Comparison of Pure-Tone Average Methods for Estimation of Hearing Loss Caused by Environmental Exposure to Lead and Cadmium: Does the Pure-Tone Average Method Which Uses Low-Frequency Ranges Underestimate the Actual Hearing Loss Caused by Environmental Lead and Cadmium Exposure?

Previous studies have reported that exposure to lead and cadmium can damage the inner ear receptor, which perceives high-frequency sounds. However, few studies have used the pure-tone average (PTA), including high-frequency ranges, for the estimation of hearing loss caused by lead and cadmium exposure. We estimated hearing loss using the PTA test, in low-frequency, speech frequency, and high-frequency ranges and compared the differences in the results using 3 PTA calculation methods. We analyzed the data of 2,387 participants, between the ages of 19 and 85 years, that were obtained from the Korea National Health and Nutrition Examination Survey (KNHANES) of 2010–2012. A dose-response relationship between hearing loss and heavy metal exposure was observed in the high-frequency method after adjustment for confounding factors. When using the high-frequency PTA, it was found that doubling of the levels of lead and cadmium in the blood was associated with a 1.88- (95% CI 1.11–3.17) and 1.89-fold (95% CI 1.02–3.50) increase in the OR for hearing loss. In the case of the low-frequency and speech frequency PTA, however, there were no significant relationships between hearing loss and the concentrations of lead and cadmium in the blood. The outcomes of the present study suggest that the estimation of hearing loss caused by environmental exposure to lead and cadmium is affected by the frequencies used in the PTA calculation.

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Impacts of Diabetes, Aging, and Hearing Loss on Speech-on-Speech Masking and Spatial Release in a Large Veteran Cohort

American Journal of Audiology ◽

10.1044/2021_aja-21-00022 ◽

2021 ◽

pp. 1-14

Author(s):

Sarah M. Theodoroff ◽

Frederick J. Gallun ◽

Garnett P. McMillan ◽

Michelle Molis ◽

Nirmal Srinivasan ◽

...

Keyword(s):

Hearing Loss ◽

Pure Tone ◽

Mixed Model ◽

Linear Mixed Model ◽

Low Frequency ◽

Correct Identification ◽

Speech Understanding ◽

Impaired Hearing ◽

Pure Tone Average ◽

Spatial Release

Purpose Type 2 diabetes mellitus (DM2) is associated with impaired hearing. However, the evidence is less clear if DM2 can lead to difficulty understanding speech in complex acoustic environments, independently of age and hearing loss effects. The purpose of this study was to estimate the magnitude of DM2-related effects on speech understanding in the presence of competing speech after adjusting for age and hearing. Method A cross-sectional study design was used to investigate the relationship between DM2 and speech understanding in 190 Veterans ( M age = 47 years, range: 25–76). Participants were classified as having no diabetes ( n = 74), prediabetes ( n = 19), or DM2 that was well controlled ( n = 24) or poorly controlled ( n = 73). A test of spatial release from masking (SRM) was presented in a virtual acoustical simulation over insert earphones with multiple talkers using sentences from the coordinate response measure corpus to determine the target-to-masker ratio (TMR) required for 50% correct identification of target speech. A linear mixed model of the TMR results was used to estimate SRM and separate effects of diabetes group, age, and low-frequency pure-tone average (PTA-low) and high-frequency pure-tone average. A separate model estimated the effects of DM2 on PTA-low. Results After adjusting for hearing and age, diabetes-related effects remained among those whose DM2 was well controlled, showing an SRM loss of approximately 0.5 dB. Results also showed effects of hearing loss and age, consistent with the literature on people without DM2. Low-frequency hearing loss was greater among those with DM2. Conclusions In a large cohort of Veterans, low-frequency hearing loss and older age negatively impact speech understanding. Compared with nondiabetics, individuals with controlled DM2 have additional auditory deficits beyond those associated with hearing loss or aging. These results provide a potential explanation for why individuals who have diabetes and/or are older often report difficulty understanding speech in real-world listening environments. Supplemental Material https://doi.org/10.23641/asha.16746475

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Validity of Hearing Thresholds Obtained from the Rising Portion of the Audiogram in Sensorineural Hearing Loss

Journal of Speech Language and Hearing Research ◽

10.1044/jshr.2702.206 ◽

1984 ◽

Vol 27 (2) ◽

pp. 206-211 ◽

Cited By ~ 4

Author(s):

Larry E. Humes ◽

Anne Marie Tharpe ◽

Gene W. Bratt

Keyword(s):

