Hearing loss, aging, and speech perception in reverberation and noise

The present investigation examined the effect of reverberation and noise on the perception of nonsense syllables by four groups of subjects: younger (less than or equal to 35 years of age) and older (greater than 60 years of age) listeners with mild-to-moderate sensorineural hearing loss; younger, normal-hearing individuals; and older adults with minimal peripheral hearing loss. Copies of the Nonsense Syllable Test (Resnick, Dubno, Huffnung, & Levitt, 1975) were re-recorded under four levels of reverberation (0.0, 0.6, 0.9, 1.3 s) in quiet and in cafeteria noise at +10 dB S:N. Results suggest that both age and amount of pure-tone hearing loss contribute to senescent changes in the ability to understand noisy, reverberant speech: pure-tone threshold and age were correlated negatively with performance in reverberation plus noise, although age and pure-tone hearing loss were not correlated with each other. Further, many older adults with minimal amounts of peripheral hearing loss demonstrated difficulty understanding distorted consonants.     

The auditory phenotype of children harboring mutations in the prestin gene

Conclusion Auditory phenotypes of two children harboring prestin gene mutations were congenital or pre-lingual onset, moderate to profound, slowly progressive or non-progressive, and audiograms with either flat configuration or prominently elevated thresholds at middle and high frequencies. Objectives Despite the essential role of the prestin gene in hearing, only one mutation in two families and a missense variant in a family had been reported previously before our study reporting another family. The purpose of this study was to characterize auditory phenotypes in children recently found to harbor novel mutations in the prestin gene. Methods The subjects were two sisters with bilateral sensorineural hearing loss who were compound heterozygotes for c.209G?>?A (p.W70X) and c.390A?>?C (p.R130S) mutations in the prestin gene. Clinical history and auditory test results were collected and analyzed. Results Hearing loss was present from birth in the younger sister and occurred before 6 years of age in the elder sister. The degree of hearing loss was profound in the elder sister with little progression, and moderate in the younger sister with no progression. The audiogram of the elder sister showed prominently elevated thresholds at middle and high frequencies, while that of the younger sister demonstrated a flat configuration.     

Speech and language development in a population of Swedish hearing-impaired pre-school children, a cross-sectional study

OBJECTIVE: There is little information on speech and language development in pre-school children with mild, moderate or severe hearing impairment. The primary aim of the study is to establish a reference material for clinical use covering various aspects of speech and language functions and to relate test values to pure tone audiograms and parents' judgement of their children's hearing and language abilities. METHODS: Nine speech and language tests were applied or modified, both classical tests and newly developed tests. Ninety-seven children with normal hearing and 156 with hearing impairment were tested. Hearing was 80 dB HL PTA or better in the best ear. Swedish was their strongest language. None had any additional diagnosed major handicaps. The children were 4-6 years of age. The material was divided into 10 categories of hearing impairment, 5 conductive and 5 sensorineural: unilateral; bilateral 0-20; 21-40; 41-60; 61-80 dB HL PTA. The tests, selected on the basis of a three component language model, are phoneme discrimination; rhyme matching; Peabody Picture Vocabulary Test (PPVT-III, word perception); Test for Reception of Grammar (TROG, grammar perception); prosodic phrase focus; rhyme construction; Word Finding Vocabulary Test (word production); Action Picture Test (grammar production); oral motor test. RESULTS: Only categories with sensorineural loss showed significant differences from normal. Word production showed the most marked delay for 21-40 dB HL: 5 and 6 years p<0.01; for 41-60 dB: 4 years p<0.01 and 6 years p<0.01 and 61-80 dB: 5 years p<0.05. Phoneme discrimination 21-40 dB HL: 6 years p<0.05; 41-60 dB: 4 years p<0.01; 61-80 dB: 4 years p<0.001, 5 years p<0.001. Rhyme matching: no significant difference as compared to normal data. Word perception: sensorineural 41-60 dB HL: 6 years p<0.05; 61-80 dB: 4 years p<0.05; 5 years p<0.01. Grammar perception: sensorineural 41-60 dB HL: 6 years p<0.05; 61-80 dB: 5 years p<0.05. Prosodic phrase focus: 41-60 dB HL: 5 years p<0.01. Rhyme construction: 41-60 dB HL: 4 years p<0.05. Grammar production: 61-80 dB HL: 5 years p<0.01. Oral motor function: no differences. The Word production test showed a 1.5-2 years delay for sensorineural impairment 41-80 dB HL through 4-6 years of age. There were no differences between hearing-impaired boys and girls. Extended data for the screening test [E. Borg, A. Risberg, B. McAllister, B.M. Undemar, G. Edquist, A.C. Reinholdsson, et al., Language development in hearing-impaired children. Establishment of a reference material for a "Language test for hearing-impaired children", Int. J. Pediatr. Otorhinolaryngol. 65 (2002) 15-26] are presented. CONCLUSIONS: Reference values for expected speech and language development are presented that cover nearly 60% of the studied population. The effect of the peripheral hearing impairment is compensated for in many children with hearing impairment up to 60 dB HL. Above that degree of impairment, language delay is more pronounced, probably due to a loss of acuity. The importance of central cognitive functions, speech reading and signing for compensation of peripheral limitations is pointed out.     

