Sensorineural hearing loss in children: The association with Apgar score. A registry-based study of 392 371 children in Norway

ObjectivesThe causes of congenital permanent hearing loss in children are insufficiently understood. We studied the association of Apgar score 5 min after birth with sensorineural hearing loss diagnosed before the age of 5 years.MethodsWe performed an epidemiological cohort study with data obtained by linkage between The Medical Birth Registry of Norway and the Norwegian County Registry of Children with Hearing Loss. Cases were 327 children born in Norway during the period 1978–1998 with sensorineural hearing loss. Controls were all children in Norway without sensorineural hearing loss born in the same counties and during the same period as the cases (n = 392 044). The associations of Apgar score 5 min after birth with sensorineural hearing loss were estimated as odds ratios (OR) with 95% confidence intervals (CI) by applying logistic regression analyses.ResultsAmong children with sensorineural hearing loss 0.9% (3/327) had Apgar score <3, whereas that was true for 0.1% (304/392 044) of children without hearing loss (p = 0.001, chi square test). The aOR for sensorineural hearing loss was 7.5 [95% CI 2.3–, 24.2] comparing Apgar score <3 to Apgar score 10, after adjustment for birthweight and concurrent birth defects. Most children with sensorineural hearing loss (90%) had Apgar score >8 five minutes after birth.ConclusionsLow Apgar score was associated with childhood sensorineural hearing loss. However, most children with sensorineural hearing loss, had Apgar score >8.     

Auditory performance after cochlear reimplantation

AimThe aim of this study was to evaluate the impact of cochlear reimplantation (CR) on hearing performance in children and adults with severe to profound hearing loss.Material and MethodsRetrospective observational study.ObjectivesThe main objective of this study was to determine whether there was a difference in hearing performance before and after CR. Secondary objectives were to analyze reasons for CR; to assess correlations between auditory performance and complete electrode reinsertion during CR, age, gender, explantation-to-CR interval, and interval between first implantation and CR; and to assess difference in APCEI score and the French evaluation protocol for implanted patients before and after CR.ResultsComparison of speech perception scores before and after explantation-reimplantation showed no significant difference (P > 0.005) at 1 year or at 2 years after CR. In 80% of cases, reimplantation was due to hard implant failure. In other cases, it was undertaken for soft failure (diminished performance but no abnormalities on integrity testing) (8%), medical reasons (6%), or undetermined reasons (6%). There was no significant correlation between auditory performance at 1 or 2 years and complete or incomplete reinsertion of electrodes, age, gender, explantation-to-CR interval, or interval between first implantation and CR (P > 0.005). For the adult subgroup, the French evaluation protocol scores did not differ after reimplantation (P = 0.62). Likewise, for the child sub-group, APCEI and CAP results did not deteriorate after reimplantation.ConclusionReimplantation had no negative impact on hearing and speech perception, but provided performance equivalent to or better than after initial implantation.     

Evaluación del muy bajo peso (≤ 1.500 g) al nacer como indicador de riesgo para la hipoacusia neurosensorial

Introduction and objectiveHearing plays an essential role in the acquisition, development and maintenance of the properties of the speech and language. Birth weight is an indicator of biological maturation of the newborn. Premature newborns with very low birth weight (VLBW < 1,500 g) constitute a group with the highest risk of sensorineural hearing loss. Our objective was to ascertain the degree of hearing loss, sensorineural hearing loss and presence of the association to other risk factors for hearing loss in VLBW infants included in the Universal Hearing Loss Screening Programme at the University Mother-Child Hospital of Gran Canaria (Spain) in the 2007-2010 period.Material and methodsThis was a retrospective study of 364 infants with VLBW, measured by transient evoked otoacoustic emissions and auditory brainstem response.ResultsThere were 112 newborn (30.8%) referred for auditory brainstem response. A diagnosis of hearing loss was given to 22 newborns (2.2%), 14 had conductive hearing loss and 8, sensorineural hearing loss (SNHL), of which 2 had bilateral profound hearing loss. The VLBW newborn presented the association to another risk factor in more than a quarter of the sample studied. All those diagnosed with SNHL were premature.ConclusionsThe percentage of VLBW newborns diagnosed with hearing loss is higher than expected in the general population. All those diagnosed with SNHL were premature and presented one or 2 hearing risk factors associated with VLBW.     

