Detection of Hearing Impairment in Patients with Subjective Complaints of Hearing Loss using the Whispered Voice Test and Standard Pure Tone Audiometry: A Prospective Non-Randomized Trial

2017 ◽  
Vol 1 (1) ◽  
pp. 36-42
Author(s):  
Giselle L Gotamco ◽  
Norberto V Martinez
2013 ◽  
Author(s):  
Βασίλειος Ψαλτάκος

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.


2019 ◽  
Vol 161 (6) ◽  
pp. 996-1003 ◽  
Author(s):  
Nicholas S. Reed ◽  
Matthew G. Huddle ◽  
Joshua Betz ◽  
Melinda C. Power ◽  
James S. Pankow ◽  
...  

Objective To investigate the association of midlife hypertension with late-life hearing impairment. Study Design Data from the Atherosclerosis Risk in Communities study, an ongoing prospective longitudinal population-based study (baseline, 1987-1989). Setting Washington County, Maryland, research field site. Subjects and Methods Subjects included 248 community-dwelling men and women aged 67 to 89 years in 2013. Systolic blood pressure (SBP) and diastolic blood pressure were measured at each of 5 study visits from 1987-1989 to 2013. Hypertension was defined by elevated systolic or diastolic blood pressure or antihypertensive medication use. A 4-frequency (0.5-4 kHz) better-hearing ear pure tone average in decibels hearing loss (dB HL) was calculated from pure tone audiometry measured in 2013. A cutoff of 40 dB HL was used to indicate clinically significant moderate to severe hearing impairment. Hearing thresholds at 5 frequencies (0.5-8 kHz) were also considered separately. Results Forty-seven participants (19%) had hypertension at baseline (1987-1989), as opposed to 183 (74%) in 2013. The SBP association with late-life pure tone average differed by the time of measurement, with SBP measured at earlier visits associated with poorer hearing; the difference in pure tone average per 10–mm Hg SBP measured was 1.43 dB HL (95% CI, 0.32-2.53) at baseline versus −0.43 dB HL (95% CI, −1.41 to 0.55) in 2013. Baseline hypertension was associated with higher thresholds (poorer hearing) at 4 frequencies (1, 2, 4, 8 kHz). Conclusion Midlife SBP was associated with poorer hearing measured 25 years later. Further analysis into the longitudinal relationship between hypertension and hearing impairment is warranted.


2018 ◽  
Vol 29 (07) ◽  
pp. 648-655 ◽  
Author(s):  
Gabrielle H. Saunders ◽  
Ian Odgear ◽  
Anna Cosgrove ◽  
Melissa T. Frederick

AbstractThere have been numerous recent reports on the association between hearing impairment and cognitive function, such that the cognition of adults with hearing loss is poorer relative to the cognition of adults with normal hearing (NH), even when amplification is used. However, it is not clear the extent to which this is testing artifact due to the individual with hearing loss being unable to accurately hear the test stimuli.The primary purpose of this study was to examine whether use of amplification during cognitive screening with the Montreal Cognitive Assessment (MoCA) improves performance on the MoCA. Secondarily, we investigated the effects of hearing ability on MoCA performance, by comparing the performance of individuals with and without hearing impairment.Participants were 42 individuals with hearing impairment and 19 individuals with NH. Of the individuals with hearing impairment, 22 routinely used hearing aids; 20 did not use hearing aids.Following a written informec consent process, all participants completed pure tone audiometry, speech testing in quiet (Maryland consonant-nucleus-consonant [CNC] words) and in noise (Quick Speech in Noise [QuickSIN] test), and the MoCA. The speech testing and MoCA were completed twice. Individuals with hearing impairment completed testing once unaided and once with amplification, whereas individuals with NH completed unaided testing twice.The individuals with hearing impairment performed significantly less well on the MoCA than those without hearing impairment for unaided testing, and the use of amplification did not significantly change performance. This is despite the finding that amplification significantly improved the performance of the hearing aid users on the measures of speech in quiet and speech in noise. Furthermore, there were strong correlations between MoCA score and the four frequency pure tone average, Maryland CNC score and QuickSIN, which remain moderate to strong when the analyses were adjusted for age.It is concluded that the individuals with hearing loss here performed less well on the MoCA than individuals with NH and that the use of amplification did not compensate for this performance deficit. Nonetheless, this should not be taken to suggest the use of amplification during testing is unnecessary because it might be that other unmeasured factors, such as effort required to perform or fatigue, were decreased with the use of amplification.


