-
JAMA Otolaryngology-- Head & Neck... Jan 2022Sudden sensorineural hearing loss (SSNHL) is an acute, usually unilateral deficit. Systemic and intratympanic steroids are accepted treatments. Although evidence... (Meta-Analysis)
Meta-Analysis
IMPORTANCE
Sudden sensorineural hearing loss (SSNHL) is an acute, usually unilateral deficit. Systemic and intratympanic steroids are accepted treatments. Although evidence suggests that hyperbaric oxygen therapy (HBOT) may be beneficial, it is not widely offered.
OBJECTIVES
To review and evaluate recent evidence of the association of HBOT with hearing outcomes in SSNHL and to determine if HBOT should be a single or part of a combination treatment regimen.
DATA SOURCES
Cochrane Central Register of Controlled Trials, PubMed, EMBASE, CINAHL, Web of Science, CAB, ICTRP, Google Scholar, Clinicaltrials.gov, and ISRCTN databases were searched for randomized controlled trials (RCTs) published in English from January 1, 2000, and April 30, 2020.
STUDY SELECTION
Prospective RCTs involving only adult participants (≥18 years) with SSNHL and comparing HBOT, as a single or combination therapy, with control therapies, such as steroids and/or placebo. Only RCTs that used the American Academy of Otolaryngology-Head and Neck Surgery's diagnostic criteria for SSNHL were included.
DATA EXTRACTION AND SYNTHESIS
Data were extracted independently by 2 researchers. A fixed-effects model was used for analysis and performed from November 30, 2020, to May 20, 2021.
MAIN OUTCOMES AND MEASURES
The mean difference in absolute hearing gain recorded by pure-tone audiometric (PTA) thresholds averaged across 4 low (0.5, 1, 2, and 3 or 4 kHz) or 3 high (3 or 4, 6, and 8 kHz) frequencies was the primary outcome. The secondary outcomes were the odds ratio of hearing recovery defined as a hearing gain of ≥10 decibels (dB) in PTA average and treatment-related adverse effects.
RESULTS
Of the 826 records initially identified, 358 duplicates and 451 articles were excluded based on article type, title, and abstract. The full texts of 17 articles were reviewed, of which 14 were excluded because they were either not prospective RCTs (11 articles), the participants were less than 18 years old (2 articles), or the PTA was not reported at frequencies of interest (1 article). Three prospective RCTs with a total of 88 participants who received HBOT in the intervention groups and 62 participants who received only medical therapy in the control groups were studied. The intergroup difference in mean absolute hearing gain (mean difference, 10.3 dB; 95% CI, 6.5-14.1 dB; I2 = 0%) and the odds ratio of hearing recovery (4.3; 95% CI, 1.6-11.7; I2 = 0%) favored HBOT over the control therapy.
CONCLUSIONS AND RELEVANCE
In this systematic review and meta-analysis, HBOT as part of a combination treatment was significantly associated with improved hearing outcomes in patients with SSNHL over control treatments.
TRIAL REGISTRATION
PROSPERO Identifier: CRD42020193191.
Topics: Audiometry, Pure-Tone; Combined Modality Therapy; Hearing Loss, Sensorineural; Hearing Loss, Sudden; Humans; Hyperbaric Oxygenation; Randomized Controlled Trials as Topic
PubMed: 34709348
DOI: 10.1001/jamaoto.2021.2685 -
Ear, Nose, & Throat Journal Apr 2021Coronavirus disease 2019 (COVID-19) is an infectious respiratory disease caused by the severe acute respiratory syndrome coronavirus 2, brings with it a plethora of...
Coronavirus disease 2019 (COVID-19) is an infectious respiratory disease caused by the severe acute respiratory syndrome coronavirus 2, brings with it a plethora of health concerns. Although most people have mild symptoms, which are respiratory in nature, some experience neurological symptoms, central nervous system manifestations, peripheral nervous manifestations, and skeletal muscle manifestations. But the damaging impact of COVID-19 virus on the hearing organs in the inner ear is a new finding yet to be explored. Currently, there is little evidence published connecting novel coronavirus and tinnitus directly. But according to the American Tinnitus Association, preexisting behavioral conditions make it more likely for patients to experience tinnitus due to the stress and depression associated with social isolation and infection avoidance. Hearing loss and Tinnitus is a common pathology seen in otolaryngology and there are numerous papers in literature describing its associations with other infections. However, this is the first reported case of hearing loss and tinnitus in a COVID-19 patient, in the State of Qatar, and this case report strives to contribute to the ocean of literature highlighting the need for otorhinolaryngologists to be aware of its correlation with COVID-19 virus.
