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Introduction. La surdité est une perturbation auditive correspondant à la diminution ou la suppression de la capacité d'entendre le son. L'objectif de cette étude était de déterminer le profil audiométrique de la surdité à Brazzaville Méthodologie. Il s'agissait d'une étude transversale descriptive et rétrospective réalisée dans les services d'Oto-Rhino-Laryngologie et chirurgie cervico-facialedu CHU de Brazzaville et de l'hôpital de référence de Talangaï. L'étude s'est déroulée sur une période de 12 moisallant du 01 janvier2021 au 31 décembre 2021 et avait inclus les patients présentant une hypoacousie et /ou vertige périphérique et ayant réalisé une audiométrie tonale liminaire mettant en évidence une surdité. Résultats. Nous avons étudié360 dossiers depatients atteints de surdité. La moyenne d'âge était 24,6 ans avec une prédominance féminine (57%). Les étudiants et les élèves constituaient la classe professionnelle la plus retrouvée (47,2%). Le signe fonctionnel le plus représenté était l'hypoacousie bilatérale avec 88,6%. L'audiométrie tonale liminaire était dominée par la surdité de perception moyenne (41,6%).Conclusion. La surdité estun handicap auditif invalidantdont la prise en charge pourrait être améliorée par l'utilisation de l'audiométrie tonale.
Introduction.Deafness is an auditory disturbance corresponding to the decrease or suppression of the ability to hear sound. The objective of this study was to determine the audiometric profile of deafness in Brazzaville. Methodology. This was a descriptive and retrospective cross-sectional study conducted in the Oto-Rhino-Laryngology and Cervico-Facial Surgery departments of the University Hospital of Brazzaville and the Talangai reference hospital. The study took place over a period of 12 months from January 1, 2021, to December 31, 2021, and included patients with hearing loss and/or peripheral vertigo who underwent a pure-tone audiometry revealing deafness. Results.We studied 360 medical records of patients with deafness. The average age was 24.6 years with a female predominance (57%). Students and pupils constituted the most frequently encountered professional group (47.2%). Bilateral hearing loss was the most represented functional sign, accounting for 88.6%. Pure-tone audiometry was predominantly indicative of moderate sensorineural hearing loss (41.6%). Conclusion. Deafness is a disabling auditory handicap that could benefit from improved management through the use of pure-tone audiometry.
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Humans , Male , Femaleالملخص
RESUMO Objetivo Verificar longitudinalmente a influência dos limiares tonais auditivos obtidos com as próteses auditivas ancoradas no osso transcutâneas e percutâneas na percepção da fala em indivíduos com malformação de orelha externa e/ou média e Otite Média Crônica. Método Estudo observacional, retrospectivo, de seguimento longitudinal de 30 indivíduos usuários unilaterais de sistema Baha® transcutâneo e percutâneo, para coleta de dados secundários dos limiares tonais obtidos por meio da audiometria em campo livre e do limiar de reconhecimento de sentenças no silêncio e no ruído nas condições: sem a prótese; no momento de ativação; no primeiro mês de uso (pós 1); e no terceiro mês (pós 2). Resultados Houve diferença significante entre os limiares tonais obtidos nas frequências de 3 e 4kHz, com melhores resultados para o percutâneo em todos os momentos de avaliação. Para os dois sistemas, observou-se melhor desempenho no reconhecimento de sentenças no silêncio e ruído, com diferença significante na ativação (p<0,001), porém manteve-se estável nos demais momentos de avaliação. O sistema percutâneo mostrou melhor benefício no reconhecimento de sentenças no ruído apenas na ativação (p=0,036), quando comparado ao transcutâneo. Conclusão O sistema percutâneo possibilitou melhor audibilidade para as frequências altas; contudo, tal audibilidade não influenciou no reconhecimento de sentenças na situação de silêncio para ambos os sistemas. Para a situação de ruído, melhores respostas foram observadas no sistema percutâneo; porém, a diferença não se manteve no decorrer do tempo.
