Blog Archives

Comparison of auditory electrophysiological responses in normal-hearing patients with and without tinnitus

Conclusion: The pathogenesis and optimum management of tinnitus are still unclear. It often occurs with primary ear disease, usually associated with hearing loss, but may occur in patients with normal hearing. Observed changes in auditory brainstem and middle latency responses indicate central auditory alterations. Tinnitus involves both peripheral and central activity, and complete audiological and neurophysiological investigation is required. Management should be based on both audiological and neurophysiological findings.

from the Journal of Laryngology and Otology

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Evaluation of Audio-Rhinological Changes During Pregnancy

A number of physiological changes occur during pregnancy and amongst them, audiological and nasal changes are quite significant. These are mainly due to the changing levels of sex hormones and return to normal once the pregnancy is over. This study was conducted to document these changes. Forty (pregnant 40 and non-pregnant 40) consenting subjects in age group of 20–35 years were assigned to test and control groups. They underwent complete ENT and Obstetric examination. In test group Pure Tone Audiometry was performed in all trimesters of pregnancy and within 3 months of delivery. The subjects in the control group underwent pure tone audiometry only once. The nasal patency was measured by Gertner’s plate method. Results from each trimester and postpartum period were compared. A highly significant difference in pure tone thresholds was observed at frequencies ranging from 125 to 1000 Hz (P < 0.001). However frequencies higher than 1000 Hz demonstrated no significant correlation. Nasal patency as measured by mean area of vapour condensation in all trimesters and control groups was highly significant (P < 0.001). The results of this study confirm that these changes occur in the first trimester and gradually improve during the subsequent trimesters returning to normal in post partum period. However number of pregnancies bear no relationship with these changes

from the Indian Journal of Otolaryngology

Hearing and vestibular functions after plugging surgery for the posterior semicircular canal

Conclusions. Results of audiometry, caloric testing and vestibular evoked myogenic potential (VEMP) testing were hardly influenced by plugging surgery. Objective. To evaluate the influence of surgical plugging of the posterior semicircular canal on inner ear function in patients with benign paroxysmal positional vertigo (BPPV). Subjects and methods. The subjects were five consecutive patients with intractable BPPV who underwent plugging surgery. The following functions of the inner ear were examined before and 6 months after surgery. Cochlea function was evaluated by the average hearing level of three frequencies (500, 1000 and 2000 Hz), that of the semicircular canal by canal paresis percent (CP%) in caloric testing and that of the otolith by the left-right difference ratio on VEMP testing. Results. Positional vertigo was resolved in all patients. One subject was completely deaf before and after surgery. The average hearing level did not change more than 10 dB after surgery in the other four cases. CP% did not worsen more than 10% in any case. The VEMP results after surgery did not change more than 10% from before surgery in any case.

from Acta Oto-Laryngologica

The impact of chronic suppurative otitis media on children’s and teenagers’ hearing

Results and conclusions
Air conduction, bone conduction thresholds and air-bone gaps in children and teenagers with CCOM are significantly greater. There were no significative differences between air-bone gaps in epitympanic and posterior mesotympanic cholesteatomas. In NCCOM, the gap value is positively correlated with the number of quadrants with tympanic perforation. There was no significative difference between the air-bone gaps in tympanic perforations affecting the posterior and anterior quadrants.

from the International Journal of Pediatric Otorhinolaryngology

High Frequency Pure Tone Audiometry (8–16 kHz) in Children: A Normative Study

Establishing normative high frequency pure tone audiometry (HFPTA) threshold data would assist in monitoring ototoxicity in the paediatric oncology population. The present study aimed to acquire HFPTA (8–16 kHz) data from normally hearing children in a common clinical setting. Participants were 129 normally hearing children (63 males and 66 females), aged between 4 and 13 years (mean = 8.4 years; SD = 2.2 years). HFPTA thresholds at 8, 9, 10, 11.2, 12.5, 14, and 16 kHz were measured using an Interacoustics AC40 audiometer with Koss R/80 high frequency headphones. The results from the normative HFPTA data showed that the mean threshold and standard deviation values increased with frequency. A significant age effect was found with the youngest age group showing poorer HFPTA thresholds than their older counterparts. This indicates that children aged 4 to 6 years require a separate set of norms from children aged 7 years and older.

