Exploring the influence of culture on hearing help-seeking and hearing-aid uptake

Objective: The purpose of this paper was to highlight the importance of cultural influence in understanding hearing-help seeking and hearing-aid uptake. Design: Information on audiological services in different countries and ‘theories related to cross-culture’ is presented, followed by a general discussion. Study sample: Twenty-seven relevant literature reviews on hearing impairment, cross-cultural studies, and the health psychology model and others as secondary resources. Results: Despite the adverse consequences of hearing impairment and the significant potential benefits of audiological rehabilitation, only a small number of those with hearing impairment seek professional help and take up appropriate rehabilitation. Therefore, hearing help-seeking and hearing-aid uptake has recently become the hot topic for clinicians and researchers. Previous research has identified many contributing factors for hearing help-seeking with self-reported hearing disability being one of the main factors. Although significant differences in help-seeking and hearing-aid adoption rates have been reported across countries in population studies, limited literature on the influence of cross-cultural factors in this area calls for an immediate need for research. Conclusions: This paper highlights the importance of psychological models and cross-cultural research in the area of hearing help-seeking and hearing-aid uptake, and consequently some directions for future research are proposed.     

A causal relationship between hearing loss and cognitive impairment

Conclusion Moderate hearing loss in young mice caused decreases in cognition associated with spatial working and recognition memories in 6 months. These results provide evidence for a causal relationship between hearing loss and cognitive impairment. Objectives Hypothesized mechanisms to connect sensory and cognitive functions include the sensory-deprivation, information-degradation, and common-cause hypotheses. This study intended to investigate the effect of hearing loss on cognitive function, as estimated by radial arm maze (RAM) and novel object recognition (NOR) tasks in mice through age- and hearing-matched longitudinal work during a 6-month period. Methods Twenty-four male C57BL/6 mice aged 1 month with normal ABR thresholds were used. Twelve mice in the hearing loss (HL) group were exposed to white noise at 110?dB SPL for 60?min every day for 20 days. At post-noise 6 months, all mice underwent RAM and one-trial NOR test. RAM performance measures and NOR discrimination index were compared between two groups. Results At 6 months after noise exposure, all mice in the experimental group had moderate hearing loss. Most of the RAM performances improved gradually within each group across five trials, probably due to learning effect. The HL group showed lower performance scores than the control group in several trial points in the RAM task. The contact time with the novel object was shorter in the HL group than in the control group.     

On the relationship between functional hearing and depression

Objective: To establish the effect of self-rated and measured functional hearing on depression, taking age and gender into account. Additionally, the study investigates if hearing-aid usage mitigates the effect, and if other physical health problems and social engagement confound it. Design: Cross-sectional data from the UK Biobank resource, including subjective and behavioural measures of functional hearing and multifactorial measures of depressive episodes and symptoms, were accessed and analysed using multi-regression analyses. Study sample: Over 100 000 community-dwelling, 39–70 year-old volunteers. Results: Irrespective of measurement method, poor functional hearing was significantly (p < 0.001) associated with higher levels of depressive episodes (≤ 0.16 factor scores) and depressive symptoms (≤ 0.30 factor scores) when controlling for age and gender. Associations were stronger for subjective reports, for depressive symptoms, and the younger participants. Females generally reported higher levels of depression. Hearing-aid usage did not show a mitigating effect on the associations. Other physical health problems particularly partially confounded the effects. Conclusion: Data support an association between functional hearing and depression that is stronger in the younger participants (40–49 years old) and for milder depression. The association was not alleviated by hearing-aid usage, but was partially confounded by other physical health problems.     

A prospective case-controlled study of patients presenting with idiopathic sensorineural hearing loss to examine the relationship between hyperlipidaemia and sensorineural hearing loss

The prevalence of hyperlipidaemia in the normal population means that hyperlipidaemia is often found in patients who have a hearing loss of unknown aetiology. We prospectively undertook a case-controlled study of 85 patients presenting consecutively with a sensorineural hearing loss of unknown aetiology to see if the prevalence of hyperlipidaemia differed between the group with an idiopathic sensorineural hearing loss and a control population. Control subjects were recruited from patients undergoing nasal surgery for structural abnormalities. Both the study and control groups were also compared with the National Study of Hearing data. Hyperlipidaemia was no more prevalent in a population with idiopathic sensorineural hearing loss than a control population. No consistent association between hyperlipidaemia and hearing loss was found.     

