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Otology & Neurotology : Official... Aug 2012To examine the safety and effectiveness of fully implantable middle ear devices in the treatment of hearing loss. (Comparative Study)
Comparative Study Meta-Analysis Review
OBJECTIVE
To examine the safety and effectiveness of fully implantable middle ear devices in the treatment of hearing loss.
DATA SOURCES
MEDLINE, EMBASE, The Cochrane Library, Web of Science, CINAHL, PsycINFO, and the Centre for Reviews and Dissemination were searched without date or language limits.
STUDY SELECTION
Titles and abstracts of 7,700 citations were screened, and 30 articles were selected for full review, of which, 7 articles on the Esteem and 13 on the Carina met the study's eligibility criteria.
DATA EXTRACTION
Information was extracted using a pretested data abstraction form, and study quality was assessed using the Oxford Centre for Evidence-Based Medicine Levels of Evidence.
DATA SYNTHESIS
Because of heterogeneity across studies, meta-analysis was not performed, and comparisons were made by structured review.
CONCLUSION
The majority of studies were quasi-experimental, prepost comparisons of aided and unaided conditions. Complication rates with the Esteem were higher than with the Carina, and most commonly included taste disturbance. However, device failure was common with the Carina, predominately related to charging difficulties. For both devices, clinically significant improvements in functional gain, speech reception, and speech recognition over the unaided condition were found. In studies comparing the Esteem or Carina to hearing aids, findings were mixed. Although improvements in functional gain were similar to those for hearing aids, speech recognition and quality of life were greater with the implants. Despite limited evidence, these devices seem to offer a relatively safe and effective treatment option, particularly for patients who are medically unable to wear conventional hearing aids.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Audiometry; Data Interpretation, Statistical; Evidence-Based Medicine; Female; Hearing Aids; Hearing Loss; Humans; Male; Middle Aged; Ossicular Prosthesis; Prosthesis Implantation; Quality of Life; Risk; Speech Perception; Speech Reception Threshold Test; Treatment Outcome; Young Adult
PubMed: 22772013
DOI: 10.1097/MAO.0b013e31825f230d -
International Journal of Occupational... Jun 2017This study is a meta-analysis of the previous epidemiological studies which investigated the quantitative estimates of the association between independent or combined... (Meta-Analysis)
Meta-Analysis Review
The risk of hearing loss associated with occupational exposure to organic solvents mixture with and without concurrent noise exposure: A systematic review and meta-analysis.
This study is a meta-analysis of the previous epidemiological studies which investigated the quantitative estimates of the association between independent or combined exposure to noise and mixed organic solvents and hearing loss until October 2014. Overall, 15 studies with information on 7530 individuals (6% female) were included. Having assessed - by puretone audiometry - the adjusted odds ratio estimates for the association between solvents mixture exposure and the risk of developing hearing loss stood at 2.05 (95% confidence interval (CI): 1.44-2.9). Similarly, for subjects who were concurrently exposed to noise and solvents mixture, an OR of 2.95 (95% CI: 2.1-4.17) was obtained. There was some evidence of heterogeneity within each of the 2 exposure groups (p heterogeneity < 0.001). This heterogeneity was not explained by differences in strength of effect between duration of exposure, the number of solvent and exposure index in subgroups of solvents mixture exposure. Based on the available data, our analysis has provided the evidence of increased risk of developing hearing loss for workers exposed to organic solvents even at quite low concentration. Moreover, if such exposure is accompanied by noise, it will exacerbate the extent of hearing loss. Int J Occup Med Environ Health 2017;30(4):521-535.
Topics: Hearing Loss; Hearing Loss, Noise-Induced; Humans; Noise, Occupational; Occupational Diseases; Occupational Exposure; Solvents
PubMed: 28584326
DOI: 10.13075/ijomeh.1896.01024 -
International Archives of... Jul 2016The literature reports on high-frequency audiometry as one of the exams used on hearing monitoring of individuals exposed to high sound pressure in their work... (Review)
Review
INTRODUCTION
The literature reports on high-frequency audiometry as one of the exams used on hearing monitoring of individuals exposed to high sound pressure in their work environment, due to the method́s greater sensitivity in early identification of hearing loss caused by noise. The frequencies that compose the exam are generally between 9 KHz and 20KHz, depending on the equipment.
