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Radiation and Environmental Biophysics Nov 2021Numerous studies have documented the adverse effects of high-dose radiation on hearing in patients. On the other hand, radiographers are exposed to a low dose of... (Review)
Review
Numerous studies have documented the adverse effects of high-dose radiation on hearing in patients. On the other hand, radiographers are exposed to a low dose of ionizing radiation, and the effect of a low dose of radiation on hearing is quite abstruse. Therefore, the present systematic review aimed to elucidate the effect of low-dose ionizing radiation on hearing. Two authors independently carried out a comprehensive data search in three electronic databases, including PUBMED/MEDLINE, CINAHL, and SCOPUS. Eligible articles were independently assessed for quality by two authors. Cochrane Risk of Bias tool was used assess quality of the included studies. Two articles met the low-dose radiation exposure criteria given by Atomic Energy Regulatory Board (AERB) and National Council on Radiation Protection (NCRP) guidelines. Both studies observed the behavioral symptoms, pure-tone hearing sensitivity at the standard, extended high frequencies, and the middle ear functioning in low-dose radiation-exposed individuals and compared with age and gender-matched controls. One study assessed the cochlear function using transient-evoked otoacoustic emissions (TEOAE). Both studies reported that behavioral symptoms of auditory dysfunction and hearing thresholds at extended high frequencies were higher in radiation-exposed individuals than in the controls. The current systematic review concludes that the low-dose ionizing radiation may affect the hearing adversely. Nevertheless, further studies with robust research design are required to explicate the cause and effect relationship between the occupational low-dose ionizing radiation exposure and hearing.
Topics: Audiometry, Pure-Tone; Auditory Threshold; Hearing; Humans; Otoacoustic Emissions, Spontaneous
PubMed: 34302524
DOI: 10.1007/s00411-021-00926-6 -
JMIR MHealth and UHealth Sep 2021Hearing loss is one of the most common disabilities worldwide and affects both individual and public health. Pure tone audiometry (PTA) is the gold standard for hearing... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Hearing loss is one of the most common disabilities worldwide and affects both individual and public health. Pure tone audiometry (PTA) is the gold standard for hearing assessment, but it is often not available in many settings, given its high cost and demand for human resources. Smartphone-based audiometry may be equally effective and can improve access to adequate hearing evaluations.
OBJECTIVE
The aim of this systematic review is to synthesize the current evidence of the role of smartphone-based audiometry in hearing assessments and further explore the factors that influence its diagnostic accuracy.
METHODS
Five databases-PubMed, Embase, Cochrane Library, Web of Science, and Scopus-were queried to identify original studies that examined the diagnostic accuracy of hearing loss measurement using smartphone-based devices with conventional PTA as a reference test. A bivariate random-effects meta-analysis was performed to estimate the pooled sensitivity and specificity. The factors associated with diagnostic accuracy were identified using a bivariate meta-regression model. Study quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool.
RESULTS
In all, 25 studies with a total of 4470 patients were included in the meta-analysis. The overall sensitivity, specificity, and area under the receiver operating characteristic curve for smartphone-based audiometry were 89% (95% CI 83%-93%), 93% (95% CI 87%-97%), and 0.96 (95% CI 0.93-0.97), respectively; the corresponding values for the smartphone-based speech recognition test were 91% (95% CI 86%-94%), 88% (95% CI 75%-94%), and 0.93 (95% CI 0.90-0.95), respectively. Meta-regression analysis revealed that patient age, equipment used, and the presence of soundproof booths were significantly related to diagnostic accuracy.
CONCLUSIONS
We have presented comprehensive evidence regarding the effectiveness of smartphone-based tests in diagnosing hearing loss. Smartphone-based audiometry may serve as an accurate and accessible approach to hearing evaluations, especially in settings where conventional PTA is unavailable.
Topics: Audiometry, Pure-Tone; Hearing Loss; Humans; Sensitivity and Specificity; Smartphone; Speech
PubMed: 34515644
DOI: 10.2196/28378 -
Telemedicine Journal and E-health : the... Oct 2023nn (Meta-Analysis)
Meta-Analysis Review
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Topics: Adult; Humans; Hearing Loss; Audiometry, Pure-Tone; Sensitivity and Specificity; Cohort Studies; Telemedicine
PubMed: 36862527
DOI: 10.1089/tmj.2022.0427 -
Laryngoscope Investigative... Dec 2020To describe otologic dysfunction in patients with the novel SARS-CoV-2. (Review)
Review
OBJECTIVE
To describe otologic dysfunction in patients with the novel SARS-CoV-2.
