scholarly journals A Controlled Comparison of Auditory Steady-State Responses and Pure-Tone Audiometry in Patients with Hearing Loss

2017 ◽  
Vol 96 (10-11) ◽  
pp. E47-E52
Author(s):  
Raman Wadhera ◽  
Sharad Hernot ◽  
Sat Paul Gulati ◽  
Vijay Kalra

We performed a prospective interventional study to evaluate correlations between hearing thresholds determined by pure-tone audiometry (PTA) and auditory steady-state response (ASSR) testing in two types of patients with hearing loss and a control group of persons with normal hearing. The study was conducted on 240 ears—80 ears with conductive hearing loss, 80 ears with sensorineural hearing loss, and 80 normal-hearing ears. We found that mean threshold differences between PTA results and ASSR testing at different frequencies did not exceed 15 dB in any group. Using Pearson correlation coefficient calculations, we determined that the two responses correlated better in patients with sensorineural hearing loss than in those with conductive hearing loss. We conclude that measuring ASSRs can be an excellent complement to other diagnostic methods in determining hearing thresholds.

Author(s):  
Seema Panday ◽  
Harsha Kathard ◽  
Wayne J. Wilson

Background: This study continued the development of an isiZulu speech reception threshold (zSRT) test for use with first language, adult speakers of isiZulu.Objectives: The objective of this study was to determine the convergent and concurrent validity of the zSRT test.Methods: One hundred adult isiZulu first-language speakers with normal hearing and 76 first-language, adult isiZulu speakers with conductive or sensorineural hearing losses ranging from mild to severe were assessed on pure tone audiometry and a newly developed isiZulu SRT test. Convergent validity was established through agreement of the zSRT scores with pure tone average (PTA) scores. Concurrent validity was assessed by examining the steepness of the psychometric curve for each word in the zSRT test for each type and degree of hearing loss.Results: Intraclass correlation coefficient analyses showed zSRT scores were in substantial to very high agreement with PTA scores for the normal hearing and hearing loss groups (NH – right ear ICC consistency = 0.78, left ear ICC = 0.67; HL – right ear ICC consistency = 0.97, left ear ICC consistency = 0.95). The mean psychometric slope (%/dB) at 50% correct perception for all words in the zSRT test was 4.92%/dB for the mild conductive hearing loss group, 5.26%/dB for the moderate conductive hearing loss group, 2.85%/dB for the moderately severe sensorineural hearing loss group and 2.47%/dB for the severe sensorineural hearing loss group. These slopes were appropriate for the degree of hearing loss observed in each group.Conclusion: The zSRT test showed convergent and concurrent validity for assessing SRT in first language, adult speakers of isiZulu.


1998 ◽  
Vol 41 (3) ◽  
pp. 549-563 ◽  
Author(s):  
Sid P. Bacon ◽  
Jane M. Opie ◽  
Danielle Y. Montoya

Speech recognition was measured in three groups of listeners: those with sensorineural hearing loss of (presumably) cochlear origin (HL), those with normal hearing (NH), and those with normal hearing who listened in the presence of a spectrally shaped noise that elevated their pure-tone thresholds to match those of individual listeners in the HL group (NM). Performance was measured in four backgrounds that differed only in their temporal envelope: steady-state (SS) speech-shaped noise, speech-shaped noise modulated by the envelope of multi-talker babble (MT), speech-shaped noise modulated by the envelope of single-talker speech (ST), and speech-shaped noise modulated by a 10-Hz square wave (SQ). Threshold signal-to-noise ratios (SNRs) were typically best in the ST and especially the SQ conditions, indicating a masking release in those modulated backgrounds. SNRs in the SS and MT conditions were essentially identical to one another. The masking release was largest in the listeners in the NH group, and it tended to decrease as hearing loss increased. In 5 of the 11 listeners in the HL group, the masking release was nearly identical to that obtained in the NM group matched to those listeners; in the other 6 listeners, the release was smaller than that in the NM group. The reduced masking release was simulated best in those HL listeners for whom the masking release was relatively large. These results suggest that reduced masking release for speech in listeners with sensorineural hearing loss can only sometimes be accounted for entirely by reduced audibility.