Effects of sensorineural hearing loss on cortical event-related potential and behavioral measures of speech-sound processing

OBJECTIVE: To investigate systematically the effects of sensorineural hearing loss on cortical event-related potentials (ERPs) N1, MMN, N2 and P3 and their associated behavioral measures (d' sensitivity and reaction time) to the speech sounds /ba/ and /da/ presented at 65 and 80 dB ppe SPL. DESIGN: Cortical ERPs were recorded to /ba/ and /da/ speech stimuli presented at 65 and 80 dB ppe SPL from 20 normal-hearing adults and 20 adults who are hearing impaired. The degree of sensorineural impairments at 1000 to 2000 Hz ranged from mild losses (defined as 25 to 49 dB HL) to severe/profound losses (75 to 120 dB HL). The speech stimuli were presented in an oddball paradigm and the cortical ERPs were recorded in both active and passive listening conditions for each stimulus intensity. RESULTS: Both ERP amplitudes and behavioral discrimination (d') scores were lower for listeners with sensorineural hearing loss than for those with normal hearing. However, these differences in response strength were evident only for those listeners whose average hearing loss at 1000 to 2000 Hz exceeded 60 dB HL for the lower intensity stimuli and exceeded 75 dB HL for the higher intensity stimuli. In contrast, prolongations in the ERP and behavioral latencies, relative to responses from normal-hearing subjects, began with even mild (25 to 49 dB HL) threshold elevations. The amplitude and latency response changes that occurred with sensorineural hearing loss were significantly greater for the later ERP peaks (N2/P3) and behavioral discrimination measures (d' and RT) in comparison with earlier (N1, MMN) responses. CONCLUSIONS: The results indicate that latency measures are more sensitive indicators of the early effects of decreased audibility than are response strength (amplitude, d' or percent correct) measures. Sensorineural hearing loss has a greater impact on higher level or "nonsensory" cortical processing in comparison with lower level or "sensory" cortical processing. Possible physiologic mechanisms within the cortex that may be responsible for these response changes are presented. Lastly, the possible clinical significance of these ERP and behavioral findings is discussed.     

Noncongenital hereditary hearing loss in children. Prospective documentation

Younger siblings of children with sensorineural hearing loss of possible hereditary cause underwent interval audiologic examination. Seven siblings (in unrelated families) were found to have progressive sensorineural hearing loss despite early audiograms documenting normal hearing levels for age. Continued testing of these children allowed for early identification and intervention. We advocate regular otolaryngologic and audiologic follow-up even after normal audiologic assessments are made for younger siblings of children with documented sensorineural hearing loss, unless a definite nongenetic origin of the hearing loss in the older child is known. Recessive sensorineural hearing loss with onset in infancy or childhood may present with no antecedent family history and with normal behavioral audiograms early in life.     