OBJECTIVE
This study aims to perform a retrospective and secondary systematic revision of publications on high-frequency audiometry on hearing monitoring of individuals exposed to occupational noise.
DATA SYNTHESIS
This systematic revision followed the methodology proposed in the Cochrane Handbook, focusing on the question: "Is High-frequency Audiometry more sensitive than Conventional Audiometry in the screening of early hearing loss individuals exposed to occupational noise?" The search was based on PubMed data, Base, Web of Science (Capes), Biblioteca Virtual em Saúde (BVS), and in the references cited in identified and selected articles. The search resulted in 6059 articles in total. Of these, only six studies were compatible with the criteria proposed in this study.
CONCLUSION
The performed meta-analysis does not definitively answer the study's proposed question. It indicates that the 16 KHz high frequency audiometry (HFA) frequency is sensitive in early identification of hearing loss in the control group (medium difference (MD = 8.33)), as well as the 4 KHz frequency (CA), this one being a little less expressive (MD = 5.72). Thus, others studies are necessary to confirm the HFA importance for the early screening of hearing loss on individuals exposed to noise at the workplace.
PubMed: 27413413
DOI: 10.1055/s-0035-1570072 -
Otolaryngology--head and Neck Surgery :... Mar 2015To perform a systematic review evaluating the association between sensorineural hearing loss and (1) nonsteroidal anti-inflammatory drugs (NSAIDs) as a class, (2) NSAIDs... (Review)
Review
OBJECTIVE
To perform a systematic review evaluating the association between sensorineural hearing loss and (1) nonsteroidal anti-inflammatory drugs (NSAIDs) as a class, (2) NSAIDs available over the counter, (3) NSAIDs in short intravenous courses, (4) prescription NSAIDs utilized by patients without systemic inflammatory conditions, (5) prescription NSAIDs in patients with arthritides, and (6) acetaminophen with and without concomitant narcotic usage.
DATA SOURCES
Computerized searches of PubMed, EMBASE, and the Cochrane Library were updated through May 2014, along with manual searches and inquiries to topic experts.
REVIEW METHODS
The systematic review was performed according to an a priori protocol. Data extraction was performed by 2 independent investigators, and it focused on relevant audiologic measurements, methodological elements related to risk of bias, and potential confounders.
RESULTS
The 23 criterion-meeting studies included a total of 92,532 participants, with mixed results. Sulindac was the only specific agent to have been studied with formal audiometry in a randomized double-blind placebo-controlled trial in which hearing was the reported primary outcome: Although an effect was seen in the unadjusted analysis (pure tone threshold>15 dB, 9.3% vs 2.9%; relative risk [RR], 3.2; confidence interval [CI], 1.09-9.55; P=.02), the effect dissipated in the adjusted analysis (P=.09). There was a significant effect on self-reported hearing loss from NSAIDs as a class (RR, 1.21; CI, 1.11-1.33), ibuprofen (RR, 1.13; CI, 1.06-1.19), and acetaminophen (RR, 1.21; CI, 1.11-1.33), but no formal audiometric data confirm or refute this suggested effect. Audiometry has demonstrated profound loss in some instances of acetaminophen-narcotic combination ingestions.
CONCLUSIONS
Data are varied regarding the impact of NSAIDs and acetaminophen on population hearing health.
Topics: Acetaminophen; Analgesics, Non-Narcotic; Anti-Inflammatory Agents, Non-Steroidal; Audiometry; Hearing; Hearing Loss, Sensorineural; Humans; Risk Factors
PubMed: 25560405
DOI: 10.1177/0194599814564533 -
Otolaryngology--head and Neck Surgery :... Jul 2022Equivalent outcomes, such as procedural safety and audiometry, have been reported between endoscopic ear surgery (EES) and microscopic ear surgery (MES). This study aims... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
Equivalent outcomes, such as procedural safety and audiometry, have been reported between endoscopic ear surgery (EES) and microscopic ear surgery (MES). This study aims to determine if EES leads to decreased postoperative pain when compared with MES.
