Tinnitus in adolescents: the start of the vulnerability of the auditory pathways

INTRODUCTION: Although tinnitus is an increasingly common symptom, few studies have assessed its prevalence or incidence among adolescents. PURPOSE: To assess whether the presence of tinnitus in adolescents is associated with minimal hearing damage, evaluated through high-frequency audiometry (HFA), otoacoustic emission (OAE), and loudness discomfort level (LDL). METHODS: The sample comprised 168 adolescents of a private school (61.3% boys; mean age 14.1 years old; standard deviation=2). All of them completed a questionnaire about tinnitus and hypersensitivity to sounds (sound intolerance), and then underwent otoscopy, pure-tone audiometry, HFA, LDL, transient and distortion product otoacoustic emissions (TOAE and DPOAE), and tinnitus pitch/loudness matching (the latter only in those with tinnitus). Participants were later divided into three groups: with no tinnitus (n=73, 43.4%), with sporadic tinnitus (n=47, 28%), and with constant tinnitus (n=48, 28.6%). RESULTS: No significant difference was observed between the groups regarding audiometry thresholds in frequencies from 0.25 to 16 kHz, or TOAE and DPOAE. However, the LDL in adolescents with constant tinnitus was significantly lower than that in other groups, suggesting hypersensitivity to sounds. CONCLUSION: There was no evidence of minimal hearing damage in the audiometry and OAE. Nonetheless, the decreased LDL in adolescents with constant tinnitus suggests that their auditory system is more sensitive. Therefore, this may be the first sign of vulnerability to sounds. Future medium- to long-term monitoring of these students may show whether they will begin a process of functional impairment, altering hearing thresholds, and OAE.

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Otoacoustic emissions in young adults with a history of otitis media

The Journal of Laryngology & Otology ◽

10.1017/s0022215105004871 ◽

2005 ◽

Vol 120 (2) ◽

pp. 103-107 ◽

Cited By ~ 1

Author(s):

Sule Yilmaz ◽

Ahmet Rifat Karasalihoglu ◽

Abdullah Tas ◽

Recep Yagiz ◽

Memduha Tas

Keyword(s):

Young Adults ◽

Otitis Media ◽

Otoacoustic Emissions ◽

Pure Tone Audiometry ◽

Otoacoustic Emission ◽

Distortion Product Otoacoustic Emission ◽

Distortion Product ◽

The Third ◽

Hearing Thresholds ◽

History Of

The aim of this study was to investigate otoacoustic emissions in young adults who had a history of otitis media (OM) in childhood and to assess whether a history of OM had an irreversible effect on hearing. We studied 116 cases between 15 and 25 years of age, divided into three groups. Each subject underwent a single examination comprising otoscopy, pure-tone audiometry (PTA), tympanometry, and transient evoked otoacoustic emission (TEOAE) and distortion product otoacoustic emission (DPOAE) testing. Subjects in the first and second groups had normal audiometric hearing thresholds and type A tympanograms. The only difference between the first and second group was the presence or absence of a history of OM. The third group consisted of patients diagnosed as having active OM; these patients had poorer hearing thresholds and type B or C tympanograms. After statistical analysis of TEOAE and DPOAE results (one-way analysis of variance test), significant differences were noted between groups. Otoacoustic emission levels were, unsurprisingly, lowest in the third group, as expected. However, the most striking result in the study was that significantly fewer otoacoustic emissions were detected in subjects with a history of OM than in subjects without a history of OM. These findings suggest that OM in childhood may cause minor but irreversible damage to the middle ear or cochlea. Otoacoustic emissions testing can be used to detect this sub-clinical damage.

