A Study Prevalence of Congenital Rubella Syndrome Cases Before and After Rubella Vaccination Campaign.

Rubella is a vaccine-preventable disease and is the leading cause of congenital disabilities. This study was performed to identify the congenital rubella syndrome (CRS) patients before and after the Rubella Vaccination Campaign in the Outpatient Unit of the Audiology Department at Dr. Soetomo General Hospital Surabaya. This was a descriptive study that used secondary data from a CRS surveillance case investigation form and medical records from 2015 to 2020 at Dr. Soetomo Hospital. A total of 346 suspected CRS cases were included in this study. According to the final classification, 145 (41.9%) patients had clinical CRS, 65 (18.8%) had confirmed CRS, and 136 (39.3%) had discarded CRS. The majority of the suspected cases were in the < 1-month age group (27.4%). Hearing loss was the most prevalent symptom in both the pre and post-rubella vaccination campaign (RVC) introduction periods campaign among groups. A patient with suspected CRS clinical signs.

Screening for hearing loss using the electronic whisper test: A prospective cross-sectional study.

Background: Hearing screening is a method for early identification of hearing loss. Hearing screening is widely used in hospitals as part of physical examination. However, some of them are difficult to operate outside the hospitals regarding portability and user-friendliness. Therefore, we developed a simple yet easy-to-use portable electronic whisper test (EWT) for field deployment, particularly on many subjects. The EWT validity is a hearing screening method compared to pure-tone audiometry. Methods: This study was a cross-sectional comparative with a prospective approach. The subjects were outpatients at the Audiology Clinic of Dr. Soetomo Academic Medical Center, Surabaya, Indonesia, who met the inclusion and exclusion criteria. Statistical analysis made sensitivity and specificity tables using a 2 × 2 table, positive and negative predictive values. Results: Samples of 50 participants (100 ears) obtained a sensitivity value of 83%, specificity of 78%, positive predictive value of 45%, and negative predictive value of 95%. Conclusions: The EWT is valid for use as a hearing screening method.

Factors associated with time of diagnosis and habilitation of congenital hearing loss in Indonesia: A multicenter study.

OBJECTIVES: To investigate factors associated with time of diagnosis and habilitation of congenital hearing loss in Indonesia. METHOD: A retrospective cohort study was conducted from January to December 2020 by collecting data on patients with congenital hearing loss using validated questionnaires. RESULT: Among 535 children with congenital hearing loss, 2.7% had a family history of congenital hearing loss, 11.2% and 37.4% had a maternal history of ototoxic drugs and herbal medicine use during pregnancy, respectively, and 17.8% had prenatal exposure to TORCH infection. Lower maternal education level was shown to be associated with older age at diagnosis (p = 0.045), while older maternal age (p < 0.001), non-housewife mothers (p = 0.029), and out-of-pocket payment scheme (p = 0.027) were associated with a higher rate of habilitation. CONCLUSION: The present study showed that the presence of family history, the use of certain medications during pregnancy, and prenatal TORCH infection are prevalent in children with congenital hearing loss in Indonesia. Several factors such as maternal education level, age, occupation, and habilitation payment scheme may be associated with time of diagnosis and habilitation of congenital hearing loss.

Score of Hearing Handicap Inventory for the Elderly (HHIE) Compared to Whisper Test on Presbycusis.

Presbycusis is a sensorineural type of hearing loss caused by a degenerative process of the hearing organ. Examination was done to detect hearing loss, with Audiometry as the diagnostic gold standard and screening with whisper test and using Hearing Handicap Inventory for the Elderly-Screening (HHIE-S) questionnaire. This study was aimed to compare the sensitivity and specificity between Hearing Handicap Inventory for the Elderly Screening questionnaire score and Whisper test in hearing loss of presbycusis patients in Dr. Soetomo Hospital. Subjects were elderly patients in outpatient clinic of Geriatry and Audiology of Dr. Soetomo General Hospital in Surabaya. Data samples were collected by consecutive sampling. All collected samples were analyzed statistically by Pearson correlation test to identify the correlation between variables. Results: Statistic analysis with Pearson correlation test obtained p-value = 0.001 and correlation coefficient (r) = 0.691 for HHIE-S questionnaire and p = 0.001 and (r) = 0.298 for Whisper test. The sensitivity of the Whisper test was 72.73% while the HHIE-S questionnaire was 61.82%. Both tests had the same specificity of 80%. Conclusions: The Whisper test is more sensitive than HHIE-S questionnaires in detecting hearing loss in presbycusis patients in outpatient clinic of Geriatry and Audiology of Dr. Soetomo General Hospital in Surabaya.

Correction to: Score of Hearing Handicap Inventory for the Elderly (HHIE) Compared to Whisper Test on Presbycusis.

