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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 -
Radiation and Environmental Biophysics Nov 2021Numerous studies have documented the adverse effects of high-dose radiation on hearing in patients. On the other hand, radiographers are exposed to a low dose of... (Review)
Review
Numerous studies have documented the adverse effects of high-dose radiation on hearing in patients. On the other hand, radiographers are exposed to a low dose of ionizing radiation, and the effect of a low dose of radiation on hearing is quite abstruse. Therefore, the present systematic review aimed to elucidate the effect of low-dose ionizing radiation on hearing. Two authors independently carried out a comprehensive data search in three electronic databases, including PUBMED/MEDLINE, CINAHL, and SCOPUS. Eligible articles were independently assessed for quality by two authors. Cochrane Risk of Bias tool was used assess quality of the included studies. Two articles met the low-dose radiation exposure criteria given by Atomic Energy Regulatory Board (AERB) and National Council on Radiation Protection (NCRP) guidelines. Both studies observed the behavioral symptoms, pure-tone hearing sensitivity at the standard, extended high frequencies, and the middle ear functioning in low-dose radiation-exposed individuals and compared with age and gender-matched controls. One study assessed the cochlear function using transient-evoked otoacoustic emissions (TEOAE). Both studies reported that behavioral symptoms of auditory dysfunction and hearing thresholds at extended high frequencies were higher in radiation-exposed individuals than in the controls. The current systematic review concludes that the low-dose ionizing radiation may affect the hearing adversely. Nevertheless, further studies with robust research design are required to explicate the cause and effect relationship between the occupational low-dose ionizing radiation exposure and hearing.
Topics: Audiometry, Pure-Tone; Auditory Threshold; Hearing; Humans; Otoacoustic Emissions, Spontaneous
PubMed: 34302524
DOI: 10.1007/s00411-021-00926-6 -
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 -
International Journal of Audiology Jan 2022Telecommunication can be difficult in the presence of noise or hearing loss. The purpose of this study was to systematically review evidence regarding the effects of...
OBJECTIVE
Telecommunication can be difficult in the presence of noise or hearing loss. The purpose of this study was to systematically review evidence regarding the effects of text supplementation (e.g. captions, subtitles) of auditory or auditory-visual signals on speech intelligibility for listeners with normal or impaired hearing.
DESIGN
Three databases were searched. Articles were evaluated for inclusion based on the Population Intervention Comparison Outcome framework. The Effective Public Health Practice Project instrument was used to evaluate the quality of the identified articles.
STUDY SAMPLE
After duplicates were removed, the titles and abstracts of 2019 articles were screened. Forty-six full texts were reviewed; ten met inclusion criteria.
RESULTS
The quality of all ten articles was moderate or strong. The articles demonstrated that text added to auditory (or auditory-visual) signals improved speech intelligibility and that the benefits were largest when auditory signal integrity was low, accuracy of the text was high, and the auditory signal and text were synchronous. Age and hearing loss did not affect benefits from the addition of text.
CONCLUSIONS
Although only based on ten studies, these data support the use of text as a supplement during telecommunication, such as while watching television or during telehealth appointments.
Topics: Auditory Threshold; Deafness; Dietary Supplements; Hearing; Hearing Loss; Hearing Loss, Sensorineural; Humans; Speech Intelligibility; Speech Perception; Telecommunications
PubMed: 34154488
DOI: 10.1080/14992027.2021.1937346 -
Efficacy of behavioral audiological tests in identifying cochlear synaptopathy: a systematic review.European Archives of... Feb 2022Cochlear synaptopathy or hidden hearing loss is difficult to assess due to the lack of sensitivity with standard audiological tests. Poor speech perception, especially... (Review)
Review
PURPOSE
Cochlear synaptopathy or hidden hearing loss is difficult to assess due to the lack of sensitivity with standard audiological tests. Poor speech perception, especially in the presence of noise or tinnitus, is the most common complaint of these patients. The purpose of this systematic review is to identify articles in peer-reviewed journals that used behavioral measures in the effective assessment of cochlear synaptopathy or hidden hearing loss.
METHODS
The manuscripts were searched in various international databases, and the manuscripts were screened based on titles, abstracts, and full-length content. A total of 14 human studies were selected after the appropriate exclusion of other articles.
RESULTS
Results showed that high-frequency audiometry could be used for the early identification of cochlear synaptopathy. The tone in noise detection test can also be added in the test battery along with speech perception in noise. The amplitude modulation detection test, interaural phase difference, and differential sensitivity tests require more research before using them for the assessment of cochlear synaptopathy or hidden hearing loss.
CONCLUSIONS
Self-reports and questionnaires also help in determining the extent of noise exposure.
Topics: Auditory Threshold; Cochlea; Evoked Potentials, Auditory, Brain Stem; Hearing Loss, Noise-Induced; Humans; Noise
PubMed: 34106328
DOI: 10.1007/s00405-021-06927-x -
Trials Mar 2021This systematic review aimed to identify, compare and contrast outcome domains and outcome instruments reported in studies investigating interventions that seek to... (Review)
Review
Systematic review of outcome domains and instruments used in designs of clinical trials for interventions that seek to restore bilateral and binaural hearing in adults with unilateral severe to profound sensorineural hearing loss ('single-sided deafness').
