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Indian Journal of Otolaryngology and... Jun 2024To comprehensively understand the manifestation, treatments, and resultant consequences of temporal bone fractures, given their substantial impact on auditory and...
UNLABELLED
To comprehensively understand the manifestation, treatments, and resultant consequences of temporal bone fractures, given their substantial impact on auditory and balance systems and the overall quality of life. A prospective study, adhering to the STROBE guidelines, spanning five years (2011-2015) was conducted on 83 male patients aged between 20 and 54 years, diagnosed with temporal bone fractures primarily caused by road traffic accidents. Evaluations comprised symptom presentation, otologic manifestations, radiological classifications, and management strategies, including both conservative and surgical interventions. Our study found that patients commonly presented with symptoms such as Oto-haematorrhoea, hearing impairment, and vertigo. Specifically, longitudinal fractures were the most frequent radiological finding, occurring in 63 cases ( < 0.001 for road traffic accidents). In terms of treatment outcomes, there was a notable improvement in the average hearing threshold, decreasing from 50 dB to 25 dB post-treatment ( < 0.001), and the air-bone gap reduced from 30 dB to 10 dB ( < 0.001). Audiometric outcomes varied significantly with fracture type, showing severe hearing loss was more common in transverse fractures (50%, < 0.001) compared to longitudinal and mixed fractures. Additionally, the study revealed a significant reduction in the incidence of post-trauma vertigo over eight weeks ( < 0.001), underscoring the importance of early and appropriate intervention in managing temporal bone fractures. Efficient early detection and tailored interventions for temporal bone fractures lead to optimistic results. This research underscores the imperative for healthcare practitioners to adopt a comprehensive approach, from initial diagnosis to ongoing monitoring, to achieve optimal patient care.
SUPPLEMENTARY INFORMATION
The online version contains supplementary material available at 10.1007/s12070-024-04519-9.
PubMed: 38883469
DOI: 10.1007/s12070-024-04519-9 -
Scientific Reports Jun 2024Low-grade chronic inflammation is associated with many age-related conditions. Non-invasive methods to monitor low-grade chronic inflammation may improve the management...
Low-grade chronic inflammation is associated with many age-related conditions. Non-invasive methods to monitor low-grade chronic inflammation may improve the management of older people at risk of poorer outcomes. This longitudinal cohort study has determined baseline inflammation using neopterin volatility in monthly urine samples of 45 independent older adults (aged 65-75 years). Measurement of neopterin, an inflammatory metabolite, enabled stratification of individuals into risk categories based on how often in a 12-month period their neopterin level was raised. Hearing was measured (pure-tone audiometry) at baseline, 1 year and 3 years of the study. Results show that those in the highest risk category (neopterin raised greater than 50% of the time) saw greater deterioration, particularly in high-frequency, hearing. A one-way Welch's ANOVA showed a significant difference between the risk categories for change in high-frequency hearing (W (3, 19.6) = 9.164, p = 0.0005). Despite the study size and duration individuals in the highest risk category were more than twice as likely to have an additional age-related morbidity than those in the lowest risk category. We conclude that volatility of neopterin in urine may enable stratification of those at greatest risk of progression of hearing loss.
Topics: Humans; Neopterin; Aged; Male; Female; Longitudinal Studies; Hearing Loss; Audiometry, Pure-Tone; Biomarkers; Auditory Threshold; Inflammation
PubMed: 38871776
DOI: 10.1038/s41598-024-64648-7 -
Redox Biology Aug 2024The ABCC1 gene belongs to the ATP-binding cassette membrane transporter superfamily, which plays a crucial role in the efflux of various endogenous and exogenous...
The ABCC1 gene belongs to the ATP-binding cassette membrane transporter superfamily, which plays a crucial role in the efflux of various endogenous and exogenous substances. Mutations in ABCC1 can result in autosomal dominant hearing loss. However, the specific roles of ABCC1 in auditory function are not fully understood. Through immunofluorescence, we found that ABCC1 was expressed in microvascular endothelial cells (ECs) of the stria vascularis (StV) in the murine cochlea. Then, an Abcc1 knockout mouse model was established by using CRISPR/Cas9 technology to elucidate the role of ABCC1 in the inner ear. The ABR threshold did not significantly differ between WT and Abcc1 mice at any age studied. After noise exposure, the ABR thresholds of the WT and Abcc1 mice were significantly elevated. Interestingly, after 14 days of noise exposure, ABR thresholds largely returned to pre-exposure levels in WT mice but not in Abcc1 mice. Our subsequent experiments showed that microvascular integrity in the StV was compromised and that the number of outer hair cells and the number of ribbons were significantly decreased in the cochleae of Abcc1 mice post-exposure. Besides, the production of ROS and the accumulation of 4-HNE significantly increased. Furthermore, StV microvascular ECs were cultured to elucidate the role of ABCC1 in these cells under glucose oxidase challenge. Notably, 30 U/L glucose oxidase (GO) induced severe oxidative stress damage in Abcc1 cells. Compared with WT cells, the ROS and 4-HNE levels and the apoptotic rate were significantly elevated in Abcc1 cells. In addition, the reduced GSH/GSSG ratio was significantly decreased in Abcc1 cells after GO treatment. Taken together, Abcc1 mice are more susceptible to noise-induced hearing loss, possibly because ABCC1 knockdown compromises the GSH antioxidant system of StV ECs. The exogenous antioxidant N-acetylcysteine (NAC) may protect against oxidative damage in Abcc1 murine cochleae and ECs.
