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Otology & Neurotology : Official... Sep 2023To compare audiometric outcomes, complications, and revisions required for implantable bone-conduction devices (BCDs) versus atresia surgery for the treatment of hearing... (Meta-Analysis)
Meta-Analysis
Comparison of Outcomes of Surgery Versus Implantable Device for the Treatment of Hearing Loss Associated With Congenital Aural Atresia: A Systematic Review and Meta-Analysis.
OBJECTIVE
To compare audiometric outcomes, complications, and revisions required for implantable bone-conduction devices (BCDs) versus atresia surgery for the treatment of hearing loss associated with congenital aural atresia.
DATABASES REVIEWED
PubMed, Scopus, CINAHL.
METHODS
Databases were searched for English articles from inception to July 1, 2022, for studies reporting audiometric outcomes or complications for either BCDs or atresia surgery for the treatment of congenital aural atresia. Main outcome measures included pure-tone audiometry, air-bone gap, speech reception threshold, associated complications, and rates of revision for each treatment option.
RESULTS
We identified 973 abstracts, of which 89 were selected for data extraction and analysis. A total of 2,611 patients were included, 1,901 in the atresia surgery group and 710 in the BCDs group. A meta-analysis of single means was conducted for age and audiometric outcomes, and a meta-analysis of proportions was conducted for complications and revisions. The average short-term improvement in pure-tone audiometry for the BCDs group was 34.4 ± 1.6 dB compared with 22.4 ± 1.5 dB for the atresia surgery group, representing a significant difference (12.0 dB; 95% confidence interval, 11.9-12.2; p < 0.0001). A smaller proportion of complications were reported in the devices group (16.9%) compared with the atresia surgery group (45.7%). In addition, a smaller proportion of cases in the devices group required some degree of revision (17.8%) compared with the atresia surgery group (23.0%).
CONCLUSIONS
This study demonstrates that implantable BCDs have significantly better audiometric outcomes as well as a lower rate of complications and revisions required compared with atresia surgery.
Topics: Humans; Treatment Outcome; Hearing Loss; Deafness; Audiometry, Pure-Tone; Ossicular Prosthesis; Hearing Loss, Conductive; Retrospective Studies; Bone Conduction
PubMed: 37464461
DOI: 10.1097/MAO.0000000000003950 -
International Journal of Environmental... Sep 2017: Hearing loss is defined as worsening of hearing acuity and is usually expressed as an increase in the hearing threshold. Tinnitus, defined as "ringing in the ear", is... (Review)
Review
: Hearing loss is defined as worsening of hearing acuity and is usually expressed as an increase in the hearing threshold. Tinnitus, defined as "ringing in the ear", is a common and often disturbing accompaniment of hearing loss. Hearing loss and environmental exposures to noise are increasingly recognized health problems. : The objective was to assess whether the exposure-response relationship can be established between exposures to non-occupational noise and permanent hearing outcomes such as permanent hearing loss and tinnitus. : Computer searches of all accessible medical and other databases (PubMed, Web of Science, Scopus) were performed and complemented with manual searches. The search was not limited to a particular time span, except for the effects of personal listening devices (PLDs). The latter was limited to the years 2008-June 2015, since previous knowledge was summarized by SCENIHR descriptive systematic review published in 2008. The inclusion criteria were as follows: the exposure to noise was measured in sound pressure levels (SPLs) and expressed in individual equivalent decibel values (L), the studies included both exposed and reference groups, the outcome was a permanent health effect, i.e., permanent hearing loss assessed with pure-tone audiometry and/or permanent tinnitus assessed with a questionnaire. The eligibility criteria were evaluated by two independent reviewers. The risk of bias was assessed for all of the papers using a template for assessment of quality and the risk of bias. The GRADE (grading of recommendations assessment, development, and evaluation) approach was used to assess the overall quality of evidence. Meta-analysis was not possible due to methodological heterogeneity of included studies and the inadequacy of data. Out of 220 references identified, five studies fulfilled the inclusion criteria. All of them were related to the use of PLDs and comprised in total of 1551 teenagers and young adults. Three studies used hearing loss as the outcome and three tinnitus. There was a positive correlation between noise level and hearing loss either at standard or extended high frequencies in all three of the studies on hearing loss. In one study, there was also a positive correlation between the duration of PLD use and hearing loss. There was no association between prolonged listening to loud music through PLDs and tinnitus or the results were contradictory. All of the evidence was of low quality. The studies are cross-sectional. No study provides odds ratios of hearing loss by the level of exposure to noise. While using very strict inclusion criteria, there is low quality GRADE evidence that prolonged listening to loud music through PLDs increases the risk of hearing loss and results in worsening standard frequency audiometric thresholds. However, specific threshold analyses focused on stratifying risk according to clearly defined levels of exposure are missing. Future studies are needed to provide actionable guidance for PLDs users. No studies fulfilling the inclusion criteria related to other isolated or combined exposures to environmental noise were identified.
