Laboratory evaluation of an optimised internet-based speech-in-noise test for occupational high-frequency hearing loss screening: Occupational Earcheck.

OBJECTIVE: The "Occupational Earcheck" (OEC) is a Dutch online self-screening speech-in-noise test developed for the detection of occupational high-frequency hearing loss (HFHL). This study evaluates an optimised version of the test and determines the most appropriate masking noise. DESIGN: The original OEC was improved by homogenisation of the speech material, and shortening the test. A laboratory-based cross-sectional study was performed in which the optimised OEC in five alternative masking noise conditions was evaluated. STUDY SAMPLE: The study was conducted on 18 normal-hearing (NH) adults, and 15 middle-aged listeners with HFHL. RESULTS: The OEC in a low-pass (LP) filtered stationary background noise (test version LP 3: with a cut-off frequency of 1.6 kHz, and a noise floor of -12 dB) was the most accurate version tested. The test showed a reasonable sensitivity (93%), and specificity (94%) and test reliability (intra-class correlation coefficient: 0.84, mean within-subject standard deviation: 1.5 dB SNR, slope of psychometric function: 13.1%/dB SNR). CONCLUSIONS: The improved OEC, with homogenous word material in a LP filtered noise, appears to be suitable for the discrimination between younger NH listeners and older listeners with HFHL. The appropriateness of the OEC for screening purposes in an occupational setting will be studied further.

[Clinical analysis of sudden deafness after radiotherapy and chemotherapy in nasopharyngeal carcinoma patients].

OBJECTIVE: To investigate the clinical features and therapeutic effects of sudden deafness after radiotherapy combined with chemotherapy in nasopharyngeal carcinoma patients. METHOD: Clinical data of 42 nasopharyngeal carcinoma patients suffered from sudden deafness after radiotherapy combined with chemotherapy were analyzed retrospectively. Among the 42 patients, 2 showed moderate deafness, 4 presented excessive deafness, 30 suffered from severe deafness, and 6 exhibited profound deafness. The audiogram pattern of 33 patients met with the type of high tone frequencies hearing loss, and that of the rest 9 cases showed hearing loss at all frequencies. All patients received medical therapy combined with hyperbaric oxygen therapy. RESULT: Of all the cases with hearing loss, 2 were cured, 2 showed excellent recovery, 9 came out partial recovery, and 29 showed no response to the treatment. The total effective rate was 30.95%. For the accompanied symptoms, none of the 30 cases of tinnitus were relieved, 3 out of 10 cases of aural fullness were cured, and the 5 cases of dizziness or vertigo were all improved. CONCLUSION: The sudden deafness after radiotherapy combined with chemotherapy in patients with nasopharyngeal carcinoma is closely related to radiotherapy. The hearing loss is serious, and the therapeutic effects are not satisfactory.

Hyperactive auditory efferent system and lack of acoustic reflexes in Williams syndrome.

The auditory efferent system and acoustic reflexes have been investigated in patients with Williams syndrome (WS). Twenty-one patients aged 6-26 years with a genetically confirmed diagnosis of WS and with reported hyperacusis were compared with 21 normally developing age-matched subjects. The medial olivocochlear (MOC) efferent system was tested by stimulation of the contralateral ear with increasing levels of white noise, while recording transient evoked otoacoustic emissions (TEOAE) in the ipsilateral ear. The suppression effect on the amplitudes of the TEOAE was computed for each contralateral stimulus level. This measure reflects the strength of the MOC efferent system. In addition, the thresholds of ipsilateral and contralateral acoustic reflexes in response to 1, 2 and 4 kHz tones as well as to broadband stimuli were also recorded. Results showed that patients with WS had a significantly higher suppression effect of the MOC reflex on TEOAE. Ipsilateral and contralateral acoustic reflexes to tonal and broadband stimuli presented at maximum stimulus intensities were absent in 62-86% of the patients with WS. In the remainder, acoustic reflexes were elicited at lower auditory sensation thresholds than in controls. Hyperexcitability of the MOC efferent system coupled with absence of acoustic reflexes may contribute to the hyperacusis in WS and the consequent high-tone hearing loss induced by environmental noise. Both measures can be used for objective detection and thus, intervention of hyperacusis in the early stages of life.

The behavioral salience of tones as indicated by prepulse inhibition of the startle response: relationship to hearing loss and central neural plasticity in C57BL/6J mice.

Adult C57BL/6J mice exhibit high-frequency, sensorineural hearing loss accompanied by physiological changes in the upper auditory brainstem and cortex, referred to as hearing-loss induced (HLI) plasticity: as high-frequency sensitivity declines, many neurons come to respond better to still-audible, middle-frequency tones (especially 12-16 kHz). We used prepulse inhibition (PPI) to assess the relationship between the behavioral salience of tones and HLI plasticity. The ability of a tone 'prepulse' (S1), presented 100 ms before a startle-eliciting tone (S2), to 'inhibit' startle responses was measured in normal-hearing 1-month-olds and 5-month-olds with high-frequency hearing loss. Tone bursts of 4, 8, 12, 16, and 24 kHz were used as S1s and S2s in all possible combinations. PPI was significantly improved (more inhibition) in 5-month-olds with 12 or 16 kHz S1s. This effect was not influenced by S2 frequency or the size of the startle evoked by S2-only stimuli (smaller for high-frequency S2s in older mice). The increased salience of 12-16 kHz S1s in 5-month-old C57 mice parallels changes in the central representation of tone frequency and implies a behavioral effect of HLI plasticity.