REVIEW METHODS
Search strategies acquired for each database included keywords. The keywords use were-Otologic OR Vestibular OR Audiologic and COVID-19 OR Coronavirus OR SARS-CoV-2. Resulting articles were imported into a systematic review software and screened for appropriateness.To be eligible for inclusion in the analysis, the studies and case reports should have met the following criteria:Description of otologic dysfunction in COVID-19 patientspeer review Studies were excluded if:the description of the specific dysfunction was inadequatethere were no original case descriptions Data that met the inclusion criteria was extracted and analyzed.
RESULTS
A total of 62 articles were identified and screened, seven articles met the inclusion criteria and were analyzed. The articles were mainly case reports (5) with 2 case series. There were 28 patients in total identified with the largest study comprising 20 patients. All patients presented with hearing loss, 27 of whom had audiometry. Three patients had associated vestibular symptoms (vertigo, otalgia, and tinnitus).
CONCLUSION
SARS-CoV-2 is a probable cause of middle ear infections and sensorineural hearing loss, secondary to spread of the novel virus into the middle ear and related neural structures.
PubMed: 33365394
DOI: 10.1002/lio2.498 -
Journal of Neurology Jan 2022Intratympanic therapies, usually including glucocorticoid and gentamicin, are becoming worldwide used in clinical practice of Ménière's disease today. However,... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
Intratympanic therapies, usually including glucocorticoid and gentamicin, are becoming worldwide used in clinical practice of Ménière's disease today. However, clinical efficacy and safety of these two therapies are still in controversial.
DATA SOURCES
Electronic searches in PubMed, CENTRAL, Web of Science, EMBASE, CINAHL, ClinicalTrials.gov and the European Union Clinical Trials Register were conducted from inception until September 2020.
REVIEW METHODS
The pre-specified protocol of this systematic review and meta-analysis has been registered and published in November 2018 (PROSPERO Identifier: CRD42018114389). All randomized controlled trials of intratympanic gentamicin or glucocorticoids for Ménière's disease, compared with each other or placebo, were considered for this review.
RESULTS
Ten studies with 455 patients met the inclusion criteria. Pooled results indicated significant advantage of intratympanic gentamicin and glucocorticoids over placebo treatments in vertigo control (gentamicin vs placebo: risk rate, RR, 2.56; 95% CI 1.18-5.54; glucocorticoids vs placebo: RR, 3.02; 95% CI 1.36-6.73). There was no significant difference between gentamicin and glucocorticoids in vertigo control (gentamicin vs placebo: RR, 1.18; 95% CI 0.97-1.45). Intratympanic glucocorticoids showed better hearing protective results than gentamicin (change of pure tone audiometric, PTA, mean difference, MD, - 6.48 dB; 95% CI - 11.84 to - 1.13 dB; change of speech discrimination scale, SDS, MD 7.69%; 95% CI 0.83-14.55%).
CONCLUSIONS
Intratympanic gentamicin and glucocorticoids are two effective approaches to control vertigo symptoms for Ménière's disease. Glucocorticoids showed a potentially better hearing protective role over gentamicin.
Topics: Anti-Bacterial Agents; Audiometry, Pure-Tone; Gentamicins; Glucocorticoids; Humans; Meniere Disease; Network Meta-Analysis; Treatment Outcome
PubMed: 33387016
DOI: 10.1007/s00415-020-10320-9 -
International Journal of Audiology Jun 2023Hearing aids are typically programmed using the individual's audiometric thresholds and verified using real-ear measures. Developments in technology have resulted in a... (Review)
Review
OBJECTIVE
Hearing aids are typically programmed using the individual's audiometric thresholds and verified using real-ear measures. Developments in technology have resulted in a new category of direct-to-consumer devices, which are not necessarily programmed using the individual's audiometric thresholds. This review aimed to identify whether programming hearing aids using the individual's validated audiogram-based prescription, and verified using real-ear measures, results in better outcomes for adults with hearing loss.
DESIGN
The review was registered in PROSPERO and reported in accordance with PRISMA guidelines.