[This corrects the article DOI: 10.1007/s12070-020-01997-5.].

Correlation between blood urea nitrogen level and cochlear outer hair cell function in non-dialysis chronic kidney disease patients.

BACKGROUND: Hearing loss due to impaired cochlear function, which results from increased blood urea nitrogen (BUN) level, is one of the important clinical problems in chronic kidney disease (CKD) patients with uremia. This study aims to determine correlation between blood urea nitrogen (BUN) levels and cochlear Outer Hair Cell (OHC) dysfunction in non-dialysis stage 3-5 CKD patients so that the BUN levels may also be used to determine the presence of cochlear OHC dysfunction. DESIGN AND METHODS: An observational analytic study with a cross sectional design and consecutive sampling. This study was conducted from November 2019 to February 2020 at the Department of Internal Medicine, Soetomo Hospital, Surabaya, Indonesia, and Otorhinolaryngology-Head and Neck Surgery Department, Soetomo Hospital, Surabaya, Indonesia. Non-dialysis CKD patients who met the inclusion and exclusion criteria were subjected to a Distortion Product Otoacoustic Emissions (DPOAE) test to assess cochlear OHC function at the Otorhinolaryngology-Head and Neck Surgery, Soetomo Hospital, Surabaya. RESULTS: Female patients were in larger number than male patients in a ratio of 1 : 2. Most of the patients were between 51-60 years of age. DPOAE distribution was referred in 25 patients (83.3%) and pass in 5 patients (16.7%). The highest pass was at 2000 Hz in 24 patients (80.0%), while the refer results were mostly at 12,000 Hz in 29 patients (96.7%). The highest average signal to noise ratio (SNR) was at 2000 Hz and 4000 Hz (12.77 dB and 11.13 dB), while the lowest at 11,000 Hz and 12,000 Hz (1.60 dB and 1.03 dB). Pearson's correlation test on DPOAE results did not show a significant correlation (P >0.05) between BUN levels and impaired cochlear OHC function. CONCLUSIONS: There was no correlation between increased blood urea nitrogen levels and cochlear outer hair cell function disorders in non-dialysis patients with CKD stage 3-5.

Validity of automated audiometry for hearing examination in patients with multidrug-resistant tuberculosis.

Background: The objective of this study was to test the validity of automated audiometry as a method of hearing examination in patients with multidrug-resistant tuberculosis. Method s: This was a cross-sectional comparative study with a retrospective approach, using patient medical records. Patients with multidrug-resistant tuberculosis (MDR-TB) were recruited based-on medical records that met the inclusion and exclusion criteria at the Pulmonology outpatient unit, then referred to the Otorhinolaryngology outpatient unit of the Dr. Soetomo Academic Medical Center. The subjects' hearing function was measured with two different devices (automated audiometer and conventional audiometer) before being given anti-tuberculosis drug therapy (aminoglycoside injection) as ototoxicity monitoring from July to December 2019 period. Sensitivity and specificity analysis was used to assess the validity of the test. Results: A total of 36 patients (72 ears) were included. The comparison test results using the Mann-Whitney test showed that there were significant differences between automated audiometry and conventional audiometry in both ears. Analysis values were: sensitivity 80-97%, specificity 37-96%, positive predictive value 74-98%, and negative predictive value 59-96%. Conclusion s: Automated audiometry is valid for use as a method of hearing examination and monitoring in patients with multidrug-resistant tuberculosis.

Profile of congenital rubella syndrome in Soetomo General Hospital Surabaya, Indonesia.

Background: Definition of Congenital Ruben Syndrome (CRS): a disease caused by rubella virus infection. Routine surveillance of CRS is part of a government program in documenting the incidence of CRS so that infants with CRS are diagnosed promptly and receive appropriate care. Objective: This study aims to report the profile of CRS patients 2015 in Audiology Outpatient General Hospital Dr. Soetomo Surabaya. Method: A descriptive study from CRS surveillance data for the period from January 1st until December 31rd, 2015. Data was from Infants who came to the Audiology Outpatient General Hospital Dr. Soetomo Surabaya and did hearing and serological examination. Results: A total of 65 infants were involved in surveillance. The highest number of patients was the age group 1- <3 years (21 patients, 31.2%). A total of 36 patients (55.4%) were male, 45 babies (69.2%) were suspected of suffering from CRS with 2 infants (3.1%) classified as a laboratory-confirmed CRS. Hearing abnormalities were found in 36 infants (55.4%). Bilateral hearing loss was found in 23 infants (35.4%) and unilateral in 13 infants (20%). Conclusions: This study shows that hearing impairment is the most common clinical symptom with most bilateral hearing loss. The supervision still needs to be continued to capture more CRS cases in the community and effective supervision to detect hearing impairment early.

