1
|
Leung JH, Thorne PR, Purdy SC, Cheyne K, Steptoe B, Ambler A, Hogan S, Ramrakha S, Caspi A, Moffitt TE, Poulton R. Trajectories of Hearing From Childhood to Adulthood. Ear Hear 2024:00003446-990000000-00301. [PMID: 38898547 DOI: 10.1097/aud.0000000000001542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2024]
Abstract
OBJECTIVES The Dunedin Multidisciplinary Health and Development Study provides a unique opportunity to document the progression of ear health and hearing ability within the same cohort of individuals from birth. This investigation draws on hearing data from 5 to 13 years and again at 45 years of age, to explore the associations between childhood hearing variables and hearing and listening ability at age 45. DESIGN Multiple linear regression analyses were used to assess associations between childhood hearing (otological status and mid-frequency pure-tone average) and (a) age 45 peripheral hearing ability (mid-frequency pure-tone average and high-frequency pure-tone average), and (b) age 45 listening ability (listening in spatialized noise and subjective questionnaire on listening experiences). Sex, childhood socioeconomic status, and adult IQ were included in the model as covariates. RESULTS Peripheral hearing and listening abilities at age 45 were consistently associated with childhood hearing acuity at mid-frequencies. Otological status was a moderate predicting factor for high-frequency hearing and utilization of spatial listening cues in adulthood. CONCLUSIONS We aim to use these findings to develop a foundational model of hearing trajectories. This will form the basis for identifying precursors, to be investigated in a subsequent series of analyses, that may protect against or exacerbate hearing-associated cognitive decline in the Dunedin Study cohort as they progress from mid-life to older age.
Collapse
Affiliation(s)
- Joan H Leung
- Faculty of Science, School of Psychology, University of Auckland, Auckland, New Zealand
- Faculty of Medical and Health Sciences, Centre for Brain Research, University of Auckland, Auckland, New Zealand
- Faculty of Medical and Health Sciences, Eisdell Moore Centre for Hearing and Balance Research, School of Medicine, University of Auckland, Auckland, New Zealand
- Faculty of Science, Department of Psychology, Dunedin Multidisciplinary Health and Development Research Unit, University of Otago, Dunedin, New Zealand
| | - Peter R Thorne
- Faculty of Science, School of Psychology, University of Auckland, Auckland, New Zealand
- Faculty of Medical and Health Sciences, Centre for Brain Research, University of Auckland, Auckland, New Zealand
- Faculty of Medical and Health Sciences, Eisdell Moore Centre for Hearing and Balance Research, School of Medicine, University of Auckland, Auckland, New Zealand
| | - Suzanne C Purdy
- Faculty of Science, School of Psychology, University of Auckland, Auckland, New Zealand
- Faculty of Medical and Health Sciences, Centre for Brain Research, University of Auckland, Auckland, New Zealand
- Faculty of Medical and Health Sciences, Eisdell Moore Centre for Hearing and Balance Research, School of Medicine, University of Auckland, Auckland, New Zealand
| | - Kirsten Cheyne
- Faculty of Science, Department of Psychology, Dunedin Multidisciplinary Health and Development Research Unit, University of Otago, Dunedin, New Zealand
| | - Barbara Steptoe
- Faculty of Science, Department of Psychology, Dunedin Multidisciplinary Health and Development Research Unit, University of Otago, Dunedin, New Zealand
| | - Antony Ambler
- Faculty of Science, Department of Psychology, Dunedin Multidisciplinary Health and Development Research Unit, University of Otago, Dunedin, New Zealand
| | - Sean Hogan
- Faculty of Science, Department of Psychology, Dunedin Multidisciplinary Health and Development Research Unit, University of Otago, Dunedin, New Zealand
| | - Sandhya Ramrakha
- Faculty of Science, Department of Psychology, Dunedin Multidisciplinary Health and Development Research Unit, University of Otago, Dunedin, New Zealand
| | - Avshalom Caspi
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina, USA
- Department of Biostatistics and Bioinformatics, Center for Genomic and Computational Biology, Duke University, Durham, North Carolina, USA
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- PROMENTA, Faculty of Social Sciences, University of Oslo, Oslo, Norway
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina, USA
| | - Terrie E Moffitt
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina, USA
- Department of Biostatistics and Bioinformatics, Center for Genomic and Computational Biology, Duke University, Durham, North Carolina, USA
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- PROMENTA, Faculty of Social Sciences, University of Oslo, Oslo, Norway
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina, USA
| | - Richie Poulton
- Faculty of Science, Department of Psychology, Dunedin Multidisciplinary Health and Development Research Unit, University of Otago, Dunedin, New Zealand
| |
Collapse
|
2
|
Araújo ALPKD, Cordeiro FP, da Costa Monsanto R, Penido NDO. Audiometric evaluation in different clinical presentations of otitis media. Braz J Otorhinolaryngol 2024; 90:101359. [PMID: 38070239 PMCID: PMC10755540 DOI: 10.1016/j.bjorl.2023.101359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 09/21/2023] [Accepted: 10/20/2023] [Indexed: 01/01/2024] Open
Abstract
OBJECTIVES To assess the hearing thresholds in acute otitis media, otitis media with effusion and chronic otitis media (non-suppurative, non-cholesteatomatous suppurative and cholesteatomatous) and to compare the hearing outcomes with non-diseased ears (in bilateral cases) or contralateral healthy ears (in unilateral cases), since hearing loss is the most frequent sequel of otitis media and there is no previous study comparing the audiometric thresholds among the different forms of otitis media. METHODS Cross sectional, controlled study. We performed conventional audiometry (500-8000Hz) and tympanometry in patients with otitis media and healthy individuals (control group). Hearing loss was considered when the hearing thresholds were > 25 dBHL. RESULTS Of the 112 patients diagnosed with otitis media (151 ears), 48 were men (42.86%) and 64 were women (57.14%). The average age was 42.72 years. Of those, 25 (22.32%) were diagnosed as AOM, 15 (13.39%) were diagnosed with OME and the remaining 72 (63.28%) were diagnosed with COM (non-suppurative COM, n=31; suppurative COM, n=18; cholesteatomatous COM, n=23). As compared with controls, all forms of otitis media had significantly higher bone-conduction thresholds (500-4000Hz). Conductive hearing loss was the most frequent type of hearing loss (58.94%). However, the number of patients with mixed hearing loss was also relevant (39.07%). We noted that the presence of sensorioneural component occurred more frequently in 1) Higher frequencies; and 2) In groups of otitis media that were more active or severe in the inflammatory/infective standpoint (AOM, suppurative COM and cholesteatomatous COM). CONCLUSION All types of otitis media, even those with infrequent episodes of inflammation and otorrhea, had worse bone conduction thresholds as compared with nondiseased ears (p<0.01). We observed worse hearing outcomes in ears with recurrent episodes of otorrhea and in ears with AOM, especially in high frequencies.
Collapse
Affiliation(s)
| | | | - Rafael da Costa Monsanto
- Universidade Federal de São Paulo - Escola Paulista de Medicina (UNIFESP), São Paulo, SP, Brazil; Otopathology Laboratory - University of Minnesota, Minneapolis, MN, USA
| | - Norma de Oliveira Penido
- Universidade Federal de São Paulo - Escola Paulista de Medicina (UNIFESP), São Paulo, SP, Brazil
| |
Collapse
|
3
|
Mishra SK, Moore DR. Auditory Deprivation during Development Alters Efferent Neural Feedback and Perception. J Neurosci 2023; 43:4642-4649. [PMID: 37221095 PMCID: PMC10286938 DOI: 10.1523/jneurosci.2182-22.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 05/09/2023] [Accepted: 05/14/2023] [Indexed: 05/25/2023] Open
Abstract
Auditory experience plays a critical role in hearing development. Developmental auditory deprivation because of otitis media, a common childhood disease, produces long-standing changes in the central auditory system, even after the middle ear pathology is resolved. The effects of sound deprivation because of otitis media have been mostly studied in the ascending auditory system but remain to be examined in the descending pathway that runs from the auditory cortex to the cochlea via the brainstem. Alterations in the efferent neural system could be important because the descending olivocochlear pathway influences the neural representation of transient sounds in noise in the afferent auditory system and is thought to be involved in auditory learning. Here, we show that the inhibitory strength of the medial olivocochlear efferents is weaker in children with a documented history of otitis media relative to controls; both boys and girls were included in the study. In addition, children with otitis media history required a higher signal-to-noise ratio on a sentence-in-noise recognition task than controls to achieve the same criterion performance level. Poorer speech-in-noise recognition, a hallmark of impaired central auditory processing, was related to efferent inhibition, and could not be attributed to the middle ear or cochlear mechanics.SIGNIFICANCE STATEMENT Otitis media is the second most common reason children go to the doctor. Previously, degraded auditory experience because of otitis media has been associated with reorganized ascending neural pathways, even after middle ear pathology resolved. Here, we show that altered afferent auditory input because of otitis media during childhood is also associated with long-lasting reduced descending neural pathway function and poorer speech-in-noise recognition. These novel, efferent findings may be important for the detection and treatment of childhood otitis media.
Collapse
Affiliation(s)
- Srikanta K Mishra
- Department of Speech, Language and Hearing Sciences, University of Texas at Austin, Austin, Texas 78712
| | - David R Moore
- Communication Sciences Research Center, Cincinnati Children's Hospital, Cincinnati, Ohio 45229
- Department of Otolaryngology, College of Medicine, University of Cincinnati, Cincinnati, Ohio 45267
- Manchester Centre for Audiology and Deafness, University of Manchester, Manchester, M13 9PL, United Kingdom
| |
Collapse
|
4
|
Pauli N, Sunnergren O, Florentzson R. High frequency hearing 25 years after transmyringeal ventilation tube treatment. Int J Pediatr Otorhinolaryngol 2023; 167:111509. [PMID: 36907111 DOI: 10.1016/j.ijporl.2023.111509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 02/22/2023] [Accepted: 03/04/2023] [Indexed: 03/14/2023]
Abstract
OBJECTIVES The main aim of the study was to compare hearing outcome between a healthy control group and patients treated with transmyringeal ventilation tubes, 25 years after primary surgery. Another aim was to analyse the relation between ventilation tube treatment in childhood and the occurrence of persistent middle ear pathology 25 years later. METHODS In 1996, children treated with transmyringeal ventilation tubes were recruited for a prospective study on the outcome of ventilation tube treatment. In 2006, a healthy control group were recruited and examined together with the original participants (case group). All participants in the 2006 follow-up were eligible for this study. A clinical ear microscopy examination including eardrum pathology grading and high frequency audiometry (10-16 kHz) was carried out. RESULTS A total of 52 participants were available for analysis. Hearing outcome was worse in the treatment group (n = 29) compared to the control group (n = 29), both in regard to standard frequency range hearing, (0.5-4 kHz), and high frequency hearing (HPTA3 10-16 kHz). Almost half the case group (48%) had eardrum retraction to some extent, compared to 10% in the control group. No case of cholesteatoma was found in this study and eardrum perforation was rare (<2%). CONCLUSION In the long term, high frequency hearing (HPTA3 10-16 kHz) was more often affected in the patients with transmyringeal ventilation tube treatment during childhood compared with the healthy controls. Middle ear pathology of greater clinical significance was rare.
Collapse
Affiliation(s)
- Nina Pauli
- Department of Otorhinolaryngology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden; Region Västra Götaland, Sahlgrenska University Hospital, Department of Otorhinolaryngology, Gothenburg, Sweden.
| | - Ola Sunnergren
- Region Jönköping County, Ryhov Hospital, Ear, Nose and Throat Clinic, Jönköping, Sweden
| | - Rut Florentzson
- Department of Otorhinolaryngology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden; Region Västra Götaland, Sahlgrenska University Hospital, Department of Otorhinolaryngology, Gothenburg, Sweden
| |
Collapse
|
5
|
Porter H, Buss E, Merchant GR, Leibold LJ. Observational Study to Preliminarily Characterize the Audiological Profile of Children With Down Syndrome. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:4498-4506. [PMID: 36179216 PMCID: PMC9940888 DOI: 10.1044/2022_jslhr-22-00023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 04/08/2022] [Accepted: 07/06/2022] [Indexed: 05/03/2023]
Abstract
PURPOSE Down syndrome occurs in one of 700 births, and high rates of hearing loss are reported in this population. This puts children with Down syndrome at risk for communication, learning, and social development difficulties, compounding known language and cognitive vulnerabilities in this population. The purpose of this study was to comprehensively characterize audiological profiles in children with Down syndrome, including the use of extended high-frequency sensitivity and speech intelligibility index assessment. METHOD Participants were 18 children with Down syndrome between 5 and 17 years of age. Audiological profiles were characterized using behavioral audiometry, tympanometry, and wideband acoustic immittance (WAI). Audibility was characterized using the speech intelligibility index. RESULTS Of the participants successfully completing behavioral audiometry, hearing loss of a moderate or greater degree was observed in one or both ears for 46% of the participants at conventional audiometric test frequencies and 85% of the participants at frequencies above 8 kHz. Seven children met criteria for amplification based on the speech intelligibility index, but only two wore hearing aids. Abnormal middle ear function was found in approximately 50% of the participants for whom WAI or tympanometry were successfully measured. CONCLUSIONS Consistent with prior research, high rates of hearing loss and middle ear dysfunction were observed. The high prevalence of hearing loss above 8 kHz suggests the importance of including extended high-frequency assessment in audiologic characterization of children with Down syndrome. Few children meeting audibility-based guidelines for amplification wore hearing aids, putting them at additional risk for speech/language and educational difficulties. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.21200422.
