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Jiang W, Mu Y, Zhao F, Wang P. Advancements in Pediatric Audiological Assessments Using Wideband Acoustic Immittance: A Review. Audiol Res 2024; 14:684-700. [PMID: 39194414 DOI: 10.3390/audiolres14040058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Revised: 08/04/2024] [Accepted: 08/11/2024] [Indexed: 08/29/2024] Open
Abstract
OBJECTIVES This study's objectives were to explore the potential of wideband acoustic immittance (WAI) as a diagnostic tool, examining its accuracy and efficiency in pediatric audiology. METHODS A narrative review of the contemporary literature was conducted, focusing on studies that assessed the use of WAI in diagnosing pediatric auditory conditions. Key variables such as diagnostic accuracy, efficiency, and clinical outcomes were considered. RESULTS This review highlighted that WAI offers a broader range of test frequencies and more comprehensive diagnostic information compared with traditional tympanometry. The studies indicated that WAI has the potential to improve diagnostic accuracy and efficiency in pediatric audiology. Distinct patterns of wideband absorbance were identified, enabling more detailed and accurate diagnostic evaluations. CONCLUSIONS WAI shows substantial potential as a diagnostic tool in pediatric audiology, offering improvements in diagnostic accuracy and efficiency over traditional methods. While the initial findings are promising, further research is needed to fully understand its applicability and benefits across different pediatric populations. Future studies should aim to validate the clinical utility of WAI to ensure its widespread adoption in pediatric audiological assessments.
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Affiliation(s)
- Wen Jiang
- Department of Otolaryngology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou 221000, China
- The College of Medical Technology, Xuzhou Medical University, Xuzhou 221000, China
- The Second College of Clinical Medicine, Xuzhou Medical University, Xuzhou 221000, China
- Auditory Engineering Laboratory of Jiangsu Province, Xuzhou 221000, China
| | - Yi Mu
- The College of Medical Technology, Xuzhou Medical University, Xuzhou 221000, China
| | - Fei Zhao
- Centre for SLT and Hearing Sciences, Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff CF5 2YB, UK
| | - Peng Wang
- National Intellectual Property Information Service Center, China University of Mining and Technology, Xuzhou 221000, China
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Jiang W, Li X, Mu Y, Zhang H, Konduru N, Qiao Y, Zhao F, Liu W. Predictive accuracy of wideband absorbance in children with large vestibular aqueduct syndrome: A single-center retrospective study. Heliyon 2024; 10:e33776. [PMID: 39040356 PMCID: PMC11261878 DOI: 10.1016/j.heliyon.2024.e33776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 06/26/2024] [Accepted: 06/26/2024] [Indexed: 07/24/2024] Open
Abstract
Objectives This study aimed to assess the clinical significance of Wideband Absorbance (WBA) in children with Large Vestibular Aqueduct Syndrome (LVAS), which could potentially serve as diagnostic and predictive markers for LVAS in children. Design This was a single-center retrospective case-control study. Audiological measurements and Wideband Acoustic Immittance (WAI) were performed. Propensity score matching (PSM) was considered to treat group imbalance. The Receiver Operating Characteristic (ROC) curves and area under the ROC curve (AUC) were used to evaluate the sensitivity and specificity of WBA. Study sample Participants included 42 children with LVAS and 163 normal children aged 6 months -11 years recruited from clinical audiology settings between 2019 and 2021. Results The WBA at Tympanometric Peak Pressure (WBATPP) and Ambient Pressure (WBAA) in the LVAS group were significantly lower than those of the control group at 1259-2000 Hz but higher at 4000-6349 Hz (p < 0.05, power >0.8). The WBAA (1587 Hz) AUC value was 0.805, identifying a score ≤0.565 as indicative of a LVAS risk. Conclusions WBA holds promise in distinguishing LVAS from the normal condition and warrants further exploration as a tool to examine the influence of inner ear pressure on acoustic energy transmission in the middle ear.