Relationship between self-reported hearing and measured hearing impairment in an elderly population in Finland

Abstract

Objective: The objective of this study was to evaluate the usefulness of the Finnish version of the Hearing Handicap Inventory for Elderly Screening (HHIE-S) questionnaire and a simple single-question method in detecting hearing loss. Design: We compared the HHIE-S score and the single question with audiometry results. By analysing the receiver operating characteristic (ROC) curves of the HHIE-S scores we estimated the appropriate cut-off points for the different degrees of hearing loss. Study Sample: 164 home-dwelling subjects in the age cohorts of 70, 75, 80 and 85 years in an industrialized town in Finland filled in the questionnaire, and attended the audiometry. Results: For the detection of moderate or worse hearing loss (i.e., pure tone average at 0.5-4 kHz frequencies >40 dB), the HHIE-S cut-off score of >8 had a sensitivity of 100% and a specificity of 59.7%. The single question had a sensitivity of 100% and a specificity of 70.7%. Thus, the single question was equally sensitive and more specific in detecting moderate or worse hearing loss than the HHIE-S score. However, for the detection of mild hearing loss (i.e., pure tone average >25 dB), the HHIE-S was more sensitive but less specific than the single question.

Sumario

Objetivo: El objetivo de este estudio fue evaluar la utilidad de la versión finlandesa del Cuestionario para la Identificación de Discapacidad Auditiva de Adultos Mayores (HHIE-S) y la de un método simple de una sola pregunta para detectar pérdidas auditivas. Diseño: Comparamos la puntuación del HHIE-S y de la pregunta aislada con los resultados audiométricos. Al analizar las curvas caracter sticas de operación del receptor (ROC) y las puntuaciones del HHIE-S, estimamos los puntos de corte apropiados para los diferentes grados de pérdida auditiva. Muestra de Estudio: Llenaron el cuestionario 164 sujetos que vivían en sus propias casas, pertenecientes a las cohortes de edad de 70, 75, 80 y 85 ańos, en una localidad industrializada de Finlandia y que se sometieron a la audiometría. Resultados: Para la identificación de pérdidas moderadas o peores (p. ej. promedio de tonos puros en las frecuencias de 0.5–4 kHz, >40 dB), la puntuación para el corte del HHIE-S en >8, tuvo una sensibilidad de 100% y una especificidad de 59.7%. La pregunta aislada tuvo una sensibilidad de 100% y una especificidad de 70.7%. Por esto, la pregunta aislada fue igualmente sensible pero más específica para la identificación de pérdidas auditivas moderadas o peores que la puntuación del HHIE-S. No obstante, para la identificación de pérdidas leves (p. ej. promedio de tonos puros >25 dB), el HHIE-S tuvo mayor sensibilidad aunque su especificidad fue menor que para la pregunta aislada.     

Evaluation of the impact of hearing loss in adults: Validation of a quality of life questionnaire

ObjectivesThe impact of hearing loss and of auditory rehabilitation (hearing aid, cochlear implant) on quality of life is a crucial issue. Commonly used questionnaires to assess quality of life in these patients (Nijmegen, APHAB, GBI) are time-consuming, difficult for patients to fill out, and show poor sensitivity to small improvements or deterioration. The objective of the present study was to validate a dedicated quality of life scale for hearing-impaired adults with or without auditory rehabilitation.Material and methodsERSA (Évaluation du Retentissement de la Surdité chez l’Adulte: Evaluation of the Impact of Hearing Loss in Adults) is a self-administered questionnaire. It is divided into 4 domains, each comprising 5 questions graded from 1 to 10. The questions are simple, and formulated so patients will answer according to how they feel at the actual time of the session. Test-retest reliability was measured in 38 patients. Internal coherence and validity against the APHAB questionnaire as gold standard and in relation to hearing performance were measured in 122 patients at auditory assessment. Sensitivity to change in hearing was measured in 36 cochlear implant patients, before and 6 or 12 months after implantation.ResultsTest-retest reliability was very satisfactory (ρ = 0.88). Internal coherence was good for all questions. External validity, comparing ERSA to APHAB scores in the same non-implanted hearing-impaired patients, was good (ρ = 0.52). Additionally, ERSA scores correlated with hearing performance in adverse conditions (monosyllabic words: ρ = 0.22; sentences in noise: ρ = 0.19). In patients tested before and after cochlear implantation, improvement in hearing performance in silence and in noise correlated with an improvement in ERSA score (ρ = 0.37 to 0.59, depending on the test), but not to GBI score.ConclusionThe ERSA questionnaire is easy and quick to use, reliable, and sensitive to change in hearing performance after cochlear implantation.     

