scholarly journals Longitudinal Tracking of Sound Exposure and Hearing Aid Usage through Objective Data Logs

2018 ◽  
Vol 159 (1) ◽  
pp. 110-116
Author(s):  
John B. Doyle ◽  
Rohit R. Raghunathan ◽  
Ilana Cellum ◽  
Gen Li ◽  
Justin S. Golub
Keyword(s):  
Hearing Loss ◽  
Pure Tone ◽  
Hearing Aid ◽  
Medical Center ◽  
Academic Medical Center ◽  
Case Series ◽  
Data Logging ◽  
Sound Exposure ◽  
Pure Tone Average

Objective To use data-logging technology to objectively track and identify predictors of hearing aid (HA) usage and aided sound exposure. Study Design Case series with planned data collection. Setting Tertiary academic medical center. Subjects and Methods Individuals with HAs between 2007 and 2016 were included (N = 431; mean, 74.6 years; 95% CI, 73.1-76.0). Data-logging technology intrinsic to new-generation HAs was enabled to track usage and sound exposure. With multivariable linear regression, age, sex, number of audiology visits, duration of audiologic follow-up, pure tone average, and HA side were assessed as predictors of usage (hours/day) and aided sound exposure (dB-hours/day; ie, “dose” of sound per day). Results Mean follow-up was 319 days (95% CI, 277-360). Mean HA usage was 8.4 hours/day (95% CI, 8.0-8.8; N = 431). Mean aided sound exposure was 440 dB-hours/day (95% CI, 385-493; n = 110). HA use (β < 0.001, P = .45) and aided sound exposure (β = −0.006, P = .87) were both stable over time. HA usage was associated only with hearing loss level (pure tone average; β = 0.030, P = .04). Aided sound exposure was associated only with duration of audiologic follow-up (β = 0.100, P = .02). Conclusion While measurement of HA use has traditionally relied on subjective reporting, data logging offers an objective tool to longitudinally track HA use and sound exposure. We demonstrate the feasibility of using this potentially powerful research tool. Usage and sound exposure were stable among patients throughout the study period. Use was greater among subjects with greater hearing loss. Maximizing aided sound exposure might be possible through continued audiology follow-up visits.

Growth and Management of Repaired Complete Tracheal Rings after Slide Tracheoplasty

2019 ◽  
Vol 161 (1) ◽  
pp. 164-170 ◽  
Author(s):  
Lyndy J. Wilcox ◽  
Claudia Schweiger ◽  
Catherine K. Hart ◽  
Alessandro de Alarcon ◽  
Nithin S. Peddireddy ◽  
...  
Keyword(s):  
Medical Center ◽  
Academic Medical Center ◽  
Balloon Dilation ◽  
Case Series ◽  
Slide Tracheoplasty ◽  
Time Period ◽  
Academic Medical ◽  
Operative Notes ◽  
Over Time

ObjectiveThis study documents the growth and course of repaired complete tracheal rings over time after slide tracheoplasty.Study DesignCase series with review.SettingTertiary pediatric academic medical center.Subjects/MethodsMedical records of pediatric patients with confirmed tracheal rings on bronchoscopy who underwent slide tracheoplasty between January 2001 and December 2015 were reviewed. Patients who had operative notes documenting tracheal sizing over time were included. Exclusion criteria included tracheal stenosis not caused by complete tracheal rings, surgical repair prior to presentation at our institution, or lack of adequate sizing information. The postoperative follow-up was examined and airway growth over time documented.ResultsOf 197 slide tracheoplasties performed during the study time period, 139 were for complete tracheal rings, and 40 of those children met inclusion criteria. The median age at time of surgery was 7 months, and the median initial airway size was 3.9 mm (n = 34). The median growth postoperatively was 1.9 mm over a median follow-up period of 57 months (0.42 mm/year), which is similar to growth rates of unrepaired complete tracheal rings ( P = .53). Children underwent a median of 10 postoperative endoscopies, with time between endoscopies increasing further out from surgery. The most commonly performed adjunctive procedure was balloon dilation.ConclusionsThis is the first study documenting continued growth of repaired complete tracheal rings after slide tracheoplasty. Postoperative endoscopic surveillance ensures adequate growth. Intervals between airway endoscopies can be increased as the child gets older, as the airway increases in size, and as long as symptoms are minimal.

