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Ophthalmology Jan 2024To better characterize the frequency and patterns of hearing dysfunction in patients who have received teprotumumab to treat thyroid eye disease. (Review)
Review
PURPOSE
To better characterize the frequency and patterns of hearing dysfunction in patients who have received teprotumumab to treat thyroid eye disease.
DESIGN
Noncomparative case series.
PARTICIPANTS
Patients who underwent audiology testing before and after completion of teprotumumab infusions.
METHODS
A review of patients who underwent audiology testing before and after completion of teprotumumab infusions was carried out. Additional audiogram testing during treatment was included when available. Hearing function was analyzed using audiogram data measuring threshold hearing levels at specific frequencies. Basic demographic data as well as information regarding otologic symptoms also were obtained and analyzed.
MAIN OUTCOME MEASURES
Hearing loss demonstrated by a significant change in decibel hearing thresholds or that meets criteria for ototoxicity.
RESULTS
Twenty-two patients (44 ears) were included in the study, with baseline and most recent audiology testing after treatment ranging from 84 days before to 496 days after treatment. Fifteen patients (30 ears) also underwent testing during treatment starting after the second infusion up until the day of, but before, the eighth infusion. Hearing loss after treatment met criteria for ototoxicity in 17 of the 44 ears (38.6%), with 11 of the 22 patients (50.0%) meeting criteria in at least 1 ear. The pure-tone average decibel hearing levels (HLs) across all 44 ears demonstrated hearing loss after treatment (P = 0.0029), specifically at high (P = 0.0008) and middle frequencies (P = 0.0042), but not at low frequencies (P = 0.8344). Patients who were older also were more likely to experience hearing loss after treatment (P = 0.0048).
CONCLUSIONS
Audiometric data demonstrate that teprotumumab influences hearing function, most significantly at higher frequencies and in older patients. Audiometric testing is critical for counseling patients regarding teprotumumab treatment. A protocol for monitoring hearing during treatment is needed to detect and manage hearing changes associated with teprotumumab use.
FINANCIAL DISCLOSURE(S)
Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
Topics: Humans; Aged; Ototoxicity; Auditory Threshold; Audiometry, Pure-Tone; Hearing Loss; Hearing
PubMed: 37567417
DOI: 10.1016/j.ophtha.2023.08.001 -
Irish Journal of Medical Science Feb 2024Subjective tinnitus is an unpleasant perception of sound without any external acoustic stimulus. It can be manifested in the form of various phantom sounds, which most...
BACKGROUND
Subjective tinnitus is an unpleasant perception of sound without any external acoustic stimulus. It can be manifested in the form of various phantom sounds, which most often resemble ringing, whistling, squeaking, noise, chirping, or buzzing. The sounds are heard solely by the sufferer and can occur in the middle of the head, but also in the ears-on one or both sides.
AIM
The aim of the study was to evaluate the hearing capacity based on audiometric threshold measurements in the frequency range of 0.125-16 kHz in patients with tinnitus. In addition, we investigated the following questions: Can high-frequency audiometry be useful in the diagnosis of tinnitus? Does hearing loss occur in an increasingly wide frequency range with age compared to the control group? Can tinnitus be considered the first symptom of the onset of high-frequency hearing loss?
METHODS
The study included 99 patients, all of whom underwent pure-tone audiometry (PTA) and extended high-frequency audiometry (HFA) in the ranges of 0.125-8 kHz and 8-16 kHz, respectively. In each patient (excluding the control group), tinnitus was characterized in terms of its frequency and intensity.
RESULTS AND CONCLUSION
The study concluded that tinnitus may be a symptom indicating the presence of high-frequency hearing loss as hearing loss occurs in an increasingly wider frequency range with age, so HFA should be a routine audiological test in patients with tinnitus.
Topics: Humans; Tinnitus; Audiometry, Pure-Tone; Hearing Loss, High-Frequency; Auditory Threshold
PubMed: 37518821
DOI: 10.1007/s11845-023-03462-y -
European Archives of... Oct 2023The main objective of this study is to evaluate the short-term and long-term audiological outcomes in patients who underwent cochlear implantation with a robot-assisted...