10.2196/17213 ◽  
2020 ◽  
Vol 8 (10) ◽  
pp. e17213
Author(s):  
Lok Yee Joyce Li ◽  
Shin-Yi Wang ◽  
Cheng-Jung Wu ◽  
Cheng-Yu Tsai ◽  
Te-Fang Wu ◽  
...  

Background Hearing impairment is the most frequent sensory deficit in humans, affecting more than 360 million people worldwide. In fact, hearing impairment is not merely a health problem, but it also has a great impact on the educational performance, economic income, and quality of life. Hearing impairment is therefore an important social concern. Objective We aimed to evaluate and compare the accuracy of self-perception, Hearing Handicap Inventory for the Elderly-Screening (HHIE-S) questionnaire, free-field voice test, and smartphone-based audiometry as tests for screening moderate hearing impairment in older adults in China. Methods In this study, 41 patients were recruited through a single otology practice. All patients were older than 65 years. Patients with otorrhea and cognitive impairment were excluded. Moderate hearing impairment was defined as mean hearing thresholds at 500, 1000, 2000, and 4000 Hz >40 dB hearing loss (pure-tone average > 40 dB hearing loss). All patients completed 5 hearing tests, namely, the self-perception test, HHIE-S questionnaire test, free-field voice test, smartphone-based audiometry test, and standard pure-tone audiometry by the same audiologist. We compared the results of these tests to the standard audiogram in the better-hearing ear. Results The sensitivity and the specificity of the self-perception test were 0.58 (95% CI 0.29-0.84) and 0.34 (95% CI 0.19-0.54), respectively. The sensitivity and the specificity of the HHIE-S questionnaire test were 0.67 (95% CI 0.35-0.89) and 0.31 (95% CI 0.316-0.51), respectively. The sensitivity and the specificity of the free-field voice test were 0.83 (95% CI 0.51-0.97) and 0.41 (95% CI 0.24-0.61), respectively. The sensitivity and the specificity of the smartphone-based audiometry test were 0.92 (95% CI 0.60-0.99) and 0.76 (95% CI 0.56-0.89), respectively. Smartphone-based audiometry correctly diagnosed the presence of hearing loss with high sensitivity and high specificity. Conclusions Smartphone-based audiometry may be a dependable screening test to rule out moderate hearing impairment in the older population.


2021 ◽  
Vol 11 (10) ◽  
pp. 1035
Author(s):  
Lok-Yee Joyce Li ◽  
Shin-Yi Wang ◽  
Jinn-Moon Yang ◽  
Chih-Jou Chen ◽  
Cheng-Yu Tsai ◽  
...  