Long-Term Otologic and Audiometric Outcomes in Patients with Cleft Palate

2017 ◽  
Vol 157 (4) ◽  
pp. 676-682 ◽  
Author(s):  
Terence E. Imbery ◽  
Lindsay B. Sobin ◽  
Emily Commesso ◽  
Lindsey Koester ◽  
Sherard A. Tatum ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Medical Center ◽  
Academic Medical Center ◽  
Case Series ◽  
Closure Rate ◽  
Pressure Equalization

Objective Describe longitudinal audiometric and otologic outcomes in patients with cleft palates. Study Design Case series with chart review. Setting Single academic medical center. Methods Charts of 564 patients with a diagnosis of cleft palate (59% syndromic etiology, 41% nonsyndromic) from 1998 to 2014 were reviewed. Patients without at least 1 audiometric follow-up were excluded from analysis. Patient demographics, surgeries, audiometric tests, and otologic data were recorded for 352 patients. Results Forty-five percent had isolated cleft palates, 34% had unilateral cleft lip and palate, and 21% had bilateral cleft lip and palate. Patients were followed for a mean of 50.3 months with a mean of 3.2 separate audiograms performed. Patients received a mean of 2.93 pressure equalization tubes. Increased number of pressure equalization tubes was not associated with incidence of cholesteatoma, which was identified in only 4 patients. Nine patients underwent eventual tympanoplasty with an 89% closure rate. Analysis of mean air-bone gap by cleft type did not reveal significant differences ( P = .08), but conductive losses and abnormal tympanometry persisted into teenage years. Conclusions Patients with cleft palates have eustachian tube dysfunction, which, in our cohort, resulted in persistent conductive hearing loss, highlighting the importance of long-term follow-up. Cholesteatoma incidence was low and not associated with number of tubes, which at our institution were placed prophylactically. Tympanoplasty was successful in those with persistent perforations.

scholarly journals Longitudinal associations between hearing aid usage and cognition in community-dwelling Japanese older adults with moderate hearing loss

PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0258520
Author(s):  
Saiko Sugiura ◽  
Yukiko Nishita ◽  
Yasue Uchida ◽  
Mariko Shimono ◽  
Hirokazu Suzuki ◽  
...  
Keyword(s):  
Older Adults ◽  
Hearing Loss ◽  
Cognitive Function ◽  
Pure Tone ◽  
Community Dwelling ◽  
Pure Tone Average ◽  
Time Interaction ◽  
Picture Completion ◽  
Moderate Hearing Loss

We investigated the associations between hearing aids (HA) and the maintenance of cognitive function among community-dwelling older adults with moderate hearing loss. A total of 407 participants aged 60 years or older with moderate hearing loss were recruited from the National Institute for Longevity Sciences, Longitudinal Study for Aging (NILS-LSA). Moderate hearing loss was defined as a pure-tone average of 40–69 dB at 500, 1000, 2000, and 4000 Hz of the better ear, according to the definition proposed by the Japan Audiological Society. Cognitive function was evaluated using the four subtests of the Japanese version of the Wechsler Adult Intelligence Scale-Revised Short Forms (WAIS-R-SF): Information, Similarities, Picture completion, and Digit Symbol Substitution (DSST). A longitudinal analysis of 1192 observations with a mean follow-up period of 4.5 ± 3.9 years was performed. The HA use rate at any time during the follow-up period was 31.4%, and HA users were significantly younger (t-test, p = 0.001), had worse hearing (p < .0001) and higher education (p = 0.001), participated more frequently in the survey (p < .0001), and were less depressed (χ2 test, p = 0.003) than the older adults not using HA. General linear mixed models consisted of the fixed effects of HA use, follow-up time, and an HA use × time interaction term adjusted for age and pure-tone average thresholds at baseline, sex, education, and other possible confounders. HA use showed significant main effects on the scores for Picture completion and DSST after adjustment; scores were better in the HA use group than in the no HA use group. The HA use × time interaction was significant for the Information score (p = 0.040). The model-predicted 12-year slope with centralizing age indicated that the no HA use group showed greater decline over time on Information scores than did HA use group. The slopes did not differ between HA users and non-users for the Similarities, Picture completion and DSST. In conclusion, HA use may have a protective effect on the decline in general knowledge in older adults with moderate hearing loss.

scholarly journals Stable and Progressive Hearing Loss in Type 2A Usher's Syndrome

1996 ◽  
Vol 105 (12) ◽  
pp. 962-967 ◽  
Author(s):  
Annelies van Aarem ◽  
Alfred J. L. G. Pinckers ◽  
William J. Kimberling ◽  
Patrick L. M. Huygen ◽  
Elisabeth M. Bleeker-Wagemakers ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Pure Tone ◽  
Regression Coefficient ◽  
Significant Heterogeneity ◽  
Progressive Hearing Loss ◽  
Chromosome 1Q ◽  
Pure Tone Average ◽  
Significant Regression ◽  
Usher’S Syndrome

