Hearing Outcomes in Failed Newborn Hearing Screening Infants With and Without Chronic Serous Otitis.

OBJECTIVE: To identify outcomes in hearing loss (HL) diagnosis and intervention in infants with a failed newborn hearing screen (NBHS) and otitis media with effusion (OME) compared to those with failed NBHS and without OME. STUDY DESIGN: Retrospective review. SETTING: Tertiary medical center. METHODS: A chart review was performed on infants referred to Primary Children's Hospital for failed NBHS from 2012 to 2018. Eighty infants with failed NBHS and OME and 55 with failed NBHS and no OME were included. Incidence of permanent HL along with the age of HL confirmation and early intervention (EI) enrollment were compared. RESULTS: The incidence of OME in infants with failed NBHS was 59.3%. Fifty-six percent of infants with OME and 12.5% of those without OME did not receive definitive hearing confirmation in either ear due to loss to follow-up or insufficient audiometric assessment. Permanent HL was identified in 11.3% (n = 9) of infants with OME and in 20.0% (n = 11) of those without OME. Infants with OME were significantly older at the time of HL confirmation (4.2 ± 2.1 months) and EI enrollment (5.4 ± 2.5 months) compared to those without OME at the time of HL confirmation (1.0 ± 1.0 months; p < .001) and EI enrollment (2.6 ± 1.8 months; p = .04). CONCLUSION: Infants with failed NBHS and OME are highly susceptible to a significant delay in HL confirmation or lack of confirmatory hearing tests. Timely OME resolution with earlier ventilation tube insertion by 3 months of age and follow-up audiologic assessment is recommended.

Applications of the Grading Scales for the Detection of Ototoxicity in Children after Treatment of Neuroblastoma and Extracranial Germinal Tumor.

INTRODUCTION: Advances in treatment have resulted in a significant increase in survival rates for patients cured of malignant diseases such as neuroblastoma (NBL) and extracranial germ cell tumor (GCT). NBL is one of the pediatric cancers during which potentially ototoxic cytostatic drugs (cisplatin and carboplatin) are used for treatment. Other cancers include germinal tumors, hepatoblastoma, sarcomas, and brain tumors. Often, this very aggressive treatment has a high risk of causing long-term side effects, including hearing loss. Hence, the present study aimed to evaluate the usefulness of the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE), Brock, Chang, and International Society of Pediatric Oncology (SIOP) Boston scales in terms of detecting the high-frequency nature of hearing loss induced by ototoxic drugs and monitoring hearing status in children after completion of oncological treatment. Additionally, the frequency of hearing loss in children treated for NBL and extracranial GCT was assessed, and the principles of monitoring hearing in these patients were indicated. METHODS: The study group consisted of 78 patients diagnosed with NBL (n = 47) and GCT (n = 31). There were 23 boys and 24 girls in the NBL group, aged 0-16 years, and 21 boys and 10 girls in the GCT group, aged 0-18 years. The control group consisted of 54 patients who had never received oncological treatment, were not taking potentially ototoxic drugs, and appeared socially efficient in the subjective audiological assessment. Audiometric examinations and DP-acoustic otoemission measurements were performed. Additionally, impedance audiometry tests were done to exclude a possible conductive component of the hearing loss. RESULTS: The analysis shows that ototoxicity-induced hearing loss was observed in 13.8-65.5% of children. 75.9% of patients showed hearing loss in the 16 kHz frequency range, and at least 56.8% of patients showed hearing loss in the frequency range above 12.5 kHz. Hearing impairment, relevant to speech understanding, was displayed by more than 40% of children treated for NBL and GCT. CONCLUSIONS: The confirmation of hearing loss in nearly 65% of cases in both patients indicates the necessity to monitor the long-term side effects of anticancer treatment. Acoustic otoemission measurements, the adoption of articulatory indices based on an audiogram, or the use of arbitrary ototoxicity assessment scales such as Brock, Chang, or SIOP Boston are fully justified techniques for studying ototoxicity induced by cytostatic drugs. However, they all require continuous improvement to increase their sensitivity and specificity, especially in the pediatric group.

Osteopathic Cranial Manipulative Medicine as a Proposed Addition to the Treatment Regimen for Idiopathic Sudden-Onset Unilateral Sensorineural Hearing Loss: A Case Report.

Adult sudden-onset unilateral sensorineural hearing loss is primarily idiopathic. There are few treatment options with high success rates, but the literature suggests there is equally moderate success with oral or intratympanic steroids, with some evidence to support the use of acupuncture as a salvage treatment. Here, we present a case of sudden unilateral sensorineural hearing loss with otolaryngology evaluation and audiograms before and after osteopathic manipulative treatment (OMT). Osteopathic cranial manipulative medicine (OCMM) directed at eustachian tube dysfunction elicited findings indicating resolution of symptoms was at least partly due to cranial treatment. This report explains a probable anatomic mechanism contributing to hearing loss and suggests treatment options that should be considered as part of the treatment of idiopathic unilateral hearing loss. Future research opportunities are also proposed.