Collapse
Affiliation(s)
- Heather Porter
- Center for Hearing Research, Boys Town National Research Hospital, Omaha, NE
| | - Emily Buss
- Department of Otolaryngology/Head and Neck Surgery, The University of North Carolina at Chapel Hill
| | | | - Lori J. Leibold
- Center for Hearing Research, Boys Town National Research Hospital, Omaha, NE
| |
Collapse
|
6
|
Mishra SK, Saxena U, Rodrigo H. Hearing Impairment in the Extended High Frequencies in Children Despite Clinically Normal Hearing. Ear Hear 2022; 43:1653-1660. [PMID: 35470812 DOI: 10.1097/aud.0000000000001225] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Pediatric hearing impairment, regardless of degree and type, has a detrimental effect on speech perception, cognition, oral language development, academic outcomes, and literacy. Hearing assessment in the clinic is limited to 8 kHz although humans can hear up to 20 kHz. Hearing impairment in the extended high frequencies (EHFs > 8 kHz) can occur despite clinically normal hearing. However, to date, the nature and effects of EHF hearing impairment in children remain unknown. The goals of the present study were to determine the effects of EHF hearing impairment on speech-in-noise recognition in children and to examine whether hearing impairment in the EHFs is associated with altered cochlear functioning in the standard frequencies. DESIGN A volunteer sample of 542 participants (4 to 19 years) with clinically normal audiograms were tested. Participants identified with EHF impairment were assigned as cases in a subsequent case-control study. EHF loss was defined as hearing thresholds greater than 20 dB in at least one EHFs (10, 12.5, or 16 kHz). Speech recognition thresholds in multi-talker babble were measured using the digit triplet test. Distortion product otoacoustic emissions ( f2 = 2, 3, 4, and 5 kHz) were measured to assess cochlear functioning. RESULTS Thresholds in the EHFs were as reliable as those in the standard frequency range. Thirty-eight children had EHF hearing impairment regardless of a clinically normal audiogram. A linear mixed-effects model revealed that children with EHF hearing impairment had higher (poorer) mean speech recognition threshold than children with normal EHF sensitivity ( estimate = 2.14 dB, 95% CI: 1.36 to 3.92; effect size = small). The overall magnitude of distortion product otoacoustic emissions was lower for children with EHF impairment ( estimate = -2.47 dB, 95% CI: -4.60 to -0.73; effect size = medium). In addition, the pure-tone average for standard audiometric frequencies was relatively higher for EHF-impaired children ( estimate = 3.68 dB, 95% CI: 2.56 to 4.80; effect size = small). CONCLUSIONS Hearing impairment in the EHFs is common in children despite clinically normal hearing and can occur without a history of otitis media. EHF impairment is associated with poorer speech-in-noise recognition and preclinical cochlear deficits in the lower frequencies where hearing thresholds are normal. This study highlights the clinical need to identify EHF impairments in children.
Collapse
Affiliation(s)
- Srikanta K Mishra
- Department of Communication Sciences & Disorders, University of Texas Rio Grande Valley, Edinburg, Texas, USA
| | - Udit Saxena
- MAA Institute of Speech & Hearing, Hyderabad, India
| | - Hansapani Rodrigo
- School of Mathematical and Statistical Sciences, The University of Texas Rio Grande Valley, Edinburg, Texas, USA
| |
Collapse
|
7
|
Liang C, Fang Q, Chen H, Wang Z, Qiao X, Liao Y, Lv C, Chen M, Li L, Yang J. Vulnerable frequency as an independent prognostic factor for sudden sensorineural hearing loss. Front Neurol 2022; 13:962376. [PMID: 36237617 PMCID: PMC9552834 DOI: 10.3389/fneur.2022.962376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 09/12/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectivesSudden sensorineural hearing loss (SSNHL) is a common otology emergency in the practice. Its severe hearing impairment and prognosis impair the quality of life. Given that cochlear hair cell vulnerability is not consistent across frequencies, this study aims to investigate the impact of frequency-specific hearing loss on prognosis in SSNHL.MethodsThe study included 255 patients with full-frequency SSNHL. The baseline, clinical, and hearing characteristics, as well as possible cardiovascular predictors in blood, were collected for analysis.ResultsThe 4,000 and 8,000 Hz hearing levels in the responder group were significantly lower than those in the non-responder group (p = 0.008, p < 0.001), while the average hearing was not (p = 0.081). Logistic regression showed that only vertigo (OR, 95% CI, 0.265, 0.102–0.684, p = 0.006) and 8,000 Hz hearing level (OR, 95% CI, 0.943, 0.916–0.971, p < 0.001) were strongly associated with treatment outcome.ConclusionsCompared with other frequencies, 8,000 Hz hearing level was closely related to prognosis in SSNHL. In an adjusted model, our study did not find an effect of mean hearing on prognosis in SSNHL. However, further multicenter prospective studies are needed for validation.
Collapse
|
8
|
Lough M, Plack CJ. Extended high-frequency audiometry in research and clinical practice. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2022; 151:1944. [PMID: 35364938 DOI: 10.1121/10.0009766] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 02/15/2022] [Indexed: 06/14/2023]
Abstract
Audiometric testing in research and in clinical settings rarely considers frequencies above 8 kHz. However, the sensitivity of young healthy ears extends to 20 kHz, and there is increasing evidence that testing in the extended high-frequency (EHF) region, above 8 kHz, might provide valuable additional information. Basal (EHF) cochlear regions are especially sensitive to the effects of aging, disease, ototoxic drugs, and possibly noise exposure. Hence, EHF loss may be an early warning of damage, useful for diagnosis and for monitoring hearing health. In certain environments, speech perception may rely on EHF information, and there is evidence for an association between EHF loss and speech perception difficulties, although this may not be causal: EHF loss may instead be a marker for sub-clinical damage at lower frequencies. If there is a causal relation, then amplification in the EHF range may be beneficial if the technical difficulties can be overcome. EHF audiometry in the clinic presents with no particular difficulty, the biggest obstacle being lack of specialist equipment. Currently, EHF audiometry has limited but increasing clinical application. With the development of international guidelines and standards, it is likely that EHF testing will become widespread in future.
Collapse
Affiliation(s)
- Melanie Lough
- Manchester Centre for Audiology and Deafness, The University of Manchester, Oxford Road, Manchester, M13 9PL, United Kingdom
| | - Christopher J Plack
- Manchester Centre for Audiology and Deafness, The University of Manchester, Oxford Road, Manchester, M13 9PL, United Kingdom
| |
Collapse
|
9
|
Analysis of tinnitus severity and associated risk factors in patients with chronic otitis media: data from the multinational collaborative Chronic Otitis Media Questionnaire-12 study. The Journal of Laryngology & Otology 2022; 136:1203-1210. [PMID: 35000639 DOI: 10.1017/s0022215121004266] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND Subjective tinnitus is a common symptom, and there is often an underlying otological cause. This study investigated the degree of tinnitus-related annoyance in patients with chronic otitis media and analysed whether associations with tinnitus severity exist. METHOD The multinational collaborative Chronic Otitis Media Questionnaire-12 study collected prospective data on 478 adult patients suffering from chronic otitis media across 9 otology referral centres in 8 countries. Based on this dataset, we investigated tinnitus severity using participant responses to item 7 of a native version of the Chronic Otitis Media Questionnaire-12. RESULTS With respect to tinnitus severity, 23.8 per cent, 17.4 per cent, 15.5 per cent, and 43.4 per cent of participants reported no, minor, moderate, and major inconvenience or greater, respectively. The absence of ear discharge, absence of cholesteatoma, and poorer disease-specific health-related quality-of-life were associated with increased tinnitus severity in patients with chronic otitis media, whereas age, hearing disability and geographical region showed no association. CONCLUSION This analysis provided novel insight into potential risk factors for tinnitus in patients with chronic otitis media.
Collapse
|
10
|
Cholesteatoma Is Associated With Pediatric Progressive Sensorineural Hearing Loss. Ear Hear 2022; 43:1282-1290. [PMID: 34860720 PMCID: PMC9149138 DOI: 10.1097/aud.0000000000001176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVES This study identified an association between cholesteatoma and progressive sensorineural hearing loss using a large pediatric longitudinal audiologic dataset. Cholesteatoma is a potential sequela of chronic otitis media with effusion, a commonly observed auditory pathology that can contribute to hearing loss in children. The purpose of this report is to (i) describe the process of identifying the association between cholesteatoma and progressive sensorineural hearing loss in a large pediatric dataset and (ii) describe the audiologic data acquired over time in patients identified with cholesteatoma-associated progressive sensorineural hearing loss. DESIGN Records of patients included in the Audiologic and Genetics Database (n = 175,215 patients) were examined using specified criteria defining progressive hearing loss. A linear regression model examined the log frequency of all diagnostic codes in the electronic health record assigned to patients for a progressive hearing loss cohort compared with a stable hearing loss group. Based on findings from the linear regression analysis, longitudinal audiometric air (AC) and bone conduction (BC) thresholds were extracted for groups of subjects with cholesteatoma-associated progressive (n = 58 subjects) and stable (n = 55 subjects) hearing loss to further analyze changes in hearing over time. RESULTS The linear regression analyses identified that diagnostic codes for cholesteatoma were associated with progressive sensorineural hearing loss in children. The longitudinal audiometric data demonstrated within-subject changes in masked BC sensitivity consistent with progressive sensorineural hearing loss in children diagnosed with cholesteatoma. Additional analyses showed that mastoidectomy surgeries did not appear to contribute to the observed progressive hearing loss and that a high number of cholesteatoma patients with progressive hearing loss had normal-hearing thresholds at their first test. CONCLUSIONS The statistical analyses demonstrated an association between cholesteatoma and pediatric progressive sensorineural hearing loss. These findings inform clinical management by suggesting that children with cholesteatoma diagnoses may be at increased risk for progressive sensorineural hearing loss and should receive continued monitoring even after a normal masked BC baseline has been established.
Collapse
|
11
|
Petley L, Hunter LL, Zadeh LM, Stewart HJ, Sloat NT, Perdew A, Lin L, Moore DR. Listening Difficulties in Children With Normal Audiograms: Relation to Hearing and Cognition. Ear Hear 2021; 42:1640-1655. [PMID: 34261857 PMCID: PMC8545703 DOI: 10.1097/aud.0000000000001076] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Children presenting at audiology services with caregiver-reported listening difficulties often have normal audiograms. The appropriate approach for the further assessment and clinical management of these children is currently unclear. In this Sensitive Indicators of Childhood Listening Difficulties (SICLiD) study, we assessed listening ability using a reliable and validated caregiver questionnaire (the Evaluation of Children's Listening and Processing Skills [ECLiPS]) in a large (n = 146) and heterogeneous sample of 6- to 13-year-old children with normal audiograms. Scores on the ECLiPS were related to a multifaceted laboratory assessment of the children's audiological, psycho- and physiological-acoustic, and cognitive abilities. This report is an overview of the SICLiD study and focuses on the children's behavioral performance. The overall goals of SICLiD were to understand the auditory and other neural mechanisms underlying childhood listening difficulties and translate that understanding into clinical assessment and, ultimately, intervention. DESIGN Cross-sectional behavioral assessment of children with "listening difficulties" and an age-matched "typically developing" control group. Caregivers completed the ECLiPS, and the resulting total standardized composite score formed the basis of further descriptive statistics, univariate, and multivariate modeling of experimental data. RESULTS All scores of the ECLiPS, the SCAN-3:C, a standardized clinical test suite for auditory processing, and the National Institutes of Health (NIH) Cognition Toolbox were significantly lower for children with listening difficulties than for their typically developing peers using group comparisons via t-tests and Wilcoxon Rank-Sum tests. A similar effect was observed on the Listening in Spatialized Noise-Sentences (LiSN-S) test for speech sentence-in-noise intelligibility but only reached significance for the Low Cue and High Cue conditions and the Talker Advantage derived score. Stepwise regression to examine the factors contributing to the ECLiPS Total scaled score (pooled across groups) yielded a model that explained 42% of its variance based on the SCAN-3:C composite, LiSN-S Talker Advantage, and the NIH Toolbox Picture Vocabulary, and Dimensional Change Card Sorting scores (F[4, 95] = 17.35, p < 0.001). High correlations were observed between many test scores including the ECLiPS, SCAN-3:C, and NIH Toolbox composite measures. LiSN-S Advantage measures generally correlated weakly and nonsignificantly with non-LiSN-S measures. However, a significant interaction was found between extended high-frequency threshold and LiSN-S Talker Advantage. CONCLUSIONS Children with listening difficulties but normal audiograms have problems with the cognitive processing of auditory and nonauditory stimuli that include both fluid and crystallized reasoning. Analysis of poor performance on the LiSN-S Talker Advantage measure identified subclinical hearing loss as a minor contributing factor to talker segregation. Beyond auditory tests, evaluations of children with complaints of listening difficulties should include standardized caregiver observations and consideration of broad cognitive abilities.