Topics: Animals; Mice; Multidrug Resistance-Associated Proteins; Cochlea; Hearing Loss, Noise-Induced; Mice, Knockout; Antioxidants; Oxidative Stress; Disease Models, Animal; Reactive Oxygen Species; Endothelial Cells
PubMed: 38870779
DOI: 10.1016/j.redox.2024.103218 -
Hearing Research Jun 2024The study aimed to explore the auditory temporal resolution and dichotic listening skills in patients with type 2 diabetes mellitus (T2DM) and identify associated...
The study aimed to explore the auditory temporal resolution and dichotic listening skills in patients with type 2 diabetes mellitus (T2DM) and identify associated health-related factors. Using a cross-sectional design, 87 adults with T2DM and 48 non-diabetic controls, all with normal hearing, participated. The two central auditory processing (CAP) skills were assessed through the Gaps-In-Noise (GIN) and Dichotic-Digits Listening (DDL) tests. T2DM participants underwent blood tests to measure various health-related factors. In the GIN test, the shortest gap threshold (GapTh) obtained across both ears was significantly higher in the diabetic group (9.1 ± 2.4 ms) compared to the non-diabetic group (7.5 ± 1.5 ms), and the score of correctly identified gaps (GapSc) in the diabetic group (45±11 %) was significantly lower than GapSc in the non-diabetic group (52±9 %), p < 0.001. In the DDL test, the free-recall score (73.8 ± 18.5 %) across both ears and the right-ear advantage (-1.3 ± 20.6 %) in the diabetic group were significantly lower than the free-recall score (85.8 ± 11.9 %) and right-ear advantage (6.9 ± 11.9 %) in the non-diabetic group, p < 0.005. Furthermore, the duration of diabetes, eGFR level, retinopathy, carotid plaque, fasting blood glucose level, and HDL-C (good cholesterol) level were factors significantly associated with performances in the GIN and/or DDL tests for T2DM participants. In conclusion, individuals with T2DM are at risk of reduced auditory processing skills in temporal resolution and dichotic listening, impacting their speech understanding. Six health-related factors were identified as significantly associated with CAP skills in T2DM patients.
PubMed: 38870778
DOI: 10.1016/j.heares.2024.109067 -
Trends in Hearing 2024Almost since the inception of the modern-day electroacoustic audiometer a century ago the results of pure-tone audiometry have been characterized by an audiogram. For...
Almost since the inception of the modern-day electroacoustic audiometer a century ago the results of pure-tone audiometry have been characterized by an audiogram. For almost as many years, clinicians and researchers have sought ways to distill the volume and complexity of information on the audiogram. Commonly used approaches have made use of pure-tone averages (PTAs) for various frequency ranges with the PTA for 500, 1000, 2000 and 4000 Hz (PTA4) being the most widely used for the categorization of hearing loss severity. Here, a three-digit triad is proposed as a single-number summary of not only the severity, but also the configuration and bilateral symmetry of the hearing loss. Each digit in the triad ranges from 0 to 9, increasing as the level of the pure-tone hearing threshold level (HTL) increases from a range of optimal hearing (< 10 dB Hearing Level; HL) to complete hearing loss (≥ 90 dB HL). Each digit also represents a different frequency region of the audiogram proceeding from left to right as: (Low, L) PTA for 500, 1000, and 2000 Hz; (Center, C) PTA for 3000, 4000 and 6000 Hz; and (High, H) HTL at 8000 Hz. This LCH Triad audiogram-classification system is evaluated using a large United States (U.S.) national dataset (N = 8,795) from adults 20 to 80 + years of age and two large clinical datasets totaling 8,254 adults covering a similar age range. Its ability to capture variations in hearing function was found to be superior to that of the widely used PTA4.