单侧人工耳蜗植入术前后双耳残余听力变化的初步研究

目的 通过观察单侧人工耳蜗植入术后儿童双耳残余听力情况,分析其变化趋势,探讨各种可能的影响因素。 方法 将29例单侧人工耳蜗植入的重度极重度感音神经性耳聋儿童纳入研究,根据术前颞骨CT分为A组(有大前庭导水管综合征)和B组(非大前庭导水管综合征),分别于术前、术后1周、开机时、术后半年定期进行裸耳纯音测听,比较植入耳残余听力保存情况及非植入耳残余听力的变化。 结果 患儿术前双耳均不同程度存在残余听力,术后均定期行纯音测听或行为测听,各频率仍部分存有残余听力,主要分布在低频区,且随频率升高其残余听力保留率逐渐下降,各频率残余听力保留率之间差异有统计学意义(Wald χ2=16.980, P=0.001);植入耳与非植入耳各频率残余听力保留率之间差异有统计学意义(Wald χ2=10.031, P=0.002);术前后各时间节点残余听力保留率之间差异无统计学意义(Wald χ2=3.384, P=0.336); AB两组之间残余听力保留率之间差异无统计学意义(Wald χ2=0.906, P=0.341)。 结论 人工耳蜗植入对植入耳残余听力的保留主要分布在低频区;随着植入时间的延长,残余听力可以基本保持;少部分患儿行单侧植入后对非植入耳残余听力有影响;前庭导水管扩大症患儿行单侧耳蜗植入术后,非植入耳残余听力在短期内可有波动。     

A prospective case-controlled study of patients presenting with idiopathic sensorineural hearing loss to examine the relationship between hyperlipidaemia and sensorineural hearing loss 1

The prevalence of hyperlipidaemia in the normal population means that hyperlipidaemia is often found in patients who have a hearing loss of unknown aetiology. We prospectively undertook a case-controlled study of 85 patients presenting consecutively with a sensorineural hearing loss of unknown aetiology to see if the prevalence of hyperlipidaemia differed between the group with an idiopathic sensorineural hearing loss and a control population. Control subjects were recruited from patients undergoing nasal surgery for structural abnormalities. Both the study and control groups were also compared with the National Study of Hearing data. Hyperlipidaemia was no more prevalent in a population with idiopathic sensorineural hearing loss than a control population. No consistent association between hyperlipidaemia and hearing loss was found.     

A retrospective study of cochlear implant outcomes in children with residual hearing

Background

Mixed results exist as to whether positive surgical margins impact survival. The aim of this study was to determine whether positive surgical margins are indeed associated with decreased survival in patients with primary head and neck cancer.

Methods

We conducted a retrospective cohort study of 261 cases diagnosed with cancer of the larynx or tongue between 1995 and 1999. Cases were followed through December 31, 2002. Survival curves by margin status were generated by Kaplan-Meier methods. Categorical data were evaluated with odds ratios (OR).

Results

All-cause mortality was markedly higher in cases with positive margins as compared with those with negative margins (54% versus 29%, P = 0.005). This pattern also appeared after adjusting for age and sex (OR = 2.97, 95% CI: 1.29 – 6.84).

Conclusion

Our findings suggest that positive surgical margin status is associated with increased mortality. This association also generally persists after adjustment for tumor size, stage, and adjuvant therapy.     

The relationship between tinnitus pitch and hearing sensitivity

Tinnitus is the phantom perception of sounds. No single theory explaining the cause of tinnitus enjoys universal acceptance, however, it is usually associated with hearing loss. The aim of this study was to investigate the relationship between tinnitus pitch and audiometry, minimum masking levels (MML), tinnitus loudness, and distortion product otoacoustic emissions (DPOAE). This was a retrospective analysis of participant’s records from the University of Auckland Hearing and Tinnitus Clinic database. The sample consisted of 192 participants with chronic tinnitus (more than 18 months) who had comprehensive tinnitus assessment from March 2008 to January 2011. There were 116 males (mean = 56.5 years, SD = 12.96) and 76 females (mean = 58.7 years, SD = 13.88). Seventy-six percent of participants had a tinnitus pitch ≥8 kHz. Tinnitus pitch was most often matched to frequencies at which hearing threshold was 40–60 (T50) dBHL. There was a weak but statistically significant positive correlation between tinnitus pitch and T50 (r = 0.15 at p < 0.05). No correlation was found between tinnitus pitch and DPOAEs, MML, audiometric edge and worst threshold. The strongest audiometric predictor for tinnitus pitch was the frequency at which threshold was approximately 50 dBHL. We postulate that this may be due to a change from primarily outer hair cell damage to lesions including inner hair cells at these levels of hearing loss.     

Application and usage of the bone anchored hearing aid

Performance of two cases of direct utilization of osseous leadership was aim of work through anchorage in temple' s bone of apparatus of aural type BAHA. In first case this method was applied from bilateral at seven aged boy lack of external ear and under development of central. Ear and co-existent cholesteatoma. Authors introduce technique of introducing of titanic implant to temple's bone, they talk over rule of working of at anchor apparatus--leaning's onto phenomenon osseointegration. In both cases positive functional results were got. At one child prolapsus of implant followed in result of injury. On basis of own observation advantage aural of method were introduced. Difficulties in her and survival were shown also.     

