Music students: conventional hearing thresholds and at high frequencies

IntroductionResearch has shown that hearing loss in musicians may cause difficulty in timbre recognition and tuning of instruments.AimTo analyze the hearing thresholds from 250 Hz to 16,000 Hz in a group of music students and compare them to a non-musician group in order to determine whether high-frequency audiometry is a useful tool in the early detection of hearing impairment.MethodsStudy design was a retrospective observational cohort. Conventional and high-frequency audiometry was performed in 42 music students (Madsen Itera II audiometer and TDH39P headphones for conventional audiometry, and HDA 200 headphones for high-frequency audiometry).ResultsOf the 42 students, 38.1% were female students and 61.9% were male students, with a mean age of 26 years. At conventional audiometry, 92.85% had hearing thresholds within normal limits; but even within the normal limits, the worst results were observed in the left ear for all frequencies, except for 4000 Hz; compared to the non-musician group, the worst results occurred at 500 Hz in the left ear, and at 250 Hz, 6000 Hz, 9000 Hz, 10,000 Hz, and 11,200 Hz in both the ears.ConclusionThe periodic evaluation of high-frequency thresholds may be useful in the early detection of hearing loss in musicians.     

Analysis of subtle auditory dysfunctions in young normal-hearing subjects affected by Williams syndrome

ObjectiveTo assess if young subjects affected by Williams syndrome (WS) with normal middle ear functionality and normal hearing thresholds might have subtle auditory dysfunctions that could be detected by using clinically available measurements.MethodsOtoscopy, acoustic reflexes, tympanometry, pure-tone audiometry, and distortion product otoacoustic emissions (DPOAEs) were measured in a group of 13 WS subjects and in 13 age-matched, typically developing control subjects. Participants were required to have normal otoscopy, A-type tympanogram, normal acoustic reflex thresholds, and pure-tone thresholds ≤15 dB HL at 0.5, 1, and 2 kHz bilaterally. To limit the possible influence of middle ear status on DPOAE recordings, we analyzed only data from ears with pure-tone thresholds ≤15 dB HL across all octave frequencies in the range 0.25–8 kHz, middle ear pressure (MEP) > −50 daPa, static compliance (SC) in the range 0.3–1.2 cm³, and ear canal volume (ECV) in the range 0.2–2 ml, and we performed analysis of covariance to remove the possible effects of middle ear variables on DPOAEs.ResultsNo differences in mean hearing thresholds, SC, ECV, and gradient were observed between the two groups, whereas significantly lower MEP values were found in WS subjects as well as significantly decreased DPOAEs up to 3.2 kHz after adjusting for differences in middle ear status.ConclusionsResults revealed that WS subjects with normal hearing thresholds (≤15 dB HL) and normal middle ear functionality (MEP > −50 daPa, SC in the range 0.3–1.2 cm³, ECV in the range 0.2–2 ml) might have subtle auditory dysfunctions that can be detected by using clinically available methods. Overall, this study points out the importance of using otoacoustic emissions as a complement to routine audiological examinations in individuals with WS to detect, before the onset of hearing loss, possible subtle auditory dysfunctions so that patients can be early identified, better monitored, and promptly treated.     

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.     

French Society of ENT (SFORL) guidelines (short version): Audiometry in adults and children

IntroductionFrench Society of ENT (SFORL) good practice guidelines for audiometric examination in adults and children.MethodsA multidisciplinary working group performed a review of the scientific literature. Guidelines were drawn up, reviewed by an independent reading group, and finalized in a consensus meeting.ResultsAudiometry should be performed in an acoustically controlled environment (< 30 dBA); audiometer calibration should be regularly checked; and patient-specific masking rules should be systematically applied. It should be ensured that masking is not overmasking. Adult pure-tone audiometry data should be interpreted taking account of clinical data, speech audiometry and impedancemetry. In case of discrepancies between clinical and pure-tone and speech audiometry data, objective auditory tests should be perform. In children aged 2 years or younger, subjective audiometry should be associated to behavioral audiometry adapted to the child's age. In suspected hearing impairment, behavioral audiometry should be systematically supplemented by objective hearing tests to determine and confirm the level and type of hearing impairment.     

