The possibility of cochlear synaptopathy in young people using a personal listening device.

OBJECTIVE: To evaluate the association of listening to music loudly through personal listening devices with cochlear synaptopathy in young adults. METHODS: Fifty healthy young adults selected among 109 volunteers were included in the study. Participants of high risk (n=25) and low risk (n=25) groups estimated according to ETDNL (estimated total daily noise level) were evaluated using pure tone audiometry, tympanometry, matrix test, electrocochleography (EcochG) and auditory brainstem response (ABR) to evaluate the occurrence of cochlear synaptopathy. RESULTS: Audiometric thresholds between the groups were not significantly different (p>0.05). High risk group participants showed poorer performance than the low-risk group on the TurMatrix test, in non-adaptive noise with -5 SNR and -7.5 SNR, and at the 50% understanding SNR level with headphones (p<0.01). There was no difference in the adaptive free field in noise test at which 50% understanding was achieved (p>0.05). The AP amplitudes on EcochG and wave V amplitudes on ABR were significantly smaller in the high-risk group (p<0.05). There was no association between ETDNL and I/V ratio on ABR. CONCLUSION: Poorer performance in TurMatrix and other electrophysiologic tests revealed the negative effect of personal listening devices on the auditory system. Our findings support the hypothesis that personal listening devices could cause cochlear synaptopathy. Long-term studies are needed to determine the effects of binaural hearing and duration of noise exposure on the auditory system.

Sonotherapy in the reduction of anxiety and postoperative pain in patients with regional anesthesia as a sole technique: randomized, controlled clinical trial.

OBJECTIVE: To determine if sonotherapy reduces the anxiety level and postoperative pain in adults undergoing outpatient orthopedic surgery under regional anesthesia. METHOD: A randomized, double-blind, placebo-controlled study in 80 adult patients undergoing orthopedic surgery, 40 received intervention with sonotherapy and 40 did not receive it. Pain, anxiety in the preoperative period, immediate postoperative, high, 24 and 48 hours later were measured. Hemodynamic parameters were measured in four moments. RESULTS: No significant differences were found between the two groups in the pain scales neither anxiety. A significant reduction of the systolic blood pressure was observed after the application of sonotherapy and in recovery. There was no difference in other hemodynamic variables such as heart rate, respiratory rate, arterial oxygen saturation or diastolic blood pressure between groups, however, the observed changes in some of them occurred faster in the intervention group. CONCLUSIONS: In adult patients undergoing outpatient orthopaedic surgery under regional anaesthesia, sound therapy is a novel strategy that significantly reduces systolic blood pressure, considered as an indicator of decreased anxiety. However, in our study, no difference could be demonstrated in terms of pain control or the need for additional sedation or analgesia.

OBJETIVO: Evaluar la eficacia de la sonoterapia en la diminución de la ansiedad y el dolor posoperatorio en adultos llevados a cirugía ambulatoria de ortopedia bajo anestesia regional. MÉTODO: estudio aleatorizado, doble ciego, controlado con placebo, en 80 pacientes adultos sometidos a cirugía ortopédica; 40 recibieron intervención con sonoterapia y 40 no la recibieron. Se midieron el dolor y la ansiedad en el preoperatorio, en el posoperatorio inmediato, al alta, y 24 y 48 horas después. Se midieron parámetros hemodinámicos en cuatro momentos. RESULTADOS: No se encontraron diferencias significativas entre ambos grupos en las escalas de dolor ni ansiedad. Se observó una reducción significativa de la presión arterial sistólica luego de la aplicación de la intervención y en recuperación. No se observaron diferencias en otras variables hemodinámicas entre los grupos, pero la reducción de algunas ocurre de forma más rápida en el grupo de intervención. CONCLUSIONES: En pacientes adultos llevados a cirugía ambulatoria de ortopedia bajo anestesia regional, la sonoterapia es una estrategia novedosa que reduce la presión arterial sistólica, y esto puede considerarse como un indicador de disminución de la ansiedad. En nuestro estudio no se pudo demostrar diferencia en términos de control del dolor ni de requerimiento de sedación o analgesia adicional.