Exploration of a physiologically-inspired hearing-aid algorithm using a computer model mimicking impaired hearing

Objective: To use a computer model of impaired hearing to explore the effects of a physiologically-inspired hearing-aid algorithm on a range of psychoacoustic measures. Design: A computer model of a hypothetical impaired listener’s hearing was constructed by adjusting parameters of a computer model of normal hearing. Absolute thresholds, estimates of compression, and frequency selectivity (summarized to a hearing profile) were assessed using this model with and without pre-processing the stimuli by a hearing-aid algorithm. The influence of different settings of the algorithm on the impaired profile was investigated. To validate the model predictions, the effect of the algorithm on hearing profiles of human impaired listeners was measured. Study sample: A computer model simulating impaired hearing (total absence of basilar membrane compression) was used, and three hearing-impaired listeners participated. Results: The hearing profiles of the model and the listeners showed substantial changes when the test stimuli were pre-processed by the hearing-aid algorithm. These changes consisted of lower absolute thresholds, steeper temporal masking curves, and sharper psychophysical tuning curves. Conclusion: The hearing-aid algorithm affected the impaired hearing profile of the model to approximate a normal hearing profile. Qualitatively similar results were found with the impaired listeners’ hearing profiles.     

The relationship between audiometric and self-report measures of hearing handicap

In 430 individuals with adult onset hearing loss, relationships were explored between definitions of handicap based on a number of arithmetic formulas applied to audiometric data and definitions of handicap based on two self-report questionnaires (the Denver Scale of Communication Function and the Social Hearing Handicap Index). Resulting linear correlations were very low with the highest relationship--between better ear pure-tone average and perceived handicap--being only 0.38. Of the standard hearing handicap formulas, the 1947 American Medical Association calculation and the 1980 Ohio State formula showed the highest correlations with perceived handicap (0.33 and 0.28, respectively). The results highlight the difference between audiometrically calculated and self-reported hearing handicap.     

Comparison of the CAM2A and NAL-NL2 hearing-aid fitting methods for participants with a wide range of hearing losses

Objective: To compare preferences for sounds processed via a simulated five-channel compression hearing aid fitted using CAM2A and NAL-NL2. Design: Within a trial, the same segment of sound was presented twice, once with CAM2A settings and once with NAL-NL2 settings, in random order. The participant indicated which one was preferred and by how much. Stimuli included female and male speech in quiet and four types of music. The compression speed was slow or fast and the input sound level was 50, 65, or 80 dB SPL. Study sample: Sixteen experienced hearing-aid users with a wide range of sensorineural hearing losses. Results: For both compression speeds, CAM2A was slightly preferred over NAL-NL2 for input levels of 65 and 80 dB, but NAL-NL2 was slightly preferred at 50 dB SPL. Conclusions: Preferences for CAM2A relative to NAL-NL2 vary with input level. The results suggest that preferences for CAM2A might be increased by using lower gains for high frequencies and low input levels.     

Evaluation of relationship between hearing threshold and loudness discomfort level in sensorineural hearing loss.

The relationship between hearing level and loudness discomfort level (LDL) for narrow-band noise was evaluated in two groups of patients with sensorineural hearing loss. Group I had thresholds ranging from 25-60 dB SPL and Group II's thresholds ranged from 65-100 dB SPL. LDLs were determined for narrow bands of noise centered at 500, 1000, 2000, and 4000 Hz. The LDLs for Group II were greater than those for Group I and the differences were statistically significant. It is speculated that one reason for others not finding differences as a function of hearing level may be the absence of severe to profound hearing loss in the test populations.     

Natural history of contralateral residual hearing in binaural-bimodal hearing

Conclusions. The range of evaluation tools used in deciding which ear to implant and which to designate for a hearing aid (HA) should be expanded to include additional aspects to those tested by audiometry and basic speech perception. Residual hearing in non-implanted ears remains stable for at least 3 years after unilateral cochlear implantation, but regular refitting and monitoring of the HA function combined with cochlear implant (CI) mapping are mandatory for maximizing benefit from binaural-bimodal hearing. Objectives. To examine whether the clinical decision-making tools currently used to assess hearing are reliable guides when choosing the preferred ear for CI, and to determine the rate of residual hearing deterioration in the non-implanted ear over 36 months post-CI as a guide to recommending subsequent continued use of a contralateral HA as opposed to CI. Patients and methods. This was a retrospective evaluation of patients’ charts. The pre-CI choice of the ear for implantation in a group of 37 binaural-bimodal users was re-evaluated. In a second group of 22 patients, residual hearing deterioration was followed for 36 months post-implantation. Results. In the group of 37 patients, subjective identification of the worse-hearing ear was in agreement with audiometric results in 28 cases, but disagreed with the unaided audiometric results in the other 9. Mean threshold values for the group of 22 patients remained stable over 36 months post-CI, except for the aided threshold at 4.0kHz, which deteriorated by 10.9dB (p=0.003).