Trends in Distributions of Hearing Threshold Levels by Ages: A Comparison of the ISO 7029 and Newly Available Country-Specific Data.

Hearing thresholds provide essential information and references about the human auditory system. This study aimed to identify changing trends in distributions of hearing threshold levels across ages by comparing the International Organization for Standardization (ISO) 7029 and newly available data after publishing ISO 7029. To compare ISO 7029 and newly available hearing threshold data after publishing ISO 7029, four country-specific datasets that presented average hearing threshold levels under conditions similar to ISO 7029 were utilized. For frequencies between 125 Hz and 8,000 Hz, the deviations of hearing threshold values by ages from the hearing threshold of the youngest age group for each data point were utilized. For frequencies from 9,000 Hz to 12,500 Hz, the median threshold information was utilized. Hearing threshold data reported after publishing ISO 7029 from the four countries were mostly similar to the ISO 7029 data but tended to deviate in some age groups and sexes. As national hearing threshold trends change, the following ISO 7029 revision suggests the need to integrate hearing threshold data from different countries.

Behavioral characterization of the cochlear amplifier lesion due to loss of function of stereocilin (STRC) in human subjects.

Loss of function of stereocilin (STRC) is the second most common cause of inherited hearing loss. The loss of the stereocilin protein, encoded by the STRC gene, induces the loss of connection between outer hair cells and tectorial membrane. This only affects the outer hair cells (OHCs) function, involving deficits of active cochlear frequency selectivity and amplifier functions despite preservation of normal inner hair cells. Better understanding of cochlear features associated with mutation of STRC will improve our knowledge of normal cochlear function, the pathophysiology of hearing impairment, and potentially enhance hearing aid and cochlear implant signal processing. Nine subjects with homozygous or compound heterozygous loss of function mutations in STRC were included, age 7-24 years. Temporal and spectral modulation perception were measured, characterized by spectral and temporal modulation transfer functions. Speech-in-noise perception was studied with spondee identification in adaptive steady-state noise and AzBio sentences with 0 and -5 dB SNR multitalker babble. Results were compared with normal hearing (NH) and cochlear implant (CI) listeners to place STRC-/- listeners' hearing capacity in context. Spectral ripple discrimination thresholds in the STRC-/- subjects were poorer than in NH listeners (p < 0.0001) but remained better than for CI listeners (p < 0.0001). Frequency resolution appeared impaired in the STRC-/- group compared to NH listeners but did not reach statistical significance (p = 0.06). Compared to NH listeners, amplitude modulation detection thresholds in the STRC-/- group did not reach significance (p=  0.06) but were better than in CI subjects (p < 0.0001). Temporal resolution in STRC-/- subjects was similar to NH (p = 0.98) but better than in CI listeners (p = 0.04). The spondee reception threshold in the STRC-/- group was worse than NH listeners (p = 0.0008) but better than CI listeners (p = 0.0001). For AzBio sentences, performance at 0 dB SNR was similar between the STRC-/- group and the NH group, 88 % and 97 % respectively. For -5 dB SNR, the STRC-/- performance was significantly poorer than NH, 40 % and 85 % respectively, yet much better than with CI who performed at 54 % at +5 dB SNR in children and 53 % at + 10 dB SNR in adults. To our knowledge, this is the first study of the psychoacoustic performance of human subjects lacking cochlear amplification but with normal inner hair cell function. Our data demonstrate preservation of temporal resolution and a trend to impaired frequency resolution in this group without reaching statistical significance. Speech-in-noise perception compared to NH listeners was impaired as well. All measures were better than those in CI listeners. It remains to be seen if hearing aid modifications, customized for the spectral deficits in STRC-/- listeners can improve speech understanding in noise. Since cochlear implants are also limited by deficient spectral selectivity, STRC-/- hearing may provide an upper bound on what could be obtained with better temporal coding in electrical stimulation.

Treatment of Far-Advanced Otosclerosis: Stapedotomy Plus Hearing Aids to Maximize the Recovery of Auditory Function-A Retrospective Case Series.

Far-advanced otosclerosis (FAO) refers to severe otosclerosis with scarce auditory functions. The identification of the best method to correctly listen to sound and speech has a large impact on patients' quality of life. We retrospectively analyzed the auditory function of 15 patients affected by FAO who were treated with stapedectomy plus hearing aids independent of the severity of their auditory deficit before surgery. The combination of surgery and hearing aids allowed excellent recovery of the perception of pure tone sounds and speech. Four patients, because of poor auditory thresholds, needed a cochlear implant after stapedectomy. Despite being based on a small sample of patients, our results suggest that stapedotomy plus hearing aids could improve the auditory capacities of patients with FAO independent of their auditory thresholds at T0. The careful selection of patients is fundamental to obtain the best outcomes.