DATA SOURCES
PubMed, OVID MEDLINE, Scopus, Web of Science, and Cochrane Central from 2000 to 2020.
REVIEW METHODS
A systematic review in accordance with the PRISMA guidelines and standardized bias assessment was performed. Studies containing original data on postoperative pain following EES and MES were included.
RESULTS
Fourteen studies fulfilled eligibility: 7 retrospective studies, 6 randomized controlled trials, and 1 case series. Studies included surgery for cholesteatoma (n = 3), tympanoplasty/myringoplasty (n = 6), and stapedotomy (n = 5), pooling data from 974 patients. Postoperative pain was quantitatively described through a variety of numeric pain scores. Meta-analysis was performed on 11 studies. Among the 7 studies utilizing the numeric rating scale or visual analog scale, postoperative pain in the EES cohort was significantly lower than that of the MES cohort (standardized mean difference = -1.45 [95% CI, -2.05 to -0.85], < .001). Similarly, pain scores were lower in the EES cohort among the 4 studies utilizing the Three Grades Pain Scale (odds ratio = 0.2 [95% CI, 0.09-0.45], < .001). Additional qualitative strengths identified in EES included significant improvements in visualization, operative time, postoperative complications, and decreased need for canalplasty. Quality assessment indicated low to moderate risk of bias for all studies.
CONCLUSION
Meta-analysis confirms that EES results in significantly less postoperative pain when compared with MES. This surgical approach should be considered in the armamentarium of otologic surgeons, allowing for improved outcomes.
Topics: Endoscopy; Humans; Otologic Surgical Procedures; Pain, Postoperative; Retrospective Studies; Treatment Outcome; Tympanoplasty
PubMed: 34491858
DOI: 10.1177/01945998211041946 -
Ear and Hearing 2022To examine the prevalence of hearing impairment in children with hypothyroidism, and to characterize clinical and subclinical hearing loss by examining cochlear... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To examine the prevalence of hearing impairment in children with hypothyroidism, and to characterize clinical and subclinical hearing loss by examining cochlear function, auditory brainstem pathways, and integration of the auditory system as a whole.
DESIGN
An electronic search was conducted using PubMed, Scopus, and Cochrane Library databases. This systematic review was performed in accordance with the PRISMA guidelines. Original observational studies that utilized audiological tests for auditory system evaluations in hypothyroidism were included. A total of 2004 studies were found in the search, with 23 studies meeting the inclusion criteria.
RESULTS
The pooled prevalence of hearing loss was 16.1% [95% confidence interval 10.7, 22.4] for children with congenital hypothyroidism. Hearing thresholds at pure-tone averages (0.5-2 kHz) were 1.6 dB [95% confidence interval 1.7, 4.8] higher for children with hypothyroidism compared to age-matched controls. Cochlear dysfunction was detected at middle frequencies (1-3 kHz) by otoacoustic emission testing, indicating abnormalities of hair cell function or cochlear integration. Retrocochlear involvement was detected on auditory brainstem response (ABR), with prolonged Wave I indicating a peripheral conduction abnormality localized to the middle or inner ear and eighth cranial nerve.
CONCLUSIONS
Children with hypothyroidism have a higher prevalence of hearing loss than children without hypothyroidism. For children with congenital hypothyroidism, evidence of subclinical abnormalities at the level of the cochlea and eighth cranial nerve are present despite early initiation of levothyroxine therapy. Dysfunction of the auditory system might begin with predominance of peripheral conduction abnormalities early in development.
Topics: Audiometry, Pure-Tone; Auditory Threshold; Child; Cochlea; Congenital Hypothyroidism; Deafness; Evoked Potentials, Auditory, Brain Stem; Hearing Loss; Humans; Otoacoustic Emissions, Spontaneous
PubMed: 34282088
DOI: 10.1097/AUD.0000000000001082 -
European Archives of... Sep 2022To date, there is no consensus about the benefits of paper patching over spontaneous healing in the management of isolated acute traumatic tympanic membrane perforations...