A feasibility study of predictable and unpredictable surf-like sounds for tinnitus therapy using personal music players.

OBJECTIVE: To evaluate the feasibility of predictable or unpredictable amplitude-modulated sounds for tinnitus therapy. DESIGN: The study consisted of two parts. (1) An adaptation experiment. Loudness level matches and rating scales (10-point) for loudness and distress were obtained at a silent baseline and at the end of three counterbalanced 30-min exposures (silence, predictable and unpredictable). (2) A qualitative 2-week sound therapy feasibility trial. Participants took home a personal music player (PMP). STUDY SAMPLE: Part 1: 23 individuals with chronic tinnitus and part 2: seven individuals randomly selected from Part 1. RESULTS: Self-reported tinnitus loudness and annoyance were significantly lower than baseline ratings after acute unpredictable sound exposure. Tinnitus annoyance ratings were also significantly lower than the baseline but the effect was small. The feasibility trial identified that participant preferences for sounds varied. Three participants did not obtain any benefit from either sound. Three participants preferred unpredictable compared to predictable sounds. Some participants had difficulty using the PMP, the average self-report hours of use were low (less <1 h/day). CONCLUSIONS: Unpredictable surf-like sounds played using a PMP is a feasible tinnitus treatment. Further work is required to improve the acceptance of the sound and ease of PMP use.

Comparison of acoustic therapies for tinnitus suppression: a preliminary trial.

OBJECTIVE: This study obtained preliminary data using two types of sound therapy to suppress tinnitus and/or reduce its functional effects: (1) Notched noise (1000-12,000 Hz notched within a 1-octave range centred around the tinnitus pitch match [PM] frequency); and (2) Matched noise (1-octave wide band of noise centred around the PM frequency). A third (Placebo) group listened to low frequency noise (250-700 Hz). DESIGN: Participants with bothersome tinnitus were randomised into one of the three groups and instructed to listen to the acoustic stimulus for 6 hours a day for 2 weeks. Stimuli were delivered using an iPod Nano, and tinnitus counselling was not performed. Outcome measures were recorded at the 0, 2 and 4 week study visits. STUDY SAMPLE: Thirty participants with constant and bothersome tinnitus were recruited and randomised. RESULTS: All groups showed, on average, overall improvement, both immediately post-treatment and 2 weeks following treatment. Outcomes varied between groups on the different measures and at the two outcome points. CONCLUSION: This study showed improvement for all of the groups, lending support to the premise that any type of sound stimulation is beneficial for relieving effects of tinnitus. These results may serve as a preliminary evidence for a larger study.

Decreasing Delirium through Music (DDM) in critically ill, mechanically ventilated patients in the intensive care unit: study protocol for a pilot randomized controlled trial.

BACKGROUND: Delirium is a highly prevalent and morbid syndrome in intensive care units (ICUs). Changing the stressful environment within the ICU via music may be an effective and a scalable way to reduce the burden of delirium. METHODS/DESIGN: The Decreasing Delirium through Music (DDM) study is a three-arm, single-blind, randomized controlled feasibility trial. Sixty patients admitted to the ICU with respiratory failure requiring mechanical ventilation will be randomized to one of three arms (20 participants per arm): (1) personalized music, (2) non-personalized relaxing music, or (3) attention-control. Music preferences will be obtained from all enrolled participants or their family caregivers. Participants will receive two 1-h audio sessions a day through noise-cancelling headphones and mp3 players. Our primary aim is to determine the feasibility of the trial design (recruitment, adherence, participant retention, design and delivery of the music intervention). Our secondary aim is to estimate the potential effect size of patient-preferred music listening in reducing delirium, as measured by the Confusion Assessment Method for the ICU (CAM-ICU). Participants will receive twice daily assessments for level of sedation and presence of delirium. Enrolled participants will be followed in the hospital until death, discharge, or up to 28 days, and seen in the Critical Care Recovery Clinic at 90 days. DISCUSSION: DDM is a feasibility trial to provide personalized and non-personalized music interventions for critically ill, mechanically ventilated patients. Our trial will also estimate the preliminary efficacy of music interventions on reducing delirium incidence and severity. TRIAL REGISTRATION: ClinicalTrials.gov, Identifier: NCT03095443 . Registered on 23 March 2017.