BACKGROUND
This systematic review aimed to identify, compare and contrast outcome domains and outcome instruments reported in studies investigating interventions that seek to restore bilateral (two-sided) and/or binaural (both ears) hearing in adults with single-sided deafness (SSD). Findings can inform the development of evidence-based guidance to facilitate design decisions for confirmatory trials.
METHODS
Records were identified by searching MEDLINE, EMBASE, PubMed, CINAHL, ClinicalTrials.gov, ISRCTN, CENTRAL, WHO ICTRP and the NIHR UK clinical trials gateway. The search included records published from 1946 to March 2020. Included studies were those as follows: (a) recruiting adults aged 18 years or older diagnosed with SSD of average threshold severity worse than 70 dB HL in the worse-hearing ear and normal (or near-normal) hearing in the better-hearing ear, (b) evaluating interventions to restore bilateral and/or binaural hearing and (c) enrolling those adults in a controlled trial, before-and-after study or cross-over study. Studies that fell just short of the participant eligibility criteria were included in a separate sensitivity analysis.
RESULTS
Ninety-six studies were included (72 full inclusion, 24 sensitivity analysis). For fully included studies, 37 exclusively evaluated interventions to re-establish bilateral hearing and 29 exclusively evaluated interventions to restore binaural hearing. Overall, 520 outcome domains were identified (350 primary and 170 secondary). Speech-related outcome domains were the most common (74% of studies), followed by spatial-related domains (60% of studies). A total of 344 unique outcome instruments were reported. Speech-related outcome domains were measured by 73 different instruments and spatial-related domains by 43 different instruments. There was considerable variability in duration of follow-up, ranging from acute (baseline) testing to 10 years after the intervention. The sensitivity analysis identified no additional outcome domains.
CONCLUSIONS
This review identified large variability in the reporting of outcome domains and instruments in studies evaluating the therapeutic benefits and harms of SSD interventions. Reports frequently omitted information on what domains the study intended to assess, and on what instruments were used to measure which domains.
TRIAL REGISTRATION
The systematic review protocol is registered on PROSPERO (International Prospective Register of Systematic Reviews): Registration Number CRD42018084274 . Registered on 13 March 2018, last revised on 7th of May 2019.
Topics: Adult; Cochlear Implantation; Cross-Over Studies; Deafness; Hearing; Hearing Loss, Sensorineural; Humans; Speech Perception
PubMed: 33743802
DOI: 10.1186/s13063-021-05160-5 -
Frontiers in Neurology 2020Despite our understanding of the impact of noise-induced damage to the auditory system, much less is known about the impact of noise exposure on the vestibular system.... (Review)
Review
Despite our understanding of the impact of noise-induced damage to the auditory system, much less is known about the impact of noise exposure on the vestibular system. In this article, we review the anatomical, physiological, and functional evidence for noise-induced damage to peripheral and central vestibular structures. Morphological studies in several animal models have demonstrated cellular damage throughout the peripheral vestibular system and particularly in the otolith organs; however, there is a paucity of data on the effect of noise exposure on human vestibular end organs. Physiological studies have corroborated morphological studies by demonstrating disruption across vestibular pathways with otolith-mediated pathways impacted more than semicircular canal-mediated pathways. Similar to the temporary threshold shifts observed in the auditory system, physiological studies in animals have suggested a capacity for recovery following noise-induced vestibular damage. Human studies have demonstrated that diminished sacculo-collic responses are related to the severity of noise-induced hearing loss, and dose-dependent vestibular deficits following noise exposure have been corroborated in animal models. Further work is needed to better understand the physiological and functional consequences of noise-induced vestibular impairment in animals and humans.
PubMed: 33324332
DOI: 10.3389/fneur.2020.593919 -
JAMA Otolaryngology-- Head & Neck... Jul 2020Utility is a single-value, preference-based measure of health-related quality of life that represents the desirability of a health state relative to being dead or in...
IMPORTANCE
Utility is a single-value, preference-based measure of health-related quality of life that represents the desirability of a health state relative to being dead or in perfect health. Clinical, funding, and policy decisions rely on measured changes in utility. The benefit of hearing loss treatments may be underestimated because existing utility measures fail to capture important changes in quality of life associated with hearing loss.
OBJECTIVE
To develop a comprehensive profile of items that describe how quality of life is associated with hearing loss and its treatments that can be used to generate hearing-related quality of life measures, including a novel utility measure.
DESIGN, SETTING, AND PARTICIPANTS
This qualitative study, performed from August 1, 2018, to August 1, 2019, in tertiary referral centers, comprised a systematic literature review, focus groups, and semistructured interviews. The systematic review evaluated studies published from 1982 to August 1, 2018. Focus groups included 8 clinical experts experienced in the measurement, diagnosis, treatment, and rehabilitation of hearing loss. Semistructured interviews included 26 adults with hearing loss recruited from an institutional data set and outpatient hearing aid and otology clinics using stratified convenience sampling to include individuals of diverse ages, urban and rural residency, causes of hearing loss, severity of hearing loss, and treatment experience.