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Effect of mastoid drilling on hearing of the contralateral ear

The Journal of Laryngology & Otology ◽

10.1017/s0022215113001965 ◽

2013 ◽

Vol 127 (10) ◽

pp. 952-956 ◽

Cited By ~ 6

Author(s):

A Goyal ◽

P P Singh ◽

A Vashishth

Keyword(s):

Hearing Loss ◽

High Frequency ◽

Otoacoustic Emissions ◽

Pure Tone Audiometry ◽

Otoacoustic Emission ◽

Prospective Clinical Study ◽

Distortion Product Otoacoustic Emission ◽

High Frequencies ◽

Distortion Product ◽

Contralateral Ear

AbstractObjectives:This study aimed to: understand the effect that high intensity noise associated with drilling (during otological surgery) has on hearing in the contralateral ear; determine the nature of hearing loss, if any, by establishing whether it is temporary or persistent; and examine the association between hearing loss and various drill parameters.Methods:A prospective clinical study was carried out at a tertiary centre. Thirty patients with unilateral cholesteatoma and normal contralateral hearing were included. Patients were evaluated pre-operatively and for five days following surgery using high frequency pure tone audiometry, and low and high frequency transient evoked and distortion product otoacoustic emission testing.Results:The findings revealed statistically significant changes in distortion product otoacoustic emissions at high frequencies (p = 0.016), and in transient evoked otoacoustic emissions at both low and high frequencies (p = 0.035 and 0.021, respectively). There was a higher statistical association between otoacoustic emission changes and cutting burrs compared with diamond burrs.Conclusion:Drilling during mastoid surgery poses a threat to hearing in the contralateral ear due to noise and vibration conducted transcranially.

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Does Vincristine affect Cochlear function in children with acute lymphoblastic leukaemia?

Bangladesh Journal of Medicine ◽

10.3329/bjmed.v27i1.28068 ◽

2016 ◽

Vol 27 (1) ◽

pp. 3-7

Author(s):

Suchetha Rao ◽

Ranjith Kumar ◽

Jayashree Bhat ◽

Nutan Kamath

Keyword(s):

High Frequency ◽

Otoacoustic Emissions ◽

Lymphoblastic Leukemia ◽

Statistical Significance ◽

Pure Tone Audiometry ◽

Cochlear Function ◽

Hearing Sensitivity ◽

Distortion Product ◽

High Frequency Audiometry

Context: Vincristine chemotherapy has dose dependent ototoxicity. Early detection of ototoxicity is better with otoacoustic emissions and high frequency audiometry than conventional pure tone audiometry. The study was done to see if vincristine treatment interferes with hearing sensitivity in children.Methods and Material: A prospective study was conducted on twenty-three children with acute lymphoblastic leukemia (ALL) on Multi Center Protocol (MCP 841).These were subjected to conventional audiometry, high frequency audiometry and distortion product otoacoustic emissions (DPOAEs) before starting chemotherapy. The follow up audiological evaluation after early intensive phase chemotherapy (approximately 6 months) was conducted in thirteen children, who received 12 doses of vincristine (1.4 mg/m2), cranial irradiation of 1800cGy (>3 years) as per protocol and antibiotics as per clinical demands.Results: Baseline audiological evaluation was normal. Follow-up evaluation DPOAEs showed a declining tendency, however changes did not reach statistical significance. Differences in median hearing thresholds prior and post treatment in higher frequency audiometry were also minimal which was not statistically significant. Conventional audiometric thresholds were not altered.Conclusions: The reduction in the signal noise ratio of DPOAE, and reduced hearing sensitivity in high frequencies in post chemotherapy in comparison with baseline measures cannot be ignored though it has failed to reach the level of statistical significance. children on vincristine should have a pre chemotherapy and follow up audiological evaluation with DPOAE The results of the present study needs to be strengthened by including larger sample and long term follow up.Bangladesh J Medicine Jan 2016; 27(1) : 3-7

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Comparison of distortion product otoacoustic emissions and pure tone audiometry in occupational screening for auditory deficit due to noise exposure

