Audiometría de altas frecuencias en adolescentes expuestos a ruidos / High frequency audiometry in adolescents exposed to noises

Introducción: La audiometría de altas frecuencias (9000-20 000 Hz) puede ser de gran utilidad en el diagnóstico precoz de hipoacusia inducida por ruidos en contraste con la audiometría convencional (125-8000 Hz). Objetivo: Evaluar la utilidad de la audiometría de altas frecuencias en el diagnóstico precoz de la hipoacusia inducida por ruidos en adolescentes. Métodos: Estudio descriptivo, observacional y transversal en 85 adolescentes expuestos a ruidos; 45 cursaban el décimo grado en un preuniversitario de la provincia La Habana, en el curso escolar 2013-2014 y 40, el primer año de la carrera de medicina, en una facultad de La Habana en el curso escolar 2015- 2016. A todos se le realizó una encuesta, examen físico de otorrinolaringología, audiometría convencional y audiometría de alta frecuencia. Resultados: La audiometría convencional fue normal en todos los casos. En la audiometría de altas frecuencias en todos los adolescentes estudiados comenzó a disminuir la audición a partir de los 13 000 Hz y se apreció una hipoacusia neurosensorial en aumento hasta 85 decibeles en oído derecho y 78 decibeles en oído izquierdo en 20 000 Hz de frecuencia. Conclusiones: Los adolescentes evaluados tienen hábitos auditivos que pueden perjudicar su audición, todos ya poseen signos de daño que no se manifiestan a través de la audiometría convencional pero sí a través de la audiometría de alta frecuencia en las diferentes exposiciones a ruidos de altos decibeles. Lo anterior demuestra la utilidad de esta audiometría, no solo dentro del campo de la audiología, sino también en la medicina preventiva(AU)

Introduction: High frequency audiometry (9000-20 000 Hz) can be really useful in the early diagnosis of deafness induced by noises, in contrast with conventional tonal audiometry (125-8000 Hz). Objective: Assess the usefulness of high frequency audiometry in the early diagnosis of deafness induced by noises in adolescents. Methods: Descriptive, observational and cross-sectional study in 85 adolescents exposed to noises; 45 of them were studying the 10th grade in a high school of Havana province, and 40 of them were in the first year of Medicine in a faculty of Havana province during school year 2015-2016. All of them took a survey, a physical examination of otolaryngology, liminar total audiometry and high frequency audiometry. Results: Tonal audiometry was normal in all the cases. In high frequency audiometry of all the studied adolescents started to decrease audition from 13000 HZ and it was noticed an increasing neurosensorial deafness up to 85 decibels in the right ear and 78 decibels in the left ear in 20 000 Hz of frequency. Conclusions: The adolescents assessed have auditive habits that can jeopardize their audition; all of them already have signs of damage that are not noticed in the tonal audiometry but in the high frequency audiometry in the different exposures to noises of high decibels. This proves the usefulness of this kind of audiometry not only in the field of audiology, but also in preventive medicine(AU)

Utilidad diagnóstica de la audiometría de alta frecuencia en sujetos expuestos a ruido recreacional / Diagnostic utility of high frequency audiometry in subjects exposed to recreational noise

INTRODUCCIÓN: Recientes investigaciones mencionan que, debido a los altos niveles de ruidos, el 75% de los habitantes en las ciudades industrializadas padecen algún tipo de deficiencia auditiva. La audiometría de alta frecuencia es un examen complementario importante para detectar tempranamente la pérdida de audición. OBJETIVO: Determinar la utilidad diagnóstica de la audiometría de alta frecuencia en la detección temprana de la hipoacusia en sujetos expuestos a ruido recreacional. MATERIAL Y MÉTODO: Estudio analítico de corte transversal. Se evaluaron 87 estudiantes de fonoaudiología. Se aplicó una audiometría convencional y de alta frecuencia mediante audiómetro clínico. RESULTADOS: La audiometría de alta frecuencia presenta una sensibilidad del 100%, especificidad del 64,60%. El valor predictivo (+) es de 14,70%, mientras que el valor predictivo (-) es del 100%. La razón de verosimilitud (+) es de 2,28, y para la razón de verosimilitud (-) es de 0,0. CONCLUSIÓN: La audiometría de alta frecuencia puede ser utilizada para monitorizar la audición de los sujetos, comprobando que efectivamente los umbrales auditivos de alta frecuencia se encuentren dentro de rangos normales. Lo anterior, dado por sus valores de sensibilidad, valor predictivo negativo, razón de verosimilitud negativa y por el aumento entre la probabilidad preprueba y posprueba.

