Assessment of Deafness in Term Infants with Birth Asphyxia with Otoacoustic Emission and Brain Stem Evoked Response Audiometry: A Prospective Observational Study.

To assess deafness in term infant with birth asphyxia by otoacoustic emission and brain stem evoked response audiometry. A Prospective observational study was done at Tertiary care government hospital from 15/02/2021 to 15/10/2022.Total 130 patients were included in the study by consecutive sampling method. All the patients fulfilling the inclusion criteria during the study period were included. After explaining the aims, objectives and methods of study, written informed consent was obtained from the parents to undergo Otoacoustic Emission (OAE) and Brain Stem Evoked Response Audiometry Test (BERA). Data was entered in case record form. Collected data was analysed by appropriate statistical methods. Hearing impairment was present in eight (6.15%) asphyxiated term infants. A mild degree of hearing loss was seen in three (37.5%), a moderate degree of hearing loss was seen in four (50%), severe degree of hearing loss was seen in one (12.5%) asphyxiated term infant. In asphyxiated term infants, no significant difference in hearing loss was seen with respect to gender, Obstetrics history, and type of delivery. Significant difference in hearing loss was seen in antenatal Diabetes mellitus, hypertension, family history of SNHL and APGAR Score less than 6. Severe degree of hearing loss was seen in prolonged labour and HTN mother. Significant difference in hearing loss was seen in antenatal Diabetes mellitus, hypertension, family history of SNHL and APGAR Score less than 4 and 6 in one and five minutes respectively. Severe degree of hearing loss was seen in prolonged labour and HTN mother. Supplementary Information: The online version contains supplementary material available at 10.1007/s12070-024-04736-2.

A Prospective Comparative Study of Impedance Audiometry Findings Preoperatively and Postoperatively in Cases of Conventional Adenoidectomy versus Microdebrider Assisted Adenoidectomy.

The aim of the study was to evaluate and compare the efficacy of Endoscopic Adenoidectomy with Microdebrider over Conventional technique by Curettage using Impedance Audiometry findings. In this prospective, randomised, comparative study patients were divided into two groups to undergo one of the above adenoidectomy surgeries. Patients with symptoms of Adenoid hypertrophy after failed maximal medical therapy (12 weeks) were selected after due consideration of the inclusion and exclusion criteria. Baseline Impedance Audiometric assessment was done one week prior to surgery which was compared to Impedance Audiometric values 12 weeks post operatively in each group. This study enrolled 50 patients with adenoid hypertrophy, 25 patients of group A underwent Conventional adenoidectomy and the other 25 patients of group B underwent Endoscopic Adenoidectomy with Microdebrider. Significant difference in type of tympanogram before and after adenoidectomy was found in both the groups (p = 0.0008 in group A & p < 0.0001 in group B). In Group A Percentage of abnormal tympanograms becoming normal (Type A), 12 weeks after adenoidectomy was 80%. In Group B Percentage of abnormal tympanograms becoming normal (Type A), 12 weeks after adenoidectomy was 88%. A statistically significant improvement (p < 0.0001 in both the groups) in the percentage of ears with absent stapedial reflex was observed in both groups postoperatively, with no difference between the two groups suggestive of improvement in eustachian tube function. Association of Preoperatively & Postoperatively Eustachian tube function in each group undergoing adenoidectomy was statistically significant (p < 0.0001). Both forms of adenoidectomy are effective in managing adenoid hypertrophy with tubal dysfunction causing mild conductive hearing loss and prone for OME. However, the audiological and endoscopic evaluation seems to favor Endoscopic Adenoidectomy with microdebrider over conventional adenoidectomy, and it should be therefore considered in the therapeutic management of young patients with adenoidal disease.

Audiological Profile of Yakshagana Artists.