Topics: Acoustic Impedance Tests; Adult; Audiometry, Pure-Tone; Audiometry, Speech; COVID-19; Female; Hair Cells, Auditory, Outer; Hearing Loss, Sensorineural; Humans; Otoacoustic Emissions, Spontaneous; SARS-CoV-2; Speech Perception; Time Factors; Tinnitus
PubMed: 33275033
DOI: 10.1177/0145561320974849 -
International Journal of Environmental... Mar 2021Audiometric booths are used to reduce background noise levels at testing locations to below values specified in the standards. As such, they are considered inherent... (Review)
Review
Audiometric booths are used to reduce background noise levels at testing locations to below values specified in the standards. As such, they are considered inherent parts of the audiometric testing equipment. This paper presents the results from a literature search of solutions that could ensure that background noise levels are acceptable outside booths. The technology used is especially valuable for survey tests and for locations where booths are unavailable or cannot be used for different reasons. However, its use is recommendable for only screening hearing tests but not for clinical or research applications.
Topics: Audiometry, Pure-Tone; Humans; Mass Screening
PubMed: 33802657
DOI: 10.3390/ijerph18063073 -
Journal of Global Health Aug 2022We aimed to investigate the effectiveness of using minimally trained community health workers (CHW) to screen schoolchildren in rural Nicaragua for hearing loss using a... (Review)
Review
BACKGROUND
We aimed to investigate the effectiveness of using minimally trained community health workers (CHW) to screen schoolchildren in rural Nicaragua for hearing loss using a tablet-based audiometric system integrated with asynchronous telehealth evaluations and mobile health (mHealth) appointment reminders.
METHODS
A population-based survey was conducted using community health workers (CHWs) to perform tablet-based audiometry, asynchronous telehealth evaluations, and mHealth reminders to screen 3398 school children (7-9 years of age) in 92 rural Nicaraguan communities. The accuracy of screening, test duration, testing efficiency, telehealth data validity, and compliance with recommended clinic visits were analyzed.
RESULTS
Minimally trained CHWs successfully screened children within remote rural schools with automated audiometry (test duration = 5.8 minutes) followed by manual audiometry if needed (test duration = 4.3 minutes) with an estimated manual audiometry validity of 98.5% based on a review of convergence patterns. For children who were referred based on audiometry, the otoscopy and tympanometry obtained during telehealth evaluations were high quality (as reviewed by 3 experts) in 44.6% and 80.1% of ears, respectively. A combination of automated short message service (SMS) text messages and voice reminders resulted in a follow-up compliance of 75.2%. No families responded to SMS messages alone.
CONCLUSIONS
Tablet-based hearing screening administered by minimally trained CHWs is feasible and effective in low- and middle-income countries. Manual audiometry was as efficient as automated audiometry in this setting. The physical exam tasks of otoscopy and tympanometry require additional training. Mobile phone messages improve compliance for confirmatory audiometry, but the utility of SMS messaging alone is unclear in this population.
Topics: Audiometry; Child; Community Health Workers; Hearing; Humans; Telemedicine; Text Messaging
PubMed: 35938885
DOI: 10.7189/jogh.12.04060 -
Lin Chuang Er Bi Yan Hou Tou Jing Wai... Jul 2020The symptoms of hidden hearing loss(HHL) are concealed, mainly manifested as defects in the threshold upper auditory function, which are related to noise exposure,... (Review)
Review
The symptoms of hidden hearing loss(HHL) are concealed, mainly manifested as defects in the threshold upper auditory function, which are related to noise exposure, aging and drug damage. There is no definite evidence to prove that whether the three factors participate in mechanism of synaptic damage in the cochlea. The clinical audiological characteristics of HHL are mostly as follows: the normal threshold of PTA and the wave response of ABR; the amplitude of the CAP of ABR wave Ⅰ or ECochG is lower at medium and high stimulation intensity; the lower speech recognition rate under noise, etc. Ultra-high frequency pure tone audiometry, a series of objective audiological examinations, such as ABR, ECochG and frequency-following response, speech audiometry under noise, noise exposure questionnaire evaluation were applied to detect HHL at early stage.
Topics: Acoustic Stimulation; Audiometry, Pure-Tone; Auditory Threshold; Evoked Potentials, Auditory, Brain Stem; Hearing Loss, Noise-Induced; Humans; Noise
PubMed: 32791650
DOI: 10.13201/j.issn.2096-7993.2020.07.023 -
Journal of Medical Internet Research Feb 2022Hearing loss affects 1 in 5 people worldwide and is estimated to affect 1 in 4 by 2050. Treatment relies on the accurate diagnosis of hearing loss; however, this first... (Review)
Review
BACKGROUND
Hearing loss affects 1 in 5 people worldwide and is estimated to affect 1 in 4 by 2050. Treatment relies on the accurate diagnosis of hearing loss; however, this first step is out of reach for >80% of those affected. Increasingly automated approaches are being developed for self-administered digital hearing assessments without the direct involvement of professionals.
