Hearing loss and its relationship with blood pressure among workers exposed to noise in a brewery / 公共卫生与预防医学

Objective To investigate the health status of workers exposed to noise in a brewery in Beijing and to analyze the relationship between hearing loss and blood pressure. Methods A total of 949 noise-exposed workers in a brewery who participated in occupational health examination were selected as the investigation subjects. A survey was conducted to investigate the pure tone hearing threshold and abnormal blood pressure of the workers with different characteristics, and to analyze the relationship between the two. Results Among the noise-exposed workers, the detection rates of hearing abnormality, hypertension, and increased systolic and diastolic blood pressure were 73.55%, 52.37%, 43.84% and 46.47%, respectively. The detection rates of hearing abnormality, indicators of hypertension, high frequency hearing threshold abnormality and increased binaural high frequency hearing threshold on average in males were higher than those in females (P 0.05), the detection rates of other hearing abnormality, indicators of hypertension, speech frequency hearing threshold abnormality, high frequency hearing threshold abnormality，increased binaural high frequency hearing threshold on average and the weighted value of the better ear's hearing threshold all increased or had an increasing trend with the increase of age or working years (P< 0.05). The detection rates of hypertension in the groups with high frequency hearing threshold abnormality and increased binaural high frequency hearing threshold on average were higher than those in the normal group (P＜0.05). Conclusion The noise-exposed workers in the brewery have hearing impairment, which is related to the occurrence of hypertension. It is recommended to strengthen the publicity and education on noise protection and take protective measures to reduce the occurrence of occupational noise injury.

Análise de limiares tonais de crianças submetidas ao reimplante: seguimento de 10 anos / Analysis of aided thresholds in children who have undergone cochlear reimplantation: a ten-year follow-up

RESUMO Objetivo Caracterizar os limiares auditivos nas frequências de 500, 1000, 2000 e 4000 Hz em crianças submetidas ao reimplante com follow-up de no mínimo 10 anos. Método Revisão retrospectiva de prontuários de crianças submetidas a cirurgia de reimplante há pelo menos 10 anos. Foram avaliados os limiares auditivos obtidos na audiometria tonal liminar em campo livre com o implante coclear nas frequências de 500, 1000, 2000 e 4000 Hz em quatro momentos distintos: 1 (antes da falha), 2 (ativação), 3 (cinco anos após o reimplante) e 4 (dez anos após o reimplante, independentemente do tempo de uso do uso do 2o IC) em pacientes com follow-up de no mínimo 10 anos. Resultados Avaliando-se pacientes submetidos ao reimplante, observou-se que os limiares de 500, 1000, 2000, 4000 Hz apresentaram-se a longo prazo semelhante àqueles obtidos nos pacientes implantados somente uma única vez, não apresentando prejuízo assim na detecção dos sons. Conclusão O reimplante não teve efeito de longo prazo sobre os limiares auditivos obtidos em crianças que se submeteram a esta cirurgia por falha do componente interno.

ABSTRACT Purpose To characterize hearing thresholds at frequencies of 500, 1000, 2000 and 4000 Hz in children undergoing reimplantation with a follow-up of at least 10 years. Methods Retrospective review of medical records of children who underwent reimplantation surgery for at least 10 years. The auditory thresholds obtained in free-field pure tone audiometry with the cochlear implant were evaluated at frequencies of 500, 1000, 2000 and 4000 Hz at four different times: 1 (before failure), 2 (activation), 3 (five years after reimplantation) and 4 (ten years after reimplantation, regardless of the time of use of the 2nd CI) in patients with a follow-up of at least 10 years. Results Evaluating patients who underwent reimplantation, it was observed that the thresholds of 500, 1000, 2000, 4000 Hz were similar in the long term to those obtained in patients who were implanted only once, thus not presenting damage in the detection of sounds. Conclusion Reimplantation had no long-term effect on the hearing thresholds obtained in children who underwent this surgery due to internal component failure.

Prevalence of hearing loss among community-dwelling older people in China in 2020 / 中华老年医学杂志