ABSTRACT Purpose Longitudinally verify the influence of auditory tonal thresholds obtained with transcutaneous and percutaneous bone-anchored hearing aids on speech perception in individuals with external and/or middle ear malformation and chronic otitis media. Methods Observational, retrospective, longitudinal follow-up study of 30 unilateral users of the transcutaneous and percutaneous Baha® system for the collection of secondary data on pure tone thresholds obtained through free field audiometry and sentence recognition threshold in silence and noise in conditions: without the prosthesis; at the time of activation; in the first month of use (post 1); and in the third month (post 2). Results There was a significant difference between pure tone thresholds obtained at frequencies of 3 and 4kHz with better results for the percutaneous technique at all evaluation moments. For both systems, better performance was observed in sentence recognition in silence and in noise, with a significant difference in activation (p<0.001), but it remained stable during the other evaluation moments. The percutaneous system showed better benefit in recognizing sentences in noise only on activation (p=0.036), when compared to the transcutaneous system. Conclusion The percutaneous system provided better audibility for high frequencies; however, such audibility did not influence sentence recognition in the silent situation for both systems. For the noise situation, better responses were observed in the percutaneous system, however, the difference was not maintained over time.
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Abstract Objectives To assess the hearing thresholds in acute otitis media, otitis media with effusion and chronic otitis media (non-suppurative, non-cholesteatomatous suppurative and cholesteatomatous) and to compare the hearing outcomes with non-diseased ears (in bilateral cases) or contralateral healthy ears (in unilateral cases), since hearing loss is the most frequent sequel of otitis media and there is no previous study comparing the audiometric thresholds among the different forms of otitis media. Methods Cross sectional, controlled study. We performed conventional audiometry (500-8000 Hz) and tympanometry in patients with otitis media and healthy individuals (control group). Hearing loss was considered when the hearing thresholds were > 25 dBHL. Results Of the 112 patients diagnosed with otitis media (151 ears), 48 were men (42.86%) and 64 were women (57.14%). The average age was 42.72 years. Of those, 25 (22.32%) were diagnosed as AOM, 15 (13.39%) were diagnosed with OME and the remaining 72 (63.28%) were diagnosed with COM (non-suppurative COM, n = 31; suppurative COM, n = 18; cholesteatomatous COM, n = 23). As compared with controls, all forms of otitis media had significantly higher bone-conduction thresholds (500-4000 Hz). Conductive hearing loss was the most frequent type of hearing loss (58.94%). However, the number of patients with mixed hearing loss was also relevant (39.07%). We noted that the presence of sensorioneural component occurred more frequently in 1) Higher frequencies; and 2) In groups of otitis media that were more active or severe in the inflammatory/infective standpoint (AOM, suppurative COM and cholesteatomatous COM). Conclusion All types of otitis media, even those with infrequent episodes of inflammation and otorrhea, had worse bone conduction thresholds as compared with nondiseased ears (p < 0.01). We observed worse hearing outcomes in ears with recurrent episodes of otorrhea and in ears with AOM, especially in high frequencies.
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Abstract Introduction Obstructive sleep apnea (OSA) is a breathing disorder related to sleep that has a negative effect on the behavior and health of people around the globe. Chronic hypoxemia and variations in the concentration of oxygen in the blood noticed in OSA individuals may have adverse effects on the process of auditory transduction and transmission. Objective To assess the effect of OSA on hearing and to find out the parameters that have more influence on hearing recorded during polysomnography of patients with OSA. Methods The present is a hospital-based, observational, analytical, cross-sectional study conducted over a period of one year. After application of the exclusion criteria, the patients were then submitted to the application of the Berlin questionnaire, as well as polysomnography, impedance, and pure tone audiometry (PTA). Results A total of 58 individuals were studied. Age, gender, and height were comparable among cases and controls, while weight, body mass index (BMI), and neck circumference were significantly higher in cases in comparison to controls. The mean PTA was significantly higher at 10 kHz or higher frequencies in cases in comparison to controls. Conclusion We observed that there is evidence that the auditory mechanism is affected in OSA patients. We recommend early auditory screening of OSA patients for timely diagnosis and to raise awareness about its prevention.
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Introducción: La audición es la vía habitual para adquirir el lenguaje, lo cual permite el desarrollo del pensamiento y el conocimiento; la pérdida auditiva puede afectar la capacidad de aprendizaje y comunicación en el niño y ocasionar alteraciones en su comportamiento y rendimiento académico. Objetivo: Determinar la relación entre el nivel auditivo y el rendimiento académico en estudiantes de educación primaria de una institución educativa pública de Lima. Métodos: Estudio observacional, correlacional y transversal. Se realizó otoscopía y audiometría en 94 alumnos del sexto año de primaria de la institución educativa Santa Rosa de Lima, en Los Olivos-Lima. Se usó como instrumento el otoscopio, el audiómetro y las notas finales de cada alumno del primer semestre académico 2022. Se analizó la relación mediante el coeficiente de correlación de Rho de Spearman. Resultados: El 35,1% de estudiantes presentaron hipoacusia leve y el 64,9%, normoacusia. El rendimiento académico promedio de la muestra fue 14,74; el rendimiento académico promedio de los normoacúsicos; 14,89 y el de los hipoacúsicos, 14,48. En el análisis de correlación de Rho de Spearman, se encontró correlación positiva entre nivel de audición y rendimiento académico (0,200). Conclusiones: Existe relación positiva entre el nivel de audición y rendimiento académico en estudiantes del sexto año de primaria de la institución educativa Santa Rosa de Lima en Los Olivos.