Clinical analysis of otoendoscopic myringoplasty with tragus perichondrium in 20 cases / 中国基层医药

Objective:To analyze the clinical application effect of otoendoscopic myringoplasty with tragus perichondrium.Methods:The clinical data of 20 patients with tympanic membrane perforation who received treatment in Suixian Traditional Chinese Medicine Hospital from March 2019 to March 2020 were retrospectively analyzed. Among the 20 patients, 6 patients had traumatic tympanic membrane perforation, and 14 patients had tympanic membrane perforation caused by chronic suppurative otitis media (stationary phase). All patients underwent otoendoscopic myringoplasty with tragus perichondrium. After surgery, the healing of tympanic membrane perforation and the improvement of hearing were evaluated.Results:After surgery, all patients were followed up for 12 months. Traumatic tympanic membrane perforation healed in six patients. The tympanic membrane grafts survived in 12 patients with tympanic membrane perforation caused by chronic suppurative otitis media (stationary phase). One patient had poor postoperative healing and the remaining small perforation healed after secondary treatment under local anesthesia. Healing from tympanic membrane perforation was not achieved in one patient because of perforation caused by otitis media. The healing rate of tympanic membrane perforation caused by chronic suppurative otitis media was 95%. Before surgery, the air conduction pure tone hearing threshold was (42 ± 11) dBHL, and it was (25 ± 10) dBHL 12 months after surgery. There was a significant difference in air conduction pure tone hearing threshold between before and after surgery ( t = 4.00, P < 0.05). No complications such as tragus cartilage infection, skin flap necrosis of external auditory meatus, peripheral facial paralysis, hearing loss, or tinnitus occurred in 20 patients with tympanic membrane perforation. Conclusion:Otoendoscopic myringoplasty with tragus perichondrium leads to a high perforation healing rate, improves healing greatly, has no serious complications, produces minimal trauma, and contributes to a rapid recovery from tympanic membrane perforation.

The Effect of Various Patterns of Personal Listening Devices on Hearing Among University Students in Saudi Arabia.

Background: The long-term use of earphones at high volume levels is a major risk factor for noise-induced hearing loss. Aim: To compare the hearing of university students who use personal listening devices (PLDs) at extremes (upper & lower quartiles) with respect to a) Duration of use/day b) The number of years since use c) Volume level. Methods: This cross-sectional study was conducted in the Department of Physiology, College of Medicine, at Imam Abdulrahman bin Faisal University (IAU), from September 2021 to April 2022. An online survey was distributed among IAU medical students on the subjects' patterns of earphone use. Forty participants volunteered to participate in the hearing tests: Pure Tone Audiometry (PTA), Tympanometry, and Transient Evoked Otoacoustic Emission (TEOAEs) at the ENT clinic of the King Fahd Hospital of the University (KFHU). Results: The pure tone audiometry and TEOAE showed no significant differences in the hearing thresholds/levels of participants in upper quartiles vs lower quartiles of both ears, in any of the PLD use pattern categories. However, in the TEOAE two observation were detected: a) Significantly lower amplitude in the upper quartile of the category "duration of PLD use/day" at a frequency of 1.0 kHz in the left ear (p-value 0.04) b) Significantly lower amplitude in the upper quartile of the category "volume of PLD use" at a frequency of 1.0 kHz in the left ear (p-value 0.03). Conclusion: The present findings suggest that hearing threshold/level and cochlear outer hair cells' functions do not differ significantly in the participants belonging to the upper and lower quartiles of PLD use pattern (volume level, duration of use/day, and the number of years since use).

Reaction Time Sensitivity to Spectrotemporal Modulations of Sound.

We tested whether sensitivity to acoustic spectrotemporal modulations can be observed from reaction times for normal-hearing and impaired-hearing conditions. In a manual reaction-time task, normal-hearing listeners had to detect the onset of a ripple (with density between 0-8 cycles/octave and a fixed modulation depth of 50%), that moved up or down the log-frequency axis at constant velocity (between 0-64 Hz), in an otherwise-unmodulated broadband white-noise. Spectral and temporal modulations elicited band-pass filtered sensitivity characteristics, with fastest detection rates around 1 cycle/oct and 32 Hz for normal-hearing conditions. These results closely resemble data from other studies that typically used the modulation-depth threshold as a sensitivity criterion. To simulate hearing-impairment, stimuli were processed with a 6-channel cochlear-implant vocoder, and a hearing-aid simulation that introduced separate spectral smearing and low-pass filtering. Reaction times were always much slower compared to normal hearing, especially for the highest spectral densities. Binaural performance was predicted well by the benchmark race model of binaural independence, which models statistical facilitation of independent monaural channels. For the impaired-hearing simulations this implied a "best-of-both-worlds" principle in which the listeners relied on the hearing-aid ear to detect spectral modulations, and on the cochlear-implant ear for temporal-modulation detection. Although singular-value decomposition indicated that the joint spectrotemporal sensitivity matrix could be largely reconstructed from independent temporal and spectral sensitivity functions, in line with time-spectrum separability, a substantial inseparable spectral-temporal interaction was present in all hearing conditions. These results suggest that the reaction-time task yields a valid and effective objective measure of acoustic spectrotemporal-modulation sensitivity.