Yakshagana is an India's traditional folk theatre musical dance drama. The purpose of the study is to profile audiological characteristics and document hearing-related symptoms in Yakshagana artists. A cross-sectional study was performed on 96 Yakshagana artists. Participants' demographic data were captured, and audiological evaluations, including high frequency audiometry (HFA), tympanometry, acoustic reflex threshold and transient evoked otoacoustic emission (TEOAE), were performed. The majority of the individuals had minimal and mild hearing loss. The mean scores of pure tone thresholds were greater at 4 kHz and 8 kHz. The majority of the HFA thresholds at 10 kHz, 12.5 kHz, and 16 kHz indicated no responses, which can be accredited to the fact that noise-induced hearing loss (NIHL) first affects the higher frequencies. TEOAE analysis showed a greater percentage of failures in the higher frequencies, particularly at 3 and 4 kHz in both ears, which can be an indicator of bilateral cochlear damage. These findings indicate that Yakshagana artists are at risk of hearing loss due to noise exposure. Hearing evaluation and regular monitoring of hearing thresholds is advisable for this population as it can impact their careers.

The ANTI-LAMBDA: A Non-statical Tonal Indicator Low-Frequency Air-Bone Gap of Ménière's Bouts and Disease Activity.

INTRODUCTION:  There have been reports of patients with Ménière´s disease (MD) showing unexplained audiometric air-bone gaps at low frequencies. Little is known about the clinical significance of this finding. The objective of this study was to describe this phenomenon while relating it with clinical features, namely the incidence of attacks. METHODS: Unilateral MD patients were selected and cerebral magnetic resonance imaging (cMRI) was assessed to exclude structural pathology. A retrospective longitudinal analysis regarding disease activity and audiometric details was performed. A coincidence index and regression predictive models were considered to assess the relationship between the air-bone gap and MD activity. RESULTS:  A total of 70 MD patients were enrolled and 252 audiograms were assessed. Low-frequency air-bone gaps (LFABGs) were significantly associated with unstable MD (p < 0.001), demonstrating a sensitivity and specificity of 93.8% and 82.7%, respectively. The incidence of unstable disease with the presence of LFABG was 89.1 %. A higher LFABG magnitude correlated with increased disease activity (p < 0.001) and was particularly pronounced at 250 Hz and 500 Hz. CONCLUSION: The typical LFABG encountered was here called ANTI-LAMBDA (A Non-statical Tonal Indicator Low-Frequency Air-Bone Gap of Ménière's Bouts and Disease Activity). It relates to MD activity and is a potential new tool to assess MD stability/need for additional therapeutics.

Development and evaluation of a novel user-operated slider-based audiometry method.

OBJECTIVE: To evaluate a novel user-operated audiometry method allowing users full control in determining their pure-tone hearing thresholds. DESIGN: Comparative study. Participants were recruited from a hearing clinic after undergoing manual audiometry (six frequencies). They then performed test-retests of a new test (slider audiometry, eight frequencies) and completed the System Usability Scale questionnaire. STUDY SAMPLE: 37 adult participants, including 30 hearing-impaired and seven normal-hearing individuals. RESULTS: Mean (SD) threshold differences for octave frequencies between 250 to 2000 Hz between manual and slider audiometry ranged from -7.8 (6.6) to -5.7 (6.5) dB and were significant. For 4000 and 8000 Hz mean differences were -0.3 (8.4) and 0.0 (9.7) dB and insignificant. Standard deviations ranged from 6.5 to 9.7 dB across six tested frequencies. Slider test-retest mean threshold differences ranged from -1.4 (4.7) to 0.3 (6.0) dB across eight tested frequencies, with standard deviations ranging from 4.1 to 8.5 dB. The average usability score for the slider audiometry was 88.3. CONCLUSION: When compared to manual audiometry, the slider audiometry demonstrated validity at 4000 and 8000 Hz but found significantly lower thresholds for octave frequencies between 250 to 2000 Hz. Test-retests of the new method revealed small mean differences and acceptable SDs.

The Audible Contrast Threshold (ACT) test: A clinical spectro-temporal modulation detection test.