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Affiliation(s)
- Wen Jiang
- Department of Otolaryngology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, China
- The Second College of Clinical Medicine, Xuzhou Medical University, Xuzhou, 221000, China
- Auditory Engineering Laboratory of Jiangsu Province, Xuzhou, 221000, China
- The College of Medical Technology, Xuzhou Medical University, Xuzhou, 221000, China
| | - Xuanyi Li
- Department of Otolaryngology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, China
| | - Yi Mu
- The College of Medical Technology, Xuzhou Medical University, Xuzhou, 221000, China
| | - Huiying Zhang
- The College of Medical Technology, Xuzhou Medical University, Xuzhou, 221000, China
| | - Naveena Konduru
- Department of Otolaryngology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, China
| | - Yuehua Qiao
- Department of Otolaryngology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, China
- The Second College of Clinical Medicine, Xuzhou Medical University, Xuzhou, 221000, China
- Auditory Engineering Laboratory of Jiangsu Province, Xuzhou, 221000, China
- The College of Medical Technology, Xuzhou Medical University, Xuzhou, 221000, China
| | - Fei Zhao
- Centre for SLT and Hearing Sciences, Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, CF5 2YB, UK, Wales
| | - Wen Liu
- Department of Otolaryngology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, China
- The Second College of Clinical Medicine, Xuzhou Medical University, Xuzhou, 221000, China
- Auditory Engineering Laboratory of Jiangsu Province, Xuzhou, 221000, China
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Saliba I, Alshehri S, Fournier I, Altamami N. Large Vestibular Aqueduct-Associated Symptoms: Endolymphatic Duct Blockage as a Surgical Treatment. Audiol Res 2024; 14:304-316. [PMID: 38525688 PMCID: PMC10961693 DOI: 10.3390/audiolres14020027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 02/18/2024] [Accepted: 03/15/2024] [Indexed: 03/26/2024] Open
Abstract
OBJECTIVE This study aimed to evaluate the effectiveness of endolymphatic duct blockage (EDB) on dizziness control in patients with a large vestibular aqueduct (LVA) and to evaluate its effect on hearing. STUDY DESIGN This is a prospective nonrandomized study. SETTING Five adults and one child with dizziness and five children with progressive hearing loss were referred to our tertiary centers. METHODS The dizziness handicap inventory (DHI) and DHI-PC (dizziness handicap inventory-patient caregiver) questionnaires were used before and after surgery. All patients underwent a preoperative temporal bone HRCT scan and pure tone audiometry one day before surgery, then four and twelve months after surgery and at the last follow-up. The mean follow-up time was 5.6 years. Student's t-test was used to compare DHI/-PC results. RESULTS The DHI scores were 44, 24, 84, 59 and 56 before surgery, respectively, for Patients 1 to 5. The DHI scores at four months was significantly different, i.e., 4, 6, 0, 7 and 18 (p = 0.001). No differences were found between 4 and 12 months. Patient 6 (child) had Trisomy 21; their DHI-PC score dropped from 38 (preoperative score) to 8 (postoperative score), showing no activity limitations; clinical evaluation showed the complete resolution of symptoms. We found no significant differences between hearing loss before the surgery and at 1 and 12 months post operation for four adult patients. Our fifth adult patient's hearing changed from severe to profound SNHL. For 5 out of 6 pediatric patients, preoperative PTA and mean ABG were 63 dB and 20 dB, respectively; postoperatively, they improved to 42 dB and 16 dB, respectively. The hearing loss level for the sixth pediatric patient dropped from moderate (PTA = 42 dB) to severe (PTA = 85 dB) due to an opening of the endolymphatic sac and a sudden leak of the endolymph. CONCLUSIONS EDB, using two titanium clips, seems to be helpful for controlling vestibular symptoms and for stabilizing hearing or even to improve hearing in 82% of cases. Nevertheless, there is a risk of hearing worsening.