[Hearing tests in practice : Audiometric masking in pure-tone and speech audiometry]. / Hörtests in der Praxis : Vertäubung in der Ton- und Sprachaudiometrie.

Correct execution of hearing tests is essential for audiologic diagnostics and selection of treatment by the ENT physician. Especially in the case of pure-tone and speech audiometry, incorrectly performed audiometric masking can lead to false measurement results. Often, hearing that is too good is feigned by overhearing in the contralateral ear. Herein, a masking strategy is described by which errors in the execution of masking can be recognized and corrected. The aim of this paper is to identify and prevent the most common errors made during the masking process in pure-tone and speech audiometry.

Unexpected Motherhood-Triggered Hearing Loss in the Two-Pore Channel (TPC) Mutant Mouse.

Calcium signaling is crucial for many physiological processes and can mobilize intracellular calcium stores in response to environmental sensory stimuli. The endolysosomal two-pore channel (TPC), regulated by the second messenger nicotinic acid adenine dinucleotide phosphate (NAADP), is one of the key components in calcium signaling. However, its role in neuronal physiology remains largely unknown. Here, we investigated to what extent the acoustic thresholds differed between the WT mice and the TPC KO mice. We determined the thresholds based on the auditory brainstem responses (ABRs) at five frequencies (between 4 and 32 kHz) and found no threshold difference between the WT and KO in virgin female mice. Surprisingly, in lactating mothers (at P9-P10), the thresholds were higher from 8 to 32 kHz in the TPC KO mice compared to the WT mice. This result indicates that in the TPC KO mice, physiological events occurring during parturition altered the detection of sounds already at the brainstem level, or even earlier.

Noise-induced hearing loss correlates with inner ear hair cell decrease in larval zebrafish.

Anthropogenic noise can be hazardous for the auditory system and wellbeing of animals, including humans. However, very limited information is known on how this global environmental pollutant affects auditory function and inner ear sensory receptors in early ontogeny. The zebrafish (Danio rerio) is a valuable model in hearing research, including investigations of developmental processes of the vertebrate inner ear. We tested the effects of chronic exposure to white noise in larval zebrafish on inner ear saccular sensitivity and morphology at 3 and 5 days post-fertilization (dpf), as well as on auditory-evoked swimming responses using the prepulse inhibition (PPI) paradigm at 5 dpf. Noise-exposed larvae showed a significant increase in microphonic potential thresholds at low frequencies, 100 and 200 Hz, while the PPI revealed a hypersensitization effect and a similar threshold shift at 200 Hz. Auditory sensitivity changes were accompanied by a decrease in saccular hair cell number and epithelium area. In aggregate, the results reveal noise-induced effects on inner ear structure-function in a larval fish paralleled by a decrease in auditory-evoked sensorimotor responses. More broadly, this study highlights the importance of investigating the impact of environmental noise on early development of sensory and behavioural responsiveness to acoustic stimuli.

Evoked auditory potentials from African mole-rats and coruros reveal disparity in subterranean rodent hearing.

Hearing in subterranean rodents exhibits numerous peculiarities, including low sensitivity and restriction to a narrow range of comparatively low frequencies. Past studies provided two conflicting hypotheses explaining how these derived traits evolved: structural degeneration and adaptive specialization. To further elucidate this issue, we recorded auditory brainstem responses from three species of social subterranean rodents that differ in the degree of specialization to the underground habitat: the naked mole-rat (Heterocephalus glaber) and the Mashona mole-rat (Fukomys darlingi), which represent the ancient lineage of African mole-rats (Bathyergidae), and the coruro (Spalacopus cyanus), a South American rodent (Octodontidae) that adopted a subterranean lifestyle in more recent geological time. Additionally, we measured call amplitudes of social vocalizations to study auditory vocal coupling. We found elevated auditory thresholds and severe hearing range restrictions in the African mole-rats, with hearing in naked mole-rats tending to be more sensitive than in Mashona mole-rats, in which hearing notably deteriorated with increasing age. In contrast, hearing in coruros was similar to that of epigeic rodents, with its range extending into ultrasonic frequencies. However, as in the mole-rats, the coruros' region of best hearing was located at low frequencies close to 1 kHz. We argue that the auditory sensitivity of African mole-rats, although remarkably poor, has been underestimated by recent studies, whereas data on coruros conform to previous results. Considering the available evidence, we propose to be open to both degenerative and adaptive interpretations of hearing physiology in subterranean mammals, as each may provide convincing explanations for specific auditory traits observed.