Quantitative biomechanical assessment of trunk control in Huntington's disease reveals more impairment in static than dynamic tasks.

Postural instability is common in individuals with Huntington's disease (HD), yet little is known about control of the trunk during static and dynamic activities. We compared the trunk motion of 41 individuals with HD and 36 controls at thoracic and pelvic levels during sitting, standing, and walking using wearable iPod sensors. We also examined the ability of individuals with HD to respond to an auditory cue to modify trunk position when the pelvis moved >8° in sagittal or frontal planes during sitting using custom software. We found that amplitude of thoracic and pelvic trunk movements was significantly greater in participants with HD, and differences were more pronounced during static (i.e. sitting, standing) than dynamic (i.e. walking) tasks. In contrast to the slow, smooth sinusoidal trunk movements of controls, individuals with HD demonstrated rapid movements with varying amplitudes that continuously increased without stabilizing. Ninety-seven percent of participants with HD were able to modify their trunk position in response to auditory cues. Our results demonstrate that wearable iPod sensors are clinically useful for rehabilitation professionals to measure and monitor trunk stability in persons with HD. Additionally, auditory cueing holds potential as a useful training tool to improve trunk stability in HD.

Hearing thresholds, tinnitus, and headphone listening habits in nine-year-old children.

OBJECTIVE: Investigate hearing function and headphone listening habits in nine-year-old Swedish children. DESIGN: A cross-sectional study was conducted and included otoscopy, tympanometry, pure-tone audiometry, and spontaneous otoacoustic emissions (SOAE). A questionnaire was used to evaluate headphone listening habits, tinnitus, and hyperacusis. STUDY SAMPLE: A total of 415 children aged nine years. RESULTS: The prevalence of a hearing threshold ≥20 dB HL at one or several frequencies was 53%, and the hearing thresholds at 6 and 8 kHz were higher than those at the low and mid frequencies. SOAEs were observed in 35% of the children, and the prevalence of tinnitus was 5.3%. No significant relationship between SOAE and tinnitus was found. Pure-tone audiometry showed poorer hearing thresholds in children with tinnitus and in children who regularly listened with headphones. CONCLUSION: The present study of hearing, listening habits, and tinnitus in nine-year old children is, to our knowledge, the largest study so far. The main findings were that hearing thresholds in the right ear were poorer in children who used headphones than in children not using them, which could be interpreted as headphone listening may have negative consequences to children's hearing. Children with tinnitus showed poorer hearing thresholds compared to children without tinnitus.

A feasibility pilot study on the use of complementary therapies delivered via mobile technologies on Icelandic surgical patients' reports of anxiety, pain, and self-efficacy in healing.

BACKGROUND: Complementary therapies (CT), such as relaxation technique, massage, guided imagery, and accupuncture have shown to benefit patients undergoing surgery. The aim of this study was to determine the feasibility of using audio relaxation technique (ART), music intervention (MI), nature video application with music (NVAM), and nature video application without music (NVA) delivered via mobile technologies in a clinical setting. Secondary, the effects of ART, MI, NVAM and NVA on patients' state anxiety, pain perception, and perceived self-efficacy in healing were determined. METHODS: A randomized clinical trial (RCT) involving 105 same day surgery (SDS) patients, who were assigned to an ART (n = 25), MI (n = 25), NVAM (n = 15), NVA (n = 16), or a control group (n = 24) were assessed for state anxiety, self-reported pain, and self-efficacy four days prior to surgery, immediately prior and following a surgical intervention, and day five post-operative. RESULTS: ANOVA found no statistically significant differences in anxiety scores; pain, or perceived self-efficacy between the five groups. Matched pairs t-Test revealed all participants had an increase in anxiety from pre-op to day 10 follow-up; a significant change in pain levels from pre-op to day 10 follow-up; and all participants had a significant increase in general self-efficacy from pre-op to day 10 follow-up. Mean pain level scores from day 1 to pre-op showed a significant decrease in pain for the ART group and NVAM group. Matched pairs t-Test for self-efficacy scores indicated the MI group and the NVA group had significant increases in self-efficacy. A significant decrease in anxiety from pre-op to day 10 for participants reporting a prior history of anxiety and for those reporting prior history of taking anti-anxiety medications. CONCLUSIONS: Despite the non-significant findings between the five groups, at any measurement point, there were valuable trends toward significance and confirmed feasibility in a clinical setting. Among the groups there were statistically significant findings for all interventions on anxiety, pain, and self-efficacy. The feasability of the implementation of novel interventions of NVAM and NVAM adds to clinical practice and the CT literature. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02236455 (September 4, 2014).