STUDY SAMPLE
After screening more than 1370 records, seven experimental studies met the eligibility criteria.
RESULTS
Studies were categorised under three methods of fitting: (i) comparative fitting evaluating different settings based on the beliefs of the audiologist; (ii) client choice of preset responses; and (iii) self-fit by adjustment. The findings suggest that using a prescription based on the individual's audiogram improves outcomes relative to the comparative and client choice fitting approaches. Self-adjustment during daily use may produce equivalent (or better) outcomes than an audiogram-based prescription. The quality of evidence for the outcomes ranged from low to very low.
CONCLUSIONS
This review has highlighted the dearth of high-quality studies on which to make evidence-based decisions on hearing aid fitting methods.
Topics: Adult; Humans; Hearing Loss; Hearing Tests; Audiometry; Deafness; Hearing Aids
PubMed: 35531751
DOI: 10.1080/14992027.2022.2064925 -
Efficacy of gelfoam middle ear packing in type-1 tympanoplasty: systematic review and meta-analysis.European Archives of... Aug 2023To conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) that evaluated the surgical outcomes of type-1 tympanoplasty with and without... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
To conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) that evaluated the surgical outcomes of type-1 tympanoplasty with and without gelfoam middle ear packing.
METHODS
PubMed, CENTRAL, Scopus, Web of Science, and Google Scholar databases were screened from inception until October 2022. The included RCTs were evaluated for risk of bias, and the quality of each outcome was assessed according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system.
RESULTS
Nine RCTs with 773 participants (gelfoam = 381 and non-gelfoam = 392) were analyzed. The overall study quality varied: low risk (n = 4 RCTs), some concerns (n = 3 RCTs), and high risk (n = 2 RCTs). There were no significant differences between both arms regarding the graft uptake rate (moderate certainty), hearing improvement rate (moderate certainty), type of impedance audiometry (moderate certainty), and ear discharge (low certainty). The mean change in air-bone gap was significantly higher in the non-gelfoam arm compared with the gelfoam arm (low certainty). However, the non-gelfoam group had superior hearing improvement in only the early postoperative period (i.e., one month); however, after two, three, and six months, there were no significant differences between both arms. The rate of ear fullness was significantly higher in the gelfoam arm compared with the non-gelfoam arm (moderate certainty).
CONCLUSION
Among patients undergoing type-1 tympanoplasty, the surgical outcomes did not significantly differ between both arms. The practice of middle ear packing with gelfoam needs to be standardized.
Topics: Humans; Tympanoplasty; Myringoplasty; Ear, Middle
PubMed: 37081199
DOI: 10.1007/s00405-023-07975-1 -
Journal of Cancer Survivorship :... Feb 2023A cornerstone of treatment for many cancers is the administration of platinum-based chemotherapies and/or ionizing radiation, which can be ototoxic. An accurate... (Review)
Review
PURPOSE
A cornerstone of treatment for many cancers is the administration of platinum-based chemotherapies and/or ionizing radiation, which can be ototoxic. An accurate ototoxicity risk assessment would be useful for counseling, treatment planning, and survivorship follow-up in patients with cancer.
METHODS
This systematic review evaluated the literature on predictive models for estimating a patient's risk for chemotherapy-related auditory injury to accelerate development of computational approaches for the clinical management of ototoxicity in cancer patients. Of the 1195 articles identified in a PubMed search from 2010 forward, 15 studies met inclusion for the review.
CONCLUSIONS
All but 1 study used an abstraction of the audiogram as a modeled outcome; however, specific outcome measures varied. Consistently used predictors were age, baseline hearing, cumulative cisplatin dose, and radiation dose to the cochlea. Just 5 studies were judged to have an overall low risk of bias. Future studies should attempt to minimize bias by following statistical best practices including not selecting multivariate predictors based on univariate analysis, validation in independent cohorts, and clearly reporting the management of missing and censored data. Future modeling efforts should adopt a transdisciplinary approach to define a unified set of clinical, treatment, and/or genetic risk factors. Creating a flexible model that uses a common set of predictors to forecast the full post-treatment audiogram may accelerate work in this area. Such a model could be adapted for use in counseling, treatment planning, and follow-up by audiologists and oncologists and could be incorporated into ototoxicity genetic association studies as well as clinical trials investigating otoprotective agents.