Effect of Environmental Noise, Distance and Warning Sound on Pedestrians' Auditory Detectability of Electric Vehicles.

With developments in science and technology, the number of electric vehicles will increase, and they will even replace ICE vehicles. Thus, perceiving the presence of approaching electric vehicles on the road has become an important issue. In this study, the auditory detectability of the electric vehicle warning sound at different volumes, distances, and environmental noise levels was investigated. To this end, the detection rate was recorded in experiments with three environmental noise levels (50, 60, and 70 dBA), two sound pressure levels (SPLs) of the warning sound (46 and 51 dBA), three frequency combinations of the warning sound (5000, 2500, 1250, and 630 Hz for high frequencies; 2500, 1250, 630, and 315 Hz for medium frequencies; and 1250, 630, 315, and 160 Hz for low frequencies), and five distances (2, 4, 6, 8, and 10 m). The main results showed that the detection rate at 51 dBA was significantly higher than that at 46 dBA under a high-frequency warning sound; however, the detection rates were similar under medium- and low-frequency warning sounds. The participants' rates of detection for warning sounds were less than 20% under all experimental conditions, and a high-frequency warning sound was not affected by environmental noise. With regard to distances, no significant effects were observed between the distances and the detection rate at any of the three frequencies. In addition, auditory thresholds based on high-, medium-, and low-frequency warning sounds were found through logistic regression analysis results. The results of this study can be used as a reference for the future design of warning sounds.

Pérdida auditiva y consumo de alcohol en mujeres entre 20 y 40 años de edad, en la comuna de Temuco, Chile / Hearing loss and alcohol consumption in women between 20 and 40 years of age, in the commune of Temuco, Chile / Perda auditiva e consumo de álcool em mulheres entre 20 e 40 anos, na comuna de Temuco, Chile

Resumen Objetivo: Analizar la diferencia en la pérdida auditiva según el consumo de alcohol, en mujeres de entre 20 y 40 años de edad, en la comuna de Temuco, Chile. Metodología: Estudio de corte, donde se evaluaron 30 mujeres consumidoras y no consumidoras de alcohol, divididas en 3 grupos (G): G1 abstemias, G2 consumidoras de 40-59 y G3 consumidoras demás de 60g de alcohol diarios (15, 6 y 9 respectivamente), con un muestreo intencional, contactadas en centros comerciales. Se realizaron pruebas auditivas: audiometría, discriminación de la palabra y potenciales evocados auditivos de tronco cerebral. Resultados: El oído derecho presentó diferencias significativas en las frecuencias medias y discriminación de la palabra en G1 vs. G2 (p = 0,045 y 0,010, respectivamente). El oído izquierdo mostró diferencias significativas en las frecuencias agudas en G1 vs. G3, en las latencias interpeakde las ondas iii-v (tiempo en milisegundo transcurrido entre la onda iii y v posterior al estímulo) en G1 vs. G2 (p = 0,003) y G2 vs. G3 (p = 0,005) a 80 dB; en las latencias interpeaki-iiiy iii-v en G1 vs. G2 (p = 0,039) a 60 dB y en la discriminación de la palabra en G1 vs. G2 (p = 0,009) y G1 vs. G3 (p = 0,013). Conclusiones: En el grupo estudiado existe pérdida auditiva relacionada con un consumo diario a partir de los 40g de alcohol, siendo el oído más afectado el izquierdo, en las frecuencias medias y agudas, en la cóclea y el tronco cerebral.

Abstract Objective: To analyze the relationship between alcohol consumption and loss hearing in women between 20 and 40 years of age in Temuco city. Methodology: Cutting study. We evaluated 30 consuming and non alcoholic women divided into 3 groups (G): G1 abstemies, G2 consumers of 40-59 and G3 consumers of> 60 grams alcohol daily (15, 6 and 9 respectively), intentional sampling contacted in shopping centers. Auditory tests were performed: Audiometry, Discrimination of the Word and Auditory Evoked Potentials of the Brain Stem. Results: In the right ear, there were significant differences in medium frequencies and word discrimination between groups 1 versus 2 (p = 0.045 and 0.010, respectively). In left ear, there were significant differences in the high frequencies between groups 1 versus 3, interpeak latencies of iii-v waves (time elapsed between iii and v waves in millisecond after the stimulus) between groups 1 versus 2 (p = 0.003) and groups 2 versus 3 (p = 0.005) to 80 dB; in interpeak latencies i-iii and iii-vbetween groups 1 versus 2 (p = 0.039) at 60 dB and in word discrimination between groups 1 versus 2 (p = 0.009) and 1 versus 3 (p = 0.013). Conclusion: In the group studied there is hearing loss related to a daily consumption from the 40 grams of alcohol being the most affected ear the left in the medium and high frequencies and affecting to the cochlea and also brainstem.