[Study on relation of kidney-deficiency with hearing damage and serum trace elements in patients with chronic nephropathy].

The hearing and serum trace element of 73 cases of chronic nephropathy were measured. Results showed that the incidence of hearing damage in high frequency was 68.5% with a mean hypoacusis of 35.1 +/- 6.1 dB, while in 55 patients of Kidney Deficiency type, the incidence of hearing damage in high frequency was 83.6%, it was significantly higher than that in patients without Kidney Deficiency. The serum levels of trace elements (iron and zinc) in patients with Kidney Deficiency were lower than that of normal level and in patients without Kidney Deficiency, and the decrease of serum iron was directly proportional to the degree of hearing damage. There were close relationship between the Kidney Deficiency with the hearing damage as well as the serum levels of iron and zinc.

Binaural interference in multiple sclerosis: case study.

A case report of a young, adult male with multiple sclerosis who demonstrates binaural interference is presented. Binaural interference was demonstrated on behavioral and physiologic measures during the active stage. Binaural interference was present, although reduced, during the stage of remission. During remission, binaural interference occurred despite the absence of interaural asymmetry in the audiometric configuration or suprathreshold speech-recognition score. A trial period of left ear amplification was introduced. A possible explanation for the improvement in soundfield suprathreshold speech-recognition score with amplification is the reduction of the binaural-interference effect with monaural amplification of the affected ear when there is bilateral normal-hearing sensitivity.

[Hearing disorders after Bungee jumping?]. / Hörstörungen nach Bungee-Springen?

Acceleration forces in bungee jumping acting on the head are different in nature and extent from those in merry-go-round, looping and scooter rides. They act mainly in the vertical plane, horizontal accelerations may develop only during uncontrollable vibrations in different directions after slowing down. According to our present knowledge the risks for injuries of the cervical spine and functional disorders of the inner ear in bungee jumping are lower than in merry-go-round, looping and scooter rides. They seem to be enhanced, however, in individuals suffering from diseases of the cervical spine and disorders of the heart and the blood circulation.

ABR amplitude and dispersion variables. Relation to audiogram shape and click polarity.

ABR amplitude behaviour to condensation (C) and rarefaction (R) clicks was investigated in normal ears, ears affected by Ménière's disease and ears with high-frequency hearing loss (HF ears). The wave IV-V amplitude-intensity function was steeper in ABRs evoked by R than by C clicks. This may suggest that two different cochlear generator components, one intensity-dependent as well as one polarity-dependent, contribute to click-evoked ABRs. Wave IV-V amplitude was significantly higher in Ménière ears compared to HF ears in spite of comparable 2-4 kHz hearing loss in the two groups. Hence, audiometric steepness (which is lower in Ménière ears than in HF ears) seems to predict the wave IV-V amplitude decline more precisely than the 2-4 kHz perception threshold. The wave IV-V dispersion variable (SR IV-V) was close to normal in Ménière ears, while wave IV-V was more dispersed in HF ears. In general, C click ABRs were less affected than R click ABRs by 'peripheral' factors (i.e. intensity and audiometric steepness).

No evidence of hearing loss due to fetal acoustic stimulation test.

The fetal acoustic stimulation test is used increasingly for fetal assessment. To evaluate the possibility of acoustic trauma, 465 children who had been exposed to vibroacoustic stimulation in utero were screened at 4 years of age for high-frequency hearing loss. A hand-held audiometer with test tones at 25 dB for 1000 and 4000 Hz was used because responses at this level indicate hearing within normal limits for middle and high frequencies. Thirty-one children failed the test. Failure to respond was followed by inspection of the ear canal for wax, tympanometry, and reflex measurement to assess the tympanic membrane, middle ear, and eustachian tube. Hearing was retested across the full frequency range using conventional audiometric technique, and referral for otolaryngologic examination and treatment was made if necessary. The causes of hearing loss were impacted wax in 12, current or recent upper respiratory tract infection with eustachian tube dysfunction and middle ear effusion in 15, and unresolved middle ear effusion after treatment with antibiotics for otitis media in two. Profound bilateral sensorineural hearing loss of unknown origin was found in one and slight bilateral gently sloping hearing loss in another. Retesting of all children with conductive hearing loss indicated that hearing had returned to normal after treatment. None of the children showed evidence of hearing loss.

High-frequency electrostimulation hearing after mastoidectomy.

This study was undertaken to measure the degree of high-frequency sensorineural hearing loss following mastoid surgery. Twenty-five patients undergoing mastoidectomy procedures were tested preoperatively, less than 2 days postoperatively, and at 30 days postoperatively using the Tonndorf Audimax 500 high-frequency audiometer. Electrostimulation thresholds in 1-kHz intervals, from 1 to 20 kHz, were measured, and the highest detectable frequency was determined to within 0.1 kHz. Surgical drilling time was recorded. Average drilling time was 51 minutes. A significant temporary threshold shift was observed, measurable at multiple frequencies, less than 48 hours after mastoidectomy. There was no clinically significant change in electrostimulation thresholds (measured in 1-kHz increments, from 1 to 16 kHz) preoperatively to 30 days postoperatively. A statistically significant average loss of 0.89 kHz in the highest frequency producing a measurable response was noted (p less than 0.05). Determinations of the highest measurable frequency may be the most sensitive measure of surgically-induced, high-frequency sensorineural hearing changes.