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International Journal of Audiology Sep 2019Determine whether a combination of electrocochleography determined summating/action potential (SP/AP) ratio and other audiological measurements has greater sensitivity... (Meta-Analysis)
Meta-Analysis
Determine whether a combination of electrocochleography determined summating/action potential (SP/AP) ratio and other audiological measurements has greater sensitivity and specificity than that achieved with electrocochleography SP/AP ratio alone in diagnosing definite Ménière's Disease. Systematic review and meta-analysis. Pubmed, Cochrane Library, and Web of Science were searched using search terms "electrocochleography", "ECochG, ,"ECoG", "Ménière's Disease", and "Idiopathic Endolymphatic Hydrops". Inclusion criteria were extratympanic electrocochleography methodology, English language publication between January 2002 and December 2017, and the 1995 American Academy of Otolaryngology and Head and Neck Surgery Ménière's disease diagnostic criteria. Five articles satisfied inclusion criteria and were sufficiently detailed for aggregate quantitative analysis of SP/AP ratio (315 subjects) and combination audiological measures (113 subjects). The diagnostic sensitivity and specificity of the SP/AP amplitude ratio was 47.6% and 83.8% and of combination diagnostic measures 63.5% and 89.3%, respectively. Point estimates of sensitivity ( = 0.248) and specificity ( = 0.969) and the summary Receiver Operator Characteristic Curve ( = 0.407) were not statistically significant. Statistically, combination diagnostic measures do not result in greater accuracy of definite Ménière's disease diagnosis compared to the SP/AP amplitude ratio alone. However, given the small sample size further studies are recommended to arrive at a definitive conclusion.
Topics: Audiometry, Evoked Response; Cross-Sectional Studies; Ear, Middle; Humans; Meniere Disease; Prospective Studies; ROC Curve; Retrospective Studies; Sensitivity and Specificity
PubMed: 31066337
DOI: 10.1080/14992027.2019.1606947 -
Frontiers in Psychology 2021An association between age-related hearing loss (ARHL) and Alzheimer's Disease (AD) has been widely reported. However, the nature of this relationship remains poorly...
An association between age-related hearing loss (ARHL) and Alzheimer's Disease (AD) has been widely reported. However, the nature of this relationship remains poorly understood. Quantification of hearing loss as it relates to AD is imperative for the creation of reliable, hearing-related biomarkers for earlier diagnosis and development of ARHL treatments that may slow the progression of AD. Previous studies that have measured the association between peripheral hearing function and AD have yielded mixed results. Most of these studies have been small and underpowered to reveal an association. Therefore, in the current report, we sought to estimate the degree to which AD patients have impaired hearing by performing a meta-analysis to increase statistical power. We reviewed 248 published studies that quantified peripheral hearing function using pure-tone audiometry for subjects with AD. Six studies, with a combined total of 171 subjects with AD compared to 222 age-matched controls, met inclusion criteria. We found a statistically significant increase in hearing threshold as measured by pure tone audiometry for subjects with AD compared to controls. For a three-frequency pure tone average calculated for air conduction thresholds at 500-1,000-2,000 Hz (0.5-2 kHz PTA), an increase of 2.3 decibel hearing level (dB HL) was found in subjects with AD compared to controls ( = 0.001). Likewise, for a four-frequency pure tone average calculated at 500-1,000-2,000-4,000 (0.5-4 kHz PTA), an increase of 4.5 dB HL was measured ( = 0.002), and this increase was significantly greater than that seen for 0.5-2 kHz PTA. There was no difference in the average age of the control and AD subjects. These data confirm the presence of poorer hearing ability in AD subjects, provided a quantitative estimate of the magnitude of hearing loss, and suggest that the magnitude of the effect is greater at higher sound frequencies. https://www.crd.york.ac.uk/prospero/, identifier: CRD42021288280.
PubMed: 35153910
DOI: 10.3389/fpsyg.2021.788045 -
The Laryngoscope Jul 2017To establish the relationship between the presence of type 1 diabetes mellitus (DM) and auditory dysfunction in clinical settings by a systematic review and... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To establish the relationship between the presence of type 1 diabetes mellitus (DM) and auditory dysfunction in clinical settings by a systematic review and meta-analysis of currently available published data.