Collapse
Affiliation(s)
- Lauren Petley
- Communication Sciences Research Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
- Department of Psychology, Clarkson University, Potsdam, NY, USA
| | - Lisa L. Hunter
- Communication Sciences Research Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Lina Motlagh Zadeh
- Communication Sciences Research Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Hannah J. Stewart
- Communication Sciences Research Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
- Division of Psychology and Language Sciences, University College London, London, UK
| | - Nicholette T. Sloat
- Communication Sciences Research Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Audrey Perdew
- Communication Sciences Research Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Li Lin
- Communication Sciences Research Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - David R. Moore
- Communication Sciences Research Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
- Department of Otolaryngology, College of Medicine, University of Cincinnati
- Manchester Centre for Audiology and Deafness, University of Manchester, Manchester, UK
| |
Collapse
|
12
|
Li T, Zeng W, Liu R. Effect of Erdosteine on Middle Ear Effusion in Rats by Mediating TLR4 Signaling Pathway. BIOMED RESEARCH INTERNATIONAL 2021; 2021:9968907. [PMID: 34734089 PMCID: PMC8560256 DOI: 10.1155/2021/9968907] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 07/02/2021] [Indexed: 11/17/2022]
Abstract
The study aimed to investigate the effect of erdosteine on middle ear effusion in rats through mediating the Toll-like receptor 4 (TLR4) signaling pathway. Rats were injected with endotoxin to prepare the model of acute secretory otitis media (SOM). Then, they were divided into an acute SOM model group (model group, n = 15) and erdosteine treatment group (18 mg/kg, gavage, treatment group, n = 15). Besides, a normal group (n = 15) was set up. Two weeks later, routine biochemical indicators such as aspartate aminotransferase (AST) and alkaline phosphatase (ALP) were detected. The inflammatory effusion due to otitis media was scored. The content of myeloperoxidase (MPO), matrix metalloproteinase (MMP), and tumor necrosis factor-beta (TNF-β) in middle ear lavage fluid was detected via enzyme-linked immunosorbent assay (ELISA). Additionally, histomorphological changes were observed with the help of hematoxylin-eosin (HE) staining, and quantitative reverse transcription-polymerase chain reaction (qRT-PCR) and Western blotting assays were carried out to measure the expression levels of TLR4 pathway genes and proteins as well as the messenger ribonucleic acid (mRNA) expression levels of key factors for otitis media (mucin 2 (MUC2) and MUC5A). In the model group, the levels of AST, ALP, and glutamic-pyruvic transaminase (GPT) were significantly increased (p < 0.05). Besides, the content of MPO, MMP, and TNF-β was overtly raised in the model group (p < 0.05), while it was notably lowered in the treatment group (p < 0.05). In the treatment group, the cilia were slightly swollen, and inflammatory cells were fewer. The mRNA levels of MUC2, MUC5A, and pathway genes TLR4 and c-Jun N-terminal kinase (JNK) were elevated in the model group. In addition, the protein assay results revealed that the protein levels of TLR4 and JNK were evidently increased in the model group. Erdosteine can treat the middle ear effusion in rats by repressing the activation of the TLR4 signaling pathway.
Collapse
Affiliation(s)
- Te Li
- Department of Otolaryngology Head and Neck Surgery, The Third Affiliated Hospital, Army Military Medical University, Chongqing 400042, China
| | - Wanting Zeng
- Department of Otolaryngology Head and Neck Surgery, The Third Affiliated Hospital, Army Military Medical University, Chongqing 400042, China
| | - Rongrong Liu
- Department of Otolaryngology Head and Neck Surgery, The Third Affiliated Hospital, Army Military Medical University, Chongqing 400042, China
| |
Collapse
|
13
|
Minimal and Mild Hearing Loss in Children: Association with Auditory Perception, Cognition, and Communication Problems. Ear Hear 2021; 41:720-732. [PMID: 31633598 DOI: 10.1097/aud.0000000000000802] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES "Minimal" and "mild" hearing loss are the most common but least understood forms of hearing loss in children. Children with better ear hearing level as low as 30 dB HL have a global language impairment and, according to the World Health Organization, a "disabling level of hearing loss." We examined in a population of 6- to 11-year-olds how hearing level ≤40.0 dB HL (1 and 4 kHz pure-tone average, PTA, threshold) is related to auditory perception, cognition, and communication. DESIGN School children (n = 1638) were recruited in 4 centers across the United Kingdom. They completed a battery of hearing (audiometry, filter width, temporal envelope, speech-in-noise) and cognitive (IQ, attention, verbal memory, receptive language, reading) tests. Caregivers assessed their children's communication and listening skills. Children included in this study (702 male; 752 female) had 4 reliable tone thresholds (1, 4 kHz each ear), and no caregiver reported medical or intellectual disorder. Normal-hearing children (n = 1124, 77.1%) had all 4 thresholds and PTA <15 dB HL. Children with ≥15 dB HL for at least 1 threshold, and PTA <20 dB (n = 245, 16.8%) had minimal hearing loss. Children with 20 ≤PTA <40 dB HL (n = 88, 6.0%) had mild hearing loss. Interaural asymmetric hearing loss ( left PTA - right PTA ≥10 dB) was found in 28.9% of those with minimal and 39.8% of those with mild hearing loss. RESULTS Speech perception in noise, indexed by vowel-consonant-vowel pseudoword repetition in speech-modulated noise, was impaired in children with minimal and mild hearing loss, relative to normal-hearing children. Effect size was largest (d = 0.63) in asymmetric mild hearing loss and smallest (d = 0.21) in symmetric minimal hearing loss. Spectral (filter width) and temporal (backward masking) perceptions were impaired in children with both forms of hearing loss, but suprathreshold perception generally related only weakly to PTA. Speech-in-noise (nonsense syllables) and language (pseudoword repetition) were also impaired in both forms of hearing loss and correlated more strongly with PTA. Children with mild hearing loss were additionally impaired in working memory (digit span) and reading, and generally performed more poorly than those with minimal loss. Asymmetric hearing loss produced as much impairment overall on both auditory and cognitive tasks as symmetric hearing loss. Nonverbal IQ, attention, and caregiver-rated listening and communication were not significantly impaired in children with hearing loss. Modeling suggested that 15 dB HL is objectively an appropriate lower audibility limit for diagnosis of hearing loss. CONCLUSIONS Hearing loss between 15 and 30 dB PTA is, at ~20%, much more prevalent in 6- to 11-year-old children than most current estimates. Key aspects of auditory and cognitive skills are impaired in both symmetric and asymmetric minimal and mild hearing loss. Hearing loss <30 dB HL is most closely related to speech perception in noise, and to cognitive abilities underpinning language and reading. The results suggest wider use of speech-in-noise measures to diagnose and assess management of hearing loss and reduction of the clinical hearing loss threshold for children to 15 dB HL.
Collapse
|
14
|
Chronic Conductive Hearing Loss Is Associated With Speech Intelligibility Deficits in Patients With Normal Bone Conduction Thresholds. Ear Hear 2021; 41:500-507. [PMID: 31490800 DOI: 10.1097/aud.0000000000000787] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVES The main objective of this study is to determine whether chronic sound deprivation leads to poorer speech discrimination in humans. DESIGN We reviewed the audiologic profile of 240 patients presenting normal and symmetrical bone conduction thresholds bilaterally, associated with either an acute or chronic unilateral conductive hearing loss of different etiologies. RESULTS Patients with chronic conductive impairment and a moderate, to moderately severe, hearing loss had lower speech recognition scores on the side of the pathology when compared with the healthy side. The degree of impairment was significantly correlated with the speech recognition performance, particularly in patients with a congenital malformation. Speech recognition scores were not significantly altered when the conductive impairment was acute or mild. CONCLUSIONS This retrospective study shows that chronic conductive hearing loss was associated with speech intelligibility deficits in patients with normal bone conduction thresholds. These results are as predicted by a recent animal study showing that prolonged, adult-onset conductive hearing loss causes cochlear synaptopathy.
Collapse
|
15
|
Extended high-frequency hearing and head orientation cues benefit children during speech-in-speech recognition. Hear Res 2021; 406:108230. [PMID: 33951577 DOI: 10.1016/j.heares.2021.108230] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 03/03/2021] [Accepted: 03/18/2021] [Indexed: 12/29/2022]
Abstract
While the audible frequency range for humans spans approximately 20 Hz to 20 kHz, children display enhanced sensitivity relative to adults when detecting extended high frequencies (frequencies above 8 kHz; EHFs), as indicated by better pure tone thresholds. The impact that this increased hearing sensitivity to EHFs may have on children's speech recognition has not been established. One context in which EHF hearing may be particularly important for children is when recognizing speech in the presence of competing talkers. In the present study, we examined the extent to which school-age children (ages 5-17 years) with normal hearing were able to benefit from EHF cues when recognizing sentences in a two-talker speech masker. Two filtering conditions were tested: all stimuli were either full band or were low-pass filtered at 8 kHz to remove EHFs. Given that EHF energy emission in speech is highly dependent on head orientation of the talker (i.e., radiation becomes more directional with increasing frequency), two masker head angle conditions were tested: both co-located maskers were facing 45°, or both were facing 60° relative to the listener. The results demonstrated that regardless of age, children performed better when EHFs were present. In addition, a small change in masker head orientation also impacted performance, with better recognition at 60° compared to 45°. These findings suggest that EHF energy in the speech signal above 8 kHz is beneficial for children in complex listening situations. The magnitude of benefit from EHF cues and talker head orientation cues did not differ between children and adults. Therefore, while EHFs were beneficial for children as young as 5 years of age, children's generally better EHF hearing relative to adults did not provide any additional benefit.
Collapse
|
16
|
Abstract
OBJECTIVES Hearing in the extended high frequencies (EHFs; >8 kHz) is perceptually and clinically relevant. Recent work suggests the possible role of EHF audibility in natural listening environments (e.g., spatial hearing) and hidden hearing loss. In this article, we examine the development of frequency discrimination (FD) in the EHFs. Specifically, the objectives of the present study were to answer if the developmental timeline for FD is different for EHFs; and whether the discontinuity of FD thresholds across frequency-representing the hypothetical shift from a temporal to place code-for children occurs at about the same frequency as adults. DESIGN Thirty-one normal-hearing children (5 to 12 years) and 15 young adults participated in this study. FD thresholds were measured for standard frequencies (1, 2, 4, 6, and 8 kHz) and EHFs (10 and 12.5 kHz) using a three-alternative (odd-ball) forced-choice paradigm. Statistical analysis focused on examining the change of FD thresholds as a function of age and estimating the breakpoints in the discrimination threshold-frequency functions. RESULTS FD performance in younger children for EHFs was nearly six times poorer relative to older children and adults; however, there was no effect of test frequency on the child-adult difference. Change-point detection on group data revealed a higher knot frequency-representing the putative transition from temporal to place mechanisms-for adults (9.8 kHz) than children (~6 kHz). Individual spline functions suggest that the knot frequency varied from 2 to 10 kHz across participants. CONCLUSIONS The present study provides evidence for a similar rate of maturation of FD for EHFs and standard frequencies. FD at EHFs matures by 10 to 12 years of age. Adult listeners may not all use temporal cues up to 10 kHz. Young children are relatively inefficient in using temporal fine-structure cues for FD at frequencies above 6 kHz.