A study of the effectiveness of MP3 players to support family carers of people living with dementia at home.

BACKGROUND: Music can be therapeutic to people with dementia; however, little is known about its effect on the family carers. This project aimed to (1) assess the effects of MP3 player use by a person with dementia on caregivers' mental health and wellbeing, including their self-care and health-promoting behavior and (2) determine whether MP3 player use increases caregivers' self-reported capacity to cope with their role. METHODS: A pre-post quantitative and qualitative design was used. Carers completed a survey prior to commencing and four weeks after using the player. The survey included validated measures to assess the level of stress and coping among carers. Carers also kept a diary of the way they used the MP3 player. Half of the carers were interviewed about their experiences at the end of the study. RESULTS: Of 59 people who started using the MP3 player, 51 carers completed the four-week study period and surveys. Use of the MP3 player significantly decreased psychological distress, significantly improved the mental health and wellbeing of carers, significantly increased caregiver self-efficacy to manage symptoms of dementia, and was reported to provide valued respite from the high level of vigilance required for caring for a person with dementia. CONCLUSION: An MP3 player loaded with music can be a low cost and relatively simple and effective additional strategy to support families caring for people with dementia in the community.

Effects of Music Therapy on Pain, Anxiety and Length of Stay of Patients with Laparoscopic Hysterectomy in the Postanesthesia Care Unit

PURPOSE: This study examined the effects of music therapy on pain, anxiety and length of stay of patients undergoing laparoscopic hysterectomy in the postanesthesia care unit (PACU). METHODS: Sixty patients who received laparoscopic hysterectomy under general anesthesia from a PACU in a university hospital located in Cheonan city participated in this study. The experimental group (n=30) was offered the option to listen to their preferred music by using MP3 players and headphones for 30 minutes. The control group (n=30) received routine postoperative nursing care. Visual analogue scale was used to measure participants' pain and anxiety, length of stay in the PACU was examined by using their medical records. Data were collected from December 2013 to February 2014 and analyzed by descriptive statistics, chi2-test, Fisher's exact test, and independent t-test using SPSS version 21.0. RESULTS: The result showed that the level of post-operative pain (t=2.44, p=.018), anxiety (t=2.37, p=.021), and the length of stay in PACU (t=3.06, p=.004) significantly decreased in the experimental group as compared to the control group. CONCLUSION: This study indicated that music therapy with the patients' preferred music showed positive effects. Therefore, it can be used as a therapeutic intervention for postoperative pain management of patients with laparoscopic hysterectomy.

Hearing and loud music exposure in 14-15 years old adolescents.

Adolescent exposure to loud music has become a social and health problem whose study demands a holistic approach. The aims of the current study are: (1) To detect early noise-induced hearing loss among adolescents and establish its relationship with their participation in musical recreational activities and (2) to determine sound immission levels in nightclubs and personal music players (PMPs). The participants consisted in 172 14-15 years old adolescents from a technical high school. Conventional and extended high frequency audiometry, transient evoked otoacoustic emissions and questionnaire on recreational habits were administered. Hearing threshold levels (HTLs) were classified as: normal (Group 1), slightly shifted (Group 2), and significantly shifted (Group 3). The musical general exposure (MGE), from participation in recreational musical activities, was categorized in low, moderate, and high exposure. The results revealed an increase of HTL in Group 2 compared with Group 1 (P < 0.01), in Group 3 compared with Group 2 (P < 0.05) only in extended high frequency range, in Group 3 compared with Group 1 (P < 0.01). Besides, a decrease in mean global amplitude, reproducibility and in frequencies amplitude in Group 2 compared with Group 1 (P < 0.05) and in Group 3 compared with Group 1 (P < 0.05). A significant difference (P < 0.05) was found in Group 1's HTL between low and high exposure, showing higher HTL in high exposure. The sound immission measured in nightclubs (107.8-112.2) dBA and PMPs (82.9-104.6) dBA revealed sound levels risky for hearing health according to exposure times. It demonstrates the need to implement preventive and hearing health promoting actions in adolescents.