INTRODUCTION: Recent research mentions that, due to the high noise levels, 75% of the habitants in industrialized cities suffer from some type of hearing impairment. High frequency audiometry is an important complementary test to detect early hearing loss. AIM: To determine the diagnostic utility of high frequency audiometry in the early detection of hearing loss in subjects exposed to recreational noise. MATERIAL AND METHODS: Study analytical type and cross section. 87 speech therapy students were evaluated. A conventional and high frequency audiometry was applied, using a clinical audiometer. RESULTS: High frequency audiometry has a sensitivity of 100%, specificity of 64,60%. The predictive value (+) is 14,70%, while the predictive value (-) is 100%. The likelihood ratio (+) is 2,28, and for the likelihood ratio (-) it is 0,0. CONCLUSION: High frequency audiometry can be used to monitor the hearing of the subjects, checking that effectively the high frequency hearing thresholds are within normal ranges. The above, given by their values of sensitivity, negative predictive value, negative likelihood ratio and the increase between the pre-test probability and the posttest probability.

Ototoxicity: A Challenge in Diagnosis and Treatment

Ototoxicity is the pharmacological adverse reaction affecting the inner ear or auditory nerve, characterized by cochlear or vestibular dysfunction. The panorama of drug-induced hearing loss has widened over last few decades. Although ototoxic medications play an imperative role in modern medicine, they have the capacity to cause harm and lead to significant morbidity. Evidence has shown early detection of toxicity through prospective ototoxicity monitoring allows for consideration of treatment modifications to minimize or prevent permanent hearing loss and balance impairment. Although many ototoxicity monitoring protocols exist, their practicality is questionable due to several factors. Even though the existing protocols have proven to be effective, certain lacunae in practice have been encountered due to discrepancies among recommended protocols. Implementation of these protocols is mostly held back due to the incapacitated status of the patient. The choice of early ototoxicity identification techniques is still debatable due to variables such as high degree of sensitivity, specificity and reliability, less time consumption and less labour-intensive to the patient. Hence, the diagnosis and effective treatment of ototoxicity is challenging, even today. A stringent protocol with more practicality encompassing all elements aimed at profiling the effects of ototoxicity is greatly needed. This review describes an efficient application of ototoxicity monitoring and treatment protocol as an attempt to reduce the challenges in diagnosis and management of ototoxicity.

Hearing Thresholds at Extended High Frequencies in Civilian Student Pilotswith Normal Hearing at Conventional Frequencies / 听力学及言语疾病杂志

Objective To study extended high frequency (EHF) audiometry for early detection of hearing loss in student pilots in civil aviation.Methods A total of 175 student pilots (all male,18~25 years old, mean 20.2±0.92 years) from a university flight academy were surveyed and underwent EHFA.All subjects had hearing thresholds ≤25 dB HL at conventional frequencies (0.25~8 kHz).The results were compared with the corresponding recommended standards in other countries.According to the use of personal listening devices, all the subjects were divided into the low risk group (non-use, 121 cases) and the high risk group (using>1 year, day>1 hour, 52 cases).The differences of hearing thresholds and detection rates at EHF between the two groups were compared.Results The hearing thresholds of 173 subjects (1 case of middle ear disease and 1 case with family history of hearing loss were excluded) at 9~20 kHz were slightly higher than the reference equivalent threshold sound pressure level (RETSPL) prescribed by American National Standardization Association and the age-matched thresholds recommended by a foreign literature (P<0.05 or P<0.01).The hearing thresholds in the high risk group elevated dramatically than that in the low risk group at 9,12.5,16 and 18 kHz(P<0.05 or P<0.01).As frequencies increased, the detection rate of hearing thresholds in the high risk group decreased gradually, and at 18 and 20 kHz it was significantly lower than that in the low risk group (P<0.01).Conclusion EHF audiometry is a helpful tool for early detection of noise-induced hearing loss in student pilots.Hearing health care should be emphasized in civilian student pilots.It is recommended to avoid the use of personal listening devices or reduce the use time of them.