Hearing Loss ◽

Sensorineural Hearing Loss ◽

Recent Work ◽

High Frequency ◽

Pure Tone ◽

Low Frequency ◽

Sensorineural Hearing ◽

Test Frequency ◽

Hearing Thresholds

Two experiments were performed for this study. The purpose of both experiments was to examine the validity of pure-tone hearing thresholds obtained near the rising portion of a sensorineural hearing loss. Recent work by other investigators has suggested that thresholds obtained near the rising portion of the audiogram may not correspond to the severity of damage at the cochlear place associated with the test frequency. In the first experiment this issue was addressed in 11 subjects having low frequency sensorineural hearing loss, whereas 12 subjects (19 ears) having notch-shaped high-frequency sensorineural hearing losses were examined in the second experiment. The results indicated that thresholds obtained from the rising portion of the audiometric configuration were, in most instances, determined by sensitivity at the test frequency. An exception to this generalization involved low-frequency sensorineural hearing loss with a slope for the rising portion of the audiogram exceeding -25 dB/octave. In these cases the severity of the loss may be underestimated for test frequencies immediately adjacent to the rising portion of the audiogram.

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Prospective Study of Dietary Patterns and Hearing Threshold Elevation

American Journal of Epidemiology ◽

10.1093/aje/kwz223 ◽

2019 ◽

Vol 189 (3) ◽

pp. 204-214

Author(s):

Sharon G Curhan ◽

Christopher Halpin ◽

Molin Wang ◽

Roland D Eavey ◽

Gary C Curhan

Keyword(s):

Hearing Loss ◽

Prospective Study ◽

Dietary Patterns ◽

High Frequency ◽

Pure Tone ◽

Low Frequency ◽

Threshold Elevation ◽

Diet Adherence ◽

Hearing Thresholds ◽

Frequency Threshold

Abstract We conducted a prospective study of dietary patterns and longitudinal change in audiometric hearing thresholds among 3,135 women (mean age = 59 years) in the Nurses’ Health Study II (2012–2018). Diet adherence scores for the Dietary Approaches to Stop Hypertension (DASH) and Alternate Mediterranean (AMED) diets and the Alternate Healthy Eating Index 2010 (AHEI-2010) were calculated using validated food-frequency questionnaires. Baseline and 3-year follow-up hearing sensitivities were assessed by pure-tone audiometry at 19 US sites. We used multivariable-adjusted logistic regression models to examine independent associations between diet adherence scores and risk of ≥5 dB elevation in the pure-tone average (PTA) of low-frequency (LPTA0.5,1,2 kHz), mid-frequency (MPTA3,4 kHz), and high-frequency (HPTA6,8 kHz) hearing thresholds. Higher adherence scores were associated with lower risk of hearing loss. Compared with the lowest quintile of DASH score, the multivariable-adjusted odds ratios for mid-frequency and high-frequency threshold elevation in the highest quintile were 0.71 (95% confidence interval (CI): 0.55, 0.92; P for trend = 0.003) and 0.75 (95% CI: 0.59, 0.96; P for trend = 0.02); for AMED and AHEI scores, for mid-frequency threshold elevation, they were 0.77 (95% CI: 0.60, 0.99; P for trend = 0.02) and 0.72 (95% CI: 0.57, 0.92; P for trend = 0.002). Nonsignificant inverse associations were observed for high-frequency threshold elevation. There were no significant associations between adherence scores and low-frequency threshold elevation. Our findings indicate that eating a healthy diet might reduce the risk of acquired hearing loss.

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Factors Affecting Hearing Aid Adoption by Adults With High-Frequency Hearing Loss: The Beaver Dam Offspring Study

American Journal of Audiology ◽

10.1044/2021_aja-21-00050 ◽

2021 ◽

pp. 1-9

Author(s):

Jacqueline M. Weycker ◽

Lauren K. Dillard ◽

Alex Pinto ◽

Mary E. Fischer ◽

Karen J. Cruickshanks ◽

...

Keyword(s):