French adaptation and validation of the Stapesplasty Outcome Test (SPOT-25), following COSMIN guidelines

AimsOtosclerosis can severely impact quality of life, but no questionnaire is available in French. The present study aimed to adapt and validate a French version of the SPOT-25.Materials and methodsA controlled prospective study was conducted between September 2021 and April 2022. The translation used the “forward-backward” technique and statistical validation was performed in non-operated adult otosclerosis patients (cases) and a control group. Assessment Internal consistency, discrimination performance and test-retest reliability were assessed on global score, subscores and items.ResultsFifty-one cases and 58 control subjects filled out the test questionnaire and 35 of the 51 cases, also filled out the retest. Internal consistency on Cronbach alpha was 0.95 for the cases. Median total SPOT-25 score was 44 (range, 10–78) for cases and 2 (range, 0–33) for controls (p= P < 0.0001). Test-retest reliability on intraclass correlation coefficient was excellent (ICC = 0.92; [95% CI, 0.84–0.96]). Individual items all showed satisfactory performance.ConclusionThe French version of SPOT-25 was short and easy to use, with satisfactory performance in assessing quality of life in otosclerosis patients.     

Quality and readability of French on-line information about otitis media with effusion

IntroductionChildhood otitis media with effusion (OME) is a frequent disease often misunderstood by parents. Information on the Internet is of variable quality and readability. The aim of this study was to measure the quality and readability of French websites related to OME.Material and methodsAn advanced Google search was conducted using the terms “Otite séro-muqueuse OR Otite séreuse”. Quality was assessed on DISCERN criteria. Readability was assessed using Flesch Reading Ease Scoring (FRES), Flesch-Kincaid Grade Level (FKGL), the Simple Measure of Gobbledygook (SMOG) and a Fry graph. Medians and standard deviations were calculated. Correlation between quality and readability was assessed on Spearman r coefficient.ResultsThe first ten websites meeting inclusion and exclusion criteria were evaluated. One had been updated during the last 12 months. Median DISCERN score was 49 ± 13.7/80. Median FRES score was 46 ± 9.5/100. Median USA grade-level estimated by FKGL and SMOG respectively was 11 ± 1.7 and 12 ± 1.5. Six websites had Fry score > 12. One website showed high quality. One had a readability score in the target range (below 9th grade reading level (age 14–15)) according to FRES and FKGL. A suggestive correlation was found between lower SMOG readability and higher quality: r = 0.72 (P = 0.024). Three websites followed the most recent scientific guidelines.ConclusionOnline information about OME was of variable quality and readability. Good quality information tended to be less easily understandable by parents.     

Quality of life after hemifacial spasm surgery: French versions of the HFS-8 and HFS-30 questionnaires

ObjectivesThe aim of the present study was to assess quality of life before and after surgery for hemifacial spasm, in order to validate two specific quality of life scales translated in French. Surgical results and complications were reported.Material and methodsTwenty-three patients with hemifacial spasm treated by microvascular decompression were retrospectively included. The HFS-8 and HFS-30 quality of life scales were translated from English into French using a forward-backward method and implemented on patients at least one year after surgery.ResultsMedian HFS-8 and HFS-30 values were respectively 16 ± 12.5 (range: 8–20.5) and 38 ± 38.5 (range: 23–61.5) before surgery and 0.5 ± 4.5 (range: 0–4.5) and 5 ± 17.5 (range: 1–18.5) after surgery, showing significant improvement in quality of life (P < 0.001). The internal consistency of both scales was excellent (Cronbach's alpha > 0.9), and they were significantly correlated (Pearson coefficient = 0.95; 95% CI [0.91; 0.98]; P < 0.0001). Success rates were 83% and 91%, respectively, after primary and revision surgeries. Complications were transient with minor consequences in 80% of cases, but could impact quality of life when lasting.ConclusionsThese results support the validity of the French versions of HFS-8 and HFS-30. Microvascular decompression is a safe and effective treatment for hemifacial spasm, and these scales are reliable tools to assess postoperative quality of life.     

