infants with prelingual hearing loss developed significantly with the use of hearing aids within the first year after fitting. The degree of hearing loss in infants had significant influence on the development of auditory performance.

[Effect of age at cochlear implantation on auditory performance at the early stage after surgery in infants].

OBJECTIVE: To evaluate the auditory performance of infants with cochlear implants at the early stage after surgery, summarize the development of auditory ability, investigate the effect of age at cochlear implantation on auditory performance within the first year after surgery and provide a reference for their habilitation program. METHOD: A total of 272 infants with prelingually profound hearing loss participated in this study, ranging in age at cochlear implantation from 18 to 36 months. The mean age was 21 months with a standard deviation of 7 months. Infants with cochlear implants were divided into three groups according to their age at implantation. Infants in group A were implanted under 18 months of age. Infants in group B were implanted between 18 and 24 months of age. Infants in group C were implanted between 25 and 36 months of age. Categories of auditory performance (CAP) was used to evaluate the auditory performance, which rates auditory abilities in eight categories for a scale of 0 to 7. RESULT: The mean scores of CAP for all infants at each interval were significantly different after implantation. Significant differences were observed in mean scores of CAP among these three groups in 1 and 3 months after switch-on. However there were no significant differences in pre-operation, 6, 9 and 12 months after switch-on. CONCLUSION: There is a significant improvement in auditory performance of infants with prelingually profound hearing loss within the first year after cochlear implantation. The age at cochlear implantation has no critical influence on the development of auditory capabilities at the early stage after surgery. CAP is a practical tool which can be used in clinic in China.

[Clinical findings of a group of children with auditory neuropathy spectrum disorder].

OBJECTIVE: In order to extend the knowledge of auditory neuropathy spectrum disorder (ANSD), the clinical data of a group of infants and young children with this disorder was reported. METHOD: This retrospective study involved 84 cases (151 ears). The subjects aged from 2 months to 6 years old. Descriptive analysis was carried out on case history, audiological and imaging results and the outcome of cochlear implantation. RESULT: There were a variety of case history, including 11 of hyperbilirubinemia, 2 of family history of deafness, 3 of hypoxia, 1 of prematurity, 1 of nuclei basales pathology, 2 of congenital atelencephalia,and 13 of cochlear nerve deficiency (CND). The audiological results varied too. Click ABR ranged from no response at the maximum output level to Wave V thresholds as low as 70 dB nHL. Behavioral thresholds were mild in 1, moderate in 2 and profound in 20. The inner ear MRI were normal in 16 cases, CND in 12 and CND accompanied by periventricular leukomalacia in 1. 5 cases were implanted in the affected ear. The results in 3 were comparable with that of cochlear loss, 1 were less effective than that of cochlear loss, 1 became none user of the device. CONCLUSION: ANSD is a heterogeneous group with a wide variety on case history, audiological and imaging results and the outcome of cochlear implant. Therefore, comprehensive clinical examinations are necessary so that individualized intervention program can be made.

The development of auditory skills in infants with isolated Large Vestibular Aqueduct Syndrome after cochlear implantation.

OBJECTIVE: The purpose of this study was to investigate the auditory performance of infants with isolated Large Vestibular Aqueduct Syndrome (LVAS) after cochlear implantation, compare their performance with those of infants with a normal inner ear, and establish a database of auditory development. METHOD: 435 infants with congenital severe to profound hearing loss participated in this study. 62 infants in group A were diagnosed with isolated LVAS. 373 infants in group B had a normal inner ear. Infant-Toddler Meaningful Auditory Integration Scale (IT-MAIS) was used to evaluate the development of auditory skills. RESULTS: The mean scores for auditory ability showed no significant difference between groups A and B. The mean scores for the three different auditory skills increased significantly over time. The differences were statistically significant in mean scores among the three different auditory skills for group B. CONCLUSION: Auditory skills of infants with isolated LVAS developed rapidly after cochlear implantation, in a similar manner to those of infants with a normal inner ear. Cochlear implantation is an effective interventional approach and an established therapeutic option for infants with isolated LVAS.

[Audiometric configuration distribution of hearing loss in a clinical population].

OBJECTIVE: Audiometric configuration distribution of hearing loss was analyzed for public policy efforts of hearing loss prevention and rehabilitation. METHOD: According to the archived records of the Clinical Audiology Center of Beijing Tongren Hospital, Capital Medical University, audiometric configuration distribution was analyzed by different type,degree of hearing loss and age factor. RESULT: 1. Overall audiometric configuration distribution: the percentages of "sloping", "rising", "flat", "U-shaped", and other type of audiometric configuration distributions are 52.8%, 7.6%, 15.4%, 13.2% and 11.0%, respectively. No difference was found between male and female in the audiometric configuration distribution; 2. Audiometric configuration distribution by type of hearing loss: sloping hearing loss dominants sensorineural and mixed hearing loss; 3. Audiometric configuration distribution by degree of hearing loss: sloping hearing loss dominants mild, moderate and severe hearing loss, U-shaped hearing loss dominants profound hearing loss; 4. Audiometric configuration distribution by age: for age group 5 to 7, the highest prevalence of audiometric configuration is "sloping", followed by "flat", "U-shaped", other type and "rising"; with the age increasing, the percentage of sloping hearing loss increased dramatically. CONCLUSION: Audiometric configuration distribution shows obvious characteristic of on the type, degree of hearing loss and age factor. "sloping" hearing loss dominates the audiometric configuration.