Collapse
|
17
|
Hunter LL, Monson BB, Moore DR, Dhar S, Wright BA, Munro KJ, Zadeh LM, Blankenship CM, Stiepan SM, Siegel JH. Extended high frequency hearing and speech perception implications in adults and children. Hear Res 2020; 397:107922. [PMID: 32111404 PMCID: PMC7431381 DOI: 10.1016/j.heares.2020.107922] [Citation(s) in RCA: 79] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 02/10/2020] [Accepted: 02/11/2020] [Indexed: 01/09/2023]
Abstract
Extended high frequencies (EHF), above 8 kHz, represent a region of the human hearing spectrum that is generally ignored by clinicians and researchers alike. This article is a compilation of contributions that, together, make the case for an essential role of EHF in both normal hearing and auditory dysfunction. We start with the fundamentals of biological and acoustic determinism - humans have EHF hearing for a purpose, for example, the detection of prey, predators, and mates. EHF hearing may also provide a boost to speech perception in challenging conditions and its loss, conversely, might help explain difficulty with the same task. However, it could be that EHF are a marker for damage in the conventional frequency region that is more related to speech perception difficulties. Measurement of EHF hearing in concert with otoacoustic emissions could provide an early warning of age-related hearing loss. In early life, when EHF hearing sensitivity is optimal, we can use it for enhanced phonetic identification during language learning, but we are also susceptible to diseases that can prematurely damage it. EHF audiometry techniques and standardization are reviewed, providing evidence that they are reliable to measure and provide important information for early detection, monitoring and possible prevention of hearing loss in populations at-risk. To better understand the full contribution of EHF to human hearing, clinicians and researchers can contribute by including its measurement, along with measures of speech in noise and self-report of hearing difficulties and tinnitus in clinical evaluations and studies.
Collapse
Affiliation(s)
- Lisa L Hunter
- Communication Sciences Research Center, Cincinnati Children's Hospital Medical Center, USA; Department of Otolaryngology, University of Cincinnati, USA.
| | - Brian B Monson
- Department of Speech and Hearing Science, University of Illinois at Urbana-Champaign, USA; Neuroscience Program, University of Illinois at Urbana-Champaign, USA
| | - David R Moore
- Communication Sciences Research Center, Cincinnati Children's Hospital Medical Center, USA; Department of Otolaryngology, University of Cincinnati, USA; Manchester Centre for Audiology and Deafness, School of Health Sciences, University of Manchester, UK
| | - Sumitrajit Dhar
- Roxelyn & Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL, USA; Knowles Hearing Center, Northwestern University, Evanston, IL, USA
| | - Beverly A Wright
- Roxelyn & Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL, USA
| | - Kevin J Munro
- Manchester Centre for Audiology and Deafness, School of Health Sciences, University of Manchester, UK
| | - Lina Motlagh Zadeh
- Communication Sciences Research Center, Cincinnati Children's Hospital Medical Center, USA
| | - Chelsea M Blankenship
- Communication Sciences Research Center, Cincinnati Children's Hospital Medical Center, USA
| | - Samantha M Stiepan
- Roxelyn & Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL, USA; Knowles Hearing Center, Northwestern University, Evanston, IL, USA
| | - Jonathan H Siegel
- Roxelyn & Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL, USA; Knowles Hearing Center, Northwestern University, Evanston, IL, USA
| |
Collapse
|
18
|
Abstract
OBJECTIVES This study tested the hypothesis that undetected peripheral hearing impairment occurs in children with idiopathic listening difficulties (LiDs), as reported by caregivers using the Evaluation of Children"s Listening and Processing Skills (ECLiPS) validated questionnaire, compared with children with typically developed (TD) listening abilities. DESIGN Children with LiD aged 6-14 years old (n = 60, mean age = 9.9 yr) and 54 typical age matched children were recruited from audiology clinical records and from IRB-approved advertisements at hospital locations and in the local and regional areas. Both groups completed standard and extended high-frequency (EHF) pure-tone audiometry, wideband absorbance tympanometry and middle ear muscle reflexes, distortion product and chirp transient evoked otoacoustic emissions. Univariate and multivariate mixed models and multiple regression analysis were used to examine group differences and continuous performance, as well as the influence of demographic factors and pressure equalization (PE) tube history. RESULTS There were no significant group differences between the LiD and TD groups for any of the auditory measures tested. However, analyses across all children showed that EHF hearing thresholds, wideband tympanometry, contralateral middle ear muscle reflexes, distortion product, and transient-evoked otoacoustic emissions were related to a history of PE tube surgery. The physiologic measures were also associated with EHF hearing loss, secondary to PE tube history. CONCLUSIONS Overall, the results of this study in a sample of children with validated LiD compared with a TD group matched for age and sex showed no significant differences in peripheral function using highly sensitive auditory measures. Histories of PE tube surgery were significantly related to EHF hearing and to a range of physiologic measures in the combined sample.
Collapse
|
19
|
Nakeva von Mentzer C. Phonemic discrimination and reproduction in 4-5-year-old children: Relations to hearing. Int J Pediatr Otorhinolaryngol 2020; 133:109981. [PMID: 32247932 DOI: 10.1016/j.ijporl.2020.109981] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 02/27/2020] [Accepted: 02/29/2020] [Indexed: 12/28/2022]
Abstract
OBJECTIVE The long-term objective of this research is to highlight the importance of speech perception assessment in children with developmental language disorder (DLD), and to investigate how hearing contributes to speech and language skills. As a first step in fulfilling this aim, the present study explored relations between phonemic discrimination and reproduction, and sensitive measures of hearing in young healthy children. METHODS The American Listen-Say test was developed and served as speech perception tool. This test reports speech discrimination of phonemic contrasts quantitatively for both quiet and in noise conditions, along with reproduction scores, all measured within one session. Speech tokens were perceptually homogenized in noise. Forty-one 4-5-year-old American children participated. Phonemic discrimination (quiet and speech shaped noise) and phonemic reproduction, audiometric thresholds in the conventional (1-8 kHz) and extended high frequency (EHF; 10-16 kHz) range, and distortion product otoacoustic emissions (DPOAEs) were examined. RESULTS All children had normal hearing thresholds within the conventional range (mean PTA bilaterally 8.6 dB HL). Ten (24.3%) of the children had elevated EHF thresholds (> 20 dB HL) for one or more frequencies or ears, and six (14.6%) had DPOAE signal to noise ratios (SNR) < 6 dB. EHF thresholds and DPOAE SNRs were significantly associated. Children's phonemic discrimination was impaired in noise, relative to quiet. There was a moderate, significant correlation between overall phonemic discrimination in noise and EHF audiometric thresholds. CONCLUSIONS Overall, the present study showed that sensitive hearing measures enabled the detection of subtle hearing difficulties in young healthy children. In particular, phonemic discrimination in noise showed associations with hearing. Implications of including sensitive hearing measures in children with DLD are discussed.
Collapse
|
20
|
The Association Between Hearing Impairment and Problem Behaviors in 11-Year-Old Pacific Children Living in New Zealand. Ear Hear 2020; 41:539-548. [DOI: 10.1097/aud.0000000000000777] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
21
|
Mealings K, Harkus S, Hwang J, Fragoso J, Chung K, Dillon H. Hearing loss and speech understanding in noise in Aboriginal and Torres Strait Islander children from locations varying in remoteness and socio-educational advantage. Int J Pediatr Otorhinolaryngol 2020; 129:109741. [PMID: 31677536 DOI: 10.1016/j.ijporl.2019.109741] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 10/22/2019] [Accepted: 10/22/2019] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Otitis media resulting in conductive hearing loss is a major health issue for Aboriginal and Torres Strait Islander children, which can also lead to the child developing spatial processing disorder (SPD). This study examined the prevalence of hearing loss and deficits in speech understanding in noise, including SPD, in Aboriginal and Torres Strait Islander children from schools varying in remoteness and socio-educational advantage. METHOD 288 Aboriginal and Torres Strait Islander children aged 4-14 years from three schools varying in remoteness and socio-educational advantage completed audiological assessment and the Listening in Spatialized Noise - Sentences test to assess for hearing loss and SPD. Children also completed Sound Scouts, a self-administered tablet-based hearing test which screens for these deficits. The prevalence of hearing issues was compared to what is expected from a typical population. RESULTS The proportion of children with hearing problems was related to the school's socio-educational advantage, with higher proportions in schools with a lower socio-educational advantage. Proportions of children with speech-in-noise deficits (including SPD) was related to the remoteness of the school, with higher proportions in schools that were more remote. CONCLUSIONS The prevalence of hearing loss and SPD is much higher in Aboriginal and Torres Strait Islander children than described for non-Aboriginal populations, and is related to the socio-educational advantage or remoteness of the school. Resources are needed to reduce the incidence of hearing loss and health disparity in Aboriginal communities, especially those in remote areas with lower socio-educational advantages.
Collapse
Affiliation(s)
| | | | | | | | - King Chung
- Northern Illinois University, United States
| | - Harvey Dillon
- National Acoustic Laboratories, Sydney, Australia; University of Manchester, Manchester, United Kingdom; Macquarie University, Sydney, Australia
| |
Collapse
|
22
|
Hemmingsen D, Mikalsen C, Hansen AR, Fjalstad JW, Stenklev NC, Klingenberg C. Hearing in Schoolchildren After Neonatal Exposure to a High-Dose Gentamicin Regimen. Pediatrics 2020; 145:peds.2019-2373. [PMID: 31915192 DOI: 10.1542/peds.2019-2373] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/04/2019] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To assess the association between gentamicin exposure in the neonatal period and hearing in school age. METHODS This study included children exposed to a high-dose (6 mg/kg) gentamicin regimen as neonates (2004-2012), invited for follow-up at school age, and a healthy age-matched control group. We assessed hearing with pure tone audiometry including the extended high-frequency (EHF) range. Outcomes were average hearing thresholds in the midfrequencies (0.5-4 kHz) and the EHFs (9-16 kHz). The measures of gentamicin exposure were cumulative dose and highest trough plasma concentration. We used linear regression models to assess the impact of gentamicin exposure, and other peri- and postnatal morbidities, on hearing thresholds. RESULTS A total of 219 gentamicin-exposed and 33 healthy-control children were included in the audiological analysis. In the gentamicin cohort, 39 (17%) had a birth weight <1500 g. Median cumulative doses and trough plasma concentrations were 30 (interquartile range 24-42) mg/kg and 1.0 (interquartile range 0.7-1.2) mg/L, respectively. Median hearing thresholds for the midfrequencies and the EHFs were 2.5 (0 to 6.3) dB hearing level and -1.7 (-5.0 to 5.0) dB hearing level, both of which were within the normal range. In an adjusted analysis, increasing hearing thresholds were associated with lower birth weight and postnatal middle-ear disease but not level of gentamicin exposure. After adjusting for birth weight, there was no difference in hearing threshold between the gentamicin-exposed cohort and healthy controls. CONCLUSIONS Exposure to a high-dose gentamicin regimen in the neonatal period was not associated with an increase in hearing thresholds in schoolchildren being able to complete audiometry.
Collapse
Affiliation(s)
- Dagny Hemmingsen
- Departments of Otorhinolaryngology and Head and Neck Surgery and.,Paediatric Research Group, Faculty of Health Sciences, Univeristy of Tromsø-Arctic University of Norway, Tromsø, Norway; and
| | - Camilla Mikalsen
- Departments of Otorhinolaryngology and Head and Neck Surgery and
| | | | - Jon Widding Fjalstad
- Paediatric Research Group, Faculty of Health Sciences, Univeristy of Tromsø-Arctic University of Norway, Tromsø, Norway; and
| | | | - Claus Klingenberg
- Paediatrics and Adolescence Medicine, University Hospital of North Norway, Tromsø, Norway; .,Paediatric Research Group, Faculty of Health Sciences, Univeristy of Tromsø-Arctic University of Norway, Tromsø, Norway; and
| |
Collapse
|
23
|
Motlagh Zadeh L, Silbert NH, Sternasty K, Swanepoel DW, Hunter LL, Moore DR. Extended high-frequency hearing enhances speech perception in noise. Proc Natl Acad Sci U S A 2019; 116:23753-23759. [PMID: 31685611 PMCID: PMC6876232 DOI: 10.1073/pnas.1903315116] [Citation(s) in RCA: 102] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Young healthy adults can hear tones up to at least 20 kHz. However, clinical audiometry, by which hearing loss is diagnosed, is limited at high frequencies to 8 kHz. Evidence suggests there is salient information at extended high frequencies (EHFs; 8 to 20 kHz) that may influence speech intelligibility, but whether that information is used in challenging listening conditions remains unknown. Difficulty understanding speech in noisy environments is the most common concern people have about their hearing and usually the first sign of age-related hearing loss. Digits-in-noise (DIN), a widely used test of speech-in-noise perception, can be sensitized for detection of high-frequency hearing loss by low-pass filtering the broadband masking noise. Here, we used standard and EHF audiometry, self-report, and successively higher cutoff frequency filters (2 to 8 kHz) in a DIN test to investigate contributions of higher-frequency hearing to speech-in-noise perception. Three surprising results were found. First, 74 of 116 "normally hearing," mostly younger adults had some hearing loss at frequencies above 8 kHz. Early EHF hearing loss may thus be an easily measured, preventive warning to protect hearing. Second, EHF hearing loss correlated with self-reported difficulty hearing in noise. Finally, even with the broadest filtered noise (≤8 kHz), DIN hearing thresholds were significantly better (P < 0.0001) than those using broadband noise. Sound energy above 8 kHz thus contributes to speech perception in noise. People with "normal hearing" frequently report difficulty hearing in challenging environments. Our results suggest that one contribution to this difficulty is EHF hearing loss.