Threshold changes of ABR results in toddlers and children

IntroductionAuditory brainstem response (ABR) is a clinically established method to identify the hearing threshold in young children and is regularly performed after hearing screening has failed. Some studies have shown that, after the first diagnosis of hearing impairment in ABR, further development takes place in a spectrum between progression of hearing loss and, surprisingly, hearing improvement.ObjectiveThe aim of this study is to evaluate changes over time of auditory thresholds measured by ABR among young children.Material and MethodsFor this retrospective study, 459 auditory brainstem measurements were performed and analyzed between 2010 and 2014. Hearing loss was detected and assessed according to national guidelines. 104 right ears and 101 left ears of 116 children aged between 0 and 3 years with multiple ABR measurements were included. The auditory threshold was identified using click and/or NB-chirp-stimuli in natural sleep or in general anesthesia. The frequency of differences of at least more than 10 dB between the measurements was identified.ResultsIn 37 (35%) measurements of right ears and 38 (38%) of left ears there was an improvement of the auditory threshold of more than 10 dB; in 27 of those measurements more than 20 dB improvement was found. Deterioration was seen in 12% of the right ears and 10% of the left ears. Only half of the children had stable hearing thresholds in repeated measurements. The time between the measurements was on average 5 months (0 to 31 months).ConclusionHearing threshold changes are often seen in repeated ABR measurements. Therefore multiple measurements are necessary when ABR yields abnormal. Hearing threshold changes should be taken into account for hearing aid provision.     

Contribution of bone conduction click-evoked auditory brainstem responses to diagnosis of hearing loss in infants in France

IntroductionNeonatal hearing screening in France involves confirmation by a childhood hearing expert centre in case of suspected hearing loss. Although click-evoked air-conduction auditory brainstem responses (AC-ABR) are the gold standard in France, there are no guidelines for bone-conduction ABRs (BC-ABR). The present study assessed the interest of associating click-evoked BC- and AC-ABRs for diagnostic confirmation in neonatal hearing screening.Materials and methodsA retrospective study included 59 infant ears with conductive hearing loss referred to the centre of Lyon, France. Objective hearing thresholds were compared between click-evoked BC- and AC-ABRs on a method previously validated in a normal-hearing population.ResultsThere was a significant difference in mean threshold between AC-ABR (53.27 ± 1.189 dBnHL) and BC-ABR (28.1 ± 0.935 dBnHL) (P < 0.001). AC thresholds ranged from 40 to 60 dBnHL while BC thresholds exceeded 40 dBnHL in only 9 ears.ConclusionUsing BC-ABRs could reduce the false-positive rate in neonatal bilateral permanent hearing loss screening, in complement to AC-ABRs using the same stimulus. Click-evoked BC-ABR could be contributive whenever conductive hearing loss is suspected, in complement to AC-ABR, without unreasonably increasing examination time.     

Contralateral occlusion test: The effect of external ear canal occlusion on predicting conductive hearing loss

Introduction and objectivesThe contralateral occlusion test (COT) has the potential to allow the quantitative evaluation of unilateral conductive hearing loss. The purpose of this study was to determine the accuracy of the test in predicting the degree of hearing loss.Materials and methodsFifty-three subjects with unilateral conductive hearing loss were recruited from an otolaryngology department of a tertiary hospital. The COT was performed using 128, 256, 512, 1024 and 2048 Hz tuning forks with the non-affected ear canal totally occluded to determine lateralization. Pure-tone audiometry was performed to establish the presence and degree of the air-bone gap (ABG) and the pure-tone average (PTA). The tuning fork responses were correlated with the ABG and the PTA to determine their accuracy.ResultsThe COT showed a better association between hearing loss and the lateralization response using the 512 Hz tuning fork (p = 0.001). The sensitivity of the 512 Hz fork in detecting a PTA of at least 35.6 dB was 94.6% and the specificity was 75.0% for a positive predictive value of 89.7% and a negative predictive value of 85.7%, assuming a pretest prevalence of 69.8%.ConclusionsThe overall accuracy of the COT in predicting the degree of unilateral conductive hearing loss was significant. The COT had significant power in one direction: if lateralization to the affected ear occurred, it was almost certain evidence of a moderate or severe conductive hearing loss.     

