Early Detection of High-frequency Presbycusis Among Normal Hearing Individuals

Construction and Effect of the Three-Level and Two-Stage Screening Mode for Age-Related Hearing Loss: A Study Based on the Community in Shanghai, China

Background

There is a high incidence rate of age-related hearing loss. Severe hearing loss may increase the prevalence of mental illness, cognitive impairment, and even the risk of all-cause death.

Purpose

Construction of the three-level and two-stage screening mode for age-related hearing loss of the community and to evaluate its effectiveness.

Materials and Methods

A total of 401 participants (aged 60 years or older) from five typical communities were enrolled in the study. The risk factors assessment of age-related hearing loss was completed by using a cross-sectional survey and receiver operating characteristic (ROC) curve. Multiple screening method was adopted and verified by serial and parallel tests, respectively. Based on research data, incorporate risk factors assessment, the Hearing Handicap Inventory for the Elderly Screening Version (HHIE-s) and pure tone audiometry (PTA) were used to construct the screening mode.

Results

Multiple screening series testing and multiple screening parallel testing, including risk factors assessment, HHIE-s, and PTA, were used for verification: the sensitivity, specificity, and Kappa index were 70.5% and 9.2%, 95.0% and 71.6%, 0.26 and 0.63, respectively. Finally, the three-level and two-stage screening mode for age-related hearing loss was established. "Three-level" was defined as the risk factors assessment/HHIE-s (high-risk population), PTA (suspect population), and comprehensive hearing loss assessment (confirmed population). "Two-stage" was defined as the population screening by general practitioner in the community and target screening by otolaryngologist of the tertiary hospitals.

Conclusion

The three-level and two-stage screening mode for age-related hearing loss consists of the following framework: from population screening to target screening, from suspicious diagnosis to accurate diagnosis, from primary health care to tertiary hospitals. The study objective is to structure a new secondary prevention and treatment mode for age-related hearing loss with primary health care as the core, so as to help the front-end management of healthy aging.

Analysis of Factors Affecting Cranial Nerve Function of Patients With Vascular Mild Cognitive Impairment Through Functional Magnetic Resonance Imaging Under Artificial Intelligence Environment

The study aimed to explore the risk factors of effects of patients with vascular mild cognitive impairment (VaMCI) through functional magnetic resonance imaging (fMRI). In this study, 62 patients were selected from the department of neurology, admitted to Changzhi People's Hospital from October 1, 2018 to February 1, 2020. Patients with VaMCI were defined as the VaMCI group according to Clinical Dementia Rating (CDR), and subjects with normal cognitive function were defined as the normal control (NC) group. All patients underwent fMRI to identify the amplitude low-frequency fluctuation (ALFF) and regional homogeneity (ReHo) values, and to analyze their association with VaMCI. The results showed that the VaMCI group had lower scores for Mini-mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and their subitems (visual space and execution, recall, attention and computation, and language ability) than NC group, with statistical differences (P < 0.05). In VaMCI group, the brain regions with increased ALFF values were the left temporal lobe, left parietal lobe, right temporal lobe, right parietal lobe, and posterior cingulate gyrus. Of them, the left parietal lobe and right temporal lobe were negatively correlated with the recall score on MMSE scale (r = -0.216, r = -0.132, P < 0.01). In VaMCI group, the brain regions with decreased ReHo values were the left temporal lobe, occipital lobe, and left middle temporal gyrus. Of them, the left temporal lobe and occipital lobe were positively correlated with MoCA score (r = 0.473, r = 0.848, P < 0.01). In conclusion, VaMCI patients have cognitive impairment and abnormally increased spontaneous brain activity, especially in the left parietal lobe and the right temporal lobe. At rest, VaMCI patients show decreased whole-brain ReHo in the left medial temporal lobe and occipital lobe. Hypertension is a high-risk factor for cognitive impairment in VaMCI patients. The study can provide a theoretical basis for early diagnosis of VaMCI.

Extended high frequency hearing loss in tinnitus-positive chronic suppurative otitis media patient

OBJECTIVES

To determine the association between extended high frequency hearing loss and tinnitus in normal cochlear function based on a conventional audiometry chronic suppurative otitis media (CSOM) patient.

DESIGN AND METHODS

A cross-sectional study was conducted on 220 ears diagnosed as having CSOM with an equal number of tinnitus and without tinnitus groups. Only those with normal cochlear function based on conventional pure tone audiometry (250 Hz to 8 kHz) were included. They were further tested for hearing at extended high frequencies of up to 16 kHz. The severity of tinnitus was tested using a tinnitus questionnaire.

RESULTS

The prevalence of extended high frequency hearing loss in the normal cochlear function CSOM patients with tinnitus was 81.8% (95% CI 74.5%, 89.1%), whereas the prevalence in the tinnitus negative group was 30.0% (95% CI 21.3%, 38.7%). There was a significant association between extended high frequency hearing loss and tinnitus in CSOM patients (P < .001). The average thresholds were significantly higher in the tinnitus group at all extended high frequencies tested with an increasing trend of significance toward the higher frequencies. However, this study did not observe any association between the severity of tinnitus and extended high frequency hearing loss.

CONCLUSION

The development of tinnitus among normal cochlear function CSOM patients indicates that the damage has occurred at a higher frequency level. However, the severity of tinnitus does not predict the degree of higher frequency hearing loss. Therefore, the presence of tinnitus warrants more aggressive monitoring and treatment to prevent sensorineural hearing loss from developing into the speech frequencies.

LEVEL OF EVIDENCE

4.

Vestibular status: A missing factor in our understanding of brain reorganization in deaf individuals

The brain of deaf people is definitely not just deaf, and we have to reconsider what we know about the impact of hearing loss on brain development in light of comorbid vestibular impairments.