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Affiliation(s)
- Issam Saliba
- Division of Otorhinolaryngology and Head & Neck Surgery, University of Montreal, Montreal, QC H3C 3J7, Canada
- University of Montreal Health Center (CHUM), Department of Otorhinolaryngology and Head & Neck Surgery, Montreal, QC H2X 3E4, Canada
- University of Montreal Health Center Research Center (CRCHUM), Montreal, QC H2X 0A9, Canada
- Sainte-Justine University Hospital Center (CHU-SJ), Otorhinolaryngology and Head & Neck Surgery, Montreal, QC H3T 1C5, Canada
| | - Sarah Alshehri
- Division of Otorhinolaryngology and Head & Neck Surgery, University of Montreal, Montreal, QC H3C 3J7, Canada
| | - Isabelle Fournier
- Division of Otorhinolaryngology and Head & Neck Surgery, University of Montreal, Montreal, QC H3C 3J7, Canada
| | - Nasser Altamami
- Division of Otorhinolaryngology and Head & Neck Surgery, University of Montreal, Montreal, QC H3C 3J7, Canada
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Zhang VW, Hou S, Wong A, Flynn C, Oliver J, Weiss M, Milner S, Ching TYC. Audiological characteristics of children with congenital unilateral hearing loss: insights into Age of reliable behavioural audiogram acquisition and change of hearing loss. Front Pediatr 2023; 11:1279673. [PMID: 38027307 PMCID: PMC10663346 DOI: 10.3389/fped.2023.1279673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 10/27/2023] [Indexed: 12/01/2023] Open
Abstract
Objectives The aims of this study were to report the audiological characteristics of children with congenital unilateral hearing loss (UHL), examine the age at which the first reliable behavioural audiograms can be obtained, and investigate hearing changes from diagnosis at birth to the first reliable behavioural audiogram. Method This study included a sample of 91 children who were diagnosed with UHL via newborn hearing screening and had reliable behavioural audiograms before 7 years of age. Information about diagnosis, audiological characteristics and etiology were extracted from clinical reports. Regression analysis was used to explore the potential reasons influencing the age at which first reliable behavioural audiograms were obtained. Correlation and ANOVA analyses were conducted to examine changes in hearing at octave frequencies between 0.5 and 4 kHz. The proportions of hearing loss change, as well as the clinical characteristics of children with and without progressive hearing loss, were described according to two adopted definitions: Definition 1: criterion (1): a decrease in 10 dB or greater at two or more adjacent frequencies between 0.5 and 4 kHz, or criterion (2): a decrease in 15 dB or greater at one octave frequency in the same frequency range. Definition 2: a change of ≥20 dB in the average of pure-tone thresholds at 0.5, 1, and 2 kHz. Results The study revealed that 48 children (52.7% of the sample of 91 children) had their first reliable behavioural audiogram by 3 years of age. The mean age at the first reliable behavioural audiogram was 3.0 years (SD 1.4; IQR: 1.8, 4.1). We found a significant association between children's behaviour and the presence or absence of ongoing middle ear issues in relation to the delay in obtaining a reliable behavioural audiogram. When comparing the hearing thresholds at diagnosis with the first reliable behavioural audiogram across different frequencies, it was observed that the majority of children experienced deterioration rather than improvement in the initial impaired ear at each frequency. Notably, there were more instances of hearing changes (either deterioration or improvement), in the 500 Hz and 1,000 Hz frequency ranges compared to the 2,000 Hz and 4,000 Hz ranges. Seventy-eight percent (n = 71) of children had hearing deterioration between the diagnosis and the first behavioural audiogram at one or more frequencies between 0.5 and 4 kHz, with a high proportion of them (52 out of the 71, 73.2%) developing severe to profound hearing loss. When using the averaged three frequency thresholds (i.e., definition 2), only 26.4% of children (n = 24) in the sample were identified as having hearing deterioration. Applying definition 2 therefore underestimates the proportion of children that experienced hearing changes. The study also reported diverse characteristics of children with or without hearing deterioration. Conclusion The finding that 78% of children diagnosed with UHL at birth had a decrease in hearing loss between the hearing levels at first diagnosis and their first behavioural audiogram highlights the importance of monitoring hearing threshold levels after diagnosis, so that appropriate intervention can be implemented in a timely manner. For clinical management, deterioration of 15 dB at one or more frequencies that does not recover warrants action.