Objective:To investigate the prevalence of hearing loss among community-dwelling older people aged 60 and over, and also to compare the discrepancies between self-reported hearing loss and hearing loss diagnosed via audiometry.Methods:Subjects were from the Prevention and Intervention on Neurodegenerative Disease for the Elderly in China(PINDEC)project.By using the stratified multi-stage cluster random sampling method, a total of 10 347 residents aged 60 years and over were selected from 12 counties and districts in Liaoning, Henan and Guangdong Provinces and hearing function assessment was performed in 2020 through otoscopy, pure-tone audiometry and questionnaires.Hearing loss(HL)was defined by the World Health Organization criteria.Self-reported hearing loss was assessed by asking participants whether they had difficulty in hearing.The χ2 and Cochran-Armitage trend tests were used to analyze the differences in HL between different groups.The multivariate Logistic regression model was applied to assess factors influencing HL. Results:In 2020, the prevalence of HL among the elderly aged 60 and older in Liaoning, Henan and Guangdong Provinces was 69.8%(95% CI: 68.9%-70.7%). The prevalence of HL in men was higher than that in women, and increased gradually with age.The prevalence of mild HL was 47.2%, and the prevalence of moderate, severe and profound HL were 18.0%, 3.6% and 0.9%, respectively.Multivariate Logistic regression analysis showed that factors positively correlated with HL were aging, male sex, living in rural areas and working in manual labor.Education level was negatively correlated with HL.Of the 7223 participants who were found to have HL, 5106(70.7%)self-reported having good hearing.Those of a younger age, with a higher educational achievement, having a spouse, or with mild HL were more likely to report having good hearing(all P<0.05). Conclusions:Hearing loss is quite prevalent among community-dwelling older people, and there is a large discrepancy in prevalence between self-reported HL and HL diagnosed via audiometry.Screening and comprehensive intervention for hearing loss for the elderly should be strengthened.

Analyzing the influencing factors of quality control assessment of pure tone audiometry among noise exposed personnel in Guangzhou City from 2021 to 2022 / 中国职业医学

{L-End}Objective To explore the status of quality control assessment of pure tone audiometry (PTA) and to analyze its influencing factors in occupational medical examination (OME) institutions in Guangzhou City. {L-End}Methods A total of 41 OME institutions in Guangzhou City were selected as the research subjects from 2021 to 2022 using random sampling method, and its status of on-site quality and PTA quality for individuals exposed to noise were assessed. {L-End}Results A total of 205 rectification items were identified among the 41 OME institutions from 2021 to 2022. Among them, 19, 28, 30, and 28 OME institutions did not meet the requirements of organizational structure, quality management system, quality control of OME, and health examination information reporting, respectively. A total of 1 095 OME reports for individuals exposed to noise were assessed, with 820 reports having correct results and conclusions, resulting in an accuracy rate of 74.9%. The results of the multiple logistic regression analysis showed that OME institutions without meeting the requirements for the quality management system had a higher risk of failing the PTA quality control assessment and having inaccurate hearing test results compared with those meeting the requirements (all P<0.05). OME institutions with a filing period less than one year had a higher risk of having inaccurate hearing test results than those with a filing period of one year or more (P<0.05). OME institutions not meeting the requirements for quality control of OME had a higher risk of having abnormal OME conclusions than those meeting the requirements (P<0.05). OME institutions not meeting the requirements for health examination information reporting had a higher risk of having abnormal conclusions in suspected occupational disease than those meeting the requirements (P<0.05). OME institutions not meeting the requirements for the quality management system had a higher risk of having abnormal conclusions of occupational contraindications than those meeting the requirements (P<0.05). {L-End}Conclusion The quality of PTA in OME institutions in Guangzhou City needs to be improved. And a well-established quality management system for OME is beneficial for improving the quality of PTA.

Ossicular chain status in ear pathology cases

Introduction: The tympanic cavity contains three ossicles in humans, the malleus, incus and stapes. These ossicles form a chain across the tympanic cavity from the tympanic membrane to fenestra vestibuli respectively. They develop from mesenchymal condensation of tubotympanic recess at the 6th week of intrauterine life. Later due to programmed cell death a part of tissue remains as ossicles. It attains adult size in the fetal life itself. However, studies have shown gain in size and weight even 2 years after birth. The ossicles help in sound conducting mechanism in hearing. These ossicles are vulnerable to damage in the various diseases of the middle ear cleft resulting into either partial or total loss. Incus is the most, followed by stapes and least by malleus. 20% mucosal diseases show ossicular damage, while squamous epithelial disease involve in 80% [1,2]. The integrity of the ossicular chain is most important for the transmission mechanism of external sounds to the inner ear fluids. Objectives: 1. To study the percentage of ossicular damage in the diseases of the middle ear cleft among the patients being operated for chronic suppurative otitis media in our tertiary care hospital. 2.To assess the extent and frequency of individual ossicular chain involvement in simple mucosal disease and squamous epithelial diseases. Methods: A prospective clinical study was conducted in our tertiary care hospital over a period of five and a half years in our tertiary care hospital among 100 cases of chronic suppurative otitis media after ethical committee clearance. Detailed clinical and radiological examinations of the patients were done and ossicular chain status was noted on table. Patients were also called up for regular follow up. Results: Ossicular chain erosion was mostly seen in squamosal disease, with incus and incudo-stapedial joint being the most common sites for ossicular erosion. Conclusion: it was concluded that long process of incus was the most commonly eroded structure, with the incus being the most commonly involved ossicle Few factors that were found to be associated with ossicular erosion were atticoantral disease, pediatric age group and bigger tympanic membrane perforations.

