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Ear and Hearing 2018The electrically evoked compound action potential (eCAP) is widely used in the clinic as an objective measure to assess cochlear implant functionality. During the past... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
The electrically evoked compound action potential (eCAP) is widely used in the clinic as an objective measure to assess cochlear implant functionality. During the past decade, there has been increasing interest in applying eCAPs for fitting of cochlear implants. Several studies have shown that eCAP-based fitting can potentially replace time-consuming behavioral fitting procedures, especially in young children. However, a closer look to all available literature revealed that there is no clear consensus on the validity of this fitting procedure. This study evaluated the validity of eCAP-based fitting of cochlear implant recipients based on a systematic review of the recent literature.
DESIGN
The Preferred Reporting Items for Systematic Reviews and Meta-Analyses were used to search the PubMed, Web of Science, and Cochrane Library databases. The term "eCAP" was combined with "cochlear implants," "thresholds," and "levels," in addition to a range of related terms. Finally, 32 studies met the inclusion criteria. These studies were evaluated on the risk of bias and, when possible, compared by meta-analysis.
RESULTS
Almost all assessed studies suffered from some form of risk of bias. Twenty-nine of the studies based their conclusion on a group correlation instead of individual subject correlations (analytical bias); 14 studies were unclear about randomization or blinding (outcome assessment bias); 9 studies provided no clear description of the populations used, for example, prelingually or postlingually implanted subjects (selection bias); and 4 studies had a high rate of loss (>10%) for patients or electrodes (attrition bias). Meta-analysis of these studies revealed a weak pooled correlation between eCAP thresholds and both behavioral T- and C-levels (r = 0.58 and r = 0.61, respectively).
CONCLUSIONS
This review shows that the majority of the assessed studies suffered from substantial shortcomings in study design and statistical analysis. Meta-analysis showed that there is only weak evidence to support the use of eCAP data for cochlear implant fitting purposes; eCAP thresholds are an equally weak predictor for both T- and C-levels. Based on this review, it can be concluded that research on eCAP-based fitting needs a profound reflection on study design and analysis to draw well-grounded conclusions about the validity of eCAP-based fitting of cochlear implant recipients.
Topics: Action Potentials; Auditory Threshold; Cochlear Implantation; Cochlear Implants; Deafness; Evoked Potentials, Auditory; Humans; Selection Bias
PubMed: 28945656
DOI: 10.1097/AUD.0000000000000495 -
Brazilian Journal of Otorhinolaryngology 2018Hearing loss is conceptualized as any impairment of the ability to hear and/or detect speech or environment sounds, regardless of cause, type, or degree. It may occur at... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Hearing loss is conceptualized as any impairment of the ability to hear and/or detect speech or environment sounds, regardless of cause, type, or degree. It may occur at different stages of life; during pregnancy or childbirth, in childhood, adulthood or old age. It should be noted that aging is the most common cause of sensorineural hearing loss followed by noise-induced hearing loss, and both are closely related to the formation of reactive oxygen species. Dietary antioxidant supplementation has been employed as a therapeutic strategy to prevent and/or delay the risks of major human diseases.
OBJECTIVE
To assess randomized clinical trials to determine the effect of antioxidant supplementation on the auditory thresholds in patients of different age groups with sensorineural hearing loss.
METHODS
This systematic review consisted of a search in the following databases: MEDLINE, CENTRAL, ScienceDirect, Scopus, Web of Science, LILACS, SciELO and ClinicalTrials.gov. Additionally, the gray literature was also searched. The search strategy included terms related to the intervention (antioxidant supplementation), primary outcome (sensorineural hearing loss), as well as terms related to randomized clinical trials to improve search sensitivity.
RESULTS
Based on 977 potentially relevant records identified through the search in the databases, ten full-text publications were retrieved for further evaluation. The increase in threshold at the 4kHz frequency was statistically higher in the control group (1.89 [1.01-2.78], p<0.0001) when compared to the NAC group and the ginseng group, whereas at 6kHz, the threshold increase was higher in the control group (1.42 [-1.14-3.97], p=0.28), but no statistically significant differences were found between groups.