Resumo Objetivo: O objetivo foi analisar a relação entre consumo de álcool e perda auditiva em mulheres entre 20 e 40 anos. Metodologia: Foi realizado um estudo transversal não experimental em que 30 consumidoras femininas e não o álcool foram divididas em 3 grupos: abstêmios G1, consumidores G2 de 40-59 gramas e consumidores G3> 60 gramas de álcool por dia. Testes auditivos foram realizados: audiometria, discriminação de palavras e potencial evocado auditivo de tronco encefálico. O teste não paramétrico de Mann-Whitney U foi utilizado para a análise estatística. Resultados: Na orelha direita, há diferenças significativas nas frequências médias e discriminação de palavras entre os grupos 1 e 2 (p = 0,045 e 0,010, respectivamente). Na orelha esquerda, há diferenças significativas nas freqüências agudas entre os grupos 1 versus 3, nas latências interpicos das ondas iii-v entre os grupos 1 versus 2 (p = 0,003) e os grupos 2 versus 3 (p = 0,005) a 80dB; nas latências interpicos i-iii e iii-v entre os grupos 1 versus 2 (p = 0,039) a 60 dB e na discriminação de palavras entre os grupos 1 versus 2 (p = 0,009) e 1 versus 3 (p = 0,013). Conclusões: Há uma perda auditiva relacionada ao consumo diário de 40 gramas de álcool, sendo que a orelha mais afetou a esquerda nas freqüências média e aguda, afetando a cóclea e o tronco cerebral.

[Relationship between binaural high-frequency mean hearing threshold and hypertension in female worker exposed to noise].

Objective: To explore the relationship between the binaural high-frequency mean hearing threshold and the hypertension of female workers exposed to noise, and to understand the application significance of the binaural high-frequency mean hearing threshold as an internal effect indicator of the risk of hypertension in female workers exposed to noise. Methods: From January to December 2018, a total of 20882 female workers exposed to noise in Guangzhou were selected by cluster sampling. Pure tone audiometry, blood pressure, age and length of service were collected. Trend test was used to evaluate the effects of exposure to noise and binaural high-frequency mean hearing threshold on blood pressure. Binary logistic regression model was used to evaluate the risk of hypertension associated with exposure to noise and binaural high-frequency mean hearing threshold. Results: The detection rate of normal hearing threshold, mild hearing loss and severe hearing loss was 80.73% (16858/20882) , 16.21% (3384/20882) and 3.06% (640/20882) respectively. The prevalence of hypertension was 6.04% (1018/16858) in normal hearing group, 10.28% (348/3384) in patients with high frequency mild hearing loss, and 11.25% (72/640) in patients with high frequency severe hearing loss. There was a linear relationship between the increase of working age and high-frequency mean hearing threshold and the increase of systolic and diastolic blood pressure (P< 0.05) . Compared with those exposed to noise for less than 1 year, the risk of hypertension in female workers with 7-9 years and more than 9 years was decreased (OR= 0.79, 0.75, P<0.05) . Compared with normal hearing group, the risk of hypertension in high frequency mild hearing loss group was increased (OR=1.31, P<0.05) . Conclusion: The increase in the binaural high-frequency mean hearing threshold of female workers exposed to noise can increase the blood pressure level and the risk of hypertension, and attention should be paid to female workers with high-frequency mild hearing loss.

Auditory perception is influenced by the orientation of the trunk relative to a sound source.

The study investigated how hearing depends on the whole body, head and trunk orientation relative to a sound source. In normal hearing humans we examined auditory thresholds and their ability to recognize logatomes (bi-syllabic non-sense words) at different whole body, head and trunk rotation relative to a sound source. We found that auditory threshold was increased and logatome recognition was impaired when the body or the trunk were rotated 40° away from a sound source compared to when the body or the trunk was oriented towards the sound source. Conversely, no effects were seen when only the head was rotated. Further, an increase of thresholds and impairment of logatome recognition were also observed after unilateral vibration of dorsal neck muscles that induces, per se, long-lasting illusory trunk displacement relative to the head. Thus, our findings support the idea that processing of acoustic signals depends on where a sound is located within a reference system defined by the subject's trunk coordinates.

The influence of stimulation levels on auditory thresholds and speech recognition in adult cochlear implant users.