High-frequency sensorineural hearing loss after stapedectomy.

OBJECTIVE: To describe the pattern and duration of high frequency sensorineural hearing loss after stapedectomy. STUDY DESIGN: Retrospective case series. SETTING: Tertiary referral center. PATIENTS: All patients who underwent stapedectomy by the senior author during the period between January 1, 1998, and October 1, 2005, with preoperative, 4- to 6-week postoperative, and at least 9-month postoperative audiograms were included. Fifty-three patients met the inclusion criteria, with surgeries performed on 61 ears. INTERVENTION(S): Stapedectomy was performed using a CO2 laser. MAIN OUTCOME MEASURE(S): Mean preoperative and postoperative pure-tone bone thresholds, mean preoperative and postoperative pure-tone air thresholds, and hearing outcomes for 4,000 Hz bone conduction (BC) and 8,000 Hz air conduction (AC) based on the patient's age and interval after the operative procedure. RESULTS:: Mean BC thresholds at 4,000 Hz BC worsened by 6 dB at 4 to 6 weeks and improved by 3 dB by 9 months. There was an 8-dB average loss at 8,000 Hz AC at 4 to 6 weeks with a gain of 4 dB by 9 months. Patients older than 40 years were 4 times more likely to experience early loss at 4,000 Hz BC when preoperative thresholds were held constant. The late outcome for hearing loss was dependent more on the preoperative threshold than was the age of the patient. At 8,000 Hz AC, the preoperative hearing threshold was a predictor of early and late hearing loss at 8,000 Hz. CONCLUSION: High-frequency sensorineural hearing loss is initially seen after stapes surgery, and improvement does occur over time. When preoperative hearing threshold is held constant, patients older than 40 years are more likely to experience short-term hearing loss at high frequencies than patients younger than 40 years. Age was not a predictor of postoperative high-frequency hearing loss in the long term.     

Should hyperbaric oxygen be added to treatment in idiopathic sudden sensorineural hearing loss?

At present, there is still no agreement about the therapy of idiopathic sudden sensorineural hearing loss (ISSHL). Hyperbaric oxygen (HBO) is used in the therapy of ISSHL to increase the partial oxygen pressure and the oxygen concentration in the inner ear and also to improve the blood profile and the microcirculation. In our prospective randomized study, we aimed to investigate the therapeutic effects of HBO therapy in the 1st 2 weeks of the onset of ISSHL. Fifty-one hospitalized patients with confirmed ISSHL who had received therapy were grouped randomly into two groups. Twenty-one patients (group I) received steroids, plasma expander dextrans (rheomacrodex), diazepam, pentoxiphylline and salt restriction, and 30 patients (group II) received the same basic treatment with the addition of HBO therapy. Audiological assessments of the patients were performed before and after the treatment. The hearing gains at frequencies of 250, 500, 1,000, 2,000 and 4,000 Hz were calculated separately. The level of hearing loss at the five frequencies was assessed in three groups at the first visit: equal or below 60 dB, between 61–80 dB and equal or above 81 dB. The average of the mean hearing gains at the five frequencies of the patients according to the age groups in group II was compared. The mean hearing gains at the five frequencies were compared between the two groups, and statistically significant improvement was detected in all the frequencies except at 2,000 Hz in group II. The mean hearing gains in group II were found to be significantly high in patients with initial hearing levels up to 60 dB in comparison to patients with initial hearing levels below 60 dB. When age groups and mean hearing gains were compared, there was no statistically significant difference in group I. In group II, the mean hearing gains were 39.1±18.3 dB in patients younger than 50 years and 22.7±11.3 dB in patients older than 50 years (P=0.044). In conclusion, the addition of HBO therapy to conventional treatment modalities significantly improves the outcome of ISSHL, especially at the frequencies of 250, 500, 1,000 and 4,000 Hz and in hearing loss of above 61 dB. Furthermore, HBO therapy was found to be more effective in patients younger than 50 years.     