Author(s):  
Jessie Chao-Yun Chi ◽  
Shin-Da Lee ◽  
Ren-Jing Huang ◽  
Ching-Hsiang Lai ◽  
Stanley Yung Liu ◽  
...  

This article investigates the effects of continuous positive airway pressure (CPAP) on hearing impairment in sensorineural hearing loss (SNHL) patients with sleep-disordered breathing (SDB). This retrospective and observational study took place from September 2016 to February 2021, accumulating 77 subjects with SNHL and SDB (60.7 ± 11.1 years). Of which, 28 received CPAP treatment (63.0 ± 8.5 years). In our methodology, hearing thresholds at low, medium, high, and average frequencies are assessed by pure-tone audiometry at baseline (BL), three (3 m), six (6 m), and 12 (12 m) months. Our results show that the BL of at least three frequencies in all subjects is positively associated with old age, males, smoking, alcohol, coronary artery disease, hypertension, and apnea-hypopnea index [AHI] (all p < 0.05). Moreover, low, medium, and average frequencies are negatively correlated at CPAP-6 m (−5.60 ± 2.33, −5.82 ± 2.56, and −5.10 ± 2.26 dB; all p < 0.05) and CPAP-12 m (−7.97 ± 2.74, −8.15 ± 2.35, and −6.67 ± 2.37 dB; all p < 0.01) against corresponding measures of CPAP-BL. High, medium, and average frequencies positively correlated with age (p < 0.001 for high and average frequencies and <0.01 for medium frequencies). We conclude that in SNHL patients with SDB, hearing thresholds at low and medium frequencies improves under CPAP use after six months, which persists at least to the end of one year.


2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S306-S306
Author(s):  
Sarah Lofgren ◽  
Martha Montgomery ◽  
Nathan Yueh ◽  
Alice Namudde ◽  
Joshua Rhein ◽  
...  

Abstract Background Hearing loss is a known complication cryptococcal meningitis (CM); however, there is a paucity of data. We aimed to describe hearing loss in CM survivors. Methods We assessed hearing via audiometry 8 and 18 weeks after diagnosis of CM in Kampala, Uganda from 2015-2016. We measured at 0.5, 1, 2, 4 Hz. Normal hearing was defined as minimum hearing level at &lt;25 decibels (dB), mild at 25-39, moderate hearing at 40–69, severe at 70–89, and profound hearing loss at 90+ dB. We compared clinical factors, fungal burden, and CSF parameters to evaluate for factors associated with improvement (change in hearing loss category). Results We evaluated hearing symptoms via audiogram at week 8 (n = 117) and week 18 (n = 98). At 8-weeks, 6 (5%) participants had normal hearing, 36 (31%) had mild hearing loss, 72 (62%) had moderate hearing loss, 3 (3%) had severe hearing loss and none had profound hearing loss. Of those with moderate/severe/profound loss at week 8, 63 (54%) had mixed conductive + sensorineural hearing loss, 15 (13%) had sensorineural hearing loss, and 14 (12%) had conductive hearing loss. An additional 19 (16%) had sensorineural loss but unknown air conduction, and 3 (3%) did not have sensorineural loss but unknown air conduction. We compared risk factors for hearing loss summarized in Table 1. We assessed 66 participants who had repeated audiograms at week 8 and week 18. Of those 31 (47%) had no change, 30 (45%) had improvement and 5 (8%) had worsening. Conclusion Moderate/severe hearing loss was common 8 weeks after diagnosis of CM. More than half had mixed hearing loss and 20% had conductive hearing loss which represents a higher incidence than noted in other types of meningitis. The data is complicated by advanced HIV. Further research is needed evaluating immunologic factors causes hearing impairment in those who survived CM. Disclosures All authors: No reported disclosures.