Hearing Loss ◽

High Frequency ◽

Pure Tone ◽

Middle Age ◽

Hearing Aid ◽

Factors Associated ◽

Pure Tone Average ◽

Beaver Dam ◽

Hearing Handicap ◽

The Impact

Purpose Hearing loss (HL) is common among middle-age and older adults, but hearing aid adoption is low. The purpose of this study was to measure the 10-year incidence of hearing aid adoption in a sample of primarily middle-age adults with high-frequency HL and identify factors associated with hearing aid adoption. Method This study included 579 adults (ages 34–80 years) with high-frequency pure-tone average > 25 dB HL (3–8 kHz) enrolled in the Beaver Dam Offspring Study. Hearing aid adoption was measured at 5- and 10-year follow-up examinations. Cox discrete-time proportional hazards models were used to evaluate factors associated with hearing aid adoption (presented as hazards ratios [HRs] and 95% confidence intervals [95% CI]). Results The 10-year cumulative incidence of hearing aid adoption was 14 per 1,000 person years. Factors significantly associated with adoption in a multivariable model were higher education (vs. 16+ years; 0–12: HR: 0.36, 95% CI [0.19, 0.69]; 13–15: HR: 0.52, 95% CI [0.27, 0.98]), worse high-frequency pure-tone average (per +1 dB; HR: 1.04, 95% CI [1.02, 1.06]), self-reported hearing handicap (screening versions of the Hearing Handicap Inventory score > 8; HR: 1.85, 95% CI [1.02, 3.38]), answering yes to “Do friends and relatives think you have a hearing problem?” (HR: 3.18, 95% CI [1.60, 6.33]) and using closed captions (HR: 2.86, 95% CI [1.08, 7.57]). Effects of age and sex were not significant. Conclusions Hearing aid adoption rates were low. Hearing sensitivity, socioeconomic status, and measures of the impact of HL on daily life were associated with adoption. Provider awareness of associated factors can contribute to timely and appropriate intervention.

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Modeling Hearing Loss Progression and Asymmetry in the Older Old: A National Population-Based Survey

Innovation in Aging ◽

10.1093/geroni/igaa057.693 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 214-215

Author(s):

Rahul Sharma ◽

Anil Lalwani ◽

Justin Golub

Keyword(s):

Hearing Loss ◽

Pure Tone ◽

Population Level ◽

Population Based ◽

National Database ◽

Cross Sectional ◽

Adult Lifespan ◽

Pure Tone Average ◽

Age Related ◽

Public Datasets

Abstract The progression and asymmetry of age-related hearing loss has not been well characterized in those 80 years of age and older because public datasets mask upper extremes of age to protect anonymity. We aimed to model the progression and asymmetry of hearing loss in the older old using a representative, national database. This was a cross-sectional, multicentered US epidemiologic analysis using the National Health and Nutrition Examination Study (NHANES) 2005-2006, 2009-2010, and 2011-2012 cycles. Subjects included non-institutionalized, civilian adults 80 years and older (n=621). Federal security clearance was granted to access publicly-restricted age data. Outcome measures included pure-tone average air conduction thresholds and the 4-frequency pure tone average (PTA). 621 subjects were 80 years old or older (mean=84.2 years, range=80-104 years), representing 10,600,197 Americans. Hearing loss exhibited constant acceleration across the adult lifespan at a rate of 0.0052 dB/year2 (95% CI = 0.0049, 0.0055). Compounded over a lifetime, the velocity of hearing loss would increase five-fold, from 0.2 dB loss/year at age 20 to 1 dB loss/year at age 100. This model predicted mean PTA within 2 dB of accuracy for most ages between 20 and 100 years. There was no change in the asymmetry of hearing loss with increasing age over 80 years (linear regression coefficient of asymmetry over age=0.07 (95% CI=-0.01, 0.24). In conclusion, hearing loss steadily and predictably accelerates across the adult lifespan to at least age 100, becoming near-universal. These population-level statistics will guide treatment and policy recommendations for hearing health in the older old.

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Ossicular Discontinuity and Exostoses in Proteus Syndrome: A Case Report

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348940511400314 ◽

2005 ◽

Vol 114 (3) ◽

pp. 242-246

Author(s):

Joni K. Doherty ◽

Dennis R. Maceri

Keyword(s):

Hearing Loss ◽

High Frequency ◽

Conductive Hearing Loss ◽

Ossicular Chain ◽

Typical Feature ◽

Proteus Syndrome ◽

Frequency Range ◽

Pure Tone Average ◽

Ossicular Chain Reconstruction ◽

Conductive Hearing

Proteus syndrome (PS) is a rare hamartomatous disorder characterized by mosaic overgrowth of multiple tissues that manifests early in life and is progressive. The presence of unilateral external auditory canal exostoses in a patient who is not a swimmer or surfer is suggestive of PS. However, hearing loss is not a typical feature. Here, we describe exostoses and ossicular discontinuity with conductive hearing loss in a patient with PS. The treatment consisted of canalplasty and ossicular chain reconstruction. A postoperative reduction was demonstrated in the patient's air-bone gap, from 21 dB to 13 dB for the pure tone average (four frequencies) and from 41 dB to 15 dB in the high-frequency range (6,000 to 8,000 Hz). Causes of ossicular discontinuity are discussed. Routine annual audiometric and otolaryngological evaluation should be considered in all patients with temporal bone inyolvement of PS.