Collapse
Affiliation(s)
- Lina Motlagh Zadeh
- Communication Sciences Research Center, Cincinnati Children's Hospital, Cincinnati, OH 45229;
- Department of Communication Sciences & Disorders, University of Cincinnati, Cincinnati, OH 45267
| | - Noah H Silbert
- Department of Communication Sciences & Disorders, University of Cincinnati, Cincinnati, OH 45267
| | - Katherine Sternasty
- Communication Sciences Research Center, Cincinnati Children's Hospital, Cincinnati, OH 45229
| | - De Wet Swanepoel
- Department of Speech-Language Pathology and Audiology, University of Pretoria, 0002 Pretoria, Republic of South Africa
| | - Lisa L Hunter
- Communication Sciences Research Center, Cincinnati Children's Hospital, Cincinnati, OH 45229
- Department of Communication Sciences & Disorders, University of Cincinnati, Cincinnati, OH 45267
- Department of Otolaryngology, College of Medicine, University of Cincinnati, Cincinnati, OH 45267
| | - David R Moore
- Communication Sciences Research Center, Cincinnati Children's Hospital, Cincinnati, OH 45229
- Department of Otolaryngology, College of Medicine, University of Cincinnati, Cincinnati, OH 45267
- Manchester Centre for Audiology and Deafness, University of Manchester, M13 9PL Manchester, United Kingdom
| |
Collapse
|
24
|
Lauer AM, Dent ML, Sun W, Xu-Friedman MA. Effects of Non-traumatic Noise and Conductive Hearing Loss on Auditory System Function. Neuroscience 2019; 407:182-191. [PMID: 30685543 DOI: 10.1016/j.neuroscience.2019.01.020] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 01/11/2019] [Accepted: 01/14/2019] [Indexed: 01/25/2023]
Abstract
The effects of traumatic noise-exposure and deafening on auditory system function have received a great deal of attention. However, lower levels of noise as well as temporary conductive hearing loss also have consequences on auditory physiology and hearing. Here we review how abnormal acoustic experience at early ages affects the ascending and descending auditory pathways, as well as hearing behavior.
Collapse
Affiliation(s)
- Amanda M Lauer
- Dept of Otolaryngology-HNS, Center for Hearing and Balance, Johns Hopkins University School of Medicine, United States
| | - Micheal L Dent
- Dept. Psychology, University at Buffalo, SUNY, United States
| | - Wei Sun
- Dept. Communicative Disorders and Sciences, University at Buffalo, SUNY, United States
| | | |
Collapse
|
25
|
Hoffman HJ, Dobie RA, Losonczy KG, Themann CL, Flamme GA. Kids Nowadays Hear Better Than We Did: Declining Prevalence of Hearing Loss in US Youth, 1966-2010. Laryngoscope 2018; 129:1922-1939. [DOI: 10.1002/lary.27419] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 05/08/2018] [Accepted: 05/30/2018] [Indexed: 11/11/2022]
Affiliation(s)
- Howard J. Hoffman
- Epidemiology and Statistics Program; National Institute on Deafness and Other Communication Disorders, National Institutes of Health; Bethesda Maryland
| | - Robert A. Dobie
- Department of Otolaryngology-Head and Neck Surgery; The University of Texas Health Science Center at San Antonio; San Antonio Texas
| | - Katalin G. Losonczy
- Epidemiology and Statistics Program; National Institute on Deafness and Other Communication Disorders, National Institutes of Health; Bethesda Maryland
| | - Christa L. Themann
- Hearing Loss Prevention Team, Engineering and Physical Hazards Branch; National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention; Cincinnati Ohio
| | - Gregory A. Flamme
- Stephenson and Stephenson Research and Consulting, LLC-West; Forest Grove Oregon U.S.A
| |
Collapse
|
26
|
Cordeiro FP, da Costa Monsanto R, Kasemodel ALP, de Almeida Gondra L, de Oliveira Penido N. Extended high-frequency hearing loss following the first episode of otitis media. Laryngoscope 2018; 128:2879-2884. [DOI: 10.1002/lary.27309] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 04/18/2018] [Accepted: 05/03/2018] [Indexed: 12/12/2022]
Affiliation(s)
- Francisco Polanski Cordeiro
- Department of Otolaryngology-Head and Neck Surgery; Universidade Federal de São Paulo/Escola Paulista de Medicina (UNIFESP/EPM); São Paulo Brazil
| | - Rafael da Costa Monsanto
- Department of Otolaryngology-Head and Neck Surgery; Universidade Federal de São Paulo/Escola Paulista de Medicina (UNIFESP/EPM); São Paulo Brazil
| | - Ana Luiza Papi Kasemodel
- Department of Otolaryngology-Head and Neck Surgery; Universidade Federal de São Paulo/Escola Paulista de Medicina (UNIFESP/EPM); São Paulo Brazil
| | - Luiza de Almeida Gondra
- Department of Otolaryngology-Head and Neck Surgery; Universidade Federal de São Paulo/Escola Paulista de Medicina (UNIFESP/EPM); São Paulo Brazil
| | - Norma de Oliveira Penido
- Department of Otolaryngology-Head and Neck Surgery; Universidade Federal de São Paulo/Escola Paulista de Medicina (UNIFESP/EPM); São Paulo Brazil
| |
Collapse
|
27
|
Abstract
Many people with difficulties following conversations in noisy settings have “clinically normal” audiograms, that is, tone thresholds better than 20 dB HL from 0.1 to 8 kHz. This review summarizes the possible causes of such difficulties, and examines established as well as promising new psychoacoustic and electrophysiologic approaches to differentiate between them. Deficits at the level of the auditory periphery are possible even if thresholds remain around 0 dB HL, and become probable when they reach 10 to 20 dB HL. Extending the audiogram beyond 8 kHz can identify early signs of noise-induced trauma to the vulnerable basal turn of the cochlea, and might point to “hidden” losses at lower frequencies that could compromise speech reception in noise. Listening difficulties can also be a consequence of impaired central auditory processing, resulting from lesions affecting the auditory brainstem or cortex, or from abnormal patterns of sound input during developmental sensitive periods and even in adulthood. Such auditory processing disorders should be distinguished from (cognitive) linguistic deficits, and from problems with attention or working memory that may not be specific to the auditory modality. Improved diagnosis of the causes of listening difficulties in noise should lead to better treatment outcomes, by optimizing auditory training procedures to the specific deficits of individual patients, for example.
Collapse
|
28
|
le Clercq CMP, van Ingen G, Ruytjens L, Goedegebure A, Moll HA, Raat H, Jaddoe VWV, Baatenburg de Jong RJ, van der Schroeff MP. Prevalence of Hearing Loss Among Children 9 to 11 Years Old: The Generation R Study. JAMA Otolaryngol Head Neck Surg 2017; 143:928-934. [PMID: 28750130 DOI: 10.1001/jamaoto.2017.1068] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Importance Hearing loss (HL), a major cause of disability globally, negatively affects both personal and professional life. Objective To describe the prevalence of sensorineural hearing loss (SNHL) among a population-based cohort of 9- to 11-year-old children, and to examine potential associations between purported risk factors and SNHL in early childhood. Design, Setting, and Participants The study was among the general, nonclinical, pediatric community within the city of Rotterdam, the Netherlands, and was conducted between 2012 and 2015 as a cross-sectional assessment within the Generation R Study, a population-based longitudinal cohort study from fetal life until adulthood. Participants are children of included pregnant women in the Generation R Study with an expected delivery date between April 2002 and January 2006. They form a prenatally recruited birth cohort. Main Outcomes and Measures Pure-tone air-conduction hearing thresholds were obtained at 0.5, 1, 2, 3, 4, 6, and 8 kHz, and tympanometry was performed in both ears. Demographic factors and parent-reported questionnaire data, including history of otitis media, were also measured. Results A total of 5368 participants with a mean age of 9 years 9 months (interquartile range, 9 years 7 months-9 years 11 months) completed audiometry and were included in the analyses. A total of 2720 were girls (50.7%), and 3627 (67.6%) were white. Most of the participants (4426 children [82.5%]) showed normal hearing thresholds 15 dB HL or less in both ears. Within the cohort, 418 children (7.8%) were estimated to have SNHL (≥16 dB HL at low-frequency pure-tone average; average at 0.5, 1, and 2 kHz or high-frequency pure-tone average; average at 3, 4, and 6 kHz in combination with a type A tympanogram) in at least 1 ear, most often at higher frequencies. In multivariable analyses, a history of recurrent acute otitis media and lower maternal education were associated with the estimated SNHL at ages 9 to 11 years (odds ratio, 2.0 [95% CI. 1.5-2.8] and 1.4 [95% CI, 1.1-1.7], respectively). Conclusions and Relevance Within this cohort study in the Netherlands, 7.8% of the children ages 9 to 11 years had low-frequency or high-frequency HL of at least 16 dB HL in 1 or both ears. A history of recurrent acute otitis media and lower maternal education seem to be independent risk factors for presumed SNHL in early childhood.
Collapse
Affiliation(s)
- Carlijn M P le Clercq
- Department of Otolaryngology-Head and Neck Surgery, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands.,The Generation R Study Group, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Gijs van Ingen
- Department of Otolaryngology-Head and Neck Surgery, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands.,The Generation R Study Group, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Liesbet Ruytjens
- Department of Otolaryngology-Head and Neck Surgery, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - André Goedegebure
- Department of Otolaryngology-Head and Neck Surgery, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Henriette A Moll
- The Generation R Study Group, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Hein Raat
- The Generation R Study Group, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Vincent W V Jaddoe
- The Generation R Study Group, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Rob J Baatenburg de Jong
- Department of Otolaryngology-Head and Neck Surgery, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Marc P van der Schroeff
- Department of Otolaryngology-Head and Neck Surgery, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands.,The Generation R Study Group, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
| |
Collapse
|
29
|
Tengroth B, Hederstierna C, Neovius E, Flynn T. Hearing thresholds and ventilation tube treatment in children with unilateral cleft lip and palate. Int J Pediatr Otorhinolaryngol 2017; 97:102-108. [PMID: 28483218 DOI: 10.1016/j.ijporl.2017.03.031] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Revised: 03/20/2017] [Accepted: 03/26/2017] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Children with cleft lip and palate have a high prevalence of otitis media with effusion (OME) which is often associated with a fluctuating, conductive hearing loss in the low and mid-frequencies and a risk for permanent hearing loss in the higher frequencies. Although common, there is no consensus on the treatment of OME with ventilation tubes. The aim of this study is to document if the risk for permanent hearing loss and acquired cholesteatoma increases due to treatment with ventilation tubes (VT treatments) during childhood in a group of children with cleft lip and palate. METHODS A retrospective medical chart review of 33 children (25 boys and 8 girls) born with unilateral cleft lip and palate (UCLP) was completed. Audiological data (results of hearing sensitivity tests, the total number of hearing tests, and number of VT treatments) were extracted from medical records from when the children were 4-7 and >7-10 years of age. RESULTS The hearing thresholds in the speech frequencies improved with age (p < 0,05) but a minority of the children continued to present with elevated hearing thresholds in the higher frequencies at >7-10 years of age. There were no significant correlations between number of VT treatments and hearing thresholds at >7-10 years. Four of the 33 children presented with complications: two children exhibited perforations of the ear drum (6.1%) and two children developed unilateral cholesteatoma (6.1%). CONCLUSION In the current study, the hearing sensitivity of children with cleft lip and palate improved with age. However, this improvement was not seen in the higher frequencies. Twelve percent of the children experienced complications following VT treatments. Due to these complications, it is recommended that all children with cleft palate should have routine follow-ups by an ENT doctor and audiologist. As part of the routine follow-up care, hearing assessments should be performed before and after VT treatments.