Effects of Obesity on the Auditory Function of Children and Adolescents

Abstract Introduction Childhood and adolescent obesity is associated with insulin resistance, abnormal glucose metabolism, hypertension, dyslipidemia, inflammation, liver disease, and compromised vascular function. Objective We aimed to evaluate the effects of obesity on the auditory function and speech audiometry of children and adolescents. Methods Subjects with a body mass index (BMI) higher than +2 standard deviation (SD) were classified as obese, and subjects with normal BMI SD were classified as the control group. Blood samples were taken for glucose, insulin, and lipid profiles following an 8-hour fasting period, and a hepatobiliary ultrasound was performed. The homeostatic model assessment for insulin resistance (HOMA-IR) was calculated. The audiological evaluation included pure-tone audiometry (PTA), speech reception threshold (SRT), and speech discrimination score (SDS). Results The study included 100 children (50 girls) with obesity, with a mean age of 11.4 ± 2.9 years and 30 children with normal body weight, with a mean age of 11.9 ± 3.3 years. Of the children with obesity, 55% (n = 55) were found to have hyperlipidemia, 68% (n = 68) insulin resistance, and 21% (n = 21) hepatosteatosis. There were no statistically significant differences between children with obesity and the control group in terms of SDS or PTA, while SRT was found to be higher in children with obesity. There was no difference between obese children with or without hyperlipidemia, between obese children with or without insulin resistance, and between obese children with or without hepatosteatosis, according to hearing tests. Conclusion The result of the present study indicates that children with obesity are more prone to having auditory problems than the normal population. We recommend more frequent audiological evaluations, including speech audiometry, in children and adolescents with obesity problems

A study of pure tone audiometry in adults with hypothyroidism

Background: Thyroid hormones are important for overall growth and maturation. Hypothyroidism is associated with many symptom complexes, one of them being hearing loss. Aim and Objectives: Evaluating the hearing loss in hypothyroid patients of the age group of 18� years and comparing them with those in healthy people. Materials and Methods: A case-control study was conducted in subjects aged between 18 and 45 years, in which 80 hypothyroid cases were selected after proper exclusion and informed consent and 80 age-and sex-matched healthy controls were studied. Hearing loss was assessed by pure tone audiometry. Statistical Package for the Social Sciences version 18 was used for statistical analysis. Results: SNHL was the common type of hearing loss seen. The prevalence of hearing loss was found to be 66.3% in cases. Hearing loss was mild, bilateral, and commonly affected the high frequency. Conclusions: Hypothyroid patients were more prone to sensorineural hearing loss. In patients with thyroid disorders, hearing evaluation helps in the detection of hearing loss earlier and thus treatment could be started.

Comparative study of pure tone audiometry in diabetics and non-diabetics

Background: Diabetes mellitus (DM) is a non-communicable disorder which is metabolically disrupted associated with several complications, which include retinopathy, nephropathy, angiopathy, and neuropathy. Angiopathy and neuropathy caused by DM have been considered important factor for vestibulocochlear disorder found in these patients. Aims and Objectives: The study was done to compare sensory-neural hearing losses (SNHL) in Type 2 diabetics with healthy individuals. To find out effect of age of individual on hearing, how glycemic control of diabetes affects hearing acuity which frequencies of hearing affected by diabetic patients. Materials and Methods: The present study was conducted on 30 Type 2 diabetics and 30 healthy individuals are takes as controls in the age group of 30–60 years. Selection of individuals is done based on inclusion and exclusion criteria. All patients are asked for detailed history and their detailed clinical examination is done. After this, all patients are investigated for HbA1C. All subjects underwent pure tone audiometry and findings were recorded and analyzed. Results: The diabetics with SNHL are 90% when compared to the control are 60% which is highly significant (P = 0.017). Diabetes patients had hearing losses which are insidious in nature which is gradually progressive and affects hearing in both the sides. The audiogram of diabetics was suggestive of mild to moderately severe SNHL which was more toward higher frequencies. SNHL is aggravated with increasing age. In non-diabetic, SNHL is mainly due to age, but in diabetic, SNHL is mainly due to poorer control of diabetes not only due to age. Conclusion: The Type 2 diabetic patients had hearing losses at higher threshold more significantly which is bilateral, mild to moderately severe SNHL as compared to healthy individual of similar age. The glycemic control-HbA1C has significant correlation with severity of hearing loss. SNHL is more significant in patients whom had poor glycemic control.