Topics: Hearing Loss, Noise-Induced; Humans; Noise; Tinnitus; World Health Organization
PubMed: 28953238
DOI: 10.3390/ijerph14101139 -
Brazilian Journal of Otorhinolaryngology 2005Despite its high prevalence in the aged, hearing loss has been poorly investigated. Audiometry is the gold standard for evaluation of hearing loss, but large-scale use... (Comparative Study)
Comparative Study Meta-Analysis Review
UNLABELLED
Despite its high prevalence in the aged, hearing loss has been poorly investigated. Audiometry is the gold standard for evaluation of hearing loss, but large-scale use of the procedure involves operational difficulties. Thus, self-report may be an alternative.
AIM
To determine if a single global question is valid for use in epidemiologic research.
STUDY DESIGN
Systematic review.
MATERIAL AND METHOD
A search of the medical literature from 1990 to 2004 was performed using MEDLINE and LILACS. The references of the articles identified in the electronic search were also reviewed.
STUDY SELECTION AND DATA EXTRACTION
The articles that compared the results obtained with self-report to a single global question with those obtained by pure tone audiometry were selected. Data about the prevalence of hearing loss, and sensitivity, specificity and predictive values were extracted.
DATA SYNTHESIS
Ten longitudinal studies were included. A single global question seems to be an acceptable indicator of hearing loss, sensitive and reasonably specific, mainly if the hearing loss is identified as the tone average that includes frequencies up to 2 or 4 kHz, at 40 dBHL level, in the best ear.
CONCLUSION
A single global question shows good performance in identifying older persons with hearing loss and can be recommended for an epidemiologic study if audiometric measurements cannot be performed.
Topics: Aged; Aged, 80 and over; Audiometry, Pure-Tone; Female; Hearing Loss; Humans; Male; Mass Screening; Middle Aged; Prevalence; Surveys and Questionnaires
PubMed: 16446917
DOI: 10.1016/s1808-8694(15)31310-0 -
Laryngoscope Investigative... Aug 2023This systematic review aims to establish the expected hearing and speech outcomes following cochlear implantation (CI) in patients with profound congenital deafness... (Review)
Review
OBJECTIVE
This systematic review aims to establish the expected hearing and speech outcomes following cochlear implantation (CI) in patients with profound congenital deafness secondary to Waardenburg syndrome (WS).
METHODS
A systematic review of the literature and narrative synthesis was performed in accordance with the PRISMA statement. Databases searched: Medline, Pubmed, Embase, Web of Science, Cochrane Collection, and ClinicalTrials.gov. No limits were placed on language or year of publication.
RESULTS
Searches identified 186 abstracts and full texts. Of these, 16 studies met inclusion criteria reporting outcomes in 179 patients and at least 194 implants. Hearing outcomes of those receiving cochlear implantation were generally good. Five studies included genetic analysis of one or more of the participants. A total of 11 peri/post-operative complications were reported. The methodological quality of included studies was modest, mainly comprising noncontrolled case series with small cohort size. All studies were OCEBM grade III-IV.