Over the last decade, multiple studies have shown that hearing-impaired listeners' speech-in-noise reception ability, measured with audibility compensation, is closely associated with performance in spectro-temporal modulation (STM) detection tests. STM tests thus have the potential to provide highly relevant beyond-the-audiogram information in the clinic, but the available STM tests have not been optimized for clinical use in terms of test duration, required equipment, and procedural standardization. The present study introduces a quick-and-simple clinically viable STM test, named the Audible Contrast Threshold (ACT™) test. First, an experimenter-controlled STM measurement paradigm was developed, in which the patient is presented bilaterally with a continuous audibility-corrected noise via headphones and asked to press a pushbutton whenever they hear an STM target sound in the noise. The patient's threshold is established using a Hughson-Westlake tracking procedure with a three-out-of-five criterion and then refined by post-processing the collected data using a logistic function. Different stimulation paradigms were tested in 28 hearing-impaired participants and compared to data previously measured in the same participants with an established STM test paradigm. The best stimulation paradigm showed excellent test-retest reliability and good agreement with the established laboratory version. Second, the best stimulation paradigm with 1-second noise "waves" (windowed noise) was chosen, further optimized with respect to step size and logistic-function fitting, and tested in a population of 25 young normal-hearing participants using various types of transducers to obtain normative data. Based on these normative data, the "normalized Contrast Level" (in dB nCL) scale was defined, where 0 ± 4 dB nCL corresponds to normal performance and elevated dB nCL values indicate the degree of audible contrast loss. Overall, the results of the present study suggest that the ACT test may be considered a reliable, quick-and-simple (and thus clinically viable) test of STM sensitivity. The ACT can be measured directly after the audiogram using the same set up, adding only a few minutes to the process.

Evaluation of Cholesteatoma.

Evaluation of cholesteatoma depends on clinical history and examination, with microscope and/or endoscope. A history of hearing loss with a chronic draining ear, refractory to ototopical medication, raises suspicion for cholesteatoma. Symptoms of Eustachian tube dysfunction or prior ear surgery including ear tubes should be elicited. Inflammation can be severe and should be suppressed if possible. Once cholesteatoma is diagnosed or strongly suspected, further workup includes audiometry prior to surgical excision. Imaging may supplement the workup and is especially helpful if there are concerning features including vertigo, third window symptoms, asymmetric bone line, facial nerve weakness, or for anticipatory guidance.

Functional hearing impairment common in Parkinson's disease: Insights from a pilot study.

INTRODUCTION: Hearing impairments in Parkinson's Disease (PD) have received limited attention in the past, possibly because PD patients often report no perceived hearing disability, yet negative consequences of hearing impairment might aggravate communication difficulties and social withdrawal. OBJECTIVE: Our aim was to investigate functional hearing (speech in noise recognition) in PD and evaluate its relationship to neuropsychiatric symptoms, cognition and quality of life. METHODS: Participants with PD were recruited in a tertiary movement disorder clinic. Demographic, audiological, neuropsychiatric and quality of life data were collected. Participants underwent pure tone audiometry (PTA) and Hearing in Noise test (HINT) as a part of their audiological evaluation. RESULTS: A total of 29 participants (mean age: 65.8±8.3 years, M:F= 1.6:1, mean disease duration 5.2 ± 4.0 years) completed the study. All assessments were done in the ON state. 19/29 (65.5 %) participants had normal tone audiometry for age; functional hearing loss, however, was present in 17/29 (58.6 %) according to the HINT. 65 % (11/17) of the affected participants had a disease duration of <4 years. The majority (72.4 %) with poor functional hearing did not perceive any hearing impairment. Hearing deficits did not correlate with non-motor symptoms (NMS), including cognition or other quality of life measures. CONCLUSIONS: Functional hearing loss is common in PD, often presents early in the disease and the majority of PD patients are unaware of their functional hearing loss. Its potential impact on cognition, communication and quality of life requires further investigation and tailored treatment.

Optimisation of visual reinforcement audiometry: a scoping review.