Auditory perceptual discomfort and low-hearing tolerance in the first episode psychosis

Awareness of perceptual and sensory changes that might occur in visual, auditory, proprioception, and other senses, in the early stages towards the First Episode Psychosis (FEP), and their subsequent sensorial evolution as the disturb progresses deeper into an acute episode, might be a key element for interrupting the process. In the present study, we investigated hearing discomfort/tolerance to 16 given sound streams. Sixteen people diagnosed with FEP, participated in the experiment. Sixteen frequency sweeps varying in modulation envelopes (sawtooth, sine), order (ascending, descending), duration (4s, 8s), and range (50­8000 Hz, 2­8 kHz) were presented randomly, but always in the same sequence, to FEP and healthy controls (HC). The level of discomfort was estimated by the participant by making a mark across a continuous line whose extremes read "nothing bad" (left) and "too bad" (right). Results showed that ascending sine pure frequency sweeps (p < 0.01) and descending sine pure frequencies sweeps (p < 0.01) caused the maximum discomfort in FEP. Other variables also showed differences between FEP and HC, and FEP were always more intolerant to such pure frequency sweeps than HC. We conclude that this might be useful for very early assessment of people at risk, people with FEP, and people with schizophrenia. (AU)

O perfil audiológico e a funcionalidade coclear na síndrome de Williams / Audiological profile and cochlear functionality in Williams syndrome

RESUMO Objetivo avaliar o perfil audiológico e a funcionalidade coclear em indivíduos com SW. Método estudo com 39 indivíduos, sendo 22 indivíduos com SW com idade entre 7 e 17 anos, sendo 15 do sexo masculino e 7 do sexo feminino e 17 indivíduos com desenvolvimento típico e normo-ouvintes. Todos os indivíduos foram avaliados por meio da audiometria tonal limiar, medidas de imitância acústica e análise das Emissões Otoacústicas Transientes (EOAT). Foi avaliado o perfil audiológico dos indivíduos com SW, e também foram comparadas as respostas das EOAT entre os indivíduos com SW sem perda auditiva e indivíduos controles. Resultados perda auditiva foi observada em 50% dos pacientes, sendo 78,95% neurossensorial e 21,05% mista. Esta perda foi predominantemente de grau leve a moderado, acometendo principalmente as frequências a partir de 3 kHz. Quanto às EOAT, observou-se maior incidência de ausência e de respostas de menor amplitude em indivíduos com SW. Conclusão indivíduos com SW apresentam disfunção das células ciliadas, principalmente da região basal da cóclea. Assim, a análise das EOAT é um recurso clínico importante a ser considerada na avaliação audiológica de rotina.

ABSTRACT Purpose to evaluate cochlear functionality in Williams syndrome (WS) individuals. Methods a study with 39 individuals, being 22 with WS aged between 7 and 17 years, 15 male and 7 female, and 17 individuals with typical development and normal hearing. All individuals were evaluated using pure tone audiometry, acoustic immittance measurements, and Transient Evoked Otoacoustic Emissions (TEOAE). The audiological profile in individuals with WS was analyzed, and TEOAE responses were compared between WS individuals without hearing loss and typical developmental individuals. Results The hearing loss was observed in 50% of patients, being 78.95% sensorineural and 21.05% mixed. This hearing loss was predominantly mild to moderate, affecting mainly frequencies above 3 kHz. As for TEOAE, there was a higher incidence of absence and lower amplitude responses in individuals with WS. Conclusion WS individuals have hair cell dysfunction, mainly in the basal region of the cochlea. Thus, TEOAE analysis is an important clinical resource to be considered in the routine audiological evaluation.

Development of High-performance Hearing Test System / 中国医疗器械杂志

This paper analyzes the shortcomings of the existing pure tone audiometers, and proposes a system to realize pure tone audiometry and speech audiometry with a new DSP processor. The pure tone test signal produced by the system has accurate frequency, high signal-to-noise ratio, and small harmonic distortion. The noise generator that comes with DSP adds a band-pass filter to realize the generation of narrow-band noise. At the same time, due to the modular structure of software design, the system has good ease of use and scalability. The test results show that the hearing test system has excellent performance and can be better used in hearing medical diagnosis.

Vertigo Patients Characteristic in Neurotology Outpatient Clinic, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia

@#Introduction: Vertigo is estimated to occur in 3% of adults every year. In contrast to dizziness, vertigo is associated with symptoms of peripheral or central balance disorders, while dizziness is associated with cardiovascular, neuropathic, neuromuscular, or psychosomatic diseases. Methods: Data for 123 patients at Hospital were taken retrospectively. The variables studied were demographic data, vestibular examination, audiometry, and vertigo diagnosis. Results: There were 123 vertigo patients consisting of 42 men and 81 women. The average age of the patients was 48.46 years. Most patients were diagnosed with other peripheral vertigo 37.40%, then unspecified disorder of vestibular function 15.45%, BPPV 14.63%, Meniere’s disease 8.94%, dizziness 8.94%, central vertigo 8.13%, and vestibular neuritis 6.50%. The types of hearing loss were Conductive Hearing loss (CHL) 6.10%, Sensorineural Hearing Loss (SNHL) 21.54%, and Mixed Hearing Loss (MHL) 11.38%. Location of hearing loss was unilateral 23.58% and bilateral 26.83%. Mean Pure Tone Average (PTA) of vertigo with hearing loss was 52.54 dB in right ear and 55.96 dB in left ear. Conclusion: Most patients were diagnosed with other peripheral vertigo is female. They had normal hearing. The most common type of hearing loss was SNHL with a mean PTA of 52.54 dB in right ear and 55.96 dB in left ear. Mean PTA in vertigo patients with normal hearing was 18.29 ± 4.24 dB in right ear and 17.55 ± 4.13 dB in left ear, while mean PTA in vertigo with hearing loss was 52.54 ± 29.93 dB in right ear and 55.96 ± 28.01 in left ear.

Comparison of ASSR, ABR and 40 Hz AERP Response Thresholds at Different Frequencies and Their Forensic Applications / 法医学杂志

OBJECTIVES@#To explore the relationship between the frequency characteristics and response threshold of auditory steady-state response (ASSR), auditory brainstem response (ABR) and 40 Hz auditory event related potential (40 Hz AERP), and their application values in forensic medicine.@*METHODS@#Thirty volunteers with normal hearing (60 ears) were selected to perform pure tone audiometry (PTA) threshold and ASSR, ABR and 40 Hz AERP response threshold tests in the standard sound insulation shielding room, and the results were statistically analyzed by SPSS 22.0 software.@*RESULTS@#At 0.5 kHz and 1.0 kHz frequencies, the correlation between 40 Hz AERP response threshold and PTA threshold was good, which was better than that of ASSR and ABR response threshold. At 2.0 kHz and 4.0 kHz frequencies, the correlation between ASSR and ABR response thresholds and PTA threshold was good, which was better than that of 40 Hz AERP response threshold.@*CONCLUSIONS@#To evaluate the hearing at 0.5 kHz and 1.0 kHz frequencies, it is recommended to use 40 Hz AERP and ASSR to comprehensively assess the PTA threshold of the subjects. To evaluate the hearing at 2.0 kHz and 4.0 kHz frequencies, ABR and ASSR are recommended to assess the PTA threshold of subjects comprehensively. The combination of ASSR, ABR and 40 Hz AERP can improve the accuracy of hearing function evaluation.

Comparison of radiation and chemoradiation-induced sensorineural hearing loss in head and neck cancer patients

Aim: The purpose of this study was to assess and compare the incidence and severity of sensorineural hearing loss (SNHL) in head-and-neck patients undergoing radiotherapy (RT) and concurrent cisplatin-based chemoradiotherapy (CRT). Materials and Methods: Pure tone audiometry (PTA) was performed at 0.25–12 kHz on 35 RT and 25 CRT patients after 12-month followed up. The hearing loss was evaluated according to the Common Terminology Criteria for Adverse Events (CTCAE) criteria. Results: SNHL increased to 84% in patients who had received CRT, compared with 26% increasing in patients who had treated with RT. There was an increased risk of SNHL at all frequencies for ears received a cochlear mean dose >50 Gy in RT group, compared to those receiving cochlear mean dose >30 Gy in CRT group. SNHL was more severe at higher frequencies in both patient groups. Conclusion: Characteristic of radiation-induced SNHL is different from CRT-induced SNHL, especially in threshold radiation dose and PTA frequency.

Osteoporosis and hearing loss: findings from the Korea National Health and Nutrition Examination Survey 2009-2011 / Osteoporose e perda auditiva: resultados da Pesquisa Nacional do Exame de Saúde e Nutrição da Coreia de 2009 a 2011

Abstract Introduction: Age-related hearing impairment is the most common sensory dysfunction in older adults. In osteoporosis, the mass of the ossicles will be decreased, affecting the bone density of the cochlea, and interfering with the sound transmission to the cochlea. Age related hearing loss might be closely related to osteoporosis. Objective: To determine the relationship between age-related hearing impairment and osteoporosis by investigating the relationship between hearing loss and cortical bone density evaluated from femur neck bone mineral density. Methods: We used data from the Korea National Health and Nutrition Examination Survey to examine the associations between osteoporosis and age-related hearing impairment from 2009 to 2011. Total number of participants was 4861 including 2273 men and 2588 women aged 50 years or older. Osteoporosis was defined as a bone mineral density 2.5 standard deviations below according to the World Health Organization diagnostic classification. Age-related hearing impairment was defined as the pure-tone averages of test frequencies 0.5, 1, 2, and 4 kHz at a threshold of 40 dB or higher on the more impaired hearing side. Results: Total femur T-score (p < 0.001), lumbar-spine T-score (p < 0.001) and, femur neck T-score (p < 0.001) were significantly lower in the osteoporosis group compared to the normal group. Thresholds of pure-tone averages were significantly different in normal compared to osteopenia, and osteoporosis groups. In addition, there were significantly higher pure-tone averages thresholds in the osteoporosis group compared to other groups (p < 0.001). After adjusting for all covariates, the odds ratio for hearing loss was significantly increased by 1.7 fold with reduced femur neck bone mineral density (p < 0.01). However, lumbar spine bone mineral density was not statistically associated with hearing loss (p = 0.22). Conclusion: Our results suggest that osteoporosis is significantly associated with a risk of hearing loss. In addition, femur neck bone mineral density was significantly correlated with hearing loss, but lumbar spine bone mineral density was not.

