In the present study, pure-tone audiometry was used in 687 Finnish school children, aged 6-15 years, to determine the prevalence of a 6 kHz acoustic dip and related factors among three age groups. Trained audiometricians tested air conduction thresholds in a sound-proof room. A total of 57 children (8.3%) had a clear-cut dip of at least 20 dB at 6 kHz. This dip was more pronounced in older children and in boys. A thorough case history was obtained by questionnaire, with logistic regression analysis showing that low birth weight (
Department of Otorhinolaryngology, Head and Neck Surgery, Research Laboratory, University Hospital, Rigshospitalet, Copenhagen, Denmark. steen.olsen@rh.regionh.dk
The acceptable noise level (ANL) test is used for quantification of the amount of background noise subjects accept when listening to speech. This study investigates Danish hearing-aid users' ANL performance using Danish and non-semantic speech signals, the repeatability of ANL, and the association between ANL and outcome of the international outcome inventory for hearing aids (IOI-HA).
ANL was measured in three conditions in both ears at two test sessions. Subjects completed the IOI-HA and the ANL questionnaire.
Sixty-three Danish hearing-aid users; fifty-seven subjects were full time users and 6 were part time/non users of hearing aids according to the ANL questionnaire.
ANLs were similar to results with American English speech material. The coefficient of repeatability (CR) was 6.5-8.8 dB. IOI-HA scores were not associated to ANL.
Danish and non-semantic ANL versions yield results similar to the American English version. The magnitude of the CR indicates that ANL with Danish and non-semantic speech materials is not suitable for prediction of individual patterns of future hearing-aid use or evaluation of individual benefit from hearing-aid features. The ANL with Danish and non-semantic speech materials is not related to IOI-HA outcome.
Research Laboratory, Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital, Rigshospitalet, Copenhagen, Denmark. steen.olsen@rh.regionh.dk
The acceptable noise level (ANL) is used to quantify the amount of background noise that subjects can accept while listening to speech, and is suggested for prediction of individual hearing-aid use. The aim of this study was to assess the repeatability of the ANL measured in normal-hearing subjects using running Danish and non-semantic speech materials as stimuli and modulated speech-spectrum and multi-talker babble noises as competing stimuli.
ANL was measured in both ears at two test sessions separated by a period ranging from 12 to 77 days. At each session the measurements at the first and the second ear were separated in time by 15-30 minutes. Bland-Altman plots and calculation of the coefficient of repeatability (CR) were used to estimate the repeatability.
Thirty nine normal-hearing subjects.
The ANL CR was 6.0-8.9 dB for repeated tests separated by about 15-30 minutes and 7.2-10.2 dB for repeated tests separated by 12 days or more.
The ANL test has poor repeatability when assessed with Danish and non-semantic speech materials on normal-hearing subjects. The same CR among hearing-impaired subjects would imply too poor repeatability to predict individual patterns of future hearing-aid use.
The acceptable noise level (ANL) test is a method for quantifying the amount of background noise that subjects accept when listening to speech. Large variations in ANL have been seen between normal-hearing subjects and between studies of normal-hearing subjects, but few explanatory variables have been identified.
To explore a possible relationship between a Swedish version of the ANL test, working memory capacity (WMC), and auditory evoked potentials (AEPs).
ANL, WMC, and AEP were tested in a counterbalanced order across subjects.
Twenty-one normal-hearing subjects participated in the study (14 females and 7 males; aged 20-39 yr with an average of 25.7 yr).
Reported data consists of age, pure-tone average (PTA), most comfortable level (MCL), background noise level (BNL), ANL (i.e., MCL - BNL), AEP latencies, AEP amplitudes, and WMC. Spearman's rank correlation coefficient was calculated between the collected variables to investigate associations. A principal component analysis (PCA) with Varimax rotation was conducted on the collected variables to explore underlying factors and estimate interactions between the tested variables. Subjects were also pooled into two groups depending on their results on the WMC test, one group with a score lower than the average and one with a score higher than the average. Comparisons between these two groups were made using the Mann-Whitney U-test with Bonferroni correction for multiple comparisons.