CONCLUSION
Ginseng was the antioxidant agent that showed the best effect in preventing auditory threshold worsening at the frequency of 4kHz, but not at 6kHz in patients with sensorineural hearing loss caused by exposure to high sound pressure levels. There was no improvement in the thresholds with vitamin E supplementation.
Topics: Antioxidants; Auditory Threshold; Dietary Supplements; Hearing Loss, Sensorineural; Humans; Randomized Controlled Trials as Topic
PubMed: 28888754
DOI: 10.1016/j.bjorl.2017.07.011 -
Ear and Hearing 2017To undertake a systematic review of available evidence on the effect of hearing impairment and hearing aid amplification on listening effort. Two research questions were... (Review)
Review
OBJECTIVES
To undertake a systematic review of available evidence on the effect of hearing impairment and hearing aid amplification on listening effort. Two research questions were addressed: Q1) does hearing impairment affect listening effort? and Q2) can hearing aid amplification affect listening effort during speech comprehension?
DESIGN
English language articles were identified through systematic searches in PubMed, EMBASE, Cinahl, the Cochrane Library, and PsycINFO from inception to August 2014. References of eligible studies were checked. The Population, Intervention, Control, Outcomes, and Study design strategy was used to create inclusion criteria for relevance. It was not feasible to apply a meta-analysis of the results from comparable studies. For the articles identified as relevant, a quality rating, based on the 2011 Grading of Recommendations Assessment, Development, and Evaluation Working Group guidelines, was carried out to judge the reliability and confidence of the estimated effects.
RESULTS
The primary search produced 7017 unique hits using the keywords: hearing aids OR hearing impairment AND listening effort OR perceptual effort OR ease of listening. Of these, 41 articles fulfilled the Population, Intervention, Control, Outcomes, and Study design selection criteria of: experimental work on hearing impairment OR hearing aid technologies AND listening effort OR fatigue during speech perception. The methods applied in those articles were categorized into subjective, behavioral, and physiological assessment of listening effort. For each study, the statistical analysis addressing research question Q1 and/or Q2 was extracted. In seven articles more than one measure of listening effort was provided. Evidence relating to Q1 was provided by 21 articles that reported 41 relevant findings. Evidence relating to Q2 was provided by 27 articles that reported 56 relevant findings. The quality of evidence on both research questions (Q1 and Q2) was very low, according to the Grading of Recommendations Assessment, Development, and Evaluation Working Group guidelines. We tested the statistical evidence across studies with nonparametric tests. The testing revealed only one consistent effect across studies, namely that listening effort was higher for hearing-impaired listeners compared with normal-hearing listeners (Q1) as measured by electroencephalographic measures. For all other studies, the evidence across studies failed to reveal consistent effects on listening effort.
CONCLUSION
In summary, we could only identify scientific evidence from physiological measurement methods, suggesting that hearing impairment increases listening effort during speech perception (Q1). There was no scientific, finding across studies indicating that hearing aid amplification decreases listening effort (Q2). In general, there were large differences in the study population, the control groups and conditions, and the outcome measures applied between the studies included in this review. The results of this review indicate that published listening effort studies lack consistency, lack standardization across studies, and have insufficient statistical power. The findings underline the need for a common conceptual framework for listening effort to address the current shortcomings.
Topics: Auditory Fatigue; Auditory Perception; Hearing Aids; Hearing Loss; Humans
PubMed: 28234670
DOI: 10.1097/AUD.0000000000000396 -
Brazilian Journal of Otorhinolaryngology 2017High-frequency audiometry may contribute to the early detection of hearing loss caused by ototoxic medications. Many ototoxic drugs are widely used in the treatment of... (Review)
Review
INTRODUCTION
High-frequency audiometry may contribute to the early detection of hearing loss caused by ototoxic medications. Many ototoxic drugs are widely used in the treatment of patients with cystic fibrosis. Early detection of hearing loss should allow known harmful drugs to be identified before the damage affects speech frequencies. The damage caused by ototoxicity is irreversible, resulting in important social and psychological consequences. In children, hearing loss, even when restricted to high frequencies, can affect the development of language.