Otoacoustic emissions before and after listening to music on a personal player.

BACKGROUND: The problem of the potential impact of personal music players on the auditory system remains an open question. The purpose of the present study was to investigate, by means of otoacoustic emissions (OAEs), whether listening to music on a personal player affected auditory function. MATERIAL/METHODS: A group of 20 normally hearing adults was exposed to music played on a personal player. Transient evoked OAEs (TEOAEs) and distortion product OAEs (DPOAEs), as well as pure tone audiometry (PTA) thresholds, were tested at 3 stages: before, immediately after, and the next day following 30 min of exposure to music at 86.6 dBA. RESULTS: We found no statistically significant changes in OAE parameters or PTA thresholds due to listening to the music. CONCLUSIONS: These results suggest that exposure to music at levels similar to those used in our study does not disturb cochlear function in a way that can be detected by means of PTA, TEOAE, or DPOAE tests.

Evaluation of the olivocochlear efferent reflex strength in the susceptibility to temporary hearing deterioration after music exposure in young adults.

The objective of the current study was to evaluate the predictive role of the olivocochlear efferent reflex strength in temporary hearing deterioration in young adults exposed to music. This was based on the fact that a noise-protective role of the medial olivocochlear (MOC) system was observed in animals and that efferent suppression (ES) measured using contralateral acoustic stimulation (CAS) of otoacoustic emissions (OAEs) is capable of exploring the MOC system. Knowing an individual's susceptibility to cochlear damage after noise exposure would enhance preventive strategies for noise-induced hearing loss. The hearing status of 28 young adults was evaluated using pure-tone audiometry, transient evoked OAEs (TEOAEs) and distortion product OAEs (DPOAEs) before and after listening to music using an MP3 player during 1 h at an individually determined loud listening level. CAS of TEOAEs was measured before music exposure to determine the amount of ES. Regression analysis showed a distinctive positive correlation between temporary hearing deterioration and the preferred gain setting of the MP3 player. However, no clear relationship between temporary hearing deterioration and the amount of ES was found. In conclusion, clinical measurement of ES, using CAS of TEOAEs, is not correlated with the amount of temporary hearing deterioration after 1 h music exposure in young adults. However, it is possible that the temporary hearing deterioration in the current study was insufficient to activate the MOC system. More research regarding ES might provide more insight in the olivocochlear efferent pathways and their role in auditory functioning.

Use of media technology to enhance the learning of student nurses in regards to auditory hallucinations.

The aim of this study was to determine if simulation aided by media technology contributes towards an increase in knowledge, empathy, and a change in attitudes in regards to auditory hallucinations for nursing students. A convenience sample of 60 second-year undergraduate nursing students from an Australian university was invited to be part of the study. A pre-post-test design was used, with data analysed using a paired samples t-test to identify pre- and post-changes on nursing students' scores on knowledge of auditory hallucinations. Nine of the 11 questions reported statistically-significant results. The remaining two questions highlighted knowledge embedded within the curriculum, with therapeutic communication being the core work of mental health nursing. The implications for practice are that simulation aided by media technology increases the knowledge of students in regards to auditory hallucinations.

Music provided through a portable media player (iPod) blunts pain during physical therapy.