DATA SOURCES AND REVIEW METHODS
The electronic databases PubMed, Embase, and Wanfang Data were searched for eligible relevant studies up to May 2016, and the reference lists of the retrieved articles were used for additional manual search. All the articles included in this pooled analysis were determined according to the preset inclusion and exclusion criteria. Meta-analysis of pooled data was performed using Review Manager 5.3.
RESULTS
A total of 15 studies were included for further combined analysis. The results showed that patients with type 1 diabetes had a significantly higher prevalence of hearing loss than controls (odds ratio = 49.08, 95% confidence interval = 12.03-200.31, P < 0.00001); standardized mean of differences (SMD) of pure tone audiometry at 4,000 Hz between diabetes and controls was 0.87 (Z = 2.22, P = 0.03, I = 95%); SMD of the latency time was 0.54 (Z = 2.69, P = 0.007, I = 78%) for waves III and 0.61 (Z = 2.38, P = 0.02, I = 86%) for wave V, respectively; and SMD of the interpeak latency time was 0.41 (Z = 2.84, P = 0.005, I = 39%) for waves I to III and 0.61 (Z = 2.67, P = 0.008, I = 81%) for waves I to V, respectively, between diabetics and controls.
CONCLUSION
Our study reveals that there is relationship between the presence of type 1 DM and an increased risk for developing mild and subclinical hearing impairment.
LEVEL OF EVIDENCE
NA. Laryngoscope, 127:1689-1697, 2017.
Topics: Adolescent; Adult; Comorbidity; Cross-Sectional Studies; Diabetes Complications; Diabetes Mellitus, Type 1; Female; Hearing Loss; Humans; Male; Middle Aged; Risk Factors; Young Adult
PubMed: 27714821
DOI: 10.1002/lary.26346 -
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 -
Journal of Audiology & Otology Jan 2022Although the digit-in-noise (DIN) test is simple and quick, little is known about its key factors. This study explored the considerable components of the DIN test...
BACKGROUND AND OBJECTIVES
Although the digit-in-noise (DIN) test is simple and quick, little is known about its key factors. This study explored the considerable components of the DIN test through a systematic review and meta-analysis.
MATERIALS AND METHODS
After six electronic journal databases were screened, 14 studies were selected. For the meta-analysis, standardized mean difference was used to calculate effect sizes and 95% confidence intervals.
RESULTS
The overall result of the meta-analysis showed an effect size of 2.224. In a subgroup analysis, the patient's hearing status was found to have the highest effect size, meaning that the DIN test was significantly sensitive to screen for hearing loss. In terms of the length of the presenting digits, triple digits had lower speech recognition thresholds (SRTs) than single or pairs of digits. Among the types of background noise, speech-spectrum noise provided lower SRTs than multi-talker babbling. Regarding language variance, the DIN test showed better performance in the patient's native language(s) than in other languages.
CONCLUSIONS
When uniformly developed and well validated, the DIN test can be a universal tool for hearing screening.
PubMed: 34775699
DOI: 10.7874/jao.2021.00416 -
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 -
Otolaryngology--head and Neck Surgery :... Jun 2014To evaluate whether absence of hearing loss on pure-tone audiometry (PTA) is reliable as a diagnostic test for predicting benign paroxysmal positional vertigo (BPPV) in... (Review)
Review
OBJECTIVE
To evaluate whether absence of hearing loss on pure-tone audiometry (PTA) is reliable as a diagnostic test for predicting benign paroxysmal positional vertigo (BPPV) in adult patients with vertigo.
DATA SOURCES
PubMed, Embase, and the Cochrane Library.
METHODS
A systematic literature search was conducted on December 10, 2013. Relevant publications were selected based on title, abstract, and full text. Selected articles were assessed for relevance and risk of bias using predetermined criteria. Prevalence and the positive and negative predictive value (PPV and NPV) were extracted.
RESULTS
Of 603 retrieved publications, 1 article with high relevance and moderate risk of bias was included. In this study, the prevalence of BPPV was 28%. The PPV of hearing loss assessed by PTA was 31% (95% CI, 17-49) and the NPV was 73% (95% CI, 61-83). The absence of hearing loss on PTA decreased the risk of BPPV by 1%.
CONCLUSION AND RECOMMENDATION
There is insufficient high-quality evidence regarding the diagnostic value of the absence of hearing loss, assessed by PTA, for predicting BPPV in adult patients with vertigo.