OBJECTIVE
To investigate the efficacy and effectiveness of hearing monitoring through high-frequency audiometry in pediatric patients with cystic fibrosis.
METHODS
Electronic databases PubMed, MedLine, Web of Science and LILACS were searched, from January to November 2015. The selected studies included those in which high-frequency audiometry was performed in patients with cystic fibrosis, undergoing treatment with ototoxic drugs and published in Portuguese, English and Spanish. The GRADE system was chosen for the evaluation of the methodological quality of the articles.
RESULTS
During the search process carried out from January 2015 to November 2015, 512 publications were identified, of which 250 were found in PubMed, 118 in MedLine, 142 in Web of Science and 2 in LILACS. Of these, nine articles were selected.
CONCLUSION
The incidence of hearing loss was identified at high frequencies in cystic fibrosis patients without hearing complaints. It is assumed that high-frequency audiometry can be an early diagnostic method to be recommended for hearing investigation of patients at risk of ototoxicity.
Topics: Aminoglycosides; Audiometry, Pure-Tone; Auditory Threshold; Cystic Fibrosis; Hearing Loss; Humans; Otoacoustic Emissions, Spontaneous
PubMed: 27894912
DOI: 10.1016/j.bjorl.2016.10.006 -
CoDAS 2015This review aimed at presenting the benefits regarding the speech perception in noise shown by children who wear hearing aid devices and/or cochlear implants with the... (Review)
Review
PURPOSE
This review aimed at presenting the benefits regarding the speech perception in noise shown by children who wear hearing aid devices and/or cochlear implants with the Frequency Modulation (FM) System at school.
RESEARCH STRATEGY
A bibliographic survey was conducted in an electronic database with standardized search until the year 2012, and a manual search was performed by using specific keywords.
SELECTION CRITERIA
For the selection and evaluation of the scientific studies chosen in the search, criteria were established covering the following aspects: type of study, participants, adopted intervention, and evaluation of results.
DATA ANALYSIS
The FM system was verified to improve speech perception and speech threshold in noise in all studies.
RESULTS
Regarding the performance as to type, the best results were obtained when children used the personal FM system, followed by the table and the sound field systems.
CONCLUSION
After extensive review of national and international literature, it was concluded that the studies indicate the need for further research concerning mainly the impact of the FM system on the school performance of children who have sensory devices coupled to the FM system. Findings in the literature with relation to the publications focused on speech perception in noise did not relate educational and auditory aspects.
Topics: Child; Cochlear Implantation; Cochlear Implants; Hearing Aids; Hearing Loss, Sensorineural; Humans; Speech Perception; Verbal Learning
PubMed: 26222948
DOI: 10.1590/2317-1782/20152014103 -
Iranian Journal of Public Health Dec 2014Noise-induced hearing loss, which is one of the 10 leading occupational diseases, is a debilitating and irreversible disease. During the recent 15-years period... (Review)
Review
Noise-induced hearing loss, which is one of the 10 leading occupational diseases, is a debilitating and irreversible disease. During the recent 15-years period (1997-2012), several studies have investigated the association between noise, hearing damage and other side effects of noise in Iran. The aim of this study was to review systematically the relevant literature related to noise-induced hearing loss, lead to developing noise exposure limits. In this systematic review, two researchers independently extracted the data from 31 past studies that had considered noise-induced hearing loss (including hearing loss, temporary and permanent hearing threshold shift and auditory trauma). The data were then recorded in a modified form and Statistical analyses were performed using SPSS, version 16.0. In analyzed studies the weighted average equivalent sound pressure level [L Aeq ] was 90.29 dB(A) and average hearing loss was 26.44 dB(A). The Highest degree of hearing loss in the right ear was associated at 4000 Hz, and the highest degree of hearing loss in the left ear was associated to 1000 and 4000 Hz. The majority of the reviewed studies have confirmed that exposure to a noise level above 85 dB (A) can lead to an increased chance of hearing loss. Furthermore, the results of the present review indicated that as L Aeq increased up to 85 dB(A), so did the severity of the hearing loss.