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.     

Validation of the French version of HHIE-S (Hearing Handicap Inventory for the Elderly - Screening) questionnaire in French over-60 year-olds

IntroductionThe HHIE-S (Hearing Handicap Inventory for the Elderly - Screening) is widely used for hearing-loss disorder in the elderly. The main objective of the present study was to validate a French version. The secondary objective was to determinate a cut-off score as indication for hearing rehabilitation.MethodsWe translated the HHIE-S into French, respecting the cross-cultural adaptation process for medical questionnaires. An observational study assessed the translation (10 questions, scored from 0 to 40) used for screening purposes in a prospective cohort, aged ≥ 60 years, with comparison to pure tone, speech-in-silence and speech-in-noise audiometry. Subjects were considered hearing-impaired if the pure-tone average at 500, 1,000, 2,000 and 4,000 Hz was > 20 dB HL in one or both ears.ResultsWe tested 294 subjects (mean age = 67 ± 6 years). Hearing loss prevalence was 34.7 %. Cronbach's alpha (test reliability) was high (0.84). Taking HHIE-S score > 8/40 as cut-off defining hearing loss, sensitivity was 80.4%, specificity 85.4 %, positive predictive value 74.5 % and negative predictive value 89.1 %. Seventy-three subjects (24.8 %) had theoretic indications for hearing aids, optimally detected by HHIE-S score > 16/40 (88,4 %).ConclusionOur study validated the French version of the HHIE-S. This tool could be useful in screening for age-induced hearing loss in the elderly French population.     

Positioning of earphones and variations in auditory thresholds

IntroductionOne of the problems observed in pure-tone audiometry tonal has been the variation in test results of a same individual, particularly at frequencies of 4 kHz, 6 kHz and/or 8 kHz. Improper placement of headphones is one of the factors that can cause alterations in results.ObjectiveTo compare differences in auditory thresholds using earphones positioned by the examiner and by the worker.MethodsClinical and experimental study conducted in 2009, with 324 workers aged between 19 and 61 years, with a mean of 33.29 years and mean exposure time of 7.67 years. All subjects were familiar with audiometry procedures. Auditory thresholds were obtained at frequencies of 0.25–8 kHz, with earphones positioned by the examiners, and at frequencies of 4, 6 and 8 kHz, with earphones placed by workers in a comfortable position, following the examiner's instructions. The thresholds obtained in these two situations were compared.ResultsThe three frequencies exhibited better responses with earphones placed by the workers themselves (p < 0.001). At a frequency of 8 kHz a greater difference was found (p < 0.001), with a mean of 13.89 dB and standard deviation of 6.07 dB.ConclusionEarphone placement by the workers themselves under supervision of the examiner results in improved mean auditory thresholds at frequencies of 4, 6 and 8 kHz, the last one significantly higher than the other two.     

Tone-evoked brainstem responses and auditory steady state responses to 40hz and 80hz amplitude modulated stimuli with different frequencies — a comparative study

Abstract  Tone burst evoked auditory brainstem responses and auditory steady state responses with 40 or > 80 Hz modulation can be used to determine frequency specific threshold. Aim  The present study was taken up to check for the efficacy of estimating hearing thresholds by tone burst ABR and ASSR. The frequency effect (low, mid and high) on estimating the threshold was also focused upon. Methods  20 normal hearing adults (40 ears) in the age range of 16 to 30 years participated in the study. The pure tone audiometry and immittance was initially done. Subsequently, tone-burst ABR, 80Hz ASSR and 40Hz ASSR to estimate the threshold with three frequencies 500Hz (low), 2000Hz (mid) and 4000Hz (high) was done. The data was analyzed statistically using pair sample t-test. Results  ASSR threshold for 80Hz and 40Hz was almost comparable. ASSR was superior to estimate the threshold than tone-burst ABR. For the low frequency the discrepancy between the behavioral threshold and frequency-specific evoked audiometry was more when compared to mid and high frequency. Conclusion  Present study showed that steady-state responses were efficient means of threshold detection than visual detection of ABR wave-V. In awake adult subjects, 40Hz and 80Hz amplitude modulated produced similar results. For the threshold estimation ASSR was better than tone-burst ABR.     