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Affiliation(s)
- Vicky W. Zhang
- Audiological Science Department, National Acoustic Laboratories, Sydney, NSW, Australia
- Department of Linguistics, Macquarie University, Sydney, NSW, Australia
| | - Sanna Hou
- Audiological Science Department, National Acoustic Laboratories, Sydney, NSW, Australia
| | - Angela Wong
- Audiological Science Department, National Acoustic Laboratories, Sydney, NSW, Australia
| | - Christopher Flynn
- Audiological Science Department, National Acoustic Laboratories, Sydney, NSW, Australia
- Lutwyche centre, Hearing Australia, Brisbane, QLD, Australia
| | - Jane Oliver
- Audiological Science Department, National Acoustic Laboratories, Sydney, NSW, Australia
- Upper Mt Gravatt centre, Hearing Australia, Brisbane, QLD, Australia
| | - Michelle Weiss
- Audiological Science Department, National Acoustic Laboratories, Sydney, NSW, Australia
- Dandenong centre, Hearing Australia, Melbourne, VIC, Australia
| | - Stacey Milner
- Audiological Science Department, National Acoustic Laboratories, Sydney, NSW, Australia
- Cheltenham centre, Hearing Australia, Melbourne, VIC, Australia
| | - Teresa Y. C. Ching
- Audiological Science Department, National Acoustic Laboratories, Sydney, NSW, Australia
- NextSense Institute, Macquarie Park, Sydney, NSW, Australia
- Macquarie School of Education, Macquarie University, Sydney, NSW, Australia
- School of Health and Rehabilitation Sciences, University of Queensland, St Lucia, QLD, Australia
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Alahmadi A, Abdelsamad Y, Salamah M, Alenzi S, Badr KM, Alghamdi S, Alsanosi A. Cochlear implantation in adults and pediatrics with enlarged vestibular aqueduct: a systematic review on the surgical findings and patients' performance. Eur Arch Otorhinolaryngol 2022; 279:5497-5509. [PMID: 35771280 DOI: 10.1007/s00405-022-07511-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 06/13/2022] [Indexed: 01/04/2023]
Abstract
PURPOSE Cochlear implantation (CI) has been considered a safe and effective management option for patients with severe to profound hearing loss. Patients with enlarged vestibular aqueduct (EVA) could be challenging with some variations in surgical approaches, intraoperative surgical notes, and clinical outcomes. This study aimed to review the surgical and clinical outcomes of cochlear implantation among patients with EVA. MATERIALS AND METHODS A systematic literature search was carried out in five major databases. All original studies reporting cochlear implantation in patients with EVA were included for qualitative data synthesis. The risk of bias was independently assessed through the National Intuitional of Health tool. The review protocol was registered in PROSPERO (reference number: CRD42021225900). RESULTS A total of 34 studies with 4035 subjects were included. Of them, 853 (21.14%) had EVA and underwent CI. Mondini malformation was the most frequently associated anomaly (n = 78, 11.1%). Unilateral implantation was performed in 258 cases while bilateral in 119 subjects. Postoperative complications included CSF/perilymph gusher (n = 112), CSF oozing (n = 18), and partial electrode insertion (n = 6). Closing the cochleostomy with temporalis fascia, muscle, connective tissue, or fibrin glue was the most frequently reported approach to manage CSF/perilymph gusher (n = 67, 56.7%) while packing was performed in six patients. CONCLUSION Patients with EVA demonstrated audiometric and speech performance improvement after CI. However, many patients had intra- or postoperative complications. Further research is needed as the outcomes may be affected by associated temporal bone pathology, the timing of implant, and hearing condition.
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Affiliation(s)
- Asma Alahmadi
- King Abdullah Ear Specialist Center (KAESC), College of Medicine, King Saud University Medical City (KSUMC), King Saud University, P.O. Box; 245, Riyadh, 11411, Saudi Arabia.
| | | | - Marzouqi Salamah
- King Abdullah Ear Specialist Center (KAESC), College of Medicine, King Saud University Medical City (KSUMC), King Saud University, P.O. Box; 245, Riyadh, 11411, Saudi Arabia
| | - Saad Alenzi
- King Fahad Specialist Hospital, MOH, Tabuk, Saudi Arabia
| | | | | | - Abdulrahman Alsanosi
- King Abdullah Ear Specialist Center (KAESC), College of Medicine, King Saud University Medical City (KSUMC), King Saud University, P.O. Box; 245, Riyadh, 11411, Saudi Arabia
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Cochlear Implantation in Children with Enlarged Vestibular Aqueduct: A Systematic Review of Surgical Implications and Outcomes. Ear Hear 2022; 44:440-447. [PMID: 36397213 DOI: 10.1097/aud.0000000000001309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVES This study investigated age at implantation, improvement in hearing and speech perception outcomes, as well as surgical complications in pediatric cochlear implant recipients with Pendred Syndrome (PS) or non-syndromic enlarged vestibular aqueduct (NSEVA). DESIGN A systematic review of the literature between 1984 and 2021 was performed. Two independent reviewers performed abstract and full-text screening using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. The inclusion criteria were: English language, cochlear implant, age at implantation available, age <18 years, PS, Mondini malformation, and enlarged vestibular aqueduct. Full-text analysis was completed using the National Institute of Health assessment tool for case series and case-control studies. Studies were also graded according to the Oxford Centre for Evidence-Based Medicine grading system. RESULTS In total, 198 studies were identified and screened, and 55 studies were included for analysis. Audiological outcomes were available in 46 studies, and the four-frequency pure-tone audiogram average improved by 60 to 78 dB HL due to cochlear implantation. Auditory performance and speech intelligibility scores increased by 44%. The overall average implantation age was 60 months. The implantation age was 21 months lower in the studies where individuals were implanted after the year 2000 compared with those implanted before the year 2000. Perilymph gusher/oozing was the most common surgical incident reported, occurring in 187 of 1572 implantations. CONCLUSIONS In children with PS/NSEVA, cochlear implantation improves pure-tone average by 60 to 78 dB HL and capacity of auditory performance/speech intelligibility by 44%. The implantation age for these children has decreased during the last two decades but is still somewhat higher than reported for unselected pediatric cochlear implantation. Perilymph gusher/oozing is the most common surgical complication.