Introduction: Hearing is the usual way to acquire language, which allows us the development of thought and knowledge; hearing loss can affect the ability to learn and communicate in children and cause alterations in their behavior and academic performance. Objective: To determine the relationship between hearing level and academic performance in primary school students from a public educational institution in Lima. Methods: Observational, correlational and cross-sectional study. Otoscopy and audiometry were performed in 94 students of the sixth year of primary school of the Santa Rosa de Lima educational institution, in Los Olivos-Lima. Was used the otoscope, the audiometer and the final grades of each student of the first academic semester 2022 as instruments. The relationship was analyzed using Spearman's Rho correlation coefficient. Results: 35.1% of students had mild hearing loss and 64.9% had normal hearing loss. The average academic performance of the sample was 14.74; the average academic performance of the normoacusic students, 14.89 and the average academic performance of the hearing impaired, 14.48. In the Spearman's Rho correlation análisis, it was found a positive correlation between hearing level and academic performance (0.200). Conclusions: There is a positive relationship between hearing level and academic performance in sixth grade students of the Santa Rosa de Lima- Los Olivos educational institution.
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Abstract Objective: To compare functional outcome of microscopic and endoscopic approach regarding type of ossiculoplasty. Methods: In this retrospective study, cases who had undergone type-II and type-III tympanoplasty between February 2007 to September 2019 were divided into two groups according to the type of approach as microscopic and endoscopic. In cases with type-II reconstruction; Partial Ossicular chain Replacement Prosthesis (PORP), incus interposition and bone cement were used in order of frequency. Whereas in cases with type-III reconstruction, only Total Ossicular chain Replacement Prosthesis (TORP) was used. The average Air Bone Gap (ABG) was determined pre- and post-operatively for the calculation of Air Conductance Gain (ACG). The ACG, pre- and post-operative ABG values of each group were compared with regard to the type of ossiculoplasty. Results: A total of 79 cases consisting of 32 females and 47 males who had undergone type-II and type-III tympanoplasty were enrolled. No statistically significant difference between microscopic and endoscopic approach was found in terms of ACG (p = 0.42), pre-(p = 0.23) and postoperative ABG (p = 0.99). We did not find any significant difference in terms of ACG, pre- and postoperative ABG between two approaches for type-II and type-III reconstructions (p>0.05). Conclusions: According to the current study, endoscopic approach in type-II and type-III reconstruction is at least reliable as microscopic approach regarding functional outcome. Since both techniques have similar functional results, other factors (anatomic characteristics, habitude of the surgeon and duration of the surgery) should be considered when choosing the technique. Level of evidence: In the current paper we present a retrospective comparative study of two different approaches of a particular type of otologic surgery. Level of evidence corresponds to level III.
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The qualitative, quantitative, and localization analysis of hearing loss is one of the important contents of forensic clinical research and identification. Pure-tone audiometry is the "gold standard" for hearing loss assessment, but it is affected by the subjective cooperation of the assessed person. Due to the complexity of the auditory pathway and the diversity of hearing loss, the assessment of hearing loss requires the combination of various subjective and objective audiometric techniques, along with comprehensive evaluation based on the case situation, clinical symptoms, and other examinations to ensure the scientificity, accuracy and reliability of forensic hearing impairment assessment. Objective audiometry includes acoustic impedance, otoacoustic emission, and various auditory evoked potentials. The frequency-specific auditory brainstem response (ABR), 40 Hz auditory event related potential, and auditory steady-state response are commonly used for objective hearing threshold assessment. The combined application of acoustic impedance, otoacoustic emission and ABR can be used to locate hearing loss and determine whether it is located in the middle ear, cochlea, or posterior cochlea. This article reviews the application value of objective audiometry techniques in hearing threshold assessment and hearing loss localization, aiming to provide reference for forensic identification of hearing loss.