Collapse
Affiliation(s)
- Birgitta Tengroth
- Department of Audiology and Neurootology, Karolinska University Hospital, 171 76 Stockholm, Sweden.
| | - Christina Hederstierna
- Department of Audiology and Neurootology, Karolinska University Hospital, 171 76 Stockholm, Sweden
| | - Erik Neovius
- Department of Reconstructive Plastic Surgery, Karolinska University Hospital, Stockholm, Sweden
| | - Traci Flynn
- Division of Speech and Language Pathology, Department of Clinical Science, Intervention and Technology, Karolinska Institute, Sweden
| |
Collapse
|
30
|
Hunter LL, Keefe DH, Feeney MP, Brown DK, Meinzen-Derr J, Elsayed AM, Amann JM, Manickam V, Fitzpatrick D, Shott SR. Wideband acoustic immittance in children with Down syndrome: prediction of middle-ear dysfunction, conductive hearing loss and patent PE tubes. Int J Audiol 2017; 56:622-634. [PMID: 28434272 DOI: 10.1080/14992027.2017.1314557] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The purpose of this study was to evaluate pressurised wideband acoustic immittance (WAI) tests in children with Down syndrome (DS) and in typically developing children (TD) for prediction of conductive hearing loss (CHL) and patency of pressure equalising tubes (PETs). DESIGN Audiologic diagnosis was determined by audiometry in combination with distortion-product otoacoustic emissions, 0.226 kHz tympanometry and otoscopy. WAI results were compared for ears within diagnostic categories (Normal, CHL and PET) and between groups (TD and DS). STUDY SAMPLE Children with DS (n = 40; mean age 6.4 years), and TD children (n = 48; mean age 5.1 years) were included. RESULTS Wideband absorbance was significantly lower at 1-4 kHz in ears with CHL compared to NH for both TD and DS groups. In ears with patent PETs, wideband absorbance and group delay (GD) were larger than in ears without PETs between 0.25 and 1.5 kHz. Wideband absorbance tests were performed similarly for prediction of CHL and patent PETs in TD and DS groups. CONCLUSIONS Wideband absorbance and GD revealed specific patterns in both TD children and those with DS that can assist in detection of the presence of significant CHL, assess the patency of PETs, and provide frequency-specific information in the audiometric range.
Collapse
Affiliation(s)
- Lisa L Hunter
- a Divisions of Otolaryngology and.,b Audiology , Cincinnati Children's Hospital Medical Center , Cincinnati , OH , USA
| | | | - M Patrick Feeney
- d National Center for Rehabilitative Auditory Research, Portland , OR , USA.,e Oregon Health & Science University, Portland , OR , USA
| | | | - Jareen Meinzen-Derr
- g Biostatistics and Epidemiology , Cincinnati Children's Hospital Medical Center , Cincinnati , OH , USA
| | | | | | | | - Denis Fitzpatrick
- d National Center for Rehabilitative Auditory Research, Portland , OR , USA
| | | |
Collapse
|
31
|
Hearing sensitivity in adults with a unilateral cleft lip and palate after two-stage palatoplasty. Int J Pediatr Otorhinolaryngol 2017; 94:76-81. [PMID: 28167017 DOI: 10.1016/j.ijporl.2016.12.030] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Revised: 12/24/2016] [Accepted: 12/24/2016] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To evaluate long-term hearing and middle ear status in patients treated for a unilateral complete cleft lip and palate (UCLP) by two-stage palatoplasty. METHODS Forty-nine UCLP patients aged 17 years and older were included in this retrospective study. Patients were invited for a multidisciplinary long-term follow-up of their treatment at a tertiary center for craniofacial surgery in the Netherlands. ENT assessment included tympanometry and pure-tone audiometry. Medical files were searched for medical and surgical history. RESULTS In total, 19.4% of the patients had significant long-term hearing loss (PTA > 20 dB), comprising conductive hearing loss in 21.5% of the patients. In the majority (70%), this hearing loss was more pronounced at higher frequencies. In 25% the high fletcher index showed hearing thresholds above 20 dB. Ventilation tubes were placed at least once in 78.7% of the patients. The frequency of tube insertion was positively correlated with the incidence of reduced tympanic compliance (tympanogram type B) and the need for a pharyngoplasty. CONCLUSION The present study reports long-term hearing outcomes in UCLP patients with hard palate closure at 3 years of age. Persistent hearing loss was observed in 19.4% of our patients (PTA > 20 dB), mainly at the higher frequencies. Ventilation tube placement was associated with reduced tympanic compliance and higher risk on hearing loss (PTA air conduction). Our high incidence of velopharyngeal incompetence during early childhood, which is likely associated with Eustachian tube dysfunction, might have contributed to these results.
Collapse
|
32
|
Casselbrant ML, Gravel JS, Margolis RH, Bellussi L, Dhooge I, Downs MP, Karma P, Marchisio P, Ogra PL, Passali D, Stewart IA, van Cauwenberge PB, Vernon-Feagans L. 8. Diagnosis and Screening. Ann Otol Rhinol Laryngol 2016. [DOI: 10.1177/00034894021110s311] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
33
|
Bluestone CD, Klein JO, Rosenfeld RM, Berman S, Casselbrant ML, Chonmaitree T, Giebink GS, Grote JJ, Ingvarsson LB, Linder T, Lous J, Maw AR, Paradise JL, Sando I, Stool SE, Takasaka T. 9. Treatment, Complications, and Sequelae. Ann Otol Rhinol Laryngol 2016. [DOI: 10.1177/00034894021110s312] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
|
34
|
de Beer BA, Schilder AGM, Ingels K, Snik AF, Zielhuis GA, Graamans K. Hearing Loss in Young Adults Who Had Ventilation Tube Insertion in Childhood. Ann Otol Rhinol Laryngol 2016; 113:438-44. [PMID: 15224825 DOI: 10.1177/000348940411300604] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
It is known that insertion of ventilation tubes can cause damage to the tympanic membrane and hearing deterioration in the long term. To investigate long-term effects of recurrent otitis media and of ventilation tube insertion, we used a study group (n = 358 subjects), with or without a history of otitis media and/or ventilation tube insertion, derived from a birth cohort that had been followed for 16 years. At 18 years of age, a standardized audiometric and otoscopic examination was performed. We found that ventilation tube insertion in childhood was associated with a mean persistent hearing loss in young adults of about 5 to 10 dB at the group level with a sensorineural component of 3 to 4 dB. This hearing loss could not be explained by the disease load of otitis media in childhood. Repeated insertions of ventilation tubes caused a greater deterioration of hearing than did a single insertion. Structural changes of the tympanic membrane were a mediating factor in the causal relationship between ventilation tube insertion and hearing loss. We conclude that ventilation tube insertion in childhood may induce hearing deterioration in the long term.
Collapse
Affiliation(s)
- Brechtje A de Beer
- Department of Otorhinolaryngology, University Medical Center Nijmegen, Nijmegen, The Netherlands
| | | | | | | | | | | |
Collapse
|
35
|
Båsjö S, Möller C, Widén S, Jutengren G, Kähäri K. Hearing thresholds, tinnitus, and headphone listening habits in nine-year-old children. Int J Audiol 2016; 55:587-96. [PMID: 27329351 PMCID: PMC4989862 DOI: 10.1080/14992027.2016.1190871] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Objective: Investigate hearing function and headphone listening habits in nine-year-old Swedish children. Design: A cross-sectional study was conducted and included otoscopy, tympanometry, pure-tone audiometry, and spontaneous otoacoustic emissions (SOAE). A questionnaire was used to evaluate headphone listening habits, tinnitus, and hyperacusis. Study sample: A total of 415 children aged nine years. Results: The prevalence of a hearing threshold ≥20 dB HL at one or several frequencies was 53%, and the hearing thresholds at 6 and 8 kHz were higher than those at the low and mid frequencies. SOAEs were observed in 35% of the children, and the prevalence of tinnitus was 5.3%. No significant relationship between SOAE and tinnitus was found. Pure-tone audiometry showed poorer hearing thresholds in children with tinnitus and in children who regularly listened with headphones. Conclusion: The present study of hearing, listening habits, and tinnitus in nine-year old children is, to our knowledge, the largest study so far. The main findings were that hearing thresholds in the right ear were poorer in children who used headphones than in children not using them, which could be interpreted as headphone listening may have negative consequences to children’s hearing. Children with tinnitus showed poorer hearing thresholds compared to children without tinnitus.
Collapse
Affiliation(s)
- Sara Båsjö
- a Audiological Research Centre, School of Health and Medical Sciences / Swedish Institute for Disability Research, Örebro University Hospital, Örebro University , Örebro , Sweden .,b HEAD Graduate School, Linköping University , Linköping , Sweden
| | - Claes Möller
- a Audiological Research Centre, School of Health and Medical Sciences / Swedish Institute for Disability Research, Örebro University Hospital, Örebro University , Örebro , Sweden
| | - Stephen Widén
- a Audiological Research Centre, School of Health and Medical Sciences / Swedish Institute for Disability Research, Örebro University Hospital, Örebro University , Örebro , Sweden
| | - Göran Jutengren
- c School of Health Sciences, University of Borås , Borås , Sweden , and
| | - Kim Kähäri
- d Division of Audiology , Sahlgrens' Academy at Göteborg University , Göteborg , Sweden
| |
Collapse
|
36
|
Rosenfeld RM, Shin JJ, Schwartz SR, Coggins R, Gagnon L, Hackell JM, Hoelting D, Hunter LL, Kummer AW, Payne SC, Poe DS, Veling M, Vila PM, Walsh SA, Corrigan MD. Clinical Practice Guideline: Otitis Media with Effusion (Update). Otolaryngol Head Neck Surg 2016; 154:S1-S41. [PMID: 26832942 DOI: 10.1177/0194599815623467] [Citation(s) in RCA: 307] [Impact Index Per Article: 38.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE This update of a 2004 guideline codeveloped by the American Academy of Otolaryngology-Head and Neck Surgery Foundation, the American Academy of Pediatrics, and the American Academy of Family Physicians, provides evidence-based recommendations to manage otitis media with effusion (OME), defined as the presence of fluid in the middle ear without signs or symptoms of acute ear infection. Changes from the prior guideline include consumer advocates added to the update group, evidence from 4 new clinical practice guidelines, 20 new systematic reviews, and 49 randomized control trials, enhanced emphasis on patient education and shared decision making, a new algorithm to clarify action statement relationships, and new and expanded recommendations for the diagnosis and management of OME. PURPOSE The purpose of this multidisciplinary guideline is to identify quality improvement opportunities in managing OME and to create explicit and actionable recommendations to implement these opportunities in clinical practice. Specifically, the goals are to improve diagnostic accuracy, identify children who are most susceptible to developmental sequelae from OME, and educate clinicians and patients regarding the favorable natural history of most OME and the clinical benefits for medical therapy (eg, steroids, antihistamines, decongestants). Additional goals relate to OME surveillance, hearing and language evaluation, and management of OME detected by newborn screening. The target patient for the guideline is a child aged 2 months through 12 years with OME, with or without developmental disabilities or underlying conditions that predispose to OME and its sequelae. The guideline is intended for all clinicians who are likely to diagnose and manage children with OME, and it applies to any setting in which OME would be identified, monitored, or managed. This guideline, however, does not apply to patients <2 months or >12 years old. ACTION STATEMENTS The update group made strong recommendations that clinicians (1) should document the presence of middle ear effusion with pneumatic otoscopy when diagnosing OME in a child; (2) should perform pneumatic otoscopy to assess for OME in a child with otalgia, hearing loss, or both; (3) should obtain tympanometry in children with suspected OME for whom the diagnosis is uncertain after performing (or attempting) pneumatic otoscopy; (4) should manage the child with OME who is not at risk with watchful waiting for 3 months from the date of effusion onset (if known) or 3 months from the date of diagnosis (if onset is unknown); (5) should recommend against using intranasal or systemic steroids for treating OME; (6) should recommend against using systemic antibiotics for treating OME; and (7) should recommend against using antihistamines, decongestants, or both for treating OME.The update group made recommendations that clinicians (1) should document in the medical record counseling of parents of infants with OME who fail a newborn screening regarding the importance of follow-up to ensure that hearing is normal when OME resolves and to exclude an underlying sensorineural hearing loss; (2) should determine if a child with OME is at increased risk for speech, language, or learning problems from middle ear effusion because of baseline sensory, physical, cognitive, or behavioral factors; (3) should evaluate at-risk children for OME at the time of diagnosis of an at-risk condition and at 12 to 18 months of age (if diagnosed as being at risk prior to this time); (4) should not routinely screen children for OME who are not at risk and do not have symptoms that may be attributable to OME, such as hearing difficulties, balance (vestibular) problems, poor school performance, behavioral problems, or ear discomfort; (5) should educate children with OME and their families regarding the natural history of OME, need for follow-up, and the possible sequelae; (6) should obtain an age-appropriate hearing test if OME persists for 3 months or longer OR for OME of any duration in an at-risk child; (7) should counsel families of children with bilateral OME and documented hearing loss about the potential impact on speech and language development; (8) should reevaluate, at 3- to 6-month intervals, children with chronic OME until the effusion is no longer present, significant hearing loss is identified, or structural abnormalities of the eardrum or middle ear are suspected; (9) should recommend tympanostomy tubes when surgery is performed for OME in a child <4 years old; adenoidectomy should not be performed unless a distinct indication exists (nasal obstruction, chronic adenoiditis); (10) should recommend tympanostomy tubes, adenoidectomy, or both when surgery is performed for OME in a child ≥4 years old; and (11) should document resolution of OME, improved hearing, or improved quality of life when managing a child with OME.