Valoración clínica, epidemiológica y del diagnóstico de Enfermería del síndrome de Usher / Clinical, epidemiological and nursing diagnostic evaluation of Usher syndrome

RESUMEN Introducción: El síndrome de Usher es un heterogéneo grupo de enfermedades hereditarias, que se manifiesta clínicamente por asociar pérdida auditiva neurosensorial con la ceguera, hecho este que hace que los pacientes que lo padecen requieran de cuidados de Enfermería especiales. Objetivo: valorar clínica, epidemiológica y del diagnóstico de Enfermería con síndrome de Usher, en Pinar del Río entre los años 2016 y 2018. Métodos: investigación observacional, descriptiva y transversal. El universo estuvo conformado por 63 pacientes y la muestra por 55 que cumplieron los criterios de inclusión. Las variables analizadas fueron: edad, sexo, agudeza visual central mejor corregida, tipo de pérdida auditiva neurosensorial, forma clínica del síndrome de Usher y diagnóstico de Enfermería. Resultados: el 56,3 % de los pacientes fueron masculinos, el 60% de los pacientes presentaron USH Tipo II, el 38,2 % presentó valores de la agudeza visual central mejor corregida entre 0,7 -1,0, en el 43,6 % de los pacientes la pérdida auditiva neurosensorial fue moderada; el 100 % de los casos presentaron como diagnóstico de Enfermería deterioro de la habilidad de traslación, seguido del deterioro de la integridad tisular y riesgo de caída (85,5 %). Conclusiones: el sexo masculino predominó en la evaluación y el grupo etario de 61 años y más, con una agudeza visual central mejor corregida entre 0,7-1,0 y una pérdida auditiva neurosensorial moderada; y la forma clínica de Usher II la más frecuente, así como el diagnóstico de Enfermería de deterioro de la habilidad de traslación.

ABSTRACT Introduction: Usher syndrome is a heterogeneous group of hereditary diseases, which manifests itself clinically by associating sensorineural hearing loss with blindness, a fact that makes patients suffering from this disease require special nursing care. Objective: to assess the clinical, epidemiological and nursing diagnostic status of Usher syndrome in Pinar del Río between 2016 and 2018. Methods: observational, descriptive and cross-sectional research. The target group consisted of 63 patients and the sample of 55 who met the inclusion criteria. The variables analyzed were: age, gender, best corrected central visual acuity, type of sensorineural hearing loss, clinical type of Usher syndrome and nursing diagnosis. Results: 56,3 % of patients were male, 60 % of patients suffered from Usher Type II, 38,2 % presented values of central visual acuity better corrected between 0,7 -1,0, in 43,6 % of patients the sensorineural hearing loss was moderate; 100 % of cases presented as a nursing diagnosis the deterioration of the ability of movement, followed by deterioration of tissue integrity and risk of falling (85,5 %). Conclusions: male gender predominated in the assessment and the age group of 61 years and older, with better corrected central visual acuity between 0.7-1.0 and moderate sensorineural hearing loss; and the clinical type of Usher II was the most frequent, as well as the diagnosis of nursing involving impaired ability to move.

Risk factors and prevalence of newborn hearing loss in a private health care system of Porto Velho, Northern Brazil / Factores de riesgo y prevalencia de la deficiencia auditiva neonatal en un sistema privado de salud en Porto Velho, Rondonia (Brasil) / Fatores de risco e prevalencia da deficiencia auditiva neonatal em um sistema privado de saude de Porto Velho, Rondonia

OBJECTIVE: To determine the prevalence of hearing loss and to analyze the results of newborn hearing screening and audiological diagnosis in private health care systems. METHODS Cross-sectional and retrospective study in a database of newborn hearing screening performed by a private clinic in neonates born in private hospitals of Porto Velho, Rondônia, Northern Brazil. The screening results, the risk for hearing loss, the risk indicators for hearing loss and the diagnosis were descriptively analyzed. Newborns cared in rooming in with their mothers were compared to those admitted to the Intensive Care Unit regarding risk factors for hearing loss. RESULTS: Among 1,146 (100%) enrolled newborns, 1,064 (92.8%) passed and 82 (7.2%) failed the hearing screening. Among all screened neonates, 1,063 (92.8%) were cared in rooming and 83 (7.2%) needed intensive care; 986 (86.0%) were considered at low risk and 160 (14.0%) at high risk for hearing problems. Of the 160 patients identified as having high risk for hearing loss, 83 (37.7%) were admitted to an hospitalized in the Intensive Care Unit, 76 (34.5%) used ototoxic drugs and 38 (17.2%) had a family history of hearing loss in childhood. Hearing loss was diagnosed in two patients (0.2% of the screened sample). CONCLUSIONS: The prevalence of hearing loss in newborns from private hospitals was two cases per 1,000 evaluated patients. The use of ototoxic drugs, admission to Intensive Care Unit and family history of hearing loss were the most common risk factors for hearing loss in the studied population. .