2018 ◽  
Vol 132 (11) ◽  
pp. 1039-1041 ◽  
Author(s):  
J Suzuki ◽  
Y Takanashi ◽  
A Koyama ◽  
Y Katori

AbstractObjectivesSodium bromate is a strong oxidant, and bromate intoxication can cause irreversible severe-to-profound sensorineural hearing loss. This paper reports the first case in the English literature of bromate-induced hearing loss with hearing recovery measured by formal audiological assessment.Case reportA 72-year-old woman was admitted to hospital with complaints of profound hearing loss, nausea, diarrhoea and anuria after bromate ingestion in a suicide attempt. On admission, pure tone audiometry and auditory brainstem responses showed profound bilateral deafness. Under the diagnosis of bromate-induced acute renal failure and sensorineural hearing loss, continuous haemodiafiltration was performed. When dialysis was discontinued, pure tone audiometry and auditory brainstem responses showed partial threshold recovery from profound deafness.ConclusionSevere-to-profound sensorineural hearing loss is a common symptom of bromate intoxication. Bromate-induced hearing loss may be partially treated, and early application of continuous haemodiafiltration might be useful as a treatment for this intractable condition.


10.2196/23047 ◽  
2020 ◽  
Vol 8 (11) ◽  
pp. e23047
Author(s):  
Heng-Yu Haley Lin ◽  
Yuan-Chia Chu ◽  
Ying-Hui Lai ◽  
Hsiu-Lien Cheng ◽  
Feipei Lai ◽  
...  

Background Sudden sensorineural hearing loss (SSNHL) is an otologic emergency that warrants urgent management. Pure-tone audiometry remains the gold standard for definitively diagnosing SSNHL. However, in clinical settings such as primary care practices and urgent care facilities, conventional pure-tone audiometry is often unavailable. Objective This study aimed to determine the correlation between hearing outcomes measured by conventional pure-tone audiometry and those measured by the proposed smartphone-based Ear Scale app and determine the diagnostic validity of the hearing scale differences between the two ears as obtained by the Ear Scale app for SSNHL. Methods This cross-sectional study included a cohort of 88 participants with possible SSNHL who were referred to an otolaryngology clinic or emergency department at a tertiary medical center in Taipei, Taiwan, between January 2018 and June 2019. All participants underwent hearing assessments with conventional pure-tone audiometry and the proposed smartphone-based Ear Scale app consecutively. The gold standard for diagnosing SSNHL was defined as the pure-tone average (PTA) difference between the two ears being ≥30 dB HL. The hearing results measured by the Ear Scale app were presented as 20 stratified hearing scales. The hearing scale difference between the two ears was estimated to detect SSNHL. Results The study sample comprised 88 adults with a mean age of 46 years, and 50% (44/88) were females. PTA measured by conventional pure-tone audiometry was strongly correlated with the hearing scale assessed by the Ear Scale app, with a Pearson correlation coefficient of .88 (95% CI .82-.92). The sensitivity of the 5–hearing scale difference (25 dB HL difference) between the impaired ear and the contralateral ear in diagnosing SSNHL was 95.5% (95% CI 87.5%-99.1%), with a specificity of 66.7% (95% CI 43.0%-85.4%). Conclusions Our findings suggest that the proposed smartphone-based Ear Scale app can be useful in the evaluation of SSNHL in clinical settings where conventional pure-tone audiometry is not available.


Author(s):  
Raphella Khan ◽  
Anirudh Kasliwal

<p class="abstract"><strong>Background:</strong> Chronic squamosal otitis media can occur due to many conditions affecting the middle ear. Most common sign of developing a chronic squamosal otitis media is formation of a retraction pocket in the tympanic membrane leading to further development of a cholesteatoma and if not treated properly, may lead to development of dangerous complication in the affected ear. These etiological factors may also affect the other ear. It is therefore very necessary to assess and diagnose the contralateral ear, so that the disease can be intervened and treated at the right time, to prevent any deterioration in hearing of the contralateral ear.</p><p class="abstract"><strong>Methods:</strong> The prospective study was done in 100 patients with unilateral chronic squamosal otitis media, where the contra lateral ear was examined and assessed for any hearing loss.  </p><p class="abstract"><strong>Results:</strong> We found hearing loss in the contra lateral ear ranging from mild conductive hearing loss to sensorineural hearing loss with the maximum patients with mild conductive hearing loss (42%) and lowest in sensorineural hearing loss (1%).  </p><p class="abstract"><strong>Conclusions:</strong> In our study, 76 patients were seen with conductive hearing loss. Out of that, 42% patients were seen with mild conductive hearing loss, 30% with moderate conductive hearing loss and 4% with severe conductive hearing loss. 20% patients were seen with normal hearing. 3% patients were seen with mixed hearing loss and only 1% patient was seen with sensorineural hearing loss in contralateral ear.</p>