PURPOSE
The main objective of this study is to evaluate the short-term and long-term audiological outcomes in patients who underwent cochlear implantation with a robot-assisted system to enable access to the cochlea, and to compare outcomes with a matched control group of patients who underwent cochlear implantation with conventional access to the cochlea.
METHODS
In total, 23 patients were implanted by robot-assisted cochlear implant surgery (RACIS). To evaluate the effectiveness of robotic surgery in terms of audiological outcomes, a statistically balanced control group of conventionally implanted patients was created. Minimal outcome measures (MOM), consisting of pure-tone audiometry, speech understanding in quiet and speech understanding in noise were performed pre-operatively and at 3 months, 6 months, 12 months and 2 years post-activation of the audioprocessor.
RESULTS
There was no statistically significant difference in pure-tone audiometry, speech perception in quiet and speech perception in noise between robotically implanted and conventionally implanted patients pre-operatively, 3 months, 6 months, 12 months and 2 years post-activation. A significant improvement in pure-tone hearing thresholds, speech understanding in quiet and speech understanding in noise with the cochlear implant has been quantified as of the first measurements at 3 months and this significant improvement remained stable over a time period of 2 years for HEARO implanted patients.
CONCLUSION
Clinical outcomes in robot-assisted cochlear implant surgery are comparable to conventional cochlear implantation. CLINICALTRAILS.
GOV TRAIL REGISTRATION NUMBERS
NCT03746613 (date of registration: 19/11/2018), NCT04102215 (date of registration: 25/09/2019).
Topics: Humans; Cochlear Implantation; Cochlear Implants; Hearing Loss, Sensorineural; Robotic Surgical Procedures; Robotics
PubMed: 37043021
DOI: 10.1007/s00405-023-07961-7 -
The Laryngoscope Oct 2023To characterize otologic and audiologic manifestations in our NF1 cohort and explore the relationship between otologic and audiologic findings in a subset of patients...
OBJECTIVES
To characterize otologic and audiologic manifestations in our NF1 cohort and explore the relationship between otologic and audiologic findings in a subset of patients with ear-related plexiform neurofibromas (PNs).
METHODS
Audiologic and otologic clinical evaluations were conducted on 102 patients with NF1 in a natural history study (5-45 years; M = 14.4 years; Mdn = 14). Testing included pure tone and speech audiometry, middle ear function, neurodiagnostic auditory brainstem response (ABR), auditory processing, and MRIs of the head and neck region. Patients referred to this study had an overall higher incidence and burden of PNs than the overall NF1 population.
RESULTS
The majority of subjects in this cohort had normal hearing sensitivity (81%) and normal middle ear function (78%). Nineteen participants had hearing loss that ranged in degree from mild to profound, with the majority in the mild range. Hearing loss was twice as likely to be conductive than sensorineural. In patients with ear-related PNs (n = 12), hearing loss was predominantly conductive (60%). Seventy-five percent of ears with PNs had atypical tympanometric tracings that could not be characterized by the classic categories. In all 20 patients with a PN in the temporal bone, the ear canal was affected, and the PNs often extended to the surrounding soft tissue regions.
CONCLUSIONS
People with NF1-related PNs in the temporal bone and adjacent skull base should have audiometric and otologic monitoring. Addressing hearing concerns should be part of routine clinical evaluations in patients with NF1. Magnetic resonance imaging (MRI) should be performed in patients with NF1 who have hearing loss.
LEVEL OF EVIDENCE
3 Laryngoscope, 133:2770-2778, 2023.
Topics: Humans; Child; Young Adult; Neurofibromatosis 1; Neurofibroma, Plexiform; Audiometry; Hearing; Hearing Loss; Deafness
PubMed: 36583617
DOI: 10.1002/lary.30522 -
Otology & Neurotology : Official... Jan 2024To evaluate long-term outcomes of active transcutaneous bone conduction implants (atBCIs) regarding safety, hearing, and quality of life.
OBJECTIVE
To evaluate long-term outcomes of active transcutaneous bone conduction implants (atBCIs) regarding safety, hearing, and quality of life.
STUDY DESIGN
A clinical study with retrospective medical record analysis combined with prospective audiometry and quality of life questionnaires.
SETTING
Three secondary to tertiary care hospitals.
PATIENTS
All subjects operated with an atBCI in three regions in Sweden were asked for informed consent. Indications for atBCI were single-sided deafness (SSD) and conductive or mixed hearing loss (CMHL).
