Significant association between osteoporosis and hearing loss: a systematic review and meta-analysis / Associação significativa entre osteoporose e perda auditiva: uma revisão sistemática e metanálise

Abstract Introduction: There is inconclusive evidence whether osteoporosis increases risk of hearing loss in current literature. Objective: We conducted this meta-analysis to determine whether there is an association between hearing loss and osteoporosis. Methods: This systematic review and meta-analysis was conducted from studies of MEDLINE, EMBASE, and LILACS. Osteoporosis was defined as having a bone mineral density with a T-score of less than −2.5 standard deviation. The outcome was hearing loss as assessed by audiometry or self-reported assessment. Random-effects model and pooled hazard ratio, risk ratio, or odds ratio of hearing loss with 95% confidence intervals were compared between normal bone mineral density and low bone mineral density or osteoporosis. Results: A total of 16 articles underwent full-length review. Overall, there was a statistically significant increased odds of hearing loss in the low bone mineral density or osteoporosis group with odds ratio of 1.20 (95% confidence intervals 1.01-1.42, p = 0.04, I 2 = 82%, Pheterogeneity = 0.01). However, the study from Helzner et al. reported significantly increase odds of hearing loss in the low bone mineral density in particular area and population included femoral neck of black men 1.37 (95% confidence intervals 1.07-1.76, p = 0.01) and total hip of black men 1.36 (95% confidence intervals 1.05-1.76, p = 0.02). Conclusion: Our study proposed the first meta-analysis that demonstrated a probable association between hearing loss and bone mineral density. Osteoporosis could be a risk factor in hearing loss and might play an important role in age-related hearing loss.

Abstract Introduction: There is inconclusive evidence whether osteoporosis increases risk of hearing loss in current literature. Objective: We conducted this meta-analysis to determine whether there is an association between hearing loss and osteoporosis. Methods: This systematic review and meta-analysis was conducted from studies of MEDLINE, EMBASE, and LILACS. Osteoporosis was defined as having a bone mineral density with a T-score of less than −2.5 standard deviation. The outcome was hearing loss as assessed by audiometry or self-reported assessment. Random-effects model and pooled hazard ratio, risk ratio, or odds ratio of hearing loss with 95% confidence intervals were compared between normal bone mineral density and low bone mineral density or osteoporosis. Results: A total of 16 articles underwent full-length review. Overall, there was a statistically significant increased odds of hearing loss in the low bone mineral density or osteoporosis group with odds ratio of 1.20 (95% confidence intervals 1.01-1.42, p = 0.04, I 2 = 82%, Pheterogeneity = 0.01). However, the study from Helzner et al. reported significantly increase odds of hearing loss in the low bone mineral density in particular area and population included femoral neck of black men 1.37 (95% confidence intervals 1.07-1.76, p = 0.01) and total hip of black men 1.36 (95% confidence intervals 1.05-1.76, p = 0.02). Conclusion: Our study proposed the first meta-analysis that demonstrated a probable association between hearing loss and bone mineral density. Osteoporosis could be a risk factor in hearing loss and might play an important role in age-related hearing loss.

Significant association between osteoporosis and hearing loss: a systematic review and meta-analysis.

INTRODUCTION: There is inconclusive evidence whether osteoporosis increases risk of hearing loss in current literature. OBJECTIVE: We conducted this meta-analysis to determine whether there is an association between hearing loss and osteoporosis. METHODS: This systematic review and meta-analysis was conducted from studies of MEDLINE, EMBASE, and LILACS. Osteoporosis was defined as having a bone mineral density with a T-score of less than -2.5 standard deviation. The outcome was hearing loss as assessed by audiometry or self-reported assessment. Random-effects model and pooled hazard ratio, risk ratio, or odds ratio of hearing loss with 95% confidence intervals were compared between normal bone mineral density and low bone mineral density or osteoporosis. RESULTS: A total of 16 articles underwent full-length review. Overall, there was a statistically significant increased odds of hearing loss in the low bone mineral density or osteoporosis group with odds ratio of 1.20 (95% confidence intervals 1.01-1.42, p=0.04, I2=82%, Pheterogeneity=0.01). However, the study from Helzner et al. reported significantly increase odds of hearing loss in the low bone mineral density in particular area and population included femoral neck of black men 1.37 (95% confidence intervals 1.07-1.76, p=0.01) and total hip of black men 1.36 (95% confidence intervals 1.05-1.76, p=0.02). CONCLUSION: Our study proposed the first meta-analysis that demonstrated a probable association between hearing loss and bone mineral density. Osteoporosis could be a risk factor in hearing loss and might play an important role in age-related hearing loss.

Otologic and audiologic features of ethnic Chinese patients with Turner syndrome in Taiwan.

BACKGROUND/PURPOSE: Otologic and audiologic characteristics of Turner syndrome (TS) have been well documented in Caucasian-but not in Asian-populations. We report these features and possible causative factors for hearing loss in ethnic Chinese TS patients in Taiwan. METHODS: The study was a cross-sectional trial that analyzed patients diagnosed with TS. We enrolled patients for otologic evaluations and age-appropriate pure tone audiometry. To explore the potential associations with hearing loss, we studied patient karyotype, history of recurrent otitis media (OM) and various craniofacial anomalies. RESULTS: The 46 patients (mean age 17.3 years, range 5-34 years) enrolled, 22 (47.8%) had a history of recurrent OM. Otoscopic examination identified eardrum abnormalities in 45.6% of patients with myringosclerosis as the most common condition. A total of 21.7% patients showed auricular anomalies. Audiologic analysis revealed five cases (10.7%) with conductive hearing loss (CHL) and eight cases (17.4%) with sensorineural hearing loss (SNHL). Among patients with a history of recurrent OM, CHL prevailed (p = 0.0192) over SNHL (p = 0.1278). Karyotype and craniofacial anomalies were not associated with CHL or SNHL (p > 0.05). CONCLUSION: We found varying degrees of otologic and audiologic abnormalities among the TS in ethnic Chinese population. About one-half of the patients had recurrent OM, which was more likely to be associated with CHL in early life. Therefore, regular surveillance, early diagnosis, and the initiation of appropriate treatment are crucial in improving the hearing and speech in children with TS as well as in preventing short- and long-term associated complications.