This research studied, 25 adult patients who underwent physical therapy to assess the analgesic effect of distraction with the use of music during physical therapy. Patients randomly underwent physical therapy once with music provided by an iPod and once without music. In both sessions patients underwent identical physical procedures. At end of both sessions patients filled in 5-item questionnaire where they scored pain and other parameters, such as stress, enjoyment, interaction, and satisfaction, on 10-cm visual analog scale. The mean scores (range, 0-10) of the two sessions were statistically compared. Mean pain scores were significantly lower (p = .031) during the session in which patients received music (4.8 ± 2.5) than during the session without music (5.8 ± 2.3). The other items of the questionnaire did not disclose any statistically significant difference when the sessions with versus without music were compared. Enjoyment (8.5 ± 1.6), interaction (8.3 ± 1.9), and satisfaction (8.6 ± 1.7) scores with music did not significantly differ in the sessions without music (8.5 ± 2.1, 8.5 ± 1.9, and, 8.5 ± 1.5, respectively); mean stress score was, 3.9 in both sessions. The conclusion of the study is that music provided through a portable media player has an analgesic effect. This can be an effective analgesic strategy during painful physical therapy.

Audiometric thresholds and portable digital audio player user listening habits.

OBJECTIVE: To examine the relationship between portable digital audio player listening behaviours and (1) measured sound pressure levels, (2) audiometric measures, (3) self-reported hearing loss symptoms. DESIGN: A questionnaire to evaluate listening behaviours, including self-reported hearing loss symptoms and listening duration/volume settings. Multivariate regression analysis was used to determine the relationship between these variables, audiometric evaluation, calculated exposure levels, Lex(8hr), and measured sound pressure levels, Leq(32sec). STUDY SAMPLE: This study included 103 males and 134 female subjects aged 10 to 17 years. RESULTS: Calculated Lex(8hr) and measured Leq(32sec) levels increased with age and self-reported usage time. Audiometric thresholds averaged over 4 and 8 kHz were higher when usage exceeded five years as compared to less than one year. Higher measured sound pressure levels were associated with worse audiometric thresholds at (0.5, 1, 2 kHz, averaged) and 4 kHz. Self-reported hearing loss symptoms were reported by 33% to 50% of subjects. CONCLUSIONS: In this cohort sample, our results support a statistical association between hearing acuity and (1) Self-reported weekly usage in hours; (2) Tightness of fit; (3) Years of usage; and (4) Measured sound pressure levels. Generalizing these results beyond the current sample would require additional research.

Does enriched acoustic environment in humans abolish chronic tinnitus clinically and electrophysiologically? A double blind placebo controlled study.

Animal research has shown that loss of normal acoustic stimulation can increase spontaneous firing in the central auditory system and induce cortical map plasticity. Enriched acoustic environment after noise trauma prevents map plasticity and abolishes neural signs of tinnitus. In humans, the tinnitus spectrum overlaps with the area of hearing loss. Based on these findings it can be hypothesized that stimulating the auditory system by presenting music compensating specifically for the hearing loss might also suppress chronic tinnitus. To verify this hypothesis, a study was conducted in three groups of tinnitus patients. One group listened just to unmodified music (i.e. active control group), one group listened to music spectrally tailored to compensate for their hearing loss, and a third group received music tailored to overcompensate for their hearing loss, associated with one (in presbycusis) or two notches (in audiometric dip) at the edge of hearing loss. Our data indicate that applying overcompensation to the hearing loss worsens the patients' tinnitus loudness, the tinnitus annoyance and their depressive feelings. No significant effects were obtained for the control group or for the compensation group. These clinical findings were associated with an increase in current density within the left dorsal anterior cingulate cortex in the alpha2 frequency band and within the left pregenual anterior cingulate cortex in beta1 and beta2 frequency band. In addition, a region of interest analysis also demonstrated an associated increase in gamma band activity in the auditory cortex after overcompensation in comparison to baseline measurements. This was, however, not the case for the control or the compensation groups. In conclusion, music therapy compensating for hearing loss is not beneficial in suppressing tinnitus, and overcompensating hearing loss actually worsens tinnitus, both clinically and electrophysiologically.

Listening level of music through headphones in train car noise environments.

