Psychosocial outcome measures for conductive and mixed hearing loss treatment: An overview of the relevant literature.

OBJECTIVE: To identify the psychosocial assessments utilized with individuals with conductive and/or mixed hearing loss as part of a broader effort by the Auditory Rehabilitation Outcomes Network (AURONET) group to develop a core set of patient-centred outcome measures. DESIGN: A review of articles published between 2006 and 2016 was completed. Included studies had more than three adult participants, were available in English, and reported a psychosocial outcome from any treatment of mixed and/or conductive hearing loss. STUDY SAMPLE: Sixty-six articles from seven databases. RESULTS: Sixty-six articles met our inclusion/exclusion criteria. Within this set, 15 unique psychosocial or patient-reported outcome measures (PROs) were identified, with the Abbreviated Profile of Hearing Aid Benefit (APHAB) and Glasgow Benefit Inventory (GBI) being the most frequently dispensed. Five of the fifteen were only administered in one study. In-house questionnaires (IHQs) were reported in 19 articles. CONCLUSIONS: Only 66 (22%) of the 300 articles with outcomes contained a PRO. Some of the mostly frequently employed PROs (e.g., APHAB) were judged to include only social items and no psychological items. Lack of PRO standardization and the use of IHQs make psychosocial comparisons across treatments in this population difficult for patients, clinicians and stakeholders.

Hearing outcome measures for conductive and mixed hearing loss treatment in adults: a scoping review.

OBJECTIVE: Rehabilitation options for conductive and mixed hearing loss are continually expanding, but without standard outcome measures comparison between different treatments is difficult. To meaningfully inform clinicians and patients core outcome sets (COS), determined via a recognised methodology, are needed. Following our previous work that identified hearing, physical, economic and psychosocial as core areas of a future COS, the AURONET group reviewed hearing outcome measures used in existing literature and assigned them into different domains within the hearing core area. DESIGN: Scoping review. STUDY SAMPLE: Literature including hearing outcome measurements for the treatment of conductive and/or mixed hearing loss. RESULTS: The literature search identified 1434 studies, with 278 subsequently selected for inclusion. A total of 837 hearing outcome measures were reported and grouped into nine domains. The largest domain constituted pure-tone threshold measurements accounting for 65% of the total outcome measures extracted, followed by the domains of speech testing (20%) and questionnaires (9%). Studies of hearing implants more commonly included speech tests or hearing questionnaires compared with studies of middle ear surgery. CONCLUSIONS: A wide range of outcome measures are currently used, highlighting the importance of developing a COS to inform individual practice and reporting in trials/research.

Test-retest reliability of distortion-product otoacoustic emissions in children with normal hearing: a preliminary study.

The test-retest reliability of DPOAEs was investigated in 24 children (43 ears) with normal hearing at five F2 frequencies (2530, 3561, 5014, 7029, and 10,028 Hz). Two DPOAE recordings were performed on the same subjects in the same location using the same equipment. The second recordings were made 13 to 15 days after the first recording. The DPOAE level recorded in the subjects ranged between -13.10 and 20.20 dB for all the five frequencies. The variation in DPOAE level was greater at 10,028 Hz than at other frequencies. The mean difference between the test and retest recordings was 0.52+/-2.87, -1.57+/-4.62, 0.01+/-3.38, -0.55+/-2.85, and -0.56+/-5.57 dB at 2530, 3561, 5014, 7029, and 10,028 Hz, respectively. The intra-correlation coefficients for DPOAE level at each of the five (F2) frequencies were 0.85, 0.68, 0.62, 0.89, and 0.64 respectively. Calculations of mean +2SD showed that retest recordings greater than 6.26, 7.67, 6.81, 5.15, and 10.58 dB SPL at 2530, 3561, 5014, 7029, and 10,028 Hz respectively could possibly be interpreted as a significant change in status of the ear.

The role of mitochondrial DNA large deletion for the development of presbycusis in Fischer 344 rats.

Age-related hearing loss, or presbycusis, has been associated with large-scale mitochondrial DNA (mtDNA) deletion in previous studies. However, the role of this mtDNA damage in presbycusis is still not clear because the deletion in inner ears has not been measured quantitatively and analyzed in parallel with the time course of presbycusis. In the present study, the deletion was quantified using quantitative real-time PCR (qRT-PCR) in male Fischer 344 rats of different ages. It was found that the deletion increased quickly during young adulthood and reached over 60% at 6 months of age. However, a significant hearing loss was not seen until after 12 months of age. The results suggest that the existence of the deletion per se does not necessarily imply cochlear damage, but rather a critical level of the accumulated deletion seems to precede the hearing loss. The long delay may indicate the involvement of mechanisms other than mtDNA deletion in the development of presbycusis.

Automatic auditory processing of english words as indexed by the mismatch negativity, using a multiple deviant paradigm.