CONCLUSION
Cochlear implantation in congenitally deafened children with Waardenburg Syndrome is a well-established intervention as a method of auditory rehabilitation. Due to the uncommon nature of the condition, there is a lack of large-scale high-quality studies examining the use of cochlear implantation in this patient group. However, overall outcomes following implantation are positive with the majority of patients demonstrating improved audiometry, speech perception and speech intelligibility supporting its use in appropriately selected cases.
PubMed: 37621295
DOI: 10.1002/lio2.1110 -
Journal of Personalized Medicine Nov 2023Profound sensorineural hearing loss (SNHL) can be successfully treated with a cochlear implant (CI), and treatment is usually accompanied by increased quality of life... (Review)
Review
Profound sensorineural hearing loss (SNHL) can be successfully treated with a cochlear implant (CI), and treatment is usually accompanied by increased quality of life (QoL). Therefore, the aim of this study was to investigate generic and health-related QoL, as well as the level of audiological outcomes, of CI users, in addition to whether Qol can be restored to the extent of those with normal hearing. Furthermore, different implantation timepoints were compared (early vs. late), and a possible correlation between health and generic QoL questionnaires was investigated. The outcomes from 93 pediatric CI users from Romania were analyzed in the study. Two QoL questionnaires (SSQ12, AQoL-6D), as well as the HSM sentence test and Soundfield measurements, were assessed. The outcomes revealed that the CI users were able to achieve the same QoL as their age- and-gender matched peers with normal hearing, and hearing was restored with good speech comprehension. No significant difference between early- and late-implanted children was detected, although a tendency of a better Word Recognition Score (+10%) in the early-implanted group was discovered. A moderate and significant correlation between the generic and health-related Qol questionnaire was observed. Audiological examinations are still the standard practice by which to measure the benefit of any hearing intervention; nonetheless, generic and health-related QoL should be assessed in order to provide a full picture of a successful and patient-satisfactory cochlear implant procedure.
PubMed: 38003925
DOI: 10.3390/jpm13111610 -
International Journal of Pediatric... May 2009The Joint Committee on Infant Hearing 2007 Position Statement includes in utero toxoplasmosis infection as a risk indicator for delayed-onset or progressive... (Review)
Review
INTRODUCTION
The Joint Committee on Infant Hearing 2007 Position Statement includes in utero toxoplasmosis infection as a risk indicator for delayed-onset or progressive sensorineural hearing loss. It is recommended that children with congenital toxoplasmosis infection undergo audiologic monitoring to identify congenital and delayed-onset sensorineural hearing loss.
OBJECTIVE
To determine the prevalence of sensorineural hearing loss and to develop evidence-based guidelines for audiologic monitoring of children born with congenital toxoplasmosis infection.
DATA SOURCES
Systematic search of Medline, EMBASE and Cochrane databases and manual search of references.
STUDY SELECTION
Longitudinal studies reporting an inception cohort identified at birth, with serologic confirmation of toxoplasmosis infection, and long-term serial audiometric evaluation.
DATA EXTRACTION
Independent extraction of patient and audiometric data.
DATA SYNTHESIS
Descriptive statistics.
CONCLUSION
The five studies meeting our inclusion criteria report a prevalence of toxoplasmosis-associated hearing loss from 0% to 26%. Improved treatment regimens for toxoplasmosis may account for this range. Three treatment groups were identified and a subgroup analysis of the compiled data was performed. In children receiving limited or no treatment, the prevalence of toxoplasmosis-associated SNHL was found to be 28%. In children prescribed 12 months of antiparasitic treatment but in whom treatment was not confirmed to have started prior to 2.5 months of age and in whom compliance was not ensured, the prevalence of SNHL was 12%. In children treated with 12 months of antiparasitical therapy initiated prior to 2.5 months of age with serologically-confirmed compliance, the prevalence of SNHL was 0%. Only two longitudinal studies were identified and neither reported any cases of delayed-onset or progressive toxoplasmosis-associated SNHL. Children who have received a 12-month course of antiparasitical therapy initiated prior to 2.5 months with serologically-confirmed compliance should have repeat audiometric evaluation at 24-30 months of age. Children with congenital toxoplasmosis that had no treatment, partial treatment, delayed onset of treatment, or compliance issues should undergo annual audiologic monitoring until able to reliably self-report hearing loss.