Hearing impairment is a frequent human sensory impairment. It was estimated that over 50% of those aged >75 years experience hearing impairment in the United States. Several hearing impairment–related factors are detectable through screening; thus, further deterioration can be avoided. Early identification of hearing impairment is the key to effective management. However, hearing screening resources are scarce or inaccessible, underlining the importance of developing user-friendly mobile health care systems for universal hearing screening. Mobile health (mHealth) applications (apps) act as platforms for personalized hearing screening to evaluate an individual’s risk of developing hearing impairment. We aimed to evaluate and compare the accuracy of smartphone-based air conduction and bone conduction audiometry self-tests with that of standard air conduction and bone conduction pure-tone audiometry tests. Moreover, we evaluated the use of smartphone-based air conduction and bone conduction audiometry self-tests in conductive hearing loss diagnosis. We recruited 103 patients (206 ears) from an otology clinic. All patients were aged ≥20 years. Patients who were diagnosed with active otorrhea was excluded. Moderate hearing impairment was defined as hearing loss with mean hearing thresholds >40 dB. All patients underwent four hearing tests performed by a board-certified audiologist: a smartphone-based air conduction audiometry self-test, smartphone-based bone conduction audiometry self-test, standard air-conduction pure-tone audiometry, and standard bone conduction pure-tone audiometry. We compared and analyzed the results of the smartphone-based air conduction and bone conduction audiometry self-tests with those of the standard air conduction and bone conduction pure-tone audiometry tests. The sensitivity of the smartphone-based air conduction audiometry self-test was 0.80 (95% confidence interval CI = 0.71–0.88) and its specificity was 0.84 (95% CI = 0.76–0.90), respectively. The sensitivity of the smartphone-based bone conduction audiometry self-test was 0.64 (95% CI = 0.53–0.75) and its specificity was 0.71 (95% CI = 0.62–0.78). Among all the ears, 24 were diagnosed with conductive hearing loss. The smartphone-based audiometry self-tests correctly diagnosed conductive hearing loss in 17 of those ears. The personalized smartphone-based audiometry self-tests correctly diagnosed hearing loss with high sensitivity and high specificity, and they can be a reliable screening test to rule out moderate hearing impairment among the population. It provided patients with moderate hearing impairment with personalized strategies for symptomatic control and facilitated individual case management for medical practitioners.


Author(s):  
Ibekwe Matilda Uju ◽  
Alasia Datonye Dennis

Background: It is known that HIV infection is a risk factor for hearing loss. Therefore this study is to determine the pattern and severity of hearing loss and whether there is a correlation between the CD4 count and hearing impairment in the HIV positive adult patients seen in the infectious outpatient clinic of university of Port Harcourt teaching hospital (UPTH).Methods: A hospital based descriptive cross sectional study of consecutive patients that are HIV positive seen in the infectious outpatient clinic of UPTH within a period of three months, from May to July of 2020. The biodata, history of hearing difficulties and management of the disease was obtained using a semi structured questionnaire. All the patients had otoscopy done and hearing assessment with pure tone audiometry (PTA). The analysis was done with the SPSS version 25 software at a 95% confidence interval and a p value less than 0.05 was considered significant.Results: The study involved 234 subjects comprising 127 males and 107 females. Hearing impairment was seen in n=113 (48.29%). The patients with CD4 count less than 500 cells/mm2 was found to have more hearing loss; 55.8% than those with counts greater than 500 cells/mm2. Age distribution was statistically significant with a p=0.0001.Conclusions:  The pure tone audiometric pattern in the majority of the studied population was more of CHL. The age, duration of ARVT and the CD4 count all had statistically significant association with hearing loss in the HIV positive adults. 


2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Marina L. Alisaputri ◽  
Siti Hazwani Yusoh

Introduction: Hearing impairment has been listed as one of the health risks associated with scuba diving. Evidence of hearing loss associated with inner ear barotrauma was found in previous studies. This cross-sectional study investigates the relationship between hearing status and years, depth and total hours of diving. Methods: Thirty male divers from Kuantan and neighbouring areas, with age ranging between 22 and 45 years old, were recruited as subjects. Details regarding diving activity were gathered using a set of questionnaires. Assessment of hearing status was done using otoscopic examination, tympanometry, pure tone audiometry (PTA) and distortion-product otoacoustic emission (DPOAE). Results: Fifteen subjects were found to have sensorineural hearing loss at high frequencies. Pearson's correlation showed no significant correlation between pure tone hearing thresholds and years, depth and total hours of diving. Significant negative correlation was found between DPOAE at 6 kHz on the left ear and years of diving (r= -0.378, p= 0.04) and depth of diving (r= -0.404, p= 0.027). Conclusions: These findings indicate that scuba diving activity may affect cochlear function, particularly in the basal region of the cochlea.


2019 ◽  
Author(s):  
Lok Yee Joyce Li ◽  
Shin-Yi Wang ◽  
Cheng-Jung Wu ◽  
Cheng-Yu Tsai ◽  
Te-Fang Wu ◽  
...  