OBJECTIVE: Visual reinforcement audiometry (VRA) is a well-established behavioural test used to assess hearing in infants and young children. This scoping review aimed to summarise the evidence for different approaches to optimising and improving the effectiveness of VRA for clinical practice. DESIGN: A pre-registered scoping review was conducted. STUDY SAMPLE: Fifty-nine original articles were included in the review. RESULTS: The review identified a number of factors which improved response behaviour, such as increased variety and complexity of visual reinforcers, short reinforcer durations, and providing breaks. Intermittent conditioning, where as few as 50% of conditioning trials were rewarded, did not have an impact on response behaviour, and neither did the (suprathreshold) presentation level used during conditioning. More responses were achieved for younger (around 12 months) than older (around 18-24 months) infants. Once infants were developmentally ready to condition to play audiometry, this allowed for a more comprehensive hearing evaluation. CONCLUSIONS: VRA is a successful behavioural hearing test for most infants of developmental age around 7-24 months, with well-established protocols describing its clinical implementation. Further evidence is needed to assess potential benefits of different reinforcers, different auditory stimuli (e.g. filtered familiar sounds), and technologies to assist response detection.

Disparities between objectively measured hearing loss and subjectively perceived aided hearing loss: A scoping review.

Objectives: This scoping review aims to summarize and synthesize research findings on the disparities between audiometrically diagnosed and aided hearing loss versus the individual's own experience of hearing loss. Methods: A systematic search strategy was employed across multiple databases to identify studies published between 1990 and October 2023 focusing on the experiences of hearing problems among individuals with aided hearing loss. The selected studies underwent screening based on predetermined inclusion and exclusion criteria. These criteria revolved around including papers featuring a population of adult (+18) individuals with audiometrically measured hearing loss who had undergone technological rehabilitation. Data charting was employed to provide an overview of the studies and was additionally utilized to identify key themes. Narrative analysis was used to identify subthemes within the data set. Results: A total of 11 articles met the inclusion criteria. The analysis identified five themes: "disability experience and discrepancy between measured and self-perceived hearing loss"; "listening effort"; "mental burden/psychological consequences"; "factors that alleviate the consequences of HL"; and "sociodemographic factors." Conclusions: The scoping review shows that, despite the proliferation of technological options, there is a pressing need for a more concentrated effort to identify and scrutinize the supplementary facets of hearing loss that remain inadequately addressed by current hearing technology. This includes subjective experiences associated with hearing loss that may not be effectively treated solely with hearing aids.

EXPRESS: Pure-tone audiometry and dichotic listening in primary progressive aphasia and Alzheimer's disease.

Hearing is multifaceted and the relative contributions of peripheral and central hearing loss are rarely considered together in the context of dementia. Here, we assessed peripheral (as measured with pure-tone audiometry) and central (as measured with dichotic listening) hearing in 19 patients with typical amnestic Alzheimer's disease (tAD), 10 patients with logopenic variant primary progressive aphasia (lvPPA), 11 patients with nonfluent/agrammatic variant PPA (nfvPPA), 15 patients with semantic variant PPA (svPPA), and 28 healthy age-matched individuals. Participants also underwent neuropsychological assessment and magnetic resonance image scanning, allowing us to use voxel-based morphometry to assess associations between hearing scores and grey matter volume. Dichotic listening was impaired in all patient groups relative to healthy controls. In the combined patient (but not healthy control) cohort, dichotic listening scores were significantly correlated with measures of global cognitive functioning and speech-based neuropsychological tasks. Pure-tone audiometry scores were not significantly elevated in any patient group relative to the healthy control group, and no significant correlations were observed between peripheral hearing and neuropsychological task performance in either the combined patient or healthy control cohorts. Neuroanatomically, dichotic listening performance was associated with grey matter volume in a bilateral fronto-temporo-parietal network over the combined patient cohort, but no correlates were identified for pure-tone audiometry. Our findings highlight the importance of speech parsing mechanisms beyond elementary sound detection in driving cognitive test performance, underline the importance of assessing central hearing alongside peripheral hearing in people with dementia, and further delineate the complex auditory profiles of neurodegenerative dementias.

Comparative Evaluation of Hearing and Salivary Flow Rate in Smokers and Non-smokers: A Cross-Sectional Study.