The 500 Hz masking-level difference and word recognition in multitalker babble for 40- to 89-year-old listeners with symmetrical sensorineural hearing loss

The purpose of this study was to determine if performances on a 500 Hz MLD task and a word-recognition task in multitalker babble covaried or varied independently for listeners with normal hearing and for listeners with hearing loss. Young listeners with normal hearing (n = 25) and older listeners (25 per decade from 40-80 years, n = 125) with sensorineural hearing loss were studied. Thresholds at 500 and 1000 Hz were < or = 30 dB HL and < or = 40 dB HL, respectively, with thresholds above 1000 Hz < 100 dB HL. There was no systematic relationship between the 500 Hz MLD and word-recognition performance in multitalker babble. Higher SoNo and SpiNo thresholds were observed for the older listeners, but the MLDs were the same for all groups. Word recognition in babble in terms of signal-to-babble ratio was on average 6.5 (40- to 49-year-old group) to 10.8 dB (80- to 89-year-old group) poorer for the older listeners with hearing loss. Neither pure-tone thresholds nor word-recognition abilities in quiet accurately predicted word-recognition performance in multitalker babble.     

Sudden deafness--on the age dependence of therapy results with reference to naftidrofuryl (Dusodril)

The results of treatment of 100 patients with sudden sensorineural hearing loss were analysed in three age groups (under 30, 30-60, over 60 years). The basic therapy consisted of Dextran, Diazepam and Vitamins. One half of the patients in each age group was treated with Naftidrofuryl (Dusodril) too. Sudden hearing loss was more profound in the elderly patients than in the younger ones, and the hearing gain (%) decreased with increasing age. The absolute (dB) hearing gain was more or less independent of age and Dusodril, and for all patients averaged 21 dB. Only the hearing gain (%) of the 30-60 year old patients treated with Dusodril was significantly greater than that of the control group treated without Dusodril.     

Clinicostatical study on the sensorineural hearing loss accompanying otitis media with effusion

It is pointed out that sensorineural hearing loss sometimes accompanies otitis media with effusion. In order to clarify the incidence and clinical features of sensorineural hearing loss associated with otitis media with effusion, the cases over the past ten years were reviewed. During the period from January 1979 through December 1988, 1338 patients were diagnosed to have otitis media with effusion and showed reliable audiograms in our clinic. Among these patients, 237 patients (17.7%) showed sensorineural hearing loss, defined as a bone conduction loss of 25 dB or more at any one of the frequencies of 500 through 4 kHz. The incidence of sensorineural hearing loss increased as the age of the patients increased. By analyzing their clinical course, these 237 patients were classified into 3 groups according to the etiological relationship of sensorineural hearing loss and otitis media with effusion. In Group A which comprises 14 patients (1.0%), a strong causal relationship was suspected. This group was further divided into 2 subgroups. In one subgroup of 4 patients, sensorineural hearing loss developed rather rapidly during the course of otitis media with effusion and recovered gradually. In the other subgroup of 10 patients, sensorineural hearing loss progressed and did not recover. The clinical features of these 2 subgroups were quite different. In Group B which comprises 50 patients (3.7%), causal relationship was suspected but was not confirmed. Many of the patients in this group showed unilateral otitis media with effusion and the sensorineural hearing loss in the same ear, which was characteristically demonstrated as bone conduction loss at 2 and 4 kHz.(ABSTRACT TRUNCATED AT 250 WORDS)     