OBJECTIVE: The aim of this study was to investigate mismatch negativity (MMN) responses to a variety of speech stimuli (/de:/, /ge:/, /deI/ "day", and /geI/ "gay") in a multiple deviant paradigm. It was hypothesized that all speech stimulus contrasts in the multiple deviant paradigm, including the fine acoustic speech contrast [d/g], would elicit robust MMN responses and that consonant vowel (CV) real word deviants (e.g., "day" and "gay") would elicit larger MMN responses than CV nonword deviants (e.g., "de" and "ge") within and across experimental contrasts. DESIGN: Ten healthy, right-handed, native English-speaking adults (23.4 +/- 2.27 yr) with normal hearing were presented with 12 blocks of stimuli, using a multiple deviant oddball paradigm. Each of the four speech stimuli were presented as standards (p = 0.7) in three blocks, with the remaining stimuli acting as deviants (p = 0.1 each). Subjects were also presented with the same stimuli in a behavioral discrimination task. RESULTS: MMN responses to the fine acoustic speech contrast [d/g] (e.g., "de" versus "ge", "day" versus "gay") did not reach significance. However, a significant and larger MMN response was obtained at an earlier latency to the real word deviants among nonword standards with the same initial consonant (i.e., de-->day, ge-->gay) when compared with the responses to nonword deviants among word standards (day-->de, gay-->ge). CONCLUSIONS: The results showed that MMN responses could be elicited by speech stimuli with large, single acoustic deviances, within a multiple deviant paradigm design. This result has positive clinical implications for the testing of subjects who may only tolerate short testing sessions (e.g., pathological populations) in that responses to a wider range of speech stimuli may be recorded without necessarily having to increase session length. The results also demonstrated that MMN responses were elicited by large, single acoustic deviances but not fine acoustic deviances within the speech stimuli. The poor results for the fine acoustic deviances support previous studies that have used single contrast paradigms and found that when carefully controlled methodological designs and strict methods of analysis are applied, robust responses to fine-grained CV syllable contrasts may be difficult to obtain. The enhanced MMN observed in response to the real word deviants among nonword standards may provide further evidence for the presence of long-term neural traces for words in the brain, however possible contextual effects limit the interpretation of these data. Further research is needed to investigate the ability of the MMN response to accurately reflect speech sounds with fine acoustic contrasts, as well as the ability of the MMN to reflect neural traces for words in the brain, before it can be reliably used as a clinical tool in the investigation of spoken word processing in pathological populations.

Processing of English words with fine acoustic contrasts and simple tones: a mismatch negativity study.

The purpose of this study was to compare the robustness of the event-related potential (ERP) response, called the mismatch negativity (MMN), when elicited by simple tone stimuli (differing in frequency, duration, or intensity) and speech stimuli (CV nonword contrast /de:/ vs. /ge:/ and CV word contrast /del/ vs. /gel/). The study was conducted using 30 young adult subjects (Groups A and B; n = 15 each). The speech stimuli were presented to Group A at a stimulus onset asynchrony (SOA) of 610 msec and to Group B at an SOA of 900 msec. The tone stimuli were presented to both groups at an SOA of 610 msec. MMN responses were elicited by the simple tone stimuli (66.7%-96.7% of subjects with MMN "present," or significantly different from zero, p < 0.05) but not the speech stimuli (10% subjects with MMN present for nonwords, 10% for words). The length of the SOA (610 msec or 900 msec) had no effect on the ability to obtain consistent MMN responses to the speech stimuli. The results indicated a lack of robust MMN elicited by speech stimuli with fine acoustic contrasts under carefully controlled methodological conditions. The implications of these results are discussed in relation to conflicting reports in the literature of speech-elicited MMNs, and the importance of appropriate methodological design in MMN studies investigating speech processing in normal and pathological populations.

Transient evoked otoacoustic emissions in adults: a comparison between two test protocols.

This study compares the performance of the Quickscreen and Default protocols of the ILO-96 Otodynamics Analyzer in recording transient evoked otoacoustic emissions (TEOAEs) from adults using clinical decision analysis. Data were collected from 25 males (mean age = 29.0 years, SD = 6.8) and 35 females (mean age = 28.1 years, SD = 9.6). The results showed that the mean signal-to-noise ratios obtained from the Quickscreen were significantly greater than those from the Default protocol at 1, 2, and 4 kHz. The comparison of the performance of the two protocols, based on the results using receiver operating characteristics curves, revealed a higher performance of the Quickscreen than the Default protocol at 1 and 4 kHz but not at 2 kHz. In view of the enhanced performance of the Quickscreen over the Default protocol in general, the routine use of the Default protocol for testing adults in audiology clinics should be reconsidered.

Cisplatin-induced ototoxicity and pharmacokinetics: preliminary findings in a dog model.

The early effects of a clinical dose of cisplatin (100 mg/m2) on distortion-product otoacoustic emissions (DPOAE) thresholds and the relationship between DPOAE threshold shifts and changes in plasma concentrations of filterable and total platinum (Pt) following infusion of cisplatin in a dog model were investigated. The DPOAE thresholds (based on input-output function) were measured 2 days before a single high dose of cisplatin administration, and compared with measurements recorded 2 and 4 days after infusion. The results revealed DPOAE thresholds to be elevated by 4 days after the administration of cisplatin. However, this elevation could not be correlated with plasma concentrations of filterable and total Pt, which showed little variation over the 48-hour postinfusion period between animals. The present study demonstrated that DPOAE thresholds have the potential to be used as an indicator of cisplatin-induced ototoxicity, and cisplatin-induced ototoxicity could not be explained by plasma Pt kinetics in individual animals.