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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 -
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 -
Cancer Epidemiology, Biomarkers &... Jun 2024Childhood cancer survivors treated with platinum-based chemotherapy are at risk of treatment-induced hearing loss. Accurate evaluation of hearing thresholds has...
BACKGROUND
Childhood cancer survivors treated with platinum-based chemotherapy are at risk of treatment-induced hearing loss. Accurate evaluation of hearing thresholds has historically been limited to clinical audiometry, which is logistically challenging and expensive to include in epidemiological studies. We evaluated the feasibility of using a remote, tablet-based hearing assessment in a cohort of pediatric germ cell tumor (GCT) survivors treated with platinum-based chemotherapy.
METHODS
Survivors from the GCT Outcomes and Late effects Data (GOLD) study were recruited to the pilot study (n=100). Study personnel conducted remote hearing assessments of standard and extended high frequency thresholds using validated tablet-based audiometry (SHOEBOX Inc). T-tests and Wilcoxon rank-sum tests evaluated differences in assessment characteristics between children and adults. Agreement between self-reported and measured hearing loss was calculated using Cohen's kappa.
RESULTS
We were able to reach 136/168 (81%) eligible participants, of which 100 (74%) agreed to participate. Successful completion of the remote hearing assessment was high (97%; 20 children [ages 7-17], 77 adults [ages 18-31]). Mean assessment length was 37.6 minutes and mean turnaround time was 8.3 days. We observed hearing loss at standard frequencies in 21% of participants. Agreement between self-reported and measured hearing loss was significant (p-value = 1.41 x 10-7), with 83.5% concordance.
CONCLUSIONS
Hearing loss measured using the remote assessment aligns with self-reporting and rates of hearing loss reported in the literature for this population.
IMPACT
Remote application of tablet-based audiometry is a feasible and efficacious method for measuring hearing in epidemiologic studies with participants spread across large geographical areas.
PubMed: 38869488
DOI: 10.1158/1055-9965.EPI-24-0203 -
BMC Geriatrics Jun 2024Hearing loss is common in aging adults and is an important public health concern. Self-reported measures of hearing difficulty are often used in research and clinical...
BACKGROUND
Hearing loss is common in aging adults and is an important public health concern. Self-reported measures of hearing difficulty are often used in research and clinical practice, as they capture the functional impacts of hearing loss on individuals. However, little research has evaluated the prevalence or factors associated with self-reported hearing difficulty. Therefore, the purpose of this study was to determine the prevalence of self-reported hearing difficulty, measured by the Revised Hearing Handicap Inventory (RHHI), and associated factors.
METHODS
This study was conducted in a community-based cohort study based in Charleston, SC. We determined the prevalence of RHHI self-reported hearing difficulty (score ≥ 6 points) and evaluated associated factors with logistic regression models. Results are presented as odds ratios (OR) with corresponding 95% confidence intervals (95% CI).
RESULTS
There were 1558 participants included in this study (mean age 63.7 [SD 14.4], 56.9% female, 20.0% Minority race). The prevalence of RHHI self-reported hearing difficulty was 48.8%. In a multivariable model, older age (per + 1 year; OR 0.97 [95% CI 0.96, 0.98]), Minority (vs. White) race (OR 0.68 [95% CI 0.49, 0.94]), and speech-in-noise scores that are better than predicted (OR 0.99 [95% CI 0.98, 1.00]) were associated with lower odds of RHHI self-reported hearing difficulty. Furthermore, female (vs. male) sex (OR 1.39 [95% CI 1.03, 1.86]), higher PTA in the worse ear (per + 1 dB; OR 1.10 [95% CI 1.09, 1.12]), more comorbid conditions (vs. 0; 1 condition: OR 1.50 [95% CI 1.07, 2.11]; 2 conditions: OR 1.96 [95% CI 1.32, 2.93]; 3 + conditions: OR 3.00 [95% CI 1.60, 5.62]), noise exposure (OR 1.54 [95% CI 1.16, 2.03]), bothersome tinnitus (OR 2.16 [95% CI 1.59, 2.93]), and more depressive symptoms (OR 1.04 [95% CI 1.01, 1.07]) were associated with higher odds of RHHI self-reported hearing difficulty.
CONCLUSIONS
The prevalence of RHHI self-reported hearing difficulty is high, and associated factors included demographics, audiometric hearing and other hearing-related factors, and physical and mental health. The RHHI likely captures functional impacts of hearing loss that are not captured by audiometry alone. Study findings can support the correct interpretation of the RHHI in research and clinical settings.