الموضوعات
Humans , Reproducibility of Results , Auditory Threshold/physiology , Evoked Potentials, Auditory, Brain Stem/physiology , Hearing Loss/diagnosis , Audiometry, Pure-Tone/methods , Clinical Medicineالملخص
{L-End}Objective To explore the status of quality control assessment of pure tone audiometry (PTA) and to analyze its influencing factors in occupational medical examination (OME) institutions in Guangzhou City. {L-End}Methods A total of 41 OME institutions in Guangzhou City were selected as the research subjects from 2021 to 2022 using random sampling method, and its status of on-site quality and PTA quality for individuals exposed to noise were assessed. {L-End}Results A total of 205 rectification items were identified among the 41 OME institutions from 2021 to 2022. Among them, 19, 28, 30, and 28 OME institutions did not meet the requirements of organizational structure, quality management system, quality control of OME, and health examination information reporting, respectively. A total of 1 095 OME reports for individuals exposed to noise were assessed, with 820 reports having correct results and conclusions, resulting in an accuracy rate of 74.9%. The results of the multiple logistic regression analysis showed that OME institutions without meeting the requirements for the quality management system had a higher risk of failing the PTA quality control assessment and having inaccurate hearing test results compared with those meeting the requirements (all P<0.05). OME institutions with a filing period less than one year had a higher risk of having inaccurate hearing test results than those with a filing period of one year or more (P<0.05). OME institutions not meeting the requirements for quality control of OME had a higher risk of having abnormal OME conclusions than those meeting the requirements (P<0.05). OME institutions not meeting the requirements for health examination information reporting had a higher risk of having abnormal conclusions in suspected occupational disease than those meeting the requirements (P<0.05). OME institutions not meeting the requirements for the quality management system had a higher risk of having abnormal conclusions of occupational contraindications than those meeting the requirements (P<0.05). {L-End}Conclusion The quality of PTA in OME institutions in Guangzhou City needs to be improved. And a well-established quality management system for OME is beneficial for improving the quality of PTA.
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Objective:To investigate the prevalence of hearing loss among community-dwelling older people aged 60 and over, and also to compare the discrepancies between self-reported hearing loss and hearing loss diagnosed via audiometry.Methods:Subjects were from the Prevention and Intervention on Neurodegenerative Disease for the Elderly in China(PINDEC)project.By using the stratified multi-stage cluster random sampling method, a total of 10 347 residents aged 60 years and over were selected from 12 counties and districts in Liaoning, Henan and Guangdong Provinces and hearing function assessment was performed in 2020 through otoscopy, pure-tone audiometry and questionnaires.Hearing loss(HL)was defined by the World Health Organization criteria.Self-reported hearing loss was assessed by asking participants whether they had difficulty in hearing.The χ2 and Cochran-Armitage trend tests were used to analyze the differences in HL between different groups.The multivariate Logistic regression model was applied to assess factors influencing HL. Results:In 2020, the prevalence of HL among the elderly aged 60 and older in Liaoning, Henan and Guangdong Provinces was 69.8%(95% CI: 68.9%-70.7%). The prevalence of HL in men was higher than that in women, and increased gradually with age.The prevalence of mild HL was 47.2%, and the prevalence of moderate, severe and profound HL were 18.0%, 3.6% and 0.9%, respectively.Multivariate Logistic regression analysis showed that factors positively correlated with HL were aging, male sex, living in rural areas and working in manual labor.Education level was negatively correlated with HL.Of the 7223 participants who were found to have HL, 5106(70.7%)self-reported having good hearing.Those of a younger age, with a higher educational achievement, having a spouse, or with mild HL were more likely to report having good hearing(all P<0.05). Conclusions:Hearing loss is quite prevalent among community-dwelling older people, and there is a large discrepancy in prevalence between self-reported HL and HL diagnosed via audiometry.Screening and comprehensive intervention for hearing loss for the elderly should be strengthened.