Topics: Adult; Aged; Aged, 80 and over; Female; Humans; Male; Middle Aged; Young Adult; Acoustic Stimulation; Audiometry, Pure-Tone; Auditory Threshold; Hearing; Hearing Loss; Predictive Value of Tests; Reproducibility of Results; Severity of Illness Index
PubMed: 38870447
DOI: 10.1177/23312165241260041 -
Journal of the Chinese Medical... Jun 2024The senior author Shiao, had introduced a modified version of the traditional stapes surgery, called minimally traumatic stapes surgery (MTSS), and explored its...
BACKGROUND
The senior author Shiao, had introduced a modified version of the traditional stapes surgery, called minimally traumatic stapes surgery (MTSS), and explored its effectiveness in reducing postoperative vertigo. However, MTSS exhibited no significant breakthrough in terms of audiometric results. Building upon the original MTSS through slight modifications and the use of the Medtronic Big Easy® Piston as the prosthesis, this study evaluates a refined version of the original MTSS technique. In particular, this research sought to investigate the impact of this refined approach on hearing outcomes and postoperative complications among patients diagnosed with otosclerosis.
METHODS
This research comprehensively examined the medical records of individuals diagnosed with otosclerosis who underwent MTSS. The postoperative outcomes assessed encompassed hearing outcomes and the occurrence of any new complications.
RESULTS
Overall, 95 patients diagnosed with otosclerosis (comprising 106 affected ears) underwent MTSS. Significant improvements in both the average air conduction threshold (40 ± 16.82 dB after vs. 60 ± 14.56 dB before surgery; p < 0.0001) and average air-bone gap (11.99 ± 7.24 dB after vs. 29.65 ± 9.47 dB before surgery; p =0.003) were observed after the surgery. Conversely, no significant change in the average bone conduction threshold was observed after the procedure (28 ± 13.81 dB after vs. 29 ± 12.31 dB before surgery; p = 0.149). Among the 106 affected ears, 102 showed postoperative air-bone gap measurements <20 dB, indicating an impressive 96.2% overall hearing improvement. Notably, only a few postoperative complications were observed, including vertigo, chorda tympani injury, facial weakness, and a slight hearing deterioration.
CONCLUSION
The refined MTSS technique promoted significant postoperative hearing improvements with minimal complications. This approach showed potential for addressing the surgical challenges in Asian patients with otosclerosis, emphasizing the importance of further research on this advanced procedural method.
PubMed: 38869453
DOI: 10.1097/JCMA.0000000000001107 -
The Journal of International Medical... Jun 2024To investigate which factors influence the adherence to hearing aid (HA) use in elderly patients with moderate-to-severe hearing loss. (Observational Study)
Observational Study
OBJECTIVE
To investigate which factors influence the adherence to hearing aid (HA) use in elderly patients with moderate-to-severe hearing loss.
METHODS
This observational, prospective, single-centre study enrolled patients with moderate-to-severe hearing loss. They were evaluated before and 1 year after having either one or two HAs fitted.
RESULTS
A total of 86 patients were enrolled in the study and of these 69.8% (60 of 86; USER group) continued to use their HA at 1 year after fitting; six patients had not continued their use (NON-USERS). The USER group was younger than the NON-USER group, but the difference was not significant. The USER group had a significantly better unaided auditory threshold at baseline than the NON-USER group. HA use resulted in improvements in speech audiometry and auditory threshold. There was also a maintenance of cognitive function in the USER group.
CONCLUSION
Use of HA for 1 year resulted in improved auditory performance and an absence of a deterioration of cognitive function. This research was retrospectively registered under no. NCT04333043 at ClinicalTrials.gov (http://www.clinicaltrials.gov/) on the 26 March 2020. This research has been registered with the Ethics Committee of the Area Vasta Emilia Nord under number 104, date of approval 17/07/2017.
Topics: Humans; Hearing Aids; Female; Male; Aged; Prospective Studies; Hearing Loss; Patient Compliance; Aged, 80 and over; Auditory Threshold; Middle Aged; Cognition
PubMed: 38861681
DOI: 10.1177/03000605241232549 -
The Journal of the Acoustical Society... Jun 2024Amplitude modulation (AM) of a masker reduces its masking on a simultaneously presented unmodulated pure-tone target, which likely involves dip listening. This study...
Amplitude modulation (AM) of a masker reduces its masking on a simultaneously presented unmodulated pure-tone target, which likely involves dip listening. This study tested the idea that dip-listening efficiency may depend on stimulus context, i.e., the match in AM peakedness (AMP) between the masker and a precursor or postcursor stimulus, assuming a form of temporal pattern analysis process. Masked thresholds were measured in normal-hearing listeners using Schroeder-phase harmonic complexes as maskers and precursors or postcursors. Experiment 1 showed threshold elevation (i.e., interference) when a flat cursor preceded or followed a peaked masker, suggesting proactive and retroactive temporal pattern analysis. Threshold decline (facilitation) was observed when the masker AMP was matched to the precursor, irrespective of stimulus AMP, suggesting only proactive processing. Subsequent experiments showed that both interference and facilitation (1) remained robust when a temporal gap was inserted between masker and cursor, (2) disappeared when an F0-difference was introduced between masker and precursor, and (3) decreased when the presentation level was reduced. These results suggest an important role of envelope regularity in dip listening, especially when masker and cursor are F0-matched and, therefore, form one perceptual stream. The reported effects seem to represent a time-domain variant of comodulation masking release.