INTERVENTION
Evaluation of atBCI.
MAIN OUTCOME MEASURES
Pure tone and speech audiometry and Glasgow Benefit Inventory (GBI).
RESULT
Thirty-three subjects were included and 29 completed all parts. The total follow-up time was 124.1 subject-years. Nineteen subjects had CMHL and in this group, pure tone averages (PTA4) were 56.6 dB HL unaided and 29.6 dB HL aided, comparable with a functional gain of 26.0 dB. Effective gain (EG) was -12.7 dB. With bilateral hearing, Word Recognition Scores (WRS) in noise were 36.5% unaided and 59.1% aided. Fourteen subjects had SSD or asymmetric hearing loss (AHL) and in this group, PTA4 were >100 dB HL unaided and 32.1 dB HL aided with the contralateral ear blocked. EG was -9.1 dB. With bilateral hearing, WRSs were 53.2% unaided and 67.9% aided. The means of the total GBI scores were 31.7 for CMHL and 23.6 for SSD/AHL.
CONCLUSION
Few complications occurred during the study. The atBCI is concluded to provide a safe and effective long-term hearing rehabilitation.
Topics: Humans; Bone Conduction; Follow-Up Studies; Hearing Loss, Mixed Conductive-Sensorineural; Retrospective Studies; Prospective Studies; Quality of Life; Hearing Aids; Hearing Loss, Conductive; Hearing Loss; Speech Perception; Treatment Outcome
PubMed: 38085764
DOI: 10.1097/MAO.0000000000004057 -
Journal of Neurology Nov 2023Approximately 28%-57% of patients with idiopathic sudden sensorineural hearing loss (ISSNHL) have an acute vertigo attack and probable vestibular dysfunction; however,...
BACKGROUND
Approximately 28%-57% of patients with idiopathic sudden sensorineural hearing loss (ISSNHL) have an acute vertigo attack and probable vestibular dysfunction; however, the prognosis of vestibular function in these patients remains unclear.
METHODS
A prospective cohort study of patients with ISSNHL and vertigo was conducted to evaluate the prognosis of vestibular function, especially the roles of peripheral vestibular restoration and central compensation, in patients with ISSNHL and vertigo. Clinical data were recorded at baseline and at 60 days from onset in participants with unilateral ISSNHL with vertigo. Enrolment occurred from May 1, 2019 to May 1, 2022 in the outpatient clinics and inpatient departments of the Eye and ENT Hospital of Fudan University in Shanghai. The primary outcome measure was the recovery rate of vestibular function 60 days after onset as assessed by vestibular function tests, including caloric tests, cervical and ocular vestibular-evoked myogenic potential tests (cVEMP, oVEMP), video head impulse tests (vHIT), and sensory organization tests (SOT). The secondary outcome measure was the recovery of subjective evaluations in vestibular dysfunction (the dizziness handicap inventory [DHI], and the visual analogue scale for vertigo [VAS-V]) and hearing assessments (pure-tone audiometry [PTA]).
RESULTS
Overall, 86 patients were recruited, with an average duration of disease of 11.7 days and follow-up time of 60.7 days. Vestibular function was significantly improved (p < 0.05) after 60 days. The recovery rates were 100% for anterior semicircular canal (ASC), 56% for posterior semicircular canal (PSC), 41% for horizontal semicircular canal (HSC), 28% for saccule, and 23% for utricle. The recovery of vestibular function was not significantly related to changes in DHI (p = 0.245), VAS-V score (p = 0.509), or hearing outcome (p = 0.390).
CONCLUSIONS
Restoration of peripheral vestibular sensory input and central vestibular compensation can occur during the course of ISSNHL with vertigo. The otolith organs are at a higher risk of being affected and have worse recovery than the semicircular canals. Incomplete and in-process restoration of vestibular dysfunction may perturb and delay the establishment of central compensation for balance. Neither hearing outcomes nor subjective vestibular symptoms are related to recovery from vestibular dysfunction.
TRIAL REGISTRATION
ClinicalTrials.gov (identifier NCT03951584).