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Objective:To investigate the application value of auditory steady-state response (ASSR) combined with short sound auditory brainstem response (ABR) for hearing assessment in children with sensorineural hearing impairment, providing evidence for clinical diagnosis of the disorder.Methods:A total of 90 children with sensorineural hearing impairment who received treatment at Jiaxing Maternity and Child Health Care Hospital from January 2020 to June 2021 were included in this prospective study. These children were randomly divided into a control group and an observation group ( n = 45 per group). The children in the control group underwent ABR testing, while those in the observation group underwent ASSR testing in addition to ABR thresholds testing. The hearing impairment was compared between the two groups. The ABR and ASSR thresholds were compared among children with different degrees of hearing impairment. The correlation between ABR and ASSR at 2 and 4 kHz carrier frequencies was analyzed in the observation group. Results:The abnormal rate of hearing in the observation group was 68.89% (31/45), which was significantly higher than 44.44% (20/45) in the control group ( χ2 = 5.48, P = 0.019). At a carrier frequency of 0.5 kHz, the ASSR thresholds of children with moderate and severe hearing impairment in the observation group were (63.11 ± 6.82) dB nHL and (84.65 ± 5.31) dB nHL, respectively, which were significantly higher than the ABS thresholds (56.12 ± 4.63) dB nHL and (76.87 ± 5.15) dB nHL ( t = 2.94, 2.78, both P < 0.05). There was a positive correlation between ABR and ASSR thresholds at 2 and 4 kHz carrier frequencies in children with different degrees of hearing impairment in the observation group ( r = 0.896, 0.901, both P < 0.05). Conclusion:The combination of ABR and ASSR testings is more accurate in judging the degree of hearing impairment in children with sensorineural hearing impairment than the ABR testing, and can provide a reliable basis for later clinical treatment.
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RESUMO Objetivo Caracterizar os limiares auditivos nas frequências de 500, 1000, 2000 e 4000 Hz em crianças submetidas ao reimplante com follow-up de no mínimo 10 anos. Método Revisão retrospectiva de prontuários de crianças submetidas a cirurgia de reimplante há pelo menos 10 anos. Foram avaliados os limiares auditivos obtidos na audiometria tonal liminar em campo livre com o implante coclear nas frequências de 500, 1000, 2000 e 4000 Hz em quatro momentos distintos: 1 (antes da falha), 2 (ativação), 3 (cinco anos após o reimplante) e 4 (dez anos após o reimplante, independentemente do tempo de uso do uso do 2o IC) em pacientes com follow-up de no mínimo 10 anos. Resultados Avaliando-se pacientes submetidos ao reimplante, observou-se que os limiares de 500, 1000, 2000, 4000 Hz apresentaram-se a longo prazo semelhante àqueles obtidos nos pacientes implantados somente uma única vez, não apresentando prejuízo assim na detecção dos sons. Conclusão O reimplante não teve efeito de longo prazo sobre os limiares auditivos obtidos em crianças que se submeteram a esta cirurgia por falha do componente interno.
ABSTRACT Purpose To characterize hearing thresholds at frequencies of 500, 1000, 2000 and 4000 Hz in children undergoing reimplantation with a follow-up of at least 10 years. Methods Retrospective review of medical records of children who underwent reimplantation surgery for at least 10 years. The auditory thresholds obtained in free-field pure tone audiometry with the cochlear implant were evaluated at frequencies of 500, 1000, 2000 and 4000 Hz at four different times: 1 (before failure), 2 (activation), 3 (five years after reimplantation) and 4 (ten years after reimplantation, regardless of the time of use of the 2nd CI) in patients with a follow-up of at least 10 years. Results Evaluating patients who underwent reimplantation, it was observed that the thresholds of 500, 1000, 2000, 4000 Hz were similar in the long term to those obtained in patients who were implanted only once, thus not presenting damage in the detection of sounds. Conclusion Reimplantation had no long-term effect on the hearing thresholds obtained in children who underwent this surgery due to internal component failure.
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Abstract Introduction The audiological evaluation has the main objective of determining the integrity of the auditory system. Pure tone audiometry is a standardized behavioral procedure that aims to investigate auditory thresholds to describe auditory sensitivity. Despite being recognized since the mid-1960s, high frequency audiometry is still little used and explored in clinical practice, and its use is more considered as an audiological monitoring tool or as a research tool. Objective To analyze the audiological thresholds of high frequency audiometry in normal hearing individuals, and to verify the predictive capacity of age in the auditory thresholds of high frequency audiometry. Methods This is a retrospective, cross-sectional, and quantitative study that was approved by the Research Ethics Committee under number 5.039.583/21. The procedures were: clinical evaluation, pure tone audiometry, acoustic immittance measurements, and high frequency audiometry. All data collected from the exams were tabulated in an Excel spreadsheet and analyzed using appropriate statistical tests in the Statistical Package Social Sciences software. Results A total of 980 medical records were analyzed. The right and left ears presented similar tonal hearing thresholds for the frequencies of 12 kHz and 16 kHz. The threshold variance of 29.8% in the 12 kHz frequency can be explained by the variance of age, while, for the frequency of 16 kHz, this percentage is of 46.4%. Conclusion For 12 kHz hearing thresholds, an increase of 1 year leads to a 0.66 dBHL increase in hearing threshold. For 16 kHz hearing thresholds, an increase of 1 year leads to a 1.02 dBHL increase in hearing threshold.