Congenital Rubella Syndrome profile of audiology outpatient clinic in Surabaya, Indonesia.

Congenital Rubella Syndrome (CRS) consists of hearing impairment, ophthalmology abnormalities, and congenital heart disease in children, resulting from rubella infection during pregnancy. Rubella vaccine has been implemented as national immunization program in Indonesia since 2017, and needed to be evaluated. This study aimed to report the CRS patients' profile of Audiology Outpatient Clinic in Surabaya. A descriptive study from patient's medical record was conducted in Dr. Soetomo Hospital Surabaya from January 2016 to December 2017. CRS was categorized using World Health Organization classification. Suspected infants with CRS burden were assessed by Otoacoustic Emission and rubella antibody test. Ninety five infants suspected with CRS classified as laboratory- confirmed CRS (58.95%), clinically confirmed CRS (15.79%), and discarded CRS (25.26%). Clinical manifestations included combination of congenital heart disease and hearing impairment (17.89%), congenital heart disease, ophthalmology abnormalities, and hearing impairment (16.84%), and hearing impairment and ophthalmology abnormalities (13.68%). The data show a high burden of CRS in Surabaya. These implies the urgent need for national rubella immunization program.

The Association of IL-1 Alpha Level and TNF Alpha Expressions on Bone Destruction in Chronic Suppurative Otitis Media and Cholesteatoma.

Bone destruction in patients with chronic suppurative otitis media (CSOM) and cholesteatoma is considered to be quite high. Bone destruction is caused by various inflammatory cytokines and osteoclasts including IL-1α and TNF-α. The imbalance between the resorption process by osteoclasts and the process of bone formation is also a causative factor for bone destruction. On top of that, the large number of patients is not supported by an equal amount of medical facilities and personnel to conduct operative procedures. To analyze the associated of IL-1α level and TNF-α expression on the severity of bone destruction in CSOM and cholesteatoma patients. The total number of the subjects was 46 patients which group I (TNF-α) consisted of 26 individuals and group II (IL-1α) contained 26 individuals as well. The analysis was conducted in 2 different places (Solo, Indonesia and Surabaya, Indonesia). IL-1α expression was assessed by using ELISA kit at the absorbance rate of 450 nm whereas the rabbit anti-TNF-α polyclonal antibody was applied to examine TNF-α. The assessment of bone destruction was carried out during the operative procedure in Dr. Soetomo General Hospital Surabaya, Indonesia. Group I assessment resulted in severe bone destruction of 65.39% whilst group II showed severe bone destruction of 65.00%. This study revealed that TNF-α was categorized as strong positive (34.62%), moderate positive (42.30%), weak positive (19.23%), and negative (3.85%) with the value of r = 0.775; p ≤ 0.001. On the other hand, the rate of IL-1α was attained as follows: 14.93 ± 4.36 pg/ml, 22.75 ± 12.18 pg/ml, and 31.98 ± 14.16 pg/ml with the value of r = 0.625; p = 0.003. There is a significant association between expression of TNF-α and IL-1α level on the severity of bone destruction in CSOM and cholesteatoma patients. Hence, it has been proven that it is necessary to develop an additional therapeutic interventions to reduce TNF-α and IL-1α in CSOM and cholesteatoma patients.

The Association Between Cochlear and Retrocochlear Disorders with Tinnitus with Normal Hearing Thresholds.

Tinnitus is the perception of hearing the sound without any sound stimulus. It is a symptom of abnormality in a form of conductive disorder when it comes from the outer ear canal and middle ear. A tinnitus complaint has a normal hearing threshold but it has been not fully recognized its causes. Thus, an objective evaluation is needed to locate the abnormality by using OAE and BERA test. To analyze the association of TEOAE, DPOAE, and BERA to locate cochlear and retrocochlear disorders in tinnitus patients with normal hearing threshold. The study was conducted from August to November 2010 until the number of samples was fulfilled in Outpatient Clinic and Audiology Unit in Department of Otolaryngology-Head and Neck Surgery, Dr. Soetomo General Hospital Surabaya. The inclusion criteria in this study included: patients aged 20-50 years old, hearing threshold of ≤ 25 dB, type A tympanogram. The comparison and the association test of TEOAE, DPOAE and BERA in tinnitus group were: TEOAE-BERA analysis result using Mc Nemar obtained p = 0.006, Kappa p = 0.047, likelihood ratio p = 0.066, and the result of DPOAE-BERA analysis using Mc Nemar obtained p = 0.008, Kappa p = 0.439, likelihood ratio p = 0.336. There was a difference in the results of DPOAE examination between tinnitus patients with normal hearing threshold and the control group. There was no difference in TEOAE and BERA test results between tinnitus patients with normal hearing threshold and the control group. This indicates an abnormality in the cochlear.