Author(s): Nuala Beahan 1 | Joseph Kei 2 * | Carlie Driscoll 3 | Rebecca Forde 4 | Matthew le Dilly 5 | Bruce Charles 6

from

Cochlear microphonic audiometry: a new hearing test for objective diagnosis of deafness

Conclusions. Objective audiometric tests could constitute a valuable tool for detection of deafness. This could be especially useful in children (universal newborn hearing screening) and non-collaborative patients, who are especially difficult candidates for classic audiometry. The cochlear microphonic audiometry (CMA) technique offers the possibility of obtaining objective audiometric profiles, highly correlated with those obtained by pure tone audiometry (PTA). Therefore, CMA could be used as an alternative test to obtain the audiometric profile of these patients. Objective. The main purpose of the present study was to demonstrate that CMA provides objective audiometric profiles by avoiding active participation by the patient. Subjects and methods. CMA specific equipment, improved for non-invasive recording of cochlear microphonic potentials, was used. This tool plots the recordings obtained as the classic audiogram. Verification of the method was carried out in adult patients by comparing the PTA with the CMA audiometric profiles obtained for each patient. Results. Our findings showed that audiometric profiles obtained from CMA are highly correlated, without statistical differences, to those obtained with PTA. More than 81% of patients explored (91.67% at 250 Hz) exhibited differences below 10 dB(HL) between tests at all exploration frequencies, while a low number of cases showed differences over 20 dB(HL).

from Acta Oto-Laryngologica

Subjective audiological tests and transient evoked otoacoustic emissions in patients with rheumatoid arthritis: analysis of the factors affecting hearing levels

Abstract We investigated hearing functions in patients with rheumatoid arthritis (RA) using audiological tests and transient evoked otoacoustic emissions (TEOAEs). The study group consisted of 20 adult patients with RA (7 males, 13 females); 20 adult healthy subjects without RA (7 males, 13 females) were recruited as controls. All patients were evaluated by pure tone audiometry, high frequency audiometry, tympanometry and TEOAEs. There were no statistical differences between the study and control groups with respect to the pure tone and high frequency audiometries. TEOAE results of 1.0–2.0 kHz % and of 1.5 and 3.0 kHz amplitude values were significantly lower, and ipsilateral stapes reflex threshold value at 1.0 kHz was significantly higher in the study group when compared to respective values in the control group. In elderly patients and those with longer disease duration, RA nodules and higher methotrexate cumulative doses, hearing thresholds increased and TEOAE values decreased. In active stage of the disease, hearing thresholds diminished and in higher Brinkman Index values, TEOAE values decreased. Compliance values decreased in patients with higher Ritchie Articular Index, C-reactive protein, erythrocyte sedimentation rate and platelet counts, and longer disease duration. Sensorineural hearing loss is generally observed in patients with RA, and this condition may be detected by TEOAEs in an early period of the disease. Inflammation during the active stage of the disease and the subsequent fibrosis may cause conductive hearing loss of varying degrees. In those patients detected as having initiation of TEOAE decrease, vasodilator treatment and antioxidant drugs may be useful in protecting the inner ear.

from the European Archives of Oto-Rhino-Laryngology

The extent of hearing impairment amongst Australian Indigenous prisoners in Victoria, and implications for the correctional system

Abstract
The hearing status of 109 Indigenous prisoners was investigated at five prison locations in Victoria, using audiological methods and face-to-face interview. The study found predominantly mild, sensorineural hearing loss. The rate of conductive hearing impairment was consistent with an age-matched general adult population (UK). All eardrums were intact, and 89% of middle-ears were normally air filled. Results showed 12% of prisoners had a hearing loss (average. 0.5, 1, 2, & 4 kHz =25 dB) in at least one ear, compared with 5% in an age-matched Australian adult population. More than a third (36%) had high-frequency, sensorineural hearing impairment (4 or 6 kHz =25 dB), in one or both ears. Over half of the inmates (58%) reported hearing problems sometimes, and 4% reported a lot of hearing trouble. The majority of prisoners (92%) reported exposures to loud noise, and tinnitus was reported by 72% of prisoners. For hearing-impaired individuals within the correctional system, the reduced ability to communicate with ease may impact detrimentally on daily interactions, and may impede progress through rehabilitation programs.