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Introduction: The tympanic cavity contains three ossicles in humans, the malleus, incus and stapes. These ossicles form a chain across the tympanic cavity from the tympanic membrane to fenestra vestibuli respectively. They develop from mesenchymal condensation of tubotympanic recess at the 6th week of intrauterine life. Later due to programmed cell death a part of tissue remains as ossicles. It attains adult size in the fetal life itself. However, studies have shown gain in size and weight even 2 years after birth. The ossicles help in sound conducting mechanism in hearing. These ossicles are vulnerable to damage in the various diseases of the middle ear cleft resulting into either partial or total loss. Incus is the most, followed by stapes and least by malleus. 20% mucosal diseases show ossicular damage, while squamous epithelial disease involve in 80% [1,2]. The integrity of the ossicular chain is most important for the transmission mechanism of external sounds to the inner ear fluids. Objectives: 1. To study the percentage of ossicular damage in the diseases of the middle ear cleft among the patients being operated for chronic suppurative otitis media in our tertiary care hospital. 2.To assess the extent and frequency of individual ossicular chain involvement in simple mucosal disease and squamous epithelial diseases. Methods: A prospective clinical study was conducted in our tertiary care hospital over a period of five and a half years in our tertiary care hospital among 100 cases of chronic suppurative otitis media after ethical committee clearance. Detailed clinical and radiological examinations of the patients were done and ossicular chain status was noted on table. Patients were also called up for regular follow up. Results: Ossicular chain erosion was mostly seen in squamosal disease, with incus and incudo-stapedial joint being the most common sites for ossicular erosion. Conclusion: it was concluded that long process of incus was the most commonly eroded structure, with the incus being the most commonly involved ossicle Few factors that were found to be associated with ossicular erosion were atticoantral disease, pediatric age group and bigger tympanic membrane perforations.
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Abstract Objective: To investigate the impact of certain clinical parameters on likelihood of hearing recovery after SSNHL and to detect potential variables that predict its outcome. Methods: A retrospective study was conducted in order to identify the clinical parameters which influence hearing recovery after SSNHL. Medical charts of 87 patients diagnosed with SSNHL and treated in the clinic from January 2015 to December 2019 were retrospectively reviewed. The effects of several parameters on the success of the treatment were statistically evaluated. Such parameters studied were age, gender, the severity of hearing loss, audiometric curve pattern, the time treatment was initiated, and metabolic factors. Results: Patient categorization according to tonal audiometric curve results statistically differed in terms of recovery (complete, partial, no recovery) (x2 = 32.5; p< 0.001). There are 2× more diabetic patients in the group no recovery than in the group partial recovery (OR = 3.1; 95% CI 0.95-10; p = 0.061), and 5.3× more than in the group complete recovery (OR = 10.4; 95% CI 2.3-45; p = 0.002) (χ2 = 11.2; p = 0.004). There is a statistically significant correlation between onset of therapy and recovery on a scale of significance of 93% (χ2 = 5.3, p= 0.069). Conclusion: In our study tonal audiometry results, diabetes mellitus and onset of therapy were shown to be a statistically significant negative predictive factors for recovery. Results of pure tone audiometry suggest a flat profound curve is statistically associated with the no recovery rates, and a down sloping curve proved to be statistically associated with complete recovery rates. Level of evidence: Level 1.