OBJETIVO Determinar la prevalencia de pérdida auditiva y caracterizar los resultados de los exámenes auditivos neonatales y del diagnóstico audiológico de recién nacidos provenientes de unidades privadas de salud. MÉTODOS Estudio transversal y retrospectivo en la base de datos de los exámenes neonatales realizados por la Clínica de Evaluación y Rehabilitación de la Audición - Limiar, en recién nacidos provenientes de unidades privadas de salud de la ciudad de Porto Velho, Rondônia (Brasil). Se realizó el análisis descriptivo del resultado de los exámenes, del riesgo para deficiencia auditiva, de los indicadores de riesgo para deficiencia auditiva y del diagnóstico. El alojamiento conjunto fue comparado con la Unidad de Terapia Intensiva Neonatal respecto a la ocurrencia de indicadores de riesgo para deficiencia auditiva. RESULTADOS: De los 1.146 (100%) recién nacidos catastrados, 1.064 (92,84%) aprobaron y 82 (7,16%) fallaron en los exámenes auditivos. De estos, 1.063 (92,75%) eran provenientes del alojamiento conjunto y 83 (7,25%), de la Unidad de Terapia Intensiva Neonatal; 986 (86%) eran considerados de bajo riesgo y 160 (14%) de alto riesgo para problemas de audición. De los 160 pacientes identificados como de alto riesgo para deficiencia auditiva, 83 (37,7%) permanecieron internados en Unidad de Terapia Intensiva, 76 (34,5%) utilizaron ototóxicos y 38 (17,2%) presentaban historia familiar de deficiencia auditiva en la infancia. La pérdida auditiva fue diagnosticada en 0,2% (n=2) de la muestra. CONCLUSIONES La prevalencia de pérdida auditiva en los recién nacidos en unidades privadas de salud fue de dos casos para cada mil recién nacidos evaluados. El uso de ototóxicos, la internación en Unidad de Terapia Intensiva Neonatal y la historia familiar de deficiencia auditiva fueron los factores ...

OBJETIVO Determinar a prevalência da perda auditiva e caracterizar os resultados da triagem auditiva neonatal e do diagnóstico audiológico de recém-nascidos provenientes de unidades privadas de saúde. MÉTODOS Estudo transversal e retrospectivo no banco de dados da triagem auditiva neonatal realizada pela Clínica de Avaliação e Reabilitação da Audição, em recém-nascidos provenientes de unidades privadas de saúde da cidade de Porto Velho, Rondônia. Realizou-se análise descritiva do resultado da triagem, do risco para deficiência auditiva, dos indicadores de risco para deficiência auditiva e do diagnóstico. O alojamento conjunto foi comparado com a Unidade de Terapia Intensiva Neonatal quanto à ocorrência de indicadores de risco para deficiência auditiva. RESULTADOS Dos 1.146 (100%) recém-nascidos cadastrados, 1.064 (92,8%) passaram e 82 (7,2%) falharam na triagem auditiva. Destes, 1.063 (92,8%) eram provenientes do alojamento conjunto e 83 (7,2%) da Unidade de Terapia Intensiva Neonatal; 986 (86,0%) foram considerados de baixo risco e 160 (14,0%), de alto risco para problemas de audição. Dos 160 pacientes identificados como de alto risco para deficiência auditiva, 83 (37,7%) permaneceram internados em Unidade de Terapia Intensiva, 76 (34,5%) fizeram uso de ototóxicos e 38 (17,2%) apresentavam história familiar de deficiência auditiva na infância. A perda auditiva foi diagnosticada em 0,2% (n=2) da amostra. CONCLUSÕES A prevalência de perda auditiva nos recém-nascidos em unidades privadas de saúde foi de dois casos para cada mil recém-nascidos avaliados. O uso de ototóxicos, a internação em Unidade de Terapia Intensiva Neonatal e a história familiar de deficiência auditiva foram os fatores de risco para deficiência auditiva ...