Audiograms were traced or additionally performed on 23 Usher's syndrome patients in 10 Dutch multi-affected families, all linked to chromosome 1q (USH2A locus). Serial audiograms, available in 13 patients, were used for a regression analysis of binaural pure tone average on age (follow-up, 9 to 32 years) to test for “significant progression,” ie, a significant regression coefficient, here called the “annual threshold increase” (ATI, expressed in decibels per year). A significant ATI (>1 dB/y) was observed in 3 patients. Analysis of variance of ATI demonstrated significant heterogeneity; hearing loss was either stable or progressive. This implies a significant clinical heterogeneity. A similar analysis performed on our progressive USH2A cases and “type III” cases previously reported by others (ATI of 1 to 5 dB/y), some of which were recently linked to chromosome 3q (USH3 locus), failed to show any significant heterogeneity in the progression of hearing loss.

Totally implantable active middle-ear implants: a large, single-surgeon cohort

2021 ◽  
pp. 1-6
Author(s):  
E McCarty Walsh ◽  
D R Morrison ◽  
W J McFeely
Keyword(s):  
Hearing Loss ◽  
Word Recognition ◽  
Middle Ear ◽  
Pure Tone ◽  
Case Series ◽  
Recognition Score ◽  
Hearing Level ◽  
Pure Tone Average ◽  
Surgeon Experience ◽  
Middle Ear Implants

Abstract Objectives This study aimed to evaluate hearing outcomes and device safety in a large, single-surgeon experience with the totally implantable active middle-ear implants. Methods This was a retrospective case series review of 116 patients with moderate-to-severe sensorineural hearing loss undergoing implantation of active middle-ear implants. Results Mean baseline unaided pure tone average improved from 57.6 dB before surgery to 34.1 dB post-operatively, signifying a mean gain in pure tone average of 23.5 dB (p = 0.0002). Phonetically balanced maximum word recognition score improved slightly from 70.5 per cent to 75.8 per cent (p = 0.416), and word recognition score at a hearing level of 50 dB values increased substantially from 14.4 per cent to 70.4 per cent (p < 0.0001). Both revision and explant rates were low and dropped with increasing surgeon experience over time. Conclusion This study showed excellent post-operative hearing results with active middle-ear implants with regard to pure tone average and word recognition score at a hearing level of 50 db. Complication rates in this case series were significantly lower with increasing experience of the surgeon. Active middle-ear implants should be considered in appropriate patients with moderate-to-severe sensorineural hearing loss who have struggled with conventional amplification and are good surgical candidates.

Adult Hearing Screening: Follow-Up and Outcomes1

2013 ◽  
Vol 22 (1) ◽  
pp. 183-185 ◽  
Author(s):  
C. Thodi ◽  
M. Parazzini ◽  
S. E. Kramer ◽  
A. Davis ◽  
S. Stenfelt ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Pure Tone ◽  
Hearing Aid ◽  
Pure Tone Audiometry ◽  
Hearing Screening ◽  
Community Dwelling ◽  
The People ◽  
Medical Evaluation ◽  
Cerumen Removal

Purpose To screen hearing and evaluate outcomes in community-dwelling older adults. Method Three thousand and twenty-five adults responded to an invitation to be screened by questionnaire, otoscopy, and pure-tone audiometry. Pure-tone average (PTA) >35 dB HL in the worse ear, unilateral hearing loss, or otoscopic findings were the criteria for referral for services. A questionnaire related to compliance with referral recommendations was completed by telephone interview for 160 randomly selected participants after 1–2 years from referral. Results The referral rate for audiologic/hearing aid evaluation was 46%, and referral for cerumen removal/medical evaluation was 17%. Of the people referred for audiologic/hearing aid evaluation, 18% tried a hearing aid; 2 years later, 11% were using a hearing aid. Screening recommendations affected participants' decision to seek help. Study participants stated that the screening was helpful, it should be offered to everybody, and they would participate in future screenings. Conclusion Although adult hearing screening offered timely identification of hearing loss for adults seeking help, follow-up with hearing aid treatment was low.

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

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.