Background Smoking is a major global health issue that is linked to various health conditions, including hearing loss and reduced salivary flow. This study aims to explore the relationship between smoking, hearing loss, and salivary flow rate. Methods This cross-sectional study was conducted over two months at a tertiary healthcare institute in Central India, involving 100 participants (50 smokers and 50 non-smokers) aged 18-55 years. Hearing status was assessed using audiometry, and the salivary flow rate was measured. Statistical analyses were performed using SPSS version 21 (IBM Corp., Armonk, NY, US). Results Smokers had a significantly higher prevalence of hearing loss (40%) compared to non-smokers (10%). The salivary flow rate was significantly lower in smokers (mean 0.5540 ml/min) than in non-smokers (mean 0.9240 ml/min). However, no significant correlation was found between the duration and frequency of smoking with hearing loss or salivary flow rate. Conclusion Smoking significantly impacts both hearing and salivary flow rate, hence smokers show a higher risk of hearing loss and reduced salivary flow rate. Early hearing screenings and preventive measures are recommended for smokers. Further research with larger sample sizes is needed to explore the long-term effects of smoking on these health parameters.

Are conversation and whispered voice hearing tests comparable to pure tone audiometry for assessment of hearing loss? A retrospective analysis.

Background: Pure tone audiometry (PTA) is considered the standard method of hearing assessment. However, technical and logistical challenges preclude its usage for hearing screening at primary healthcare facilities. Free field hearing (FFH) tests such as conversation voice (CV) and whispered voice (WV) tests have been used for hearing assessment. However, their correlation to PTA and accuracy in detection of hearing loss are doubtful. This study aims to determine if FFH tests can be used for estimation of hearing thresholds. Methods: A retrospective analytical study was conducted at the otorhinolaryngology department. Spearman's correlation coefficient (ρ) was determined between FFH recognition distance and average air conduction PTA thresholds. A statistical regression model was developed to estimate hearing thresholds from the FFH recognition distance. The FFH tests were studied for their accuracy in detection of hearing loss. Results: The audiometric records of 437 persons (874 ears) were analysed. The CV and WV tests were found to have a high correlation (ρ = -0.757 and -0.758, respectively) with average PTA thresholds in persons with hearing loss. The WV test was found to have a 94.7% sensitivity, 90.8% specificity, 97.6% positive predictive value, 80.9% negative predictive value, and 93.9% accuracy in detection of hearing loss. Conclusion: FFH tests such as WV test can be used to estimate the hearing thresholds and screen for hearing loss when audiometric tests are not logistically feasible, such as at primary-level healthcare facilities, remote locations, and in schools. However, such tests should not be regarded as a substitute to PTA.

Kids are not just small adults: An attempt to validate pediatric tablet-based digits in noise testing.

Objective: The objective of this study is to investigate whether conductive hearing loss (CHL) can be differentiated from sensorineural hearing loss in children ages 3-18 using a diotic and antiphasic digits-in-noise (DIN) tablet-based test using existing adult cut-off criteria. Methods: A blinded multi-institutional prospective cohort of 64 children aged 3-18 scheduled for an audiometric soundbooth evaluation with a pediatric audiologist and a same-day otolaryngologist examination were recruited for the study. Following a conventional audiogram, the subjects underwent diotic (same-phased stimuli) and antiphasic (out-of-phase stimuli) DIN testing on a HearX Samsung Galaxy tablet with over-the-ear headphones, for a total of 128 measurements. DIN test results were compared with soundbooth audiometry using known adult "cut off criteria." Results: A logistic regression analysis adjusted for demographics (age, sex) and race was performed to compare CHL determination from DIN testing to CHL determination with soundbooth audiometry. The results showed 50% agreement with a p-value of .753. The determinations based on combined DIN testing agreed with each other 33% of the time and had a p-value of .373. Otologic pathology and age were not predictive of outcome. Conclusion: This preliminary analysis of DIN testing indicated that DIN and audiometric testing completed in a soundbooth were not significantly predictive of one another in the population of children aged 3-18 when using the adult cut-off criteria for CHL differentiation. Given these findings, further testing is required in children to determine pediatric specific cut-off values.