Topics: Humans; Male; Female; Middle Aged; Self Report; Hearing Loss; Prevalence; Aged; Cohort Studies; Disability Evaluation; Adult; Aged, 80 and over
PubMed: 38867166
DOI: 10.1186/s12877-024-04901-w -
Otology & Neurotology : Official... Jul 2024To analyze the outcomes of exoscopic versus microscopic type 1 tympanoplasty. (Comparative Study)
Comparative Study
OBJECTIVE
To analyze the outcomes of exoscopic versus microscopic type 1 tympanoplasty.
STUDY DESIGN
Retrospective chart review.
SETTING
Tertiary care otology-neurotology practice.
PATIENTS
Adult subjects with a diagnosis of tympanic membrane perforation from 2018 to 2022.
INTERVENTION
Exoscopic or microscopic tympanoplasty with cartilage + perichondrium or perichondrium/fascia graft.
MAIN OUTCOME MEASURES
Primary outcomes were graft success rate (1 wk, 3 wk, 3 mo, and 6 mo postoperatively) and operative time. Secondary outcomes included audiometric outcomes of postoperative air-bone gap (ABG), change in ABG, pure tone average (PTA), speech reception threshold (SRT), and word recognition score (WRS) at 6-month follow-up and complication rates of cerebrospinal fluid leak, facial nerve injury, persistent tinnitus, and persistent vertigo.
RESULTS
Seventy-one patients underwent type 1 tympanoplasty by a single surgeon. Thirty-six patients underwent exoscopic tympanoplasty, and 35 patients underwent microscopic tympanoplasty. Cartilage and perichondrium were utilized in 27 subjects (75.0%) in the exoscopic group and in 25 subjects (71.4%) in the microscopic group (p = 0.7, Cramer's V = 0.04). Graft success rate was as follows (exoscope versus microscope): 100% (36/36) versus 100% (35/35) at 1 week (p = 1.0, Cramer's V = 0.0), 97.2% (35/36) versus 100% (35/35) at 3 weeks (p = 1.0, Cramer's V = 0.1), 97.2% (35/36) versus 94.3% (33/35) at 3 months (p = 1.0, Cramer's V = 0.07), and 91.7% (33/36) versus 91.4% (32/35) at 6 months (p = 0.7, Cramer's V = 0.0). Operative time was 57.7 minutes for the exoscopic group and 65.4 minutes for the microscopic group (p = 0.08, 95% CI [-16.4, 0.9], Cohen's d = 0.4). There were no serious complications. All preoperative and postoperative audiometric outcomes were comparable.
CONCLUSIONS
The outcomes after exoscopic versus microscopic type 1 tympanoplasty are comparable.
Topics: Humans; Tympanoplasty; Male; Female; Adult; Tympanic Membrane Perforation; Retrospective Studies; Middle Aged; Treatment Outcome; Microsurgery; Aged; Audiometry, Pure-Tone; Cartilage; Postoperative Complications
PubMed: 38865726
DOI: 10.1097/MAO.0000000000004220 -
Journal of Applied Statistics 2024In this paper, we consider the estimation of intracluster correlation for ordinal data. We focus on pure-tone audiometry hearing threshold data, where thresholds are...
In this paper, we consider the estimation of intracluster correlation for ordinal data. We focus on pure-tone audiometry hearing threshold data, where thresholds are measured in 5 decibel increments. We estimate the intracluster correlation for tests from iPhone-based hearing assessment applications as a measure of test/retest reliability. We present a method to estimate the intracluster correlation using mixed effects cumulative logistic and probit models, which assume the outcome data are ordinal. This contrasts with using a mixed effects linear model which assumes that the outcome data are continuous. In simulation studies, we show that using a mixed effects linear model to estimate the intracluster correlation for ordinal data results in a negative finite sample bias, while using mixed effects cumulative logistic or probit models reduces this bias. The estimated intracluster correlation for the iPhone-based hearing assessment application is higher when using the mixed effects cumulative logistic and probit models compared to using a mixed effects linear model. When data are ordinal, using mixed effects cumulative logistic or probit models reduces the bias of intracluster correlation estimates relative to using a mixed effects linear model.
PubMed: 38863801
DOI: 10.1080/02664763.2023.2280821 -
Ulusal Travma Ve Acil Cerrahi Dergisi =... Jun 2024Over 5% of the global population (430 million people) require rehabilitation for hearing loss. Individuals with hearing impairments face significant challenges in...
BACKGROUND
Over 5% of the global population (430 million people) require rehabilitation for hearing loss. Individuals with hearing impairments face significant challenges in business, daily life, and social participation. Hearing loss (HL) and other permanent physical and sensory disabilities escalate dramatically in cases with brain damage and temporal bone trauma associated with head injuries. This study aims to identify the significant risk factors for hearing loss following head trauma, utilizing current data, and discuss the findings in the context of the literature. This could contribute to the development of standard approaches for assessing such cases.