OBJECTIVE
To date, there is no consensus about the benefits of paper patching over spontaneous healing in the management of isolated acute traumatic tympanic membrane perforations (IATTMP). In this systematic literature review and case series, we compared paper patching of IATTMP to spontaneous healing in terms of healing rate and time to heal.
DATABASES REVIEWED
A systematic literature search of English-language studies published from 1/1975 to 9/2020 was conducted using PubMed via MEDLINE, and 201 studies were identified. Another 346 studies were derived from the references of those articles. Twenty-four studies remained after omitting duplications and articles that did not meet the inclusion criteria.
METHODS
Demographics, medical history, physical examination, and audiometric results in the selected publications and in a new series of patients treated for IATTMP between 1/2018 and 1/2021 in a single tertiary referral center were retrieved and analyzed.
RESULTS
The literature review yielded 2796 ears of which 466 underwent paper patching (intervention arm). Complete perforation healing was documented in 67-97% of control arm and 92-93% of intervention arm. Our new series included 29 ears of which six underwent paper patching. Complete healing was observed in 83% and 78% in the interventional and control arms, respectively.
CONCLUSIONS
Although paper patching and watchful waiting had similar success rates in patients with IATTMP, healing after paper patching was slightly quicker among our patients. Patching is a readily applicable and technically simple office-based intervention that should be preferentially considered for IATTMP.
Topics: Audiometry; Humans; Tympanic Membrane; Tympanic Membrane Perforation; Wound Healing
PubMed: 34817658
DOI: 10.1007/s00405-021-07185-7 -
Whispered voice test for screening for hearing impairment in adults and children: systematic review.BMJ (Clinical Research Ed.) Oct 2003To determine the accuracy of the whispered voice test in detecting hearing impairment in adults and children. (Review)
Review
OBJECTIVE
To determine the accuracy of the whispered voice test in detecting hearing impairment in adults and children.
DESIGN
Systematic review of studies of test accuracy.
DATA SOURCES
Medline, Embase, Science Citation Index, unpublished theses, manual searching of bibliographies of known primary and review articles, and contact with authors.
STUDY SELECTION
Two reviewers independently selected and extracted data on study characteristics, quality, and accuracy of studies. Studies were included if they had cross sectional designs, at least one of the index tests was the whispered voice test, and the reference test (audiometry) was performed on at least 80% of the participants.
DATA EXTRACTION
Data were used to form 2x2 contingency tables with hearing impairment by audiometry as the reference standard.
DATA SYNTHESIS
The eight studies that were found used six different techniques. The sensitivity in the four adult studies was 90% or 100% and the specificity was 70% to 87%. The sensitivity in the four childhood studies ranged from 80% to 96% and specificity ranged from 90% to 98%.
CONCLUSION
The whispered voice test is a simple and accurate test for detecting hearing impairment. There is some concern regarding the lower sensitivity in children and the overall reproducibility of the test, particularly in primary care settings. Further studies should be conducted in primary care settings to explore the influence of components of the testing procedure to optimise test sensitivity and to promote standardisation of the testing procedure.
Topics: Adult; Child; Child, Preschool; Hearing Disorders; Hearing Tests; Humans; Middle Aged; Reproducibility of Results; Sensitivity and Specificity
PubMed: 14576249
DOI: 10.1136/bmj.327.7421.967 -
Otology & Neurotology : Official... Jun 2011To analyze the influence of stapes prosthesis diameter on postoperative hearing results after stapedotomy without interposition in otosclerotic patients. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To analyze the influence of stapes prosthesis diameter on postoperative hearing results after stapedotomy without interposition in otosclerotic patients.
DATA SOURCES
PubMed search from 1970 to 2009 using the key words stapedotomy or stapedectomy or otosclerosis or stapesplasty.
STUDY SELECTION
Inclusion criteria to select articles and patient groups for meta-analysis and statistical analyses were as follows: otosclerosis as diagnosis, clear description of technique and prosthesis size, calibrated stapedotomy, and complete report of functional results.