Collapse
Affiliation(s)
- Richard M Rosenfeld
- Department of Otolaryngology, SUNY Downstate Medical Center, Brooklyn, New York, USA
| | - Jennifer J Shin
- Division of Otolaryngology, Harvard Medical School, Boston, Massachusetts, USA
| | - Seth R Schwartz
- Department of Otolaryngology, Virginia Mason Medical Center, Seattle, Washington, USA
| | - Robyn Coggins
- Society for Middle Ear Disease, Pittsburgh, Pennsylvania, USA
| | - Lisa Gagnon
- Connecticut Pediatric Otolaryngology, Madison, Connecticut, USA
| | | | - David Hoelting
- American Academy of Family Physicians, Pender, Nebraska, USA
| | - Lisa L Hunter
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Ann W Kummer
- University of Virginia Health System, Charlottesville, Virginia, USA
| | - Spencer C Payne
- University of Virginia Health System, Charlottesville, Virginia, USA
| | - Dennis S Poe
- Department of Otology and Laryngology, Harvard Medical School and Boston Children's Hospital, Boston, Massachusetts, USA
| | - Maria Veling
- University of Texas-Southwestern Medical Center/Children's Medical Center-Dallas, Dallas, Texas, USA
| | - Peter M Vila
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri, USA
| | - Sandra A Walsh
- Consumers United for Evidence-Based Healthcare, Davis, California, USA
| | - Maureen D Corrigan
- American Academy of Otolaryngology-Head and Neck Surgery Foundation, Alexandria, Virginia, USA
| |
Collapse
|
37
|
Malaty J, Lee JC, Zhang MEI, Stevens G, Antonelli PJ. Hearing loss and extent of labyrinthine injury in Pseudomonas otitis media. Otolaryngol Head Neck Surg 2016. [DOI: 10.1016/j.otohns.2004.09.088] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVES: To determine if the severity of hearing loss due to semicircular canal transection (SCT) in Pseudomonas otitis media (POM) is a function of the extent of the labyrinthine injury. METHODS: POM was induced bilaterally in 45 guinea pigs. After 2 to 4 days, SCT was performed in one 1 on the horizontal canal, the superior canal, or both the horizontal and the superior canals. Auditory-evoked brainstem responses were measured before and after SCT. RESULTS: POM was induced bilaterally in all animals. Elevation of click thresholds was found in almost all SCT ears of all 3 groups; however, there were no significant differences between groups. Comparing the SCT ear to the contralateral, control ear, mean hearing losses in the horizontal, superior, and horizontal + superior SCT groups were 23 dB, 27 dB, and 24 dB, respectively. CONCLUSIONS Hearing loss does not correlate with extent of labyrinthine injury in POM in the guinea pig. EBM rating: B-2.
Collapse
Affiliation(s)
- John Malaty
- From the Department of Otolaryngology, University of Florida, Gainesville, FL
| | - James C. Lee
- From the Department of Otolaryngology, University of Florida, Gainesville, FL
| | - MEI Zhang
- Department of Communicative Disorders, University of Florida, Gainesville, FL
| | - Gary Stevens
- Department of Biostatistics, University of Florida, Gainesville, FL
| | | |
Collapse
|
38
|
The effect of childhood infection on hearing function at age 61 to 63 years in the newcastle thousand families study. Ear Hear 2016; 36:185-90. [PMID: 25225919 PMCID: PMC4338477 DOI: 10.1097/aud.0000000000000094] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Objectives: It is known that childhood hearing function can become impaired after the occurrence of specific infections. However, evidence on the effect of common childhood infections on adult hearing function is limited. The objective of the study was to identify whether associations exist between the occurrence of common childhood infections in a UK birth cohort and hearing function across different frequencies at age 61 to 63 years. Design: The Newcastle Thousand Families study is a birth cohort of all individuals born in May and June 1947 to mothers resident in Newcastle upon Tyne, United Kingdom. Of the original cohort members who had an audiometry test at age 61 to 63 years, 333 had data available on infections during their first year of life and 296 on infections up to their fifth year of life. These data were analyzed using linear regression in relation to adult hearing function across differing frequencies in isolation. Results: After adjustment for sex, overcrowding in the first year, having had an ear operation, and having worked in a loud environment, significant negative associations were identified between adult hearing and tonsillitis at 250 Hz (p = 0.013), 1 kHz (p = 0.018), 6 kHz (p = 0.012), and 8 kHz (p = 0.033); otorrhea at 4 kHz (p = 0.005), 6 kHz (p = 0.003), and 8 kHz (p = 0.002); bronchitis (two or more episodes) at 2 kHz (p = 0.001), 3 kHz (p = 0.005), 4 kHz (p = 0.009), 6 kHz (p < 0.001), and 8 kHz (p < 0.001); and the total number of severe respiratory infections in the first year at 2 kHz (p = 0.037), 3 kHz (p = 0.049), 4 kHz (p = 0.030), 6 kHz (p < 0.001), and 8 kHz (p = 0.006). That is, individuals who had tonsillitis, bronchitis (twice or more), otorrhea, or a severe respiratory infection (twice or more) in their first year of life were more likely to have impaired adult hearing function than those who did not have any infections in early life. Conclusion: The occurrence of some, but not all, childhood infections appears to have an effect on adult hearing function across different frequencies. Reducing the incidence of infectious diseases in early life may reduce subsequent incidence of hearing impairment among adults. However, further research in modern cohorts is needed to clarify the links between infectious childhood diseases and adult hearing function. Identifying preventable risk factors for adult hearing loss could inform interventions aimed at alleviating the burden of this disease. It is known that specific infections can impair childhood hearing function. However, evidence on common childhood infections, including those known to impair childhood hearing, and their effect on adult hearing is limited. This study found that individuals who had tonsillitis, otorrhea, or bronchitis during their first year, or a severe respiratory infection up to five years of age, were more likely to develop impaired hearing as adults across differing frequencies than individuals who had not.
Collapse
|
39
|
da Costa Monsanto R, Erdil M, Pauna HF, Kwon G, Schachern PA, Tsuprun V, Paparella MM, Cureoglu S. Pathologic Changes of the Peripheral Vestibular System Secondary to Chronic Otitis Media. Otolaryngol Head Neck Surg 2016; 155:494-500. [PMID: 27165677 DOI: 10.1177/0194599816646359] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2016] [Accepted: 04/05/2016] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To evaluate the histopathologic changes of dark, transitional, and hair cells of the vestibular system in human temporal bones from patients with chronic otitis media. STUDY DESIGN Comparative human temporal bone study. SETTING Otopathology laboratory. SUBJECTS AND METHODS To compare the density of vestibular dark, transitional, and hair cells in temporal bones with and without chronic otitis media, we used differential interference contrast microscopy. RESULTS In the chronic otitis media group (as compared with the age-matched control group), the density of type I and type II hair cells was significantly decreased in the lateral semicircular canal, saccule, and utricle (P < .05). The density of type I cells was also significantly decreased in the chronic otitis media group in the posterior semicircular canal (P = .005), but that of type II cells was not (P = .168). The mean number of dark cells was significantly decreased in the chronic otitis media group in the lateral semicircular canal (P = .014) and in the posterior semicircular canal (P = .002). We observed no statistically significant difference in the density of transitional cells between the 2 groups (P > .1). CONCLUSION The findings of our study suggest that the decrease in the number of vestibular sensory cells and dark cells could be the cause of the clinical symptoms of imbalance of some patients with chronic otitis media.
Collapse
Affiliation(s)
- Rafael da Costa Monsanto
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, USA Department of Otolaryngology and Head and Neck Surgery, Banco de Olhos de Sorocaba Hospital, Sorocaba, Brazil
| | - Mehmet Erdil
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, USA Department of Otolaryngology, Head and Neck Surgery, Bagcilar Training and Research Hospital, Istanbul, Turkey
| | - Henrique F Pauna
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, USA Department of Otolaryngology and Head and Neck Surgery, Campinas State University, Campinas, Brazil
| | - Geeyoun Kwon
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, USA
| | - Patricia A Schachern
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, USA
| | - Vladimir Tsuprun
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, USA
| | - Michael M Paparella
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, USA Paparella Ear Head and Neck Institute, Minneapolis, Minnesota, USA
| | - Sebahattin Cureoglu
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, USA
| |
Collapse
|
40
|
Kaya S, Tsuprun V, Hızlı Ö, Schachern PA, Paparella MM, Cureoglu S. Cochlear changes in serous labyrinthitis associated with silent otitis media: A human temporal bone study. Am J Otolaryngol 2016; 37:83-8. [PMID: 26954857 DOI: 10.1016/j.amjoto.2015.10.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2015] [Accepted: 10/03/2015] [Indexed: 11/27/2022]
Abstract
PURPOSE To determine histopathological findings in the cochlea of human temporal bones with serous labyrinthitis. MATERIALS AND METHODS We compared human temporal bones with serous labyrinthitis (20 cases) associated with silent otitis media and without serous labyrinthitis (20 cases) to study location of serous labyrinthitis, the degree of endolymphatic hydrops, number of spiral ganglion cells and hair cells, loss of fibrocytes in the spiral ligament, and areas of the spiral ligament and stria vascularis. RESULTS The serous labyrinthitis caused significant loss of outer hair cells in the lower basal (P=0.006), upper basal (P=0.005), and lower middle (P=0.011) cochlear turns, and significant increase in the degree of endolymphatic hydrops than the control group (P=0.036). No significant difference was found in the loss of inner hair cells, in the number of spiral ganglion cells and fibrocytes in the spiral ligament, and in areas of the stria vascularis and spiral ligament (P>0.05). CONCLUSIONS Serous labyrinthitis resulted in significant loss of outer hair cells and significant increase in the degree of endolymphatic hydrops.
Collapse
|
41
|
Abstract
OBJECTIVES To study the extent to which otitis media (OM) in childhood is associated with adult hearing thresholds. Furthermore, to study whether the effects of OM on adult hearing thresholds are moderated by age or noise exposure. DESIGN Population-based cohort study of 32,786 participants who had their hearing tested by pure-tone audiometry in primary school and again at ages ranging from 20 to 56 years. Three thousand sixty-six children were diagnosed with hearing loss; the remaining sample had normal childhood hearing. RESULTS Compared with participants with normal childhood hearing, those diagnosed with childhood hearing loss caused by otitis media with effusion (n = 1255), chronic suppurative otitis media (CSOM; n = 108), or hearing loss after recurrent acute otitis media (rAOM; n = 613) had significantly increased adult hearing thresholds in the whole frequency range (2 dB/17-20 dB/7-10 dB, respectively). The effects were adjusted for age, sex, and noise exposure. Children diagnosed with hearing loss after rAOM had somewhat improved hearing thresholds as adults. The effects of CSOM and hearing loss after rAOM on adult hearing thresholds were larger in participants tested in middle adulthood (ages 40 to 56 years) than in those tested in young adulthood (ages 20 to 40 years). Eardrum pathology added a marginally increased risk of adult hearing loss (1-3 dB) in children with otitis media with effusion or hearing loss after rAOM. The study could not reveal significant differences in the effect of self-reported noise exposure on adult hearing thresholds between the groups with OM and the group with normal childhood hearing. CONCLUSIONS This cohort study indicates that CSOM and rAOM in childhood are associated with adult hearing loss, underlining the importance of optimal treatment in these conditions. It appears that ears with a subsequent hearing loss after OM in childhood age at a faster rate than those without; however this should be confirmed by studies with several follow-up tests through adulthood.