Topics: Humans; Prospective Studies; Vestibular Evoked Myogenic Potentials; China; Vertigo; Hearing Loss, Sensorineural; Dizziness; Hearing Loss, Sudden; Semicircular Canals; Audiometry, Pure-Tone; Prognosis
PubMed: 37517037
DOI: 10.1007/s00415-023-11894-w -
Scientific Reports Oct 2023The purpose of this study was to investigate the correlation between glycated hemoglobin (HbA1c) levels and hearing loss (HL) using data from a tertiary hospital. Our...
The purpose of this study was to investigate the correlation between glycated hemoglobin (HbA1c) levels and hearing loss (HL) using data from a tertiary hospital. Our hypothesis regarding the relationship between HL and HbA1c levels was that elevated HbA1c levels are associated with an increased risk of HL. We retrospectively reviewed the medical charts of patients diagnosed with sensorineural HL or diabetes between 2006 and 2021 at the Catholic Medical Center (CMC). Data were collected from the CMC's Clinical Data Warehouse. Participants were selected from patients who were prescribed pure-tone audiometry and an HbA1c blood test. The survey was completed for 5287 participants. The better ear pure-tone audiometry (PTA) for air conduction thresholds at 500, 1000, 2000, and 4000 Hz was calculated. Sensorineural HL was defined as a better ear PTA of 25 dB or higher. We used the HbA1c level as a diagnostic criterion for diabetes. The following criteria were used to define the HbA1c level: normal, HbA1c level below 5.6%; prediabetes, level between 5.6 and 6.4%; and diabetes, level of 6.5% or more. Among 5287 participants, 1129 were categorized as normal, 2119 as prediabetic, and 2039 as diabetic. The diabetic group was significantly older (p < 0.05). The PTA also significantly deteriorated in the diabetes group (p < 0.05). We analyzed the effects of age, sex, and HbA1c level on frequency-specific hearing using multiple regression. The hearing thresholds at all frequencies deteriorated significantly with increasing age and HbA1c level (p < 0.05). A case-control study was also performed to facilitate a comprehensive comparison between distinct groups. The participants were categorized into two groups: a case (PTA > 25 dB) and control group (PTA ≤ 25 dB), based on their PTA threshold of four frequencies. After adjusting for age and sex, we found no significant odds ratio (OR) of HL between the prediabetes group and the normal group. Notably, the OR of HL was significantly higher in the diabetes group with each PTA threshold and frequency. The 6.3% HbA1c level cutoff value was determined by analyzing the receiver operating characteristic curve for predicting hearing impairment > 25 dB. Diabetes was associated with hearing loss in all frequency ranges, particularly at high frequencies. Screening for HL is strongly recommended for patients with elevated HbA1c levels.
Topics: Humans; Tertiary Care Centers; Glycated Hemoglobin; Case-Control Studies; Retrospective Studies; Prediabetic State; Hearing Loss; Hearing Loss, Sensorineural; Deafness; Audiometry, Pure-Tone; Auditory Threshold
PubMed: 37891326
DOI: 10.1038/s41598-023-44909-7 -
American Journal of Audiology Jun 2024Phone- and tablet-based hearing testing systems are now widely available. Here, we evaluated one such system from TympaHealth by comparing air conduction thresholds and...
OBJECTIVE
Phone- and tablet-based hearing testing systems are now widely available. Here, we evaluated one such system from TympaHealth by comparing air conduction thresholds and resultant hearing aid targets and output, measured with the TympaHealth system with those measured using standard audiometry.
DESIGN
The hearing thresholds of 35 adults were measured using standard audiometry and the TympaHealth system. Each set of thresholds was used to generate NAL-NL2 targets and program a hearing aid. The data from each system were compared.
RESULTS
Bland-Altman analyses showed overall mean differences between thresholds measured with each system to be small, with 85% of TympaHealth thresholds being within ±5 dB of the standard audiometric thresholds, although TympaHealth thresholds were higher (poorer) than the standard audiometric thresholds. The hearing aid targets and gains generated from the standard audiometric thresholds were lower (less amplification) than those generated from the TympaHealth thresholds but again, mean differences at each frequency were small and likely imperceptible.
CONCLUSION
These findings support the possibility that valid hearing testing can take place outside of a clinical booth using portable systems like that from TympaHealth, opening up the possibility of testing hearing and fitting hearing aids through pharmacies, opticians, and in care homes.