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Duan B, Xu Z, Pan L, Chen W, Qiao Z. Prediction of Hearing Prognosis of Large Vestibular Aqueduct Syndrome Based on the PyTorch Deep Learning Model. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:4814577. [PMID: 35463685 PMCID: PMC9020928 DOI: 10.1155/2022/4814577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 03/05/2022] [Accepted: 03/19/2022] [Indexed: 11/17/2022]
Abstract
In order to compare magnetic resonance imaging (MRI) findings of patients with large vestibular aqueduct syndrome (LVAS) in the stable hearing loss (HL) group and the fluctuating HL group, this paper provides reference for clinicians' early intervention. From January 2001 to January 2016, patients with hearing impairment diagnosed as LVAS in infancy in the Department of Otorhinolaryngology, Head and Neck Surgery, Children's Hospital of Fudan University were collected and divided into the stable HL group (n = 29) and the fluctuating HL group (n = 30). MRI images at initial diagnosis were collected, and various deep learning neural network training models were established based on PyTorch to classify and predict the two series. Vgg16_bn, vgg19_bn, and ResNet18, convolutional neural networks (CNNs) with fewer layers, had favorable effects for model building, with accs of 0.9, 0.8, and 0.85, respectively. ResNet50, a CNN with multiple layers and an acc of 0.54, had relatively poor effects. The GoogLeNet-trained model performed best, with an acc of 0.98. We conclude that deep learning-based radiomics can assist doctors in accurately predicting LVAS patients to classify them into either fluctuating or stable HL types and adopt differentiated treatment methods.
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Affiliation(s)
- Bo Duan
- Department of Otolaryngology-Head and Neck Surgery, Children's Hospital of Fudan University, Shanghai 201102, China
| | - Zhengmin Xu
- Department of Otolaryngology-Head and Neck Surgery, Children's Hospital of Fudan University, Shanghai 201102, China
| | - Lili Pan
- Department of Radiology, Children's Hospital of Fudan University, Shanghai 201102, China
| | - Wenxia Chen
- Department of Otolaryngology-Head and Neck Surgery, Children's Hospital of Fudan University, Shanghai 201102, China
| | - Zhongwei Qiao
- Department of Radiology, Children's Hospital of Fudan University, Shanghai 201102, China
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Baganha S, Marques T, Miguéis A. Asymmetric sensorineural hearing loss in children: progression and involvement of the contralateral ear. Acta Otolaryngol 2022; 142:285-290. [PMID: 35380501 DOI: 10.1080/00016489.2022.2051602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND Sensorineural hearing loss in child has a profound impact on their neurodevelopment and on language acquisition. Thus, the diagnosis and early intervention are critical, namely in unilateral or bilateral asymmetric hearing losses, which are diagnosed later than symmetric bilateral hearing losses. OBJECTIVES This study aims to examine the progression of asymmetric SNHL in children, and the link between hearing thresholds and the technological level of the hearing aid fitted. MATERIAL AND METHODS Eighteen children with asymmetric SNHL were submitted to a pure tone audiogram at the age of 5 years (T0) and reassessed at the age of 10 years (T1). Children were divided according to the technological level of the hearing aid fitted: basic, medium, and advanced. RESULTS A positive correlation was established between the hearing thresholds at T0 and T1, revealing an accelerated progression of hearing thresholds in the better ear after a 5-year period. CONCLUSIONS Hearing thresholds in the worse ear influence the progression of the SNHL. Moreover, technologically advanced hearing aids led to a slower progression of the hearing thresholds over time.
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Affiliation(s)
- Sara Baganha
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Tatiana Marques
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra, Coimbra, Portugal
- Faculty of Medicine, University of Porto, Porto, Portugal
- Audiology, Physiotherapy and Environmental Health Department, Coimbra Health School, Polytechnic Institute of Coimbra, Coimbra, Portugal
| | - Antonio Miguéis
- University Clinic of Otolaryngology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
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