BACKGROUND Hearing impairment is the most frequent sensory deficit in humans, affecting more than 360 million people worldwide. In fact, hearing impairment is not merely a health problem, but it also has a great impact on the educational performance, economic income, and quality of life. Hearing impairment is therefore an important social concern. OBJECTIVE We aimed to evaluate and compare the accuracy of self-perception, Hearing Handicap Inventory for the Elderly-Screening (HHIE-S) questionnaire, free-field voice test, and smartphone-based audiometry as tests for screening moderate hearing impairment in older adults in China. METHODS In this study, 41 patients were recruited through a single otology practice. All patients were older than 65 years. Patients with otorrhea and cognitive impairment were excluded. Moderate hearing impairment was defined as mean hearing thresholds at 500, 1000, 2000, and 4000 Hz >40 dB hearing loss (pure-tone average > 40 dB hearing loss). All patients completed 5 hearing tests, namely, the self-perception test, HHIE-S questionnaire test, free-field voice test, smartphone-based audiometry test, and standard pure-tone audiometry by the same audiologist. We compared the results of these tests to the standard audiogram in the better-hearing ear. RESULTS The sensitivity and the specificity of the self-perception test were 0.58 (95% CI 0.29-0.84) and 0.34 (95% CI 0.19-0.54), respectively. The sensitivity and the specificity of the HHIE-S questionnaire test were 0.67 (95% CI 0.35-0.89) and 0.31 (95% CI 0.316-0.51), respectively. The sensitivity and the specificity of the free-field voice test were 0.83 (95% CI 0.51-0.97) and 0.41 (95% CI 0.24-0.61), respectively. The sensitivity and the specificity of the smartphone-based audiometry test were 0.92 (95% CI 0.60-0.99) and 0.76 (95% CI 0.56-0.89), respectively. Smartphone-based audiometry correctly diagnosed the presence of hearing loss with high sensitivity and high specificity. CONCLUSIONS Smartphone-based audiometry may be a dependable screening test to rule out moderate hearing impairment in the older population.


PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e12295
Author(s):  
Jingwen Nie ◽  
Qing Li ◽  
Min Guo ◽  
Jiaqing Li ◽  
Jiahui Yang ◽  
...  

Background End-stage renal disease (ESRD) patients often experience hearing impairment, resulting in a high rate of disability and a decline in their quality of life. Fibroblast growth factor-23 (FGF23) is a diagnostic biomarker for chronic kidney disease (CKD) and a pathogenic contributor to CKD progression. However, the correlation between FGF23 level and CKD patients with hearing impairment remains elusive. This study aimed to investigate the relationship between the FGF23 and ESRD accompanied with hearing impairment. Methods A total of 144 ESRD patients, who were admitted to the First Affiliated Hospital of Kunming Medical University from November to December 2020, were enrolled in this study. Firstly, 144 ESRD patients underwent pure-tone audiometry (PTA). Secondly, it was attempted to randomly select 20 ESRD patients with normal hearing, and 20 ESRD patients with hearing impairment (match ratio, 1:1). Age- and gender-matched healthy people (n = 20) were also recruited as controls group. The expression levels of FGF23 was detected by enzyme-linked immunosorbent assay (ELISA). Results The results of pure-tone audiometry showed that the prevalence of hearing impairment in ESRD patients was 80.5%. Male ESRD patients were more likely to develop hearing impairment compared to female patients. The incidence rate of hearing impairment at a high frequency was significantly higher than that at a low frequency (P < 0.01). The serum levels of FGF23, phosphorus, and parathyroid hormone (PTH) in ESRD patients with hearing impairment significantly increased compared with those with normal hearing and healthy controls. Conclusion ESRD patients had a higher risk of hearing loss, especially high-frequency hearing impairment. As FGF23 level increased, the risk of hearing loss was also elevated. The hearing impairment in ESRD patients was associated with the degree of kidney injury, and serum FGF23 level.


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.


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