Collapse
|
42
|
Aarhus L, Tambs K, Hoffman HJ, Engdahl B. Childhood otitis media is associated with dizziness in adulthood: the HUNT cohort study. Eur Arch Otorhinolaryngol 2015; 273:2047-54. [PMID: 26335289 DOI: 10.1007/s00405-015-3764-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 08/21/2015] [Indexed: 11/28/2022]
Abstract
The objective of the study was to examine the association between otitis media in childhood and dizziness in adulthood. Longitudinal, population-based cohort study of 21,962 adults (aged 20-59 years, mean 40) who completed a health questionnaire in the Nord-Trøndelag Hearing Loss Study was conducted. At 7, 10 and 13 years of age, the same individuals underwent screening audiometry in a longitudinal school hearing investigation. Children found with hearing loss underwent an ear, nose and throat specialist examination. Adults diagnosed with childhood chronic suppurative otitis media (n = 102) and childhood hearing loss after recurrent acute otitis media (n = 590) were significantly more likely to have increased risk of reported dizziness when compared to adults with normal hearing as children at the school investigation and also a negative history of recurrent otitis media (n = 21,270), p < 0.05. After adjusting for adult age, sex and socio-economic status, the odds ratios were 2.1 [95 % confidence interval (CI): 1.4-3.3] and 1.3 (95 % CI: 1.0-1.5), respectively. This longitudinal cohort study suggests that childhood chronic suppurative otitis media and childhood hearing loss after recurrent acute otitis media are associated with increased risk of dizziness in adulthood. This might reflect a permanent effect of inflammatory mediators or toxins on the vestibular system. The new finding stresses the importance of treatment and prevention of these otitis media conditions.
Collapse
Affiliation(s)
- Lisa Aarhus
- Division of Mental Health, Department of Psychosomatic and Health Behavior, Norwegian Institute of Public Health, PO Box 4404, Nydalen, 0403, Oslo, Norway.
| | - Kristian Tambs
- Division of Mental Health, Department of Psychosomatic and Health Behavior, Norwegian Institute of Public Health, PO Box 4404, Nydalen, 0403, Oslo, Norway
| | - Howard J Hoffman
- Epidemiology and Statistics Program, Division of Scientific Programs, National Institute on Deafness and Other Communication Disorders (NIDCD), National Institutes of Health (NIH), Bethesda, MD, 20892, USA
| | - Bo Engdahl
- Division of Mental Health, Department of Psychosomatic and Health Behavior, Norwegian Institute of Public Health, PO Box 4404, Nydalen, 0403, Oslo, Norway
| |
Collapse
|
43
|
Wong ACY, Ryan AF. Mechanisms of sensorineural cell damage, death and survival in the cochlea. Front Aging Neurosci 2015; 7:58. [PMID: 25954196 PMCID: PMC4404918 DOI: 10.3389/fnagi.2015.00058] [Citation(s) in RCA: 172] [Impact Index Per Article: 19.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Accepted: 04/05/2015] [Indexed: 12/20/2022] Open
Abstract
The majority of acquired hearing loss, including presbycusis, is caused by irreversible damage to the sensorineural tissues of the cochlea. This article reviews the intracellular mechanisms that contribute to sensorineural damage in the cochlea, as well as the survival signaling pathways that can provide endogenous protection and tissue rescue. These data have primarily been generated in hearing loss not directly related to age. However, there is evidence that similar mechanisms operate in presbycusis. Moreover, accumulation of damage from other causes can contribute to age-related hearing loss (ARHL). Potential therapeutic interventions to balance opposing but interconnected cell damage and survival pathways, such as antioxidants, anti-apoptotics, and pro-inflammatory cytokine inhibitors, are also discussed.
Collapse
Affiliation(s)
- Ann C Y Wong
- Department of Surgery/Division of Otolaryngology, University of California, San Diego School of Medicine La Jolla, CA, USA ; Department of Physiology and Translational Neuroscience Facility, School of Medical Sciences, University of New South Wales Sydney, NSW, Australia
| | - Allen F Ryan
- Department of Surgery/Division of Otolaryngology, University of California, San Diego School of Medicine La Jolla, CA, USA ; Veterans Administration Medical Center La Jolla, CA, USA ; Department of Neurosciences, University of California, San Diego School of Medicine La Jolla, CA, USA
| |
Collapse
|
44
|
Vibromechanical assessment of active middle ear implant stimulation in simulated middle ear effusion: a temporal bone study. Otol Neurotol 2014; 35:470-5. [PMID: 23988990 DOI: 10.1097/mao.0b013e318299aa37] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
HYPOTHESIS Active middle ear implant (AMEI) generated vibromechanical stimulation of the ossicular chain (ossicular chain vibroplasty [OCV]) or the round window (round window vibroplasty [RWV]) is not significantly affected by simulated middle ear effusion in a human temporal bone model. BACKGROUND OCV and RWV may be employed for sensorineural, mixed, and conductive hearing losses. Although middle ear effusions may be encountered across patient populations, little is known about how effusions may affect AMEI vibromechanical efficiency. METHODS Laser Doppler vibrometry of stapes velocities (SVs) were performed in a human temporal bone model of simulated effusion (N = 5). Baseline measurements to acoustic sinusoidal stimuli, OCV, and RWV (0.25-8 kHz) were made without effusion. The measurements were repeated with simulated middle ear effusion and compared with baseline measurements. Data were analyzed across 3 frequency bands: low (0.25-1 kHz), medium (1-3 kHz), and high (3-8 kHz). RESULTS Acoustic stimulation with simulated middle ear effusion resulted in a significant (p < 0.001) frequency-dependent attenuation of SVs of 4, 10, and 7 dB (low, medium, and high ranges, respectively). OCV in simulated effusion resulted in attenuated SVs of 1, 5, and 14 dB (low, medium, and high) compared to without effusion; however, this attenuation was not significant (p = 0.07). Interestingly, in the setting of RWV, simulated effusion resulted in significantly (p = 0.001) increased SVs of 16, 11, and 8 dB (low, medium, and high). A 3-dB variance in AMEI efficiency was observed in repeated measurements in a single temporal bone. CONCLUSION The efficiency of OCV was not significantly affected by the presence of a middle ear effusion. Improved efficiency, however, was observed with RWV.
Collapse
|
45
|
Al-Malky G, Dawson SJ, Sirimanna T, Bagkeris E, Suri R. High-frequency audiometry reveals high prevalence of aminoglycoside ototoxicity in children with cystic fibrosis. J Cyst Fibros 2014; 14:248-54. [PMID: 25127922 DOI: 10.1016/j.jcf.2014.07.009] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Revised: 07/06/2014] [Accepted: 07/23/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Intravenous aminoglycoside (IV AG) antibiotics, widely used in patients with cystic fibrosis (CF), are known to have ototoxic complications. Despite this, audiological monitoring is not commonly performed and if performed, uses only standard pure-tone audiometry (PTA). The aim of this study was to investigate ototoxicity in CF children, to determine the most appropriate audiological tests and to identify possible risk factors. METHODS Auditory assessment was performed in CF children using standard pure tone audiometry (PTA), extended high-frequency (EHF) audiometry and distortion-product otoacoustic emissions (DPOAE). RESULTS 70 CF children, mean (SD) age 10.7 (3.5) years, were recruited. Of the 63 children who received IV AG, 15 (24%) children had ototoxicity detected by EHF audiometry and DPOAE. Standard PTA only detected ototoxicity in 13 children. Eleven of these children had received at least 10 courses of IV AG courses. A 25 to 85 dBHL hearing loss (mean±SD: 57.5±25.7 dBHL) across all EHF frequencies and a significant drop in DPOAE amplitudes at frequencies 4 to 8 kHz were detected. However, standard PTA detected a significant hearing loss (>20 dBHL) only at 8 kHz in 5 of these 15 children and none in 2 subjects who had significantly elevated EHF thresholds. The number of courses of IV AG received, age and lower lung function were shown to be risk factors for ototoxicity. CONCLUSIONS CF children who had received at least 10 courses of IV AG had a higher risk of ototoxicity. EHF audiometry identified 2 more children with ototoxicity than standard PTA and depending on facilities available, should be the test of choice for detecting ototoxicity in children with CF receiving IV AG.
Collapse
Affiliation(s)
- Ghada Al-Malky
- University College London Ear Institute, 332 Gray's Inn Road, London WC1X 8EE, UK.
| | - Sally J Dawson
- University College London Ear Institute, 332 Gray's Inn Road, London WC1X 8EE, UK
| | - Tony Sirimanna
- Department of Audiology & Audiological Medicine, Great Ormond Street Hospital, London WC1N 3JH, UK
| | - Emmanouil Bagkeris
- MRC Centre of Epidemiology for Child Health, UCL Institute of Child Health, University College London, London WC1N 1EH, UK
| | - Ranjan Suri
- Department of Paediatric Respiratory Medicine, Great Ormond Street Hospital, London WC1N 3JH, UK
| |
Collapse
|
46
|
|
47
|
Tikhomirova A, Kidd SP. Haemophilus influenzae and Streptococcus pneumoniae: living together in a biofilm. Pathog Dis 2013; 69:114-26. [PMID: 23913525 DOI: 10.1111/2049-632x.12073] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2013] [Revised: 07/25/2013] [Accepted: 07/25/2013] [Indexed: 11/27/2022] Open
Abstract
Streptococcus pneumoniae and Haemophilus influenzae are both commensals of the human nasopharynx with an ability to migrate to other niches within the human body to cause various diseases of the upper respiratory tract such as pneumonia, otitis media and bronchitis. They have long been detected together in a multispecies biofilm in infected tissue. However, an understanding of their interplay is a recent field of study, and while over recent years, there has been research that has identified many specific elements important in these biofilms, to date, it remains questionable whether the relationship between H. influenzae and S. pneumoniae is competitive or cooperative. Additionally, the factors that govern the nature of the interspecies interaction are still undefined. This review aims to collate the information that has emerged on the cocolonization and co-infection by S. pneumoniae and nontypeable H. influenzae (NTHi) and their formation of a multispecies biofilm.
Collapse
Affiliation(s)
- Alexandra Tikhomirova
- Research Centre for Infectious Disease, School of Molecular and Biomedical Science, The University of Adelaide, Adelaide, SA, Australia
| | | |
Collapse
|
48
|
Moore DR, Hunter LL. Auditory processing disorder (APD) in children: A marker of neurodevelopmental syndrome. HEARING BALANCE AND COMMUNICATION 2013. [DOI: 10.3109/21695717.2013.821756] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
|
49
|
A longitudinal study of hearing and middle ear status in adolescents with cleft lip and palate. Laryngoscope 2012. [DOI: 10.1002/lary.23839] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
|
50
|
Oh S, Woo JI, Lim DJ, Moon SK. ERK2-dependent activation of c-Jun is required for nontypeable Haemophilus influenzae-induced CXCL2 upregulation in inner ear fibrocytes. THE JOURNAL OF IMMUNOLOGY 2012; 188:3496-505. [PMID: 22379036 DOI: 10.4049/jimmunol.1103182] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The inner ear, composed of the cochlea and the vestibule, is a specialized sensory organ for hearing and balance. Although the inner ear has been known as an immune-privileged organ, there is emerging evidence indicating an active immune reaction of the inner ear. Inner ear inflammation can be induced by the entry of proinflammatory molecules derived from middle ear infection. Because middle ear infection is highly prevalent in children, middle ear infection-induced inner ear inflammation can impact the normal development of language and motor coordination. Previously, we have demonstrated that the inner ear fibrocytes (spiral ligament fibrocytes) are able to recognize nontypeable Haemophilus influenzae, a major pathogen of middle ear infection, and upregulate a monocyte-attracting chemokine through TLR2-dependent NF-κB activation. In this study, we aimed to determine the molecular mechanism involved in nontypeable H. influenzae-induced cochlear infiltration of polymorphonuclear cells. The rat spiral ligament fibrocytes were found to release CXCL2 in response to nontypeable H. influenzae via activation of c-Jun, leading to the recruitment of polymorphonuclear cells to the cochlea. We also demonstrate that MEK1/ERK2 signaling pathway is required for nontypeable H. influenzae-induced CXCL2 upregulation in the rat spiral ligament fibrocytes. Two AP-1 motifs in the 5'-flanking region of CXCL2 appeared to function as a nontypeable H. influenzae-responsive element, and the proximal AP-1 motif was found to have a higher binding affinity to nontypeable H. influenzae-activated c-Jun than that of the distal one. Our results will enable us better to understand the molecular pathogenesis of middle ear infection-induced inner ear inflammation.
Collapse
Affiliation(s)
- Sejo Oh
- Division of Clinical and Translational Research, House Research Institute, Los Angeles, CA 90057, USA
| | | | | | | |
Collapse
|