Objective: This study aims to evaluate the influence of minimum and maximum stimulation levels on auditory thresholds and speech recognition abilities in adult cochlear implant users. Method: Fifteen adults implanted with a Cochlear® device with over 12 months listening experience. Participants underwent routine programming for optimization of minimum (T) and maximum comfort (C) stimulation levels, which was saved in Program 1 (MO). Three further maps were constructed artificially adjusting the measured levels: Program 2 - MO with 10 fewer electrical current units at C level (MC-); Program 3 - MO with 10 fewer electric current units at T level (MT-); and Program 4 - MO with 10 more electric current units at T level (MT+). Sound field thresholds, recorded sentence recognition and monosyllable tests were presented in quiet and in noise. Results: There were significantly better thresholds at 1, 3, 4, and 6 kHz frequencies in MT+ and worse in MC-. A statistically significant difference was observed for sentences in quiet and monosyllables in quiet and noise with changing C levels, with worsening of the results for MC- program. Conclusion: The results suggest that T levels above the behavioural threshold provided an improvement in sound field thresholds but did not influence performance on speech recognition tests in quiet and in noise. In contrast, C levels below the behavioural comfort level worsened sound field thresholds and led to poorer performance in tests of sentence recognition in quiet and monosyllable recognition in quiet and in noise.

Acute Alcohol Intake Deteriorates Hearing Thresholds and Speech Perception in Noise.

OBJECTIVES: The hearing process involves complex peripheral and central auditory pathways and could be influenced by various situations or medications. To date, there is very little known about the effects of alcohol on the auditory performances. The purpose of the present study was to evaluate how acute alcohol administration affects various aspects of hearing performance in human subjects, from the auditory perceptive threshold to the speech-in-noise task, which is cognitively demanding. METHODS: A total of 43 healthy volunteers were recruited, and each of the participants received calculated amounts of alcohol according to their body weight and sex with a targeted blood alcohol content level of 0.05% using the Widmark formula. Hearing was tested in alcohol-free conditions (no alcohol intake within the previous 24 h) and acute alcohol conditions. A test battery composed of pure-tone audiometry, speech reception threshold (SRT), word recognition score (WRS), distortion product otoacoustic emission (DPOAE), gaps-in-noise (GIN) test, and Korean matrix sentence test (testing speech perception in noise) was performed in the 2 conditions. RESULTS: Acute alcohol intake elevated pure-tone hearing thresholds and SRT but did not affect WRS. Both otoacoustic emissions recorded with DPOAE and the temporal resolution measured with the GIN test were not influenced by alcohol intake. The hearing performance in a noisy environment in both easy (-2 dB signal-to-noise ratio [SNR]) and difficult (-8 dB SNR) conditions was decreased by alcohol. CONCLUSIONS: Acute alcohol elevated auditory perceptive thresholds and affected performance in complex and difficult auditory tasks rather than simple tasks.

Adaptação de próteses auditivas em idosos: prescrição de ganho acústico por meio dos limiares de audibilidade obtidos com tom puro e narrow band / Hearing aid fitting in the elderly: prescription of acoustic gain through frequency thresholds obtained with pure tone and narrow band stimuli

RESUMO Objetivo Verificar o benefício obtido pela prescrição de ganho acústico baseada nos limiares audiométricos obtidos com tons puros (Warble) e com ruído de faixa estreita (NB). Método Amostra de 30 idosos, com idade igual ou superior a 60 anos, perda auditiva neurossensorial de grau moderado a severo simétrica bilateral de configuração descendente com limiares em 4kHz iguais ou inferiores a 70dBNA. Foram dois grupos. GTP (grupo tom puro): 15 idosos tiveram as próteses auditivas adaptadas com emprego dos limiares obtidos com tom puro e grupo GNB (grupo Narrowband): 15 idosos tiveram as próteses auditivas adaptadas por meio dos limiares obtidos com NB. Os procedimentos realizados antes da adaptação de próteses auditivas e após três meses de uso de amplificação foram: Escala COSI, IPRF (Índice Percentual de Reconhecimento de fala), Relação Sinal/Ruído e análise do tempo de uso do AASI. O Questionário Internacional de Aparelho de Amplificação Sonora Individual (QI-AASI) foi aplicado após três meses. Resultados Os idosos do grupo em que as próteses auditivas foram adaptadas com ganho prescrito com base nos limiares auditivos obtidos com o estímulo Narrow Band apresentaram melhor desempenho nos seguintes testes: IPRF à orelha direita, pontuação total do questionário QI-AASI, escala COSI e maior tempo de uso do AASI em comparação ao grupo GTP. Conclusão Observou-se maior benefício com o uso de próteses auditivas, pela pontuação total do questionário QI-AASI, escala COSI e maior tempo de uso do AASI, no grupo cuja prescrição do ganho acústico baseou-se nos limiares audiométricos obtidos com o Narrowband.