Topics: Audiometry, Pure-Tone; Benign Paroxysmal Positional Vertigo; Hearing Loss; Humans; Predictive Value of Tests; Reproducibility of Results
PubMed: 24642523
DOI: 10.1177/0194599814527233 -
International Journal of Pediatric... Oct 2015Mometasone has been reported to improve the symptoms of nasal obstruction in children with adenoidal hypertrophy. This systematic review and meta-analysis were conducted... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
Mometasone has been reported to improve the symptoms of nasal obstruction in children with adenoidal hypertrophy. This systematic review and meta-analysis were conducted to evaluate the role of mometasone on different nasal symptoms, otitis media with effusion, adenoid size, and quality of life in children with adenoidal hypertrophy.
METHODS
A comprehensive search of MEDLINE, EMBASE, CINAHL and COCHRANE Collaboration databases was undertaken. We identified all the randomized controlled trials (RCTs) in children with adenoidal hypertrophy that compared the effects of mometasone nasal spray and normal saline nasal spray on different outcomes. The deadline of the search was April 2015. The search was supplemented by hand searching of cross-references in the studies and reviews and by contacting the authors of various studies. Only English language RCTs were considered for the systematic review. The primary outcomes were improvement in symptoms of nasal obstruction, mouth breathing, rhinorrhea, snoring, cough, and total nasal symptoms. The secondary outcomes were improvement in otitis media with effusion, quality of life, and size of adenoid. Quality assessment of RCTs was performed using SIGN 50 and Cochrane risk of bias tools. Risk ratio (RR), weighted mean differences (WMD) and their 95% confidence intervals (CI) were calculated for dichotomous and continuous data, respectively. Random effects model was used for the analyses. Heterogeneity was measured by using the I(2) statistics and p value <0.05.
RESULTS
Our search generated 87 citations, of which eight RCTs met the inclusion criteria. The methodological quality of all the RCTs was poor. There was no significant difference between mometasone and control groups for the patient's characteristic and grades of different nasal symptoms, otitis media with effusion, obstructive sleep apnea, and quality of life at the basal level. There was also no significant difference in the number of patients with different symptoms at the basal level. After the administration of mometasone, there were significant improvements in grades of nasal obstruction, 0.8±0.5 versus 2.0±0.6, WMD -1.16 [-2.09, -0.23], snoring 0.3±0.4 versus 1.6±0.6, WMD -1.07 [-2.09, -0.05], total nasal symptoms 2.9±1.3 versus 6.9±1.5, WMD -4.09 [-6.64, -1.53], obstructive sleep apnea, 0.6±0.3 versus 1.4±0.4, WMD -0.95 [-1.74, -0.16], as well as the percentage of patients with nasal obstruction, snoring, obstructive sleep apnea, compared to control. There was tendency of improvement in rhinorrhea, and cough with mometasone. Compared to control, mometasone nasal spray significantly improved adenoid size or adenoid/choana ratio 50.9±8.8 versus 74.2±12.6, WMD -21.2 [-34.0, -8.4], change in adenoid/choana obstruction from the basal level (p=0.01), and percentage of patients with adenoid hypertrophy, 26% versus 92%, RR 0.29 [0.18, 0.48]. There was improvement in otitis media with effusion, 40% versus 72%, pure tone audiometry 5.2±11 versus 11.6±11dB, WMD -6.40dB [-12.65, -0.15], and quality of life with mometasone. Subgroup analyses showed that RCTs that followed blinding showed significantly less response compared to RCTs that did not follow it for most of the outcomes.
CONCLUSIONS
Mometasone caused improvements in outcomes of nasal obstruction, snoring, total nasal symptoms, pure tune audiometry, otitis media with effusion, adenoid size, and quality of life. The data is based on meta-analysis of RCTs of poor methodological quality. A high methodological quality, placebo controlled RCT of different doses and duration of administration of mometasone is required to evaluate its clear efficacy and safety in children with adenoid hypertrophy.