Topics: Humans; Perceptual Masking; Acoustic Stimulation; Auditory Threshold; Young Adult; Adult; Time Factors; Female; Male; Audiometry, Pure-Tone; Auditory Perception
PubMed: 38856312
DOI: 10.1121/10.0026240 -
Laryngoscope Investigative... Jun 2024To establish audiological and other outcomes following cochlear implantation in humans and animals with eluting electrodes. (Review)
Review
OBJECTIVES
To establish audiological and other outcomes following cochlear implantation in humans and animals with eluting electrodes.
METHODS
Systematic review and narrative synthesis. Databases searched (April 2023): MEDLINE, EMBASE, CENTRAL, ClinicalTrials.gov, and Web of Science. Studies reporting outcomes in either humans or animals following cochlear implantation with a drug-eluting electrode were included. No limits were placed on language or year of publication. Risk of bias assessment was performed on all included studies using either the Brazzelli or Systematic Review Centre for Laboratory animal Experimentation (SYRCLE) assessment tools. The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 statement.
RESULTS
Searches identified 146 abstracts and 108 full texts. Of these, 18 studies met the inclusion criteria, reporting outcomes in 523 animals (17 studies) and 24 humans (1 study). Eluting electrodes included dexamethasone (16 studies), aracytine (1 study), nicotinamide adenine dinucleotide (1 study), the growth factors insulin-like growth factor 1 (IGF1) and hepatocyte growth factor (HGF) (1 study), and neurotrophin-3 (1 study). All included studies compare outcomes following implantation with an eluting electrode with a control non-eluting electrode. In the majority of studies, audiological outcomes (e.g., auditory brainstem response threshold) were superior following implantation with an eluting electrode compared with a standard electrode. Most studies which investigated post-implantation impedance reported lower impedance following implantation with an eluting electrode. The influence of eluting electrodes on other reported outcomes (including post-implantation cochlear fibrosis and the survival of hair cells and spiral ganglion neurons) was more varied across the included studies.
CONCLUSIONS
Eluting electrodes have shown promise in animal studies in preserving residual hearing following cochlear implantation and in reducing impedance, though data from human studies remain lacking. Further in-human studies will be required to determine the clinical usefulness of drug-eluting cochlear implants as a future treatment for sensorineural hearing loss.
PubMed: 38855776
DOI: 10.1002/lio2.1263 -
Acta Oto-laryngologica Mar 2024Clinically, we find that tinnitus patients often have hearing loss. According to the most accepted mechanism of tinnitus, that is, the spontaneous discharge and abnormal...
BACKGROUND
Clinically, we find that tinnitus patients often have hearing loss. According to the most accepted mechanism of tinnitus, that is, the spontaneous discharge and abnormal synchronization of neurons after afferent reduction, tinnitus frequency is closely related to the frequency of hearing loss.
OBJECTIVE
The purpose of this study was to investigate the correlation of tinnitus pitch with the frequency of hearing loss.
MATERIALS AND METHODS
A total of 500 patients with unilateral or bilateral chronic tinnitus were enrolled in this study. All patients underwent pure tone audiometry (PTA) and tinnitus acoustic examination. Hearing loss levels and frequencies were recorded. The relationship between tinnitus pitch and hearing loss level and frequency was statistically analyzed.
RESULTS
Our results showed that 96.6% of the 500 tinnitus patients had hearing loss. Statistical analysis showed that low frequency (LF) tinnitus was correlated with LF hearing loss, but moderate frequency & high frequency (MF&HF) tinnitus was not significantly associated with MF&HF hearing loss. The coincidence of tinnitus pitch with the highest hearing threshold correlated with the degree of hearing loss.
CONCLUSION AND SIGNIFICANCE
The vast majority of patients with chronic subjective tinnitus had hearing loss, and the frequency of tinnitus correlated with the degree and frequency of hearing loss but not exactly fall within the frequency range of hearing loss.
Topics: Humans; Tinnitus; Male; Cross-Sectional Studies; Female; Middle Aged; Adult; Audiometry, Pure-Tone; Aged; Hearing Loss; Young Adult; Auditory Threshold; Adolescent
PubMed: 38847804
DOI: 10.1080/00016489.2024.2355227