Resumo Introdução: A perda auditiva associada ao envelhecimento é a disfunção sensorial mais comum em idosos. Na osteoporose, a massa dos ossículos diminui e afeta a densidade óssea da cóclea, o que irá interferir na transmissão do som para a mesma. A perda auditiva associada à idade pode estar intimamente relacionada à osteoporose. Objetivo: Determinar a relação entre deficiência auditiva relacionada à idade e osteoporose, investigar a relação entre perda auditiva e densidade óssea cortical avaliada a partir da densidade mineral óssea do colo do fêmur. Método: Utilizamos dados da Korea National Health and Nutrition Examination Survey para examinar as associações entre osteoporose e perda auditiva associada ao envelhecimento de 2009 a 2011. O número total de participantes foi de 4.861, incluiu 2.273 homens e 2.588 mulheres com 50 anos ou mais. A osteoporose foi definida como densidade mineral óssea com 2,5 desvios-padrão abaixo da média, de acordo com a classificação diagnóstica da Organização Mundial da Saúde. A perda auditiva associada ao envelhecimento foi definida como as médias de tom puro das frequências de teste de 0,5, 1, 2 e 4 kHz a um limiar de 40 dB ou superior no lado da audição mais afetado. Resultados: O T-score total do fêmur (p < 0,001), o T-score da coluna lombar (p < 0,001) e o T-score do colo do fêmur (p < 0,001) foram significantemente menores no grupo com osteoporose em comparação ao grupo normal. Os limiares de médias de tom puro foram significantemente diferentes nos grupos normais em comparação com aqueles com osteopenia e osteoporose. Além disso, houve limiares significantemente maiores de médias de tom puro no grupo com osteoporose em comparação com os outros grupos (p < 0,001). Após o ajuste para todas as covariáveis, a odds ratio da perda auditiva mostrou estar significantemente aumentada em 1,7 vez com densidade mineral óssea reduzida no colo do fêmur (p < 0,01). No entanto, a densidade mineral óssea da coluna L não se associou estatisticamente à perda auditiva (p = 0,22). Conclusão: Nossos resultados sugerem que a osteoporose está significantemente associada ao risco de perda auditiva. Além disso, a densidade mineral óssea da coluna lombar não se correlacionou com a perda auditiva, apenas a densidade mineral óssea do colo do fêmur foi significantemente correlacionada.

Importance of Vestibulo-ocular Reflex Gain and Refixation Saccade Analysis in Individuals with Auditory Neuropathy Spectrum Disorder

Abstract Introduction Auditory neuropathy spectrum disorder (ANSD) features the presence of otoacoustic emissions, poor speech identification score and absent auditory brainstem response. Objective The present study was designed to evaluate the functioning of all six semicircular canals in individuals with ANSD and to compare it with those of normalhearing individuals. Methods A total of 50 individuals participated in the present study, in which Group I comprised25normal-hearingindividuals, and GroupII comprised25individualswithANSD. All of the participants underwent case history, pure tone audiometry, immittance, otoacoustic emissions, auditory evoked response and video head impulse test (vHIT). Results The independent sample t-test revealed significantly lower vestibulo-ocular reflex gain values in individuals with ANSD. A presence of 100% corrective refixation saccades was observed in the same group. The Pearson correlation test revealed no significant correlation between vestibulo-ocular reflex (VOR) gain with duration of hearing loss and pure tone thresholds for any of the three orthogonal planes. The chisquared test revealed no association between the VOR gain values and the presence or absence of saccades in any of the semicircular canals (p>0.05). Conclusion Huge percentages of individuals with ANSD have been found to have associated vestibular dysfunction as well. Therefore, the vHIT can be used as one of the important tests of the vestibular test battery to evaluate all six semicircular canals in individuals with ANSD.