儿童突发性聋患者的临床特征及预后分析

目的 分析儿童突发性聋(简称突聋)患者的临床特征及预后,为该病的临床诊治提供参考.方法 回顾性分析2008年1月～2016年10月确诊并治疗的23例(25耳)儿童突聋患者的临床资料,对所有患者的年龄、性别、耳别、就诊时间、病毒感染史、就诊时言语频率气导纯音听阈及听阈曲线类型、是否伴有耳鸣、眩晕、耳闷及治疗效果进行统计分析,并与同期住院治疗的202例(219耳)成人突聋患者进行对比.结果 本组儿童突聋患者占同期所有突聋患者的10.2％(23/225);儿童突聋患者就诊时平均听阈(87.7±16.1 dB HL)、全聋型比例(72.0％)、眩晕伴发率(52.2％)及病毒感染率(17.4％)均高于成人(分别为72.5±24.7 dB HL、44.7％、29.2％、3.5％),差异均有统计学意义(均为P＜0.05).治疗后儿童突聋患者与成人患者的总有效率分别为52.0％、46.6％,痊愈率分别为4.0％、14.2％,差异均无统计学意义(P＞0.05).结论 本组儿童突聋患者就诊时听力损失较重且常伴有耳鸣及眩晕,其听阈曲线以全聋型为主;疗效与成人突聋患者相当.     

Hearing aid candidates--some relevant features.

The age of individual seeking NHS aids has risen steadily since the service was commenced, and the median age is now over 70 years. The major type of hearing loss observed is sensorineural, but a substantial proportion of hearing aid candidates still have a significant conductive element in their hearing loss. This latter group of patients tend to be significantly younger than those without middle ear involvement. The hearing loss when applying for a hearing aid tends to be around 50 dB but is age dependent, younger subjects coming with smaller hearing losses. The most disturbing information obtained on questioning applicants was the long time lapse between recognition of hearing impairment and application for a hearing aid. This averaged almost ten years. The true delay is probably considerably greater than this and must have a substantial bearing on the outcome of hearing aid fitting. Public education and counselling of hearing aid users are suggested as vita needs.     

Asymmetric sensorineural hearing thresholds in the non‐noise‐exposed UK population: a retrospective analysis

Objectives: To estimate the distribution of inter‐aural sensorineural hearing threshold level differences in the non‐noise‐exposed adult population of the UK. Setting: A two‐stage population study carried out in 1979–1986, initially by postal questionnaire, followed up in a proportion of participants by clinical and audiological examination. Participants: Volunteers (n = 48 313) initially selected at random from the electoral registers of four cities, subsequently selected at random from questionnaire respondents stratified by answers to questions about hearing. Main outcomes measure: Inter‐aural hearing threshold level differences measured audiometrically, as a function of age and gender. Results: Tables of inter‐aural threshold level differences provided as a resource with potential medicolegal, clinical and research applications. Based on the average of the frequencies 0.5, 1, 2 and 4 kHz, ≈ 1% of the general UK population aged 18–80 years have an asymmetry of 15 dB or more. The prevalence is greater in older than in younger people. Conclusions: Inter‐aural threshold differences greater than attributable to measurement error are not uncommon in the adult population, even after screening for conductive hearing loss and substantial noise exposure. They are typically of unknown origin.     

Hereditary sensorineural hearing loss of unknown cause involving mitochondrial DNA 1555 mutation

We report on a family with maternally inherited sensorineural hearing loss, in which no history of aminoglycoside injection and no other specific etiology could be identified in any member. A 1555 A-to-G mutation of mitochondrial DNA was found in all members demonstrating hearing loss. The hearing in the propositus and his sister was severely impaired at a younger age than that in the mother. This case suggests that the 1555 point mutation of mitochondrial DNA has potential to promote inherited nonsyndromic hearing loss without any known etiology.     

Can prestin level be a biomarker for determining sensorineural hearing loss?