Counseling Adolescents With Hearing Loss Using a Narrative Therapy Approach

2009 ◽  
Vol 19 (2) ◽  
pp. 72-78
Author(s):  
Rebecca L. Nelson Crowell ◽  
Julie Hanenburg ◽  
Amy Gilbertson
Keyword(s):  
Hearing Loss ◽  
Process Evaluation ◽  
Narrative Therapy ◽  
Daily Life ◽  
Hearing Aid ◽  
Self Esteem ◽  
Therapy Approach ◽  
Self Worth ◽  
Counseling Adolescents

Abstract Audiologists have a responsibility to counsel patients with auditory concerns on methods to manage the inherent challenges associated with hearing loss at every point in the process: evaluation, hearing aid fitting, and follow-up visits. Adolescents with hearing loss struggle with the typical developmental challenges along with communicative challenges that can erode one's self-esteem and self-worth. The feeling of “not being connected” to peers can result in feelings of isolation and depression. This article advocates the use of a Narrative Therapy approach to counseling adolescents with hearing loss. Adolescents with hearing loss often have problem-saturated narratives regarding various components of their daily life, friendships, amplification, academics, etc. Audiologists can work with adolescents with hearing loss to deconstruct the problem-saturated narratives and rebuild the narratives into a more empowering message. As the adolescent retells their positive narrative, they are likely to experience increased self-esteem and self-worth.

Monitoring Progress for Children with Hearing Loss

2014 ◽  
Vol 24 (2) ◽  
pp. 74-81
Author(s):  
Monica Weston ◽  
Karen F. Muñoz ◽  
Kristina Blaiser
Keyword(s):  
Hearing Loss ◽  
Hearing Aid ◽  
Full Time ◽  
Data Logging ◽  
Standardized Measures ◽  
Word Structure ◽  
Hearing Aid Use ◽  
Outcomes For Children ◽  
Language Measures ◽  
Children With Hearing Loss

Purpose This study investigated average hours of daily hearing aid use and speech-language outcomes for children age 3 to 6 years of age with hearing loss. Method Objective measures of hearing aid use were collected via data logging. Speech and language measures included standardized measures GFTA-2, CELF Preschool-2 and additional item analyses for the word structure subtest CELF Preschool-2 and the GFTA-2. Results Hearing aid use was full time for 33% of the children (n=3; M=8.84 hours; Range: 2.9–12.1) at the beginning of the study, and for 78% at the end of the study (n=7; M=9.89 hours; Range 2.6–13.2). All participants demonstrated an improvement in articulation and language standard scores and percentiles however continued to demonstrate areas of weakness in sounds high-frequency in nature. Conclusions Through early identification and fitting, children gain access to speech sounds. Both standardized measures and individual language analysis should be used to identify and support children with hearing loss in language and subsequent literacy development.

scholarly journals Characteristics and Outcomes Among Hospitalized COVID-19-Positive Patients in a Nonurban Environment

2021 ◽  
Author(s):  
Robert P Lennon ◽  
Theodore J Demetriou ◽  
M Fahad Khalid ◽  
Lauren Jodi Van Scoy ◽  
Erin L Miller ◽  
...  
Keyword(s):  
New York ◽  
Medical Center ◽  
Academic Medical Center ◽  
Military Medicine ◽  
Case Series ◽  
Outcome Data ◽  
Urban Environments ◽  
Urban Setting ◽  
Published Data ◽  
Retrospective Case

ABSTRACT Introduction Virtually all hospitalized coronavirus disease-2019 (COVID-19) outcome data come from urban environments. The extent to which these findings are generalizable to other settings is unknown. Coronavirus disease-2019 data from large, urban settings may be particularly difficult to apply in military medicine, where practice environments are often semi-urban, rural, or austere. The purpose of this study is compare presenting characteristics and outcomes of U.S. patients with COVID-19 in a nonurban setting to similar patients in an urban setting. Materials and Methods This is a retrospective case series of adults with laboratory-confirmed COVID-19 infection who were admitted to Hershey Medical Center (HMC), a 548-bed tertiary academic medical center in central Pennsylvania serving semi-urban and rural populations, from March 23, 2020, to April 20, 2020 (the first month of COVID-19 admissions at HMC). Patients and outcomes of this cohort were compared to published data on a cohort of similar patients from the New York City (NYC) area. Results The cohorts had similar age, gender, comorbidities, need for intensive care or mechanical ventilation, and most vital sign and laboratory studies. The NYC’s cohort had shorter hospital stays (4.1 versus 7.2 days, P &lt; .001) but more African American patients (23% versus 12%, P = .02) and higher prevalence of abnormal alanine (&gt;60U/L; 39.0% versus 5.9%, P &lt; .001) and aspartate (&gt;40U/L; 58.4% versus 42.4%, P = .012) aminotransferase, oxygen saturation &lt;90% (20.4% versus 7.2%, P = .004), and mortality (21% versus 1.4%, P &lt; .001). Conclusions Hospitalists in nonurban environments would be prudent to use caution when considering the generalizability of results from dissimilar regions. Further investigation is needed to explore the possibility of reproducible causative systemic elements that may help improve COVID-19-related outcomes. Broader reports of these relationships across many settings will offer military medical planners greater ability to consider outcomes most relevant to their unique settings when considering COVID-19 planning.

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