PubMed: 26171352
DOI: No ID Found -
Journal of Occupational Health 2014A systematic review was conducted to identify the effectiveness of different permissible exposure limits in preserving the hearing threshold level. This review compared... (Review)
Review
OBJECTIVES
A systematic review was conducted to identify the effectiveness of different permissible exposure limits in preserving the hearing threshold level. This review compared the limits of the US National Institute of Occupational Safety and Health with those of the US Occupational Safety and Health Administration. The prevalence of occupational noise-induced hearing loss is on an increasing trend globally. This review was performed to reduce the prevalence of noise-induced hearing loss.
METHODS
We searched 3 major databases, i.e., PubMed, Embase and Lippincott Williams & Wilkins Journals@Ovid, for studies published up until 1May 2013 without language restrictions. All study designs were included in this review. The studies were identified and retrieved by two independent authors.
RESULTS
Of 118 titles scanned, 14 duplicates were removed, and a total of 13 abstracts from all three databases were identified for full-text retrieval. From the full text, eight articles met the inclusion criteria for this systematic review. These articles showed acceptable quality based on our scoring system. Most of the studies indicated that temporary threshold shifts were much lower when subjects were exposed to a noise level of 85 dBA or lower.
CONCLUSIONS
There were more threshold shifts in subjects adopting 90 dBA compared with 85 dBA. These temporary threshold shifts may progress to permanent shifts over time. Action curtailing noise exposure among employees would be taken earlier on adoption of 85 dBA as the permissible exposure limit, and hence prevalence of noise-induced hearing loss may be reduced.
Topics: Auditory Threshold; Databases, Bibliographic; Global Health; Hearing Loss, Noise-Induced; Humans; National Institute for Occupational Safety and Health, U.S.; Noise, Occupational; Occupational Diseases; Prevalence; Threshold Limit Values; United States; United States Occupational Safety and Health Administration
PubMed: 24270928
DOI: 10.1539/joh.13-0135-ra -
Trends in Amplification Mar 2013Cochlear implant systems that combine electric and acoustic stimulation in the same ear are now commercially available and the number of patients using these devices is... (Review)
Review
Cochlear implant systems that combine electric and acoustic stimulation in the same ear are now commercially available and the number of patients using these devices is steadily increasing. In particular, electric-acoustic stimulation is an option for patients with severe, high frequency sensorineural hearing impairment. There have been a range of approaches to combining electric stimulation and acoustic hearing in the same ear. To develop a better understanding of fitting practices for devices that combine electric and acoustic stimulation, we conducted a systematic review addressing three clinical questions: what is the range of acoustic hearing in the implanted ear that can be effectively preserved for an electric-acoustic fitting?; what benefits are provided by combining acoustic stimulation with electric stimulation?; and what clinical fitting practices have been developed for devices that combine electric and acoustic stimulation? A search of the literature was conducted and 27 articles that met the strict evaluation criteria adopted for the review were identified for detailed analysis. The range of auditory thresholds in the implanted ear that can be successfully used for an electric-acoustic application is quite broad. The effectiveness of combined electric and acoustic stimulation as compared with electric stimulation alone was consistently demonstrated, highlighting the potential value of preservation and utilization of low frequency hearing in the implanted ear. However, clinical procedures for best fitting of electric-acoustic devices were varied. This clearly identified a need for further investigation of fitting procedures aimed at maximizing outcomes for recipients of electric-acoustic devices.
Topics: Acoustic Stimulation; Auditory Perception; Auditory Threshold; Cochlear Implantation; Cochlear Implants; Correction of Hearing Impairment; Electric Stimulation; Hearing Loss; Humans; Persons With Hearing Impairments; Prosthesis Design; Prosthesis Fitting; Recovery of Function; Treatment Outcome
PubMed: 23539259
DOI: 10.1177/1084713813480857