ObjectiveTo determine prestin levels in patients with sensorineural hearing loss and to assess whether the prestin level could be a determining factor in predicting sensorineural hearing loss.Material and methodsThe study was carried out with patients that presented to the Department of Otorhinolaryngology of F?rat University. Patients were divided into four groups of 30 subjects. Group 1: individuals aged ≥55 years with no hearing loss (control group); Group 2: individuals aged 20 to 55 years with no hearing loss (control group); Group 3: individuals aged 20 to 55 years with sensorineural hearing loss; Group 4: individuals aged ≥55 years with presbycusis.Following an audiometry examination, 5 cc blood was taken from all patients to assess serum prestin levels.ResultsPrestin levels were 445.32 pg/mL in Group 1; 452.79 pg/mL in Group 2; 123.64 pg/mL in Group 3; and 79.54 pg/mL in Group 4. No difference was found between the serum prestin levels of the younger patients with hearing loss (Group 3)] and of the patients with presbycusis (Group 4) (p=0.084). No difference was found between the serum prestin levels of the younger (Group 1) and the older (Group 2) patients with presbycusis (p=0.399). Significant differences (with higher levels in the control groups) were found in between the prestin levels of between Group 3 (the younger patients with sensorineural hearing loss) and Group 2 (younger controls), and between Group 4 (older patients with presbycusis) and Group 1 (older controls) (p<0.001 and p <0.001, respectively).ConclusionSerum prestin levels can be used as biomarkers for assessing patients with presbycusis and sensorineural hearing loss. They can also be used together with audiometry tests to predict the patient's potential level of hearing loss.     

Clinical pure-tone versus three-interval forced-choice thresholds: effects of hearing level and age.

Hearing threshold levels were measured at 2 kHz using both a standard clinical procedure and a three-interval forced-choice procedure. The 240 subjects (aged 50-75 years) embraced both normal hearing and symmetrical sensorineural hearing impairment. The sample was carefully constructed to dissociate hearing threshold level from age, by oversampling the young impaired and the older normally hearing. The forced-choice threshold was found to be generally acuter than the clinical threshold. This was related to increasing severity of hearing loss at 1.7 dB per 10 dB HL and to age at 1.6 dB HL per 10 years. Hearing threshold accounted for 12% of the variance in the discrepancy between the two types of threshold, while age accounted for only 4% due to the narrow range used. After control for these thresholds and age, there were also significant associations with a self-estimate of hearing ability and with the neuroticism score from a personality questionnaire. When interpreting epidemiological findings, particularly in longitudinal studies, the separation between sensory and cognitive factors in threshold measures needs to be considered. The obtained discrepancies as a function of hearing level and age were applied to a statistical model for population prevalences for hearing impairment. The results suggested that the choice of method could have material effects on overall prevalence estimates and on the magnitude of the apparent age effect.     

Predictive models for cochlear implantation in elderly candidates

OBJECTIVE: An aging American population carries a high prevalence of profound sensorineural hearing loss. We examined the performance of multichannel cochlear implant recipients in a large database of adult subjects. DESIGN: Nonconcurrent prospective study of a national cohort with multivariate regression analysis of preoperative and postoperative performance variables in multichannel cochlear implant recipients. We applied models of prediction established in previous studies to the observed results. SETTING: Referral centers with active cochlear implant programs. PATIENTS: Adolescents and adults with profound hearing loss (N = 749; age range, 14-91 years). MAIN OUTCOME MEASURE: Postoperative monosyllabic word recognition. RESULTS: The population 65 years and older demonstrated a clinically insignificant 4.6%-smaller postoperative word score compared with the population younger than 65 years. When duration of deafness exceeded 25 years, elderly recipients demonstrated higher word scores than their younger counterparts. A more significant factor affecting outcomes is the ratio of duration of deafness to age at implantation. CONCLUSIONS: Age at implantation carried relatively little predictive value for postoperative performance in subjects 65 years and older. Although a small decrement in mean speech recognition scores was evident, the clinical significance of this difference is questionable when all of the results observed in elderly patients are considered. A shorter percentage of life spent in severe-to-profound sensorineural hearing loss suggests a foundation of acoustic/auditory processing in the elderly cohort that may mitigate potential physiological effects associated with advanced age. This study confirms and extends previous observations that duration of profound deafness and residual speech recognition carry higher predictive value than the age at which an individual receives an implant.     