Emotional prosody perception in presbycusis patients after auditory rehabilitation

ObjectivePerception of emotion plays a major role in social interaction. Studies have shown that hearing loss and aging degrade emotional recognition. The main aim of the present study was to evaluate the benefit of first-time hearing aids (HA) for emotional prosody perception in presbycusis patients. Secondary objectives comprised comparison with normal-hearing subjects, and assessment of the impact of demographic and audiologic factors.MethodsTo assess HA impact, 29 subjects with presbycusis were included. They were tested without HA and 1 month after starting to use HA. A test with emotional hearing stimuli (Montreal Affective Voice test: MAV) was performed at various intensities (50, 65 and 80 dB SPL). Patients’ experience was evaluated on the Profile of Emotional Competence questionnaire, before and after HA fitting. Results were compared with those of 29 normal-hearing subjects.ResultsAuditory rehabilitation did not significantly improve MAV results (P > 0.005), or subjective questionnaire results (P > 0.005). Scores remained lower than those of normal-hearing subjects (P < 0.001). MAV results, before and after HA, showed significant correlation with pure-tone average (r = ?0.88, P < 0.001) and age (r = 0.44, P = 0.018). The older the presbycusis patient and the more severe the hearing loss, the greater the difficulty in recognising emotional prosody.ConclusionDespite hearing rehabilitation, presbycusis patients’ results remained poorer than in normal-hearing subjects.     

Osteoporosis and hearing loss: findings from the Korea National Health and Nutrition Examination Survey 2009–2011

IntroductionAge-related hearing impairment is the most common sensory dysfunction in older adults. In osteoporosis, the mass of the ossicles will be decreased, affecting the bone density of the cochlea, and interfering with the sound transmission to the cochlea. Age related hearing loss might be closely related to osteoporosis.ObjectiveTo determine the relationship between age-related hearing impairment and osteoporosis by investigating the relationship between hearing loss and cortical bone density evaluated from femur neck bone mineral density.MethodsWe used data from the Korea National Health and Nutrition Examination Survey to examine the associations between osteoporosis and age-related hearing impairment from 2009 to 2011. Total number of participants was 4861 including 2273 men and 2588 women aged 50 years or older. Osteoporosis was defined as a bone mineral density 2.5 standard deviations below according to the World Health Organization diagnostic classification. Age-related hearing impairment was defined as the pure-tone averages of test frequencies 0.5, 1, 2, and 4 kHz at a threshold of 40 dB or higher on the more impaired hearing side.ResultsTotal femur T-score (p < 0.001), lumbar-spine T-score (p < 0.001) and, femur neck T-score (p < 0.001) were significantly lower in the osteoporosis group compared to the normal group. Thresholds of pure-tone averages were significantly different in normal compared to osteopenia, and osteoporosis groups. In addition, there were significantly higher pure-tone averages thresholds in the osteoporosis group compared to other groups (p < 0.001). After adjusting for all covariates, the odds ratio for hearing loss was significantly increased by 1.7 fold with reduced femur neck bone mineral density (p < 0.01). However, lumbar spine bone mineral density was not statistically associated with hearing loss (p = 0.22).ConclusionOur results suggest that osteoporosis is significantly associated with a risk of hearing loss. In addition, femur neck bone mineral density was significantly correlated with hearing loss, but lumbar spine bone mineral density was not.     

Glucocorticoid influence on prognosis of idiopathic sudden sensorineural hearing loss

IntroductionIdiopathic Sudden Sensorineural Hearing Loss (ISSHL) is defined when a loss of at least 30 dB occurs in over 3 continuous frequencies, in up to 72 hours, of which etiology is not established, despite adequate investigation. Different types of treatment regimens have been proposed, but only glucocorticoids have shown some evidence of benefit in the literature.ObjectiveTo analyze whether the type of treatment or time of treatment with glucocorticoids have any influence on hearing recovery in ISSHL.MethodsObservational retrospective cohort study. One hundred twenty-seven patients with ISSHL, treated at outpatient clinics between the years 2000 and 2010, were studied. We evaluated the prognostic correlation of the type of treatment and time to treatment with glucocorticoids and ISSHL.ResultsThe absolute hearing gain and the relative hearing gain was as follows: 23.6 dB and 37.2%. Complete recovery was observed in 15.7% of patients, significant recovery in 27.6% and recovery in 57.5%.ConclusionIn this study, there was no difference between the use and nonuse of glucocorticoids in hearing improvement. However, when started within seven days after onset, the use of glucocorticoids was a factor of better prognosis.     