METHODS
This retrospective study reviewed files and reports from individuals assessed for hearing loss at Dokuz Eylül University Faculty of Medicine, Department of Forensic Medicine. The study included cases that applied at least 12 months post-trauma, between January 1, 2016, and December 31, 2022, after their recovery process was completed. Sociodemographic data, types of temporal bone fractures, initial otoscopic examination findings, presence or absence of intracranial injury, type of hearing loss, and audiometry test results for air and bone conduction pure tone threshold averages were evaluated. Data analysis was conducted using SPSS 26.0 (Statistical Package for the Social Sciences).
RESULTS
Out of 244 cases, 177 (72.5%) were male and 67 (27.5%) were female. It was observed that the majority of trauma cases occurred in the 19-40 age group (49.2%; n=120). In the initial otoscopic examinations post-trauma, otorrhagia/otorrhea was the most common finding, both as an isolated symptom (n=59, 24.2%) and when accompanied by other symptoms. No temporal bone fractures were detected in 43 cases (17.6%). Longitudinal fractures were found in 141 cases (57.8%), transverse fractures in 48 (19.7%), and mixed-type fractures in 12 (4.9%). The statistical difference in air conduction and bone conduction pure tone threshold averages between groups with and without intracranial injury was significant (p<0.001).
CONCLUSION
Post-traumatic examinations should employ a multidisciplinary approach, adhering to standard medical improvement and assessment timelines. It is essential to verify whether each patient's medical improvement process has reached its maximum potential. We believe that adhering to these recommendations and utilizing standardized classifications for hearing loss will prevent the loss of rights.
Topics: Humans; Male; Female; Retrospective Studies; Adult; Hearing Loss; Middle Aged; Adolescent; Young Adult; Aged; Temporal Bone; Craniocerebral Trauma; Risk Factors; Child
PubMed: 38863291
DOI: 10.14744/tjtes.2024.63099 -
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 Craniofacial Surgery Jun 2024Cleft lip and/or palate, a treatable congenital condition, affects around 1 in 700 births, placing a large burden of care on those affected. A multidisciplinary approach...
Cleft lip and/or palate, a treatable congenital condition, affects around 1 in 700 births, placing a large burden of care on those affected. A multidisciplinary approach to treating the patient involves not only cleft surgery but also a wide array of treatments and preventative therapies to prevent further disease. In this review, the otolaryngology subspecialties, otology and audiology, are discussed in relation to orofacial clefts. As patients with clefts carry a higher risk of permanent hearing loss and speech complications caused by the pathology of their cleft, management of additional diseases such as otitis media with effusion, conductive hearing loss, or infections requires timely evaluation, treatment, and follow-up. The current practice in otology and audiology is discussed with the challenges faced in delivering timely care-in any setting, low or higher income. Lack of consensus and controversies surrounding the use and timing of tympanostomy tubes are reviewed, as well as the palatoplasty types that show significant benefit for otitis media with effusion, audiometry, and speech outcomes. Lastly, a call for further research in clefts and otology and the urgency for its awareness and advocacy in low and middle-income countries is imperative.
PubMed: 38861335
DOI: 10.1097/SCS.0000000000010396 -
Cureus May 2024This study tests the utilization of Bluetooth noise-canceling headphones in improving the quality of eye exams in patients with hearing loss. This prospective study was...
INTRODUCTION
This study tests the utilization of Bluetooth noise-canceling headphones in improving the quality of eye exams in patients with hearing loss. This prospective study was approved on ethical standards by the University of Texas Medical Branch (UTMB) Institutional Review Board (Approval No. 22-0079) and registered with the National Institutes of Health (NCT05420038).
METHODS
UTMB patients above 55 years of age were screened for hearing loss using soundcheck audiometry. Twenty-nine subjects answered pre-recorded ophthalmic exam questions that solicited precise responses. As controls, subjects were randomly administered half of the questions via headphones and half via a smartphone at normal speech volume (60 decibels). Points were awarded for responses demonstrating comprehension, and a post-exam survey was collected.
RESULTS
Collectively, the mean score was 1.79 with headphones versus 0.96 with control on the Amsler grid segment and 1.90 with headphones versus 0.97 with control on education questions (p=0.001). Between red zone and yellow zone hearing loss patients, the more severe red zone group answered significantly better in both Amsler (1.78 versus 0.50; p=0.0003) and education questions (1.88 versus 0.44; p<0.0001) with headphones. The yellow zone group answered better with headphones overall but failed to reach significance. Post-exam survey indicated that 28 of 29 patients (97%) preferred the headphones during ophthalmic exams.
CONCLUSION
Patients with hearing loss demonstrated better comprehension with Bluetooth headphones. These low-cost devices show great promise at improving effective, compassionate communication between providers and hearing loss patients.
PubMed: 38860057
DOI: 10.7759/cureus.60090