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Air Conduction Thresholds and Secretory Otitis Media: A Conventional and Extra-High Frequency Audiometric Comparison

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348948909801003 ◽

1989 ◽

Vol 98 (10) ◽

pp. 767-771 ◽

Cited By ~ 11

Author(s):

Iain W. S. Mair ◽

Oddbjørn Fjermedal ◽

Einar Laukli

Keyword(s):

Otitis Media ◽

Middle Ear ◽

High Frequency ◽

Pure Tone ◽

Low Frequency ◽

Secretory Otitis Media ◽

Middle Ear Fluid ◽

Ventilation Tubes ◽

Air Conduction

A comparison has been made of air conduction threshold changes up to 1 year after myringotomy, aspiration of middle ear fluid, and insertion of ventilation tubes in ten patients with bilateral and 12 with unilateral secretory otitis media (SOM). Pure tone air conduction thresholds have been analyzed in three frequency groups: Low frequency (LF; 0.25, 0.5, and 1 kHz), high frequency (HF; 2,4, and 8 kHz), and extra-high frequency (EHF; 10, 12, 14, and 16 kHz). In the LF and HF ranges, significant improvement came during the first 24 hours after intubation, while in the EHF range, threshold lowering occurred gradually over the following 2 months. Possible explanations for these findings are discussed.

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Hearing Loss and Hearing Handicap in Users of Recreational Firearms

Journal of the American Academy of Audiology ◽

10.1055/s-0040-1715958 ◽

2002 ◽

Vol 13 (03) ◽

pp. 160-168 ◽

Cited By ~ 8

Author(s):

Michael Stewart ◽

Rebecca Pankiw ◽

Mark E. Lehman ◽

Thomas H. Simpson

Keyword(s):

Hearing Loss ◽

American Academy ◽

High Frequency ◽

Pure Tone ◽

Occupational Safety ◽

Occupational Safety And Health ◽

Gender Effects ◽

The Self ◽

Safety And Health ◽

Hearing Handicap

This investigation sought to establish the prevalence of hearing loss and hearing handicap in a population of 232 recreational firearm users. Hearing handicap was calculated based on four methods using pure-tone threshold data from the American Academy of Ophthalmology and Otolaryngology, American Academy of Otolaryngology-Head and Neck Surgery, National Institute of Occupational Safety and Health, and American Speech-Language and Hearing Association in addition to the self-report Hearing Handicap Inventory for Adults-Screener (HHIA-S). Subjects (45 female and 187 male) ranging in age from 13 to 77 years (mean = 40 years, SD = 15.1) completed a short questionnaire regarding demographics and shooting practices followed by pure-tone air audiometry at Occupational Safety and Health Administration test frequencies of 500 to 6000 Hz. A total of 177 who exhibited varying degrees of hearing loss also received a face-to-face administration of the HHIA-S. Audiometric and HHIA-S results revealed that both high-frequency hearing loss and hearing handicap varied significantly as functions of age and occupation. Significant gender effects were observed audiometrically but not as a function of hearing handicap. HHIA-S scores varied significantly as a function of high-frequency (1000–4000 Hz) hearing loss. Correlation coefficients between the four different pure-tone methods of calculating hearing handicap and the self-reported HHIA-S were highest for pure-tone methods that do not employ 500 Hz in the calculation.

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Modification of auditory pathway functions in patients with hearing improvement after middle ear surgery

Otolaryngology ◽

10.1016/s0194-5998(98)70183-4 ◽

1998 ◽

Vol 119 (1) ◽

pp. 125-130 ◽

Cited By ~ 8

Author(s):

Juha-Pekka Vasama ◽

Jyrki P. Mäkelä ◽

Hans A. Ramsay

Keyword(s):

Hearing Loss ◽

Middle Ear ◽

Pure Tone ◽

Conductive Hearing Loss ◽

Adult Patients ◽

Middle Ear Surgery ◽

Ear Surgery ◽

Pure Tone Average ◽

The Mean ◽

Conductive Hearing

We recorded auditory-evoked magnetic responses with a whole-scalp 122-channel neuromagnetometer from seven adult patients with unilateral conductive hearing loss before and after middle ear surgery. The stimuli were 50-msec 1-kHz tone bursts, delivered to the healthy, nonoperated ear at interstimulus intervals of 1, 2, and 4 seconds. The mean preoperative pure-tone average in the affected ear was 57 dB hearing level; the mean postoperative pure-tone average was 17 dB. The 100-msec auditory-evoked response originating in the auditory cortex peaked, on average, 7 msecs earlier after than before surgery over the hemisphere contralateral to the stimulated ear and 2 msecs earlier over the ipsilateral hemisphere. The contralateral response strengths increased by 5% after surgery; ipsilateral strengths increased by 11%. The variation of the response latency and amplitude in the patients who underwent surgery was similar to that of seven control subjects. The postoperative source locations did not differ noticeably from preoperative ones. These findings suggest that temporary unilateral conductive hearing loss in adult patients modifies the function of the auditory neural pathway. (Otolaryngol Head Neck Surg 1998;119:125-30.)

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