MAIN OUTCOMES AND MEASURES
A set of items and subdomains that collectively describe the association of hearing loss with health-related quality of life.
RESULTS
The literature search yielded 2779 articles from the MEDLINE, Embase, Cochrane, PsycINFO, and CINAHL databases. Forty-five studies including 1036 individuals (age range, 18-84 years) were included. The focus group included 4 audiologists and 4 otologists. Hour-long semistructured interviews were conducted with 26 individuals (13 women; median age, 54 years; range, 25-83 years) with a broad range of hearing loss causes, configurations, and severities. From all 3 sources, a total of 125 items were generated and organized into 29 subdomains derived from the World Health Organization's International Classification of Functioning, Disability and Health.
CONCLUSIONS AND RELEVANCE
The association of hearing loss with quality of life is multidimensional and includes subdomains that are not considered in the estimation of health utility by existing utility measures. The presented comprehensive profile of items can be used to generate or evaluate measures of hearing-related quality of life, including utility measures.
Topics: Academic Success; Auditory Threshold; Communication Aids for Disabled; Focus Groups; Hearing Loss; Humans; Interpersonal Relations; Interviews as Topic; Leisure Activities; Music; Qualitative Research; Quality of Life; Sound Localization; Speech Perception; Tinnitus
PubMed: 32407468
DOI: 10.1001/jamaoto.2020.0674 -
International Journal of Environmental... Mar 2020The present study explores the scientific evidence on whether music exposure temporarily or permanently affects hearing sensitivity in young adults. Six electronic... (Meta-Analysis)
Meta-Analysis
The present study explores the scientific evidence on whether music exposure temporarily or permanently affects hearing sensitivity in young adults. Six electronic databases were searched using related keywords for the four categories of personal listening devices, listening habits, hearing outcomes, and age. The Hedges' g and its 95% confidence intervals (CIs) were estimated. A Higgins was also used to check for heterogeneity. To test for publication bias, funnel plots were drawn using Egger's regression. Based on the inclusion criteria, 16 studies were divided into two groups to identify short-term hearing changes ( = 7) and long-term hearing changes ( = 9). In the short term, there was no significant immediate change in the thresholds or amplitudes after the music exposure, although pure-tone thresholds (PTAs) and distortion product otoacoustic emissions (DPOAEs) did show the highest effect size (-0.344, CI -0.727 to 0.038) and (0.124, CI -0.047 to 0.296) at 4 kHz. On the other hand, for long-term hearing changes, the PTA provided the highest effect size at 6 kHz (-0.525, CI -0.897 to -0.154) and 8 kHz (-0.486, CI -0.819 to -0.152), while also implying that habitual and repeated personal listening device (PLD) usage can act on some significant hearing changes in audiological tests. We conclude that the use of a PLD produces a few temporary hearing changes at 4 kHz after its use but that the changes are then reversed. However, it is important to note heavy PLD users' experience regarding permanent changes in their hearing thresholds at high frequencies, and the public should be educated on this issue.
Topics: Auditory Perception; Auditory Threshold; Habits; Hearing Loss, Noise-Induced; Humans; Music; Otoacoustic Emissions, Spontaneous; Young Adult
PubMed: 32245244
DOI: 10.3390/ijerph17062091 -
Otology & Neurotology : Official... Oct 2019To conduct systematic review and meta-analyses of preclinical studies describing the efficacy of glucocorticoids administered via different routes for hearing... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
To conduct systematic review and meta-analyses of preclinical studies describing the efficacy of glucocorticoids administered via different routes for hearing preservation after cochlear implantation.
DATA SOURCES
A literature search was performed in PubMed to identify peer-reviewed articles published before December 31, 2017, with no language restrictions. Search components were "Cochlear implant," "Glucocorticoids," and "Hearing preservation." The results were specified for animal studies.
STUDY SELECTION
Original studies in which glucocorticoids were administered before or during cochlear implantation in animal models and hearing threshold shifts were measured using auditory brainstem response.
DATA EXTRACTION
Quality of included studies was assessed using the SYstematic Review Centre for Laboratory animal Experimentation protocol. Threshold Shift reduction between the "study" and "control" groups at 1-month postimplantation was the parameter used to evaluate hearing preservation.
DATA SYNTHESIS
The random-effects models were used to combine the results of selected studies. Separate meta-analyses were performed for drug-eluting electrodes, systemic, and local administration.
CONCLUSIONS
Administering either systemic or topical glucocorticosteroids had a significant effect on preserving low and high-frequency hearing. Topical administration was equally effective across a range of concentration levels and provided maximal hearing preservation when applied 120 minutes before implantation. The effect of systemic treatment was achieved with high doses, equivalent to 26 mg of dexamethasone per day in humans. No significant effect was found with the use of drug-eluting electrodes and more studies are needed to characterise the utility and efficacy of this administration method.
Topics: Animals; Auditory Threshold; Cochlear Implantation; Dexamethasone; Disease Models, Animal; Evoked Potentials, Auditory, Brain Stem; Glucocorticoids; Hearing
PubMed: 31498296
DOI: 10.1097/MAO.0000000000002383