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.     

Comparison of auditory steady-state responses and auditory brainstem responses in audiometric assessment of adults with sensorineural hearing loss

Objective

Many of the medico-legal patients who claimed compensation may exaggerate hearing loss that varies in degree, nature, and laterality. The purpose of this study was to investigate whether Auditory Steady-State Response (ASSR) could be used to predict the hearing level of adults, and whether ASSR could become a better testing method than Auditory brainstem response (ABR) in audiometric assessment of adults with sensorineural hearing loss.

Methods

This was a prospective study, which was conducted in a tertiary referral hospital. From January to June 2007, 142 subjects (284 ears) with varying degrees of sensori-neural hearing impairment were included in this study. Four commonly used frequencies (500, 1000, 2000, 4000 Hz) were evaluated. All subjects received pure-tone audiometry, multi-channel ASSR, and ABR tests for threshold measurement. The correlation of pure tone thresholds with ASSR and ABR thresholds were assessed.

Results

Between multi-channel ASSR and pure tone thresholds, a difference of less than 15 dB was found in 71% while a difference of less than 25 dB was found in 89% of patients. The correlation coefficient (r) of multi-channel ASSR and pure tone thresholds were 0.89, 0.95, 0.96, and 0.97 at 500, 1000, 2000, and 4000 Hz, respectively. The strength of the relationship increased with increasing frequency. On the other hand, between ABR and pure-tone thresholds, a difference of less than 15 dB was found in 31%; a difference of less than 25 dB was found in 62% of patients. The r correlation value for ABR and pure tone thresholds was 0.83.

Conclusion

ASSR is a more reliable test for the accurate prediction of auditory thresholds than ABR. It can be a powerful and convenient electro-physiologic examination tool for clinically assessing of adults with sensorineural hearing loss.     

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.     

High frequency hearing thresholds and product distortion otoacoustic emissions in cystic fibrosis patients

IntroductionThe treatment of patients with cystic fibrosis involves the use of ototoxic drugs, mainly aminoglycoside antibiotics. Due to the use of these drugs, fibrocystic patients are at risk of developing hearing loss.ObjectiveTo evaluate the hearing of patients with cystic fibrosis by High Frequency Audiometry and Distortion Product Otoacoustic Emissions.MethodsCross-sectional study. The study group consisted of 39 patients (7–20 years of age) with cystic fibrosis and a control group of 36 individuals in the same age group without otologic complaints, with normal audiometric thresholds and type A tympanometric curves. High Frequency Audiometry and Distortion Product Otoacoustic Emissions tests were conducted.ResultsThe study group had significantly higher thresholds at 250, 1000, 8000, 9000, 10,000, 12,500, and 16,000 Hz (p = 0.004) as well as higher prevalence of otoacoustic emission alterations at 1000 and 6000 Hz (p = 0.001), with significantly lower amplitudes at 1000, 1400, and 6000 Hz. There was a significant association between alterations in hearing thresholds in High Frequency Audiometry with the number of courses of aminoglycosides administered (p = 0.005). Eighty-three percent of patients who completed more than ten courses of aminoglycosides had hearing loss in High Frequency Audiometry.ConclusionA significant number of patients with cystic fibrosis who received repeated courses of aminoglycosides showed alterations in High Frequency Audiometry and Distortion Product Otoacoustic Emissions. The implementation of ten or more aminoglycoside cycles was associated with alterations in High Frequency Audiometry.     