The Journal of Laryngology & Otology ◽

10.1017/s0022215115002790 ◽

2015 ◽

Vol 129 (12) ◽

pp. 1174-1181 ◽

Cited By ~ 4

Author(s):

N Wooles ◽

M Mulheran ◽

P Bray ◽

M Brewster ◽

A R Banerjee

Keyword(s):

Otoacoustic Emissions ◽

Pure Tone ◽

Noise Exposure ◽

Outer Hair Cell ◽

Cell Function ◽

Pure Tone Audiometry ◽

Otoacoustic Emission ◽

Distortion Product Otoacoustic Emissions ◽

Distortion Product Otoacoustic Emission ◽

Distortion Product

AbstractObjective:To examine whether distortion product otoacoustic emissions can serve as a replacement for pure tone audiometry in longitudinal screening for occupational noise exposure related auditory deficit.Methods:A retrospective review was conducted of pure tone audiometry and distortion product otoacoustic emission data obtained sequentially during mandatory screening of brickyard workers (n = 16). Individual pure tone audiometry thresholds were compared with distortion product otoacoustic emission amplitudes, and a correlation of these measurements was conducted.Results:Pure tone audiometry threshold elevation was identified in 13 out of 16 workers. When distortion product otoacoustic emission amplitudes were compared with pure tone audiometry thresholds at matched frequencies, no evidence of a robust relationship was apparent. Seven out of 16 workers had substantial distortion product otoacoustic emissions with elevated pure tone audiometry thresholds.Conclusion:No clinically relevant predictive relationship between distortion product otoacoustic emission amplitude and pure tone audiometry threshold was apparent. These results do not support the replacement of pure tone audiometry with distortion product otoacoustic emissions in screening. Distortion product otoacoustic emissions at frequencies associated with elevated pure tone audiometry thresholds are evidence of intact outer hair cell function, suggesting that sites distinct from these contribute to auditory deficit following ototrauma.

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Η συμβολή των ωτοακουστικών εκπομπών στη μελέτη της κοχλιακής λειτουργίας σε ασθενείς με υποθυρεοειδισμό

10.12681/eadd/41695 ◽

2013 ◽

Author(s):

Βασίλειος Ψαλτάκος

Keyword(s):

Hearing Loss ◽

Hearing Impairment ◽

Otoacoustic Emissions ◽

Pure Tone ◽

Pure Tone Audiometry ◽

Otoacoustic Emission ◽

Upper Respiratory Tract ◽

Anatomic Site ◽

Cochlear Function ◽

Hearing Thresholds

Although several reports exist concerning the occurrence of hearing loss in patients withdisorders of thyroid function, there are still several unsettled issues, such as theincidence and the severity of hearing impairment, the anatomic site of the auditorypathway involved, and the possible pathogenetic mechanisms. Both congenitalhypothyroidism and environmentally based iodine deficiency are established causes ofhearing loss in humans and rodents. Congenital thyroid deficiency in humans can resultin a profound, hearing deficit, which may be prevented by early hormonal replacementtreatment in infants with hypothyroidism. However, the effect of acute or chronichypothyroidism in adults has not been adequately studied, and most information hasbeen obtained from animal experiments, whereas research in humans has been basicallybased on behavioral audiometry. The use of otoacoustic emissions may provide moreinsight into the hearing function of these patients than pure-tone audiometry, since it isconsidered as a sensitive test of the cochlear status. The aim of this study was toevaluate the hearing in a group of patients with acute hypothyroidism, using bothconventional audiometry and transiently evoked otoacoustic emissions (TEOAEs). Material and methods:A group of 52 patients with thyroid carcinoma who underwent total thyroidectomy wasstudied prospectively, All patients were examined before surgery and 6-8 weekspostoperatively. During this period there was no replacement with levothyroxine and themagnitude of thyroxin depletion was monitored by serum thyroid-stimulating hormone levels. On preoperative encounter with each patient, a detailed questionnaire of historyof hearing loss, tinnitus, vertigo, previous ear infections, noise exposure, medications,and recent upper respiratory tract infection was completed. Patients were excluded ifthey were older than 50 years, in order to avoid the phenomenon of presbycusis, or ifthey had a history of cochleovestibular, vascular or neurologic disease, or any other riskfactor for hearing impairment. Pure-tone audiometry, tympanometry and transientlyevoked otoacoustic emissions were performed. A group of healthy volunteers of similarage and sex were used for comparison.Results:(1) Tympanograms were normal, either on initial testing (75%) or on repeat testing(25%).(2) Audiometry showed elevation of all postoperative hearing thresholds, whereas thethresholds varied significantly across frequency.(3) TEOAE testing showed response signal to noise ratios lower in the postoperativesession (hypothyroid state) than in the preoperative session on all measured frequencies.(4) Emission levels varied significantly across frequency, with maximum responseobserved at 2 kHz.(5) Comparison of significant pure-tone and otoacoustic emission shifts for individualears showed more ears affected in otoacoustic emission testing, indicating subclinicalcochlear involvement.(6) Comparison of hearing thresholds and otoacoustic emission levels between patientsand controls showed significant differences on postoperative testing. Conclusions:Acute hypothyroidism in adults causes elevation of hearing thresholds and reducedotoacoustic emissions. The effect on otoacoustic emissions is greater, indicatingsubclinical damage of the cochlear function.