A negative association was found between ANL and WMC but not between AEP and ANL or WMC. Furthermore, ANL is derived from MCL and BNL, and a significant positive association was found between BNL and WMC. However, no significant associations were seen between AEP latencies and amplitudes and the demographic variables, MCL, and BNL. The PCA identified two underlying factors: One that contained MCL, BNL, ANL, and WMC and another that contained latency for wave Na and amplitudes for waves V and Na-Pa. Using the variables in the first factor, the findings were further explored by pooling the subjects into two groups according to their WMC (WMClow and WMChigh). It was found that the WMClow had significantly poorer BNL than the WMChigh.
The findings suggest that there is a strong relationship between BNL and WMC, while the association between MCL, ANL, and WMC seems less clear-cut.
OBJECTIVES: To analyze changes in tympanometric measures with age and to study some otitis-related issues in the elderly (> or = 60 years) population. MATERIAL AND METHODS: The study was designed as a combination of a cross-sectional survey and a controlled study. We studied a random sample of 232 elderly subjects using an extended battery of audiological tests, including pure-tone audiometry. tympanometry with a probe frequency of 226 Hz, otomicroscopy and a standardized questionnaire. A sample of 60 otologically normal subjects were selected for comparative analysis with young healthy controls, and for description of age-related changes and gender differences. RESULTS: Using linear regression analyses of ear canal volume, middle ear pressure and tympanic membrane compliance on age, no consistently significant change in these parameters with age was found. When these measures were compared between the elderly and the controls, using parametric and non-parametric statistical tests, no significant differences were found for either gender. The only significant gender difference was found for ear canal volume, which was greater for elderly males than for elderly females In the unscreened elderly sample, the adjusted prevalence for reported previous or current otitis media was 15-27% of the population (95% CI). The adjusted prevalence for reported previous or current chronic otitis media (COM) or sequelae thereof was 1-7% (95% CI). With the exception of cerumen obstruction, the prevalence of outer ear canal-related complaints was 1-7% (95% CI). There were some discrepancies between these reported complaints and the findings at otomicroscopy. Although elderly subjects with COM were found to have poorer hearing at speech frequencies than normal elderly subjects. no such effect was found in subjects with scarring or atrophy of the tympanic membrane. The effect of pathological findings at otomicroscopy on tympanometric measures in the elderly sample was highly variable and no consistent association was found. CONCLUSIONS: No change in middle ear sound transmission, as assessed by tympanometry, occurs with normal aging. Ear canal volume is smaller in elderly females than elderly males, which is potentially relevant to the study of otoacoustic emissions in the elderly. The estimated prevalence of ear canal-related problems, excluding cerumen obstruction, is of such a magnitude that the introduction of partially implanted hearing aids may be warranted in our elderly population.
Air space reduction tympanomastoidectomy improves outcomes over tympanoplasty in repairing tympanic membrane perforations in the presence of unfavorable risk factors.
Retrospective review of 67 subjects' 87 operations.
Interventions were tympanoplasty versus air space reduction tympanomastoidectomy. Risk factors were contracted mastoid air cells, previous failed operations, descent from the indigenous peoples of the Americas, and middle/ear mastoid volumes l
We carried out an audiological survey of 204 officers at an infantry regiment in southern Sweden. The officers were exposed to impulse noise from firearms with peak levels up to 185 dB (SPL). The audiological measurement results were summarized in four age-groups, all of which showed significant hearing loss compared to ISO 1999 (1990) database A of a non-noise-exposed male population. Even officers who claimed regular use of hearing protectors during their entire military career showed these significant hearing losses. In the survey we also studied the association of the hearing thresholds with subjective exposure to heavy detonations and the annoyance of tinnitus. We found a significant relation between exposure to heavy detonations and tinnitus.
Results from a database for sudden sensorineural hearing loss (SSNHL) demonstrate no correlation between laboratory findings, treatment, and outcome in 400 patients. The patients with pathological test results were not treated differently from those with normal test results. The value of laboratory findings and MRI might increase if the results are categorized to more specific diagnoses.