Association between interleukin-6 polymorphism in the −174 G/C region and hearing loss in the elderly with a history of occupational noise exposure

IntroductionThe biological processes involved in noise-induced hearing loss (NIHL) are still unclear. The involvement of inflammation in this condition has been suggested.ObjectiveTo investigate the association between interleukin – 6 (IL-6) polymorphism and susceptibility to NIHL.MethodsThis was a cross-sectional study with a sample of 191 independent elderly individuals aged >60 years of age. Information on exposure to occupational noise was obtained by interviews. Audiological evaluation was performed using pure tone audiometry and genotyped through PCR by restriction fragment length polymorphism – PCR-RFLP. Data were analyzed using the chi-square test and the odds ratio (OR), with the significance level set at 5%.ResultsAmong elderly with hearing loss (78.0%), 18.8% had a history of exposure to occupational noise. There was a statistically significant association between the genotype frequencies of the IL-6 −174 and NIHL. The elderly with the CC genotype were less likely to have hearing loss due to occupational noise exposure when compared to those carrying the GG genotype (OR = 0.0124; 95% CI 0.0023–0.0671; p < 0.001).ConclusionThis study suggests there is an association of polymorphisms in the IL-6 gene at position – G174C with susceptibility to noise-induced hearing loss.     

Análisis de la potencia de salida y del rendimiento auditivo de los dispositivos auditivos osteointegrados

Background and objectiveOsseointegrated auditory devices are hearing gadgets that use the bone conduction of sound to produce hearing improvement. The mechanisms and factors that contribute to this sound transmission have been widely studied, however, there are other aspects that remain unknown, for instance, the influence of the processor power output. The aim of this study was to know if there is any relationship between the power output created by the devices and the hearing improvement that they achieve.Materials and methodsForty-four patients were implanted with a percutaneous Baha® 5 model. Hearing thresholds in pure tone audiometry, free-field audiometry, and speech recognition (in quiet and in noise) were measured pre and postoperatively in each patient .The direct bone conduction thresholds and the power output values from the processors were also obtained.ResultsThe pure tone average threshold in free field was 39.29 dB (SD 9.15), so that the mean gain was 29.18 dB (SD 10.13) with the device. This involved an air-bone gap closure in 63.64% of patients. The pure tone average threshold in direct bone conduction was 27.6 dB (SD 10.91), which was 8.4 dB better than the pure tone average threshold via bone conduction. The mean gain in speech recognition was 39.15% (SD 23.98) at 40 dB and 36.66% (SD 26.76) at 60 dB. The mean gain in the signal-to-noise ratio was ?5.9 dB (SD 4.32). On the other hand, the mean power output values were 27.95 dB μN (SD 6.51) in G40 and 26.22 dB μN (SD 6.49) in G60. When analysing the relationship between bone conduction thresholds and G40 and G60 values, a correlation from the frequency of 1,000 Hz was observed. However, no statistically significant association between power output, functional gain or speech recognition gain was found.ConclusionsThe osseointegrated auditory devices generate hearing improvement in tonal thresholds and speech recognition, even in noise. Most patients closed the air-bone gap with the device. There is a direct relationship between the bone conduction threshold and the power output values from the processor, but only in mid and high frequencies. However, the relationship between power output and gain in speech recognition is weaker. Further investigation of contributing factors is necessary.     

ABR thresholds in infants born with CLP and OME and infants with OME

ObjectivesThe aim of this study was to investigate and compare auditory brainstem response (ABR) thresholds related to otitis media with effusion (OME) in infants with and without cleft palate and/or lip (CP ± L).MethodsForty-seven infants with CP ± L and 67 infants with OME participated in the study. Hearing thresholds of ears of infants with OME were compared between groups and within the group with CP ± L.ResultsInfants with CP ± L and OME presented with similar hearing thresholds as infants with OME and not CP ± L. Within the cleft group, infants with isolated cleft palate and OME demonstrated significantly higher hearing thresholds than infants with unilateral cleft lip and palate and OME.ConclusionA high prevalence of infants with CP ± L present with OME early in life. Hearing thresholds of these infants are similar to infants without CP ± L, but with OME. The ear status and hearing thresholds of infants with CP ± L needs to be monitored to be able to provide the best access to hearing in order to fully allow speech and language development.     