Validity of self-reported hearing loss in adults: performance of three single questions / Validade da perda auditiva auto-referida em adultos: desempenho de três perguntas únicas / Validez de la pérdida auditiva auto-referida en adultos: desempeño de tres preguntas únicas

OBJECTIVE: To estimate the validity of three single questions used to assess self-reported hearing loss as compared to pure-tone audiometry in an adult population. METHODS: A validity study was performed with a random sub-sample of 188 subjects aged 30 to 65 years, drawn from the fourth wave of a population-based cohort study carried out in Salvador, Northeastern Brazil. Data were collected in household visits using questionnaires. Three questions were used to separately assess self-reported hearing loss: Q1, "Do you feel you have a hearing loss?"; Q2, "In general, would you say your hearing is 'excellent,' 'very good,' 'good,' 'fair,' 'poor'?"; Q3, "Currently, do you think you can hear 'the same as before', 'less than before only in the right ear', 'less than before only in the left ear', 'less than before in both ears'?". Measures of accuracy were estimated through seven measures including Youden index. Responses to each question were compared to the results of pure-tone audiometry to estimate accuracy measures. RESULTS: The estimated sensitivity and specificity were 79.6 percent, 77.4 percent for Q1; 66.9 percent, 85.1 percent for Q2; and 81.5 percent, 76.4 percent for Q3, respectively. The Youden index ranged from 51.9 percent (Q2) to 57.0 percent (Q1) and 57.9 percent (Q3). CONCLUSIONS: Each of all three questions provides responses accurate enough to support their use to assess self-reported hearing loss in epidemiological studies with adult populations when pure-tone audiometry is not feasible.

OBJETIVO: Estimar a validade de três perguntas únicas utilizadas para avaliar a perda auditiva auto-referida em comparação com a audiometria de tons puros em uma população adulta. MÉTODOS: Estudo de validade realizado com uma sub-amostra aleatória de 188 indivíduos, com idade entre 30 e 65 anos, selecionados da quarta fase (2006) de um estudo de coorte de base populacional conduzido em Salvador, BA. Dados foram coletados em entrevistas domiciliares utilizando-se questionários. Foram utilizadas três perguntas para avaliar, separadamente, a perda auditiva auto-referida: Q1, "Você sente que você tem uma perda auditiva?"; Q2, "Em geral, você diria que sua audição é 'excelente', 'muito boa', 'boa', 'regular', 'ruim'?"; Q3, "Atualmente, você acha que 'ouve da mesma forma que ouvia antes', 'apenas o ouvido direito ouve menos do que antes', 'apenas o ouvido esquerdo ouve menos do que antes', 'os dois ouvidos ouvem menos do que ouviam antes'?". Para estimar as medidas de acurácia foram utilizadas sete medidas, incluindo o índice de Youden. As respostas obtidas para cada pergunta foram comparadas aos resultados da audiometria de tons puros. RESULTADOS: Estimativas de sensibilidade e especificidade foram, respectivamente, (Q1) 79,6 por cento e 77,4 por cento, (Q2) 66,9 por cento e 85,1 por cento, (Q3) 81,5 por cento e 76,4 por cento. O índice Youden variou de 51,9 por cento (Q2), a 57,0 por cento (Q1) e 57,9 por cento (Q3). CONCLUSÕES: Cada pergunta permite obter respostas com acurácia suficiente para recomendar o uso da perda auditiva auto-referida em estudos epidemiológicos com adultos quando a audiometria de tons puros não for factível.

OBJETIVO: Estimar la validez de tres preguntas únicas utilizadas para evaluar la pérdida auditiva auto-referida en comparación con la audiometría de sonidos puros en una población adulta. MÉTODOS: Estudio de validez realizado con una sub-muestra aleatoria de 188 individuos, con edad entre 30 y 65 años, seleccionados de la cuarta fase (2006) de un estudio de cohorte de base poblacional conducido en Salvador, noreste de Brasil. Datos fueron colectados en entrevistas domiciliares utilizándose cuestionarios. Fueron utilizadas tres preguntas para evaluar separadamente, la pérdida auditiva auto-referida: Q1, "Siente usted que tiene una pérdida auditiva?"; Q2, "En general, diría usted que su audición es 'excelente', 'muy buena', 'buena', 'regular', 'mala'?"; Q3, "Actualmente, considera usted que 'oye de la misma forma que oía antes', 'sólo el oído derecho escucha menos que antes', 'sólo el oído izquierdo escucha menos que antes', 'los dos oídos escuchan menos que antes'?". Para estimar las medidas de precisión se utilizaron siete medidas, incluyendo el índice de Youden. Las respuestas obtenidas para cada pregunta fueron comparadas a los resultados de la audiometría de sonidos puros. RESULTADOS: Estimaciones de sensibilidad y especificidad fueron, respectivamente, (Q1) 79,6 por ciento y 77,4 por ciento, (Q2) 66,9 por ciento y 85,1 por ciento, (Q3) 81,5 por ciento y 76,4 por ciento. El índice Youden varió de 51,9 por ciento (Q2), a 57,0 por ciento (Q1) y 57,9 por ciento (Q3). CONCLUSIONES: Cada pregunta permite obtener respuestas con precisión suficiente para recomendar el uso de la pérdida auditiva auto-referida en estudios epidemiológicos con adultos cuando la audiometría de sonidos puros no sea factible.