Progressive cochleovestibular impairment caused by a point mutation in the COCH gene at DFNA9.

OBJECTIVES: Analysis of phenotype-genotype correlation. STUDY DESIGN: Family study. METHODS: Auditory and vestibulo-ocular functions were examined in a Dutch family with autosomal dominantly inherited sensorineural hearing impairment caused by a 208C > T mutation in the COCH gene, located in chromosome 14q12-q13 (DFNA9). Linear regression analysis of individual longitudinal hearing threshold data (n = 11) on age was performed. RESULTS: Fifteen of the 16 genetically affected persons could be evaluated. They all developed hearing and vestibular impairment symptoms--and in many cases also cardiovascular disease--in the fourth to fifth decade. At the low frequencies (0.25-2 kHz), hearing loss started at the age of about 40 years and showed an average annual progression of approximately 3 dB, finally resulting in profound hearing losses. In two exceptional cases, annual progression attained levels of up to 24 dB. At the high frequencies (4-8 kHz), the average threshold increased from about 50 dB at the age of 35 years to about 120 dB at the age of 75 years (which amounts to 1.8 dB annual threshold increase). All affected individuals tested showed normal ocular motor functions. The patients older than 46 years generally showed absence of the vestibulo-ocular reflex, but their cervico-ocular reflex was enhanced compared with normal subjects, whereas those aged 40 to 46 years showed either severe vestibular hyporeflexia or unilateral caloric areflexia. CONCLUSION: These findings suggest a gradual development of cochleovestibular impairment caused by the new mutation found.     

Recovery from sensorineural deafness in Wegener's granulomatosis

Wegener's granulomatosis may present with deafness or other aural symptoms. This report describes two patients with histological evidence of Wegener's granulomatosis who developed reversible sensorineural hearing loss during the course of their illness. The first patient showed complete recovery of a sensorineural hearing loss averaging 50 dB after ten months treatment with cyclophosphamide and high-dose prednisolone. The second patient, who was on maintenance haemodialysis, achieved a 40 dB improvement in sensorineural hearing loss within two weeks of adding cyclophosphamide to pre-existing corticosteroid therapy. These findings suggest that the prognosis of sensorineural hearing loss in Wegener's granulomatosis can be improved with suppression of the vasculitic process by early treatment with combined cytotoxic-immunosuppressive therapy.     

Progression of hearing loss and choice of hearing aids by patients in their 60s, 70s,and 80s and older: experience in the Japanese super-aged era

Abstract

Background: Demographic data of patients with sensorineural hearing loss (SNHL) in super-aged societies are still limited.

Aims/objectives: To report audiometric statistics of SNHL and hearing aid (HA) use in patients in their 60s, 70s, and 80s and older during the super-aged era.

Material and methods: Medical charts and audiograms of 2064 older patients with SNHL who visited a Japanese University Hospital in 2007–2018 were retrospectively reviewed. Among 270 patients referred to the HA service unit (HASU), the percentage of final decisions to continue using HAs was calculated.

Results: The average pure tone thresholds on initial visit to the clinic were 56.9, 60.6, 69.4, and 82.4?dB HL in patients in their 60s, 70s, 80s, and 90s, respectively. The rates of progression were 0.25, 0.87, 1.19, and 1.37?dB/year in patients in their 50s, 60s, 70s, and 80s, respectively. The percentage of patients in HASU who chose to use HAs did not differ among the 60s (59.3%), 70s (51.2%), and 80s and older (58.2%).

Conclusions and significance: The clinical picture of patients with SNHL in their 70s and 80s differs because progression accelerates exponentially through these ages. HAs can be recommended to older adult patients in all the age groups.