Speech audiometry in noise: SNR Loss per age-group in normal hearing subjects

ObjectivesThe present study aimed to determine normal SNR values per age group for the 50% speech reception threshold in noise (SNR Loss) on the VRB (Vocale Rapide dans le Bruit: rapid speech in noise) test.Material and MethodsTwo hundred patients underwent pure-tone threshold and VRB speech-in-noise audiometry. Six ages groups were distinguished: 20–30, 30–40, 40–50, 50–60, 60–70 and > 70 years. All subjects had normal hearing for age according to ISO 7029. SNR Loss was measured according to age group.ResultsMean SNR Loss ranged from ?0.37 dB in the youngest age group (20–30 years) to +6.84 dB in the oldest (> 70 years). Range and interquartile range increased with age: 3.66 and 1.49 dB respectively for 20–30 year-olds; 6 and 3.5 dB for > 70 year-olds. Linear regression between SNR Loss and age showed a coefficient R² of 0.83.ConclusionThe present study reports SNR Loss values per age group in normal-hearing subjects (ISO 7029), confirming that SNR Loss increases with age. Scatter also increased with age, suggesting that other age-related factors combine with inner-ear aging to impair hearing in noise.     

Representation of amplified speech at cortical level in good and poor hearing aid performers

IntroductionHearing aid users reject their own hearing aid because of annoyance with background noise. The reason for dissatisfaction is located anywhere from the hearing aid microphone to the integrity of neurons along the auditory pathway. In this preview, the output of hearing aid was recorded at the level of ear canal and at auditory cortex in good and poor hearing aid users, who were classified using acceptable noise level.ObjectiveTo study the representation of amplified speech in good and poor hearing aid performers.MethodsA total of 60 participants (age ranged 15–65 years) with moderate bilateral sensorineural hearing impairment grouped into good (n = 35) and poor (n = 25) hearing aid performers. Gap detection test and aided SNR 50 were administered. In addition, ear canal acoustic measures and cortical auditory evoked potentials were recorded in unaided and aided conditions at 65 dB SPL.ResultsHearing aid minimally alters temporal contrast of speech reflected in envelope difference index. Although having similar temporal impairment, acoustic characteristics of amplified speech sounds and SNR 50 scores from both groups, the aided cortical auditory evoked potentials surprisingly showed significant earlier latencies and higher amplitudes in good performers than poor performers. In addition, good and poor performers classified based on annoyance level was predicted by latencies of 2N1 and 2P2 components of acoustic change complex. Further, a follow-up revealed hearing aid use has relation with acceptance towards noise.ConclusionParticipants who are willing to accept noise from those who are not willing to accept noise have subtle physiological changes evident at the auditory cortex, which supports the hearing aid usage.     

Sudden sensorineural hearing loss in children: Etiology,management, and outcome

Background and objectivesPediatric sudden sensorineural hearing loss (SSNHL) is uncommon, and the current guidelines for its management refer to adults. Our objective was to review cases of SSNHL in children and examine their etiologies, management, and outcome.MethodsWe performed a retrospective chart review of all children under the age of 18 years treated for SSNHL between January 2003 and September 2014. Data recorded included age, gender, symptoms, onset of hearing loss, audiometric results, diagnostic studies, treatment, and outcome.ResultsNineteen children were included. Mean age was 14 years (range 7–18 years). Male: female ratio was 9:10. Degree of hearing loss varied from mild to profound across the tested frequencies. Most common accompanying symptom was tinnitus. Serologic tests demonstrated recent Epstein–Barr virus infection in one patient and previous cytomegalovirus infection in six patients. Imaging studies included computed tomography scan (n = 3) and/or magnetic resonance imaging (n = 12). All imaging studies did not demonstrate any pathology. Treatment included systemic steroids in 19 (100%) children and intratympanic steroids in eight (42%). Hearing completely improved in three (16%) children, partially improved in nine (47%), and there was no improvement in six (32%). One child was lost to follow-up.ConclusionsViral infection was a common finding in children with SSNHL and no pathological changes were demonstrated on imaging studies. In most patients (63%), hearing improvement was observed. Intratympanic steroid injection can benefit these children. Further studies are required to investigate the etiologies and establish guidelines for the management of SSNHL in children.