The Early Intervention of Hearing Loss in Adults

A Multicenter Validity Study of Four Smartphone Hearing Test Apps in Optimized and Home Environments

OBJECTIVE

Pure tone audiometry (PTA) is the gold standard for hearing assessment. However, it requires access to specialized equipment. Smartphone audiometry applications (apps) have been developed to perform automated threshold audiometry and could allow patients to perform self-administered screening or monitoring. This study aimed to assess the validity and feasibility of patients using apps to self-assess hearing thresholds at home, with comparison to PTA.

METHODS

A multi-center, prospective randomized study was conducted amongst patients undergoing PTA in clinics. Participants were randomly allocated to one of four publicly-available apps designed to measure pure tone thresholds. Participants used an app once in optimal sound-treated conditions and a further three times at home. Ear-specific frequency-specific thresholds and pure tone average were compared using Pearson correlation coefficient. The percentage of app hearing tests with results within ±10 dB of PTA was calculated. Patient acceptability was assessed via an online survey.

RESULTS

One hundred thirty-nine participants submitted data. The results of two at-home automated smartphone apps correlated strongly/very strongly with PTA average and their frequency-specific median was within ±10 dB accuracy. Smartphone audiometry performed in sound-treated and home conditions were very strongly correlated. The apps were rated as easy/very easy to use by 90% of participants and 90% would be happy/very happy to use an app to monitor their hearing.

CONCLUSION

Judicious use of self-performed smartphone audiometry was both valid and feasible for two of four apps. It could provide frequency-specific threshold estimates at home, potentially allowing assessments of patients remotely or monitoring of fluctuating hearing loss.

LEVEL OF EVIDENCE

2 Laryngoscope, 134:2864-2870, 2024.

Hearing performance of individuals with minimal hearing loss in complex and realistic communication experiences

PURPOSE

To analyze hearing performance and expectations regarding the use of hearing aids (HA) by participants with minimal hearing loss.

METHODS

This research is a primary, observational, longitudinal and prospective study. Two questionnaires, the Speech Spatial Qualities Questionnaire (SSQ) and the Expected Consequences of Hearing Aid Ownership (ECHO), were used, respectively, to verify hearing performance in complex listening situations and expectations regarding the use of HA. The convenience sample consisted of adults aged 53 to 72.

RESULTS

SSQ showed that, for hearing performance, greater difficulties were observed in unfavorable situations such as speech and speech-in-noise, followed by greater ease in locating the sound source and in the quality and naturalness of the sound. ECHO showed that, for the expectations regarding the use of the HA, the variables with significant correlation values were age x general expectation with HA and age x HA's positive aspects. No statistically significant association existed between performance scores in complex listening situations and the analyzed variables.

CONCLUSION

Minimal hearing loss can negatively influence everyday communicative situations, and the expectation of individuals with minimal hearing loss regarding the use of HA was shown to be high. In addition, the hearing performance of individuals in this study did not show correlations with the age, gender and education level of the sample.

Comparison of passive versus active transcutaneous bone anchored hearing devices in the pediatric population

Objective

Transcutaneous bone anchored hearing devices (BAHDs) were introduced in an effort to avoid potential complications associated with the abutment of percutaneous BAHDs. Transcutaneous BAHDs can be active or passive. While studies have demonstrated good outcomes with both, a direct comparison of audiological and clinical outcomes of these devices in the pediatric population has not yet been studied.

Study design

Retrospective, multicenter study.

Setting

Two tertiary academic centers.

Methods

Between 2015 and 2019, all patients who received an active transcutaneous BAHD (Bonebridge, BB) at one center, and patients that received a passive transcutaneous BAHD (Attract, AT) at another center, were included in this study. Exclusion criteria included age > 18 years, and mixed hearing loss or single-sided deafness. Study outcomes included patient demographics, indications, complications and preoperative and one-year postoperative audiometric data.

Results

Eighteen BB and eight AT patients met the inclusion criteria. The age range was 5–16 years. There were no significant differences in complication outcomes. Both devices demonstrated similar mean improvements in hearing thresholds at frequencies of 250 Hz (38 dB Active vs. 38 dB Passive), 500 Hz (34 dB vs. 42 dB), 1000 Hz (34 dB vs. 40 dB) and 2000 Hz (31 dB vs. 22 dB). The BB was significantly more effective at frequencies of 4000 Hz (28 dB vs. 7 dB) and 8000 Hz (29 dB vs. 6 dB) (p < 0.05).

Conclusion

This is the first study comparing audiological outcomes between an active and a passive transcutaneous BAHD in the pediatric population. While both devices improved audiometric outcomes in the low and mid frequencies, the active BAHD demonstrated significantly better outcomes in the higher frequencies.

Graphical Abstract

Prognostic factors in non-organic hearing loss in children

OBJECTIVE

Exploring factors that predict a favourable clinical outcome in non-organic hearing loss (NOHL) in children. NOHL is defined as a subjective hearing loss without correlation in objective measures.

DESIGN

Retrospective analysis of all childrens' data with the diagnosis NOHL seen between 2005 and 2017 at a tertiary referral centre.

STUDY SAMPLE

Sixty-seven children (44 female, 23 male; mean age 11.26 years) were included. Statistical analyses included descriptive statistics, logistic regression, correlations, and Mann-Whitney U tests.

RESULTS

A quarter of the children (17/67) had been provided previously with hearing aids without objective sensorineural hearing loss. Having been provided with hearing aids before the first visit to our clinic lowered the chance of normal hearing at the final visit by 76%. The prescription of hearing aids was significantly more likely in girls. Children provided with hearing aids were significantly older than those without and the time span between the first occurrence of the NOHL and first presentation at our department was longer than in children not provided with hearing aids.

CONCLUSIONS

In cases of NOHL, hearing aid prescription is not indicated and significantly lowers a child's chance of full recovery and, thus, should not be prescribed unless NOHL is ruled out.