IMPLICATIONS FOR CANCER SURVIVORS
Improvements in the ability to model post-treatment hearing loss can help to improve patient quality of life following cancer care. The improvements advocated for in this review should allow for the acceleration of advancements in modeling the auditory impact of these treatments to support treatment planning and patient counseling during and after care.
Topics: Child; Humans; Adult; Antineoplastic Agents; Prognosis; Ototoxicity; Quality of Life; Cancer Survivors; Neoplasms
PubMed: 36729346
DOI: 10.1007/s11764-022-01315-8 -
European Archives of... Nov 2023This paper was aimed at estimating the prevalence and risk factors of hearing loss (HL) among the middle-aged and elderly in China. (Meta-Analysis)
Meta-Analysis Review
PURPOSE
This paper was aimed at estimating the prevalence and risk factors of hearing loss (HL) among the middle-aged and elderly in China.
METHODS
Databases including the CQVIP (VIP) Database, Chinese National Knowledge Infrastructure (CNKI), China Biology Medicine disc (CBMdisc), Wanfang, PubMed, Web of Science, Excerpta Medica Database (Embase) and the Cochrane Library were comprehensively searched. In this review, random-effect models were used for pooling the prevalence of HL and the odds ratios (ORs) of potential risk factors.
RESULTS
34 studies were included in the meta-analysis. HL among the middle-aged and elderly in China had a pooled prevalence of 45% (95% confidence interval (CI) 40-51%). There were significant differences in the prevalence of HL between males and females (47% vs. 42%), between different screening methods by self-report and pure-tone audiometry (44% vs. 46%), between the middle-aged and the elderly (18% vs. 52%), and between the uneducated and the educated (49% vs. 36%). In urban areas, the prevalence was slightly higher than that in rural areas (50% vs. 48%). The findings suggested that the middle-aged and elderly in the South Central China region (61%, 95% CI 45-78%) and Northwest China (57%, 95% CI 55-58%) were more likely to develop HL. In addition, it was confirmed that advanced age, being male, noise exposure history, hypertension and hyperglycemia were related to a higher prevalence of HL among middle-aged and older adults.
CONCLUSION
The prevalence of HL among the middle-aged and older population in China is 45%, nearly half of the total population. It is urgent to take great efforts to raise people's awareness of HL prevention and early hearing screening.
Topics: Aged; Female; Middle Aged; Humans; Male; Prevalence; Hearing Loss; Deafness; China; Risk Factors
PubMed: 37439927
DOI: 10.1007/s00405-023-08109-3 -
Otology & Neurotology : Official... Aug 2020Given the heterogeneity of papers about electrocochleography (ECochG) and cochlear implantation (CI) and the absence of a systematic review in the current literature,...
OBJECTIVE
Given the heterogeneity of papers about electrocochleography (ECochG) and cochlear implantation (CI) and the absence of a systematic review in the current literature, the aim of this work was to analyze the uses of ECochG in the different stages of CI.
DATA SOURCES
A search of PubMed from inception to December 8, 2019, with cross-references, was executed. Keywords were: "Cochlear Implant" OR "Cochlear Implantation" AND "Electrocochleography" OR "ECochG." The main eligibility criteria were English-language articles, investigating the use of ECochG in the different phases of CI.
STUDY SELECTION
Literature reviews, editorials, case reports, conference papers were excluded, as were papers in which ECochG was just sporadically executed.
DATA EXTRACTION
The quality of the included studies was assessed using "The Strengthening the Reporting of Observational Studies in Epidemiology" (STROBE) Statement.
DATA SYNTHESIS
A total of 95 articles were identified and 60 papers were included. The included articles covered a timeframe from 2003 to 2019. Of the 60 papers, 46 were human studies, 12 animal studies, and two involved more data sets. Eleven related to the diagnostic phase, 43 described intraoperative monitoring, and 10 were regarding follow-up testing. Hearing preservation was the most discussed topic with 25 included articles.
CONCLUSIONS AND RELEVANCE
ECochG measurements appeared to be useful in many aspects of CI, such as hearing preservation. Our review is the first that shows the evolution of the technique and how much has been achieved from the earliest experiments to the most recent signal process refinements and device implementation in CI.
Topics: Animals; Audiometry, Evoked Response; Cochlea; Cochlear Implantation; Cochlear Implants; Hearing; Humans
PubMed: 32420718
DOI: 10.1097/MAO.0000000000002694