La práctica clínica en el contexto de la inmigración / The clinical practice in the immigration environment

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Hearing sensitivity and bone mineral density in older adults: the Health, Aging and Body Composition Study.

Bone mineral density (BMD) may be associated with hearing loss in older adults. Demineralization of the cochlear capsule has been associated with hearing loss in those with Paget's disease of the bone and otosclerosis. Osteoporosis may also result in cochlear capsule demineralization. We hypothesized that lower hip BMD and lower heel ultrasound measurements would be associated with hearing loss in a population-based sample of 2,089 older black and white men and women. Bone parameters and hearing function were measured at the fourth clinical follow-up visit. Audiometric threshold testing was used to measure air- and bone-conduction hearing sensitivity. BMD of the hip and its subregions was measured using dual-energy X-ray absorptiometry. Calcaneal bone measurements [broadband ultrasound attenuation (BUA), speed of sound (SOS) and the quantitative ultrasound index (QUI)] were obtained using heel ultrasound. After adjusting for known hearing loss risk factors, no association was found between hearing and any of the bone measurements in whites and black women. In black men, however, lower hip BMD was associated with higher odds of hearing loss; for each standard deviation decrease in total hip BMD, the odds of hearing loss were 1.41 (95% confidence interval 1.08, 1.83), 1.39 (95% CI 1.07, 1.82) for femoral neck BMD and 1.65 (95% CI 1.26, 2.16) for trochanter BMD. Conductive hearing loss was associated with lower heel ultrasound measurements, though only among white men. The results of this study are mixed and inconclusive. Lower BMD of the hip and its subregions was associated with hearing loss among black men, but not among whites or black women. Lower measurements on heel ultrasound were associated with conductive hearing loss, though only among white men. These results suggest that axial and appendicular bone parameters may be modestly associated with hearing loss in older men, but not in women.

Comparison of risk of conductive hearing loss among three ethnic groups of Arctic audiology patients.

The purpose of the study was to investigate the relative contributions of age, gender, ethnic background, and a history of middle ear disease on the amount of conductive hearing impairment among native and non-native audiology patients in the Canadian North. A second goal of the study was to determine risk factors for conductive hearing loss in the patients studied. Three ethnic groups were represented among the 3,094 patients: Inuit, American Indian, and non-native. Loglinear and logit statistical models were applied, and these data were best explained by a 3-way interaction of history of middle ear disease, ethnic group, and hearing loss, and the 2-way interaction of age and hearing loss. The Inuit appear to be at higher risk for conductive hearing impairment than the other ethnic groups. Conductive hearing loss also appears to increase as age increases through the teenage years for all the patients regardless of ethnic group membership. Preschoolers were at the lowest risk for conductive hearing loss. The trend for the amount of hearing impairment to increase throughout childhood suggests that children living in the Arctic may manifest a unique and more serious form of the disease not often observed in audiology patients who are Caucasian in southern Canada or the United States or that they may be exposed to additional risk factors.

Excess cerumen: failure rate of black and Indian preschool children from Durban on the Middle Ear Screening Protocol (MESP).

The aim of the study was to examine the failure rate of Black and Indian subjects within the excessive cerumen category of the Middle Ear Screening Protocol (MESP). The subjects included four to five year old Black and Indian children attending pre-schools in the Durban Central Region. Thus, a sample of 728 subjects (average age = 4.6 years), 312 Black (135 male and 180 female) and 413 Indian (223 male and 190 female) was screened using referral criteria based on a Middle Ear Screening Protocol (MESP). The results of the study indicated that a significant percentage of Black (38.4%) and Indian (49.9%) subjects failed, due to excessive cerumen. These results are discussed with reference to the literature. A cerumen management program has been outlined and recommended to be implemented in preschools in South Africa.

Middle ear measures as predictors of hearing loss in Australian aboriginal schoolchildren.

This study sought to establish the value of tympanometry and otoscopy for predicting significant conductive hearing loss in remote-area Aboriginal children, and also to measure the range of hearing loss which can be expected with middle ear disease, with or without a tympanic membrane (TM) perforation. A field study is reported of 255 Aboriginal children aged up to 16 years who were examined with pneumotoscopy and tympanometry and whose hearing was tested under controlled acoustic conditions. Results showed that pneumatic otoscopy for detection of middle ear effusion and identification of perforations resulted in the best rate of prediction of significant conductive hearing loss. Furthermore, the hearing of children with perforated TMs (mean pure-tone average 30.0 dB; S.D. 11.1) was significantly worse than those in which tympanometry suggested middle ear effusion (mean pure-tone average 20.3 dB; S.D. 9.6), and both differed significantly from ears showing normal tympanograms (mean pure-tone average 11.2 dB; S.D. 5.9). Implications for community-based hearing screening and classroom management of affected children are discussed.