DATA EXTRACTION
Five controlled studies were found analyzing the influence of prosthesis diameter and reporting the results in a comparable way for meta-analysis (n = 590). Sixty-two studies not analyzing the influence of prosthesis diameter contained comparable subgroups with a total of 9,536 cases. These cases were pooled according to their diameter (0.3, 0.4, 0.5, 0.6,and 0.8 mm). The results of air conduction, bone conduction, air-bone gap (ABG), and success rate (closure of the ABG within 10 dB as percentage of the total cases) for all groups and frequency-specific ABG results were gathered. Furthermore, 12 clinical and experimental studies were reviewed that did not contribute to the statistical analysis.
DATA SYNTHESIS
A meta-analysis performed for success rate of the 5 controlled studies showed favorable results for 0.6-mm over 0.4-mm prostheses (success rate, 67% versus 58%, p = 0.05). In the statistical analysis of the pooled data, the 0.6-mm prosthesis showed better results compared with 0.4 mm (p < 0.001) in the postoperative air conduction threshold (29 dB versus 35 dB), postoperative ABG (7 dB versus 11 dB), ABG improvement (25 dB versus 21 dB), and success rate (81.1% versus 75.1%). The frequency-specific analysis of the postoperative ABG showed no advantage for the small prosthesis in the high frequencies. There was no difference in postoperative change of bone conduction in the 0.6- and 0.4-mm groups. Statistically significant results could not be assessed for other prosthesis diameters because of the small number of cases reported.
CONCLUSION
A 0.6-mm diameter piston prosthesis is associated with significantly better results than a 0.4-mm prosthesis and should be used if the surgical conditions allow it.
Topics: Audiometry, Pure-Tone; Auditory Threshold; Bone Conduction; Humans; Ossicular Prosthesis; Otosclerosis; Prosthesis Implantation; Stapes Surgery; Treatment Outcome
PubMed: 21765384
DOI: 10.1097/MAO.0b013e318216795b -
Prevalence of hearing loss in patients with Sjögren syndrome: a systematic review and meta-analysis.Rheumatology International Feb 2023Sjögren syndrome (SS) is a multisystem autoimmune disease, primarily targeting salivary and lacrimal glands; skin, nasal and vaginal dryness, along with musculoskeletal... (Meta-Analysis)
Meta-Analysis
Sjögren syndrome (SS) is a multisystem autoimmune disease, primarily targeting salivary and lacrimal glands; skin, nasal and vaginal dryness, along with musculoskeletal pain and fatigue are the most commonly reported symptoms. Hearing loss is hypothesized to be frequent as well. The purpose of this systematic review was to estimate the prevalence of Hearing loss and its different subtypes in patients with Sjögren syndrome. PRISMA guidelines were followed to ensure highest quality for our systematic review. A random effects model meta-analysis and meta-regression was conducted using I as heterogeneity indicator. Eleven observational studies were included in this systematic review. Ten of them were cross-sectional, while one study was case-control. Studies were assessed for risk of bias: all were rated to a moderate level, except for two rated to a low level. Pooled prevalence of any type of hearing loss was 52.2%. After excluding studies rated to moderate bias, the pooled prevalence of hearing loss was 36.7%. We also conducted a subgroup analysis depending on type of hearing loss. Pooled prevalence of sensorineural hearing loss was 42.6%., while pooled prevalence of conductive hearing loss and mixed hearing loss were 5% and 2.3%, respectively. Meta-regression was conducted in an effort to identify possible variables capable to explain high heterogeneity between studies. Sample size and year of study were separately found to account for a portion of heterogeneity between studies of sensorineural hearing loss. Year of study was also found to account for a portion of heterogeneity between studies of conductive hearing loss. In conclusion, sensorineural hearing loss, is highly prevalent in patients with Sjögren syndrome. On this basis, early screening and follow-up of patients with Sjögren syndrome by pure tone audiometry is important.
Topics: Female; Humans; Hearing Loss, Conductive; Sjogren's Syndrome; Prevalence; Hearing Loss; Hearing Loss, Sensorineural
PubMed: 36305918
DOI: 10.1007/s00296-022-05235-9