from the International Journal of Audiology

Validation of multi-channel auditory steady-state response in adults with sensorineural hearing loss

Objective: For various medico-legal and financial reasons, some patients may clinically demonstrate an exaggerated hearing loss that varies in degree, nature and laterality. The purpose of this study was to evaluate whether multi-channel auditory steady-state response measurement can be used as an objective test of auditory thresholds in adults with sensorineural hearing loss.

Study design and setting: This was a prospective, comparative, experimental research design study conducted in an academic medical centre. From January to June 2007, 142 subjects (284 ears) with varying degrees of sensorineural hearing loss were included. Four commonly used frequencies (500, 1000, 2000 and 4000 Hz) were evaluated. Both pure tone thresholds and multi-channel auditory steady-state response thresholds were obtained for each ear in all subjects. The correlation of auditory steady-state response thresholds and pure tone thresholds was assessed. The time taken for multi-channel auditory steady-state response testing was also recorded.

Results: Results for multi-channel auditory steady-state response thresholds and pure tone thresholds were compared for each test frequency. A difference of less than 15 dB was found in 71 per cent of patients, while a difference of less than 20 dB was found in 83 per cent. Correlation between auditory steady-state response thresholds and pure tone thresholds, expressed as the correlation coefficient (r), was 0.89, 0.95, 0.96 and 0.97 at 500, 1000, 2000 and 4000 Hz, respectively. The strength of the relationship between auditory steady-state response thresholds and pure tone thresholds increased with increasing frequency and increasing degree of hearing loss. The recorded auditory steady-state response thresholds were used to calculate regression lines predicting pure tone threshold results. The mean estimated pure tone thresholds calculated from these regression lines were all within 10 dB of the actual recorded pure tone thresholds. The average multi-channel auditory steady-state response test duration was 42 minutes per patient.

Conclusion: Measurement of multi-channel auditory steady-state response could be a powerful, convenient electro-physiological examination with which to objectively certify clinical hearing impairment in adults.

from the Journal of Laryngology and Otology

Prediction of the Pure-Tone Average from the Speech Reception and Auditory Brainstem Response Thresholds in a Geriatric Population

Conclusions: In this study, we delineated the relationship between the PTA, SRT and ABR threshold, and established an equation to predict the actual PTA from the SRT and ABR threshold in difficult-to-test patients, allowing accurate assessment of the hearing threshold in geriatric populations.

from ORL -Journal for Oto-Rhino-Laryngology and Its Related Specialties

Cochlear microphonic audiometry: a new hearing test for objective diagnosis of deafness

from Acta Oto-Laryngologica

Abstract
Conclusions. Objective audiometric tests could constitute a valuable tool for detection of deafness. This could be especially useful in children (universal newborn hearing screening) and non-collaborative patients, who are especially difficult candidates for classic audiometry. The cochlear microphonic audiometry (CMA) technique offers the possibility of obtaining objective audiometric profiles, highly correlated with those obtained by pure tone audiometry (PTA). Therefore, CMA could be used as an alternative test to obtain the audiometric profile of these patients. Objective. The main purpose of the present study was to demonstrate that CMA provides objective audiometric profiles by avoiding active participation by the patient. Subjects and methods. CMA specific equipment, improved for non-invasive recording of cochlear microphonic potentials, was used. This tool plots the recordings obtained as the classic audiogram. Verification of the method was carried out in adult patients by comparing the PTA with the CMA audiometric profiles obtained for each patient. Results. Our findings showed that audiometric profiles obtained from CMA are highly correlated, without statistical differences, to those obtained with PTA. More than 81% of patients explored (91.67% at 250Hz) exhibited differences below 10dB(HL) between tests at all exploration frequencies, while a low number of cases showed differences over 20dB(HL).