Comparative Study of Hearing Assessment in Diabetic Patients and Non-Diabetic Patients using Otoacoustic Emission and Pure Tone Audiometry at Sree Gokulam Medical College, Trivandrum, Kerala, South India

Introduction: The association between diabetes and hearing loss has been a topic of discussion since many years. Type 2diabetes mellitus (DM) which is the most predominant form of diabetes worldwide, accounts for 90% of cases globally. DMis a chronic metabolic disorder characterized by high blood glucose level, associated with insulin resistance and relativeinsulin deficiency. DM is associated with a lot of complications; a lesser known complication is auditory organ dysfunction.The International Diabetes Federation estimated in 2014 that 387 million people have diabetes worldwide and that by 2035this number will rise to 592 million. Among these, 179 million are undiagnosed. In the United States, the Centers for DiseaseControl and Prevention estimated in 2014 that 29.1 million people had diabetes and that 8.1 million of them (27.8%) wereundiagnosed. These data reflect the late detection of hearing loss due to undiagnosed diabetes. Studies have indicated thatvascular changes which include thickening of capillary walls in the stria vascularis, neural changes in the cochlea, and loss ofouter hair cells are the causes of hearing changes in DM.Objective: The objectives are as follows: (1) Primary objective: To assess the prevalence of hearing loss in patients with Type 2DM when compared to non-diabetic patients and (2) secondary objective: To analyze the effect of age, glycemic control (HbA1c),and duration of diabetes on auditory acuity and to assess whether otoacoustic emission (OAE) can be used as a screeningtest for hearing assessment in diabetics.Materials and Methods of Study: The design of this study was hospital based observational prospective study carried outfrom February 2017 to July 2018. A total of 100 patients who presented to the ENT OP Department Sree Gokulam MedicalCollege and Research Foundation were studied by dividing into two groups; Group A consisted of 50 type 2 diabetic patientsand Group B consisted of 50 age- and gender-matched non-diabetic patients. The age group of the patients was between 30and 50 years. All the patients were subjected to Pure Tone Audiometry for the quantitative and qualitative assessment of hearingloss. Transient OAE (transient evoked OAEs [TEOAE]) was also done to know whether it can be used as a screening test forthe early detection of hearing loss. HbA1c was done in diabetic patients to detect any association with the hearing loss. Ageand duration of diabetes and its correlation with hearing loss were also assessed.Results: Our study confirmed the existence of sensorineural hearing loss (SNHL) in type II diabetic patients, mostly bilateralmoderate SNHL. Age and duration of diabetics had an association with SNHL. As the age increases, there is increase in theauditory thresholds and amount of hearing loss (AHL). Type 2 diabetic patients with long duration of diabetes also had higherauditory thresholds at all frequencies from 250 to 8000 Hertz (Hz), when compared to non-diabetic patients and the AHL wasalso higher as the duration of diabetes increased. HbA1clevel had no significant correlation with hearing loss. Theresult of TEOAE was refer, i.e. abnormal in all the patientswith hearing loss.Conclusion: The present study reports SNHL in 68% of type IIdiabetic subjects and 2% of healthy non-diabetic subjects.The majority of the patients had bilateral moderate SNHL.The diabetic patients had increased hearing threshold at all frequencies with gradual increase in hearing loss from 250 Hz to 8000 Hz. Age and duration of diabetes had a positive correlationwith hearing loss. As the age increased AHL also increased. Similarly, as duration of diabetes increased, AHL also increased.HbA1c had no relation with auditory threshold and AHL. TEOAE can be used as a screening test for the early detection ofhearing loss in Type 2 diabetic patients, as the result was abnormal in all the patients with hearing loss. Since hearing loss canbe considered to be a consequence of diabetes, a metabolic assessment may be useful for patients presenting with hearingloss so as to reduce the high rate of undiagnosed diabetes mellitus in the community. The use of audio logical tests to monitorhearing in diabetic patients should be considered as a routine procedure so that quality of life can be improved for long standingdiabetics with needed therapeutic interventions for hearing improvement.

Frequency Characteristics of AEPs in Normal Young Adults and Comparison of Their Response Threshold and Pure Tone Audiometry Threshold / 法医学杂志

Objective The tests of three types of auditory evoked potentials （AEPs） were performed on normal young adults, to understand the frequency characteristics of different testing methods and the relationship between response threshold and pure tone audiometry threshold of different methods, and to discuss the forensic value of 3 types of AEPs to evaluate hearing function. Methods Twenty normal young adults were selected, their standard pure tone audiometry threshold, short-term pure tone audiometry threshold and the response threshold of 3 types of AEPs （tone burst-auditory brainstem response, 40 Hz auditory event-related potential and slow vertex response） at 0.5 kHz, 1.0 kHz, 2.0 kHz and 4.0 kHz were recorded. The relationship between the response threshold and standard pure tone audiometry threshold, short-term pure tone audiometry threshold of 3 types of AEPs at different frequencies as well as the differences between different types of AEPs were analyzed. Results The short-term pure tone audiometry threshold was higher than the standard pure tone audiometry threshold at each frequency. The response threshold and standard pure tone audiometry threshold of the 3 types of AEPs all had a certain correlation, and the response threshold of the 3 types of AEPs was higher than short-term pure tone audiometry threshold and standard pure tone audiometry threshold at each frequency. The differences in the differences between the response threshold and standard pure tone audiometry threshold of the 3 types of AEPs at different frequencies had statistical significance. Linear regression mathematical models were established to infer the standard pure tone audiometry threshold （hearing level） from response threshold （sound pressure level） of 3 types of AEPs of normal young adults. Conclusion When using response threshold of different types of AEPs to estimate pure tone audiometry threshold, conversion and correction are needed. Combined use of different types of AEPs could improve the accuracy of hearing function evaluation.