ABSTRACT Purpose To verify the benefit obtained by the prescription of acoustic gain based on the auditory thresholds obtained with pure tones modulated in frequency and with Narrow Band Noise. Methods The sample consisted of 30 elderly people, aged 60 years or over with moderate to severe descending sensorineural symmetrical hearing loss with thresholds at 4kHz equal to or less than 70dBHL. There were two groups. GTP (pure tone group): 15 elderly people had their hearing aids fitted through the auditory thresholds obtained with pure tone and the GNB group (narrow band group): 15 elderly people had their hearing aids fitted through the auditory thresholds obtained with NB. The procedures performed before the fitting of hearing aids and after three months of amplification use were: COSI, WRS (Word Recognition Score), Signal/Noise ratio. The International Outcome Inventory for Hearing Aids (IOI-HA) was applied only after three months of hearing aid fitting. Results The elderly people in the group in which the hearing aids were fitted with a prescribed gain based on the hearing thresholds obtained with the Narrow Band stimulus showed better performance in the following tests: WRS on the right ear, total score of the IOI-HA inventory, COSI and longer use of hearing aids compared to the GTP group. Conclusion There was a greater benefit with the use of hearing aids, due to the total score of the IOI-HA inventory, COSI scale and longer daily use time of hearing aids, in the group whose prescription of acoustic gain was based on the auditory thresholds obtained with narrow band.

Cortical auditory evoked potential in assessment of neonates: a study about minimum level of responses in term and preterm newborns / Potencial evocado auditivo cortical na avaliac¸ão de neonatos: um estudo sobre o nível mínimo de respostas em nascidos a termo e pré-termos

Abstract Introduction: The study of the threshold level of cortical auditory response in adults has been investigated in previous studies. Due to maturational issues, little is known about these responses in neonates. Technological advances with automatic analysis devices now allow investigation in specific populations. Thus, new studies are needed to establish the feasibility of using this auditory potential to identify the lowest levels of responses in children. Objective: Verify and compare latency and amplitude in 80 dBnNA and the minimum level of cortical auditory response in term and preterm neonates. Methods: A cross-sectional, comparative study involving 59 neonates, 35 full-term births and 24 preterm births, with positive results in the Neonatal Hearing Screening. The Hearlab system was used to investigate the P1i auditory potential with tone burst stimulus at frequencies of 500, 1000, 2000 and 4000 Hz. The minimum response level search ranged from 80 to 0 dBNA and was detected automatically. The results were compared between groups, evaluating the latency and amplitude in 80 dBNA and the minimum level of cortical auditory response. Results: The mean values obtained for the minimum level of cortical auditory response in term group were 26 ± 8.81; 26.14 ± 6.97; 29 ± 7.65 and 29.43 ± 7.04 dBNA and for preterm neonates of 31.96 ± 10.41; 34.13 ± 11.34; 33.64 ± 11.03 and 37.73 ± 11.92 dBNA, for the frequencies of 500, 1000, 2000 and 4000 Hz, respectively. There was a difference between groups for the latency of P1i at 4000 Hz and the minimum response levels at 500, 1000 and 4000 Hz, with higher values for preterm infants. Conclusion: It was possible to obtain latency and amplitude values at 80 dBnNA and the minimum level of cortical response in term and preterm newborns, with different results between groups, with higher values in those born preterm.

Resumo Introdução: A investigação do nível mínimo de resposta auditiva cortical tem sido alvo de diferentes estudos em adultos. Devido a questões de maturação, pouco se sabe sobre essas respostas em recém-nascidos. Com o avanço tecnológico, dispositivos de análise automática surgiram com o objetivo de retomar essa avaliação em populações específicas. Assim, novos estudos são necessários para verificar a viabilidade do uso desse potencial auditivo na obtenção de níveis mínimos de respostas na criança. Objetivo: Verificar e comparar latência e amplitude em 80 dBnNA e o nível mínimo de resposta auditiva cortical em recém-nascidos a termo e pré-termo. Método: Estudo transversal, comparativo, envolvendo 59 neonatos, 35 nascidos a termo e 24 pré-termos, com resultados positivos na triagem auditiva neonatal. O sistema Hearlab foi utilizado para investigar o potencial auditivo P1i com estímulo tone burst nas frequências de 500, 1000, 2000 e 4000 Hz. A busca do nível mínimo de resposta variou de 80 a 0 dBNA e foi detectado automaticamente. Os resultados foram comparados entre os grupos, avaliando a latência e amplitude em 80 dBNA e o nível mínimo de resposta auditiva cortical. Resultados: Os valores médios obtidos para o nível mínimo de resposta auditiva cortical no grupo nascido a termo foram 26 ± 8,81; 26,14 ± 6,97; 29 ± 7,65 e 29,43 ± 7,04 dBNA e para recém-nascidos pré-termos foram de 31,96 ± 10,41; 34,13 ± 11,34; 33,64 ± 11,03 e 37,73 ± 11,92 dBNA, para as frequências de 500, 1000, 2000 e 4000 Hz, respectivamente. Houve diferenc¸a entre os grupos para a latência de P1i em 4000 Hz e os níveis mínimos de resposta em 500, 1000 e 4000 Hz, com valores maiores em Pré-termos. Conclusão: Foi possível obter valores de latência e amplitude em 80 dBnNA e o nível mínimo de resposta cortical em recém-nascidos a termo e Pré-termos, com resultados diferentes entre osgrupos, com valores maiores em pré-termos.