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The effect of coronavirus disease 2019 on the hearing system

The Journal of Laryngology & Otology ◽

10.1017/s0022215121001961 ◽

2021 ◽

pp. 1-5

Author(s):

Ö Gedik ◽

H Hüsam ◽

M Başöz ◽

N Tas ◽

F Aksoy

Keyword(s):

Auditory Brainstem Response ◽

High Frequency ◽

Otoacoustic Emissions ◽

Pure Tone ◽

Pure Tone Audiometry ◽

Auditory Brainstem ◽

Distortion Product ◽

High Frequency Audiometry ◽

Brainstem Response ◽

Hearing System

Abstract Objective This study aimed to evaluate different auditory regions with audiological tests, based on the presumption that there may be damage to the structures in the hearing system after coronavirus disease 2019. Methods Twenty individuals with no history of coronavirus disease 2019 and 27 individuals diagnosed with coronavirus disease 2019 were compared. Pure tone, speech and extended high-frequency audiometry, acoustic immitansmetry, transient evoked and distortion product otoacoustic emissions testing, and auditory brainstem response testing were conducted. Results The pure tone audiometry and extended high-frequency mean threshold values were higher in the coronavirus disease 2019 group. The transient evoked otoacoustic emissions signal-to-noise ratios were bilaterally lower at 4 kHz in individuals with a coronavirus disease 2019 history. In the auditory brainstem response test, only the interpeak latencies of waves III–V were significantly different between groups. Conclusion Coronavirus disease 2019 may cause damage to the hearing system. Patients should be followed up in the long term with advanced audiological evaluation methods in order to determine the extent and level of damage.

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Acute Alcohol Intake Deteriorates Hearing Thresholds and Speech Perception in Noise

Audiology and Neurotology ◽

10.1159/000510694 ◽

2020 ◽

pp. 1-8

Author(s):

Hyo Geun Choi ◽

Sung Kwang Hong ◽

Hyo-Jeong Lee ◽

Jiwon Chang

Keyword(s):