OBJECTIVE
This study aims to provide an overview of digital approaches in automated and machine learning assessments of hearing using pure-tone audiometry and to focus on the aspects related to accuracy, reliability, and time efficiency. This review is an extension of a 2013 systematic review.
METHODS
A search across the electronic databases of PubMed, IEEE, and Web of Science was conducted to identify relevant reports from the peer-reviewed literature. Key information about each report's scope and details was collected to assess the commonalities among the approaches.
RESULTS
A total of 56 reports from 2012 to June 2021 were included. From this selection, 27 unique automated approaches were identified. Machine learning approaches require fewer trials than conventional threshold-seeking approaches, and personal digital devices make assessments more affordable and accessible. Validity can be enhanced using digital technologies for quality surveillance, including noise monitoring and detecting inconclusive results.
CONCLUSIONS
In the past 10 years, an increasing number of automated approaches have reported similar accuracy, reliability, and time efficiency as manual hearing assessments. New developments, including machine learning approaches, offer features, versatility, and cost-effectiveness beyond manual audiometry. Used within identified limitations, automated assessments using digital devices can support task-shifting, self-care, telehealth, and clinical care pathways.
Topics: Audiometry, Pure-Tone; Hearing; Hearing Loss; Humans; Machine Learning; Reproducibility of Results
PubMed: 34919056
DOI: 10.2196/32581 -
Ear and Hearing 2022Despite a diagnosis of normal hearing, many people experience hearing disability (HD) in their everyday lives. This study assessed the ability of a number of demographic...
OBJECTIVES
Despite a diagnosis of normal hearing, many people experience hearing disability (HD) in their everyday lives. This study assessed the ability of a number of demographic and auditory variables to explain and predict self-reported HD in people regarded as audiologically healthy via audiometric thresholds.
DESIGN
One-hundred eleven adults (ages 19 to 74) with clinically normal hearing (i.e., audiometric thresholds ≤25 dB HL at all octave and interoctave frequencies between 0.25 and 8 kHz and bilaterally symmetric hearing) were asked to complete the 12-item version of the Speech, Spatial, and Qualities of Hearing Scale (SSQ12) as a measure of self-reported HD. Patient history and a number of standard and expanded measures of hearing were assessed in a multivariate regression analysis to predict SSQ12 score. Patient history included age, sex, history of noise exposure, and tinnitus. Hearing-related measures included audiometry at standard and extended high frequencies, word recognition, otoacoustic emissions, auditory brainstem response, the Montreal Cognitive Assessment, and FM detection threshold.
RESULTS
History of impulse noise exposure, speech-intelligibility index, and FM detection threshold accurately predicted SSQ12 and were able to account for 40% of the SSQ12 score. These three measures were also able to predict whether participants self-reported HD with a sensitivity of 89% and specificity of 86%.
CONCLUSIONS
Although participant audiometric thresholds were within normal limits, higher thresholds, history of impulse noise exposure, and FM detection predicted self-reported HD.
Topics: Adult; Aged; Audiometry; Audiometry, Pure-Tone; Auditory Threshold; Hearing; Humans; Middle Aged; Otoacoustic Emissions, Spontaneous; Self Report; Young Adult
PubMed: 34759207
DOI: 10.1097/AUD.0000000000001161 -
International Journal of Environmental... Apr 2021The WHO considers hearing loss to be a major global problem. A literature search was conducted to see whether high-frequency audiometry (HFA) could be used for the early... (Review)
Review
The WHO considers hearing loss to be a major global problem. A literature search was conducted to see whether high-frequency audiometry (HFA) could be used for the early detection of hearing loss. A further aim was to see whether any differences exist in the hearing threshold using conventional audiometry (CA) and HFA in workers of different age groups exposed to workplace noise. Our search of electronic databases yielded a total of 5938 scientific papers. The inclusion criteria were the keywords "high frequency" and "audiometry" appearing anywhere in the article and the participation of unexposed people or a group exposed to workplace noise. Fifteen studies met these conditions; the sample size varied (51-645 people), and the age range of the people studied was 5-90 years. Commercial high-frequency audiometers and high-frequency headphones were used. In populations unexposed to workplace noise, significantly higher thresholds of 14-16 kHz were found. In populations with exposure to workplace noise, significantly higher statistical thresholds were found for the exposed group (EG) compared with the control group (CG) at frequencies of 9-18 kHz, especially at 16 kHz. The studies also showed higher hearing thresholds of 10-16 kHz in respondents aged under 31 years following the use of personal listening devices (PLDs) for longer than 5 years. The effect of noise-induced hearing loss (NIHL) first became apparent for HFA rather than CA. However, normative data have not yet been collected. Therefore, it is necessary to establish a uniform evaluation protocol accounting for age, sex, comorbidities and exposures, as well as for younger respondents using PLDs.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Audiometry; Child; Child, Preschool; Deafness; Hearing; Hearing Loss, Noise-Induced; Humans; Middle Aged; Noise; Noise, Occupational; Young Adult
PubMed: 33925120
DOI: 10.3390/ijerph18094702 -
Journal of the American Academy of... Jan 2022Up to 80% of audiograms could be automated which would allow more time for provision of specialty services. Ideally, automated audiometers would provide accurate results...