Prevention and management of hearing loss in syndromic craniosynostosis: A case series

ObjectiveTo assess the audiological profile in a cohort of children affected by syndromic craniosynostosis.MethodsEleven children with Apert syndrome (n = 4), Saethre-Chotzen syndrome (n = 3), Muenke syndrome (n = 2), Crouzon syndrome (n = 1) and Pfeiffer syndrome type 1 (n = 1) were submitted to a complete audiologic evaluation including otoscopy, pure-tone audiometry, tympanometry and acoustic reflex testing, ABR, otoacustic emissions, temporal bone High Resolution CT (HRCT) scan. The main outcome measures were prevalence, type and severity of hearing loss, prevalence of chronic otitis media, correlation with the time of first surgical correction.ResultsSeven of 11 patients (64%) presented hearing loss (HL), conductive in 3/7 patients (43%) and mixed in 4/7 (57%). No patients showed a purely sensorineural HL. All hearing impaired patients displayed middle ear disorders: the patients with conductive HL had otitis media with effusion (OME) and 3/4 patients with mixed HL showed tympanic alterations or cholesteatoma. A bilateral vestibular aqueduct enlargement was detected by HRCT scan in one normal hearing patient. The ABRs resulted normal in all cases.ConclusionOur study confirms the high prevalence of otologic diseases in such patients. In contrast with previous studies, middle ear disorders were responsible for the hearing impairment also in patients with mixed HL due to secondary inner ear damage. These findings restate the necessity of a close audiologic follow-up. We did not detect the specific ABR abnormalities previously reported, possibly because of an early correction of the cranial vault malformations.     

High levels of sound pressure: acoustic reflex thresholds and auditory complaints of workers with noise exposure

IntroductionThe clinical evaluation of subjects with occupational noise exposure has been difficult due to the discrepancy between auditory complaints and auditory test results. This study aimed to evaluate the contralateral acoustic reflex thresholds of workers exposed to high levels of noise, and to compare these results to the subjects’ auditory complaints.MethodsThis clinical retrospective study evaluated 364 workers between 1998 and 2005; their contralateral acoustic reflexes were compared to auditory complaints, age, and noise exposure time by chi-squared, Fisher's, and Spearman's tests.ResultsThe workers’ age ranged from 18 to 50 years (mean = 39.6), and noise exposure time from one to 38 years (mean = 17.3). We found that 15.1% (55) of the workers had bilateral hearing loss, 38.5% (140) had bilateral tinnitus, 52.8% (192) had abnormal sensitivity to loud sounds, and 47.2% (172) had speech recognition impairment. The variables hearing loss, speech recognition impairment, tinnitus, age group, and noise exposure time did not show relationship with acoustic reflex thresholds; however, all complaints demonstrated a statistically significant relationship with Metz recruitment at 3000 and 4000 Hz bilaterally.ConclusionThere was no significance relationship between auditory complaints and acoustic reflexes.     

Auditory steady-state response and auditory brainstem response thresholds in children

The inclusion of the auditory steady-state response (ASSR) into test-batteries for objective audiometry has allowed for clinical comparisons with the most widely used procedure, the auditory brainstem response (ABR). The current study describes ASSR and ABR thresholds for a group of infants and young children with various types and degrees of hearing loss. A sample of 48 subjects (23 female) with a mean age of 2.8 ± 1.9 years SD were assessed with a comprehensive test-battery and classified according to type and degree of hearing loss. Thresholds were determined with a broadband click-evoked ABR and single frequency ASSR evoked with continuous tones (0.25–4 kHz) amplitude modulated (67–95 Hz). Mean difference scores (±SD) between the ABR and high frequency ASSR thresholds were 9.8 (±11), 3.6 (±12) and 10.5 (±12) dB at 1, 2 and 4 kHz, respectively. An ASSR mean threshold for 2–4 and 1–4 kHz compared to the ABR threshold revealed an average difference of 7 (±9) and 7.9 (±8) dB, respectively. The overall correlation between the ABR and ASSR thresholds was highest for the mean ASSR thresholds of 2–4 and 1–4 kHz (r = 0.92 for both conditions). Correlations between the ABR and individual ASSR frequencies were slightly less (0.82–0.86). The average of the 2–4 kHz ASSR thresholds correlated best with the click-evoked ABR for all categories of hearing loss except for the sensorineural hearing loss category for which the 1–4 kHz ASSR average was better correlated to ABR thresholds. Findings demonstrate the reliability of verifying high frequency ASSR thresholds with a click-evoked ABR as an important cross-check in infants for whom behavioural audiometry may not be possible.     