[The hearing outcomes of modified canal wall down and canal wall up mastoidectomy and tympanoplasty].

Objective: To compare the effect of hearing improvement after canal wall down mastoidectomy and tympanoplasty(CWDM) and canal wall up mastoidectomy and tympanoplasty(CWUM). Methods: 88 patients who underwent CWDM or CWUM in 2014-2017 with complete follow-up data were retrospectively studied. There were 45 males and 43 females, aged 12-68 years old, and the average follow-up time was 12.3 months. Among them, 42 cases underwent CWDM and 46 cases underwent CWUM. A series of improvements were made in the clinical practice of CWDM: (1) to expand the indications properly, including limited lesions with sclerotic mastoid and narrow tympanic sinus; (2) to form disciform cavity strictly during operation in order to retain the appropriate height of facial nerve crest; (3) to avoid the cleaning of mastoid cavity in the post-operation follow up, thus the operative cavity was effectively constricted; and (4) to transfer the temporal muscle flap in pneumatic mastoid to reduce the cavity. The condition of dry ear and the size of cavity were observed after operation. The average pure tone threshold (PTA) before/after operation and threshold changes of each frequency were compared between the two groups. SPSS 19.0 software was used to analyze the data. Results: The mastoid cavity of CWDM was significantly narrowed after operation and the width of the external auditory canal was close to the CWUM group. The postoperative PTA of the CWDM and CWUM group was reduced by 11.4 dB and 10.4 dB respectively, with no significant difference (t=0.290, P=0.770). The average value of bone conduction threshold after operation was reduced by 1.8 dB and 1.9 dB respectively, with no significant difference (t=-0.076, P=0.940). The mean value of ABG after operation was shortened by 9.6 dB and 8.4 dB respectively, with no significant difference (t=-0.370, P=0.712). The threshold decrease of 1 000 Hz of CWUM was slightly better than that of CWDM, and the threshold decreases of the other frequencies of CWDM were slightly better than those of CWUM, however, the differences were not statistically significant (P>0.05). Conclusion: Through the adjustment of indications and a series of intraoperative and postoperative improvements, CWDM can achieve the same effect of postoperative hearing improvement as CWUM.

Frequency Characteristics of AEPs in Normal Young Adults and Comparison of Their Response Threshold and Pure Tone Audiometry Threshold.

ABSTRACT: Objective The tests of three types of auditory evoked potentials （AEPs） were performed on normal young adults, to understand the frequency characteristics of different testing methods and the relationship between response threshold and pure tone audiometry threshold of different methods, and to discuss the forensic value of 3 types of AEPs to evaluate hearing function. Methods Twenty normal young adults were selected, their standard pure tone audiometry threshold, short-term pure tone audiometry threshold and the response threshold of 3 types of AEPs （tone burst-auditory brainstem response, 40 Hz auditory event-related potential and slow vertex response） at 0.5 kHz, 1.0 kHz, 2.0 kHz and 4.0 kHz were recorded. The relationship between the response threshold and standard pure tone audiometry threshold, short-term pure tone audiometry threshold of 3 types of AEPs at different frequencies as well as the differences between different types of AEPs were analyzed. Results The short-term pure tone audiometry threshold was higher than the standard pure tone audiometry threshold at each frequency. The response threshold and standard pure tone audiometry threshold of the 3 types of AEPs all had a certain correlation, and the response threshold of the 3 types of AEPs was higher than short-term pure tone audiometry threshold and standard pure tone audiometry threshold at each frequency. The differences in the differences between the response threshold and standard pure tone audiometry threshold of the 3 types of AEPs at different frequencies had statistical significance. Linear regression mathematical models were established to infer the standard pure tone audiometry threshold （hearing level） from response threshold （sound pressure level） of 3 types of AEPs of normal young adults. Conclusion When using response threshold of different types of AEPs to estimate pure tone audiometry threshold, conversion and correction are needed. Combined use of different types of AEPs could improve the accuracy of hearing function evaluation.