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Abstract Introduction Chronic suppurative otitis media is one of the most common causes of reversible conductive hearing loss which can lead to necrosis of the ossicles. The incus, especially its long process, is the most common ossicle affected. Objectives The present study aims to assess the use of glass ionomer cement for the reconstruction of the long process of the incus. Methods The present study was conducted on 27 patients with chronic suppurative otitis media with central perforation with dry and quiescent ears with an eroded long process of the incus submitted to tympanoplasty. The audiological evaluations were done on all patients, including preoperative and postoperative evaluation of the airbone gap; the average pure tone threshold was done 6 months postoperatively. Results The average air pure tone threshold was 42.8 dB preoperatively and 22.5 dB postoperatively. The postoperative air pure tone thresholds were significantly smaller than the preoperative values (p < 0.01). The air-bone gap was 30.5 dB at 500 Hz, 31.6 dB at 1 KHz, and 24.1 dB at 2 kHz preoperatively, and 7.7 dB at 500 Hz, 7.2 dB at 1 KHz, and 7.1 dB at 2 kHz postoperatively at the end of 6 months of follow-up. There were significant hearing gains in the air-bone gap (p < 0.001). Conclusion Glass ionomer cement is a useful and effective material for bridging the defect of the long process of the incus.
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Abstract Introduction: Current Brazilian legislation requires that all workers exposed to noise are to be given an audiogram upon hiring, after 6 months of employment (first periodic test), and annually after the first periodic test. In other countries, the regulations of hearing conservation programs do not include the requirement for audiometric testing at 6 months of employment, but only annually. There is no evidence that the periodicity adopted by Brazilian legislation is the most appropriate. Objective: The present study aimed to evaluate the first 3 occupational audiometric tests of workers exposed to noise. Methods: Historical cohort study with cross-sectional analysis. Participants were all male metallurgy workers aged up to 40 years. The first 3 audiograms of each worker were analyzed: pre-employment audiometric test, periodic audiometric test 1, and periodic audiometric test 2. For each worker, mean frequency thresholds were calculated at 3, 4, and 6 kHz in the left and right ears for each test. Statistical analysis was performed using the nonparametric Wilcoxon test. Results: A total of 988 workers were included. There was a significant difference in auditory thresholds between the pre-employment test and the 2 subsequent periodic tests for the right and left ears. There was no significant difference between Test1 and Test2 in either ear. Conclusion: Given the lack of difference between the first 2 periodic tests, we believe that they could be merged into a single test, i.e., first periodic audiometric testing could be performed at 12 months of employment without compromising workers' health.
Resumo Introdução: A legislação brasileira atual exige que todos os trabalhadores expostos a ruído recebam um audiograma na admissão, 6 meses após a admissão (primeiro teste periódico), e anualmente após o primeiro teste periódico, mas em outros países as regulamentações dos programas de conservação auditiva não incluem a exigência de teste audiométrico após 6 meses de admissão, mas apenas anualmente. Não há evidências de que a periodicidade adotada pela legislação brasileira seja a mais adequada. Objetivo: Avaliar os três primeiros exames audiométricos ocupacionais de trabalhadores expostos ao ruído. Método: Estudo de coorte histórica com análise transversal. Os participantes eram todos trabalhadores metalúrgicos do sexo masculino com até 40 anos. Os três primeiros audiogramas de cada trabalhador foram analisados: teste audiométrico pré-admissão, teste audiométrico periódico 1 e teste audiométrico periódico 2. Para cada trabalhador, os limiares de frequência médios foram calculados em 3, 4 e 6 kHz nas orelhas esquerda e direita para cada teste. A análise estatística foi feita através do teste não paramétrico de Wilcoxon. Resultados: Foram incluídos 988 trabalhadores. Houve uma diferença significante nos limiares auditivos entre o teste pré-admissão e os 2 testes periódicos subsequentes para as orelhas direita e esquerda. Não houve diferença significante entre o teste 1 e o teste 2 em nenhuma das orelhas. Conclusão: Dada a falta de diferença entre os 2 primeiros testes periódicos, acreditamos que eles poderiam ser combinados em um único teste, ou seja, o primeiro teste audiométrico periódico poderia ser feito após 12 meses de admissão sem comprometer a saúde dos trabalhadores.
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Background: Thyroid hormones are important for overall growth and maturation. Hypothyroidism is associated with many symptom complexes, one of them being hearing loss. Aim and Objectives: Evaluating the hearing loss in hypothyroid patients of the age group of 18� years and comparing them with those in healthy people. Materials and Methods: A case-control study was conducted in subjects aged between 18 and 45 years, in which 80 hypothyroid cases were selected after proper exclusion and informed consent and 80 age-and sex-matched healthy controls were studied. Hearing loss was assessed by pure tone audiometry. Statistical Package for the Social Sciences version 18 was used for statistical analysis. Results: SNHL was the common type of hearing loss seen. The prevalence of hearing loss was found to be 66.3% in cases. Hearing loss was mild, bilateral, and commonly affected the high frequency. Conclusions: Hypothyroid patients were more prone to sensorineural hearing loss. In patients with thyroid disorders, hearing evaluation helps in the detection of hearing loss earlier and thus treatment could be started.