Digital speech hearing screening using a quick novel mobile hearing impairment assessment: an observational correlation study.

By 2050, 1 in 4 people worldwide will be living with hearing impairment. We propose a digital Speech Hearing Screener (dSHS) using short nonsense word recognition to measure speech-hearing ability. The importance of hearing screening is increasing due to the anticipated increase in individuals with hearing impairment globally. We compare dSHS outcomes with standardized pure-tone averages (PTA) and speech-recognition thresholds (SRT). Fifty participants (aged 55 or older underwent pure-tone and speech-recognition thresholding. One-way ANOVA was used to compare differences between hearing impaired and hearing not-impaired groups, by the dSHS, with a clinical threshold of moderately impaired hearing at 35 dB and severe hearing impairment at 50 dB. dSHS results significantly correlated with PTAs/SRTs. ANOVA results revealed the dSHS was significantly different (F(1,47) = 38.1, p < 0.001) between hearing impaired and unimpaired groups. Classification analysis using a 35 dB threshold, yielded accuracy of 85.7% for PTA-based impairment and 81.6% for SRT-based impairment. At a 50 dB threshold, dSHS classification accuracy was 79.6% for PTA-based impairment (Negative Predictive Value (NPV)-93%) and 83.7% (NPV-100%) for SRT-based impairment. The dSHS successfully differentiates between hearing-impaired and unimpaired individuals in under 3 min. This hearing screener offers a time-saving, in-clinic hearing screening to streamline the triage of those with likely hearing impairment to the appropriate follow-up assessment, thereby improving the quality of services. Future work will investigate the ability of the dSHS to help rule out hearing impairment as a cause or confounder in clinical and research applications.

Prevalence and Characteristics of Veterans with Severe Hearing Loss: A Descriptive Study.

Hearing loss is common among Veterans, and extensive hearing care resources are prioritized within the Veterans Administration (VA). Severe hearing loss poses unique communication challenges with speech understanding that may not be overcome with amplification. We analyzed data from the VA Audiometric Repository between 2005 and 2017 and the relationship between hearing loss severity with speech recognition scores. We hypothesized that a significant subset of Veterans with severe or worse hearing loss would have poor unaided speech perception outcomes even with adequate audibility. Sociodemographic characteristics and comorbidities were compiled using electronic medical records as was self-report measures of hearing disability. We identified a cohort of 137,500 unique Veterans with 232,789 audiograms demonstrating bilateral severe or worse hearing loss (four-frequency PTA > 70 dB HL). The median (IQR; range) age of Veterans at their first audiogram with severe or worse hearing loss was 81 years (74 to 87; 21-90+), and a majority were male (136,087 [99%]) and non-Hispanic white (107,798 [78.4%]). Among those with bilateral severe or worse hearing loss, 41,901 (30.5%) also had poor speech recognition scores (<50% words), with greater hearing loss severity correlating with worse speech perception. We observed variability in speech perception abilities in those with moderate-severe and greater levels of hearing loss who may derive limited benefit from amplification. Veterans with communication challenges may warrant alternative approaches and treatment strategies such as cochlear implants to support communication needs.

Exploring the feasibility of remote administration of speech audiometry: A comparative study of conventional and digital methods.

Objective: This study investigated the effectiveness of remote administration of speech audiometry, an essential tool for diagnosing hearing loss and determining its severity. Utilizing two software tools for remote testing, the research aimed to compare these digital methods with traditional, in-person speech audiometry to evaluate their feasibility and accuracy. Design: Participants underwent the Cantonese Hearing in Noise Test (CHINT) under three listening conditions-quiet, noise from the front, and noise from the right side-using three different administration methods: the conventional in-person approach, video conferencing software, and remote access software. Study Sample: Fifty-six Cantonese-speaking adults residing in Hong Kong participated in this study. Results: Analysis revealed no significant differences in CHINT scores among the three administration methods, indicating the potential for remote administration to yield results comparable to those of conventional methods. Conclusions: The findings supported the feasibility of remote speech audiometry using the investigated digital tools. This study paved the way for the wider adoption of tele-audiology practices, particularly in situations where in-person assessments are not possible.