Topics: Adenoids; Anti-Inflammatory Agents; Child; Child, Preschool; Humans; Hypertrophy; Mometasone Furoate; Nasal Obstruction; Quality of Life; Treatment Outcome
PubMed: 26235732
DOI: 10.1016/j.ijporl.2015.07.009 -
Ear and HearingCurrent evidence supports the growing application of extended high-frequency (EHF: 9 to 20 kHz) audiometry in hearing research, which likely results from the high... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
Current evidence supports the growing application of extended high-frequency (EHF: 9 to 20 kHz) audiometry in hearing research, which likely results from the high vulnerability of this frequency region to damage induced by known auditory risk factors. The present systematic review and meta-analysis were performed to investigate whether adults with a normal audiogram and tinnitus show increased EHF hearing thresholds relative to control peers.
DESIGN
A comprehensive search was undertaken on electronic databases consisting of PubMed, ScienceDirect, Wiley, and Google Scholar using combined keywords: "tinnitus," "extended high frequency," "normal audiogram," and "hidden hearing loss."
RESULTS
From 261 articles found by searching databases, nine studies met the inclusion criteria for the meta-analysis. A significant difference was observed between tinnitus and control groups in the effect size analysis of hearing thresholds at 10, 12.5, 14, 16, and 18 kHz ( p ≤ 0.001), and the I-square heterogeneity analysis was below 50% in all studies ( p ≥ 0.131). Visual inspection by the Funnel plot and Egger's regression test ( p ≥ 0.211) also exhibited no publication bias in the meta-analyses.
CONCLUSIONS
Our findings are in support of the idea that in most cases, tinnitus is associated with some degree of cochlear mechanical dysfunction, which may not be detected by conventional audiometry alone. This finding underscores the significance of EHF audiometry in clinical practice, which may help both early identification of individuals susceptible to developing tinnitus and reduce the number of new cases through preventive counseling programs.
Topics: Adult; Humans; Tinnitus; Auditory Threshold; Hearing; Audiometry; Hearing Loss; Audiometry, Pure-Tone
PubMed: 35612517
DOI: 10.1097/AUD.0000000000001229 -
The Laryngoscope Aug 2021Meniere's disease (MD) is a debilitating condition characterized by hearing loss, vertigo, and tinnitus. The objective of this study was to systematically investigate... (Meta-Analysis)
Meta-Analysis
OBJECTIVES/HYPOTHESIS
Meniere's disease (MD) is a debilitating condition characterized by hearing loss, vertigo, and tinnitus. The objective of this study was to systematically investigate outcomes in MD after cochlear implantation (CoI), with and without labyrinthectomy.
STUDY DESIGN
Systematic review and meta-analysis.
METHODS
A systematic review of articles in Medline and Embase was performed to identify all studies of patients with MD who underwent CoI. This analysis evaluates outcomes of speech recognition, pure tone audiometry, vertigo, tinnitus, and quality of life.
RESULTS
Of 321 studies identified, 37 were included, involving 216 patients. Mean age at implantation was 61.4 years (range 27-85 years) with average length of follow-up at 1.7 years (range 0-9 years). Forty-four (20.4%) patients underwent labyrinthectomy. Meta-analysis demonstrated significant improvements in audiometric outcomes following CoI. There was a statistically significant improvement in Hearing in Noise Test performance, with a mean difference improvement of 44.7 (95% confidence interval [CI] [8.8, 80.6]) at 6 months and 60.1 (95% CI [35.3, 85.0]) at 12 months. The Freiburger Monosyllabic Test (FMT) and Consonant-Nucleus-Consonant (CNC) also improved significantly, with mean difference improvements of 46.2 (95% CI [30.0, 62.4]) for FMT and 19.3 (95% CI [8.1, 30.4]) for CNC. There was a statistically significant decrease in tinnitus, as measured by a mean difference reduction of 48.1 (95% CI [1.0, 95.2]) in the Tinnitus Handicap Index.
CONCLUSIONS
CoI with and without simultaneous labyrinthectomy is a viable treatment option for patients with MD, yielding high rates of tinnitus suppression and vertigo control. Post-CoI MD patients demonstrate similar postoperative speech perception outcomes to non-MD implant recipients. Laryngoscope, 131:1845-1854, 2021.
Topics: Aged; Aged, 80 and over; Cochlear Implantation; Ear, Inner; Female; Humans; Male; Meniere Disease; Middle Aged; Postoperative Period; Speech Perception; Tinnitus; Treatment Outcome; Vertigo
PubMed: 33464598
DOI: 10.1002/lary.29393