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Abstract Introduction Childhood and adolescent obesity is associated with insulin resistance, abnormal glucose metabolism, hypertension, dyslipidemia, inflammation, liver disease, and compromised vascular function. Objective We aimed to evaluate the effects of obesity on the auditory function and speech audiometry of children and adolescents. Methods Subjects with a body mass index (BMI) higher than +2 standard deviation (SD) were classified as obese, and subjects with normal BMI SD were classified as the control group. Blood samples were taken for glucose, insulin, and lipid profiles following an 8-hour fasting period, and a hepatobiliary ultrasound was performed. The homeostatic model assessment for insulin resistance (HOMA-IR) was calculated. The audiological evaluation included pure-tone audiometry (PTA), speech reception threshold (SRT), and speech discrimination score (SDS). Results The study included 100 children (50 girls) with obesity, with a mean age of 11.4 ± 2.9 years and 30 children with normal body weight, with a mean age of 11.9 ± 3.3 years. Of the children with obesity, 55% (n = 55) were found to have hyperlipidemia, 68% (n = 68) insulin resistance, and 21% (n = 21) hepatosteatosis. There were no statistically significant differences between children with obesity and the control group in terms of SDS or PTA, while SRT was found to be higher in children with obesity. There was no difference between obese children with or without hyperlipidemia, between obese children with or without insulin resistance, and between obese children with or without hepatosteatosis, according to hearing tests. Conclusion The result of the present study indicates that children with obesity are more prone to having auditory problems than the normal population. We recommend more frequent audiological evaluations, including speech audiometry, in children and adolescents with obesity problems
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Background: Diabetes mellitus (DM) is a non-communicable disorder which is metabolically disrupted associated with several complications, which include retinopathy, nephropathy, angiopathy, and neuropathy. Angiopathy and neuropathy caused by DM have been considered important factor for vestibulocochlear disorder found in these patients. Aims and Objectives: The study was done to compare sensory-neural hearing losses (SNHL) in Type 2 diabetics with healthy individuals. To find out effect of age of individual on hearing, how glycemic control of diabetes affects hearing acuity which frequencies of hearing affected by diabetic patients. Materials and Methods: The present study was conducted on 30 Type 2 diabetics and 30 healthy individuals are takes as controls in the age group of 30–60 years. Selection of individuals is done based on inclusion and exclusion criteria. All patients are asked for detailed history and their detailed clinical examination is done. After this, all patients are investigated for HbA1C. All subjects underwent pure tone audiometry and findings were recorded and analyzed. Results: The diabetics with SNHL are 90% when compared to the control are 60% which is highly significant (P = 0.017). Diabetes patients had hearing losses which are insidious in nature which is gradually progressive and affects hearing in both the sides. The audiogram of diabetics was suggestive of mild to moderately severe SNHL which was more toward higher frequencies. SNHL is aggravated with increasing age. In non-diabetic, SNHL is mainly due to age, but in diabetic, SNHL is mainly due to poorer control of diabetes not only due to age. Conclusion: The Type 2 diabetic patients had hearing losses at higher threshold more significantly which is bilateral, mild to moderately severe SNHL as compared to healthy individual of similar age. The glycemic control-HbA1C has significant correlation with severity of hearing loss. SNHL is more significant in patients whom had poor glycemic control.
الملخص
Background: Diabetes mellitus is considered as most prevalent non-communicable disease throughout the world. It is associated with many complications. Hearing loss among diabetics is a recent concern, its magnitude and pathophysiology are not yet clearly defined. Aim and Objectives: The present study aimed to determine the relation between diabetes and hearing loss. Materials and Methods: The present study was conducted with 200 diabetes mellitus patients aged between 20 and 50 years, selected from endocrinology outpatient department, SCB Medical College and Hospital, Cuttack. Participants were subjected to pure tone audiometry at the department of ENT. Two hours PGBS (75 g) value was collected. Results: About 58% of the participants were detected with sensorineural hearing loss. There was a significant association of hearing loss with the duration of diabetes and glycemic status (with P < 0.05). Conclusion: The hearing loss found among diabetics showed strong association with the duration of the disease and the glycemic status. If detected earlier in its course, long-term complications of hearing can be avoided.