The multilingual digits-in-noise (DIN) test: development and evaluation.

OBJECTIVE: To develop a methodologically uniform digits-in-noise (DIN) test in 17 different languages. DESIGN: The DIN test was developed for Android devices as an extension to the open-access Hearing Test™ app, available on the Google Play store. It utilised professionally recorded female speech, speech-shaped noise, a digit scoring method and a variable step size. The test was adaptively optimised and evaluated as the results of tests taken online by users of the app became available. STUDY SAMPLE: Optimisation using 35,534 ears, evaluation using 6012 ears. RESULTS: Optimisation improved the slopes of the psychometric functions for all languages by an average of 6.8%/dB. Evaluation included calculation of normative speech reception thresholds (SRTs) and estimation of test-retest standard deviations. Normative values for SRTs ranged from -14.2 dB SNR (95% CI -14.3 to -14.0) for Chinese to -11.2 dB SNR (95% CI -11.3 to -11.1) for Japanese, with reliability estimates ranging from 0.48 dB (95% CI 0.36-0.64) for Portuguese to 0.91 dB (95% CI 0.73-1.21) for Romanian. CONCLUSIONS: The optimisation of each language version was confirmed by the improvement in the slopes of the psychometric functions. The normative values obtained from the test evaluation were in agreement with literature data. TRIAL REGISTRATION: Science Support Centre of Wroclaw Medical University BW-59/2020.

A Randomised Controlled Trial on the Effect of Hamulectomy on Hearing Outcomes in Cleft Palate Patients - A Comparative Study.

Introduction: Cleft palate, a common congenital craniofacial defect, requires surgical repair and many surgical approaches have been employed for the same to reduce the risk of post-operative complications and improve outcomes. In order to achieve tension free closure, fracture of pterygoid hamulus has been advised. However, the effect of this manoeuvre on auditory functions remains debatable. The study was designed to evaluate the effect of hamulectomy on auditory function during the post-operative period after palatoplasty. Materials and Methods: The present study enrolled 100 participants aged 10 months-2 years with isolated cleft palate defect. They were randomly divided into two groups: palatoplasty with hamulectomy (n = 50) and palatoplasty without hamulectomy (n = 50). Hearing outcomes were evaluated using objective measures (otoscopy, tympanometry, and otoacoustic emission [OAE] tests) at 1-month and 6-month post-operative follow-up visits. The Chi-square test was used to analyse the data and significance level was kept at P ≤ 0.05. Results: The findings of otoscopy, tympanometry and OAE tests were statistically similar between the two study groups (P > 0.05; Chi-square test) at both one month and six months follow-up visits. Another noteworthy observation was improvement in auditory function during follow-up period indicating recovery of middle ear function following palatoplasty. Discussion: The addition of hamulectomy to the palatoplasty treatment may improve the hearing outcomes for cleft palate patients and can be adopted to achieve tension free closure.

High-Frequency Audiovestibular Dysfunction in Long-Standing Diabetes Mellitus: Insights from a Cross-Sectional Study.

This study investigates audiovestibular dysfunction in individuals with long-standing diabetes mellitus (DM). A cross-sectional study was conducted involving 100 patients (DM for ≥ 10 years) at the Department of E.N.T. in Prakash Institute of Medical Sciences and Research, Sangli, Maharashtra. A mean age of 43.09 years among patients, with 64% male and 36% female participants. Hearing loss was the most common complaint, affecting 46% of subjects, followed by vertigo in 23%. Pure tone audiometry revealed that 34% of patients had sensorineural hearing loss, with varying degrees of severity. Vestibular dysfunction was observed in 10% of cases. Correlation analysis indicated a significant positive relationship between the duration of DM and hearing thresholds at various frequencies, as well as with HbA1c levels. This suggests a worsening of hearing with longer DM duration and higher HbA1c levels. The prevalence of hearing impairment was higher at higher frequencies, with vestibular dysfunction also noted in a subset of patients.