Topics: Antiparasitic Agents; Audiometry, Pure-Tone; Hearing Loss, Sensorineural; Humans; Infant, Newborn; Neonatal Screening; Prevalence; Severity of Illness Index; Toxoplasmosis
PubMed: 19215990
DOI: 10.1016/j.ijporl.2009.01.012 -
European Archives of... May 2019The Pro51Ser (P51S) COCH mutation is characterized by a late-onset bilateral sensorineural hearing loss (SNHL) and progressive vestibular deterioration. The aim of this...
BACKGROUND AND OBJECTIVES
The Pro51Ser (P51S) COCH mutation is characterized by a late-onset bilateral sensorineural hearing loss (SNHL) and progressive vestibular deterioration. The aim of this study was to carry out a systematic review of all reported hearing and vestibular function data in P51S COCH mutation carriers and its correlation with age.
MATERIALS AND METHODS
Scientific databases including Medline, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, ISI Web of Knowledge, and Web of Science were searched to accumulate information about hearing outcome and vestibular function. Eleven genotype-phenotype correlation studies of the P51S COCH variant were identified and analyzed.
RESULTS
The SNHL starts at the age of 32.8 years. The Annual Threshold Deterioration is 3 decibel hearing loss (dB HL) per year (1-24 dB HL/year). Profound SNHL was observed at 76 years on average (60-84 years). 136 individual vestibular measurements were collected from 86 carriers. The onset of the vestibular dysfunction was estimated around 34 years (34-40 years), and vestibular deterioration rates were higher than those of the SNHL, with complete bilateral loss observed between 49 and 60 years.
CONCLUSION
Both audiometric and vestibular data were processed with much different methodologies and pre-symptomatic P51S carriers were systematically underrepresented. Further delineation of this correlation would benefit cross-sectional and longitudinal study involving all (pre-symptomatic and symptomatic) P51S carriers.
Topics: Adult; Age Factors; Aged; Aged, 80 and over; Audiometry; Extracellular Matrix Proteins; Female; Hearing; Hearing Loss, Sensorineural; Heterozygote; Humans; Male; Middle Aged; Mutation; Vestibule, Labyrinth
PubMed: 30806805
DOI: 10.1007/s00405-019-05322-x -
Archives of Disease in Childhood Jan 2022The literature on melatonin as a sedative agent in children is limited. (Meta-Analysis)
Meta-Analysis
CONTEXT
The literature on melatonin as a sedative agent in children is limited.
OBJECTIVE
To conduct a systematic review of studies assessing the efficacy and safety of melatonin for non-operating room sedation in children.
METHODS
Medline, Embase, Cochrane Library and Cumulative Index to Nursing and Allied Health were searched until 9 April 2020 for studies using melatonin and reporting one of the prespecified outcomes of this review. Two authors independently assessed the eligibility, risk of bias and extracted the data. Studies with a similar study design, comparator and procedure were pooled using the fixed-effect model.
RESULTS
25 studies (clinical trials=3, observational studies=9, descriptive studies=13) were included. Melatonin was used for electroencephalogram (EEG) (n=12), brainstem evoked response audiometry (n=8) and magnetic resonance imaging (MRI) (n=5). No significant differences were noted on meta-analysis of EEG studies comparing melatonin with sleep deprivation (SD) (relative risk (RR) 1.06 (95% CI 0.99 to 1.12)), melatonin with chloral hydrate (RR 0.97 (95% CI 0.89 to 1.05)) and melatonin alone with melatonin and SD combined (RR 1.03 (95% CI 0.97 to 1.10)) for successful procedure completion. However, significantly higher sedation failure was noted in melatonin alone compared with melatonin and SD combined (RR 1.55 (95% CI 1.02 to 2.33)) for EEG. Additionally, meta-analysis showed lower sleep latency for melatonin compared with SD (mean difference -10.21 (95% CI -11.53 to -8.89) for EEG. No major adverse events were reported with melatonin.