PubMed: 38848255
DOI: 10.1044/2024_AJA-24-00002 -
European Review For Medical and... Oct 2023This study aimed to determine whether there is a relationship between changes in blood estrogen levels and hearing threshold levels in women undergoing in vitro...
OBJECTIVE
This study aimed to determine whether there is a relationship between changes in blood estrogen levels and hearing threshold levels in women undergoing in vitro fertilization (IVF).
PATIENTS AND METHODS
Sixty patients with normal otoscopic examination findings and scheduled for IVF treatment were included in the study. All patients underwent pure tone audiometry, tympanogram tests, and otoacoustic emission measurements (TEOAE) during IVF treatment, and estrogen levels were measured simultaneously. The patients were divided into three groups based on estrogen levels during IVF. The patients' audiological test results at the beginning and end of treatment (the 12th day) were compared between the groups.
RESULTS
There was an increase in hearing levels on the 12th day of treatment compared to the beginning of treatment in all the study groups. This increase was significant between Group 1 and Group 2 and between Group 1 and Group 3 (p<0.05). The best hearing in audiometry was determined in the patients in Group 2. While a significant increase was observed in TEOAE (otoacoustic emission) measurements in Groups 1 and 2, a significant decrease was determined in Group 3 (p<0.05). Middle ear pressure and compliance measurements on the tympanogram tests were significantly lower in Group 3 compared to Groups 1 and 2 (p<0.05).
CONCLUSIONS
During IVF treatment, as the estrogen level increases, it causes an increase in the level of hearing, but this increase does not continue after specific doses.
Topics: Humans; Female; Auditory Threshold; Hearing; Hearing Loss, Sensorineural; Otoacoustic Emissions, Spontaneous; Audiometry, Pure-Tone; Estrogens; Fertilization in Vitro
PubMed: 37869950
DOI: 10.26355/eurrev_202310_34072 -
International Journal of Pediatric... Apr 2024The Baha SoundArc coupling system has been developed as a non-surgical coupling of a Baha sound processor to the skull allowing the transfer of vibrational energy to the...
OBJECTIVE
The Baha SoundArc coupling system has been developed as a non-surgical coupling of a Baha sound processor to the skull allowing the transfer of vibrational energy to the cochlear partition via bone conduction pathways. Today, there are several alternatives to this non-surgical approach as the Baha headband/test band, or the Baha Softband, or adhesive patches. Each of these current options have benefits and liabilities. The aim of the study was to evaluate pediatric experience and performance when using two non-surgical options, the Baha SoundArc compared to the Baha Softband.
METHODS
Twenty-five children with unilateral mixed or conductive hearing loss aged 5-12 years of age evaluated the use of the Baha SoundArc compared to their existing Baha Softband in a one month take home trial. Participants had a minimum of 3 months experience using the control, Baha Softband. Participants were assessed at baseline and one month following fit of the Baha SoundArc. Measures included an experience and use patient reported outcome, speech perception testing in quiet using Phonetically Balanced Kindergarten (PBK) words, and sound field audiometry.
RESULTS
Mean aided soundfield thresholds across the frequency range were 27.6 dB HL for Softband and 26.0 dB HL for SoundArc, which were not significantly different (P = >.05). Mean word recognition score was 80.8% when aided with the Softband device and 85.1% with the SoundArc, which was also not significantly different (P = >.05). Most children favored the aesthetics and usability of the SoundArc over Softband, but comfort ratings were largely similar for both devices.
CONCLUSIONS
Bone conduction sound processors mounted on a SoundArc or a Softband resulted in comparable improvements in aided thresholds and speech understanding in children suffering from conductive or mixed hearing loss. Both wearing modalities can be considered equivalent in terms of audiological outcomes, although both patients and clinicians preferred the usability and aesthetics of the SoundArc. The SoundArc provides an alternative wearing option for patients that may otherwise be discouraged by the aesthetics and usability of the Softband device.
GOV IDENTIFIER
NCT03333577.
Topics: Humans; Child; Child, Preschool; Hearing Aids; Hearing Loss, Conductive; Audiometry; Bone Conduction; Hearing Loss; Speech Perception
PubMed: 38552429
DOI: 10.1016/j.ijporl.2024.111925