Effect of electro-nape-acupuncture on hearing in patients with refractory flat descending idiopathic sudden sensorineural hearing loss / 中国针灸

OBJECTIVE@#To compare the therapeutic effect of electro-nape-acupuncture (ENA) combined with hyperbaric oxygen therapy (HBOT) and single HBOT on refractory flat descending idiopathic sudden sensorineural hearing loss (ISSNHL).@*METHODS@#A total of 78 patients were randomized into an ENA combined with HBOT (ENA+HBOT) group and a HBOT group, 39 cases in each one. Patients in both groups were treated with oral extract of ginkgo biloba leaves and mecobalamin tablets. On the basis of the conventional medication treatment, HBOT was adopt in the HBOT group. On the basis of the treatment in the HBOT group, electro-nape-acupuncture was applied at Fengchi (GB 20), Gongxue (Extra), Zhongzhu (TE 3), Waiguan (TE 5) and Yifeng (TE 17), Tinggong (SI 19), Tinghui (GB 2) and the vertigo-auditory area of affected side in the ENA+HBOT group. Pulse acupuncture instrument was connected at Fengchi (GB 20) and Gongxue (Extra) for 30 min (with continuous wave, 2 Hz in frequency), the needles were retained for another 30 min after electroaupuncture. The treatment was given once a day, 6 times a week for 4 weeks in both groups. Before the treatment and 2,4 weeks into the treatment, the average auditory threshold, the scores of tinnitus handicap inventory (THI) and dizziness handicap inventory (DHI) were observed, and the therapeutic effect was evaluated in both groups.@*RESULTS@#Compared before treatment, the average auditory threshold, the scores of THI and DHI of 2,4 weeks into the treatment were decreased in both groups (0.05).@*CONCLUSION@#Electro-nape- acupuncture can improve the mean auditory threshold and the symptoms of tinnitus and dizziness in patients with refractory flat descending idiopathic sudden sensorineural hearing loss.

Application value of 40Hz auditory event related potential in hearing assessment in noise-exposed workers / 中国职业医学

OBJECTIVE: To evaluate the application value of 40 Hz auditory event related potential(40 Hz AERP) in hearing assessment in workers exposed to noise by observing the consistency between pure tone audiometry(PTA) and 40 Hz AERP. METHODS: A total of 240 ears of 120 workers who exposed to noise with PTA high-frequency hearing threshold > 25 dB were selected as the research subjects using the convenient sampling method. The thresholds of PTA and 40 Hz AERP at different frequencies were investigated. According to the average hearing threshold of PTA language frequency, the workers were divided into normal hearing group and mild-, medium-, medium-severe-, severe-hearing loss groups, and the difference and correlation between the thresholds of 40 Hz auditory potential and PTA were analyzed. RESULTS: The response thresholds of 40 Hz AERP of 0.5, 1.0, 2.0 kHz in ears of normal hearing group, and mild-and moderate-hearing loss groups were higher than the PTA hearing threshold(P<0.01), while the 40 Hz AERP response thresholds of 0.5 kHz in the ears of medium-severe-and severe-hearing loss groups were lower than the hearing thresholds of PTA(P<0.05). The different value of the response threshold of 40 Hz AERP and PTA of 1.0 and 2.0 kHz in ears of normal hearing group was higher than 0.5 kHz(median: 25.0 vs 15.0 dBHL, 30.0 vs 15.0 dBHL, P<0.01). Except for 0.5 and 1.0 kHz of mild-hearing loss group, the different value of the response threshold of 40 Hz AERP and PTA in ears of the other hearing loss groups were lower than that of the normal hearing group(P<0.01). The 40 Hz AERP response threshold was frequency-specific and correlated well with PTA at the same frequency. The correlation coefficients of 0.5, 1.0 and 2.0 kHz were 0.744, 0.732 and 0.665 respectively(P<0.01). CONCLUSION: It is feasible to evaluate PTA in noise-exposed workers using 40 Hz AERP response threshold, but the 40 Hz AERP cannot completely replace PTA. The measurement frequency and the degree of hearing loss should be considered simultaneously.