Although portable music devices are useful for passing time on trains, exposure to music using headphones for long periods carries the risk of damaging hearing acuity. The aim of this study is to examine the listening level of music through headphones in the noisy environment of a train car. Eight subjects adjusted the volume to an optimum level (L(music)) in a simulated noisy train car environment. In Experiment I, the effects of noise level (L(train)) and type of train noise (rolling, squealing, impact, and resonance) were examined. Spectral and temporal characteristics were found to be different according to the train noise type. In Experiment II, the effects of L(train) and type of music (five vocal and five instrumental music) were examined. Each music type had a different pitch strength and spectral centroid, and each was evaluated by φ(1) and W(φ(0)), respectively. These were classified as factors of the autocorrelation function (ACF) of the music. Results showed that L(music) increased as L(train) increased in both experiments, while the type of music greatly influenced L(music). The type of train noise, however, only slightly influenced L(music). L(music) can be estimated using L(train) and the ACF factors φ(1) and W(φ(0)).

Digital music exposure reliably induces temporary threshold shift in normal-hearing human subjects.

OBJECTIVES: One of the challenges for evaluating new otoprotective agents for potential benefit in human populations is the availability of an established clinical paradigm with real-world relevance. These studies were explicitly designed to develop a real-world digital music exposure that reliably induces temporary threshold shift (TTS) in normal-hearing human subjects. DESIGN: Thirty-three subjects participated in studies that measured effects of digital music player use on hearing. Subjects selected either rock or pop music, which was then presented at 93 to 95 (n = 10), 98 to 100 (n = 11), or 100 to 102 (n = 12) dBA in-ear exposure level for a period of 4 hr. Audiograms and distortion product otoacoustic emissions (DPOAEs) were measured before and after music exposure. Postmusic tests were initiated 15 min, 1 hr 15 min, 2 hr 15 min, and 3 hr 15 min after the exposure ended. Additional tests were conducted the following day and 1 week later. RESULTS: Changes in thresholds after the lowest-level exposure were difficult to distinguish from test-retest variability; however, TTS was reliably detected after higher levels of sound exposure. Changes in audiometric thresholds had a "notch" configuration, with the largest changes observed at 4 kHz (mean = 6.3 ± 3.9 dB; range = 0-14 dB). Recovery was largely complete within the first 4 hr postexposure, and all subjects showed complete recovery of both thresholds and DPOAE measures when tested 1 week postexposure. CONCLUSIONS: These data provide insight into the variability of TTS induced by music-player use in a healthy, normal-hearing, young adult population, with music playlist, level, and duration carefully controlled. These data confirm the likelihood of temporary changes in auditory function after digital music-player use. Such data are essential for the development of a human clinical trial protocol that provides a highly powered design for evaluating novel therapeutics in human clinical trials. Care must be taken to fully inform potential subjects in future TTS studies, including protective agent evaluations, that some noise exposures have resulted in neural degeneration in animal models, even when both audiometric thresholds and DPOAE levels returned to pre-exposure values.

Can Uhear me now? Validation of an iPod-based hearing loss screening test.

OBJECTIVE: To evaluate the uHear iPod-based application as a test for hearing loss. METHODS: We recruited 100 adult participants through a single otology practice. Patients with otorrhea and cognitive impairment were excluded. All patients completed the uHear test in the clinic and in the sound booth and underwent a standard audiogram by the same audiologist. We compared the results of the uHear test to the standard audiogram. RESULTS: The uHear was able to correctly diagnose the presence of hearing loss (pure-tone average [PTA] > 40 dB) with a sensitivity of 98% (95% CI = 89-100), a specificity of 82% (95% CI = 75-88), and a positive likelihood ratio of 9 (95% CI = 6.0-16). Compared to the audiogram, the uHear overestimated the PTA among all ears by 14 dB in the clinic and by 8 dB in the sound booth (p < .0001). Compared to the audiogram, the uHear overestimated the PTA among ears with hearing loss by 6 dB in the clinic and by 4 dB in the sound booth. CONCLUSIONS: The uHear application is a reasonable screening test to rule out moderate hearing loss (PTA > 40 dB) and and is valid at quantifying the degree of hearing loss in patients known to have abnormal hearing.