CONCLUSION
Although several studies were identified, and no serious safety concerns were noted, the evidence was not of high quality to establish melatonin's efficacy for non-operating room sedation in children.
Topics: Adolescent; Audiometry, Evoked Response; Child; Child, Preschool; Chloral Hydrate; Electroencephalography; Humans; Hypnotics and Sedatives; Infant; Infant, Newborn; Magnetic Resonance Imaging; Melatonin; Operating Rooms; Sleep Deprivation
PubMed: 33785532
DOI: 10.1136/archdischild-2020-320592 -
Otology & Neurotology : Official... Aug 2021To calculate the incidence of sensorineural hearing loss (SNHL; pure or as part of a mixed hearing loss, MHL) among bullous myringitis (BM) patients with a coexisting HL...
OBJECTIVE
To calculate the incidence of sensorineural hearing loss (SNHL; pure or as part of a mixed hearing loss, MHL) among bullous myringitis (BM) patients with a coexisting HL to assess whether steroidal treatment should be initiated even before the findings of a formal audiogram are available.
METHODS
Retrospective medical record review in a tertiary referral center and systematic review of the English literature.
RESULTS
The medical records of 81 patients with BM were retrieved among whom 50 patients (62%) had actually sustained a HL, although only 39/81 patients reported a HL when asked. Twenty-four patients had a MHL, 18 had a SNHL, and eight had a conductive HL (CHL). The systematic review included 106 ears: 17 had no HL, 53 had a MHL, 20 had a SNHL, and 16 had a CHL. The combined published and current results yielded a SNHL and MHL rates of 38/139 (27%) and 77/139 (55%), respectively of all BM patients with confirmed HL.
CONCLUSION
BM is intuitively associated with a CHL resulting from the impeded function of the affected middle ear. Medical history and physical examination are not sufficient to exclude a SNHL in BM patients, and formal audiometry is mandatory for exclusion/confirmation in this setting. Nevertheless, steroidal treatment should not be delayed until the performance of formal audiometry because the actual rate of pure CHL in this setting is very low.Level of Evidence: 2.
Topics: Audiometry; Hearing; Hearing Loss, Sensorineural; Humans; Incidence; Retrospective Studies
PubMed: 33883520
DOI: 10.1097/MAO.0000000000003160 -
PloS One 2012A systematic review was conducted to identify and quality assess how studies published since 1999 have measured and reported the usage of hearing aids in older adults.... (Review)
Review
OBJECTIVE
A systematic review was conducted to identify and quality assess how studies published since 1999 have measured and reported the usage of hearing aids in older adults. The relationship between usage and other dimensions of hearing aid outcome, age and hearing loss are summarised.
DATA SOURCES
Articles were identified through systematic searches in PubMed/MEDLINE, The University of Nottingham Online Catalogue, Web of Science and through reference checking.
STUDY ELIGIBILITY CRITERIA
(1) participants aged fifty years or over with sensori-neural hearing loss, (2) provision of an air conduction hearing aid, (3) inclusion of hearing aid usage measure(s) and (4) published between 1999 and 2011.
RESULTS
Of the initial 1933 papers obtained from the searches, a total of 64 were found eligible for review and were quality assessed on six dimensions: study design, choice of outcome instruments, level of reporting (usage, age, and audiometry) and cross validation of usage measures. Five papers were rated as being of high quality (scoring 10-12), 35 papers were rated as being of moderate quality (scoring 7-9), 22 as low quality (scoring 4-6) and two as very low quality (scoring 0-2). Fifteen different methods were identified for assessing the usage of hearing aids.
CONCLUSIONS
Generally, the usage data reviewed was not well specified. There was a lack of consistency and robustness in the way that usage of hearing aids was assessed and categorised. There is a need for more standardised level of reporting of hearing aid usage data to further understand the relationship between usage and hearing aid outcomes.
Topics: Aged; Aged, 80 and over; Audiometry; Hearing; Hearing Aids; Hearing Loss, Sensorineural; Humans; Middle Aged; Periodicals as Topic; Research Design
PubMed: 22479312
DOI: 10.1371/journal.pone.0031831