Audiometria de alta freqüência em adultos jovens e mais velhos quando a audiometria convencional é normal / High-frequency audiometry in young and older adults when conventional audiometry is normal

A audiometria de alta freqüência é capaz de detectar precocemente alterações em sensibilidade advindas de processos como o envelhecimento. Seu uso é limitado, o que recomenda estudos para esclarecer seu desempenho, especialmente entre adultos de mais idade. OBJETIVO: Comparar os limiares para as freqüências de 250Hz a 16kHz, entre adultos jovens e mais velhos normoacúsicos, com e sem queixa audiológica. CASUíSTICA E MÉTODO: A sensibilidade a tons puros de 250Hz a 16kHz foi avaliada com audiômetro AC-40, em 64 adultos, igualmente distribuídos: jovens (25 a 35 anos) e mais velhos (45 a 55 anos) de ambos os gêneros, com forma de estudo de coorte transversal. RESULTADOS: Os adultos mais velhos apresentaram limiares mais elevados em todas as freqüências, mais significativamente nas mais altas (8 a 16kHz), quando comparados com os adultos jovens. Homens apresentaram limiares mais elevados do que mulheres entre 3 e 10kHz. CONCLUSÃO: O processo de envelhecimento auditivo, envolvendo perda de sensibilidade auditiva para altas freqüências, pode ser detectado em idades anteriores às tipicamente pesquisadas, uma vez que a audiometria de alta freqüência demonstrou ser instrumento importante para distinguir a sensibilidade auditiva entre adultos jovens e mais velhos, quando audiologicamente normais.

High-frequency audiometry can detect early changes in auditory sensitivity resulting from processes such as aging. Nonetheless its use is still limited, and additional studies are required to establish its use, particularly among older adults. AIM: To compare pure tone thresholds for frequencies from 250 Hz to 16 kHz in young and older adults, with or without audiologic complaints. METHOD: Pure tone sensitivity to 250 Hz to 16 kHz was assessed with an AC-40 audiometer in 64 adults, evenly distributed in young (25 to 35 years-old) and older (45 to 55 years-old) adults of both sexes. This is a cross-sectional study. RESULTS: Although all participants presented normal audiometry in frequencies from 250 Hz to 8 kHz, according to clinical parameters, older adults had significantly higher thresholds compared to young adults, according to statistical parameters, with greater significance in higher frequencies (8 to 16 kHz). Presence or absence of clinical complaints did not distinguish thresholds. CONCLUSIONS: The process of auditory aging, including loss of sensitivity to higher frequencies, can be detected at earlier ages than those usually investigated. High frequency audiometry is an important instrument to distinguish auditory sensitivity in young and older adults, even for those considered as audiologically normal.

Evaluation of Recurrence of Otitis Media with Effusion Using Ultra High Frequency Audiometry / 대한이비인후과학회지

The goal of treatment in OME is normal aerated middle ear space. When the tympanogram convert to type A or C from type B in patients with OME, no further medication would be needed. But 1/3 of these patient had type B tympanogram again after 4 weeks follow up without medication. Many parameters-including age, sex, season, unilaterality, passive smoking, associated rhinitis etc-were concerned about the recurrence of OME. Ultra high frequency audiometry was added as a new parameter in recurrence of OME.