2020 ◽  
Vol 59 (10) ◽  
pp. 801-808 ◽  
Author(s):  
Karina C. De Sousa ◽  
Cas Smits ◽  
David R. Moore ◽  
Hermanus Carel Myburgh ◽  
De Wet Swanepoel

2008 ◽  
Vol 123 (1) ◽  
pp. 38-44 ◽  
Author(s):  
Y-H Lin ◽  
P-R Chen ◽  
C-J Hsu ◽  
H-P Wu

AbstractObjective:For various medico-legal and financial reasons, some patients may clinically demonstrate an exaggerated hearing loss that varies in degree, nature and laterality. The purpose of this study was to evaluate whether multi-channel auditory steady-state response measurement can be used as an objective test of auditory thresholds in adults with sensorineural hearing loss.Study design and setting:This was a prospective, comparative, experimental research design study conducted in an academic medical centre. From January to June 2007, 142 subjects (284 ears) with varying degrees of sensorineural hearing loss were included. Four commonly used frequencies (500, 1000, 2000 and 4000 Hz) were evaluated. Both pure tone thresholds and multi-channel auditory steady-state response thresholds were obtained for each ear in all subjects. The correlation of auditory steady-state response thresholds and pure tone thresholds was assessed. The time taken for multi-channel auditory steady-state response testing was also recorded.Results:Results for multi-channel auditory steady-state response thresholds and pure tone thresholds were compared for each test frequency. A difference of less than 15 dB was found in 71 per cent of patients, while a difference of less than 20 dB was found in 83 per cent. Correlation between auditory steady-state response thresholds and pure tone thresholds, expressed as the correlation coefficient (r), was 0.89, 0.95, 0.96 and 0.97 at 500, 1000, 2000 and 4000 Hz, respectively. The strength of the relationship between auditory steady-state response thresholds and pure tone thresholds increased with increasing frequency and increasing degree of hearing loss. The recorded auditory steady-state response thresholds were used to calculate regression lines predicting pure tone threshold results. The mean estimated pure tone thresholds calculated from these regression lines were all within 10 dB of the actual recorded pure tone thresholds. The average multi-channel auditory steady-state response test duration was 42 minutes per patient.Conclusion:Measurement of multi-channel auditory steady-state response could be a powerful, convenient electro-physiological examination with which to objectively certify clinical hearing impairment in adults.


2018 ◽  
Vol 97 (9) ◽  
pp. E18-E22 ◽  
Author(s):  
Lumy Yagueshita ◽  
Lucas Resende Lucinda ◽  
Valderilio Azevedo ◽  
Gislaine Richter Minhoto Wiemes ◽  
Nicole Richter Minhoto Wiemes ◽  
...  

Recent studies have identified sensorineural hearing loss as a possible manifestation of ankylosing spondylitis. We conducted a study of 30 patients with ankylosing spondylitis to characterize their audiologic profile and to correlate their disease activity and functional indices with their hearing thresholds. The study group was made up of 18 men and 12 women, aged 25 to 58 years (mean: 46.5), who were diagnosed with ankylosing spondylitis. We compared their findings with a socially and demographically matched group of 30 healthy controls. All 60 participants underwent an audiologic assessment, consisting of pure-tone audiometry, speech audiometry, and tympanometry. We used validated indices to assess disease activity and functional status, and we compiled information on the time of diagnosis and the types of medications used to treat the ankylosing spondylitis. We found that the average of the mean air-conduction thresholds at 0.5, 1, 2, and 4 kHz in the ankylosing spondylitis group was significantly worse than that of the controls (p = 0.004). A statistically significant difference was observed at frequencies greater than 3 kHz (p < 0.05). A subgroup of case patients who used only a tumor necrosis factor-alpha inhibitor exhibited better hearing thresholds than patients who used other drugs (p = 0.01). Differences in functional and disease activity scores between case patients with and without hearing loss were not statistically significant. We found that patients with ankylosing spondylitis did indeed have a greater prevalence of sensorineural hearing loss but that it was not correlated with either disease activity or functional status.


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