Speech Perception ◽

Otoacoustic Emissions ◽

Pure Tone ◽

Alcohol Intake ◽

Human Subjects ◽

Pure Tone Audiometry ◽

Distortion Product Otoacoustic Emission ◽

Speech Perception In Noise ◽

Distortion Product ◽

Hearing Thresholds

Objectives: The hearing process involves complex peripheral and central auditory pathways and could be influenced by various situations or medications. To date, there is very little known about the effects of alcohol on the auditory performances. The purpose of the present study was to evaluate how acute alcohol administration affects various aspects of hearing performance in human subjects, from the auditory perceptive threshold to the speech-in-noise task, which is cognitively demanding. Methods: A total of 43 healthy volunteers were recruited, and each of the participants received calculated amounts of alcohol according to their body weight and sex with a targeted blood alcohol content level of 0.05% using the Widmark formula. Hearing was tested in alcohol-free conditions (no alcohol intake within the previous 24 h) and acute alcohol conditions. A test battery composed of pure-tone audiometry, speech reception threshold (SRT), word recognition score (WRS), distortion product otoacoustic emission (DPOAE), gaps-in-noise (GIN) test, and Korean matrix sentence test (testing speech perception in noise) was performed in the 2 conditions. Results: Acute alcohol intake elevated pure-tone hearing thresholds and SRT but did not affect WRS. Both otoacoustic emissions recorded with DPOAE and the temporal resolution measured with the GIN test were not influenced by alcohol intake. The hearing performance in a noisy environment in both easy (−2 dB signal-to-noise ratio [SNR]) and difficult (−8 dB SNR) conditions was decreased by alcohol. Conclusions: Acute alcohol elevated auditory perceptive thresholds and affected performance in complex and difficult auditory tasks rather than simple tasks.

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The effect of caffeine on tinnitus: Randomized triple-blind placebo-controlled clinical trial

PLoS ONE ◽

10.1371/journal.pone.0256275 ◽

2021 ◽

Vol 16 (9) ◽

pp. e0256275

Author(s):

Alleluia Lima Losno Ledesma ◽

Daniele Leite Rodrigues ◽

Isabella Monteiro de Castro Silva ◽

Carlos Augusto Oliveira ◽

Fayez Bahmad

Keyword(s):

Otoacoustic Emissions ◽

Mood State ◽

Signal To Noise Ratio ◽

Controlled Clinical Trial ◽

Caffeine Consumption ◽

Distortion Product ◽

High Frequency Audiometry ◽

Significant Difference ◽

Placebo Capsule ◽

Tinnitus Masking

Objective To test the hypothesis that caffeine can influence tinnitus, we recruited 80 patients with chronic tinnitus and randomly allocated them into two groups (caffeine and placebo) to analyze the self-perception of tinnitus symptoms after caffeine consumption, assuming that this is an adequate sample for generalization. Methods The participants were randomized into two groups: one group was administered a 300-mg capsule of caffeine, and the other group was given a placebo capsule (cornstarch). A diet that restricted caffeine consumption for 24 hours was implemented. The participants answered questionnaires (the Tinnitus Handicap Inventory—THI, the Visual Analog Scale—VAS, the profile of mood state—POMS) and underwent examinations (tonal and high frequency audiometry, acufenometry (frequency measure; intensity measure and the minimum level of tinnitus masking), transient otoacoustic emissions—TEOAE and distortion product otoacoustic emissions—DPOAE assessments) at two timepoints: at baseline and after capsule ingestion. Results There was a significant change in mood (measured by the POMS) after caffeine consumption. The THI and VAS scores were improved at the second timepoint in both groups. The audiometry assessment showed a significant difference in some frequencies between baseline and follow-up measurements in both groups, but these differences were not clinically relevant. Similar findings were observed for the amplitude and signal-to-noise ratio in the TEOAE and DPOAE measurements. Conclusions Caffeine (300 mg) did not significantly alter the psychoacoustic measures, electroacoustic measures or the tinnitus-related degree of discomfort.

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Audiological and electrophysiological assessment of professional orchestral musicians

Revista CEFAC ◽

10.1590/1982-0216/202022216319 ◽

2020 ◽

Vol 22 (2) ◽

Author(s):

Alessandra Giannella Samelli ◽

Camila Maia Rabelo ◽

Liliane Aparecida Fagundes Silva ◽

Denise Gonzaga ◽

Joyce Miranda Santiago ◽

...