To investigate diagnostic test batteries for SSNHL and evaluate their value in the management of idiopathic SSNHL.
A total of 400 patients submitted to the Swedish national database for SSNHL were analyzed. Information was collected about the patient's past medical history, potential precipitating events, trauma, medical history, hearing loss, current disease, diagnostic protocol, and treatment, using questionnaires as well as two audiograms, one at the first ENT clinic visit and another 3 months later.
In all, 65% of these 400 patients underwent hematological tests and 40% had an MRI/CT scan. Twenty-two of 160 MRI investigated had pathological findings including 5 acoustic neuromas. Also, 300 of these 400 patients were evaluated as having idiopathic sudden sensorineural hearing loss (ISSNHL); 24% of them had one or more pathological test results. No significant correlation was found between either the MRI findings or the laboratory findings with regard to treatment or hearing recovery in patients with ISSNHL.
The aim of this study was to assess hearing and hearing disorders among rock/jazz musicians. One hundred and thirty-nine (43 women and 96 men) musicians participated. The results are based on pure-tone audiometry and questionnaire responses. According to our definition of hearing loss, tinnitus, hyperacusis, distortion and/or diplacusis as hearing disorders, we found disorders in 74%, of the rock/jazz musicians studied. Hearing loss, tinnitus and hyperacusis were most common, and the latter two were found significantly more frequently than in different reference populations. The women showed bilateral, significantly better hearing thresholds at 3-6 kHz than the men. Hyperacusis, and the combination of both hyperacusis and tinnitus, were found to be significantly more frequent among women than among men. Hearing loss and tinnitus were significantly more common among men than among women. It is important to evaluate all kinds of hearing problems (other than hearing loss) in musicians, since they represent an occupational group especially dependent on optimal, functional hearing. On the basis of our results, we suggest that hearing problems such as tinnitus, hyperacusis, distortion and/or diplacusis should, in addition to hearing loss, be defined as hearing disorders.
The association between childhood hearing disorders and adult tinnitus has not been examined in longitudinal cohort studies.
To determine the association between different types of childhood hearing loss and tinnitus in adulthood and evaluate whether tinnitus risk is mediated by adult hearing loss.
Population-based cohort study of 32?430 adults (aged 20-56 years) who underwent pure-tone audiometry and completed a tinnitus questionnaire in the Nord-Trøndelag Hearing Loss Study, which was a part of the Nord-Trøndelag Health Study 2 (HUNT2). The study was conducted from January 1, 2014, to April 1, 2015. Data analysis was performed from April 1, 2014, to April 1, 2015. As children, the same individuals had undergone screening audiometry in a longitudinal primary school hearing investigation, including ear, nose, and throat examinations when indicated.
Pure-tone audiometry, questionnaires, and ear, nose, and throat examinations.
Self-reported tinnitus (yes or no) in adulthood measured by questionnaires.
Adults who had hearing loss at the time of the school investigation (n?=?3026) reported more tinnitus, measured as odds ratio (95% CI), than did adults with normal childhood hearing (n?=?29?404) (1.4 [1.3-1.6]). Childhood hearing disorders associated with tinnitus in adulthood included sensorineural hearing loss, chronic suppurative otitis media, and hearing loss associated with a history of recurrent acute otitis media (2.4 [1.9-3.0], 2.4 [1.5-3.9], and 1.6 [1.3-2.0], respectively). These estimates were adjusted for age, sex, and noise exposure in adulthood. After further analyses that included adjustment for adult hearing threshold, none of these childhood hearing disorders remained positively associated with tinnitus.
Childhood hearing disorders associated with tinnitus in adulthood include sensorineural hearing loss, chronic suppurative otitis media, and hearing loss associated with a history of recurrent acute otitis media. After adjustment for the adult hearing threshold, none of the childhood hearing disorders was positively associated with tinnitus. Hence, it appears that these significant associations are mediated or transmitted through adult hearing loss.