BACKGROUND
Up to 80% of audiograms could be automated which would allow more time for provision of specialty services. Ideally, automated audiometers would provide accurate results for listeners with impaired hearing as well as normal hearing. Additionally, accurate results should be provided both in controlled environments like a sound-attenuating room but also in test environments that may support greater application when sound-attenuating rooms are unavailable. Otokiosk is an iOS-based system that has been available for clinical use, but there are not yet any published validation studies using this product.
PURPOSE
The purpose of this project was to complete a validation study on the OtoKiosk automated audiometry system in quiet and in low-level noise, for listeners with normal hearing and for listeners with impaired hearing.
RESEARCH DESIGN
Pure tone air conduction thresholds were obtained for each participant for three randomized conditions: standard audiometry, automated testing in quiet, and automated testing in noise. Noise, when present, was 35 dBA overall and was designed to emulate an empty medical exam room.
STUDY SAMPLE
Participants consisted of 11 adults with hearing loss and 15 adults with normal hearing recruited from the local area.
DATA COLLECTION AND ANALYSIS
Thresholds were measured at 500, 1,000, 2,000, and 4,000 Hz using the Otokiosk system that incorporates a modified Hughson-Westlake method. Results were analyzed using descriptive statistics and also by a linear mixed-effects model to compare thresholds obtained in each condition.
RESULTS
Across condition and participant group 73.6% of thresholds measured with OtoKiosk were within ± 5 dB of the conventionally measured thresholds; 92.8% were within ± 10 dB. On average, differences between tests were small. Pairwise comparisons revealed thresholds were ∼3.5-4 dB better with conventional audiometry than with the mobile application in quiet and in noise. Noise did not affect thresholds measured with OtoKiosk.
CONCLUSIONS
The OtoKiosk automated hearing test measured pure tone air conduction thresholds from 500 to 4,000 Hz at slightly higher thresholds than conventional audiometry, but less than the smallest typical 5 dB clinical step-size. Our results suggest OtoKiosk is a reasonable solution for sound booths and exam rooms with low-level background noise.
Topics: Adult; Audiometry; Audiometry, Pure-Tone; Auditory Threshold; Hearing; Hearing Loss; Humans; Noise
PubMed: 34034339
DOI: 10.1055/s-0041-1728778 -
PloS One 2023To evaluate two user-operated audiometry methods, the AMTASTM PC-based audiometry and a low-cost smartphone audiometry research application (R-App).
OBJECTIVE
To evaluate two user-operated audiometry methods, the AMTASTM PC-based audiometry and a low-cost smartphone audiometry research application (R-App).
DESIGN
A repeated-measures within-subject study design was used to compare both user-operated methods to traditional manual audiometry and to evaluate test-retest reliability of each method.
STUDY SAMPLE
58 subjects were recruited in the study of which 83 ears had normal hearing thresholds and 33 ears had hearing loss (pure-tone average > 25 dB HL). Average age of participants was 44.8 years, with an age range of 11-85.
RESULTS
Standard deviation of absolute differences ranged between 3.9-6.9 dB on AMTASTM and 4.5-6.8 dB on the R-App. The highest variability was found at the 8000 Hz frequency (R-App and AMTASTM test) and 3000 Hz frequency (AMTASTM retest). Evaluation of test-retest reliability of AMTASTM and R-App showed SD of absolute differences ranging between 3.5-5.8 dB and 3.1-5.0 dB, respectively. The mean threshold difference between test and retest was within ±1.5 dB on AMTASTM and ±1 dB on the R-App.
CONCLUSION
Accuracy of AMTASTM and the R-App was within acceptable limits for audiometry and comparable to traditional manual audiometry on all tested frequencies (250-8000 Hz). Evaluation of test-retest reliability showed acceptable variation on both AMTASTM and R-App. Both user-operated methods could be reliably performed in a quiet non-soundproofed environment.
Topics: Adult; Humans; Audiometry; Deafness; Mobile Applications; Reproducibility of Results; Smartphone; Child; Adolescent; Young Adult; Middle Aged; Aged; Aged, 80 and over
PubMed: 37708125
DOI: 10.1371/journal.pone.0291412