Keyword(s):

High Frequency ◽

Otoacoustic Emissions ◽

Pure Tone Audiometry ◽

Otoacoustic Emission ◽

Auditory Pathway ◽

Cochlear Hair Cells ◽

Significance Level ◽

Frequency Following Response ◽

High Frequency Audiometry ◽

Orchestral Musicians

ABSTRACT Purpose: to verify whether the frequent musical exposure can impair peripheral and central auditory pathway responses in professional orchestral musicians. Methods: 45 male individuals from 19 to 40 years old participated in the study. They were divided into two groups: one comprising 30 orchestral musicians who played strings or wind instruments, and another with 15 nonmusicians. The two groups were submitted to both conventional and high-frequency pure-tone audiometry, transient-evoked otoacoustic emissions, and frequency-following response. The results were subjected to descriptive and inferential statistical analysis, using the one-way ANOVA unmatched samples parametric test, with a 5% significance level. Results: no significant differences were observed between the hearing thresholds in both conventional and high-frequency audiometry and frequency-following response. However, there were statistically significant differences between transient-evoked otoacoustic emission responses, with lower responses to musicians in comparison to the nonmusician group. Conclusion: the results suggest that frequent musical exposure experienced by orchestral musicians can impair the cochlear hair cells’ function. Therefore, audiological monitoring is important to detect subclinical impairments.

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Analysis of Chronic Tinnitus in Noise-Induced Hearing Loss and Presbycusis

Journal of Clinical Medicine ◽

10.3390/jcm10081779 ◽

2021 ◽

Vol 10 (8) ◽

pp. 1779

Author(s):

Hee Jin Kang ◽

Dae Woong Kang ◽

Sung Su Kim ◽

Tong In Oh ◽

Sang Hoon Kim ◽

...

Keyword(s):

Hearing Loss ◽

Otoacoustic Emissions ◽

Pure Tone Audiometry ◽

Auditory Brainstem ◽

Outer Hair Cells ◽

Chronic Tinnitus ◽

Noise Induced Hearing Loss ◽

Distortion Product ◽

Hearing Thresholds ◽

Brainstem Response

The most frequent causes of tinnitus associated with hearing loss are noise-induced hearing loss and presbycusis. The mechanism of tinnitus is not yet clear, although several hypotheses have been suggested. Therefore, we aimed to analyze characteristics of chronic tinnitus between noise-induced hearing loss and presbycusis. Materials and Methods: This paper is a retrospective chart review and outpatient clinic-based study of 248 patients with chronic tinnitus from 2015 to 2020 with noise-induced or presbycusis. Pure tone audiometry (PTA), auditory brainstem response (ABR), distortion product otoacoustic emissions (DPOAE), transient evoked otoacoustic emissions (TEOAE), and tinnitograms were conducted. Results: PTA showed that hearing thresholds at all frequencies were higher in patients with noise-induced hearing loss than the presbycusis group. ABR tests showed that patients with presbycusis had longer wave I and III latencies (p < 0.05 each) than patients with noise-induced hearing loss. TEOAE tests showed lower values in patients with noise-induced hearing loss than presbycusis at 1.5, 2, 3, and 4 kHz (p < 0.05 each). DPOAE tests showed that response rates in both ears at 1.5, 2, and 3 kHz were significantly higher in patients with presbycusis than noise-induced hearing loss (p < 0.05 each). Discussion: This study showed that hearing thresholds were higher, the loudness of tinnitus was smaller, and the degree of damage to outer hair cells was lower in patients with presbycusis than with noise-induced hearing loss. Moreover, wave I and III latencies were more prolonged in patients with presbycusis despite their having lower hearing thresholds. These phenomena may reflect the effects of aging or degeneration of the central nervous system with age. Further studies are needed to evaluate the etiologies of tinnitus.

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