Comparison of pure tone audiometry and auditory steady-state responses in subjects with normal hearing and hearing loss

The objective of this study is to compare pure tone audiometry and auditory steady-state response (ASSR) thresholds in normal hearing (NH) subjects and subjects with hearing loss. This study involved 23 NH adults and 38 adults with hearing loss (HI). After detection of behavioral thresholds (BHT) with pure tone audiometry, each subject was tested for ASSR responses in the same day. Only one ear was tested for each subject. The mean pure tone average was 9 ± 4 dB for NH group and 57 ± 14 for HI group. There was a very strong correlation between BHT and ASSR measurements in HI group. However, the correlation was weaker in the NH group. The mean differences of pure tone average of four frequencies (0.5, 1, 2, and 4 kHz) and ASSR threshold average of same frequencies were 13 ± 6 dB in NH group and 7 ± 5 dB in HI group and the difference was significant (P = 0.01). It was found that 86% of threshold difference values were less than 20 dB in NH group and 92% of threshold difference values were less than 20 dB in HI group. In conclusion, ASSR thresholds can be used to predict the configuration of pure tone audiometry. Results are more accurate in HI group than NH group. Although ASSR can be used in cochlear implant decision-making process, findings do not permit the utilization of the test for medico-legal reasons.     

Two cases of Tullio phenomenon in which oval and round window reinforcement surgery was effective

AimTo report the effect of oval and round window reinforcement surgery performed in two patients with the Tullio phenomenon. Case 1: A male with bilateral superior canal dehiscence syndrome. Downbeat nystagmus with leftward horizontal eye movement was recorded in an electronystagmogram using a pure-tone sound of 110 dB at 2000 or 4000 Hz in the right ear. Case 2: A female who had undergone stapes surgery. Computed tomography revealed an ossicular prosthesis in the vestibule. An audiogram indicated mild to moderate hearing impairment in the right ear. Leftward horizontal nystagmus was recorded in an electronystagmogram using a pure-tone sound of 110 dB at 500 or 1000 Hz in the right ear. Surgical findings indicated that the prosthesis was inserted deep into the oval window, which was closed with thin connective tissue.OutcomesAfter oval and round window reinforcement surgery was performed in the right ear, and loud, pure-tone sounds elicited neither nystagmus nor dizziness in either patient.     

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.     

Relationship between behavioral hearing thresholds and estimated auditory steady-state response thresholds in children with a history of neonatal hyperbilirubinemia

Increased serum bilirubin levels during infancy increase the risk of hearing loss in infants. This study aimed to investigate the relationship between pure-tone audiometry hearing thresholds and thresholds estimated using auditory steady-state responses (ASSRs) in children with a history of neonatal hyperbilirubinemia, and to evaluate the usefulness of 90-Hz ASSR in estimating hearing thresholds in children. This study was conducted on 26 children (13 girls and 13 boys) who were aged 2.4–11 years and had a history of neonatal hyperbilirubinemia (bilirubin level >17 mg/dL). ASSR thresholds were compared with behavioral thresholds and were interpreted after considering the amount and type of hearing loss. Of the 26 children, 12 had normal hearing thresholds, and 14 had varying degrees of sensorineural hearing loss. In general, a high correlation (r ≥ 0.81, p < 0.01) was found between the ASSR and behavioral thresholds. The highest correlation was observed at 2,000 Hz (r = 0.88, p < 0.01). No significant difference was observed (p > 0.13) between mean behavioral and ASSR thresholds at 52 studied ears. The results of this study showed that 90-Hz ASSR assessments provide reliable estimates of behavioral hearing thresholds in children who have a history of neonatal hyperbilirubinemia and sensorineural hearing loss or normal hearing.